TEST BANK
MEDICAL-SURGICAL NURSING
600 Original NCLEX-Style Practice Questions
2026–2027 EDITION
CLINICAL REASONING PRIORITIZATION PATIENT SAFETY
NURSING PROCESS NCLEX-STYLE DETAILED RATIONALES
ADULT HEALTH CASE-BASED THINKING EXAM PREPARATION
Course: Medical-Surgical Nursing
Original educational content. Not an official NCLEX®, ATI®, HESI®, or publisher test bank.
Medical-Surgical Nursing • 600 Original NCLEX-Style Questions • 2026–2027 Page 1
, TABLE OF CONTENTS
SECTION QUESTIONS
1. Foundations, Assessment & Clinical Judgment Q1–Q50
2. Cardiovascular Disorders Q51–Q100
3. Respiratory Disorders Q101–Q150
4. Neurologic Disorders Q151–Q200
5. Endocrine & Metabolic Disorders Q201–Q250
6. Gastrointestinal & Hepatic Disorders Q251–Q300
7. Renal & Urinary Disorders Q301–Q350
8. Musculoskeletal & Integumentary Disorders Q351–Q400
9. Hematology, Oncology & Immune Disorders Q401–Q450
10. Infection, Sepsis & Emergency/Critical Care Q451–Q500
11. Perioperative, Pain, Fluids & Electrolytes Q501–Q550
12. Pharmacology, Safety, Delegation & Prioritization Q551–Q600
Medical-Surgical Nursing • 600 Original NCLEX-Style Questions • 2026–2027 Page 2
, 1. Foundations, Assessment & Clinical Judgment
Question 1. Which patient should the nurse assess first?
A) A patient with new stridor after extubation
B) A patient awaiting discharge paperwork
C) A patient requesting a bath
D) A patient with chronic pain rated 4/10
Correct Answer: A
Rationale: Stridor may indicate upper-airway obstruction and requires immediate assessment.
Cognitive Level: Analyze | Nursing Process: Implementation | NCLEX Client Need: Physiological Adaptation
Question 2. During routine rounding, a patient suddenly becomes confused and difficult to arouse. Which action
should the nurse take first?
A) Document the change later
B) Check airway and oxygen saturation
C) Offer oral fluids
D) Ask the family if this is normal
Correct Answer: B
Rationale: An acute change in consciousness can signal hypoxia or another life threat. Airway and oxygenation are immediate priorities.
Cognitive Level: Remember | Nursing Process: Assessment | NCLEX Client Need: Reduction of Risk Potential
Question 3. While caring for the patient on a medical-surgical unit, which patient should the nurse assess first?
A) A patient requesting a bath
B) A patient with chronic pain rated 4/10
C) A patient awaiting discharge paperwork
D) A patient with new stridor after extubation
Correct Answer: D
Rationale: Stridor may indicate upper-airway obstruction and requires immediate assessment.
Cognitive Level: Remember | Nursing Process: Planning | NCLEX Client Need: Physiological Adaptation
Question 4. During a focused reassessment, which patient should the nurse assess first?
A) A patient awaiting discharge paperwork
B) A patient with chronic pain rated 4/10
C) A patient with new stridor after extubation
D) A patient requesting a bath
Correct Answer: C
Rationale: Stridor may indicate upper-airway obstruction and requires immediate assessment.
Cognitive Level: Analyze | Nursing Process: Evaluation | NCLEX Client Need: Physiological Adaptation
Question 5. During routine rounding, a patient suddenly becomes confused and difficult to arouse. Which action
should the nurse take first?
A) Offer oral fluids
B) Check airway and oxygen saturation
C) Document the change later
D) Ask the family if this is normal
Correct Answer: B
Rationale: An acute change in consciousness can signal hypoxia or another life threat. Airway and oxygenation are immediate priorities.
Cognitive Level: Analyze | Nursing Process: Planning | NCLEX Client Need: Safety and Infection Control
Question 6. During discharge planning, which patient should the nurse assess first?
A) A patient requesting a bath
B) A patient awaiting discharge paperwork
C) A patient with new stridor after extubation
D) A patient with chronic pain rated 4/10
Correct Answer: C
Rationale: Stridor may indicate upper-airway obstruction and requires immediate assessment.
Cognitive Level: Understand | Nursing Process: Evaluation | NCLEX Client Need: Physiological Adaptation
Question 7. During discharge planning, which patient should the nurse assess first?
A) A patient awaiting discharge paperwork
B) A patient with new stridor after extubation
C) A patient requesting a bath
D) A patient with chronic pain rated 4/10
Medical-Surgical Nursing • 600 Original NCLEX-Style Questions • 2026–2027 Page 3
, Correct Answer: B
Rationale: Stridor may indicate upper-airway obstruction and requires immediate assessment.
Cognitive Level: Remember | Nursing Process: Implementation | NCLEX Client Need: Reduction of Risk Potential
Question 8. After a change in the patient's condition, a patient suddenly becomes confused and difficult to arouse.
Which action should the nurse take first?
A) Check airway and oxygen saturation
B) Ask the family if this is normal
C) Document the change later
D) Offer oral fluids
Correct Answer: A
Rationale: An acute change in consciousness can signal hypoxia or another life threat. Airway and oxygenation are immediate priorities.
Cognitive Level: Understand | Nursing Process: Implementation | NCLEX Client Need: Safety and Infection Control
Question 9. During discharge planning, which action best demonstrates medication reconciliation?
A) Compare the home medication list with current orders
B) Delete all home medications
C) Ask only about prescriptions
D) Review medications only at discharge
Correct Answer: A
Rationale: Medication reconciliation compares the most accurate preadmission list with current orders to identify discrepancies.
Cognitive Level: Remember | Nursing Process: Planning | NCLEX Client Need: Physiological Adaptation
Question 10. While caring for the patient on a medical-surgical unit, which action best demonstrates medication
reconciliation?
A) Compare the home medication list with current orders
B) Delete all home medications
C) Review medications only at discharge
D) Ask only about prescriptions
Correct Answer: A
Rationale: Medication reconciliation compares the most accurate preadmission list with current orders to identify discrepancies.
Cognitive Level: Understand | Nursing Process: Planning | NCLEX Client Need: Physiological Adaptation
Question 11. During the nurse's initial assessment, a patient suddenly becomes confused and difficult to arouse.
Which action should the nurse take first?
A) Offer oral fluids
B) Check airway and oxygen saturation
C) Document the change later
D) Ask the family if this is normal
Correct Answer: B
Rationale: An acute change in consciousness can signal hypoxia or another life threat. Airway and oxygenation are immediate priorities.
Cognitive Level: Remember | Nursing Process: Implementation | NCLEX Client Need: Reduction of Risk Potential
Question 12. While caring for the patient on a medical-surgical unit, which patient should the nurse assess first?
A) A patient awaiting discharge paperwork
B) A patient with new stridor after extubation
C) A patient requesting a bath
D) A patient with chronic pain rated 4/10
Correct Answer: B
Rationale: Stridor may indicate upper-airway obstruction and requires immediate assessment.
Cognitive Level: Analyze | Nursing Process: Implementation | NCLEX Client Need: Safety and Infection Control
Question 13. During routine rounding, a patient suddenly becomes confused and difficult to arouse. Which action
should the nurse take first?
A) Document the change later
B) Check airway and oxygen saturation
C) Offer oral fluids
D) Ask the family if this is normal
Correct Answer: B
Rationale: An acute change in consciousness can signal hypoxia or another life threat. Airway and oxygenation are immediate priorities.
Cognitive Level: Understand | Nursing Process: Assessment | NCLEX Client Need: Management of Care
Question 14. During the nurse's initial assessment, which patient should the nurse assess first?
Medical-Surgical Nursing • 600 Original NCLEX-Style Questions • 2026–2027 Page 4
MEDICAL-SURGICAL NURSING
600 Original NCLEX-Style Practice Questions
2026–2027 EDITION
CLINICAL REASONING PRIORITIZATION PATIENT SAFETY
NURSING PROCESS NCLEX-STYLE DETAILED RATIONALES
ADULT HEALTH CASE-BASED THINKING EXAM PREPARATION
Course: Medical-Surgical Nursing
Original educational content. Not an official NCLEX®, ATI®, HESI®, or publisher test bank.
Medical-Surgical Nursing • 600 Original NCLEX-Style Questions • 2026–2027 Page 1
, TABLE OF CONTENTS
SECTION QUESTIONS
1. Foundations, Assessment & Clinical Judgment Q1–Q50
2. Cardiovascular Disorders Q51–Q100
3. Respiratory Disorders Q101–Q150
4. Neurologic Disorders Q151–Q200
5. Endocrine & Metabolic Disorders Q201–Q250
6. Gastrointestinal & Hepatic Disorders Q251–Q300
7. Renal & Urinary Disorders Q301–Q350
8. Musculoskeletal & Integumentary Disorders Q351–Q400
9. Hematology, Oncology & Immune Disorders Q401–Q450
10. Infection, Sepsis & Emergency/Critical Care Q451–Q500
11. Perioperative, Pain, Fluids & Electrolytes Q501–Q550
12. Pharmacology, Safety, Delegation & Prioritization Q551–Q600
Medical-Surgical Nursing • 600 Original NCLEX-Style Questions • 2026–2027 Page 2
, 1. Foundations, Assessment & Clinical Judgment
Question 1. Which patient should the nurse assess first?
A) A patient with new stridor after extubation
B) A patient awaiting discharge paperwork
C) A patient requesting a bath
D) A patient with chronic pain rated 4/10
Correct Answer: A
Rationale: Stridor may indicate upper-airway obstruction and requires immediate assessment.
Cognitive Level: Analyze | Nursing Process: Implementation | NCLEX Client Need: Physiological Adaptation
Question 2. During routine rounding, a patient suddenly becomes confused and difficult to arouse. Which action
should the nurse take first?
A) Document the change later
B) Check airway and oxygen saturation
C) Offer oral fluids
D) Ask the family if this is normal
Correct Answer: B
Rationale: An acute change in consciousness can signal hypoxia or another life threat. Airway and oxygenation are immediate priorities.
Cognitive Level: Remember | Nursing Process: Assessment | NCLEX Client Need: Reduction of Risk Potential
Question 3. While caring for the patient on a medical-surgical unit, which patient should the nurse assess first?
A) A patient requesting a bath
B) A patient with chronic pain rated 4/10
C) A patient awaiting discharge paperwork
D) A patient with new stridor after extubation
Correct Answer: D
Rationale: Stridor may indicate upper-airway obstruction and requires immediate assessment.
Cognitive Level: Remember | Nursing Process: Planning | NCLEX Client Need: Physiological Adaptation
Question 4. During a focused reassessment, which patient should the nurse assess first?
A) A patient awaiting discharge paperwork
B) A patient with chronic pain rated 4/10
C) A patient with new stridor after extubation
D) A patient requesting a bath
Correct Answer: C
Rationale: Stridor may indicate upper-airway obstruction and requires immediate assessment.
Cognitive Level: Analyze | Nursing Process: Evaluation | NCLEX Client Need: Physiological Adaptation
Question 5. During routine rounding, a patient suddenly becomes confused and difficult to arouse. Which action
should the nurse take first?
A) Offer oral fluids
B) Check airway and oxygen saturation
C) Document the change later
D) Ask the family if this is normal
Correct Answer: B
Rationale: An acute change in consciousness can signal hypoxia or another life threat. Airway and oxygenation are immediate priorities.
Cognitive Level: Analyze | Nursing Process: Planning | NCLEX Client Need: Safety and Infection Control
Question 6. During discharge planning, which patient should the nurse assess first?
A) A patient requesting a bath
B) A patient awaiting discharge paperwork
C) A patient with new stridor after extubation
D) A patient with chronic pain rated 4/10
Correct Answer: C
Rationale: Stridor may indicate upper-airway obstruction and requires immediate assessment.
Cognitive Level: Understand | Nursing Process: Evaluation | NCLEX Client Need: Physiological Adaptation
Question 7. During discharge planning, which patient should the nurse assess first?
A) A patient awaiting discharge paperwork
B) A patient with new stridor after extubation
C) A patient requesting a bath
D) A patient with chronic pain rated 4/10
Medical-Surgical Nursing • 600 Original NCLEX-Style Questions • 2026–2027 Page 3
, Correct Answer: B
Rationale: Stridor may indicate upper-airway obstruction and requires immediate assessment.
Cognitive Level: Remember | Nursing Process: Implementation | NCLEX Client Need: Reduction of Risk Potential
Question 8. After a change in the patient's condition, a patient suddenly becomes confused and difficult to arouse.
Which action should the nurse take first?
A) Check airway and oxygen saturation
B) Ask the family if this is normal
C) Document the change later
D) Offer oral fluids
Correct Answer: A
Rationale: An acute change in consciousness can signal hypoxia or another life threat. Airway and oxygenation are immediate priorities.
Cognitive Level: Understand | Nursing Process: Implementation | NCLEX Client Need: Safety and Infection Control
Question 9. During discharge planning, which action best demonstrates medication reconciliation?
A) Compare the home medication list with current orders
B) Delete all home medications
C) Ask only about prescriptions
D) Review medications only at discharge
Correct Answer: A
Rationale: Medication reconciliation compares the most accurate preadmission list with current orders to identify discrepancies.
Cognitive Level: Remember | Nursing Process: Planning | NCLEX Client Need: Physiological Adaptation
Question 10. While caring for the patient on a medical-surgical unit, which action best demonstrates medication
reconciliation?
A) Compare the home medication list with current orders
B) Delete all home medications
C) Review medications only at discharge
D) Ask only about prescriptions
Correct Answer: A
Rationale: Medication reconciliation compares the most accurate preadmission list with current orders to identify discrepancies.
Cognitive Level: Understand | Nursing Process: Planning | NCLEX Client Need: Physiological Adaptation
Question 11. During the nurse's initial assessment, a patient suddenly becomes confused and difficult to arouse.
Which action should the nurse take first?
A) Offer oral fluids
B) Check airway and oxygen saturation
C) Document the change later
D) Ask the family if this is normal
Correct Answer: B
Rationale: An acute change in consciousness can signal hypoxia or another life threat. Airway and oxygenation are immediate priorities.
Cognitive Level: Remember | Nursing Process: Implementation | NCLEX Client Need: Reduction of Risk Potential
Question 12. While caring for the patient on a medical-surgical unit, which patient should the nurse assess first?
A) A patient awaiting discharge paperwork
B) A patient with new stridor after extubation
C) A patient requesting a bath
D) A patient with chronic pain rated 4/10
Correct Answer: B
Rationale: Stridor may indicate upper-airway obstruction and requires immediate assessment.
Cognitive Level: Analyze | Nursing Process: Implementation | NCLEX Client Need: Safety and Infection Control
Question 13. During routine rounding, a patient suddenly becomes confused and difficult to arouse. Which action
should the nurse take first?
A) Document the change later
B) Check airway and oxygen saturation
C) Offer oral fluids
D) Ask the family if this is normal
Correct Answer: B
Rationale: An acute change in consciousness can signal hypoxia or another life threat. Airway and oxygenation are immediate priorities.
Cognitive Level: Understand | Nursing Process: Assessment | NCLEX Client Need: Management of Care
Question 14. During the nurse's initial assessment, which patient should the nurse assess first?
Medical-Surgical Nursing • 600 Original NCLEX-Style Questions • 2026–2027 Page 4
