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Exam Number : ANCC-MSN
Exam Name : ANCC (RN-BC) Medical-Surgical Nursing
Vendor Name : Medical
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Exam Title : Medical-Surgical Nursing Board Certification Examination
Questions : 125 (25 unscored)

The ANCC Medical-Surgical Nursing board certification examination is a competency based examination that provides a valid and reliable assessment of the entry-level clinical knowledge and skills of registered nurses in the medical-surgical specialty after initial RN licensure. Once you complete eligibility requirements to take the certification examination and successfully pass the exam, you are awarded the credential: Registered Nurse-Board Certified (RN-BC). This credential is valid for 5 years. You can continue to use this credential by maintaining your license to practice and meeting the renewal requirements in place at the time of your certification renewal. The Accreditation Board for Specialty Nursing Certification accredits this ANCC certification.

There are 150 questions on this examination. Of these, 125 are scored questions and 25 are pretest questions that are not scored. Pretest questions are used to determine how well these questions will perform before they are used on the scored portion of the examination. The pretest questions cannot be distinguished from those that will be scored, so it is important for a candidate to answer all questions. A candidate's score, however, is based solely on the 125 scored questions. Performance on pretest questions does not affect a candidate's score.

Category Content Domain Number of Questions Percentage
I Assessment and Diagnosis 52 42%
II Planning, Implementation, and Evaluation 58 46%
III Professional Role 15 12%
TOTAL 125 100%

I Assessment and Diagnosis
A. Skill
1. Health history collection
2. Physical assessment (e.g., disease process, review of systems, activities of daily living)
3. Psychosocial assessment (e.g., developmental stages, suicide risk, abuse, substance use disorders)
4. Cognitive assessment (e.g., neuro status, developmental age, impairment)
5. Diagnostic and laboratory testing (e.g., patient preparation, response to abnormal values, medication considerations)
6. Nursing diagnosis identification and prioritization
B. Knowledge
1. Fluids and electrolytes (e.g., imbalances, disease-related, blood products)
II Planning, Implementation, and Evaluation
A. Skill
1. Nursing care planning (e.g., interventions, modifications, outcomes)
2. Postoperative complication prevention and management (e.g., bleeding, infection, emboli)
3. Patient teaching (i.e., learning preferences, barriers, and confirmation)
B. Knowledge
1. Education Topics (e.g., self-management, acute and chronic conditions, population specific)
2. Patient safety measures (e.g., screening tools, infection prevention, restraints, medical equipment)
3. Non-pharmacologic treatments (e.g., complementary and alternative medicine, diversional activities)
4. Medication interactions and adverse effects (e.g., pain management, polypharmacy, drug-drug, food-drug)
5. Health and wellness promotion (e.g., screenings, vaccinations, healthy lifestyle modifications)
III Professional Role
A. Skill
1. Therapeutic communication (e.g., patient- and family-centered care, cultural competence)
B. Knowledge
1. Nursing ethics (e.g., evidence-based practice, advocacy)

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Medical (RN-BC) learning

Addressing the nursing scarcity | ANCC-MSN PDF get and Latest Topics

Dr. Hannapel

Dr. Hannapel

With the onset of COVID-19, the existing nurse scarcity only worsened at many hospitals all over the country. “COVID patients require a further stage of care as a result of the virus’s infectious nature and the need for isolation,” referred to Andrew C. Hannapel, MD, chief clinical officer, director of medical education, and scientific provider in the emergency department, and hospitalist maternity care functions for Chatham sanatorium in Siler metropolis, N.C. “workforce need to placed on PPE every time they enter a COVID patient’s room. These sufferers require additional personnel and components to care for them.”

Barbara Jacobs

Barbara Jacobs

All these further demands impact nurses and other body of workers participants over time. “Nurses are leaving bedside nursing and switching to outpatient nursing, non-patient care nursing jobs, or leaving nursing altogether,” Dr. Hannapel pointed out. “other nurses have left to develop into touring nurses on account of the enormous income enhance.” as a result of the COVID-19 vaccine requirement, the sanatorium lost near 10% of its nurses.

Nurses’ burnout and frustration accelerated when challenges to mask mandates and vaccinations resulted in COVID-19 case surges over the summer season. “Some nurses felt that the very americans they sacrificed themselves for had failed them by not getting vaccinated,” spoke of Barbara S. Jacobs, MSR, RN-BC, NEA-BC, vice chairman of nursing and chief nursing officer at Luminis fitness Anne Arundel scientific center in Annapolis, Md., an academic regional scientific middle with 380 beds.

The dramatic spike in COVID-19 situations in definite parts of the U.S. resulted in a huge demand for nurses and particularly augmented hourly fees for temporary nurses, which contributed to fewer experienced nurses at the bedside in Jacobs’ sanatorium. extra, many female nurses had to supply childcare at domestic all through the pandemic, which confined their availability to work, and a different colossal group of nurses reached retirement age.

Now that the pandemic has greatly impacted the pediatric inhabitants, burnout has improved among the many nursing body of workers at Akron toddlers’s hospital in Ohio, an urban pediatric sanatorium with greater than 400 beds. “greater nurses are finding out to retire, while others are leaving the profession for different roles that don't seem to be direct care, above all clinic care,” talked about Christine younger, MSN, MBA, RN, NEA-BC, chief of health center-based mostly capabilities and chief nursing officer. “Some nurses have taken assignments as traveling nurses, enticed by using the economic incentives that commute corporations are offering, notwithstanding they have offered incentive bonuses.”

outcomes on medical institution medicine and affected person care

Having fewer nurses increases calls for on the health facility medicine department and negatively affects patient care. as an instance, Chatham health center, a rural crucial access health facility with 25 beds, is unable to at all times retain all its beds open and staffed. consequently, admitted sufferers are boarded in the emergency branch unless an inpatient bed is accessible, growing longer wait instances there.

The sanatorium additionally hasn’t been able to preserve its four-bed ICU open due to nursing shortages, which increases its transfers to larger community and educational hospitals. “however these referral hospitals have their personal complications with staffing inpatient beds, so once in a while they could’t settle for transfers or there are delays in accepting transfers,” Dr. Hannapel mentioned.

At Akron infants’s health center, the primary affect on affected person care as a result of the nursing shortage is occasional limits on

Christine Young

Christine young

access. “We monitor the staffing circumstance normally and by chance have hardly had to restrict bed availability,” younger talked about. “When this does turn up, they work intently with regional pediatric hospitals to make certain patients receive quintessential care.”

The nursing team of workers works in shut collaboration with its pediatric health center medicine department. “workforce make every effort to work collectively so any scarcity doesn’t have an effect on its skill to bring first-rate care,” younger referred to. “This scarcity has bolstered their crew; their health facility medicine colleagues are all the time willing to pitch in and work along with the nursing group of workers.”

For the primary time in its history, Anne Arundel medical core introduced in loads of temporary personnel. consequently, group individuals have been much less popular with each aside from during the past. “useful resource nurses can be found to guide less experienced or less popular nurses, but there is a lack of adventure that comes from crew individuals who've labored collectively for long intervals of time,” Jacobs spoke of.

fitness care practitioners within the department of medication at providence Mission health center in Mission Viejo, Calif., a community medical institution with 502 beds, have been very supportive all the way through the nursing shortage by way of conducting extra customary rounding, expanding working towards for brand new caregivers, and offering ongoing education about COVID-19 practice alterations to the scientific crew, observed Cherie Fox, RN, MSN, CCRN-okay, executive director of acute care functions. “We supply and guide the medical crew to push on and supply the same degree of care regardless of the nursing scarcity, COVID, or another elements,” she noted. All leaders are asked to round on sufferers, including each person from its finance branch to its satisfactory team. “while care start is for the clinical crew, checking on patients is each person’s responsibility.”

assuaging nursing shortages Eric Wolak

Eric Wolak

there is decent information as hospitals file some success in holding and recruiting nurses. Chatham hospital all started offering signal-on bonuses for two-year commitments and relocation tips for out-of-area candidates. It elevated nurse salaries across the board by using $2 per hour and should be giving a 2.5% raise to all personnel beginning in January, referred to Eric Wolak, DNP, MHA, RN, NEA-BC, chief operating officer, and chief nurse officer. All nurses got an incentive bonus of two.5% on the conclusion of October. while it has tried not to become dependent on travelers, Chatham sanatorium might be recruiting some for the ED to aid be sure elementary care. “It has turn into clear that graduate nurses might be their focal point for recruiting new skill, so we've cast a powerful relationship with a local neighborhood faculty with an RN application,” he pointed out.

Chatham health facility is additionally bringing again licensed useful nurses (LPNs) to inpatient and ED positions. “they're a community resource and have augmented their personnel,” Dr. Hannapel observed. “while they could’t do every thing an RN can do and they require nursing team of workers to supervise and mentor them, they operate a must have nursing capabilities. They also incentivize LPNs who earn an RN degree in four years via providing tuition counsel.”

Cherie Fox

Cherie Fox

providence Mission hospital has embraced a software known as Transition into observe (TIP), which has allowed it to onboard extra new graduate nurses with better retention and clinical talents after orientation. The health facility presents signal-on and referral bonuses to recruit skilled nurses, but the bulk of the brand new positions are being stuffed with new graduate nurses who're offered lengthy, strong practising, Fox observed.

Fox noted the health center additionally created a affected person care technician role for nursing college students, which has helped with recruitment. This feeder application presents the pliability of part-time work and agenda lodgings to cater to a nursing pupil’s needs.

Anne Arundel clinical core offers lessons assistance and loan forgiveness classes in its effort to entice nurses. It also has an aggressive weekend software, both to reward nurses who work weekends and to build a crew on those shifts, Jacobs observed. This reduces the variety of weekends that different body of workers deserve to work. The health facility has also adjusted its benefits. Its brief-term disability waiting period has been reduced to seven days and workforce members can receive full-time fitness advantages when working a 24-hour workweek.

At Akron babies’s health center, bonus incentive-pay courses are offered for team of workers who are inclined to work additional hours, young said. The hospital has reached out to retired nurses and different old personnel to recruit and rehire them. It created a assisting hands application by which nurses working in non-medical settings, similar to information capabilities, satisfactory, research, and accreditation, have been offered refresher training to support medical care birth at the bedside. The hospital additionally actively reaches out to nursing college students to present them positions as patient care assistants to help care delivery on the bedside. “We use this strategy as a recruitment tool to keep and transition them to nursing positions when their schooling is complete,” she spoke of.

Akron babies’s medical institution is also conducting accelerated market studies to make sure its compensation is competitive, specializing in challenging-to-fill and difficult-to-keep positions throughout the company together with nursing, specifically crucial care nursing.

ahead thinking

knowing the nursing scarcity received’t be over any time quickly, some hospitals are working on recommendations to alleviate future shortages.

taking pictures nursing college students early of their training is essential to lessening future nursing shortages, younger referred to. Akron babies’s hospital has a strong nurse tech software, called Assuring Success with a commitment to raise Nurse range (ASCEND). It’s a 10-week program for nursing college students from underrepresented groups before their senior yr in nursing faculty.

It additionally has an authorized nurse residency software that supports new graduate nurses’ transitions to follow all the way through the entire first yr after commencement. “We understand these transitions are complex; this program has more advantageous the first-12 months turnover cost for nurses greatly,” young said.

Anne Arundel medical center is additionally trying to exchange probably the most ordinary approaches of giving care and is exploring how it can provide greatest affected person care with some resourceful fashions. “We are looking to adjust their models, adding multiplied and unique assist team of workers roles,” Jacobs referred to. “We’re practicing a new generation of health care people with the aid of partnering with quite a lot of better schooling institutions to offer a normal and creative academic pathway.” 

Karen Appold is an award-successful journalist primarily based in Lehigh Valley, Pa. She has also labored in loads of capacities, including newspaper reporter, editor of a daily newspaper, and editor of a monthly magazine. attain her at [email protected].

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