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MEDICAL-SURGICAL NURSING -NCLEX-RN
EXAM QUESTIONS (100) WITH LOGICAL
RATIONALES
Nursing / Clinical
Exam coverage:
I. Section 1 (Q1-25): Professional Nursing Concepts &
Ethics - covers patient advocacy, safety culture,
interprofessional collaboration, and health promotion
strategies.
II. Section 2 (Q26-50): Cardiovascular & Respiratory
Disorders - addresses cardiac conditions, shock
management, and respiratory failure.
III. Section 3 (Q51-75): Endocrine, Renal, & Fluid/Electrolyte
Disorders - covers diabetes, electrolyte imbalances, and
renal function.
IV. Section 4 (Q76-100): Neurological, Musculoskeletal, &
Critical Care - includes stroke care, compartment syndrome,
and emergency nursing priorities.
Section 1: Professional Nursing Concepts, Ethics, & Safety
(Questions 1-25)
Question 1: A 45-year-old client with type 2 diabetes asks how
to reduce long-term complications. Which nurse teaching most
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directly reflects evidence-based health-promotion strategies?
A. "Take your medications only when your blood sugar is high."
B. "Incorporate brisk walking for 30 minutes most days and
monitor your blood glucose regularly."
C. "Focus solely on insulin therapy; lifestyle changes are
optional."
D. "Avoid all carbohydrates completely to prevent
complications."
CORRECT: B
RATIONALE: Regular exercise and blood glucose monitoring are
evidence-based health-promotion strategies that reduce
complications and support self-management in type 2 diabetes.
Inconsistent medication use (A) is unsafe, medication alone
without lifestyle modification (C) undermines prevention, and
total carbohydrate avoidance (D) is unrealistic and may cause
nutritional imbalance .
Question 2: A nurse assesses a patient's health using a holistic
model. During a health history, the patient expresses interest in
reducing stress and improving coping. Which nursing
intervention best supports wellness promotion?
A. Provide a list of pharmacologic anxiolytics to discuss with the
doctor.
B. Teach mindfulness breathing techniques and refer to
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counseling.
C. Advise the patient to ignore stress and continue usual
routines.
D. Schedule the patient for frequent lab monitoring.
CORRECT: B
RATIONALE: Teaching coping skills (mindfulness) and arranging
counseling are nonpharmacologic, patient-centered wellness
interventions that promote adaptive coping. Medications may
be needed but initiating pharmacologic options without
behavioral strategies misses the wellness focus. Ignoring stress
is maladaptive, and lab monitoring does not directly address
stress or coping .
Question 3: A hospital unit intends to reduce readmissions for
heart failure. Which nursing-led systems change aligns with
health care delivery influences to improve outcomes?
A. Require patients to call the clinic only if symptoms worsen.
B. Implement standardized discharge teaching, home-health
referrals, and follow-up scheduling.
C. Limit patient education to printed pamphlets at discharge.
D. Increase documentation requirements for nurses without
changing processes.
CORRECT: B
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RATIONALE: Standardized discharge education, coordinated
referrals, and scheduled follow-up address system-level factors
that reduce readmissions and improve continuity of care.
Passive instruction (A) fails to proactively prevent readmissions,
pamphlets alone (C) lack individualized teaching, and increased
documentation without process changes (D) does not address
the root causes of readmissions .
Question 4: Community health data show increased obesity
and type 2 diabetes in working-age adults. Which nursing
initiative best addresses these shifting disease patterns?
A. Offer weekly workplace wellness screenings and lifestyle-
change programs.
B. Focus only on treating acute infections in the clinic.
C. Encourage patients to rely exclusively on pharmacotherapy.
D. Reduce community outreach to concentrate on inpatient
care.
CORRECT: A
RATIONALE: Workplace screenings and lifestyle programs are
primary prevention strategies that target modifiable risk factors
driving rising chronic disease patterns. Acute infection care (B)
does not address chronic disease trends, pharmacotherapy
alone (C) neglects prevention and lifestyle modification, and
MEDICAL-SURGICAL NURSING -NCLEX-RN
EXAM QUESTIONS (100) WITH LOGICAL
RATIONALES
Nursing / Clinical
Exam coverage:
I. Section 1 (Q1-25): Professional Nursing Concepts &
Ethics - covers patient advocacy, safety culture,
interprofessional collaboration, and health promotion
strategies.
II. Section 2 (Q26-50): Cardiovascular & Respiratory
Disorders - addresses cardiac conditions, shock
management, and respiratory failure.
III. Section 3 (Q51-75): Endocrine, Renal, & Fluid/Electrolyte
Disorders - covers diabetes, electrolyte imbalances, and
renal function.
IV. Section 4 (Q76-100): Neurological, Musculoskeletal, &
Critical Care - includes stroke care, compartment syndrome,
and emergency nursing priorities.
Section 1: Professional Nursing Concepts, Ethics, & Safety
(Questions 1-25)
Question 1: A 45-year-old client with type 2 diabetes asks how
to reduce long-term complications. Which nurse teaching most
, Page 2 of 65
directly reflects evidence-based health-promotion strategies?
A. "Take your medications only when your blood sugar is high."
B. "Incorporate brisk walking for 30 minutes most days and
monitor your blood glucose regularly."
C. "Focus solely on insulin therapy; lifestyle changes are
optional."
D. "Avoid all carbohydrates completely to prevent
complications."
CORRECT: B
RATIONALE: Regular exercise and blood glucose monitoring are
evidence-based health-promotion strategies that reduce
complications and support self-management in type 2 diabetes.
Inconsistent medication use (A) is unsafe, medication alone
without lifestyle modification (C) undermines prevention, and
total carbohydrate avoidance (D) is unrealistic and may cause
nutritional imbalance .
Question 2: A nurse assesses a patient's health using a holistic
model. During a health history, the patient expresses interest in
reducing stress and improving coping. Which nursing
intervention best supports wellness promotion?
A. Provide a list of pharmacologic anxiolytics to discuss with the
doctor.
B. Teach mindfulness breathing techniques and refer to
, Page 3 of 65
counseling.
C. Advise the patient to ignore stress and continue usual
routines.
D. Schedule the patient for frequent lab monitoring.
CORRECT: B
RATIONALE: Teaching coping skills (mindfulness) and arranging
counseling are nonpharmacologic, patient-centered wellness
interventions that promote adaptive coping. Medications may
be needed but initiating pharmacologic options without
behavioral strategies misses the wellness focus. Ignoring stress
is maladaptive, and lab monitoring does not directly address
stress or coping .
Question 3: A hospital unit intends to reduce readmissions for
heart failure. Which nursing-led systems change aligns with
health care delivery influences to improve outcomes?
A. Require patients to call the clinic only if symptoms worsen.
B. Implement standardized discharge teaching, home-health
referrals, and follow-up scheduling.
C. Limit patient education to printed pamphlets at discharge.
D. Increase documentation requirements for nurses without
changing processes.
CORRECT: B
, Page 4 of 65
RATIONALE: Standardized discharge education, coordinated
referrals, and scheduled follow-up address system-level factors
that reduce readmissions and improve continuity of care.
Passive instruction (A) fails to proactively prevent readmissions,
pamphlets alone (C) lack individualized teaching, and increased
documentation without process changes (D) does not address
the root causes of readmissions .
Question 4: Community health data show increased obesity
and type 2 diabetes in working-age adults. Which nursing
initiative best addresses these shifting disease patterns?
A. Offer weekly workplace wellness screenings and lifestyle-
change programs.
B. Focus only on treating acute infections in the clinic.
C. Encourage patients to rely exclusively on pharmacotherapy.
D. Reduce community outreach to concentrate on inpatient
care.
CORRECT: A
RATIONALE: Workplace screenings and lifestyle programs are
primary prevention strategies that target modifiable risk factors
driving rising chronic disease patterns. Acute infection care (B)
does not address chronic disease trends, pharmacotherapy
alone (C) neglects prevention and lifestyle modification, and
