PNC Licensing Examination Medical Surgical Nursing Syllabus

Medical Surgical Nursing syllabus — full chapter and topic list

Expand any chapter to see its topics and sub-topics. This is the whole examinable outline for Medical Surgical Nursing in PNC Licensing Examination, not a summary of it.

1. 1

   Principles of Medical Surgical Nursing

   4 topics

   • Perioperative nursing care
   • Fluid, electrolyte, and acid-base imbalances
   • Shock and hemorrhage management
   • Care of the critically ill patient
2. 2

   Cardiovascular Disorders

   4 topics

   • Hypertension and heart failure
   • Myocardial infarction and angina
   • Arrhythmias and ECG basics
   • Cardiac procedures and nursing care
3. 3

   Respiratory Disorders

   4 topics

   • Pneumonia and tuberculosis
   • Asthma and COPD
   • Oxygen therapy and airway management
   • Chest drainage and ventilation
4. 4

   Gastrointestinal and Hepatic Disorders

   4 topics

   • Peptic ulcer and GI bleeding
   • Hepatitis and cirrhosis
   • Intestinal obstruction
   • Stoma and nutritional support
5. 5

   Renal and Urinary Disorders

   4 topics

   • Acute and chronic kidney disease
   • Urinary tract infections
   • Dialysis and nursing management
   • Catheterization care
6. 6

   Endocrine and Metabolic Disorders

   3 topics

   • Diabetes mellitus and complications
   • Thyroid disorders
   • Adrenal and pituitary disorders
7. 7

   Neurological and Musculoskeletal Disorders

   4 topics

   • Stroke and head injury
   • Seizures and meningitis
   • Fractures and traction
   • Arthritis and immobility care
8. 8

   Oncology and Hematologic Disorders

   4 topics

   • Cancer pathophysiology and staging
   • Chemotherapy and radiation nursing care
   • Anemia and bleeding disorders
   • Palliative and end-of-life care

Medical Surgical Nursing flashcards for PNC Licensing Examination

20 of 60 cards from the Medical Surgical Nursing deck — real questions with worked answers.

1. What are the three phases of the perioperative period?

   Preoperative (decision for surgery until transfer to OR table), intraoperative (transfer to OR until admission to PACU), and postoperative (admission to PACU until follow-up evaluation).

2. What is the purpose of the surgical "time-out" before incision?

   A final verification, performed by the whole team just before incision, confirming correct patient, correct procedure, and correct surgical site to prevent wrong-patient/wrong-site/wrong-procedure errors.

3. Why is informed consent obtained before administering preoperative sedation?

   Sedatives impair judgment and memory, so consent must be signed while the patient is alert and competent; consent given after sedation is not legally valid.

4. What is the normal serum sodium range, and what defines hyponatremia and hypernatremia?

   Normal sodium is 135-145 mEq/L. Hyponatremia is <135 mEq/L; hypernatremia is >145 mEq/L.

5. What are the classic ECG changes and key danger of hyperkalemia?

   Tall, peaked T waves, widened QRS, and flattened P waves; the major danger is lethal cardiac arrhythmias and cardiac arrest. Normal potassium is 3.5-5.0 mEq/L.

6. What is the formula for the anion gap, and what is the normal value?

   Anion gap = Na+ minus (Cl- + HCO3-). Normal is approximately 8-12 mEq/L; an elevated gap indicates metabolic acidosis from added acids (e.g., DKA, lactic acidosis).

7. In a blood gas, what pH, PaCO2, and HCO3 values define respiratory acidosis?

   pH <7.35, PaCO2 >45 mmHg (the primary problem), with HCO3 normal or rising if compensated. Caused by hypoventilation/CO2 retention.

8. How do you distinguish respiratory from metabolic acidosis on an ABG?

   In respiratory acidosis the PaCO2 is high (>45) and drives the low pH; in metabolic acidosis the HCO3 is low (<22) and drives the low pH. Normal pH 7.35-7.45, PaCO2 35-45, HCO3 22-26.

9. What are the cardinal early signs of hypovolemic shock?

   Tachycardia, tachypnea, cool/clammy pale skin, restlessness/anxiety, decreased urine output (<30 mL/hr); blood pressure falls late after compensation fails.

10. What distinguishes the hemodynamics of hypovolemic/cardiogenic shock from distributive (septic) shock?

    Hypovolemic and cardiogenic shock show cold skin with high systemic vascular resistance (vasoconstriction); distributive/septic shock is initially warm with low SVR (vasodilation) and often bounding pulses.

11. What is the nursing priority and positioning for a patient in hypovolemic shock?

    Restore circulating volume with large-bore IV fluids/blood, ensure airway and high-flow oxygen, and keep the patient supine (modified Trendelenburg/legs elevated is sometimes used) to promote venous return.

12. What are the 5 P's of acute hemorrhage assessment that signal compensatory failure?

    Pallor, perspiration (cool clammy skin), prostration (weakness), pulse (rapid, thready), and pulse pressure narrowing; together they indicate ongoing blood loss and impending decompensated shock.

13. What does the FiO2 of room air equal, and what is a normal SpO2 range?

    Room air FiO2 is 0.21 (21%). Normal oxygen saturation (SpO2) is 95-100%.

14. What does the abbreviation MAP stand for and what is its formula?

    Mean Arterial Pressure = (Systolic BP + 2 x Diastolic BP) / 3. A MAP of at least 60-65 mmHg is needed to perfuse vital organs.

15. What is the difference between sensitivity to pain and the GCS components used in critical care assessment?

    The Glasgow Coma Scale scores Eye opening (4), Verbal response (5), and Motor response (6) for a total of 3-15; a score of 8 or less indicates coma and need for airway protection.

16. How is hypertension classified per common adult guidelines (normal, elevated, stage 1, stage 2)?

    Normal <120/80; Elevated 120-129/<80; Stage 1: 130-139/80-89; Stage 2: at least 140/90 mmHg.

17. What is a hypertensive emergency and how does it differ from a hypertensive urgency?

    Hypertensive emergency is severely high BP (often >180/120) WITH acute target-organ damage requiring immediate IV treatment; urgency is severely high BP WITHOUT acute organ damage, treated with oral agents over hours.

18. What distinguishes left-sided from right-sided heart failure clinically?

    Left-sided HF causes pulmonary congestion (dyspnea, crackles, orthopnea, frothy sputum); right-sided HF causes systemic congestion (peripheral edema, JVD, hepatomegaly, ascites, weight gain).

19. Why are daily weights a key nursing assessment in heart failure?

    Daily weight is the most reliable indicator of fluid retention; a gain of 2-3 lb (about 1 kg) in a day or 5 lb in a week signals worsening fluid overload and should be reported.

20. What is the gold-standard biomarker for diagnosing myocardial infarction and its timing?

    Cardiac troponin (I or T) is most specific; it rises within 3-6 hours of MI, peaks at 12-24 hours, and remains elevated up to 10-14 days.

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