NCLEX Practice Test For Medical Surgical Nursing(Practice Mode)- Www.Rnpedia.Com

  • NCLEX
Reviewed by Editorial Team
The ProProfs editorial team is comprised of experienced subject matter experts. They've collectively created over 10,000 quizzes and lessons, serving over 100 million users. Our team includes in-house content moderators and subject matter experts, as well as a global network of rigorously trained contributors. All adhere to our comprehensive editorial guidelines, ensuring the delivery of high-quality content.
Learn about Our Editorial Process
| By RNpedia.com
R
RNpedia.com
Community Contributor
Quizzes Created: 355 | Total Attempts: 2,705,616
| Attempts: 7,104 | Questions: 50 | Updated: Mar 22, 2025
Please wait...
Question 1 / 51
🏆 Rank #-- ▾
0 %
0/100
Score 0/100

1. The nurse is attending a bridal shower for a friend when another guest, who happens to be a diabetic, starts to tremble and complains of dizziness. The next best action for the nurse to take is to: 

Explanation

In diabetic patients, the nurse should watch out for signs of hypoglycemia manifested by dizziness, tremors, weakness, pallor diaphoresis and tachycardia. When this occurs in a conscious client, he should be given immediately carbohydrates in the form of fruit juice, hard candy, honey or, if unconscious, glucagons or dextrose per IV.

Submit
Please wait...
About This Quiz
NCLEX Practice Test For Medical Surgical Nursing(Practice Mode)- Www.Rnpedia.Com - Quiz

Mark the letter of the letter of choice then click on the next button. Answer will be revealed after each question. No time limit to finish the exam. Good luck!

2.

What first name or nickname would you like us to use?

You may optionally provide this to label your report, leaderboard, or certificate.

2. Mr. Pablo, diagnosed with Bladder Cancer, is scheduled for a cystectomy with the creation of an ileal conduit in the morning. He is wringing his hands and pacing the floor when the nurse enters his room. What is the best approach? 

Explanation

The client is showing signs of anxiety reaction to a stressful event. Recognizing the client’s anxiety conveys acceptance of his behavior and will allow for verbalization of feelings and concerns.

Submit

3. The client has a good understanding of the means to reduce the chances of colon cancer when he states: 

Explanation

Numerous aspects of diet and nutrition may contribute to the development of cancer. A low-fiber diet, such as when fresh fruits and vegetables are minimal or lacking in the diet, slows transport of materials through the gut which has been linked to colorectal cancer.

Submit

4. Days after abdominal surgery, the client’s wound dehisces. The safest nursing intervention when this occurs is to 

Explanation

Dehiscence is the partial or complete separation of the surgical wound edges. When this occurs, the client is placed in low Fowler’s position and instructed to lie quietly. The wound should be covered to protect it from exposure and the dressing must be sterile to protect it from infection and moist to prevent the dressing from sticking to the wound which can disturb the healing process.

Submit

5. A client with chronic heart failure has been placed on a diet restricted to 2000mg. of sodium per day. The client demonstrates adequate knowledge if behaviors are evident such as not salting food and avoidance of which food? 

Explanation

Canned foods are generally rich in sodium content as salt is used as the main preservative.

Submit

6. Which of the ff. statements by the client to the nurse indicates a risk factor for CAD? 

Explanation

Smoking has been considered as one of the major modifiable risk factors for coronary artery disease. Exercise and maintaining normal serum cholesterol levels help in its prevention.

Submit

7. Mary received AtropineSO4 as a pre-medication 30 minutes ago and is now complaining of dry mouth and her PR is higher, than before the medication was administered. The nurse’s best 

Explanation

Atropine sulfate is a vagolytic drug that decreases oropharyngeal secretions and increases the heart rate.

Submit

8. The laboratory of a male patient with Peptic ulcer revealed an elevated titer of Helicobacter pylori. Which of the following statements indicate an understanding of this data? 

Explanation

One of the causes of peptic ulcer is H. Pylori infection. It releases toxin that destroys the gastric and duodenal mucosa which decreases the gastric epithelium’s resistance to acid digestion. Giving antibiotics will control the infection and Ranitidine, which is a histamine-2 blocker, will reduce acid secretion that can lead to ulcer.

Submit

9. A 56 year old construction worker is brought to the hospital unconscious after falling from a 2-story building. When assessing the client, the nurse would be most concerned if the assessment revealed:

Explanation

The nurse needs to perform a thorough assessment that could indicate alterations in cerebral function, increased intracranial pressures, fractures and bleeding. Bleeding from the ears occurs only with basal skull fractures that can easily contribute to increased intracranial pressure and brain herniation

Submit

10. Mr. Perez is in continuous pain from cancer that has metastasized to the bone. Pain medication provides little relief and he refuses to move. The nurse should plan to:

Explanation

Patients with cancer and bone metastasis experience severe pain especially when moving. Bone tumors weaken the bone to appoint at which normal activities and even position changes can lead to fracture. During nursing care, the patient needs to be supported and handled gently.

Submit

11. A client is being evaluated for cancer of the colon. In preparing the client for barium enema, the nurse should: 

Explanation

Barium enema is the radiologic visualization of the colon using a die. To obtain accurate results in this procedure, the bowels must be emptied of fecal material thus the need for laxative and enema.

Submit

12. Included in the plan of care for the immediate post-gastroscopy period will be: 

Explanation

The client, after gastroscopy, has temporary impairment of the gag reflex due to the anesthetic that has been sprayed into his throat prior to the procedure. Giving fluids and food at this time can lead to aspiration.

Submit

13. Which is the most relevant knowledge about oxygen administration to a client with COPD? 

Explanation

COPD causes a chronic CO2 retention that renders the medulla insensitive to the CO2 stimulation for breathing. The hypoxic state of the client then becomes the stimulus for breathing. Giving the clientoxygen in low concentrations will maintain the client’s hypoxic drive.

Submit

14. During the first 24 hours after thyroid surgery, the nurse should include in her care: 

Explanation

Following surgery of the thyroid gland, bleeding is a potential complication. This can best be assessed by checking the back and the sides of the operative dressing as the blood may flow towards the side and back leaving the front dry and clear of drainage.

Submit

15. The nurse is preparing her plan of care for her patient diagnosed with pneumonia. Which is the most appropriate nursing diagnosis for this patient? 

Explanation

Pneumonia, which is an infection, causes lobar consolidation thus impairing gas exchange between the alveoli and the blood. Because the patient would require adequate hydration, this makes him prone to fluid volume excess.

Submit

16. The husband of a client asks the nurse about the protein-restricted diet ordered because of advanced liver disease. What statement by the nurse would best explain the purpose of the diet? 

Explanation

The largest source of ammonia is the enzymatic and bacterial digestion of dietary and blood proteins in the GI tract. A protein-restricted diet will therefore decrease ammonia production.

Submit

17. Following surgery, Mario complains of mild incisional pain while performing deep- breathing and coughing exercises. The nurse’s best response would be:


Explanation

Applying pressure against the incision with a pillow will help lessen the intra-abdominal pressure created by coughing which causes tension on the incision that leads to pain.

Submit

18. What is the best reason for the nurse in instructing the client to rotate injection sites for insulin?

Explanation

Lipodystrophy is the development of fibrofatty masses at the injection site caused by repeated use of an injection site. Injecting insulin into these scarred areas can cause the insulin to be poorly absorbed and lead to erratic reactions.

Submit

19. A nurse at the weight loss clinic assesses a client who has a large abdomen and a rounded face. Which additional assessment finding would lead the nurse to suspect that the client has Cushing’s syndrome rather than obesity? 

Explanation

“ Buffalo hump” is the accumulation of fat pads over the upper back and neck. Fat may also accumulate on the face. There is truncal obesity but the extremities are thin. All these are noted in a client with Cushing’s syndrome

Submit

20. Which description of pain would be most characteristic of a duodenal ulcer? 

Explanation

Duodenal ulcer is related to an increase in the secretion of HCl. This can be buffered by food intake thus the relief of the pain that is brought about by food intake.

Submit

21. A patient with angina pectoris is being discharged home with nitroglycerine tablets. Which of the following instructions does the nurse include in the teaching? 

Explanation

Angina pectoris is caused by myocardial ischemia related to decreased coronary blood supply. Giving nitroglycerine will produce coronary vasodilation that improves the coronary blood flow in 3 – 5 mins. If the chest pain is unrelieved, after three tablets, there is a possibility of acute coronary occlusion that requires immediate medical attention.

Submit

22. After surgery, Gina returns from the Post-anesthesia Care Unit (Recovery Room) with a nasogastric tube in place following a gall bladder surgery. She continues to complain of nausea. Which action would the nurse take? 

Explanation

Nausea is one of the common complaints of a patient after receiving general anesthesia. But this complaint could be aggravated by gastric distention especially in a patient who has undergone abdominal surgery. Insertion of the NGT helps relieve the problem. Checking on the patency of the NGT for any obstruction will help the nurse determine the cause of the problem and institute the necessary intervention.

Submit

23. A client, who is suspected of having Pheochromocytoma, complains of sweating, palpitation and headache. Which assessment is essential for the nurse to make first? 

Explanation

Pheochromocytoma is a tumor of the adrenal medulla that causes an increase secretion of catecholamines that can elevate the blood pressure.

Submit

24. An adult, who is newly diagnosed with Graves disease, asks the nurse, “Why do I need to take Propanolol (Inderal)?” Based on the nurse’s understanding of the medication and Grave’s disease, the best response would be: 

Explanation

Propranolol (Inderal) is a beta-adrenergic blocker that controls the cardiovascular manifestations brought about by increased secretion of the thyroid hormone in Grave’s disease.

Submit

25. Which of the drug of choice for pain controls the patient with acute pancreatitis? 

Explanation

Pain in acute pancreatitis is caused by irritation and edema of the inflamed pancreas as well as spasm due to obstruction of the pancreatic ducts. Demerol is the drug of choice because it is less likely to cause spasm of the Sphincter of Oddi unlike Morphine which is spasmogenic.

Submit

26. Which statement by the client indicates understanding of the possible side effects of Prednisone therapy? 

Explanation

The possible side effects of steroid administration are hypokalemia, increase tendency to infection and poor wound healing. Clients on the drug must follow strictly the doctor’s order since skipping the drug can lower the drug level in the blood that can trigger acute adrenal insufficiency or Addisonian Crisis

Submit

27. The nurse needs to carefully assess the complaint of pain of the elderly because older people 

Explanation

Degenerative changes occur in the elderly. The response to pain in the elderly maybe lessened because of reduced acuity of touch, alterations in neural pathways and diminished processing of sensory data.

Submit

28. Mario undergoes a left thoracotomy and a partial pneumonectomy. Chest tubes are inserted, and one-bottle water-seal drainage is instituted in the operating room. In the postanesthesia care unit Mario is placed in Fowler’s position on either his right 
side or on his back to 

Explanation

Since only a partial pneumonectomy is done, there is a need to promote expansion of this remaining Left lung by positioning the client on the opposite unoperated side.

Submit

29. The nurse enters the room of a client with chronic obstructive pulmonary disease. The client’s nasal cannula oxygen is running at a rate of 6 L per minute, the skin color is pink, and the respirations are 9 per minute and shallow. What is the nurse’s best initial action? 

Explanation

The client with COPD is suffering from chronic CO2 retention. The hypoxic drive is his chief stimulus for breathing. Giving O2 inhalation at a rate that is more than 2-3L/min can make the client lose his hypoxic drive which can be assessed as decreasing RR.

Submit

30. Valsalva maneuver can result in bradycardia. Which of the following activities will not stimulate Valsalva’s maneuver? 

Explanation

Straining or bearing down activities can cause vagal stimulation that leads to bradycardia. Use of stool softeners promote easy bowel evacuation that prevents straining or the valsalva maneuver.

Submit

31. What instructions should the client be given before undergoing a paracentesis? 

Explanation

Paracentesis involves the removal of ascitic fluid from the peritoneal cavity through a puncture made below the umbilicus. The client needs to void before the procedure to prevent accidental puncture of a distended bladder during the procedure.

Submit

32. When suctioning mucus from a client’s lungs, which nursing action would be least appropriate? 

Explanation

One hazard encountered when suctioning a client is the development of hypoxia. Suctioning sucks not only the secretions but also the gases found in the airways. This can be prevented by suctioning the client for an average time of 5-10 seconds and not more than 15 seconds and hyperoxygenating the client before and after suctioning.

Submit

33. A client receiving heparin sodium asks the nurse how the drug works. Which of the following points would the nurse include in the explanation to the client? 

Explanation

Heparin is an anticoagulant. It prevents the conversion of prothrombin to thrombin. It does not dissolve a clot.

Submit

34. Immediately after cholecystectomy, the nursing action that should assume the highest priority is: 

Explanation

Cholecystectomy requires a subcostal incision. To minimize pain, clients have a tendency to take shallow breaths which can lead to respiratory complications like pneumonia and atelectasis. Deep breathing and coughing exercises can help prevent such complications.

Submit

35. A Sengstaken-Blakemore tube is inserted in the effort to stop the bleeding esophageal varices in a patient with complicated liver cirrhosis. Upon insertion of the tube, the client complains of difficulty of breathing. The first action of the nurse is to:

Explanation

When a client with a Sengstaken-Blakemore tube develops difficulty of breathing, it means the tube is displaced and the inflated balloon is in the oropharynx causing airway obstruction

Submit

36. The client presents with severe rectal bleeding, 16 diarrheal stools a day, severe abdominal pain, tenesmus and dehydration. Because of these symptoms the nurse should be alert for other problems associated with what disease? 

Explanation

Ulcerative colitis is a chronic inflammatory condition producing edema and ulceration affecting the entire colon. Ulcerations lead to sloughing that causes stools as many as 10-20 times a day that is filled with blood, pus and mucus. The other symptoms mentioned accompany the problem.

Submit

37. On discharge, the nurse teaches the patient to observe for signs of surgically induced hypothyroidism. The nurse would know that the patient understands the teaching when she states she should notify the MD if she develops: 

Explanation

Hypothyroidism, a decrease in thyroid hormone production, is characterized by hypometabolism that manifests itself with weight gain.

Submit

38. A client returns from the recovery room at 9AM alert and oriented, with an IV infusing. His pulse is 82, blood pressure is 120/80, respirations are 20, and all are within normal range. At 10 am and at 11 am, his vital signs are stable. At noon, however, his pulse rate is 94, blood pressure is 116/74, and respirations are 24. What nursing action is most appropriate? 

Explanation

Monitoring the client’s vital signs following surgery gives the nurse a sound information about the client’s condition. Complications can occur during this period as a result of the surgery or the anesthesia or both. Keeping close track of changes in the VS and validating them will help the nurse initiate interventions to prevent complications from occurring.

Submit

39. The nurse is teaching the patient regarding his permanent artificial pacemaker. Which information given by the nurse shows her knowledge deficit about the artificial cardiac pacemaker? 

Explanation

The client should be advised by the nurse to avoid contact sports. This will prevent trauma to the area of the pacemaker generator.

Submit

40. The nurse is conducting an education session for a group of smokers in a “stop smoking” class. Which finding would the nurse state as a common symptom of lung cancer? : 

Explanation

Cigarette smoke is a carcinogen that irritates and damages the respiratory epithelium. The irritation causes the cough which initially maybe dry, persistent and unproductive. As the tumor enlarges, obstruction of the airways occurs and the cough may become productive due to infection.

Submit

41. Which of the following would be inappropriate to include in a diabetic teaching plan? 

Explanation

The client with DM has decreased peripheral circulation caused by microangiopathy. Keeping the legs elevated during sleep will further cause circulatory impairment.

Submit

42. Ana’s postoperative vital signs are a blood pressure of 80/50 mm Hg, a pulse of 140, and respirations of 32. Suspecting shock, which of the following orders would the nurse question?

Explanation

Administering Demerol, which is a narcotic analgesic, can depress respiratory and cardiac function and thus not given to a patient in shock. What is needed is promotion for adequate oxygenation and perfusion. All the other interventions can be expected to be done by the nurse.

Submit

43. An intravenous pyelogram reveals that Paulo, age 35, has a renal calculus. He is believed to have a small stone that will pass spontaneously. To increase the chance of the stone passing, the nurse would instruct the client to force fluids and to 

Explanation

Free unattached stones in the urinary tract can be passed out with the urine by ambulation which can mobilize the stone and by increased fluid intake which will flush out the stone during urination.

Submit

44. A student nurse is assigned to a client who has a diagnosis of thrombophlebitis. Which action by this team member is most appropriate? 

Explanation

In a client with thrombophlebitis, bedrest will prevent the dislodgment of the clot in the extremity which can lead to pulmonary embolism.

Submit

45. After Billroth II Surgery, the client developed dumping syndrome. Which of the following should the nurse exclude in the plan of care? 

Explanation

The dumping syndrome occurs within 30 mins after a meal due to rapid gastric emptying, causing distention of the duodenum or jejunum produced by a bolus of food. To delay the emptying, the client has to lie down after meals. Sitting up after meals will promote the dumping syndrome.

Submit

46. A client is scheduled for a bronchoscopy. When teaching the client what to expect afterward, the nurse’s highest priority of information would be 

Explanation

Prior to bronchoscopy, the doctors sprays the back of the throat with anesthetic to minimize the gag reflex and thus facilitate the insertion of the bronchoscope. Giving the client food and drink after the procedure without checking on the return of the gag reflex can cause the client to aspirate. The gag reflex usually returns after two hours.

Submit

47. Mr. Braga was ordered Digoxin 0.25 mg. OD. Which is poor knowledge regarding this drug? 

Explanation

Inotropic effect of drugs on the heart causes increase force of its contraction. This increases cardiac output that improves renal perfusion resulting in an improved urine output.

Submit

48. The client underwent Billroth surgery for gastric ulcer. Post-operatively, the drainage from his NGT is thick and the volume of secretions has dramatically reduced in the last 2 hours and the client feels like vomiting. The most appropriate nursing action is to:

Explanation

The client’s feeling of vomiting and the reduction in the volume of NGT drainage that is thick are signs of possible abdominal distention caused by obstruction of the NGT. This should be reported immediately to the MD to prevent tension and rupture on the site of anastomosis caused by gastric distention.

Submit

49. Dr. Santos prescribes oral rifampin (Rimactane) and isoniazid (INH) for a client with a positive Tuberculin skin test. When informing the client of this decision, the nurse knows that the purpose of this choice of treatment is to 

Explanation

Pulmonary TB is treated primarily with chemotherapeutic agents for 6-12 mons. A prolonged treatment duration is necessary to ensure eradication of the organisms and to prevent relapse. The increasing prevalence of drug resistance points to the need to begin the treatment with drugs in combination. Using drugs in combination can delay the drug resistance.

Submit

50. A client with COPD is being prepared for discharge. The following are relevant instructions to the client regarding the use of an oral inhaler EXCEPT 

Explanation

If the client breathes out through the mouth with pursed lips, this can easily force the just inhaled drug out of the respiratory tract that will lessen its effectiveness.

Submit
×
Saved
Thank you for your feedback!
View My Results
Cancel
  • All
    All (50)
  • Unanswered
    Unanswered ()
  • Answered
    Answered ()
The nurse is attending a bridal shower for a friend when another...
Mr. Pablo, diagnosed with Bladder Cancer, is scheduled for a...
The client has a good understanding of the means to reduce the chances...
Days after abdominal surgery, the client’s wound dehisces. The...
A client with chronic heart failure has been placed on a diet...
Which of the ff. statements by the client to the nurse indicates a...
Mary received AtropineSO4 as a pre-medication 30 minutes ago and is...
The laboratory of a male patient with Peptic ulcer revealed an...
A 56 year old construction worker is brought to the hospital...
Mr. Perez is in continuous pain from cancer that has metastasized to...
A client is being evaluated for cancer of the colon. In preparing the...
Included in the plan of care for the immediate post-gastroscopy period...
Which is the most relevant knowledge about oxygen administration to a...
During the first 24 hours after thyroid surgery, the nurse should...
The nurse is preparing her plan of care for her patient diagnosed with...
The husband of a client asks the nurse about the protein-restricted...
Following surgery, Mario complains of mild incisional pain while ...
What is the best reason for the nurse in instructing the client to...
A nurse at the weight loss clinic assesses a client who has a large...
Which description of pain would be most characteristic of a duodenal...
A patient with angina pectoris is being discharged home with...
After surgery, Gina returns from the Post-anesthesia Care Unit...
A client, who is suspected of having Pheochromocytoma, complains of...
An adult, who is newly diagnosed with Graves disease, asks the nurse,...
Which of the drug of choice for pain controls the patient with acute...
Which statement by the client indicates understanding of the possible...
The nurse needs to carefully assess the complaint of pain of the...
Mario undergoes a left thoracotomy and a partial pneumonectomy. Chest...
The nurse enters the room of a client with chronic obstructive...
Valsalva maneuver can result in bradycardia. Which of the following...
What instructions should the client be given before undergoing a...
When suctioning mucus from a client’s lungs, which nursing action...
A client receiving heparin sodium asks the nurse how the drug works....
Immediately after cholecystectomy, the nursing action that should...
A Sengstaken-Blakemore tube is inserted in the effort to stop the...
The client presents with severe rectal bleeding, 16 diarrheal stools a...
On discharge, the nurse teaches the patient to observe for signs of...
A client returns from the recovery room at 9AM alert and oriented,...
The nurse is teaching the patient regarding his permanent artificial...
The nurse is conducting an education session for a group of smokers in...
Which of the following would be inappropriate to include in a diabetic...
Ana’s postoperative vital signs are a blood pressure of 80/50 mm Hg,...
An intravenous pyelogram reveals that Paulo, age 35, has a renal...
A student nurse is assigned to a client who has a diagnosis of...
After Billroth II Surgery, the client developed dumping syndrome....
A client is scheduled for a bronchoscopy. When teaching the client...
Mr. Braga was ordered Digoxin 0.25 mg. OD. Which is poor knowledge...
The client underwent Billroth surgery for gastric ulcer....
Dr. Santos prescribes oral rifampin (Rimactane) and isoniazid (INH)...
A client with COPD is being prepared for discharge. The following are...
play-Mute sad happy unanswered_answer up-hover down-hover success oval cancel Check box square blue
Alert!