MEDICAL-SURGICAL NURSING PRACTICE EXAM
2026/2027 : 70 ORIGINAL NCLEX-STYLE
QUESTIONS WITH DETAILED RATIONALES,
CLINICAL PEARLS & EXAM TIPS LATEST !!
Question 1
A nurse is caring for a patient diagnosed with left-sided heart failure. Which
assessment finding should the nurse expect first?
A. Jugular vein distention
B. Bilateral crackles in the lungs
C. Peripheral edema
D. Enlarged liver
Correct Answer: B
Rationale: Left-sided heart failure causes blood to back up into the lungs, leading
to pulmonary congestion. Crackles are among the earliest findings.
Question 2
Which electrolyte imbalance places a patient at the greatest risk for life-
threatening cardiac dysrhythmias?
,A. Mild hyponatremia
B. Hyperkalemia
C. Mild hypocalcemia
D. Hypermagnesemia
Correct Answer: B
Rationale: Elevated potassium interferes with cardiac conduction and can rapidly
progress to fatal arrhythmias.
Question 3
A patient with diabetes reports sweating, shakiness, and confusion. What should
the nurse do first?
A. Administer insulin.
B. Check the blood glucose level.
C. Encourage exercise.
D. Restrict fluids.
Correct Answer: B
Rationale: These symptoms suggest hypoglycemia. Confirm the blood glucose
immediately and treat promptly if low.
,Question 4
Which finding requires immediate intervention in a postoperative patient?
A. Pain rated 6/10
B. Oxygen saturation of 88%
C. Temperature of 37.6°C (99.7°F)
D. Small amount of drainage on the dressing
Correct Answer: B
Rationale: An oxygen saturation below 90% indicates inadequate oxygenation and
requires immediate assessment and intervention.
Question 5
A patient receiving intravenous heparin suddenly develops bleeding gums. What
is the nurse's priority action?
A. Continue the infusion.
B. Stop the infusion and notify the provider.
C. Encourage oral hygiene.
D. Increase the infusion rate.
Correct Answer: B
, Rationale: Bleeding is a sign of excessive anticoagulation. Stop the infusion and
notify the healthcare provider immediately.
Question 6
Which patient is at the highest risk for developing deep vein thrombosis (DVT)?
A. A healthy 20-year-old who exercises daily
B. A postoperative patient on prolonged bed rest
C. A patient with seasonal allergies
D. A patient with controlled hypertension
Correct Answer: B
Rationale: Immobility is a major risk factor for venous thromboembolism.
Question 7
Which laboratory value should the nurse review before administering warfarin?
A. Hemoglobin
B. Platelet count
C. INR
D. Sodium level
2026/2027 : 70 ORIGINAL NCLEX-STYLE
QUESTIONS WITH DETAILED RATIONALES,
CLINICAL PEARLS & EXAM TIPS LATEST !!
Question 1
A nurse is caring for a patient diagnosed with left-sided heart failure. Which
assessment finding should the nurse expect first?
A. Jugular vein distention
B. Bilateral crackles in the lungs
C. Peripheral edema
D. Enlarged liver
Correct Answer: B
Rationale: Left-sided heart failure causes blood to back up into the lungs, leading
to pulmonary congestion. Crackles are among the earliest findings.
Question 2
Which electrolyte imbalance places a patient at the greatest risk for life-
threatening cardiac dysrhythmias?
,A. Mild hyponatremia
B. Hyperkalemia
C. Mild hypocalcemia
D. Hypermagnesemia
Correct Answer: B
Rationale: Elevated potassium interferes with cardiac conduction and can rapidly
progress to fatal arrhythmias.
Question 3
A patient with diabetes reports sweating, shakiness, and confusion. What should
the nurse do first?
A. Administer insulin.
B. Check the blood glucose level.
C. Encourage exercise.
D. Restrict fluids.
Correct Answer: B
Rationale: These symptoms suggest hypoglycemia. Confirm the blood glucose
immediately and treat promptly if low.
,Question 4
Which finding requires immediate intervention in a postoperative patient?
A. Pain rated 6/10
B. Oxygen saturation of 88%
C. Temperature of 37.6°C (99.7°F)
D. Small amount of drainage on the dressing
Correct Answer: B
Rationale: An oxygen saturation below 90% indicates inadequate oxygenation and
requires immediate assessment and intervention.
Question 5
A patient receiving intravenous heparin suddenly develops bleeding gums. What
is the nurse's priority action?
A. Continue the infusion.
B. Stop the infusion and notify the provider.
C. Encourage oral hygiene.
D. Increase the infusion rate.
Correct Answer: B
, Rationale: Bleeding is a sign of excessive anticoagulation. Stop the infusion and
notify the healthcare provider immediately.
Question 6
Which patient is at the highest risk for developing deep vein thrombosis (DVT)?
A. A healthy 20-year-old who exercises daily
B. A postoperative patient on prolonged bed rest
C. A patient with seasonal allergies
D. A patient with controlled hypertension
Correct Answer: B
Rationale: Immobility is a major risk factor for venous thromboembolism.
Question 7
Which laboratory value should the nurse review before administering warfarin?
A. Hemoglobin
B. Platelet count
C. INR
D. Sodium level
