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# NCLEX Medical-Surgical Nursing Examination
## Form: MS-NCLEX-004 | | Time Limit: 90 Minutes
**1.** A client returns to the unit after a **lumbar puncture**. Which complaint requires immediate
action by the nurse?
A. “I have a mild headache when I sit up.”
B. “My lower back feels sore.”
C. “I feel nauseated and am vomiting.”
D. “I have clear drainage coming from the puncture site.”
**2.** The nurse is caring for a client **during hemodialysis** who suddenly becomes confused,
hypotensive, and complains of “difficulty breathing.” The nurse notes the venous line has air bubbles.
What is the priority action?
A. Increase the blood flow rate.
B. Place the client in Trendelenburg position.
C. Clamp the venous line and turn the client on the left side.
D. Administer a 500 mL normal saline bolus.
**3.** A client is **post-cardiac catheterization** via the right femoral artery. Which assessment
finding is most concerning?
A. Right foot is warm and pink.
B. Pedal pulse is 2+ bilaterally.
C. The right groin has a small, non-expanding hematoma.
D. The client reports “numbness and tingling” in the right foot.
**4.** A client with a new **AV fistula** asks, “How will I know if my fistula is working correctly?”
Which response by the nurse is correct? *(Select all that apply)*
A. “You should feel a buzzing vibration called a thrill.”
, B. “You should hear a whooshing sound with a stethoscope.”
C. “The arm will feel cold and pale.”
D. “You should check it every day.”
E. “You can have blood pressures taken on that arm.”
**5.** The nurse is assisting with **CRRT (continuous renal replacement therapy)** . The filter pressure
is rising steadily, and the machine alarms “high access pressure.” What should the nurse do first?
A. Increase the anticoagulant infusion rate.
B. Flush the filter with normal saline.
C. Visually assess the filter and circuit for clots.
D. Document the finding as an expected event.
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### Section 2 – Perioperative Nursing (6–12)
**6.** A client is scheduled for **elective cholecystectomy** and takes **clopidogrel ( Plavix)** daily.
The nurse should anticipate which order?
A. Give the morning dose of Plavix as scheduled.
B. Hold Plavix for 5–7 days prior to surgery.
C. Double the dose of Plavix the day before surgery.
D. Switch Plavix to warfarin 3 days before surgery.
**7.** In the operating room, the **time-out** is performed. Which of the following is **not** a
required element?
A. Correct patient identity.
B. Correct surgical site.
C. Correct procedure.
D. Correct anesthesia start time.
# NCLEX Medical-Surgical Nursing Examination
## Form: MS-NCLEX-004 | | Time Limit: 90 Minutes
**1.** A client returns to the unit after a **lumbar puncture**. Which complaint requires immediate
action by the nurse?
A. “I have a mild headache when I sit up.”
B. “My lower back feels sore.”
C. “I feel nauseated and am vomiting.”
D. “I have clear drainage coming from the puncture site.”
**2.** The nurse is caring for a client **during hemodialysis** who suddenly becomes confused,
hypotensive, and complains of “difficulty breathing.” The nurse notes the venous line has air bubbles.
What is the priority action?
A. Increase the blood flow rate.
B. Place the client in Trendelenburg position.
C. Clamp the venous line and turn the client on the left side.
D. Administer a 500 mL normal saline bolus.
**3.** A client is **post-cardiac catheterization** via the right femoral artery. Which assessment
finding is most concerning?
A. Right foot is warm and pink.
B. Pedal pulse is 2+ bilaterally.
C. The right groin has a small, non-expanding hematoma.
D. The client reports “numbness and tingling” in the right foot.
**4.** A client with a new **AV fistula** asks, “How will I know if my fistula is working correctly?”
Which response by the nurse is correct? *(Select all that apply)*
A. “You should feel a buzzing vibration called a thrill.”
, B. “You should hear a whooshing sound with a stethoscope.”
C. “The arm will feel cold and pale.”
D. “You should check it every day.”
E. “You can have blood pressures taken on that arm.”
**5.** The nurse is assisting with **CRRT (continuous renal replacement therapy)** . The filter pressure
is rising steadily, and the machine alarms “high access pressure.” What should the nurse do first?
A. Increase the anticoagulant infusion rate.
B. Flush the filter with normal saline.
C. Visually assess the filter and circuit for clots.
D. Document the finding as an expected event.
---
### Section 2 – Perioperative Nursing (6–12)
**6.** A client is scheduled for **elective cholecystectomy** and takes **clopidogrel ( Plavix)** daily.
The nurse should anticipate which order?
A. Give the morning dose of Plavix as scheduled.
B. Hold Plavix for 5–7 days prior to surgery.
C. Double the dose of Plavix the day before surgery.
D. Switch Plavix to warfarin 3 days before surgery.
**7.** In the operating room, the **time-out** is performed. Which of the following is **not** a
required element?
A. Correct patient identity.
B. Correct surgical site.
C. Correct procedure.
D. Correct anesthesia start time.
