ANCC Medical-Surgical Nursing Certification

Question 1

A patient post-op for abdominal surgery develops a fever of 38.5°C on postoperative day 2. What is the most likely cause?

Accepted Answer

Pulmonary atelectasis

Answer

Surgical site infection

Answer

Deep vein thrombosis

Answer

Urinary tract infection

Question 2

A patient develops acute respiratory distress with absent breath sounds on the left side after central line placement. What is the priority intervention?

Accepted Answer

Prepare for immediate needle decompression or chest tube insertion

Answer

Administer supplemental oxygen and monitor

Answer

Obtain a STAT chest X-ray before intervening

Answer

Reposition the patient to the right lateral decubitus position

Question 3

Which electrolyte imbalance is most commonly associated with prolonged nasogastric suctioning?

Accepted Answer

Hypokalemia and metabolic alkalosis

Answer

Hyperkalemia

Answer

Hypernatremia

Answer

Hypermagnesemia

Question 4

A patient with type 1 diabetes presents with Kussmaul respirations, fruity breath, and blood glucose of 480 mg/dL. This presentation is consistent with:

Accepted Answer

Diabetic ketoacidosis (DKA)

Answer

Hyperosmolar hyperglycemic state (HHS)

Answer

Severe hypoglycemia

Answer

Lactic acidosis

Question 5

A patient with a history of atrial fibrillation is anticoagulated. The nurse assesses sudden onset of severe right leg pain, pallor, and pulselessness. What is the priority action?

Accepted Answer

Notify the provider immediately for suspected acute arterial occlusion

Answer

Elevate the affected leg and apply warm compresses

Answer

Reassess in 1 hour for spontaneous improvement

Answer

Apply compression stockings to the affected leg

Question 6

Which finding is most indicative of increased intracranial pressure (ICP) in a patient with a traumatic brain injury?

Accepted Answer

Cushing's triad: hypertension, bradycardia, and irregular respirations

Answer

Heart rate of 110 bpm with normal BP

Answer

Temperature of 38.1°C

Answer

Mild confusion without vital sign changes