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200+ Free ANCC MedSurg-BC Practice Questions

Prepare for the ANCC Medical-Surgical Nursing Board Certified (MedSurg-BC) exam with instant access — no signup required.

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71% first-time in 2025 (3,807 of 5,330) Pass Rate
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VideoCMSRN vs MEDSURG-BC 2026: Which Med-Surg Cert? (FREE Guide)This examVideoFREE Med-Surg Nursing Certification Study Guide 2026: 8-Week MEDSURG-BC PlanThis examVideoANCC AGACNP-BC Exam Guide 2026: Acute Care NP PrepVideoANCC NPD-BC Exam Guide 2026: Eligibility, Blueprint, and Study PlanArticleCMSRN vs MEDSURG-BC 2026: Which Med-Surg Cert? (FREE Guide)15 min readArticleFREE Med-Surg Nursing Certification Study Guide 2026: 8-Week MEDSURG-BC Plan14 min readArticleFREE ANCC MEDSURG-BC Exam Guide 2026: Format, Eligibility, Study Plan13 min readArticleANCC NPD-BC Exam Guide 2026: Eligibility, Blueprint, and Study Plan13 min read
2026 Statistics

Key Facts: ANCC MedSurg-BC Exam

150

Total Questions

ANCC MedSurg page

125

Scored Questions

ANCC MedSurg page

3h

Exam Time

ANCC MedSurg page

71%

First-Time Pass Rate

ANCC 2025 Certification Data

39%

Assessment Domain

ANCC MedSurg outline

$77K+

Med-Surg RN Salary

BLS 2024

ANCC lists MEDSURG-BC as a 150-question exam with 125 scored and 25 unscored pretest items, administered over 3 hours. The current scored outline contains 49 Assessment and Diagnosis items (39%), 50 Planning, Implementation, and Evaluation items (40%), and 26 Professional Role items (21%). ANCC's 2025 data reports a 71% first-time pass rate: 3,807 of 5,330 candidates.

Sample ANCC MedSurg-BC Practice Questions

Try these sample questions to test your ANCC MedSurg-BC exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 200+ question experience with AI tutoring.

1A 68-year-old patient with a history of heart failure presents with increasing dyspnea, orthopnea, and a 5-pound weight gain over 3 days. Which assessment finding indicates acute decompensated heart failure?
A.Decreased jugular venous pressure
B.Bibasilar crackles on auscultation
C.Bradycardia with regular rhythm
D.Decreased liver span on percussion
Explanation: Bibasilar crackles on auscultation indicate pulmonary congestion, a hallmark of acute decompensated heart failure. The weight gain and orthopnea further support fluid overload. Jugular venous pressure would be elevated (not decreased) in heart failure due to increased central venous pressure. Bradycardia is not typical; instead, tachycardia is common as a compensatory mechanism. The liver may become enlarged (hepatomegaly) due to congestion, not decreased in size.
2Which cardiac biomarker rises within 3-4 hours after myocardial infarction (MI) and is most specific for myocardial injury?
A.Creatine kinase (CK)
B.Troponin I or T
C.Myoglobin
D.LDH (Lactate dehydrogenase)
Explanation: Troponin I and T are the most specific and sensitive biomarkers for myocardial injury, rising within 3-4 hours after MI and remaining elevated for 7-10 days. While CK and myoglobin rise earlier, they are less specific. CK levels increase within 3-8 hours but are also elevated in skeletal muscle injury. Myoglobin rises within 1-3 hours but lacks cardiac specificity. LDH rises much later (24-48 hours) and is rarely used for acute MI diagnosis today.
3A patient with atrial fibrillation has an INR of 3.5 on warfarin, a target of 2.0-3.0, and no bleeding. What is the most appropriate nursing action?
A.Administer vitamin K immediately without an order
B.Notify the prescriber and follow the approved anticoagulation protocol for dose adjustment and repeat INR
C.Continue the current dose and wait one week without reporting the result
D.Increase the dose to achieve a higher range
Explanation: A mildly supratherapeutic INR without bleeding calls for prompt review under the prescriber's or approved anticoagulation protocol, which determines whether a dose is reduced or held and when the INR is repeated. The nurse should not independently prescribe a hold outside an authorised protocol. Immediate vitamin K is not routine for this scenario, and increasing or ignoring the dose is unsafe.
4Which finding in a patient with acute coronary syndrome (ACS) requires immediate intervention?
A.Occasional premature ventricular contractions (PVCs)
B.ST-segment elevation in leads V1-V4
C.Sinus bradycardia at 52 bpm
D.Mild chest discomfort with exertion
Explanation: ST-segment elevation in leads V1-V4 indicates an ST-elevation myocardial infarction (STEMI) affecting the anterior wall of the heart. This requires immediate reperfusion therapy (PCI within 90 minutes or thrombolytics within 30 minutes). Occasional PVCs may warrant monitoring but do not require immediate intervention. Sinus bradycardia at 52 bpm may be normal in well-conditioned individuals. Mild chest discomfort with exertion requires evaluation but not immediate emergency intervention.
5A patient with hypertension reports taking their prescribed ACE inhibitor 'only when they feel their blood pressure is high.' What is the nurse's best response?
A.That is an appropriate way to manage your blood pressure
B.ACE inhibitors must be taken daily, not PRN, for optimal cardiovascular protection
C.You should double the dose when your blood pressure is elevated
D.ACE inhibitors are only effective when taken with food
Explanation: ACE inhibitors must be taken daily as prescribed, not on a PRN basis. These medications work through mechanisms beyond just blood pressure lowering, including cardiac remodeling protection and renin-angiotensin-aldosterone system blockade. PRN use leads to inconsistent therapeutic levels and reduced cardiovascular protection. Doubling the dose could cause hypotension and other adverse effects. While some ACE inhibitors can be taken with food, this is not their primary administration requirement.
6Which physical assessment finding is consistent with right-sided heart failure?
A.Pulmonary crackles and frothy sputum
B.Jugular venous distention and peripheral edema
C.Orthopnea and paroxysmal nocturnal dyspnea
D.S3 gallop and decreased pulse pressure
Explanation: Right-sided heart failure causes systemic venous congestion, leading to jugular venous distention (JVD), peripheral edema, hepatomegaly, and ascites. Pulmonary symptoms (crackles, orthopnea, PND) are characteristic of left-sided heart failure due to pulmonary congestion. An S3 gallop and decreased pulse pressure are more commonly associated with left-sided failure and reduced cardiac output.
7A patient on telemetry develops a regular narrow-complex tachycardia at 160 bpm with a P wave visible before each QRS complex. The blood pressure is 88/52 mmHg. What is the priority intervention?
A.Administer adenosine 6 mg rapid IV push
B.Perform synchronized cardioversion
C.Apply vagal maneuvers immediately
D.Start metoprolol infusion
Explanation: The patient has unstable supraventricular tachycardia (SVT) with hypotension (BP 88/52). Unstable tachycardia with signs of poor perfusion requires immediate synchronized cardioversion. Adenosine and vagal maneuvers are appropriate for stable SVT. Beta-blockers like metoprolol are contraindicated in unstable patients as they can worsen hypotension and cardiac output.
8What is the correct placement for V1 and V2 precordial ECG leads?
A.V1: 4th intercostal space right sternal border; V2: 4th intercostal space left sternal border
B.V1: 5th intercostal space midclavicular line; V2: 5th intercostal space anterior axillary line
C.V1: 2nd intercostal space right sternal border; V2: 2nd intercostal space left sternal border
D.V1: 4th intercostal space left sternal border; V2: 4th intercostal space right sternal border
Explanation: V1 is placed at the 4th intercostal space at the right sternal border, and V2 is placed at the 4th intercostal space at the left sternal border. These positions are critical for accurate ECG interpretation, particularly for identifying anterior and septal wall MIs. The 5th intercostal spaces are used for V3-V6 placement. The 2nd intercostal space is too superior. Reversing V1 and V2 would cause inappropriate R-wave progression and possible misdiagnosis.
9Which laboratory value is most important to monitor in a patient taking digoxin and furosemide?
A.Blood glucose
B.Serum potassium
C.Serum sodium
D.Hemoglobin
Explanation: Serum potassium is critical to monitor because hypokalemia increases the risk of digoxin toxicity. Furosemide is a loop diuretic that causes potassium loss through the kidneys. Low potassium levels make the myocardium more sensitive to digoxin, potentially causing life-threatening arrhythmias. While all electrolytes are important with diuretic use, potassium has the most direct and dangerous interaction with digoxin.
10A patient with peripheral arterial disease (PAD) reports intermittent claudication when walking more than two blocks. Which nursing intervention is most appropriate?
A.Recommend complete bed rest to preserve circulation
B.Encourage a structured walking program to improve collateral circulation
C.Apply compression stockings to improve venous return
D.Elevate the legs above heart level when resting
Explanation: A structured walking program is the first-line conservative treatment for PAD with intermittent claudication. Regular walking to the point of pain, resting, and then resuming helps develop collateral circulation and improves walking distance over time. Complete bed rest worsens outcomes. Compression stockings are contraindicated in PAD as they can further compromise arterial flow. Elevating legs above heart level reduces arterial perfusion to the lower extremities and is not recommended.

About the ANCC MedSurg-BC Exam

The ANCC Medical-Surgical Nursing Certification examination awards the Medical Surgical Nurse – Board Certified (MEDSURG-BC) credential. It measures Assessment and Diagnosis; Planning, Implementation, and Evaluation; and Professional Role.

Assessment

150 questions in 3 hours: 125 scored questions and 25 unscored pretest questions. The 125 scored items are distributed as Assessment and Diagnosis 49 (39%), Planning, Implementation, and Evaluation 50 (40%), and Professional Role 26 (21%).

Time Limit

3 hours

Passing Score

350/500 scale score

Exam Fee

$295 ANA members / $395 non-members (ANCC)

ANCC MedSurg-BC Exam Content Outline

39%

Assessment and Diagnosis

Comprehensive assessment of cardiovascular, respiratory, GI, renal, neurological, endocrine, hematology, musculoskeletal, integumentary, and immune systems. Recognition of normal vs abnormal findings and diagnostic reasoning.

40%

Planning, Implementation, Evaluation

Patient education, medication administration, therapeutic interventions, care coordination, pain management, infection control, emergency response, and evaluation of patient outcomes.

21%

Professional Role

Ethics, patient advocacy, interprofessional collaboration, evidence-based practice, quality improvement, safety principles, and delegation/supervision.

How to Pass the ANCC MedSurg-BC Exam

What You Need to Know

  • Passing score: 350/500 scale score
  • Assessment: 150 questions in 3 hours: 125 scored questions and 25 unscored pretest questions. The 125 scored items are distributed as Assessment and Diagnosis 49 (39%), Planning, Implementation, and Evaluation 50 (40%), and Professional Role 26 (21%).
  • Time limit: 3 hours
  • Exam fee: $295 ANA members / $395 non-members

Keys to Passing

  • Work through all 200 available questions
  • Review every answer and explanation
  • Track weak areas and revisit them
  • Use our AI tutor for tough concepts

ANCC MedSurg-BC Study Tips from Top Performers

1Prioritize Planning, Implementation, and Evaluation (40%) and Assessment and Diagnosis (39%) while preserving Professional Role review (21%)
2Know normal vs abnormal assessment findings for all body systems
3Study professional role topics: ethics, patient advocacy, and interprofessional collaboration
4Understand delegation principles and scope of practice for medical-surgical nursing
5Review infection control precautions (standard, contact, droplet, airborne)
6Practice prioritization and clinical reasoning with patient scenarios
7Focus on patient education and health promotion strategies
8Study quality improvement methodologies and evidence-based practice principles

Frequently Asked Questions

How many questions are on the MedSurg-BC exam?

ANCC lists 150 total questions: 125 scored items and 25 unscored pretest items. You have 3 hours to complete the exam.

What is the MedSurg-BC pass rate?

ANCC's 2025 Certification Data reports a 71% first-time pass rate: 3,807 of 5,330 first-time Medical-Surgical Nursing candidates passed.

What are the MedSurg-BC content weights?

The current ANCC outline assigns 49 of 125 scored items to Assessment and Diagnosis (39%), 50 to Planning, Implementation, and Evaluation (40%), and 26 to Professional Role (21%).

How much does MedSurg-BC certification cost?

ANCC currently lists $295 for ANA members and $395 for nonmembers. Additional eligibility-related costs may apply; verify the current fee on the official MEDSURG-BC page before applying.

What are the eligibility requirements for MedSurg-BC?

ANCC currently requires an active RN license or recognized international equivalent, the equivalent of 2 years of full-time RN practice, at least 2,000 hours of medical-surgical clinical practice within the last 3 years, and 30 hours of medical-surgical continuing education within the last 3 years.

How should I study for the MedSurg-BC exam?

Allocate study in line with the current outline: 39% Assessment and Diagnosis, 40% Planning, Implementation, and Evaluation, and 21% Professional Role. Practise scenario-based prioritization, patient education, safety, communication, delegation, ethics, and evidence-based practice.