1
Page | 1
200 NCLEX Med-Surg Questions with
Rationales | Lewis 12th Edition (2025–2026
Updated)
1.
The nurse completes an admission database and explains that the plan of care and discharge
goals will be developed with the patient’s input. The patient asks, “How is this different from
what the physician does?”
Which response would the nurse provide?
a. “The role of the nurse is to administer medications and other treatments prescribed by your
physician.”
b. “In addition to caring for you while you are sick, the nurses will help you plan to maintain
your health.” ✅
c. “The nurse’s job is to collect information and communicate any problems that occur to the
physician.”
d. “Nurses perform many of the same procedures as the physician, but nurses are with the
patients for a longer time than the physician.”
, 2
Answer: B
Rationale: The ANA describes nursing as focused on health promotion and maintenance, not
just treatment. Option B reflects this.
Page | 2
DIF: Analyze (Analysis)
TOP: Nursing Process: Implementation
MSC: NCLEX: Safe and Effective Care Environment
2.
A patient with type 2 diabetes is scheduled for surgery. The nurse instructs the patient to
continue taking metformin as prescribed. What is the most appropriate nursing action?
a. Confirm with the provider about withholding the drug before surgery. ✅
b. Administer the medication with a full glass of water.
c. Instruct the patient to take the drug after surgery instead.
d. Explain that metformin has no effect on surgical procedures.
Answer: A
Rationale: Metformin may increase the risk of lactic acidosis with contrast or anesthesia; the
provider should decide whether to continue.
DIF: Apply (Application)
TOP: Preoperative Care
MSC: NCLEX: Physiological Integrity
, 3
3.
Which information obtained by the nurse when assessing a patient with chronic obstructive
Page | 3 pulmonary disease (COPD) supports the diagnosis?
a. The patient reports a 10-pound weight gain.
b. The patient reports a cough that is worse in the morning. ✅
c. The patient denies smoking.
d. The patient complains of ankle swelling.
Answer: B
Rationale: Chronic bronchitis, a form of COPD, is characterized by a chronic productive
cough, often worse in the morning.
DIF: Understand (Comprehension)
TOP: Assessment
MSC: NCLEX: Physiological Adaptation
4.
A nurse is teaching a patient how to use a metered-dose inhaler (MDI). Which action
indicates that further teaching is required?
a. The patient exhales slowly after inhaling the medication.
b. The patient holds their breath for 10 seconds after inhalation.
c. The patient activates the inhaler after starting to inhale.
d. The patient inhales quickly and deeply while pressing the canister. ✅
, 4
Answer: D
Rationale: Inhalation should be slow and deep, not fast. Fast inhalation reduces drug
deposition in the lungs.
Page | 4
DIF: Apply (Application)
TOP: Patient Teaching
MSC: NCLEX: Health Promotion and Maintenance
5.
A nurse is caring for a client who is 2 days postoperative following abdominal surgery and
reports feeling "something popped." What is the nurse’s priority action?
a. Cover the wound with a sterile, saline-soaked dressing. ✅
b. Document the finding in the medical record.
c. Notify the charge nurse.
d. Apply a warm compress.
Answer: A
Rationale: A popping sensation may indicate wound dehiscence or evisceration; a sterile
moist dressing protects the organs until help arrives.
DIF: Analyze (Analysis)
TOP: Emergency Care
MSC: NCLEX: Safe and Effective Care Environment
Page | 1
200 NCLEX Med-Surg Questions with
Rationales | Lewis 12th Edition (2025–2026
Updated)
1.
The nurse completes an admission database and explains that the plan of care and discharge
goals will be developed with the patient’s input. The patient asks, “How is this different from
what the physician does?”
Which response would the nurse provide?
a. “The role of the nurse is to administer medications and other treatments prescribed by your
physician.”
b. “In addition to caring for you while you are sick, the nurses will help you plan to maintain
your health.” ✅
c. “The nurse’s job is to collect information and communicate any problems that occur to the
physician.”
d. “Nurses perform many of the same procedures as the physician, but nurses are with the
patients for a longer time than the physician.”
, 2
Answer: B
Rationale: The ANA describes nursing as focused on health promotion and maintenance, not
just treatment. Option B reflects this.
Page | 2
DIF: Analyze (Analysis)
TOP: Nursing Process: Implementation
MSC: NCLEX: Safe and Effective Care Environment
2.
A patient with type 2 diabetes is scheduled for surgery. The nurse instructs the patient to
continue taking metformin as prescribed. What is the most appropriate nursing action?
a. Confirm with the provider about withholding the drug before surgery. ✅
b. Administer the medication with a full glass of water.
c. Instruct the patient to take the drug after surgery instead.
d. Explain that metformin has no effect on surgical procedures.
Answer: A
Rationale: Metformin may increase the risk of lactic acidosis with contrast or anesthesia; the
provider should decide whether to continue.
DIF: Apply (Application)
TOP: Preoperative Care
MSC: NCLEX: Physiological Integrity
, 3
3.
Which information obtained by the nurse when assessing a patient with chronic obstructive
Page | 3 pulmonary disease (COPD) supports the diagnosis?
a. The patient reports a 10-pound weight gain.
b. The patient reports a cough that is worse in the morning. ✅
c. The patient denies smoking.
d. The patient complains of ankle swelling.
Answer: B
Rationale: Chronic bronchitis, a form of COPD, is characterized by a chronic productive
cough, often worse in the morning.
DIF: Understand (Comprehension)
TOP: Assessment
MSC: NCLEX: Physiological Adaptation
4.
A nurse is teaching a patient how to use a metered-dose inhaler (MDI). Which action
indicates that further teaching is required?
a. The patient exhales slowly after inhaling the medication.
b. The patient holds their breath for 10 seconds after inhalation.
c. The patient activates the inhaler after starting to inhale.
d. The patient inhales quickly and deeply while pressing the canister. ✅
, 4
Answer: D
Rationale: Inhalation should be slow and deep, not fast. Fast inhalation reduces drug
deposition in the lungs.
Page | 4
DIF: Apply (Application)
TOP: Patient Teaching
MSC: NCLEX: Health Promotion and Maintenance
5.
A nurse is caring for a client who is 2 days postoperative following abdominal surgery and
reports feeling "something popped." What is the nurse’s priority action?
a. Cover the wound with a sterile, saline-soaked dressing. ✅
b. Document the finding in the medical record.
c. Notify the charge nurse.
d. Apply a warm compress.
Answer: A
Rationale: A popping sensation may indicate wound dehiscence or evisceration; a sterile
moist dressing protects the organs until help arrives.
DIF: Analyze (Analysis)
TOP: Emergency Care
MSC: NCLEX: Safe and Effective Care Environment
