Accomplish this 50-item nursing examination covering a wide range of topics about Medical-Surgical Nursing. If you are taking the board examination or nurse board examination or even the NCLEX, then this practice exam is for you.
We also recommend you to try and answer all exams on our NCLEX page!
EXAM TIP: On the final day, focus on what you do know rather than what you don’t know. There is no point in worrying too much about the things you don’t know so well come the day of the exam. You are better off concentrating on the matter that you now know so much more than you did before and a considerable number of the exam questions you’ll be able to answer.
I will persist until I succeed. Always will I take another step. If that is of no avail I will take another, and yet another. In truth, one step at a time is not too difficult. I know that small attempts, repeated, will complete any undertaking.
― Og Mandino
Topics or concepts included in this exam are:
- Various Med-Surg questions.
Follow the guidelines below to make the most out of this exam:
- Read each question carefully and choose the best answer.
- You are given one minute per question. Spend your time wisely!
- Answers and rationales (if any) are given below. Be sure to read them.
- If you need more clarifications, please direct them to the comments section.
In Exam Mode: All questions are shown but the results, answers, and rationales (if any) will only be given after you’ve finished the quiz. You are given 1 minute per question.
NCLEX Practice Exam 17 (50 Questions)
Practice Mode: This is an interactive version of the Text Mode. All questions are given on a single page and correct answers, rationales or explanations (if any) are immediately shown after you have selected an answer. No time limit for this exam.
NCLEX Practice Exam 17 (50 Questions)
In Text Mode: All questions and answers are given for reading and answering at your own pace. You can also copy this exam and make a printout.
1. A client is scheduled for insertion of an inferior vena cava (IVC) filter. Nurse Patricia consults the physician about withholding which regularly scheduled medication on the day before the surgery?
A. Cotton buds
B. Sterile glove
C. Sterile tongue depressor
D. Wisp of cotton
3. A female client develops an infection at the catheter insertion site. The nurse in charge uses the term “iatrogenic” when describing the infection because it resulted from:
A. Client’s developmental level
B. Therapeutic procedure
C. Poor hygiene
D. Inadequate dietary patterns
4. Nurse Carol is assessing a client with Parkinson’s disease. The nurse recognizes bradykinesia when the client exhibits:
A. Intentional tremor
B. Paralysis of limbs
C. Muscle spasm
D. Lack of spontaneous movement
5. A client who suffered from automobile accident complains of seeing frequent flashes of light. The nurse should expect:
B. Detached retina
6. Kate with severe head injury is being monitored by the nurse for increasing intracranial pressure (ICP). Which finding should be most indicative sign of increasing intracranial pressure?
A. Intermittent tachycardia
D. Increased restlessness
A. Hold the client’s arms and leg firmly
B. Place the client immediately on soft surface
C. Protects the client’s head from injury
D. Attempt to insert a tongue depressor between the client’s teeth
8. A client has undergone right pneumonectomy. When turning the client, the nurse should plan to position the client either:
A. Right side-lying position or supine
B. High Fowler’s position
C. Right or left side lying position
D. Low Fowler’s position
9. Nurse Jenny should caution a female client who is sexually active in taking Isoniazid (INH) because the drug has which of the following side effects?
A. Prevents ovulation
B. Has a mutagenic effect on ova
C. Decreases the effectiveness of oral contraceptives
D. Increases the risk of vaginal infection
10. A client has undergone gastrectomy. Nurse Jovy is aware that the best position for the client is:
A. Left side-lying
B. Low fowler’s
11. During the initial postoperative period of the client’s stoma. The nurse evaluates which of the following observations should be reported immediately to the physician?
A. Stoma is dark red to purple
B. Stoma oozes a small amount of blood
C. Stoma is slightly edematous
D. Stoma does not expel stool
12. Kate which has diagnosed with ulcerative colitis is following physician’s order for bed rest with bathroom privileges. What is the rationale for this activity restriction?
A. Prevent injury
B. Promote rest and comfort
C. Reduce intestinal peristalsis
D. Conserve energy
14. A female client has acute pancreatitis. Which of the following signs and symptoms would the nurse expect to see?
15. A client is suspected to develop tetany after a subtotal thyroidectomy. Which of the following symptoms might indicate tetany?
D. Weight gain
17. A client has undergone an ileal conduit, the nurse in charge should closely monitor the client for occurrence of which of the following complications related to pelvic surgery?
18. Dr. Marquez is about to defibrillate a client in ventricular fibrillation and says in a loud voice “clear”. What should be the action of the nurse?
A. Places conductive gel pads for defibrillation on the client’s chest
B. Turn off the mechanical ventilator
C. Shuts off the client’s IV infusion
D. Steps away from the bed and make sure all others have done the same
19. A client has been diagnosed with glomerulonephritis complains of thirst. The nurse should offer:
B. Ginger ale
D. Hard candy
20. A client with acute renal failure is aware that the most serious complication of this condition is:
D. Platelet dysfunction
B. Gag reflex
C. Respiratory movement
D. Corneal reflex
22. The nurse is assessing a client with pleural effusion. The nurse expects to find:
A. Deviation of the trachea towards the involved side
B. Reduced or absent of breath sounds at the base of the lung
C. Moist crackles at the posterior of the lungs
D. Increased resonance with percussion of the involved area
23. A client admitted with newly diagnosed with Hodgkin’s disease. Which of the following would the nurse expect the client to report?
A. Lymph node pain
B. Weight gain
C. Night sweats
24. A client has suffered from fall and sustained a leg injury. Which appropriate question would the nurse ask the client to help determine if the injury caused fracture?
A. “Is the pain sharp and continuous?”
B. “Is the pain dull ache?”
C. “Does the discomfort feel like a cramp?”
D. “Does the pain feel like the muscle was stretched?”
25. The Nurse is assessing the client’s casted extremity for signs of infection. Which of the following findings is indicative of infection?
B. Weak distal pulse
C. Coolness of the skin
D. Presence of “hot spot” on the cast
26. Nurse Rhia is performing an otoscopic examination on a female client with a suspected diagnosis of mastoiditis. Nurse Rhia would expect to note which of the following if this disorder is present?
A. Transparent tympanic membrane
B. Thick and immobile tympanic membrane
C. Pearly colored tympanic membrane
D. Mobile tympanic membrane
27. Nurse Jocelyn is caring for a client with nasogastric tube that is attached to low suction. Nurse Jocelyn assesses the client for symptoms of which acid-base disorder?
A. Respiratory alkalosis
B. Respiratory acidosis
C. Metabolic acidosis
D. Metabolic alkalosis
29. A client is suspected of developing diabetes insipidus. Which of the following is the most effective assessment?
30. A 58-year-old client is suffering from acute phase of rheumatoid arthritis. Which of the following would the nurse in charge identify as the lowest priority of the plan of care?
A. Prevent joint deformity
B. Maintaining usual ways of accomplishing task
C. Relieving pain
D. Preserving joint function
31. Among the following, which client is autotransfusion possible?
A. Client with AIDS
B. Client with ruptured bowel
C. Client who is in danger of cardiac arrest
D. Client with wound infection
32. Which of the following is not a sign of thromboembolism?
33. Nurse Becky is caring for client who begins to experience seizure while in bed. Which action should the nurse implement to prevent aspiration?
A. Position the client on the side with head flexed forward
B. Elevate the head
C. Use tongue depressor between teeth
D. Loosen restrictive clothing
34. A client has undergone bone biopsy. Which nursing action should the nurse provide after the procedure?
A. Administer analgesics via IM
B. Monitor vital signs
C. Monitor the site for bleeding, swelling and hematoma formation
D. Keep area in neutral position
35. A client is suffering from low back pain. Which of the following exercises will strengthen the lower back muscle of the client?
36. A client with peptic ulcer is being assessed by the nurse for gastrointestinal perforation. The nurse should monitor for:
A. (+) guaiac stool test
B. Slow, strong pulse
C. Sudden, severe abdominal pain
D. Increased bowel sounds
37. A client has undergone surgery for retinal detachment. Which of the following goal should be prioritized?
A. Prevent an increase intraocular pressure
B. Alleviate pain
C. Maintain darkened room
D. Promote low-sodium diet
38. A Client with glaucoma has been prescribed with miotics. The nurse is aware that miotics is for:
A. Constricting pupil
B. Relaxing ciliary muscle
C. Constricting intraocular vessel
D. Paralyzing ciliary muscle
39. When suctioning an unconscious client, which nursing intervention should the nurse prioritize in maintaining cerebral perfusion?
A. Administer diuretics
B. Administer analgesics
C. Provide hygiene
D. Hyperoxygenate before and after suctioning
40. When discussing breathing exercises with a postoperative client, Nurse Hazel should include which of the following teaching?
A. Short frequent breaths
B. Exhale with mouth open
C. Exercise twice a day
D. Place hand on the abdomen and feel it rise
41. Louie, with burns over 35% of the body, complains of chilling. In promoting the client’s comfort, the nurse should:
A. Maintain room humidity below 40%
B. Place top sheet on the client
C. Limit the occurrence of drafts
D. Keep room temperature at 80 degrees
42. Nurse Trish is aware that temporary heterograft (pig skin) is used to treat burns because this graft will:
A. Relieve pain and promote rapid epithelialization
B. Be sutured in place for better adherence
C. Debride necrotic epithelium
D. Concurrently used with topical antimicrobials
43. Mark has multiple abrasions and a laceration to the trunk and all four extremities says, “I can’t eat all this food”. The food that the nurse should suggest to be eaten first should be:
A. Meatloaf and coffee
B. Meatloaf and strawberries
C. Tomato soup and apple pie
D. Tomato soup and buttered bread
44. Tony returns from surgery with permanent colostomy. During the first 24 hours, the colostomy does not drain. The nurse should be aware that:
A. Proper functioning of nasogastric suction
B. Presurgical decrease in fluid intake
C. Absence of gastrointestinal motility
D. Intestinal edema following surgery
A. Abdominal pain
C. Change in caliber of stools
D. Change in bowel habits
B. Abdominal rigidity
D. Increased bowel sounds
47. Immediately after liver biopsy, the client is placed on the right side, the nurse is aware that this position should be maintained because it will:
A. Help stop bleeding if any occurs
B. Reduce the fluid trapped in the biliary ducts
C. Position with greatest comfort
D. Promote circulating blood volume
A. Exposed with arsenic compounds at work
B. Working as local plumber
C. Working at hemodialysis clinic
D. Dishwasher in restaurants
49. Nurse Trish is aware that the laboratory test result that most likely would indicate acute pancreatitis is an elevated:
A. Serum bilirubin level
B. Serum amylase level
C. Potassium level
D. Sodium level
50. Dr. Marquez orders serum electrolytes. To determine the effect of persistent vomiting, Nurse Trish should be most concerned with monitoring the:
Answers and Rationale
Here are the answers and rationale for this exam. Counter check your answers to those below and tell us your scores. If you have any disputes or need more clarification to a certain question, please direct them to the comments section.
1. Answer: B. Warfarin Sodium
- Option B: In preoperative period, the nurse should consult with the physician about withholding Warfarin Sodium to avoid occurrence of hemorrhage.
2. Answer: D. Wisp of cotton
- Option D: A client who is unconscious is at greater risk for corneal abrasion. For this reason, the safest way to test the corneal reflex is by touching the cornea lightly with a wisp of cotton.
3. Answer: B. Therapeutic procedure
- Option B: Iatrogenic infection is caused by the health care provider or is induced inadvertently by medical treatment or procedures.
4. Answer: D. Lack of spontaneous movement
- Option D: Bradykinesia is slowing down from the initiation and execution of movement.
5. Answer: B. Detached retina
- Option B: This symptom is caused by stimulation of retinal cells by ocular movement.
6. Answer: D. Increased restlessness
- Option D: Restlessness indicates a lack of oxygen to the brain stem which impairs the reticular activating system.
7. Answer: C. Protects the client’s head from injury
- Option D: Rhythmic contraction and relaxation associated with tonic-clonic seizure can cause repeated banging of head.
8. Answer: A. Right side-lying position or supine
- Option A: Right side-lying position or supine position permits ventilation of the remaining lung and prevent fluid from draining into sutured bronchial stump.
9. Answer: C. Decreases the effectiveness of oral contraceptives
- Option C: Isoniazid (INH) interferes in the effectiveness of oral contraceptives and clients of childbearing age should be counseled to use an alternative form of birth control while taking this drug.
10. Answer: B. Low Fowler’s
- Option B: A client who has had abdominal surgery is best placed in a low Fowler’s position. This relaxes abdominal muscles and provides maximum respiratory and cardiovascular function.
11. Answer: A. Stoma is dark red to purple
- Option A: Dark red to purple stoma indicates inadequate blood supply.
12. Answer: C. Reduce intestinal peristalsis
- Option C: The rationale for activity restriction is to help reduce the hypermotility of the colon.
13. Answer: A. Hyperglycemia
- Option A: During Total Parenteral Nutrition (TPN) administration, the client should be monitored regularly for hyperglycemia.
14. Answer: D. Jaundice
- Option D: Jaundice may be present in acute pancreatitis owing to obstruction of the biliary duct.
15. Answer: A. Tingling in the fingers
- Option A: Tetany may occur after thyroidectomy if the parathyroid glands are accidentally injured or removed.
16. Answer: D. Weight gain
- Option D: Typical signs of hypothyroidism include weight gain, fatigue, decreased energy, apathy, brittle nails, dry skin, cold intolerance, constipation, and numbness.
17. Answer: B. Thrombophlebitis
- Option B: After a pelvic surgery, there is an increased chance of thrombophlebitis owing to the pelvic manipulation that can interfere with circulation and promote venous stasis.
18. Answer: D. Steps away from the bed and make sure all others have done the same
- Option D: For the safety of all personnel, if the defibrillator paddles are being discharged, all personnel must stand back and be clear of all the contact with the client or the client’s bed.
19. Answer: D. Hard candy
- Option D: Hard candy will relieve thirst and increase carbohydrates but does not supply extra fluid.
20. Answer: C. Infection
- Option C: Infection is responsible for one-third of the traumatic or surgically induced death of clients with renal failure as well as medical induced acute renal failure (ARF)
21. Answer: C. Respiratory movement
- Option C: There is no respiratory movement in stage 4 of anesthesia, prior to this stage, respiration is depressed but present.
22. Answer: B. Reduced or absent of breath sounds at the base of the lung
- Option B: Compression of the lung by fluid that accumulates at the base of the lungs reduces expansion and air exchange.
23. Answer: C. Night sweats
- Option C: Assessment of a client with Hodgkin’s disease most often reveals enlarged, painless lymph node, fever, malaise and night sweats.
24. Answer: A. “Is the pain sharp and continuous?”
- Option A: Fractured pain is generally described as sharp, continuous, and increasing in frequency.
25. Answer: D. Presence of “hot spot” on the cast
- Option D: Signs and symptoms of infection under a casted area include odor or purulent drainage and the presence of “hot spot” which are areas on the cast that are warmer than the others.
26. Answer: B. Thick and immobile tympanic membrane
- Option B: Otoscopic examination in a client with mastoiditis reveals a dull, red, thick and immobile tympanic membrane with or without perforation.
27. Answer: D. Metabolic alkalosis
- Option D: Loss of gastric fluid via nasogastric suction or vomiting causes metabolic alkalosis because of the loss of hydrochloric acid which is a potent acid in the body.
28. Answer: A. Red blood cells
- Option A: The adult with normal cerebrospinal fluid has no red blood cells.
29. Answer: D. Measuring urine output hourly
- Option D: Measuring the urine output to detect excess amount and checking the specific gravity of urine samples to determine urine concentration are appropriate measures to determine the onset of diabetes insipidus.
30. Answer: B. Maintaining usual ways of accomplishing task
- Option B: The nurse should focus more on developing less stressful ways of accomplishing routine task.
31. Answer: C. Client who is in danger of cardiac arrest
- Option C: Autotransfusion is acceptable for the client who is in danger of cardiac arrest.
32. Answer: D. Coolness
- Option D: The client with thromboembolism does not have coolness.
33. Answer: A. Position the client on the side with head flexed forward
- Option A: Positioning the client on one side with head flexed forward allows the tongue to fall forward and facilitates drainage secretions, therefore, prevents aspiration.
34. Answer: C. Monitor the site for bleeding, swelling and hematoma formation
- Option C: Nursing care after bone biopsy includes close monitoring of the punctured site for bleeding, swelling and hematoma formation.
35. Answer: D. Swimming
- Option D: Walking and swimming are very helpful in strengthening back muscles for the client suffering from lower back pain.
36. Answer: C. Sudden, severe abdominal pain
- Option C: Sudden, severe abdominal pain is the most indicative sign of perforation. When perforation of an ulcer occurs, the nurse maybe unable to hear bowel sounds at all.
37. Answer: A. Prevent an increased intraocular pressure
- Option A: After surgery to correct a detached retina, prevention of increased intraocular pressure is the priority goal.
38. Answer: A. Constricting pupil
- Option A: Miotic agent constricts the pupil and contracts ciliary muscle. These effects widen the filtration angle and permit increased outflow of aqueous humor.
39. Answer: D. Hyperoxygenate before and after suctioning
- Option D: It is a priority to hyperoxygenate the client before and after suctioning to prevent hypoxia and to maintain cerebral perfusion.
40. Answer: D. Place hand on the abdomen and feel it rise
- Option D: Abdominal breathing improves lungs expansion
41. Answer: C. Limit the occurrence of drafts
- Option C: A Client with burns is very sensitive to temperature changes because heat is lost in the burn areas.
42. Answer: A. Relieve pain and promote rapid epithelialization
- Option A: The graft covers the nerve endings, which reduces pain and provides framework for granulation
43. Answer: B. Meatloaf and strawberries
- Option B: Meat provides proteins and the fruit proteins vitamin C that both promote wound healing.
44. Answer: C. Absence of gastrointestinal motility
- Option C: This is primarily caused by the trauma of intestinal manipulation and the depressive effects anesthetics and analgesics.
45. Answer: D. Change in bowel habits
- Option D: Constipation, diarrhea, and/or constipation alternating with diarrhea are the most common symptoms of colorectal cancer.
46. Answer: B. Abdominal rigidity
- Option B: With increased intraabdominal pressure, the abdominal wall will become tender and rigid.
47. Answer: A. Help stop bleeding if any occurs
- Option A: Pressure applied in the puncture site indicates that a biliary vessel was puncture which is a common complication after liver biopsy.
48. Answer: B. Working as local plumber
- Option B: Hepatitis A is primarily spread via fecal-oral route. Sewage polluted water may harbor the virus.
49. Answer: B. Serum amylase level
- Option B: Amylase concentration is high in the pancreas and is elevated in the serum when the pancreas becomes acutely inflamed and also it distinguishes pancreatitis from other acute abdominal problems.
50. Answer: A. Chloride and sodium levels
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