Achieve confidence in NCLEX-style prep with this complete nursing
study pack. Elevate your nursing exam prep with this ultimate success
bundle of practice questions.
---
# Medical-Surgical Nursing & Pharmacology Success Pack: Complete
NCLEX-Style Prep Guide – 2025/2026 Edition | Ultimate Revision
Notes & Practice Questions Bundle
---
1. A nurse is caring for a client with a diagnosis of chronic obstructive pulmonary disease (COPD) who is
receiving oxygen at 2 L/min via nasal cannula. Which assessment finding indicates an adverse effect of
oxygen therapy?
A. The client's respiratory rate increases to 24 breaths per minute.
B. The client's oxygen saturation is 92%.
C. The client's PaCO2 level decreases.
D. The client's respiratory rate decreases to 10 breaths per minute.
💫ANSWER✔️✔️: D
💫RATIONALE✔️✔️: The correct answer is D. A decrease in respiratory rate to 10 breaths per minute in a
client with COPD may indicate oxygen-induced hypoventilation, where the hypoxic drive is blunted,
leading to respiratory depression. Option A is incorrect as an increase in respiratory rate is not the
primary concern. Option B is incorrect as 92% is an acceptable saturation for COPD. Option C is wrong
because a decrease in PaCO2 would be a desired effect, not adverse. This is a critical concept in
respiratory nursing exam prep and a must-know for student success in med-surg nursing.
2. A client is prescribed enalapril for hypertension. Which laboratory value should the nurse monitor
closely?
,A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum magnesium
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: The correct answer is B. Enalapril is an ACE inhibitor that can cause hyperkalemia by
reducing aldosterone secretion. Option A is incorrect because ACE inhibitors do not significantly affect
sodium. Option C is wrong as calcium levels are not directly impacted. Option D is incorrect because
magnesium is not the primary electrolyte affected. This is a key pharmacology study guide point for
nursing revision notes and essential for NCLEX-style prep.
3. A nurse is preparing to perform a sterile procedure. Which action violates sterile technique?
A. Keeping sterile objects above the waist.
B. Holding sterile gloved hands above the elbows.
C. Opening sterile packages away from the body.
D. Using sterile gloves to handle sterile items.
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: The correct answer is B. Sterile gloved hands should be held above the waist and
below the shoulders, not above the elbows. Option A is correct as sterile objects should be kept above
the waist. Option C is correct as opening away from the body prevents contamination. Option D is
correct as sterile gloves are used to handle sterile items. This is a fundamental nursing fundamentals
study guide topic and vital for student success in clinical skills.
4. A client with heart failure is prescribed furosemide. The nurse should assess the client for which
electrolyte imbalance?
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hypernatremia
,💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: The correct answer is B. Furosemide is a loop diuretic that causes potassium loss,
leading to hypokalemia. Option A is incorrect because furosemide does not cause hyperkalemia. Option
C is wrong as calcium loss is not the primary effect. Option D is incorrect because furosemide can cause
hyponatremia, not hypernatremia. This is a crucial pharmacology nursing study guide point and a
frequent topic in nursing exam practice.
5. A nurse is assessing a client's wound and notes purulent drainage with a foul odor. The nurse should
suspect:
A. Normal healing
B. Wound infection
C. Serous drainage
D. Hematoma formation
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: The correct answer is B. Purulent drainage with a foul odor is a classic sign of a
wound infection. Option A is incorrect as normal healing presents with serosanguineous drainage.
Option C is wrong as serous drainage is clear and thin. Option D is incorrect as a hematoma presents
with swelling and discoloration. This is a key assessment finding in nursing revision notes for wound care
and a common question in NCLEX-style prep.
6. A client is receiving continuous enteral feedings via a nasogastric tube. The nurse checks the residual
volume and obtains 300 mL. What is the priority action?
A. Reinstill the residual and continue the feeding.
B. Discard the residual and increase the feeding rate.
C. Reinstill the residual and hold the feeding for 2 hours.
D. Discard the residual and notify the healthcare provider.
💫ANSWER✔️✔️: C
💫RATIONALE✔️✔️: The correct answer is C. A residual volume of 300 mL is above the typical threshold of
200-250 mL, so the feeding should be held, and the residual reinstilled to prevent electrolyte loss.
Option A is incorrect because continuing the feeding could increase the risk of aspiration. Option B is
wrong as discarding and increasing the rate is contraindicated. Option D is incorrect because notifying
, the provider is not the immediate action. This is a key nursing intervention in gastrointestinal nursing
and essential for student success in critical care.
7. A client is experiencing chest pain and is prescribed sublingual nitroglycerin. The nurse should instruct
the client to:
A. Take one tablet every 15 minutes for up to three doses.
B. Take one tablet every 5 minutes for up to three doses.
C. Chew the tablet for rapid absorption.
D. Swallow the tablet with a full glass of water.
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: The correct answer is B. The standard protocol for sublingual nitroglycerin is to take
one tablet every 5 minutes for up to three doses, and if pain persists, call 911. Option A is incorrect
because the interval is 5 minutes, not 15. Option C is wrong as nitroglycerin should not be chewed.
Option D is incorrect as sublingual administration is not swallowed. This is a critical patient teaching
point in cardiovascular nursing exam prep.
8. A nurse is caring for a client with a new diagnosis of type 1 diabetes mellitus. Which statement by the
client indicates a need for further teaching?
A. "I will rotate my insulin injection sites."
B. "I will carry a source of fast-acting sugar with me at all times."
C. "I will take my insulin when I feel my blood sugar is high."
D. "I will check my blood glucose level before meals."
💫ANSWER✔️✔️: C
💫RATIONALE✔️✔️: The correct answer is C. Insulin should be taken as prescribed, not only when the
client feels their blood sugar is high. Option A is correct as site rotation prevents lipodystrophy. Option B
is correct for treating hypoglycemia. Option D is correct for monitoring glycemic control. This is a key
diabetes education point in nursing study guides and essential for NCLEX-style prep.
9. A nurse is assessing a client who is 2 days postpartum and reports breast engorgement. Which
intervention is most appropriate?
study pack. Elevate your nursing exam prep with this ultimate success
bundle of practice questions.
---
# Medical-Surgical Nursing & Pharmacology Success Pack: Complete
NCLEX-Style Prep Guide – 2025/2026 Edition | Ultimate Revision
Notes & Practice Questions Bundle
---
1. A nurse is caring for a client with a diagnosis of chronic obstructive pulmonary disease (COPD) who is
receiving oxygen at 2 L/min via nasal cannula. Which assessment finding indicates an adverse effect of
oxygen therapy?
A. The client's respiratory rate increases to 24 breaths per minute.
B. The client's oxygen saturation is 92%.
C. The client's PaCO2 level decreases.
D. The client's respiratory rate decreases to 10 breaths per minute.
💫ANSWER✔️✔️: D
💫RATIONALE✔️✔️: The correct answer is D. A decrease in respiratory rate to 10 breaths per minute in a
client with COPD may indicate oxygen-induced hypoventilation, where the hypoxic drive is blunted,
leading to respiratory depression. Option A is incorrect as an increase in respiratory rate is not the
primary concern. Option B is incorrect as 92% is an acceptable saturation for COPD. Option C is wrong
because a decrease in PaCO2 would be a desired effect, not adverse. This is a critical concept in
respiratory nursing exam prep and a must-know for student success in med-surg nursing.
2. A client is prescribed enalapril for hypertension. Which laboratory value should the nurse monitor
closely?
,A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum magnesium
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: The correct answer is B. Enalapril is an ACE inhibitor that can cause hyperkalemia by
reducing aldosterone secretion. Option A is incorrect because ACE inhibitors do not significantly affect
sodium. Option C is wrong as calcium levels are not directly impacted. Option D is incorrect because
magnesium is not the primary electrolyte affected. This is a key pharmacology study guide point for
nursing revision notes and essential for NCLEX-style prep.
3. A nurse is preparing to perform a sterile procedure. Which action violates sterile technique?
A. Keeping sterile objects above the waist.
B. Holding sterile gloved hands above the elbows.
C. Opening sterile packages away from the body.
D. Using sterile gloves to handle sterile items.
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: The correct answer is B. Sterile gloved hands should be held above the waist and
below the shoulders, not above the elbows. Option A is correct as sterile objects should be kept above
the waist. Option C is correct as opening away from the body prevents contamination. Option D is
correct as sterile gloves are used to handle sterile items. This is a fundamental nursing fundamentals
study guide topic and vital for student success in clinical skills.
4. A client with heart failure is prescribed furosemide. The nurse should assess the client for which
electrolyte imbalance?
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hypernatremia
,💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: The correct answer is B. Furosemide is a loop diuretic that causes potassium loss,
leading to hypokalemia. Option A is incorrect because furosemide does not cause hyperkalemia. Option
C is wrong as calcium loss is not the primary effect. Option D is incorrect because furosemide can cause
hyponatremia, not hypernatremia. This is a crucial pharmacology nursing study guide point and a
frequent topic in nursing exam practice.
5. A nurse is assessing a client's wound and notes purulent drainage with a foul odor. The nurse should
suspect:
A. Normal healing
B. Wound infection
C. Serous drainage
D. Hematoma formation
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: The correct answer is B. Purulent drainage with a foul odor is a classic sign of a
wound infection. Option A is incorrect as normal healing presents with serosanguineous drainage.
Option C is wrong as serous drainage is clear and thin. Option D is incorrect as a hematoma presents
with swelling and discoloration. This is a key assessment finding in nursing revision notes for wound care
and a common question in NCLEX-style prep.
6. A client is receiving continuous enteral feedings via a nasogastric tube. The nurse checks the residual
volume and obtains 300 mL. What is the priority action?
A. Reinstill the residual and continue the feeding.
B. Discard the residual and increase the feeding rate.
C. Reinstill the residual and hold the feeding for 2 hours.
D. Discard the residual and notify the healthcare provider.
💫ANSWER✔️✔️: C
💫RATIONALE✔️✔️: The correct answer is C. A residual volume of 300 mL is above the typical threshold of
200-250 mL, so the feeding should be held, and the residual reinstilled to prevent electrolyte loss.
Option A is incorrect because continuing the feeding could increase the risk of aspiration. Option B is
wrong as discarding and increasing the rate is contraindicated. Option D is incorrect because notifying
, the provider is not the immediate action. This is a key nursing intervention in gastrointestinal nursing
and essential for student success in critical care.
7. A client is experiencing chest pain and is prescribed sublingual nitroglycerin. The nurse should instruct
the client to:
A. Take one tablet every 15 minutes for up to three doses.
B. Take one tablet every 5 minutes for up to three doses.
C. Chew the tablet for rapid absorption.
D. Swallow the tablet with a full glass of water.
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: The correct answer is B. The standard protocol for sublingual nitroglycerin is to take
one tablet every 5 minutes for up to three doses, and if pain persists, call 911. Option A is incorrect
because the interval is 5 minutes, not 15. Option C is wrong as nitroglycerin should not be chewed.
Option D is incorrect as sublingual administration is not swallowed. This is a critical patient teaching
point in cardiovascular nursing exam prep.
8. A nurse is caring for a client with a new diagnosis of type 1 diabetes mellitus. Which statement by the
client indicates a need for further teaching?
A. "I will rotate my insulin injection sites."
B. "I will carry a source of fast-acting sugar with me at all times."
C. "I will take my insulin when I feel my blood sugar is high."
D. "I will check my blood glucose level before meals."
💫ANSWER✔️✔️: C
💫RATIONALE✔️✔️: The correct answer is C. Insulin should be taken as prescribed, not only when the
client feels their blood sugar is high. Option A is correct as site rotation prevents lipodystrophy. Option B
is correct for treating hypoglycemia. Option D is correct for monitoring glycemic control. This is a key
diabetes education point in nursing study guides and essential for NCLEX-style prep.
9. A nurse is assessing a client who is 2 days postpartum and reports breast engorgement. Which
intervention is most appropriate?
