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87+ Free ANCC Med-Surg Practice Questions

Pass your ANCC Medical-Surgical Nursing Certification (MEDSURG-BC) exam on the first try — instant access, no signup required.

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2026 Statistics

Key Facts: ANCC Med-Surg Exam

150

Total Items

ANCC MEDSURG-BC page

125 + 25

Scored + Unscored

ANCC MEDSURG-BC page

3h

Exam Time

ANCC MEDSURG-BC page

39/40/21

Domain Weights

ANCC MEDSURG-BC outline (updated 2025-10-29)

$295/$395

Member / Nonmember Fee

ANCC MEDSURG-BC page

3,282,010

US RN Employment (May 2024)

BLS OEWS RN table (May 2024)

$98,430

US RN Mean Annual Wage

BLS OEWS RN table (May 2024)

ANCC lists MEDSURG-BC at 150 total questions (125 scored + 25 unscored) in 3 hours. Domain weights: Assessment/Diagnosis 39%, Intervention/Patient Care 40%, Professional Practice 21%. Fees are $295 for ANA members and $395 for nonmembers. BLS reports 3.28 million employed RNs with a $98,430 mean annual wage (May 2024).

Sample ANCC Med-Surg Practice Questions

Try these sample questions to test your ANCC Med-Surg exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 87+ question experience with AI tutoring.

1An adult with heart failure reports a 2.5 kg (5.5 lb) weight gain in one week, bilateral crackles, and ankle edema. Which nursing action is the priority?
A.Encourage unrestricted oral fluids to protect renal perfusion.
B.Hold the prescribed loop diuretic until the next routine visit.
C.Escalate findings promptly and implement ordered fluid/sodium management.
D.Document the edema as expected and take no further action.
Explanation: Rapid weight gain with pulmonary congestion signals worsening volume overload in heart failure and requires timely escalation plus evidence-based fluid/sodium and diuretic management.
2A patient with a COPD exacerbation has increasing somnolence, shallow breathing, and a rising PaCO2. What is the best immediate response?
A.Increase oxygen to a nonrebreather at 15 L/min without reassessment.
B.Assess airway/ventilatory status, titrate oxygen to target saturation, and notify the provider/RT for escalation.
C.Withhold bronchodilators until the arterial blood gas normalizes on its own.
D.Allow the patient to sleep because fatigue is expected during an exacerbation.
Explanation: Worsening hypercapnia with somnolence suggests impending ventilatory failure; priority is reassessment and rapid escalation while titrating oxygen to the COPD target (typically SpO2 88-92%).
3A telemetry patient develops crushing chest pain with diaphoresis and new ST-segment elevation. What should the nurse do first?
A.Document the symptoms and recheck in 30 minutes.
B.Give the patient food to reduce anxiety.
C.Activate the chest-pain/STEMI protocol and obtain an immediate 12-lead ECG with rapid provider notification.
D.Ambulate the patient to test exercise tolerance.
Explanation: Time-sensitive ischemia requires immediate protocol activation, a 12-lead ECG, and coordinated escalation rather than watchful waiting.
4A post-op patient has a temperature of 39.1C, HR 124, MAP 58 mmHg, lactate 4.2 mmol/L, and a suspected infection. Which action best reflects evidence-based priority care?
A.Delay antimicrobials until all culture results are finalized.
B.Start the sepsis bundle promptly: obtain cultures, give broad-spectrum antibiotics, and begin fluid resuscitation per protocol.
C.Restrict IV fluids to avoid edema despite the hypotension.
D.Give antipyretics only and reassess in the morning.
Explanation: This presentation reflects septic shock physiology (hypotension and lactate >4). The Surviving Sepsis 1-hour bundle (cultures, early broad-spectrum antibiotics, and 30 mL/kg crystalloid) improves outcomes and should not be delayed.
5An alert patient with diabetes has shakiness and a capillary glucose of 54 mg/dL. Which intervention is most appropriate first?
A.Give 15 g of rapid-acting carbohydrate and recheck the glucose in 15 minutes.
B.Administer long-acting insulin immediately.
C.Withhold treatment unless the glucose falls below 40 mg/dL.
D.Give only water and repeat the glucose in one hour.
Explanation: Symptomatic hypoglycemia in an alert patient is treated with the 'rule of 15': 15 g of fast-acting carbohydrate, then recheck in 15 minutes, repeating until glucose exceeds 70 mg/dL.
6A patient with renal failure has a serum potassium of 6.6 mEq/L with peaked T waves on the monitor. What is the priority intervention?
A.Administer IV calcium gluconate to stabilize the cardiac membrane, then begin potassium-lowering therapy.
B.Give oral potassium-sparing measures and recheck in 6 hours.
C.Encourage a high-potassium diet to prevent rebound hypokalemia.
D.Withhold all treatment until a repeat level confirms the result.
Explanation: Potassium 6.6 mEq/L with peaked T waves is symptomatic hyperkalemia. IV calcium gluconate is given first to stabilize the myocardium, followed by insulin/glucose and albuterol to shift potassium and measures (e.g., dialysis, binders) to remove it.
7Urine output falls to 15 mL/hr for 3 hours and the creatinine rises after iodinated contrast exposure. What is the best nursing action?
A.Encourage the patient to ambulate to improve renal perfusion.
B.Identify potential nephrotoxins, verify hemodynamics and volume status, and escalate the possible acute kidney injury.
C.Restrict all IV fluids to reduce kidney workload.
D.Administer an NSAID for comfort while monitoring.
Explanation: Oliguria (<0.5 mL/kg/hr) with a rising creatinine after contrast suggests contrast-associated acute kidney injury. The nurse assesses volume status and nephrotoxins and escalates promptly.
8On post-op day 1 after abdominal surgery, a patient has shallow respirations and bibasilar crackles without severe distress. Which action is most appropriate?
A.Encourage incentive spirometry, splinted coughing/deep breathing, and early mobilization.
B.Restrict fluids and place the patient flat in bed.
C.Administer a sedative to promote rest.
D.Withhold ambulation until the crackles fully resolve.
Explanation: Post-operative atelectasis is best prevented and treated with incentive spirometry, splinted deep breathing and coughing, and early ambulation to re-expand the lung bases.
9A patient develops unilateral calf swelling, warmth, and tenderness. Which nursing response is best?
A.Vigorously massage the calf to relieve the tenderness.
B.Notify the provider and prepare for diagnostic evaluation such as venous duplex ultrasound.
C.Apply firm sequential compression directly over the tender area.
D.Have the patient perform repeated forceful calf exercises.
Explanation: Unilateral calf swelling, warmth, and tenderness suggest deep vein thrombosis. The nurse avoids dislodging a possible clot, notifies the provider, and anticipates duplex ultrasound and anticoagulation.
10An inpatient suddenly develops facial droop, expressive aphasia, and right-arm weakness. What is the priority action?
A.Activate the stroke response/code and establish the last-known-well time immediately.
B.Give aspirin by mouth before any imaging.
C.Place the patient flat and offer oral fluids to assess swallowing.
D.Wait to see whether the symptoms resolve before notifying anyone.
Explanation: Acute focal neurologic deficits require immediate stroke-team activation and determination of last-known-well time, because thrombolytic eligibility is time-dependent and a non-contrast head CT must precede any antiplatelet or thrombolytic.

About the ANCC Med-Surg Exam

ANCC's Medical-Surgical Nursing board certification validates specialty competency for RNs caring for complex adult patients across acute and chronic conditions, emphasizing clinical judgment, implementation, evaluation, and professional nursing practice.

Questions

150 scored questions

Time Limit

3 hours

Passing Score

Pass/Fail (ANCC scaled score)

Exam Fee

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

ANCC Med-Surg Exam Content Outline

39%

Assessment and Diagnosis (49/125 scored)

Recognize priority findings, synthesize assessment data, identify complications, and establish nursing diagnoses in adult medical-surgical care

40%

Intervention and Patient Care (50/125 scored)

Prioritize interventions, implement evidence-based care, coordinate transitions, monitor response, and adapt plans for safety and outcomes

21%

Professional Practice Role and Accountabilities (26/125 scored)

Ethical/legal practice, communication, delegation, collaboration, quality improvement, and systems-level accountability in med-surg nursing

How to Pass the ANCC Med-Surg Exam

What You Need to Know

  • Passing score: Pass/Fail (ANCC scaled score)
  • Exam length: 150 questions
  • Time limit: 3 hours
  • Exam fee: $295 ANA members / $395 non-members

Keys to Passing

  • Complete 500+ practice questions
  • Score 80%+ consistently before scheduling
  • Focus on highest-weighted sections
  • Use our AI tutor for tough concepts

ANCC Med-Surg Study Tips from Top Performers

1Study by ANCC weighting: start with Assessment and Diagnosis plus Intervention and Patient Care because these two domains account for 89% of scored items
2Use first-action drills for instability (respiratory decline, hemodynamic changes, sepsis indicators, neurologic deterioration)
3Pair interventions with evaluation endpoints so each plan includes objective response measures and escalation triggers
4Practice delegation and consent/legal questions weekly; these are common differentiators in the Professional Foundation domain
5Run repeated 50-question timed sets to simulate exam pacing and reduce cognitive fatigue in the 3-hour window

Frequently Asked Questions

How many questions are on the ANCC Med-Surg exam?

ANCC lists MEDSURG-BC as 150 total items: 125 scored questions and 25 unscored pretest questions.

How long is the ANCC Med-Surg exam?

ANCC lists a 3-hour testing appointment for MEDSURG-BC.

What are the MEDSURG-BC domain weights?

ANCC's current MEDSURG-BC test content outline weights Assessment and Diagnosis at 39% (49 scored items), Intervention and Patient Care at 40% (50 scored items), and Professional Practice Role and Accountabilities at 21% (26 scored items).

What does ANCC charge for MEDSURG-BC?

ANCC's posted initial certification fees include $295 for ANA members and $395 for nonmembers (with additional tier options listed by ANCC).

Does ANCC publish an official Med-Surg pass rate?

ANCC does not publish a public first-time pass-rate figure for MEDSURG-BC. Candidates should focus on blueprint-weighted preparation and scenario-based clinical reasoning.

How should I study for MEDSURG-BC effectively?

Use weighted practice: prioritize Planning/Implementation/Evaluation first, then Assessment/Diagnosis, then Professional Foundation. Train first-action safety decisions, medication monitoring, and transition-of-care scenarios.