Medical-Surgical Nursing Certification
The Medical-Surgical Nursing certification exam is one of several credentialing programs administered by the American Nurses Credentialing Center (ANCC). The ANCC was incorporated as a non-profit subsidiary of the American Nurses Association (ANA) in 1990. The ANCC has been associated with nearly 250,000 nurses over the past 28 years. Test content outlines are developed and continually reviewed by Content Expert Panels so that they remain current with standards of practice in medical-surgical nursing. Every three years a practice analysis (role delineation study) is conducted to keep pace with changes in the field and determine the need to update exam structure or content. Expert item writers construct new test questions, which are included as “pretest” (unscored) items in every exam in order to assess their suitability for inclusion, before they are adopted as scored exam questions. In 2013, the ANCC-sponsored Institute of Medicine (IOM) permanent Committee on Credentialing Research in Nursing was launched. The aim of the committee is to promote a rigorous review of the link between certification and improved health care outcomes to inform the continuous improvement of nursing credentialing programs.
Function of the Test
The Medical-Surgical board certification examination is taken by RNs who wish to obtain the RN-BC (Registered Nurse – Board Certified) credential in the specialty field of medical-surgical nursing. Achieving this specialty certification demonstrates to health care consumers and current or potential employers that the medical-surgical RN has met a standard of competence and has the knowledge and skills needed to meet patient care needs in the specialty.  To be eligible to sit for the exam, a candidate must:
- Be actively licensed as an RN in the US (or as professional equivalent for international candidates)
- Have been in practice for at least 2 years full-time, or the equivalent number of part-time hours
- Have completed at least 2,000 clinical hours in the medical-surgical specialty within the 3 years prior to registering for the exam, and
- Complete 30 hours of medical-surgical nursing continuing education within that same time period.
While the credential is not required for employment in medical-surgical nursing, RNs who achieve specialty certification feel more confident and capable, more personally satisfied, and positioned to advance in their careers.
The current cost to take the exam is $270 for ANA (American Nurses Association) members and $395 for non-members, $140 of which is non-refundable. Once an application is processed and a candidate receives an Eligibility Notice from ANCC, there is a 90-day window in which the candidate must schedule his or her exam directly with an authorized Prometric testing center. A one-time 90-day extension may be granted on request if a candidate is unable to schedule an exam date within the initial 90-day window. Special accommodations for candidates with disabilities as defined under the Americans with Disabilities Act (ADA) may be requested in writing at the time of application. All requests must be accompanied by a typed, signed and dated report from a qualified healthcare professional describing the specific medical diagnosis and supporting diagnostic testing, any limitations imposed by the disability on activities of daily living, and recommended special testing accommodations. A candidate who does not pass the exam may make a second attempt after a 60-day waiting period. The cost to retake the exam is $270. Up to three attempts may be made within a given 12-month period. Candidates must reapply for each attempt, and must satisfy eligibility rules at the time the application is submitted.
The Medical-Surgical Nursing exam is made up of 175 questions that have to do with four major domains of practice: Assessment and diagnosis; Planning, Implementation, and Outcomes Evaluation; Professional Roles; and Health Teaching and Health Promotion. Out of these 175 questions, 25 of them are pretest questions that will not be used for scoring. All 175 questions are multiple choice.
The Med-Surg Nursing test is a computer based test that takes place year round. It takes place at Prometric Testing Centers. There, candidates are expected to arrive in a timely manner for their appointment, and bring two forms of ID, one of which must be a government issued, photo ID. Personal itesms such as cell phones, bags, notes, are not allowed into the testing room. A locker will be provided to store personal items in. The test allows three and a half hours to answer all 175 questions.
- Sample Medical Surgical Practice Questions
- All of the following are true about sickle cell anemia EXCEPT:
- A. It is a genetic disease.
- B. It increases risk for stroke and heart attack.
- C. It can be diagnosed with a complete blood count (CBC).
- D. Treatment includes blood transfusion and oxygen.
- Among the following signs and symptoms, which would be the least likely to be present in a patient with acute asthma exacerbation?
- A. Low-grade fever
- B. Chest pain
- C. Shortness of breath
- D. Tinnitus
- A patient who was admitted for an acute exacerbation of congestive heart failure asks why she is being discharged on Lasix. What is the most appropriate response?
- A. "It prevents excessive edema."
- B. "It increases vasodilation"
- C. "It prevents clots."
- D. "It reduces inflammation."
- A pediatric patient has just been diagnosed with thalassemia major. Which of the following is a common complication?
- A. Obesity
- B. Diabetes
- C. Heart failure
- D. Cataracts
- A patient who has just undergone a lumbar puncture is now complaining of headache and dizziness. Which of the positions would help alleviate the symptoms?
- A. Supine
- B. Fowler's
- C. Reverse Trendelenburg
- D. Sitting
- A patient is newly diagnosed with gastroesophageal reflux disease and prescribed esomeprazole. Which of the following is an accurate explanation of the drug's action?
- A. "It slows down digestion."
- B. "It prevents peristalsis."
- C. "It coats the stomach lining to prevent acid erosion."
- D. "It decreases the production of stomach acid."
- Which of the following two medications should NOT be taken together?
- A. Lopressor and Norvasc
- B. Metformin and Lantus
- C. Aspirin and Lasix
- D. Nexium and Plavix
- Which of the following is the most appropriate test for measuring intraocular pressure?
- A. Calorimetry
- B. Fluorescein screen
- C. Spirometry
- D. Tonometry
- A patient is diagnosed with trichomoniasis. Which of the following is the most appropriate preventative therapy?
- A. Use birth control pills.
- B. Practice safe sex.
- C. Refrain from eating uncooked pork.
- D. Limit alcohol use.
The exam consists of 175 questions, 150 of which are scored and 25 of which are included to evaluate potential new test items and are not scored. Candidates should attempt to answer all questions on the exam to the best of their ability in order to achieve the best possible score. Exams are scored on a pass/fail basis. Raw scores (number of questions out of 150 that are answered correctly) are converted to scaled scores using a factor that represents the average difficulty of examination items. This allows each candidate’s performance to be measured against a minimum standard of competency, rather than against other candidates’ performance. Scaled scores may range from 0-500, and certification is granted to those candidates who pass the exam by achieving a scaled score of 350 or greater.
Answers to Sample Questions
1;C 2;D 3;A 4;C 5;A 6;D 7;D 8;D 9;B
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