Med-Surg. ANCC Certification Exam With 100% Correct Answers 2024, Exams of Advanced Education

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Med-Surg. ANCC Certification Exam

With 100% Correct Answers 2024

Mc burney's point - Correct Answer-Point in RLQ abd of appendix. Tenderness indicates appendicitis Murphy's sign - Correct Answer-Place fingers under rt coastal margin and instruct to take deep breath. Increased tenderness with sudden stop during inhalation is a positive murphy's sign Obturator muscle, psoas sign, Rovsing's sign - Correct Answer-All assessment used to r/o appendicitis Homan's sign - Correct Answer-Out dated and not recommended to use for assessment for DVT Jar sign(markle sign) - Correct Answer-Pain from a jarring movement to indicate peritonitis with appendicitis. Stand on toes and drop to heals or increaded pain with walking or running Beck's triad - Correct Answer-Acute cardiac tamponade- pericardial effusion

1. Disended neck vein's
2. Distant heart sounds
3. Hypotention Treatment- pericardiocentesis Charcot's triad for MS - Correct Answer-1. Nystagmas- repetitive uncontrolled movements of the eyes
4. Intention tremor- tremor that worsens as approaches end of intended movement
5. Scanning or staccato speech- broken speech and each syllable pronounced separately Charcot's triad for ascending cholangitis - Correct Answer-Inf. of bile duct caused by bacteria ascending from junction with duodenum 1.Jaundice
6. Fever, usually with rigors
7. RUQ ABD pain Cushing's triad - Correct Answer-Signs of increased ICP
8. HTN- widened pulse pressure
9. Bradycardia

3. Irregular respirations- cheyne- stokes( slow, fast, slow period of apnea then slow,fast,slow Kaussmaul breathing - Correct Answer-Deep and labored. Presents in severe metabolic acidosis- DKA and kidney failure Bergman's triad - Correct Answer-Signs of fat embolism
4. Mental status changes
5. Petechiae-late sign
6. Dyspnea Brudzinski sign - Correct Answer-Sign of meningitis- supine flex neck will cause involuntary flexion of hips and knees Kernig's sign - Correct Answer-Sign of meningitis- lift flexed knee and slowly extend will cause back pain if positive Chvostek's sign Trousseau' sign - Correct Answer-Nerve hyperexcitability (tetany) seen with hypocalemia Abnormal reaction to stimulation of facial nerve Inflate bp cuff to greater than systolic and hand and wrist with involuntarly curl inward Levine sign - Correct Answer-is positive when a patient is holding a clenched fist over his chest to describe dull, pressing chest pain consistent with the discomfort of angina pectoris. A patient is diagnosed with a lateral wall ST segment elevation myocardial infarction (STEMI). What do you expect the EKG to show? a. ST elevation in leads V1 -V b. ST elevation in leads I, aVL, V5, V c. ST elevation in leads II, III, aVF d. ST elevation in leads V7, V8, V9 - Correct Answer-B: Choice B would show a lateral wall MI. Choice A would show an anterior MI. Choice C would show an inferior wall MI. Choice D would show a posterior wall MI. Epididymitis - Correct Answer-commonly caused by E.coli in elderly males and/or those who are not sexually active and have normal immune function. In sexually active males with a history of unprotected sex, the causative organisms are likely gonorrhea and/or chlamydia. Cases of epididymitis caused by Staph aureus are rare. Epididymitis caused by cytomegalovirus (CMV) is incredibly rare unless the patient is immunocompromised.

Triple H therapy for Subarachnoid Hemorrhage- induced Vasospasm - Correct Answer-Nimodipine or Nimotop is a calcium channel blocker which causes vasodilation of the blood vessels. is hypervolemia, hypertension, and hemodilution. These three factors will maintain the patency of the vessels, making it difficult for them to vasoconstrict. Vasospasm left unchecked can cause stroke, neurological compromise, and death. Iatrogenic - Correct Answer-Adverse effects caused by dx procedure or treatment Confussion assessment method(cam) - Correct Answer-Dx delirium 1 Acute onset 2 Inattention 3 Disorganized thinking 4 ALOC 1,2. And 3 or 4 is positive The Confusion Assessment Method - Correct Answer-Onset: Acute changes in mental status. · Attention: Inattentive, stable, or fluctuating. · Thinking: Disorganized, rambling, switching topics, illogical. · Level of consciousness: Altered (ranging from alert to coma). · Orientation: Time, place, person. · Memory: Impaired. · Perceptual disturbances: Hallucinations, illusions. Psychomotor abnormalities: Agitations or retardation. · Sleep-wake cycle: Awake at night, sleepy in the daytime. Nursing process - Correct Answer-Assessment: Collecting data, history, and completing a physical exam. Diagnosis: Analyzing data, determining needs and problems, and applying a nursing diagnosis. Planning: Setting priorities, setting goals and expected outcomes, and planning interventions and strategies of care. Implementation: Applying interventions/treatments. Evaluation: Reassessing and auditing. Diabetes insipidus - Correct Answer-Extreme thirst and urination cause by imbalance in body fluid CAGE - Correct Answer-Alcoholism screening- C -Cutting down: Do you think about trying to cut down on drinking? A -Annoyed at criticism: Are people starting to criticize your drinking? G -Guilty feeling: Do you feel guilty or try to hide your drinking? E -Eye opener: do you increasingly need a drink earlier in the day?

Braden score - Correct Answer-PU risk assessment PUSH score - Correct Answer-Pressure Ulcer Scale for Healing- measure over time to indicate healing or deterioration Five Stages of grief - Correct Answer-1. Denial

2. Anger
3. Bargaining
4. Depression
5. Acceptance Bloom's Taxonomy(6 levels of learning) - Correct Answer-Remember Understand Apply Analyze Evaluate Create Bloom's Taxonomy(3 types of learning) - Correct Answer-1. Cognitive: Learning and gaining intellectual skills and mastering categories of effective learning (knowledge, comprehension, application, analysis, synthesis, and evaluation). ·
6. Affective: Recognizing categories of feelings and values from simple to complex (receiving and responding to phenomena, valuing, organizing, and internalizing values). ·
7. Psychomotor: Mastering motor skills necessary for independence, following a progression from simple to complex (perception, set, guided response, mechanism, complex overt response, adaptation, and origination). Tertiary - Correct Answer-Soften impact of longterm ,complex illness/injury Secondary - Correct Answer-Early detection and Treatment to halt or slow progress Primary - Correct Answer-Prevention Orchiopexy - Correct Answer-Sx to move undescended testicle or resolve testicular torsion Orchiectomy - Correct Answer-Removal of one or both testicules Piaget's stages of Cognitive Development - Correct Answer-Sensorimotor (0 -2): Infants learn about cause and effect and the permanence of objects. · Preoperational (2 -7): Thinking is concrete and tangible at the preconceptual stage, and later becomes intuitive. These children are

egocentric. Concrete operational (7 -11): Children develop the concept of conservation and reasoning becomes inductive. Formal operational (11 -15): Adolescents develop the ability to use abstract thought and to develop and test hypotheses. Tardive dyskinesia - Correct Answer-Involuntary movements. May become permanent or become worse. Treatments include stopping the drug that caused it and in some cases Botox injections may be effective "5 rights of delegation" - Correct Answer-1. Right task: The nurse determines an appropriate task to delegate for a specific patient. 2. Right circumstance: The nurse has considered all relevant information to determine appropriateness of delegation. ·

3. Right Person: The nurse chooses the right person based on education and skills to perform the task. ·
4. Right direction: The nurse provides a clear description of the task, purpose, limits, and expected outcomes. · 5.Right supervision: The nurse must supervise, intervene as needed, and evaluate performance. Types of leadership - Correct Answer-Autocratic leaders make decisions independently and strictly enforce rules. Bureaucratic leaders follow organizational rules exactly and expect others to do so, as well. Laissez-faire leaders exert little direct control and allow others to make decisions with little interference. Participatory leaders present a potential decision and make a final decision based on input from team members. Consultative leaders present a decision and welcome input, but rarely change their decisions. Democratic leaders present a problem and ask the team to arrive at a solution, although these leaders make the final decision. Selye's biological theory of stress and aging - Correct Answer-stress is a body response to demands requiring positive or negative adaptation, characterized by the "generalized adaptation syndrome," which includes 3 stages: · Alarm: Fight or flight response. · Resistance: The body mobilizes to resist a threat, focusing on those organs most involved in an adaptive response. · Exhaustion: As the body is weakened and overwhelmed, organs/systems begin to deteriorate (hypertrophy/atrophy) and can no longer cope with stress, resulting in stress-related illnesses and eventual death. Broca's aphasia - Correct Answer-Expressive aphasia- left frontal Wernicke's aphasia - Correct Answer-Receptive aphasia- damage to Lt posterior temporal

Cryptorchidism - Correct Answer-Undescended testicles Osteopenia - Correct Answer-Decrease in bone density Thalassemia major - Correct Answer-Causes anemia Phenylketonuria (PKU) - Correct Answer-Rare inherited disorder that causes an amino acid called phenylalanine to build up in the body. Treated with strict diet of avoiding foods high in protein. Nursing process - Correct Answer-Assessment: Collecting data, history, and completing a physical exam. · Diagnosis: Analyzing data, determining needs and problems, and applying a nursing diagnosis. · Planning: Setting priorities, setting goals and expected outcomes, and planning interventions and strategies of care. · Implementation: Applying interventions/treatments. Evaluation: Reassessing and auditing. Phases of nurse/client relationship - Correct Answer-Preinteraction Phase Assessment: gathering information; assessing one's feelings, fears, and anxieties about working with a particular client Goal: Explore self-perceptions Orientation (introductory) Phase nurse and client become acquainted Goal: Establish trust; Formulate contract for intervention Working Phase Goal: Promote client change Termination Phase Goal: Evaluate goal attainment; Ensure therapeutic closure H's and T's - Correct Answer-There are twelve main causes of cardiac arrest (six Hs and six Ts): hypovolemia, hypoxia, hydrogen ions (acidosis), hyper/hypokalemia, hypothermia, toxins, tamponade, tension pneumothorax, thrombosis, thromboembolism, and trauma. Maslow's hierarcy - Correct Answer-Physiological- most basic needs Safety Love/belonging Esteem Self-actualization Causes of post-operative fever 5 Ws - Correct Answer-w ind (atelectasis, aspiration, pneumonia), pod 1-

w ater (urinary tract infection), pod 3- w alking (deep vein thrombus), pod 5- w ound (wound infection), pod 5- w hat the physician caused (drug fever, line infection). After the first week post op Erik Erikson's stages of development - Correct Answer-Infant (Hope) - Basic Trust vs. Mistrust Toddler (Will) - Autonomy vs. Shame Preschooler (Purpose) - Initiative vs. Guilt School-Age Child (Competence) - Industry vs. Inferiority Adolescent (Fidelity) - Identity vs. Identity Diffusion Young Adult (Love) - Intimacy vs. Isolation Middle-aged Adult (Care) - Generativity vs. Self-absorption Older Adult (Wisdom) - Integrity vs. Despair Typical physical changes associated with death include: - Correct Answer-Sensory: Reduced sensations of pain and touch. Decreased vision and hearing · Cardiovascular: Tachycardia followed by bradycardia, dysrhythmia, and hypotension. · Respiratory: Tachypnea, progressing to Cheyne- Stokes respiration. · Muscular: Muscles relax, the jaw sags, and the ability to swallow and talk is lost. · Urinary: Output decreases (accompanied by incontinence), and anuria follows. Integumentary: Skin becomes cold, clammy, cyanotic, and waxy. Skin in the coccygeal area often tears. Dementia assessments - Correct Answer-B. The Mini-cog test assesses dementia by having patients remember and repeat 3 common objects and draw a clock face indicating a particular time. The MMSE assesses dementia through a series of tests, including remembering the names of 3 common objects, counting backward, naming, providing location, copying shapes, and following directions. The Digit Repetition Test assesses attention by asking the patient to repeat the 2 number, then 3, then 4 and so on. The Confusion Assessment Method is used to assess delirium, not dementia. Typical psychological responses to stress include: - Correct Answer-Dependence: The patient has an inability to make decisions, requires constant reassurance, and calls nurses/families frequently. · Depression: The patient is withdrawn and sad, fails to take treatments and/or misses appointments, and may be at risk for suicide. · Anger: The patient is belligerent, uncooperative, and blames others. · Confusion: The patient is forgetful, disoriented, and bewildered. · Passivity: The patient defers to others, feeling he/she has no control. Leading health indicators include: - Correct Answer-1) immunization,

2. access to health care,
3. environmental quality,
4. rates of injury and violence,
5. mental health care,
6. responsible sexual behavior,
7. rates of substance abuse and tobacco use,
8. rates of overweight and obesity, and
9. levels of physical activity. Hyperkalemia - Correct Answer-often occurs with renal disease and is characterized by ventricular arrhythmia, weakness with ascending paralysis and hyperreflexia, diarrhea, and confusion. Hypokalemia - Correct Answer-is characterized by weakness, lethargy, nausea and vomiting, paresthesias, dysrhythmias (PVCs, flattened T waves), muscle cramps with hyporeflexia, hypotension, and tetany. Hypocalcemia - Correct Answer-is characterized by tetany, tingling, seizures, altered mental status, and ventricular tachycardia. Hypercalcemia - Correct Answer-is characterized by increasing muscle weakness with hypotonicity, constipation, anorexia, nausea and vomiting, and bradycardia. Adult learners - Correct Answer-Self-directed: Adults prefer active involvement and responsibility. · Knowledgeable: Adults can relate new material to information with which they are familiar by life experience or education. · Relevancy-oriented: Adults like to know how they will use information. · Motivated: Adults like to see evidence of their own achievement, such as gaining a certificate. Conflict Resolution steps include: - Correct Answer-Allowing both parties to present their side without bias. · Encouraging cooperation through negotiation and compromise. · Maintaining focus and avoiding arguments. · Evaluating the need for renegotiation, a formal resolution process, or a 3rd party mediator. · Utilizing humor and empathy to diffuse tension. Summarizing and outlining key arguments. · Avoiding forced resolution if possible. Drug users s/s - Correct Answer-Signs of inhaled cocaine use include nasal irritation and nosebleeds, and signs of smoked cocaine include lip burns and a cough. Constricted pupils, headaches, and abdominal pain are also common. Most abused drugs have similar symptoms. However, heroin users would have needle tracks and would not have nasal irritation. Marijuana users may exhibit tachycardia and cough from lung irritation (similar to tobacco smokers), but usually do not develop nasal irritation or nose bleeds.

Methadone abuse can cause constricted pupils and abdominal pain, but does not cause nasal symptoms. disseminated intravascular coagulation (DIC) - Correct Answer-DIC causes both coagulation and hemorrhage through a complex series of events. It includes trauma of a nature that causes tissue factor (transmembrane glycoprotein) to enter the circulation and bind with coagulation factors, triggering the coagulation cascade. This cascade stimulates thrombin to convert fibrinogen to fibrin, causing aggregation and destruction of platelets and forming clots that can be disseminated throughout the intravascular system. naloxone (Narcan®) intravenously - Correct Answer-as it is an opiate antidote. Flumazenil - Correct Answer-an antidote for benzodiazepines. Charcoal - Correct Answer-may be used for an oral overdose of morphine if little time has passed since ingestion but will not have an effect on morphine that was administered intravenously. N-acetylcysteine - Correct Answer-is the antidote for overdose of acetaminophen Patients' Bill of Rights - Correct Answer-The right to pain control,respect for patient, informed consent, advance directives, and end of life care, privacy and confidentiality, protection from abuse and neglect, protection during research, appraisal of outcomes, appeal procedures, an organizational code of ethical behaviors, and procedures for donating and procuring organs/tissues. environmental assessment - Correct Answer-Environmental hazards: Piles of paper or junk, loose carpets, cluttered pathways. · Lighting: Adequate for reading in all rooms and stairways. · Heat and air-conditioning: Adequate to control heat and cold. · Sanitation: Rotting food, infestations of cockroaches or rodents · Animal care: Pets should have access to food, water, toileting, and veterinary care. · Smoke/chemicals in the environment: Second- hand smoke or cleaning chemicals. Progression of infection - Correct Answer-bacteremia, septicemia, sepsis, severe sepsis, septic shock, and finally MODS as the infection overwhelms the body's defenses Dysphagia - Correct Answer-is the term for problems with swallowing Dysphasia - Correct Answer-is difficulty with all forms of communication Dysarthria - Correct Answer-is difficulty speaking Odynophagia - Correct Answer-is the term for pain with swallowing

Cheyne Stokes breathing - Correct Answer-Is often seen in patients with heart failure, stroke, brain injury, and brain cancers. This breathing is often seen in individuals living at high altitudes. Cheyne stokes is often a feature of carbon monoxide poisoning. Tinea infections - Correct Answer-A circular skin lesion with central clearing. Tinea infections are caused by superficial dermatophytes. Scabies - Correct Answer-is an infestation by the parasite Sarcoptes scabiei. Pediculosis - Correct Answer-is an infestation by human body louse. Moniliasis - Correct Answer-Fungal/yeast infection after an adrenalectomy what is important to monitor - Correct Answer-B/P because of the possibility of an Addisonian crisis. Empathy - Correct Answer-is the capacity to recognize and, to some extent, share similar feelings that are being experienced by another sentient or semi-sentient being. Apathy - Correct Answer-Indifference, lack of interest or concern is the state of Sympathy - Correct Answer-The affinity, association, or relationship between persons or things wherein whatever affects one similarly affects the other is Compassion - Correct Answer-The desire to alleviate suffering or the hardship of another is Aphasia - Correct Answer-is a total or partial impairment of language ability. The specific brain area usually associated with prosopagnosia is the fusiform gyrus. Prosopagnosia - Correct Answer-is a disorder of face perception where the ability to recognize faces is impaired. Apraxia - Correct Answer-is the loss of ability to execute learned purposeful movements. Pyuria - Correct Answer-Urine that contains pus pheochromocytoma - Correct Answer-Tumor in adrenal gland that causes increased secretion of Epi and norepinephrine and causes HTN even with treatment Watson - Correct Answer-The seven assumptions Caring can be effectively demonstrated and practiced only interpersonally.

Caring consists of carative factors that result in the satisfaction of certain human needs. Effective caring promotes health and individual or family growth. Caring responses accept person not only as he or she is now but as what he or she may become. A caring environment is one that offers the development of potential while allowing the person to choose the best action for himself or herself at a given point in time. Caring is more " healthogenic" than is curing. A science of caring is complementary to the science of curing. The practice of caring is central to nursing. Carl Rogers's Theory of Personality - Correct Answer-He believed if an individual attained self-actualisation they would be a fully functioning person living "the good life". By this, he means that the individual would have a positive healthy psychological outlook, trust their own feelings and have congruence in their lives between self and experience