1|Page
Test Bank for Medical-Surgical Nursing Complete
Practice Questions & Answers with Rationales 500+
Questions Covering All Body Systems | 2025/2026
Updated Edition.
Exam (elaborations)
MEDICAL-SURGICAL NURSING
Complete Test Bank & Practice Questions
500+ NCLEX-Style Questions with Detailed Rationales
2025/2026 | Already Graded A+
Institution: Nursing Programs Nationwide
Course: Medical-Surgical Nursing (Med-Surg) I & II
Textbook Reference: Lewis / Ignatavicius / Harding / Brunner &
Suddarth
UNIT 1: FOUNDATIONS
Section 1: Medical-Surgical Nursing Concepts (Questions 1-25)
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Question 1
A nurse is caring for a client who is postoperative day 1 following
abdominal surgery. The client reports pain of 7 on a 0-10 scale. Which
intervention should the nurse implement first?
A. Administer prescribed IV opioid analgesic
B. Reposition the client for comfort
C. Assess the surgical incision
D. Document the pain level in the chart
Answer: C. Assess the surgical incision
Rationale: The nursing process begins with assessment. Before
administering pain medication, the nurse should assess the surgical
incision to rule out complications such as infection, dehiscence, or
hematoma that may be causing or contributing to the pain. Assessment is
always the first step before implementing interventions.
Cognitive Level: Application
Nursing Process: Assessment
Client Need: Physiological Integrity
Question 2
A client with heart failure is receiving furosemide (Lasix) 40 mg IV
push. Which assessment finding requires immediate action by the nurse?
A. Urine output of 200 mL over the past 4 hours
B. Serum potassium level of 3.2 mEq/L
C. Blood pressure of 130/80 mmHg
D. Respiratory rate of 18 breaths/min
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Answer: B. Serum potassium level of 3.2 mEq/L
Rationale: Furosemide is a loop diuretic that causes potassium
excretion. A serum potassium of 3.2 mEq/L indicates hypokalemia
(normal 3.5-5.0 mEq/L). Hypokalemia can lead to life-threatening
cardiac dysrhythmias, muscle weakness, and respiratory depression. The
nurse should report this finding immediately and anticipate potassium
replacement.
Cognitive Level: Analysis
Nursing Process: Evaluation
Client Need: Physiological Integrity – Pharmacological Therapies
Question 3
A nurse is providing discharge teaching to a client prescribed warfarin
(Coumadin). Which statement by the client indicates understanding of
the teaching?
A. "I will take aspirin if I get a headache."
B. "I should avoid eating green leafy vegetables."
C. "I need to report any signs of bleeding to my healthcare provider."
D. "I can stop taking this medication if my INR is normal."
Answer: C. "I need to report any signs of bleeding to my healthcare
provider."
Rationale: Warfarin is an anticoagulant that increases the risk of
bleeding. Clients should report any signs of bleeding (bruising, blood in
urine/stool, bleeding gums) immediately. Aspirin should be avoided as it
also affects coagulation. Clients should maintain consistent intake of
vitamin K-rich foods (not avoid them completely). Warfarin should
never be stopped without provider guidance.
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Cognitive Level: Application
Nursing Process: Evaluation
Client Need: Physiological Integrity – Pharmacological Therapies
Question 4
A client with type 2 diabetes mellitus is scheduled for surgery. The
client takes metformin (Glucophage) daily. Which instruction should the
nurse include in preoperative teaching?
A. Take metformin with a sip of water on the morning of surgery
B. Hold metformin 24 hours before surgery
C. Double the dose of metformin the day before surgery
D. Take metformin with a full breakfast before surgery
Answer: B. Hold metformin 24 hours before surgery
Rationale: Metformin should be held 24-48 hours before surgery due to
the risk of lactic acidosis, especially in clients who may develop renal
impairment during surgery. The anesthesiologist and surgeon should be
notified of all medications. Blood glucose will be managed with insulin
during the perioperative period.
Cognitive Level: Application
Nursing Process: Planning
Client Need: Safe and Effective Care Environment – Management of
Care
Question 5
Test Bank for Medical-Surgical Nursing Complete
Practice Questions & Answers with Rationales 500+
Questions Covering All Body Systems | 2025/2026
Updated Edition.
Exam (elaborations)
MEDICAL-SURGICAL NURSING
Complete Test Bank & Practice Questions
500+ NCLEX-Style Questions with Detailed Rationales
2025/2026 | Already Graded A+
Institution: Nursing Programs Nationwide
Course: Medical-Surgical Nursing (Med-Surg) I & II
Textbook Reference: Lewis / Ignatavicius / Harding / Brunner &
Suddarth
UNIT 1: FOUNDATIONS
Section 1: Medical-Surgical Nursing Concepts (Questions 1-25)
,2|Page
Question 1
A nurse is caring for a client who is postoperative day 1 following
abdominal surgery. The client reports pain of 7 on a 0-10 scale. Which
intervention should the nurse implement first?
A. Administer prescribed IV opioid analgesic
B. Reposition the client for comfort
C. Assess the surgical incision
D. Document the pain level in the chart
Answer: C. Assess the surgical incision
Rationale: The nursing process begins with assessment. Before
administering pain medication, the nurse should assess the surgical
incision to rule out complications such as infection, dehiscence, or
hematoma that may be causing or contributing to the pain. Assessment is
always the first step before implementing interventions.
Cognitive Level: Application
Nursing Process: Assessment
Client Need: Physiological Integrity
Question 2
A client with heart failure is receiving furosemide (Lasix) 40 mg IV
push. Which assessment finding requires immediate action by the nurse?
A. Urine output of 200 mL over the past 4 hours
B. Serum potassium level of 3.2 mEq/L
C. Blood pressure of 130/80 mmHg
D. Respiratory rate of 18 breaths/min
,3|Page
Answer: B. Serum potassium level of 3.2 mEq/L
Rationale: Furosemide is a loop diuretic that causes potassium
excretion. A serum potassium of 3.2 mEq/L indicates hypokalemia
(normal 3.5-5.0 mEq/L). Hypokalemia can lead to life-threatening
cardiac dysrhythmias, muscle weakness, and respiratory depression. The
nurse should report this finding immediately and anticipate potassium
replacement.
Cognitive Level: Analysis
Nursing Process: Evaluation
Client Need: Physiological Integrity – Pharmacological Therapies
Question 3
A nurse is providing discharge teaching to a client prescribed warfarin
(Coumadin). Which statement by the client indicates understanding of
the teaching?
A. "I will take aspirin if I get a headache."
B. "I should avoid eating green leafy vegetables."
C. "I need to report any signs of bleeding to my healthcare provider."
D. "I can stop taking this medication if my INR is normal."
Answer: C. "I need to report any signs of bleeding to my healthcare
provider."
Rationale: Warfarin is an anticoagulant that increases the risk of
bleeding. Clients should report any signs of bleeding (bruising, blood in
urine/stool, bleeding gums) immediately. Aspirin should be avoided as it
also affects coagulation. Clients should maintain consistent intake of
vitamin K-rich foods (not avoid them completely). Warfarin should
never be stopped without provider guidance.
, 4|Page
Cognitive Level: Application
Nursing Process: Evaluation
Client Need: Physiological Integrity – Pharmacological Therapies
Question 4
A client with type 2 diabetes mellitus is scheduled for surgery. The
client takes metformin (Glucophage) daily. Which instruction should the
nurse include in preoperative teaching?
A. Take metformin with a sip of water on the morning of surgery
B. Hold metformin 24 hours before surgery
C. Double the dose of metformin the day before surgery
D. Take metformin with a full breakfast before surgery
Answer: B. Hold metformin 24 hours before surgery
Rationale: Metformin should be held 24-48 hours before surgery due to
the risk of lactic acidosis, especially in clients who may develop renal
impairment during surgery. The anesthesiologist and surgeon should be
notified of all medications. Blood glucose will be managed with insulin
during the perioperative period.
Cognitive Level: Application
Nursing Process: Planning
Client Need: Safe and Effective Care Environment – Management of
Care
Question 5
