MEDICAL-SURGICAL NURSING
13th Edition–Aligned Practice Question Bank | Volume 1 — Foundational Release
Original NCLEX-RN & NGN-Style Questions, Clinical Judgment Cases, Rationales & Exam Strategies
Student Edition | Independently Created Educational Resource
Independently Created Educational Resource
This is an independently created study resource. It is not affiliated with, sponsored by, endorsed by, or published by Elsevier or the
authors of Lewis's Medical-Surgical Nursing. All questions, rationales, and explanations in this resource are original.
Front Matter
Copyright Notice
© 2026 [Author/Seller Name]. This is an original work. All questions, scenarios, rationales, review content, and study plans in
this document were independently authored and are not reproductions of any publisher's test bank, study guide, or copyrighted
material.
Disclaimer
This resource is an independently created educational study aid aligned with the publicly available table of contents of Lewis's
Medical-Surgical Nursing, 13th Edition. It is not affiliated with, sponsored by, endorsed by, or published by Elsevier or the
authors of that textbook. It is not an official test bank. Content is intended to supplement, not replace, course materials, faculty
instruction, and clinical judgment. Always verify clinical information against current facility policy and primary literature.
How to Use This Question Bank
Work through questions by content area, reading the full rationale — including why each distractor is wrong — even when you
answer correctly. Use the Rapid Review sections after each content block to reinforce high-yield concepts, and revisit the NGN
case study to practice the full clinical judgment cycle: recognize cues, analyze cues, prioritize hypotheses, generate solutions,
take action, and evaluate outcomes.
Study Strategy
• Study in short, focused blocks (25–45 minutes) with deliberate review of rationales.
• Track your accuracy by content area and cognitive level to target weak spots.
• Prioritize prioritization/delegation/clinical-judgment questions — these mirror current exam formats most closely.
• Revisit missed questions after 48–72 hours to reinforce retention.
30-Day Lewis 13e Review Plan (Overview)
This overview plan pairs with the full content map. Each week targets a cluster of body systems, alternating new content with
cumulative review and timed practice.
• Week 1: Foundations, perioperative care, fluid/electrolyte & acid-base, cardiovascular — 15–20 questions/day plus daily
rationale review.
• Week 2: Respiratory, gastrointestinal, renal/urinary — new content days alternate with a cumulative review day.
• Week 3: Endocrine/diabetes, neurologic/stroke, musculoskeletal — include the NGN case study for integrated practice.
Medical-Surgical Nursing Practice Question Bank — Vol. 1 Page 1 of 23
, • Week 4: Oncology, hematology, immune, infectious disease, gerontologic and safety/prioritization content, then a full
cumulative practice exam.
14-Day Intensive Exam Plan (Overview)
Compresses the same content into two systems per day with a nightly timed mini-quiz, reserving the final two days for a full-
length comprehensive exam and rationale review.
7-Day Final Review Plan (Overview)
Rapid Review sections only, one comprehensive exam split across two sittings, and targeted re-study of any content area
scoring below 80%.
Content Blueprint
This question bank is organized around the major content areas of Lewis's Medical-Surgical Nursing, 13th Edition, using its
publicly available table-of-contents structure as an organizing framework only. Concepts are cross-linked across systems where
clinically appropriate (e.g., a sepsis question may touch cardiovascular, renal, and immune content).
• Professional Nursing & Social Determinants of Health
• Health History and Physical Examination
• Patient and Caregiver Teaching
• Perioperative Care
• Pain Management
• Fluid, Electrolyte, and Acid-Base Imbalances
• Shock, Sepsis, and Multi-Organ Dysfunction
• Cardiovascular Assessment and Disorders
• Respiratory Assessment and Disorders
• Gastrointestinal Problems
• Urinary and Renal Disorders
• Endocrine Disorders and Diabetes
• Reproductive Disorders
• Neurologic Disorders and Stroke
• Dementia and Delirium
• Spinal Cord and Peripheral Nerve Disorders
• Musculoskeletal Trauma and Orthopedic Surgery
• Arthritis and Connective Tissue Disease
• Oncology
• Hematology
• Immune Disorders
• Infectious Diseases
• Emergency and Critical Care Concepts
• Gerontologic Considerations
• Patient Safety, Clinical Judgment, Prioritization, and Delegation
Medical-Surgical Nursing Practice Question Bank — Vol. 1 Page 2 of 23
, Question-Design Distribution (Target)
• Knowledge/Understanding — 20%
• Application — 25%
• Analysis — 25%
• Clinical Judgment / Prioritization — 20%
• Complex NGN-Style Reasoning — 10%
Difficulty Calibration (Target)
• 🟢 Easy — 15%
• 🟡 Moderate — 40%
• 🟠 Difficult — 35%
• 🔴 Very Difficult — 10%
Volume Roadmap
Volume 1 (this document) establishes the framework and delivers an initial set of fully original, quality-controlled questions
spanning every major body system, plus one complete NGN case study and a Rapid Review model. Volumes 2–4 (available as
a continuation) expand each content area to full depth, add the remaining NGN cases, and build toward the 500-question target
and three 75-question comprehensive exams plus a comprehensive NGN exam, following the same numbering registry so no
question is duplicated across volumes.
Volume 1: Practice Questions (Q1–21)
Answer this section first without checking answers. Full rationales, distractor explanations, Clinical Pearls, Test-Taking Tips,
and tags for every question are collected together in the Answer Key & Explanations section at the end of this document.
Question 1
A nurse is caring for four clients on a medical-surgical unit. Which client should the nurse assess first?
A. A client 2 days post-op abdominal surgery reporting incisional pain rated 5/10
B. A client with heart failure who has new-onset crackles bilaterally and increasing dyspnea
C. A client with a fractured hip requesting pain medication before physical therapy
D. A client with cellulitis whose temperature is 100.8°F (38.2°C)
Question 2
A client with an acute myocardial infarction is receiving intravenous nitroglycerin. Which finding requires the nurse to
stop the infusion and notify the provider?
A. Heart rate of 88 beats/min
B. Blood pressure of 82/50 mm Hg
C. Report of mild headache
D. Chest pain decreased from 6/10 to 2/10
Medical-Surgical Nursing Practice Question Bank — Vol. 1 Page 3 of 23
13th Edition–Aligned Practice Question Bank | Volume 1 — Foundational Release
Original NCLEX-RN & NGN-Style Questions, Clinical Judgment Cases, Rationales & Exam Strategies
Student Edition | Independently Created Educational Resource
Independently Created Educational Resource
This is an independently created study resource. It is not affiliated with, sponsored by, endorsed by, or published by Elsevier or the
authors of Lewis's Medical-Surgical Nursing. All questions, rationales, and explanations in this resource are original.
Front Matter
Copyright Notice
© 2026 [Author/Seller Name]. This is an original work. All questions, scenarios, rationales, review content, and study plans in
this document were independently authored and are not reproductions of any publisher's test bank, study guide, or copyrighted
material.
Disclaimer
This resource is an independently created educational study aid aligned with the publicly available table of contents of Lewis's
Medical-Surgical Nursing, 13th Edition. It is not affiliated with, sponsored by, endorsed by, or published by Elsevier or the
authors of that textbook. It is not an official test bank. Content is intended to supplement, not replace, course materials, faculty
instruction, and clinical judgment. Always verify clinical information against current facility policy and primary literature.
How to Use This Question Bank
Work through questions by content area, reading the full rationale — including why each distractor is wrong — even when you
answer correctly. Use the Rapid Review sections after each content block to reinforce high-yield concepts, and revisit the NGN
case study to practice the full clinical judgment cycle: recognize cues, analyze cues, prioritize hypotheses, generate solutions,
take action, and evaluate outcomes.
Study Strategy
• Study in short, focused blocks (25–45 minutes) with deliberate review of rationales.
• Track your accuracy by content area and cognitive level to target weak spots.
• Prioritize prioritization/delegation/clinical-judgment questions — these mirror current exam formats most closely.
• Revisit missed questions after 48–72 hours to reinforce retention.
30-Day Lewis 13e Review Plan (Overview)
This overview plan pairs with the full content map. Each week targets a cluster of body systems, alternating new content with
cumulative review and timed practice.
• Week 1: Foundations, perioperative care, fluid/electrolyte & acid-base, cardiovascular — 15–20 questions/day plus daily
rationale review.
• Week 2: Respiratory, gastrointestinal, renal/urinary — new content days alternate with a cumulative review day.
• Week 3: Endocrine/diabetes, neurologic/stroke, musculoskeletal — include the NGN case study for integrated practice.
Medical-Surgical Nursing Practice Question Bank — Vol. 1 Page 1 of 23
, • Week 4: Oncology, hematology, immune, infectious disease, gerontologic and safety/prioritization content, then a full
cumulative practice exam.
14-Day Intensive Exam Plan (Overview)
Compresses the same content into two systems per day with a nightly timed mini-quiz, reserving the final two days for a full-
length comprehensive exam and rationale review.
7-Day Final Review Plan (Overview)
Rapid Review sections only, one comprehensive exam split across two sittings, and targeted re-study of any content area
scoring below 80%.
Content Blueprint
This question bank is organized around the major content areas of Lewis's Medical-Surgical Nursing, 13th Edition, using its
publicly available table-of-contents structure as an organizing framework only. Concepts are cross-linked across systems where
clinically appropriate (e.g., a sepsis question may touch cardiovascular, renal, and immune content).
• Professional Nursing & Social Determinants of Health
• Health History and Physical Examination
• Patient and Caregiver Teaching
• Perioperative Care
• Pain Management
• Fluid, Electrolyte, and Acid-Base Imbalances
• Shock, Sepsis, and Multi-Organ Dysfunction
• Cardiovascular Assessment and Disorders
• Respiratory Assessment and Disorders
• Gastrointestinal Problems
• Urinary and Renal Disorders
• Endocrine Disorders and Diabetes
• Reproductive Disorders
• Neurologic Disorders and Stroke
• Dementia and Delirium
• Spinal Cord and Peripheral Nerve Disorders
• Musculoskeletal Trauma and Orthopedic Surgery
• Arthritis and Connective Tissue Disease
• Oncology
• Hematology
• Immune Disorders
• Infectious Diseases
• Emergency and Critical Care Concepts
• Gerontologic Considerations
• Patient Safety, Clinical Judgment, Prioritization, and Delegation
Medical-Surgical Nursing Practice Question Bank — Vol. 1 Page 2 of 23
, Question-Design Distribution (Target)
• Knowledge/Understanding — 20%
• Application — 25%
• Analysis — 25%
• Clinical Judgment / Prioritization — 20%
• Complex NGN-Style Reasoning — 10%
Difficulty Calibration (Target)
• 🟢 Easy — 15%
• 🟡 Moderate — 40%
• 🟠 Difficult — 35%
• 🔴 Very Difficult — 10%
Volume Roadmap
Volume 1 (this document) establishes the framework and delivers an initial set of fully original, quality-controlled questions
spanning every major body system, plus one complete NGN case study and a Rapid Review model. Volumes 2–4 (available as
a continuation) expand each content area to full depth, add the remaining NGN cases, and build toward the 500-question target
and three 75-question comprehensive exams plus a comprehensive NGN exam, following the same numbering registry so no
question is duplicated across volumes.
Volume 1: Practice Questions (Q1–21)
Answer this section first without checking answers. Full rationales, distractor explanations, Clinical Pearls, Test-Taking Tips,
and tags for every question are collected together in the Answer Key & Explanations section at the end of this document.
Question 1
A nurse is caring for four clients on a medical-surgical unit. Which client should the nurse assess first?
A. A client 2 days post-op abdominal surgery reporting incisional pain rated 5/10
B. A client with heart failure who has new-onset crackles bilaterally and increasing dyspnea
C. A client with a fractured hip requesting pain medication before physical therapy
D. A client with cellulitis whose temperature is 100.8°F (38.2°C)
Question 2
A client with an acute myocardial infarction is receiving intravenous nitroglycerin. Which finding requires the nurse to
stop the infusion and notify the provider?
A. Heart rate of 88 beats/min
B. Blood pressure of 82/50 mm Hg
C. Report of mild headache
D. Chest pain decreased from 6/10 to 2/10
Medical-Surgical Nursing Practice Question Bank — Vol. 1 Page 3 of 23
