1
Page | 1
Lewis’s Medical-Surgical Nursing Test
Bank 2025–2026 (12th Edition) | 555
NCLEX-RN/ATI Questions ✅ Verified
Answers
, 2
1. A patient with bacterial infection is hypovolemic due to fever and diaphoresis. Which
expected outcome would the nurse select?
Page | 2 a. Patient has balanced intake and output. ✅✅✅
b. Patient’s bedding is clean and dry.
c. Patient understands need for increased fluids.
d. Patient’s skin remains cool and dry.
RATIONALE: Balanced intake/output gives measurable data showing resolution of
deficient fluid volume.
DIF: Apply
TOP: Planning
MSC: Physiological Integrity
MULTIPLE CHOICE
2. The nurse admits an acutely ill older adult. Which action takes priority?
a. Speak slowly and loudly.
b. Perform physical assessment first. ✅✅✅
c. Ask family members to leave.
d. Obtain detailed medical history.
RATIONALE: Physical assessment should be done first to detect immediate physiologic
changes.
DIF: Apply
TOP: Assessment
MSC: Physiological Integrity
, 3
MULTIPLE CHOICE
Page | 3
3. You’re assigning tasks for the next shift: 3 LPNs, 2 RNs, and 2 nursing assistants on staff.
Which patient is most appropriate for an LPN?
a. 68-year-old on IV antibiotics, pending discharge
b. 25-year-old with new DKA admission
c. 75-year-old with dementia and scheduled tube feedings ✅✅✅
d. 65-year-old needing Foley removal ✅✅✅
RATIONALE: LPNs can manage stable patients like those with dementia or routine catheter
care. Complex cases need RNs.
DIF: Apply
TOP: Assignment/Delegation
MSC: Safe & Effective Care Environment
MULTIPLE CHOICE
4. A nurse caring for a post-op abdominal surgery patient notes decreased bowel sounds and
abdominal distension. What is the nurse’s priority intervention?
a. Administer antiemetic.
b. Encourage oral fluids.
c. Notify the provider. ✅✅✅
d. Offer a laxative.
RATIONALE: These symptoms suggest a potential paralytic ileus, which requires provider
notification.
, 4
DIF: Analyze
TOP: Assessment
MSC: Physiological Integrity
Page | 4
MULTIPLE CHOICE
5. A patient newly diagnosed with hypertension asks why lifestyle changes are necessary.
What is the nurse’s best response?
a. “It’s hospital policy to recommend them.”
b. “They can reduce your need for medication.” ✅✅✅
c. “Because all patients must follow them.”
d. “You’ll still need medication regardless.”
RATIONALE: Lifestyle changes can help reduce blood pressure and potentially decrease
medication dependence.
DIF: Understand
TOP: Teaching
MSC: Health Promotion & Maintenance
MULTIPLE CHOICE
6. A client has a potassium level of 2.8 mEq/L. Which assessment finding requires immediate
intervention?
a. Irregular pulse ✅✅✅
b. Abdominal cramps
Page | 1
Lewis’s Medical-Surgical Nursing Test
Bank 2025–2026 (12th Edition) | 555
NCLEX-RN/ATI Questions ✅ Verified
Answers
, 2
1. A patient with bacterial infection is hypovolemic due to fever and diaphoresis. Which
expected outcome would the nurse select?
Page | 2 a. Patient has balanced intake and output. ✅✅✅
b. Patient’s bedding is clean and dry.
c. Patient understands need for increased fluids.
d. Patient’s skin remains cool and dry.
RATIONALE: Balanced intake/output gives measurable data showing resolution of
deficient fluid volume.
DIF: Apply
TOP: Planning
MSC: Physiological Integrity
MULTIPLE CHOICE
2. The nurse admits an acutely ill older adult. Which action takes priority?
a. Speak slowly and loudly.
b. Perform physical assessment first. ✅✅✅
c. Ask family members to leave.
d. Obtain detailed medical history.
RATIONALE: Physical assessment should be done first to detect immediate physiologic
changes.
DIF: Apply
TOP: Assessment
MSC: Physiological Integrity
, 3
MULTIPLE CHOICE
Page | 3
3. You’re assigning tasks for the next shift: 3 LPNs, 2 RNs, and 2 nursing assistants on staff.
Which patient is most appropriate for an LPN?
a. 68-year-old on IV antibiotics, pending discharge
b. 25-year-old with new DKA admission
c. 75-year-old with dementia and scheduled tube feedings ✅✅✅
d. 65-year-old needing Foley removal ✅✅✅
RATIONALE: LPNs can manage stable patients like those with dementia or routine catheter
care. Complex cases need RNs.
DIF: Apply
TOP: Assignment/Delegation
MSC: Safe & Effective Care Environment
MULTIPLE CHOICE
4. A nurse caring for a post-op abdominal surgery patient notes decreased bowel sounds and
abdominal distension. What is the nurse’s priority intervention?
a. Administer antiemetic.
b. Encourage oral fluids.
c. Notify the provider. ✅✅✅
d. Offer a laxative.
RATIONALE: These symptoms suggest a potential paralytic ileus, which requires provider
notification.
, 4
DIF: Analyze
TOP: Assessment
MSC: Physiological Integrity
Page | 4
MULTIPLE CHOICE
5. A patient newly diagnosed with hypertension asks why lifestyle changes are necessary.
What is the nurse’s best response?
a. “It’s hospital policy to recommend them.”
b. “They can reduce your need for medication.” ✅✅✅
c. “Because all patients must follow them.”
d. “You’ll still need medication regardless.”
RATIONALE: Lifestyle changes can help reduce blood pressure and potentially decrease
medication dependence.
DIF: Understand
TOP: Teaching
MSC: Health Promotion & Maintenance
MULTIPLE CHOICE
6. A client has a potassium level of 2.8 mEq/L. Which assessment finding requires immediate
intervention?
a. Irregular pulse ✅✅✅
b. Abdominal cramps
