Boost your nursing success with this comprehensive study guide and
NCLEX-style prep resource. Master exam practice with these nursing
revision notes and practice questions for student success.
---
## 🏆 Medical-Surgical & Pharmacology Nursing Study Bundle – 2026
Complete Prep Pack | NCLEX-Style Practice Questions
---
**1. A nurse is assessing a client who has been prescribed digoxin. Which of the following findings
indicates a potential adverse effect of this medication?**
A. Heart rate of 68 beats per minute
B. Serum potassium level of 3.8 mEq/L
C. Anorexia and nausea
D. Blood pressure of 120/80 mmHg
💫ANSWER✔️✔️: C
💫RATIONALE✔️✔️: Anorexia and nausea are early signs of digoxin toxicity, a critical concept in nursing
exam prep. Option A is a normal heart rate, B is a normal potassium level, and D is a normal blood
pressure, making them incorrect. This nursing study guide emphasizes monitoring for GI symptoms and
bradycardia as key indicators of digoxin toxicity. For student success, remember that hypokalemia
increases the risk of toxicity, making potassium monitoring essential. These practice questions are
designed to reinforce pharmacology safety and enhance your revision notes for the NCLEX.
**2. A client with heart failure is receiving furosemide. Which laboratory value should the nurse monitor
most closely?**
A. Serum sodium
B. Serum potassium
C. Serum calcium
,D. Serum magnesium
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: Furosemide is a loop diuretic that can cause hypokalemia, a major focus in nursing
exam prep. Option A is incorrect as sodium loss is less common, C and D are not the primary electrolytes
of concern. This study guide highlights that potassium levels must be monitored to prevent cardiac
arrhythmias. Accurate monitoring is crucial for student success in pharmacology and med-surg nursing.
These revision notes emphasize the importance of electrolyte balance in diuretic therapy, a core
component of comprehensive nursing study guides.
**3. A nurse is preparing to administer an enteral feeding through a nasogastric tube. Which action
should the nurse take first?**
A. Flush the tube with 30 mL of water
B. Verify tube placement by aspirating gastric contents
C. Elevate the head of the bed to 30 degrees
D. Check the residual volume
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: Verifying tube placement is the priority to prevent aspiration and ensure safety, a
critical step in nursing exam prep. Option A is done after placement verification, C is important but
secondary, and D is done after verification. This nursing study guide emphasizes patient safety in enteral
feeding procedures. For student success, always confirm placement before any intervention. These
practice questions are fundamental for mastering skills in fundamentals of nursing and critical care.
**4. A client is receiving warfarin therapy. Which dietary change should the nurse instruct the client to
avoid?**
A. Increasing intake of green leafy vegetables
B. Decreasing intake of dairy products
C. Increasing intake of citrus fruits
D. Decreasing intake of red meat
💫ANSWER✔️✔️: A
💫RATIONALE✔️✔️: Green leafy vegetables are high in vitamin K, which antagonizes warfarin's effects, a
key point in nursing exam prep. Option B is incorrect as dairy does not significantly affect warfarin, C is
not a major concern, and D is not relevant. This study guide stresses the importance of consistent
vitamin K intake. Student success depends on understanding drug-nutrient interactions. These revision
notes are essential for pharmacology and med-surg nursing study packs.
,**5. A nurse is assessing a client with chronic obstructive pulmonary disease (COPD). Which finding is
most indicative of an exacerbation?**
A. Decreased respiratory rate
B. Increased oxygen saturation
C. Use of accessory muscles
D. Productive cough with clear sputum
💫ANSWER✔️✔️: C
💫RATIONALE✔️✔️: Use of accessory muscles indicates increased work of breathing and respiratory
distress, a classic sign in nursing exam prep. Option A is incorrect as respiratory rate typically increases,
B is incorrect as saturation decreases, and D is a common symptom but not specific to exacerbation. This
nursing study guide highlights the importance of physical assessment in COPD management. For student
success, recognize early signs of respiratory failure. These practice questions are vital for medical-
surgical nursing revision.
**6. A client prescribed metformin for type 2 diabetes mellitus reports muscle pain and weakness.
Which action should the nurse take?**
A. Administer a dose of insulin
B. Hold the next dose of metformin and notify the healthcare provider
C. Encourage the client to drink more fluids
D. Reassure the client that this is a normal side effect
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: Muscle pain and weakness can indicate lactic acidosis, a rare but serious adverse
effect of metformin, crucial for nursing exam prep. Option A is incorrect as insulin is not the immediate
action, C is supportive but not primary, and D is dangerous. This nursing study guide emphasizes
recognizing signs of lactic acidosis. Student success relies on prompt identification and reporting of
adverse effects. These revision notes are essential for pharmacology and diabetes management.
**7. A nurse is caring for a client post-operative day one following a total hip arthroplasty. Which
position is contraindicated?**
A. Supine with a pillow between the legs
B. Semi-Fowler's position
C. Side-lying on the operative side
, D. Side-lying on the non-operative side with a pillow between the legs
💫ANSWER✔️✔️: C
💫RATIONALE✔️✔️: Side-lying on the operative side can cause dislocation of the hip prosthesis, a major
concern in nursing exam prep. Option A is correct as it maintains abduction, B is safe, and D is safe with
proper support. This study guide emphasizes post-operative precautions to prevent complications. For
student success, remember the principles of hip replacement care. These practice questions are crucial
for orthopedic nursing and medical-surgical study guides.
**8. A nurse is preparing a client for a colonoscopy. Which instruction should the nurse provide
regarding the bowel preparation?**
A. Consume a clear liquid diet for 12 hours before the procedure
B. Drink the entire bowel preparation solution over 2 hours
C. Continue taking oral anticoagulants as prescribed
D. Expect to have clear, yellow-tinged stool before the procedure
💫ANSWER✔️✔️: D
💫RATIONALE✔️✔️: Clear, yellow-tinged stool indicates adequate bowel preparation, a key concept in
nursing exam prep. Option A is incorrect as the clear liquid diet is usually for 24 hours, B is incorrect as
the solution is often split-dose, and C is incorrect as anticoagulants may need to be held. This nursing
study guide stresses the importance of client education for diagnostic procedures. Student success
depends on ensuring proper preparation for accurate results. These revision notes are essential for
gastrointestinal nursing.
**9. A client with a diagnosis of major depressive disorder is prescribed fluoxetine. The nurse should
monitor for which adverse effect?**
A. Hypertensive crisis
B. Serotonin syndrome
C. Agranulocytosis
D. Hepatotoxicity
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: Fluoxetine, an SSRI, can cause serotonin syndrome, especially when combined with
other serotonergic drugs, a critical focus in nursing exam prep. Option A is associated with MAOIs, C is
associated with clozapine, and D is a rare side effect. This nursing study guide emphasizes monitoring for
agitation, confusion, and autonomic instability. For student success, recognize the signs of serotonin
syndrome early. These practice questions are vital for psychiatric nursing and pharmacology revision.
NCLEX-style prep resource. Master exam practice with these nursing
revision notes and practice questions for student success.
---
## 🏆 Medical-Surgical & Pharmacology Nursing Study Bundle – 2026
Complete Prep Pack | NCLEX-Style Practice Questions
---
**1. A nurse is assessing a client who has been prescribed digoxin. Which of the following findings
indicates a potential adverse effect of this medication?**
A. Heart rate of 68 beats per minute
B. Serum potassium level of 3.8 mEq/L
C. Anorexia and nausea
D. Blood pressure of 120/80 mmHg
💫ANSWER✔️✔️: C
💫RATIONALE✔️✔️: Anorexia and nausea are early signs of digoxin toxicity, a critical concept in nursing
exam prep. Option A is a normal heart rate, B is a normal potassium level, and D is a normal blood
pressure, making them incorrect. This nursing study guide emphasizes monitoring for GI symptoms and
bradycardia as key indicators of digoxin toxicity. For student success, remember that hypokalemia
increases the risk of toxicity, making potassium monitoring essential. These practice questions are
designed to reinforce pharmacology safety and enhance your revision notes for the NCLEX.
**2. A client with heart failure is receiving furosemide. Which laboratory value should the nurse monitor
most closely?**
A. Serum sodium
B. Serum potassium
C. Serum calcium
,D. Serum magnesium
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: Furosemide is a loop diuretic that can cause hypokalemia, a major focus in nursing
exam prep. Option A is incorrect as sodium loss is less common, C and D are not the primary electrolytes
of concern. This study guide highlights that potassium levels must be monitored to prevent cardiac
arrhythmias. Accurate monitoring is crucial for student success in pharmacology and med-surg nursing.
These revision notes emphasize the importance of electrolyte balance in diuretic therapy, a core
component of comprehensive nursing study guides.
**3. A nurse is preparing to administer an enteral feeding through a nasogastric tube. Which action
should the nurse take first?**
A. Flush the tube with 30 mL of water
B. Verify tube placement by aspirating gastric contents
C. Elevate the head of the bed to 30 degrees
D. Check the residual volume
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: Verifying tube placement is the priority to prevent aspiration and ensure safety, a
critical step in nursing exam prep. Option A is done after placement verification, C is important but
secondary, and D is done after verification. This nursing study guide emphasizes patient safety in enteral
feeding procedures. For student success, always confirm placement before any intervention. These
practice questions are fundamental for mastering skills in fundamentals of nursing and critical care.
**4. A client is receiving warfarin therapy. Which dietary change should the nurse instruct the client to
avoid?**
A. Increasing intake of green leafy vegetables
B. Decreasing intake of dairy products
C. Increasing intake of citrus fruits
D. Decreasing intake of red meat
💫ANSWER✔️✔️: A
💫RATIONALE✔️✔️: Green leafy vegetables are high in vitamin K, which antagonizes warfarin's effects, a
key point in nursing exam prep. Option B is incorrect as dairy does not significantly affect warfarin, C is
not a major concern, and D is not relevant. This study guide stresses the importance of consistent
vitamin K intake. Student success depends on understanding drug-nutrient interactions. These revision
notes are essential for pharmacology and med-surg nursing study packs.
,**5. A nurse is assessing a client with chronic obstructive pulmonary disease (COPD). Which finding is
most indicative of an exacerbation?**
A. Decreased respiratory rate
B. Increased oxygen saturation
C. Use of accessory muscles
D. Productive cough with clear sputum
💫ANSWER✔️✔️: C
💫RATIONALE✔️✔️: Use of accessory muscles indicates increased work of breathing and respiratory
distress, a classic sign in nursing exam prep. Option A is incorrect as respiratory rate typically increases,
B is incorrect as saturation decreases, and D is a common symptom but not specific to exacerbation. This
nursing study guide highlights the importance of physical assessment in COPD management. For student
success, recognize early signs of respiratory failure. These practice questions are vital for medical-
surgical nursing revision.
**6. A client prescribed metformin for type 2 diabetes mellitus reports muscle pain and weakness.
Which action should the nurse take?**
A. Administer a dose of insulin
B. Hold the next dose of metformin and notify the healthcare provider
C. Encourage the client to drink more fluids
D. Reassure the client that this is a normal side effect
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: Muscle pain and weakness can indicate lactic acidosis, a rare but serious adverse
effect of metformin, crucial for nursing exam prep. Option A is incorrect as insulin is not the immediate
action, C is supportive but not primary, and D is dangerous. This nursing study guide emphasizes
recognizing signs of lactic acidosis. Student success relies on prompt identification and reporting of
adverse effects. These revision notes are essential for pharmacology and diabetes management.
**7. A nurse is caring for a client post-operative day one following a total hip arthroplasty. Which
position is contraindicated?**
A. Supine with a pillow between the legs
B. Semi-Fowler's position
C. Side-lying on the operative side
, D. Side-lying on the non-operative side with a pillow between the legs
💫ANSWER✔️✔️: C
💫RATIONALE✔️✔️: Side-lying on the operative side can cause dislocation of the hip prosthesis, a major
concern in nursing exam prep. Option A is correct as it maintains abduction, B is safe, and D is safe with
proper support. This study guide emphasizes post-operative precautions to prevent complications. For
student success, remember the principles of hip replacement care. These practice questions are crucial
for orthopedic nursing and medical-surgical study guides.
**8. A nurse is preparing a client for a colonoscopy. Which instruction should the nurse provide
regarding the bowel preparation?**
A. Consume a clear liquid diet for 12 hours before the procedure
B. Drink the entire bowel preparation solution over 2 hours
C. Continue taking oral anticoagulants as prescribed
D. Expect to have clear, yellow-tinged stool before the procedure
💫ANSWER✔️✔️: D
💫RATIONALE✔️✔️: Clear, yellow-tinged stool indicates adequate bowel preparation, a key concept in
nursing exam prep. Option A is incorrect as the clear liquid diet is usually for 24 hours, B is incorrect as
the solution is often split-dose, and C is incorrect as anticoagulants may need to be held. This nursing
study guide stresses the importance of client education for diagnostic procedures. Student success
depends on ensuring proper preparation for accurate results. These revision notes are essential for
gastrointestinal nursing.
**9. A client with a diagnosis of major depressive disorder is prescribed fluoxetine. The nurse should
monitor for which adverse effect?**
A. Hypertensive crisis
B. Serotonin syndrome
C. Agranulocytosis
D. Hepatotoxicity
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: Fluoxetine, an SSRI, can cause serotonin syndrome, especially when combined with
other serotonergic drugs, a critical focus in nursing exam prep. Option A is associated with MAOIs, C is
associated with clozapine, and D is a rare side effect. This nursing study guide emphasizes monitoring for
agitation, confusion, and autonomic instability. For student success, recognize the signs of serotonin
syndrome early. These practice questions are vital for psychiatric nursing and pharmacology revision.
