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Nursing & Healthcare Practice Questions

NCLEX Med-Surg Practice Questions

NCLEX Medical-Surgical Nursing Practice — Practice with free NCLEX-style med-surg sample questions covering cardiovascular, respiratory, GI, endocrine, and neurological nursing. Each question includes a detailed rationale so you learn the reasoning, not just the answer.

75
Total Questions
Varies (NCLEX is CAT)
Time Limit
Pass/Fail (CAT-based)
Passing Score
$200 (NCLEX-RN registration)
Registration Fee

Free Sample Questions

Here are 5 free sample questions from our full bank of 540+ NCLEX Med-Surgpractice questions. Try them out below — click "Show Answer" to reveal the correct response and explanation.

1

A 58-year-old client arrives in the emergency department reporting crushing substernal chest pain that radiates to the left jaw and arm. The pain began 45 minutes ago while mowing the lawn and is unrelieved by rest. Which finding would most strongly support a diagnosis of acute myocardial infarction?

AA) Blood pressure of 138/86 mmHg
BB) ST-segment elevation on the 12-lead ECG with elevated troponin
CC) Heart rate of 92 beats per minute with regular rhythm
DD) Bilateral lower extremity edema with jugular vein distention
2

The nurse is caring for a client with chronic obstructive pulmonary disease (COPD) who is receiving oxygen at 4 L/min via nasal cannula. The client becomes increasingly drowsy, and the SpO2 reads 96%. What is the nurse's priority action?

AA) Increase the oxygen flow to 6 L/min
BB) Place the client in a supine position
CC) Encourage the client to take deep breaths and cough
DD) Lower the oxygen flow rate and notify the provider
3

A client with a history of alcohol use disorder is admitted with hematemesis and a hemoglobin of 7.2 g/dL. Suspected esophageal variceal bleeding is being evaluated. Which nursing action takes highest priority?

AA) Establish two large-bore IV access sites and prepare for fluid resuscitation
BB) Insert a nasogastric tube to lavage the stomach with cold saline
CC) Obtain a detailed dietary history from the client
DD) Administer oral lactulose as prescribed
4

A 24-year-old client with type 1 diabetes presents with deep, rapid respirations, fruity breath odor, blood glucose of 480 mg/dL, and serum bicarbonate of 14 mEq/L. Which prescription should the nurse anticipate first?

AA) Subcutaneous long-acting insulin glargine
BB) Oral metformin 500 mg
CC) Intravenous 0.9% sodium chloride bolus
DD) Sodium bicarbonate IV push
5

The nurse is performing a neurological assessment on a client who arrived with sudden-onset right-sided weakness, facial droop, and slurred speech that began 90 minutes ago. Which action is the priority?

AA) Schedule a routine MRI within 24 hours
BB) Notify the provider and prepare the client for an emergent non-contrast head CT
CC) Administer aspirin 325 mg by mouth
DD) Begin physical therapy referral paperwork

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About the NCLEX Med-Surg

Format & Structure

Total Questions
75
Time Limit
Varies (NCLEX is CAT)
Format
Multiple choice + alternate formats

Scoring & Cost

Passing Score
Pass/Fail (CAT-based)
Registration Fee
$200 (NCLEX-RN registration)

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Frequently Asked Questions

What is medical-surgical nursing?

Med-surg is the broad specialty that covers adult patients with acute and chronic illnesses across nearly every body system -- think heart failure, COPD, diabetes, post-op care, GI bleeds, strokes, and so on. It's where most new nurses start, and it shows up everywhere on the NCLEX. If you can think like a med-surg nurse, you can answer a huge chunk of the questions on the test.

Why is med-surg content so important on the NCLEX?

Because adults with multiple comorbidities make up the bulk of hospital populations, NCLEX leans heavily on med-surg scenarios. You'll see questions about prioritizing patients, recognizing complications, interpreting lab values, and choosing the right intervention. Even questions tagged under other categories (safety, pharmacology, management of care) often play out in a med-surg setting. Strong med-surg knowledge lifts your score across the whole test.

Which body systems should I focus on the most?

If you only have limited time, prioritize cardiovascular, respiratory, endocrine (especially diabetes), GI, and neurological content. These show up constantly. Renal/urinary, musculoskeletal, integumentary, and hematologic are next in line. And don't skip fluid and electrolyte balance -- it weaves through almost every system and trips up a lot of test takers.

What's the best way to study med-surg for NCLEX?

Honestly? Practice questions, then more practice questions. Reading textbooks is fine, but you learn the NCLEX style by doing it. Pick a system, do 25-50 questions, then read the rationales -- even for the ones you got right. Why was the wrong answer wrong? That's where the real learning happens. Mix in some test-taking strategy too. A study plan of 2-3 hours a day for 4-6 weeks works well for most people.

How do I prioritize when a question gives me four sick patients?

Use the frameworks. ABCs first (airway, breathing, circulation), then Maslow's hierarchy, then stable vs. unstable. A patient with new-onset shortness of breath beats a patient with a chronic stable wound every single time. Acute always trumps chronic. Unexpected findings trump expected ones. When in doubt, ask yourself which patient could die or deteriorate fastest if you don't see them right now.

What kinds of med-surg questions show up on NCLEX?

Lots of variety. You'll see traditional multiple choice, but also select-all-that-apply (SATA), ordered response (drag and drop), fill-in-the-blank for med calculations, and the newer Next Generation NCLEX (NGN) case studies that walk you through a patient scenario across multiple linked questions. Med-surg content fits naturally into all of these formats.

How do I pick the BEST answer when two options look right?

This is the classic NCLEX trap. Both answers might be technically correct -- but one is better given the situation. Read the question stem again and look for the priority word: "first," "initial," "most important," "best." Then apply ABCs and Maslow. Also watch for assessment vs. intervention -- if the question gives you incomplete data, assessment usually wins. And avoid answers that are absolute ("always," "never") -- nursing rarely deals in absolutes.

How many med-surg practice questions should I do before the NCLEX?

Most students who pass on the first try report doing somewhere between 2,000 and 3,500 total NCLEX-style questions, with a heavy chunk of that being med-surg. That sounds like a lot, but spread over 4-8 weeks it's very doable. Quality matters more than quantity though -- 50 questions you actually review and learn from beats 200 you blow through.

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