Med-Surg NCLEX Practice Questions

15 free NCLEX-RN med-surg questions with answers and rationales — perfect for med surg nclex questions practice. Want them as an interactive timed quiz?

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1. A 58-year-old male with type 2 diabetes is admitted with a foot ulcer. Which of the following is the BEST initial nursing action?
- A. Assess the size and depth of the ulcer. ✓
- B. Notify the physician.
- C. Apply a sterile dressing.
- D. Check the patient's blood glucose level.
Answer: A. Assess the size and depth of the ulcer. — Assessing the ulcer first allows the nurse to gather data needed to inform further interventions and communicate effectively with the healthcare team.
2. A patient is post-operative day 1 following a total hip replacement. Which action should the nurse take to prevent dislocation of the new hip joint?
- A. Instruct the patient to avoid bending the hip more than 90 degrees. ✓
- B. Place a pillow under the patient's knees.
- C. Encourage crossing legs when sitting.
- D. Position the patient on the affected side.
Answer: A. Instruct the patient to avoid bending the hip more than 90 degrees. — Avoiding hip flexion beyond 90 degrees is crucial to prevent dislocation after hip replacement surgery.
3. A patient with chronic kidney disease is receiving hemodialysis. Which assessment finding should the nurse report to the healthcare provider immediately?
- A. Blood pressure of 150/90 mmHg.
- B. Fatigue and weakness.
- C. Weight gain of 2 kg since yesterday. ✓
- D. Decreased urine output.
Answer: C. Weight gain of 2 kg since yesterday. — Rapid weight gain can indicate fluid overload, a serious complication in patients on dialysis, and requires prompt attention.
4. A patient with a history of peptic ulcer disease is admitted with severe abdominal pain and a rigid abdomen. What is the priority action for the nurse?
- A. Administer prescribed analgesics.
- B. Notify the healthcare provider immediately. ✓
- C. Insert a nasogastric tube.
- D. Obtain a complete blood count.
Answer: B. Notify the healthcare provider immediately. — A rigid abdomen with severe pain may indicate perforation, a medical emergency requiring immediate physician intervention.
5. A patient with hypothyroidism is being discharged with a prescription for levothyroxine. What should the nurse emphasize when teaching the patient about this medication?
- A. Take the medication with food.
- B. Store the medication in the refrigerator.
- C. Take the medication at bedtime.
- D. Take the medication on an empty stomach. ✓
Answer: D. Take the medication on an empty stomach. — Levothyroxine is best absorbed on an empty stomach, ideally 30 minutes to 1 hour before breakfast.
6. A patient is receiving digoxin for heart failure. Which lab result should prompt the nurse to hold the medication and notify the physician?
- A. Potassium level of 3.0 mEq/L. ✓
- B. Sodium level of 140 mEq/L.
- C. Calcium level of 9 mg/dL.
- D. Magnesium level of 2.0 mEq/L.
Answer: A. Potassium level of 3.0 mEq/L. — Hypokalemia (low potassium) increases the risk of digoxin toxicity, and the physician should be notified before administering the medication.
7. A patient with cirrhosis is experiencing ascites. Which dietary instruction should the nurse provide?
- A. Increase protein intake.
- B. Limit sodium intake. ✓
- C. Avoid carbohydrates.
- D. Increase fluid intake.
Answer: B. Limit sodium intake. — Reducing sodium intake can help manage fluid retention and ascites in patients with liver cirrhosis.
8. A patient presents with confusion, tremors, and diaphoresis. Which nursing action should be taken first?
- A. Administer dextrose 50% IV push.
- B. Obtain a blood glucose level. ✓
- C. Notify the healthcare provider.
- D. Provide a carbohydrate snack.
Answer: B. Obtain a blood glucose level. — Obtaining a blood glucose level will confirm whether the symptoms are due to hypoglycemia, guiding further interventions.
9. A patient with Addison's disease is admitted with complaints of nausea, vomiting, and confusion. What is the nurse's priority action?
- A. Administer antiemetics as prescribed.
- B. Assess electrolyte levels. ✓
- C. Encourage oral fluids.
- D. Provide a high-protein diet.
Answer: B. Assess electrolyte levels. — Patients with Addison's disease are at risk for adrenal crisis, which can cause severe electrolyte imbalances that must be assessed and managed promptly.
10. A patient is scheduled for a colonoscopy. Which pre-procedure instruction is most important for the nurse to provide?
- A. Avoid all dairy products 24 hours before the procedure.
- B. Do not take any medications on the day of the procedure.
- C. Follow a clear liquid diet the day before the procedure. ✓
- D. Eat a high-fiber diet the day before the procedure.
Answer: C. Follow a clear liquid diet the day before the procedure. — A clear liquid diet is essential to ensure the bowel is adequately prepared and clear for the colonoscopy.
11. A patient with newly diagnosed type 1 diabetes asks why insulin injections are necessary. What is the nurse's best response?
- A. Insulin helps your body use glucose for energy. ✓
- B. Insulin prevents the production of ketones.
- C. Insulin stimulates the pancreas to produce more insulin.
- D. Insulin increases the absorption of glucose in the intestines.
Answer: A. Insulin helps your body use glucose for energy. — Insulin is necessary for the metabolism of glucose, allowing cells to use it for energy, and is essential for patients with type 1 diabetes who cannot produce insulin.
12. A patient with hyperthyroidism is admitted with a heart rate of 130 bpm. What is the priority nursing intervention?
- A. Administer beta-blockers as prescribed. ✓
- B. Encourage deep breathing exercises.
- C. Place the patient in a cool environment.
- D. Restrict the patient's fluid intake.
Answer: A. Administer beta-blockers as prescribed. — Beta-blockers are often used to manage tachycardia and other cardiovascular symptoms associated with hyperthyroidism.
13. A post-operative patient is experiencing urinary retention. Which intervention should the nurse implement first?
- A. Perform a bladder scan. ✓
- B. Insert a Foley catheter.
- C. Administer prescribed diuretics.
- D. Encourage the patient to drink fluids.
Answer: A. Perform a bladder scan. — A bladder scan will help determine the volume of urine retained, guiding further interventions such as catheterization if necessary.
14. A patient with COPD is receiving oxygen therapy. Which assessment finding indicates that the oxygen flow rate may be too high?
- A. Respiratory rate of 24 breaths per minute.
- B. Increased restlessness.
- C. Decreased level of consciousness. ✓
- D. Cyanosis of the lips.
Answer: C. Decreased level of consciousness. — In patients with COPD, high oxygen flow rates can suppress the respiratory drive, leading to CO2 retention and decreased consciousness.
15. A patient with acute pancreatitis has a nasogastric tube in place. What is the primary purpose of this intervention?
- A. To provide nutrition.
- B. To relieve nausea and vomiting.
- C. To decompress the stomach. ✓
- D. To administer medications.
Answer: C. To decompress the stomach. — In acute pancreatitis, a nasogastric tube is often used to decompress the stomach, reducing pancreatic stimulation and pain.

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