, NCLEX-STYLE SAMPLE questions
Medical-Surgical Nursing
100 Questions with Answers and Rationales
INSTRUCTIONS:
This exam contains 100 questions
Questions include multiple choice and true/false formats
Select the one best answer for each question
Read each rationale carefully to understand the correct answer
Questions 1-20: Fundamentals and Perioperative Care
1. A nurse is assessing a postoperative patient's surgical incision on day
3. Which finding indicates normal healing?
A) Purulent drainage from the incision site
B) Edges well-approximated with slight redness at margins
C) Wound edges separated with visible underlying tissue
D) Large amount of bright red blood on the dressing
,Answer: B
Rationale: Slight redness at wound margins is a normal part of inflammation.
Purulent drainage (A) indicates infection. Wound separation (C) indicates
dehiscence. Bright red blood (D) indicates hemorrhage.
2. True or False: The nurse should auscultate the abdomen before
palpation and percussion to avoid altering bowel sounds.
A) True
B) False
Answer: A (True)
Rationale: Abdominal assessment should be performed in the order of
inspection, auscultation, percussion, and then palpation. Auscultation is
performed before palpation and percussion because these maneuvers can
alter bowel sounds.
3. A patient who had surgery 6 hours ago reports pain at the surgical site
rated 7 on a 0-10 scale. Based on the pain pathway, the nurse
understands that this pain is:
A) Neuropathic pain from nerve damage
B) Nociceptive pain from tissue injury
,C) Nociplastic pain without clear tissue damage
D) Psychogenic pain with no physical cause
Answer: B
Rationale: Postoperative pain is nociceptive pain resulting from tissue injury
and activation of nociceptors. Neuropathic pain (A) results from nerve
damage. Nociplastic pain (C) occurs without clear tissue or nerve damage.
Psychogenic pain (D) is not a standard classification.
4. The nurse is teaching a patient about deep breathing exercises before
surgery. Which statement indicates understanding?
A) "I should take shallow breaths to avoid pain."
B) "I will take slow, deep breaths and hold for a few seconds."
C) "Deep breathing is only needed after surgery."
D) "I should cough as hard as I can immediately after breathing."
Answer: B
Rationale: Deep breathing involves slow, deep breaths with a brief hold to
expand alveoli. Shallow breaths (A) do not prevent atelectasis. Preoperative
teaching (C) should occur before surgery. Coughing (D) is done after deep
breathing but not immediately.
,5. True or False: A patient receiving warfarin (Coumadin) should
maintain a consistent intake of vitamin K-containing foods.
A) True
B) False
Answer: A (True)
Rationale: Consistent vitamin K intake is important for stable INR. Patients
should not avoid vitamin K entirely but should keep intake consistent from
week to week.
6. The nurse is caring for a patient receiving patient-controlled analgesia
(PCA). Which statement indicates the patient understands PCA use?
A) "I should wait until the pain is severe before pressing the button."
B) "My family can press the button if I'm sleeping and they think I need
medication."
C) "I can press the button as often as I feel I need pain medication."
D) "The machine will deliver medication continuously whether I press the
button or not."
Answer: C
Rationale: PCA allows patients to self-administer pain medication within
programmed limits when they feel the need. Option A is incorrect—PCA is
most effective for preventing severe pain. Option B is dangerous—only the
,patient should press the button. Option D describes continuous infusion, not
PCA.
7. The nurse is assessing a patient for orthostatic hypotension. Which
technique is correct?
A) Measure blood pressure with the patient supine, then immediately upon
standing
B) Measure blood pressure only while the patient is sitting
C) Wait 5 minutes between supine and standing measurements
D) Measure blood pressure after the patient has been walking for 5 minutes
Answer: A
Rationale: Orthostatic hypotension is assessed by measuring BP and pulse
supine, then immediately upon standing (and again at 3 minutes). Option B
would miss the change. Option C is too long. Option D assesses exercise
response.
8. True or False: Informed consent for a surgical procedure requires the
nurse to explain the procedure details and risks to the patient.
A) True
B) False
,Answer: B (False)
Rationale: The surgeon is responsible for explaining the procedure, risks,
benefits, and alternatives. The nurse's role is to witness the signature, verify
that consent was obtained voluntarily, and ensure the patient appears to
understand.
9. The nurse is calculating intake and output for a patient. Which
measurement is considered output?
A) Oral fluids
B) IV fluids
C) Tube feedings
D) Emesis
Answer: D
Rationale: Emesis (vomitus) is output. Oral fluids (A), IV fluids (B), and tube
feedings (C) are all intake.
10. A patient with a new colostomy asks the nurse about diet. Which food
is most likely to cause odor and gas?
A) Yogurt
B) Cranberry juice
,C) Eggs and onions
D) White bread
Answer: C
Rationale: Eggs and onions are known to cause increased odor and gas in
ostomy output. Yogurt (A) and cranberry juice (B) may help decrease odor.
White bread (D) is less likely to cause gas.
11. The nurse is assessing a patient's level of consciousness using the
Glasgow Coma Scale (GCS). The patient opens eyes to painful stimulus,
utters incomprehensible sounds, and withdraws from pain. What is the
GCS score?
A) 6
B) 8
C) 10
D) 12
Answer: B
Rationale: GCS scoring: Eye opening to pain = 2; Verbal—incomprehensible
sounds = 2; Motor—withdrawal = 4. Total = 2+2+4 = 8. This indicates severe
neurologic impairment.
,12. True or False: The nurse should place a patient who has had a
lumbar puncture in a flat position to prevent headache.
A) True
B) False
Answer: A (True)
Rationale: Lying flat after lumbar puncture helps prevent CSF leakage and
post-dural puncture headache.
13. A patient with a fractured femur suddenly develops dyspnea, chest
pain, and petechiae on the chest. The nurse should suspect:
A) Pulmonary embolism
B) Fat embolism syndrome
C) Myocardial infarction
D) Pneumonia
Answer: B
Rationale: Fat embolism syndrome (from long bone fractures) presents with
dyspnea, chest pain, petechial rash (chest, axillae), and neurologic changes.
Pulmonary embolism (A) causes dyspnea but not petechiae. MI (C) causes
chest pain but not petechiae. Pneumonia (D) causes fever, cough.
, 14. The nurse is teaching a patient with a new below-knee amputation
about stump care. Which instruction is correct?
A) "Elevate the stump on pillows continuously to reduce swelling."
B) "Keep the stump in a flexed position to prevent contractures."
C) "Lie prone several times daily to prevent hip flexion contractures."
D) "Apply ice to the stump daily."
Answer: C
Rationale: Prone positioning prevents hip flexion contractures after BKA.
Elevation (A) is for first 24 hours only; prolonged elevation causes flexion
contracture. Flexion (B) promotes contractures. Ice (D) may be used initially
but not daily.
15. True or False: A patient with a C5 spinal cord injury can be expected
to have normal cough effectiveness.
A) True
B) False
Answer: B (False)
Rationale: C5 injury affects intercostals and abdominal muscles, impairing
cough effectiveness. Patients may need assisted coughing (quad cough).
Medical-Surgical Nursing
100 Questions with Answers and Rationales
INSTRUCTIONS:
This exam contains 100 questions
Questions include multiple choice and true/false formats
Select the one best answer for each question
Read each rationale carefully to understand the correct answer
Questions 1-20: Fundamentals and Perioperative Care
1. A nurse is assessing a postoperative patient's surgical incision on day
3. Which finding indicates normal healing?
A) Purulent drainage from the incision site
B) Edges well-approximated with slight redness at margins
C) Wound edges separated with visible underlying tissue
D) Large amount of bright red blood on the dressing
,Answer: B
Rationale: Slight redness at wound margins is a normal part of inflammation.
Purulent drainage (A) indicates infection. Wound separation (C) indicates
dehiscence. Bright red blood (D) indicates hemorrhage.
2. True or False: The nurse should auscultate the abdomen before
palpation and percussion to avoid altering bowel sounds.
A) True
B) False
Answer: A (True)
Rationale: Abdominal assessment should be performed in the order of
inspection, auscultation, percussion, and then palpation. Auscultation is
performed before palpation and percussion because these maneuvers can
alter bowel sounds.
3. A patient who had surgery 6 hours ago reports pain at the surgical site
rated 7 on a 0-10 scale. Based on the pain pathway, the nurse
understands that this pain is:
A) Neuropathic pain from nerve damage
B) Nociceptive pain from tissue injury
,C) Nociplastic pain without clear tissue damage
D) Psychogenic pain with no physical cause
Answer: B
Rationale: Postoperative pain is nociceptive pain resulting from tissue injury
and activation of nociceptors. Neuropathic pain (A) results from nerve
damage. Nociplastic pain (C) occurs without clear tissue or nerve damage.
Psychogenic pain (D) is not a standard classification.
4. The nurse is teaching a patient about deep breathing exercises before
surgery. Which statement indicates understanding?
A) "I should take shallow breaths to avoid pain."
B) "I will take slow, deep breaths and hold for a few seconds."
C) "Deep breathing is only needed after surgery."
D) "I should cough as hard as I can immediately after breathing."
Answer: B
Rationale: Deep breathing involves slow, deep breaths with a brief hold to
expand alveoli. Shallow breaths (A) do not prevent atelectasis. Preoperative
teaching (C) should occur before surgery. Coughing (D) is done after deep
breathing but not immediately.
,5. True or False: A patient receiving warfarin (Coumadin) should
maintain a consistent intake of vitamin K-containing foods.
A) True
B) False
Answer: A (True)
Rationale: Consistent vitamin K intake is important for stable INR. Patients
should not avoid vitamin K entirely but should keep intake consistent from
week to week.
6. The nurse is caring for a patient receiving patient-controlled analgesia
(PCA). Which statement indicates the patient understands PCA use?
A) "I should wait until the pain is severe before pressing the button."
B) "My family can press the button if I'm sleeping and they think I need
medication."
C) "I can press the button as often as I feel I need pain medication."
D) "The machine will deliver medication continuously whether I press the
button or not."
Answer: C
Rationale: PCA allows patients to self-administer pain medication within
programmed limits when they feel the need. Option A is incorrect—PCA is
most effective for preventing severe pain. Option B is dangerous—only the
,patient should press the button. Option D describes continuous infusion, not
PCA.
7. The nurse is assessing a patient for orthostatic hypotension. Which
technique is correct?
A) Measure blood pressure with the patient supine, then immediately upon
standing
B) Measure blood pressure only while the patient is sitting
C) Wait 5 minutes between supine and standing measurements
D) Measure blood pressure after the patient has been walking for 5 minutes
Answer: A
Rationale: Orthostatic hypotension is assessed by measuring BP and pulse
supine, then immediately upon standing (and again at 3 minutes). Option B
would miss the change. Option C is too long. Option D assesses exercise
response.
8. True or False: Informed consent for a surgical procedure requires the
nurse to explain the procedure details and risks to the patient.
A) True
B) False
,Answer: B (False)
Rationale: The surgeon is responsible for explaining the procedure, risks,
benefits, and alternatives. The nurse's role is to witness the signature, verify
that consent was obtained voluntarily, and ensure the patient appears to
understand.
9. The nurse is calculating intake and output for a patient. Which
measurement is considered output?
A) Oral fluids
B) IV fluids
C) Tube feedings
D) Emesis
Answer: D
Rationale: Emesis (vomitus) is output. Oral fluids (A), IV fluids (B), and tube
feedings (C) are all intake.
10. A patient with a new colostomy asks the nurse about diet. Which food
is most likely to cause odor and gas?
A) Yogurt
B) Cranberry juice
,C) Eggs and onions
D) White bread
Answer: C
Rationale: Eggs and onions are known to cause increased odor and gas in
ostomy output. Yogurt (A) and cranberry juice (B) may help decrease odor.
White bread (D) is less likely to cause gas.
11. The nurse is assessing a patient's level of consciousness using the
Glasgow Coma Scale (GCS). The patient opens eyes to painful stimulus,
utters incomprehensible sounds, and withdraws from pain. What is the
GCS score?
A) 6
B) 8
C) 10
D) 12
Answer: B
Rationale: GCS scoring: Eye opening to pain = 2; Verbal—incomprehensible
sounds = 2; Motor—withdrawal = 4. Total = 2+2+4 = 8. This indicates severe
neurologic impairment.
,12. True or False: The nurse should place a patient who has had a
lumbar puncture in a flat position to prevent headache.
A) True
B) False
Answer: A (True)
Rationale: Lying flat after lumbar puncture helps prevent CSF leakage and
post-dural puncture headache.
13. A patient with a fractured femur suddenly develops dyspnea, chest
pain, and petechiae on the chest. The nurse should suspect:
A) Pulmonary embolism
B) Fat embolism syndrome
C) Myocardial infarction
D) Pneumonia
Answer: B
Rationale: Fat embolism syndrome (from long bone fractures) presents with
dyspnea, chest pain, petechial rash (chest, axillae), and neurologic changes.
Pulmonary embolism (A) causes dyspnea but not petechiae. MI (C) causes
chest pain but not petechiae. Pneumonia (D) causes fever, cough.
, 14. The nurse is teaching a patient with a new below-knee amputation
about stump care. Which instruction is correct?
A) "Elevate the stump on pillows continuously to reduce swelling."
B) "Keep the stump in a flexed position to prevent contractures."
C) "Lie prone several times daily to prevent hip flexion contractures."
D) "Apply ice to the stump daily."
Answer: C
Rationale: Prone positioning prevents hip flexion contractures after BKA.
Elevation (A) is for first 24 hours only; prolonged elevation causes flexion
contracture. Flexion (B) promotes contractures. Ice (D) may be used initially
but not daily.
15. True or False: A patient with a C5 spinal cord injury can be expected
to have normal cough effectiveness.
A) True
B) False
Answer: B (False)
Rationale: C5 injury affects intercostals and abdominal muscles, impairing
cough effectiveness. Patients may need assisted coughing (quad cough).
