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Medical-Surgical · ANCC

MEDSURG-BC practice questions, built for nurses.

Prepare for the ANCC Medical-Surgical Nursing (MEDSURG-BC) board certification exam with 1,000+ blueprint-aligned questions across all three ANCC domains — weighted to the official test content outline, with clinical med-surg scenarios throughout, a dashboard that shows exactly where to focus, and a full exam simulation when you're ready.

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About the MEDSURG-BC exam

MEDSURG-BC certifies registered nurses in adult medical-surgical practice through the ANCC. The exam spans three domains — assessment and diagnosis; planning, implementation and evaluation; and the professional nursing role — with clinical med-surg content woven throughout.

Exam at a glance

Credentialing bodyANCC
Format150 items (125 scored)
Time3 hours
DeliveryPrometric / online proctored
Official detailsANCC ↗

What CertifyRN gives you

Question bank1,000+ questions
Blueprint matchAll 3 domains, weighted
Weak-spot dashboardPer-domain tracking
Exam simulationReal timing + conditions
PricingFree to start · subscription

Domain breakdown

Your practice mix mirrors the official ANCC MEDSURG-BC test content outline, so you study in the same proportions the exam tests. Clinical med-surg content — cardiac, pulmonary, GI, endocrine, renal, and more — runs through every domain.

Planning, Implementation & Evaluation40%
Assessment & Diagnosis39%
Professional Role21%

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Practice like the real thing

Full exam simulation mirrors the real MEDSURG-BC timing and conditions — no surprises on test day.

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Try 5 MEDSURG-BC questions

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1. A patient admitted with a suspected urinary source infection has a temperature of 39.1°C, heart rate 118, blood pressure 88/52, and a serum lactate of 4.2 mmol/L. The provider orders blood cultures, a broad-spectrum IV antibiotic, a 30 mL/kg crystalloid bolus, and an indwelling urinary catheter. Which action is most important to complete before the antibiotic is started?
AObtain the ordered blood cultures
BInfuse the isotonic crystalloid bolus
CInsert an indwelling urinary catheter
DRecheck the serum lactate level
Correct: Obtain the ordered blood cultures.
Rationale

Blood cultures must be collected before broad-spectrum antibiotics because antimicrobial exposure can sterilize the specimen and cause false negatives, obscuring the organism and its sensitivities — while not delaying antibiotic delivery. The other actions do not have to precede the antibiotic.

Why the other options are wrong

The fluid bolus treats hypoperfusion but can run concurrently. The catheter aids output monitoring but is not required first. Rechecking lactate trends resuscitation but is unaffected by antibiotic timing.

2. A patient with acute kidney injury has a serum potassium of 6.8 mEq/L, and the cardiac monitor shows tall, peaked T waves with a widening QRS complex. The provider orders IV calcium gluconate, IV regular insulin with dextrose, inhaled albuterol, and preparation for possible hemodialysis. Which action should the nurse take first?
AGive IV regular insulin with dextrose
BAdminister inhaled albuterol nebulizer
CAdminister IV calcium gluconate
DPrepare the patient for hemodialysis
Correct: Administer IV calcium gluconate.
Rationale

Peaked T waves with a widening QRS mean potassium is destabilizing the cardiac membrane and threatening a lethal arrhythmia. IV calcium gluconate is given first because it rapidly antagonizes potassium's cardiac effect and restores membrane stability — even though it does not lower the level. Insulin/dextrose and albuterol then shift potassium into cells; dialysis removes it.

Why the other options are wrong

Insulin with dextrose shifts potassium but takes 10–20 minutes and does not protect the myocardium immediately. Albuterol is a delayed adjunct. Hemodialysis definitively removes potassium but takes time to arrange and does not address the immediate cardiac threat.

3. Two hours after abdominal surgery, a patient receiving a morphine PCA is found with a respiratory rate of 6, an oxygen saturation of 84%, pinpoint pupils, and no response to verbal or tactile stimulation. After stopping the PCA, which action is the priority?
AReposition and reassess in 15 minutes
BDraw an arterial blood gas sample
CApply a non-rebreather oxygen mask
DAdminister naloxone as prescribed
Correct: Administer naloxone as prescribed.
Rationale

A rate of 6, deep unresponsiveness, and pinpoint pupils indicate opioid-induced respiratory depression — an emergency. After stopping the opioid, naloxone is the priority because it reverses the opioid effect and restores respiratory drive. Airway and oxygenation support occur alongside, but only reversal treats the cause.

Why the other options are wrong

Repositioning and delaying fails to treat a life-threatening emergency. An arterial blood gas confirms hypoventilation but delays the needed reversal. A non-rebreather supports oxygenation but does not restore the suppressed respiratory drive.

4. A patient admitted with a COPD exacerbation is receiving oxygen at 6 L/min by simple mask. The nurse notes the oxygen saturation has risen to 96%, and the patient has become increasingly drowsy and difficult to arouse. Which action is most appropriate?
AIncrease the oxygen to keep the SpO2 above 95%.
BTitrate the oxygen to keep the SpO2 88% to 92%.
CRemove the supplemental oxygen entirely now.
DMaintain the oxygen and recheck in one hour.
Correct: Titrate the oxygen to keep the SpO2 88% to 92%.
Rationale

In COPD the target saturation is generally 88% to 92%; a reading of 96% with worsening drowsiness suggests over-oxygenation contributing to carbon dioxide retention and CO₂ narcosis. The nurse titrates the oxygen down to the target while monitoring respiratory status — adequate oxygenation without suppressing ventilation.

Why the other options are wrong

Increasing oxygen worsens hypercapnia and deepens the declining level of consciousness. Removing oxygen entirely risks dangerous hypoxemia and is not needed to correct over-oxygenation. Waiting an hour lets rising carbon dioxide and sedation progress.

5. Three days after hip replacement surgery, a patient with a known calf deep vein thrombosis suddenly reports sharp chest pain and shortness of breath. Assessment reveals a heart rate of 122, respiratory rate of 30, oxygen saturation of 86%, and visible anxiety. Which action should the nurse take first?
AEncourage ambulation to relieve the dyspnea
BGive a PRN dose of oral acetaminophen
CApply oxygen and raise the head of the bed
DMassage the affected calf for comfort
Correct: Apply oxygen and raise the head of the bed.
Rationale

Sudden dyspnea, sharp chest pain, tachycardia, and hypoxemia in a patient with a known DVT strongly suggest pulmonary embolism. The first action is to support oxygenation and breathing — apply oxygen, elevate the head of the bed — while preparing to activate the rapid response team. Airway and breathing take precedence.

Why the other options are wrong

Ambulation can dislodge more thrombus and worsen the embolism. An oral analgesic ignores the life-threatening cause and risks aspiration in a dyspneic patient. Calf massage can dislodge clot and is contraindicated with a known DVT.

MEDSURG-BC prep — frequently asked

Are these MEDSURG-BC practice questions free?

Yes. You can practice MEDSURG-BC questions for free to start. The full 1,000+ question bank and exam simulation are included with an all-access CertifyRN subscription (monthly or annual, cancel anytime).

How many MEDSURG-BC practice questions are included?

The MEDSURG-BC bank has 1,000+ blueprint-aligned questions distributed across the three ANCC domains of medical-surgical nursing practice in line with the official test content outline, so your practice mix mirrors the real exam.

Do the questions follow the current ANCC MEDSURG-BC blueprint?

Yes. Questions are weighted to the ANCC MEDSURG-BC test content outline: Assessment and Diagnosis 39%, Planning, Implementation and Evaluation 40%, and Professional Role 21%. Clinical med-surg content is woven through every domain.

Is CertifyRN affiliated with ANCC?

No. CertifyRN is an independent study resource and is not affiliated with, endorsed by, or sponsored by the American Nurses Credentialing Center (ANCC). MEDSURG-BC is a registered trademark of its respective owner.

How does the weak-spot dashboard work?

As you practice, CertifyRN tracks performance by domain and shows which areas need the most work, so your study targets your weakest domains first. Full exam simulation mirrors real testing conditions.

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CertifyRN is an independent study resource and is not affiliated with, endorsed by, or sponsored by the American Nurses Credentialing Center (ANCC). MEDSURG-BC® is a registered trademark of its respective owner, used here for identification only. CertifyRN provides original practice materials and does not reproduce official exam content.