NCLEX MEDICAL-SURGICAL NURSING PRACTICE EXAM 2026–2027 Comprehensive Study Guide • 250 Original Practice Questions • 15 NGN-Style Case Studies • Detailed Rationales

NCLEX MEDICAL-SURGICAL NURSING PRACTICE EXAM
2026–2027




Comprehensive Study Guide • 250 Original Practice
Questions • 15 NGN-Style Case Studies • Detailed Rationales



Prepared by: Expert Nursing Educators

For: Nursing Students Preparing for HESI and NCLEX Medical-Surgical Examinations

Edition: 2026–2027




This study guide contains original HESI and NCLEX-style practice questions and is
designed to supplement your nursing education. It is not affiliated with, endorsed by, or
approved by Elsevier, HESI, NCSBN, ATI, Pearson, or any nursing school. These questions
are practice materials only and do not guarantee success on any official examination.




DISCLAIMER

,IMPORTANT NOTICE TO STUDENTS

This study guide is an independent educational resource created by nursing educators
to assist students in preparing for HESI and NCLEX-style medical-surgical nursing
examinations.

This guide is NOT:

• A collection of actual, leaked, or recalled HESI or NCLEX examination questions
• Affiliated with, endorsed by, or approved by Elsevier, HESI, NCSBN, ATI, Pearson,
or any nursing school
• A guarantee of passing any official nursing examination
• A substitute for formal nursing education, clinical experience, or comprehensive
exam preparation

This guide IS:

• Original practice questions written by experienced nursing educators
• Designed to strengthen medical-surgical nursing knowledge, clinical reasoning,
and test-taking skills
• Based on publicly available nursing education standards and competency
frameworks
• Intended as a supplementary study tool

Nursing Practice Acknowledgment:

All clinical scenarios, assessment findings, vital signs, laboratory values, and nursing
interventions presented in this guide are for educational practice purposes only. They do
not constitute medical advice, clinical guidelines, or protocols for actual patient care.

Exam Performance Disclaimer:

Success on any nursing examination depends on multiple factors. This guide does not
guarantee any specific examination outcome.

Educational Use Only:

This material is intended for individual study use by nursing students. Reproduction,
distribution, or commercial use without explicit permission is prohibited.

,By using this study guide, you acknowledge that you have read and understand
this disclaimer.




TABLE OF CONTENTS



COVER PAGE ............................................................................................................. 1

DISCLAIMER ............................................................................................................. 2

TABLE OF CONTENTS .............................................................................................. 3

HOW TO USE THIS GUIDE ....................................................................................... 6




PART 1 — MEDICAL-SURGICAL NURSING REVIEW
1. Cardiovascular System ........................................................................................ 8

• Heart Failure
• Myocardial Infarction
• Hypertension
• Valvular Heart Disease

2. Respiratory System .......................................................................................... 13

• COPD
• Pneumonia
• Asthma
• Pulmonary Embolism

3. Gastrointestinal System ................................................................................... 17

• GERD

, • Peptic Ulcer Disease
• Appendicitis
• Inflammatory Bowel Disease

4. Renal and Urinary System ............................................................................... 21

• Acute Kidney Injury
• Chronic Kidney Disease
• Urinary Tract Infections

5. Neurological System ........................................................................................ 25

• Stroke
• Seizures
• Parkinson's Disease
• Alzheimer's Disease

6. Endocrine System ............................................................................................ 29

• Diabetes Mellitus
• Thyroid Disorders
• Adrenal Disorders

7. Musculoskeletal System .................................................................................. 33

• Osteoporosis
• Fractures
• Osteoarthritis
• Total Joint Replacement

8. Hematological System ..................................................................................... 36

• Anemia
• Thrombocytopenia
• DIC

9. Immune System ............................................................................................... 39

• HIV/AIDS
• Autoimmune Disorders
• Organ Transplant

10. Integumentary System ................................................................................... 42