Med-Surg NCLEX-PN Practice Quiz
139 NCLEX-PN style questions with detailed rationales. Test your medical-surgical nursing knowledge across all major body systems.
Ready to Test Yourself?
139 questions modeled after the Exit Exam format — pick how many below.
About This Med-Surg Practice Test
This free medical-surgical practice test covers adult health across every major system — cardiovascular, respiratory, gastrointestinal, renal and urinary, endocrine, neurologic, musculoskeletal, sensory, hematology and oncology, and immune and infectious disease — plus fluid and electrolyte balance, burns, and shock. Every question is written in NCLEX-PN style with a full rationale after each answer.
What This Quiz Covers
- Cardiovascular 16
- Respiratory 13
- Gastrointestinal 15
- Renal / Urinary 9
- Endocrine 20
- Neurologic 13
- Musculoskeletal 8
- Sensory (Eye / Ear) 7
- Hematology / Oncology 19
- Immune / Infectious 7
- Fluid & Electrolyte 3
- Burns 5
- Shock 4
Sample Questions
Five questions pulled straight from this quiz, with the same rationales you get after every answer.
1. A nurse is caring for a client who develops hives, lip swelling, and wheezing minutes after receiving IV penicillin. Which of the following actions should the nurse take first?
- AGive an IV antihistamine
- BAdminister epinephrine
- CAdminister an IV corticosteroid
- DPlace the client in high-Fowler's
Show answer & rationale
These findings signal anaphylactic (distributive) shock. Epinephrine is the first, life-saving action — it reverses the vasodilation and airway swelling that can kill within minutes. Antihistamines and corticosteroids are useful adjuncts but work too slowly to be first-line. Positioning supports the airway but does not treat the reaction itself.
2. A nurse is reinforcing teaching with a client who has been taking long-term oral prednisone and wants to stop the medication. Which of the following statements should the nurse include? Select all that apply.
- AThe dose must be tapered slowly, not stopped suddenly
- BStopping abruptly can trigger an adrenal crisis
- CReport fatigue, weakness, nausea, and dizziness
- DTake the dose at bedtime to match your body's natural rhythm
- EYou may stop the medication once you feel better
- FSkipping doses prevents your body's cortisol production
Show answer & rationale
Long-term steroids suppress the adrenal glands, so the dose is tapered gradually to let the body resume making its own cortisol; stopping abruptly can cause life-threatening adrenal crisis (fatigue, weakness, nausea, hypotension), which is exactly why those symptoms are reported. Take the dose with food to limit GI upset, and take it in the MORNING, not at bedtime -- morning dosing matches the body's natural cortisol peak, while a bedtime dose tends to cause insomnia. Stopping once 'feeling better' is wrong (finish the taper), and skipping doses does not spare cortisol production; it worsens the suppression.
3. A nurse is reinforcing teaching with a client who takes metoprolol for hypertension and says, "I feel fine now, so I'm going to stop taking this." Which of the following responses is most appropriate?
- AThat is fine once your BP has been normal a week
- BYou can take it only when your heart is racing
- CStopping it suddenly causes a temporary dry cough
- DStopping suddenly can cause rebound high heart rate and BP
Show answer & rationale
Beta-blockers like metoprolol must never be stopped abruptly; sudden withdrawal causes rebound tachycardia and hypertension and raises MI risk, so the drug is tapered under provider guidance. Stopping when BP normalizes or using it 'as needed' both risk rebound effects. A dry cough is an ACE inhibitor side effect, not beta-blocker withdrawal.
4. A nurse is caring for a client with chronic kidney disease whose serum potassium is 6.4 mEq/L with peaked T waves on the EKG. Which of the following medications should the nurse anticipate giving FIRST?
- AIV calcium gluconate
- BInsulin with dextrose 50%
- CSodium polystyrene sulfonate (Kayexalate)
- DSodium bicarbonate
Show answer & rationale
IV calcium gluconate is given FIRST in dangerous hyperkalemia (K+ >5.0 with peaked T waves) because it stabilizes the cardiac membrane and protects the heart from lethal arrhythmias immediately, though it does not lower the K+ level. Insulin with D50 is next to shift K+ into cells, and Kayexalate then removes K+ via the GI tract — but neither protects the heart first.
5. A nurse is caring for a client who has severe dehydration from prolonged vomiting and now has decreased urine output. Which type of acute kidney injury is this client most likely experiencing?
- APrerenal AKI
- BIntrarenal AKI
- CPostrenal AKI
- DChronic kidney disease
Show answer & rationale
Prerenal AKI comes from decreased blood flow TO the kidney, and dehydration is the classic cause (also hemorrhage, heart failure, sepsis) — the most common type. Intrarenal AKI is damage within the kidney (nephrotoxins, ATN). Postrenal AKI is obstruction after the kidney (stones, BPH). CKD is a gradual, irreversible decline over months to years, not a sudden drop.
Frequently Asked Questions
Are these Med-Surg practice questions really free?
Yes. All 139 questions are free to use, with no account, no sign-up, and no card. You can retake the quiz as many times as you like.
Will this help with my ATI or HESI exit exam?
It should. Nursing school exit exams such as the ATI PN Comprehensive Predictor and the HESI PN Exit Exam are built to predict NCLEX-PN readiness, so they draw on the same content areas these questions follow. The question formats differ, but the material overlaps heavily.
Do the questions come with rationales?
Every one does. As soon as you answer, you see whether you were right along with a full explanation of the reasoning, including why the other options are wrong.
How long is the Med-Surg practice test?
You choose. Take a short set of 10 for a quick review, or work through the full pool of 139 questions as a longer practice test. You can also filter by topic to drill a single area.
Want to review before you test yourself? Read the Med-Surg study guides, or browse all 8 subject quizzes.
More practice quizzes
Every subject below is free, needs no account, and every question comes with a full rationale.
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