Comprehensive nursing revision notes and NCLEX-style practice
questions for 2025/2026 success. Compiled from student notes and
practice resources — not an official exam.
---
# Medical-Surgical Nursing Study Bundle | Complete Prep Questions –
2025/2026 Edition | Ultimate Revision Notes & Practice Questions
Pack
---
1. A nurse is caring for a client with acute pancreatitis. Which laboratory value is most indicative of this
condition?
A. Elevated serum amylase and lipase
B. Elevated serum glucose
C. Elevated serum calcium
D. Elevated serum potassium
💫ANSWER✔️✔️: A
💫RATIONALE✔️✔️: The correct answer is A. Elevated serum amylase and lipase are hallmark findings in
acute pancreatitis. Option B is incorrect because glucose may be elevated due to stress but is not
specific. Option C is wrong as hypocalcemia can occur, not hypercalcemia. Option D is incorrect because
potassium is not a primary indicator. Remember: "Think AMYLASE for the PANCREAS" — this is a classic
nursing exam prep mnemonic. This study guide highlights key lab values for student success in clinical
settings.
2. A client is prescribed a beta-blocker for hypertension. Which assessment finding indicates the
medication is effective?
A. Heart rate of 55 beats per minute
,B. Blood pressure of 140/90 mm Hg
C. Heart rate of 110 beats per minute
D. Blood pressure of 90/60 mm Hg
💫ANSWER✔️✔️: A
💫RATIONALE✔️✔️: The correct answer is A. A heart rate of 55 bpm is within the therapeutic range for
beta-blockers, indicating reduced cardiac workload. Option B is incorrect because 140/90 is still
hypertensive. Option C is wrong as 110 bpm is tachycardia, not a desired effect. Option D is incorrect
because 90/60 indicates hypotension, a side effect. This nursing study guide emphasizes monitoring for
bradycardia as a sign of effectiveness in NCLEX-style prep.
3. A nurse is teaching a client about a low-sodium diet. Which food should the client avoid?
A. Fresh apples
B. Canned soup
C. Brown rice
D. Grilled chicken
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: The correct answer is B. Canned soups are high in sodium due to preservatives and
flavorings. Option A is wrong as fresh apples are low in sodium. Option C is incorrect as brown rice is a
low-sodium whole grain. Option D is wrong because grilled chicken is low in sodium when prepared
without added salt. I always remind my patients: "Fresh is best" — this is a key revision note for nursing
exam practice.
4. A nurse is assessing a client with heart failure who has gained 2 kg in 24 hours. What is the priority
action?
A. Notify the healthcare provider immediately.
B. Encourage the client to increase fluid intake.
C. Administer a diuretic as prescribed.
D. Restrict the client's sodium intake.
💫ANSWER✔️✔️: A
,💫RATIONALE✔️✔️: The correct answer is A. A rapid weight gain of 2 kg in 24 hours indicates fluid
overload and potential worsening heart failure, requiring immediate provider notification. Option B is
wrong as increasing fluids would exacerbate the problem. Option C is incorrect because the nurse
should not administer medication without an order. Option D is wrong as sodium restriction is a long-
term strategy. This study guide stresses that early detection of fluid retention is crucial for student
success in med-surg nursing.
5. A client with a new tracheostomy is being discharged. Which instruction should the nurse include in
the teaching plan?
A. Suction the tracheostomy only when the client complains of shortness of breath.
B. Clean the inner cannula with hydrogen peroxide and water.
C. Change the tracheostomy ties daily.
D. Use sterile technique for suctioning.
💫ANSWER✔️✔️: D
💫RATIONALE✔️✔️: The correct answer is D. Sterile technique is essential when suctioning a
tracheostomy to prevent infection. Option A is wrong because suctioning should be done as needed
based on assessment, not just when the client complains. Option B is incorrect as cleaning should be
done with normal saline or as per facility policy. Option C is wrong as ties are changed when soiled or
loose, not daily. This is a key practice question for nursing exam prep in respiratory care.
6. A nurse is caring for a client with a chest tube. The nurse notes continuous bubbling in the water seal
chamber. What is the priority action?
A. Document the finding as normal.
B. Clamp the chest tube immediately.
C. Check the chest tube system for an air leak.
D. Notify the healthcare provider.
💫ANSWER✔️✔️: C
💫RATIONALE✔️✔️: The correct answer is C. Continuous bubbling in the water seal chamber indicates an
air leak that requires investigation. Option A is wrong as this is not a normal finding. Option B is
incorrect because clamping the tube can lead to tension pneumothorax. Option D is incorrect as the
nurse should assess the system first. Remember: "Bubbling in the seal means you gotta feel for the
leak!" — a helpful mnemonic for this nursing study guide.
, 7. A client is prescribed digoxin for heart failure. Which side effect should the nurse monitor for?
A. Tachycardia
B. Anorexia and nausea
C. Hypertension
D. Insomnia
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: The correct answer is B. Anorexia, nausea, and vomiting are early signs of digoxin
toxicity. Option A is incorrect as digoxin can cause bradycardia, not tachycardia. Option C is wrong as
digoxin can cause hypotension. Option D is incorrect because insomnia is not a common side effect. This
is a critical pharmacology point in this nursing study guide for student success in NCLEX-style prep.
8. A nurse is preparing to administer a blood transfusion. Which action is most important to prevent a
transfusion reaction?
A. Verify the client's blood type and cross-match with a second nurse.
B. Premedicate the client with diphenhydramine.
C. Infuse the blood over 4 hours.
D. Check the client's vital signs after the transfusion.
💫ANSWER✔️✔️: A
💫RATIONALE✔️✔️: The correct answer is A. Verifying the client's blood type and cross-match with
another nurse is the most critical safety step to prevent a transfusion reaction. Option B is wrong as
premedication is not routine. Option C is incorrect as blood should be infused within 2-4 hours but this is
not the priority. Option D is wrong as vitals should be checked before and during, not just after. I always
double-check with a colleague — this is a key nursing exam prep strategy.
9. A client is experiencing an acute asthma attack. Which medication should the nurse administer first?
A. Albuterol (SABA)
B. Prednisone (corticosteroid)
C. Montelukast (leukotriene modifier)
questions for 2025/2026 success. Compiled from student notes and
practice resources — not an official exam.
---
# Medical-Surgical Nursing Study Bundle | Complete Prep Questions –
2025/2026 Edition | Ultimate Revision Notes & Practice Questions
Pack
---
1. A nurse is caring for a client with acute pancreatitis. Which laboratory value is most indicative of this
condition?
A. Elevated serum amylase and lipase
B. Elevated serum glucose
C. Elevated serum calcium
D. Elevated serum potassium
💫ANSWER✔️✔️: A
💫RATIONALE✔️✔️: The correct answer is A. Elevated serum amylase and lipase are hallmark findings in
acute pancreatitis. Option B is incorrect because glucose may be elevated due to stress but is not
specific. Option C is wrong as hypocalcemia can occur, not hypercalcemia. Option D is incorrect because
potassium is not a primary indicator. Remember: "Think AMYLASE for the PANCREAS" — this is a classic
nursing exam prep mnemonic. This study guide highlights key lab values for student success in clinical
settings.
2. A client is prescribed a beta-blocker for hypertension. Which assessment finding indicates the
medication is effective?
A. Heart rate of 55 beats per minute
,B. Blood pressure of 140/90 mm Hg
C. Heart rate of 110 beats per minute
D. Blood pressure of 90/60 mm Hg
💫ANSWER✔️✔️: A
💫RATIONALE✔️✔️: The correct answer is A. A heart rate of 55 bpm is within the therapeutic range for
beta-blockers, indicating reduced cardiac workload. Option B is incorrect because 140/90 is still
hypertensive. Option C is wrong as 110 bpm is tachycardia, not a desired effect. Option D is incorrect
because 90/60 indicates hypotension, a side effect. This nursing study guide emphasizes monitoring for
bradycardia as a sign of effectiveness in NCLEX-style prep.
3. A nurse is teaching a client about a low-sodium diet. Which food should the client avoid?
A. Fresh apples
B. Canned soup
C. Brown rice
D. Grilled chicken
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: The correct answer is B. Canned soups are high in sodium due to preservatives and
flavorings. Option A is wrong as fresh apples are low in sodium. Option C is incorrect as brown rice is a
low-sodium whole grain. Option D is wrong because grilled chicken is low in sodium when prepared
without added salt. I always remind my patients: "Fresh is best" — this is a key revision note for nursing
exam practice.
4. A nurse is assessing a client with heart failure who has gained 2 kg in 24 hours. What is the priority
action?
A. Notify the healthcare provider immediately.
B. Encourage the client to increase fluid intake.
C. Administer a diuretic as prescribed.
D. Restrict the client's sodium intake.
💫ANSWER✔️✔️: A
,💫RATIONALE✔️✔️: The correct answer is A. A rapid weight gain of 2 kg in 24 hours indicates fluid
overload and potential worsening heart failure, requiring immediate provider notification. Option B is
wrong as increasing fluids would exacerbate the problem. Option C is incorrect because the nurse
should not administer medication without an order. Option D is wrong as sodium restriction is a long-
term strategy. This study guide stresses that early detection of fluid retention is crucial for student
success in med-surg nursing.
5. A client with a new tracheostomy is being discharged. Which instruction should the nurse include in
the teaching plan?
A. Suction the tracheostomy only when the client complains of shortness of breath.
B. Clean the inner cannula with hydrogen peroxide and water.
C. Change the tracheostomy ties daily.
D. Use sterile technique for suctioning.
💫ANSWER✔️✔️: D
💫RATIONALE✔️✔️: The correct answer is D. Sterile technique is essential when suctioning a
tracheostomy to prevent infection. Option A is wrong because suctioning should be done as needed
based on assessment, not just when the client complains. Option B is incorrect as cleaning should be
done with normal saline or as per facility policy. Option C is wrong as ties are changed when soiled or
loose, not daily. This is a key practice question for nursing exam prep in respiratory care.
6. A nurse is caring for a client with a chest tube. The nurse notes continuous bubbling in the water seal
chamber. What is the priority action?
A. Document the finding as normal.
B. Clamp the chest tube immediately.
C. Check the chest tube system for an air leak.
D. Notify the healthcare provider.
💫ANSWER✔️✔️: C
💫RATIONALE✔️✔️: The correct answer is C. Continuous bubbling in the water seal chamber indicates an
air leak that requires investigation. Option A is wrong as this is not a normal finding. Option B is
incorrect because clamping the tube can lead to tension pneumothorax. Option D is incorrect as the
nurse should assess the system first. Remember: "Bubbling in the seal means you gotta feel for the
leak!" — a helpful mnemonic for this nursing study guide.
, 7. A client is prescribed digoxin for heart failure. Which side effect should the nurse monitor for?
A. Tachycardia
B. Anorexia and nausea
C. Hypertension
D. Insomnia
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: The correct answer is B. Anorexia, nausea, and vomiting are early signs of digoxin
toxicity. Option A is incorrect as digoxin can cause bradycardia, not tachycardia. Option C is wrong as
digoxin can cause hypotension. Option D is incorrect because insomnia is not a common side effect. This
is a critical pharmacology point in this nursing study guide for student success in NCLEX-style prep.
8. A nurse is preparing to administer a blood transfusion. Which action is most important to prevent a
transfusion reaction?
A. Verify the client's blood type and cross-match with a second nurse.
B. Premedicate the client with diphenhydramine.
C. Infuse the blood over 4 hours.
D. Check the client's vital signs after the transfusion.
💫ANSWER✔️✔️: A
💫RATIONALE✔️✔️: The correct answer is A. Verifying the client's blood type and cross-match with
another nurse is the most critical safety step to prevent a transfusion reaction. Option B is wrong as
premedication is not routine. Option C is incorrect as blood should be infused within 2-4 hours but this is
not the priority. Option D is wrong as vitals should be checked before and during, not just after. I always
double-check with a colleague — this is a key nursing exam prep strategy.
9. A client is experiencing an acute asthma attack. Which medication should the nurse administer first?
A. Albuterol (SABA)
B. Prednisone (corticosteroid)
C. Montelukast (leukotriene modifier)
