Medical-Surgical Nursing forms the backbone of clinical practice and NCLEX preparation. In this section, we continue with NCLEX Medical-Surgical Nursing MCQs (Part 2: Questions 51–100), carefully designed to test high-yield topics such as cardiovascular, endocrine, renal, and perioperative nursing care.
Each question includes the correct answer and detailed explanation, helping students build strong clinical reasoning skills. Whether you’re preparing in the USA, UK, Canada, Australia, or other high-standard healthcare systems, these practice questions will enhance your preparation for the NCLEX exam and real-world nursing scenarios.
51. A patient with chronic kidney disease (CKD) is advised to limit potassium-rich foods. Which food should be avoided?
- A. Apples
- B. Bananas ✅
- C. Rice
- D. Cabbage
Answer: B. Bananas
Explanation: Bananas are high in potassium, which can worsen hyperkalemia in CKD patients. Apples, rice, and cabbage are safer low-potassium alternatives.
52. A nurse is caring for a patient with chronic obstructive pulmonary disease (COPD). What is the primary oxygen administration strategy?
- A. Administer high-flow oxygen immediately
- B. Administer 1–2 L/min via nasal cannula ✅
- C. Use non-rebreather mask at 15 L/min
- D. Administer 100% oxygen continuously
Answer: B. Administer 1–2 L/min via nasal cannula
Explanation: COPD patients rely on hypoxic drive for respiration. High oxygen flow may depress their breathing. Low-flow oxygen ensures safety.
53. Which laboratory finding is expected in a patient with diabetic ketoacidosis (DKA)?
- A. Respiratory alkalosis
- B. Metabolic acidosis ✅
- C. Metabolic alkalosis
- D. Normal pH
Answer: B. Metabolic acidosis
Explanation: DKA is characterized by accumulation of ketone bodies, leading to low pH and low bicarbonate levels.
54. A patient with heart failure is prescribed furosemide. Which electrolyte imbalance is the nurse most concerned about?
- A. Hypernatremia
- B. Hyperkalemia
- C. Hypokalemia ✅
- D. Hypercalcemia
Answer: C. Hypokalemia
Explanation: Furosemide (loop diuretic) increases potassium excretion, causing hypokalemia, which may trigger dangerous arrhythmias.
55. A patient with deep vein thrombosis (DVT) is receiving heparin. Which lab test is most important to monitor?
- A. INR
- B. aPTT ✅
- C. PT
- D. Platelet count only
Answer: B. aPTT
Explanation: Activated Partial Thromboplastin Time (aPTT) is used to monitor heparin therapy effectiveness and risk of bleeding.
56. Which sign is a classic symptom of hypoglycemia?
- A. Excessive thirst
- B. Fruity breath odor
- C. Tremors and sweating ✅
- D. Slow heart rate
Answer: C. Tremors and sweating
Explanation: Hypoglycemia causes autonomic nervous system activation, leading to sweating, tremors, tachycardia, and anxiety.
57. A nurse is caring for a patient after a thyroidectomy. Which complication should be monitored first?
- A. Constipation
- B. Hypocalcemia ✅
- C. Weight gain
- D. Bradycardia
Answer: B. Hypocalcemia
Explanation: Removal of the thyroid gland can damage parathyroid glands, leading to low calcium levels, causing tetany and muscle spasms.
58. Which nursing intervention is most important in a patient with liver cirrhosis and ascites?
- A. Encourage high-sodium diet
- B. Daily weight monitoring ✅
- C. Strict bed rest
- D. Increase fluid intake
Answer: B. Daily weight monitoring
Explanation: Ascites is fluid accumulation in the abdomen. Daily weights help assess fluid retention and effectiveness of treatment.
59. Which sign indicates left-sided heart failure?
- A. Jugular vein distension
- B. Peripheral edema
- C. Pulmonary congestion ✅
- D. Hepatomegaly
Answer: C. Pulmonary congestion
Explanation: Left-sided failure leads to backflow of blood into the lungs, causing dyspnea, orthopnea, and pulmonary edema.
60. A nurse is caring for a patient with Addison’s disease. Which emergency complication should be anticipated?
- A. Hypertensive crisis
- B. Addisonian crisis ✅
- C. Stroke
- D. Seizures
Answer: B. Addisonian crisis
Explanation: Addison’s disease is adrenal insufficiency. Addisonian crisis is life-threatening, characterized by low cortisol, severe hypotension, and shock.
61. A patient with peptic ulcer disease reports sudden severe abdominal pain and rigid abdomen. What does this indicate?
- A. Gastritis
- B. Ulcer perforation ✅
- C. GERD
- D. Constipation
Answer: B. Ulcer perforation
Explanation: Sudden pain with board-like rigidity suggests perforated ulcer, a surgical emergency due to peritonitis risk.
62. Which electrolyte imbalance is most likely in a patient with chronic diarrhea?
- A. Hyperkalemia
- B. Hypokalemia ✅
- C. Hypernatremia
- D. Hypercalcemia
Answer: B. Hypokalemia
Explanation: Diarrhea causes excessive potassium loss, leading to muscle weakness and cardiac issues.
63. Which finding is associated with Cushing’s syndrome?
- A. Moon face ✅
- B. Weight loss
- C. Hypotension
- D. Hyperpigmentation
Answer: A. Moon face
Explanation: Cushing’s syndrome is due to excess cortisol, causing moon face, truncal obesity, and hypertension.
64. In a patient with tuberculosis (TB), which infection control precaution is necessary?
- A. Standard precautions only
- B. Contact precautions
- C. Airborne precautions ✅
- D. Droplet precautions
Answer: C. Airborne precautions
Explanation: TB spreads via airborne droplets. N95 mask, negative pressure room, and airborne isolation are required.
65. A nurse is caring for a patient with myocardial infarction (MI). Which lab test is most specific?
- A. CK-MB
- B. Troponin ✅
- C. LDH
- D. Myoglobin
Answer: B. Troponin
Explanation: Troponin I and T are the most specific and sensitive markers of cardiac muscle injury.
66. Which drug is used in the treatment of anaphylaxis?
- A. Atropine
- B. Epinephrine ✅
- C. Diazepam
- D. Insulin
Answer: B. Epinephrine
Explanation: IM epinephrine is the first-line treatment for anaphylaxis because it reverses airway obstruction and hypotension.
67. A patient with stroke affecting the left hemisphere will most likely present with:
- A. Impulsivity
- B. Poor judgment
- C. Aphasia ✅
- D. Left-sided weakness
Answer: C. Aphasia
Explanation: Left hemisphere controls language; damage leads to aphasia. Right-sided weakness is also common.
68. A patient with COPD is instructed to practice pursed-lip breathing. Why?
- A. To increase respiratory rate
- B. To prevent airway collapse ✅
- C. To strengthen intercostal muscles
- D. To improve oxygen solubility
Answer: B. To prevent airway collapse
Explanation: Pursed-lip breathing maintains positive airway pressure, preventing premature airway closure in COPD.
69. A patient with aplastic anemia should avoid:
- A. Crowded places ✅
- B. Iron-rich foods
- C. Protein supplements
- D. Exercise
Answer: A. Crowded places
Explanation: Aplastic anemia causes bone marrow suppression → high risk of infection, so avoiding crowds is essential.
70. Which sign is an early indicator of increased intracranial pressure (ICP)?
- A. Irregular respirations
- B. Bradycardia
- C. Restlessness and confusion ✅
- D. Fixed pupils
Answer: C. Restlessness and confusion
Explanation: Early signs of raised ICP include altered mental status. Later signs are Cushing’s triad (bradycardia, irregular respirations, hypertension).
71. Which diet is most appropriate for a patient with celiac disease?
- A. High-protein, high-gluten
- B. Gluten-free diet ✅
- C. Low-carbohydrate diet
- D. High-fiber diet
Answer: B. Gluten-free diet
Explanation: Celiac disease is an autoimmune disorder triggered by gluten (wheat, rye, barley). Patients must avoid gluten permanently.
72. A nurse is preparing to give digoxin. Which vital sign must be checked first?
- A. Blood pressure
- B. Respiratory rate
- C. Apical pulse ✅
- D. Temperature
Answer: C. Apical pulse
Explanation: Digoxin slows heart rate. Hold medication if apical pulse <60 bpm in adults.
73. Which finding is expected in Parkinson’s disease?
- A. Spastic movements
- B. Tremors at rest ✅
- C. Rapid speech
- D. Hyperreflexia
Answer: B. Tremors at rest
Explanation: Classic Parkinson’s signs are resting tremor, rigidity, bradykinesia, and postural instability.
74. Which is the priority intervention for a patient experiencing a seizure?
- A. Restrain movements
- B. Insert a tongue depressor
- C. Maintain airway and safety ✅
- D. Start CPR
Answer: C. Maintain airway and safety
Explanation: The nurse should protect from injury, place on side, ensure airway, and not restrain or insert objects.
75. Which condition is associated with Barrett’s esophagus?
- A. Peptic ulcer
- B. GERD ✅
- C. Gastritis
- D. Crohn’s disease
Answer: B. GERD
Explanation: Chronic gastroesophageal reflux disease can cause Barrett’s esophagus, a precancerous condition.
76. Which laboratory result is expected in iron-deficiency anemia?
- A. Increased hemoglobin
- B. Increased hematocrit
- C. Low ferritin levels ✅
- D. High MCV
Answer: C. Low ferritin levels
Explanation: Ferritin reflects iron stores, which are low in iron-deficiency anemia.
77. A patient with Graves’ disease will most likely show:
- A. Cold intolerance
- B. Exophthalmos ✅
- C. Bradycardia
- D. Weight gain
Answer: B. Exophthalmos
Explanation: Graves’ disease (hyperthyroidism) causes bulging eyes, heat intolerance, tachycardia, and weight loss.
78. The nurse is caring for a patient with asthma. Which finding indicates worsening condition?
- A. Wheezing
- B. Silent chest ✅
- C. Productive cough
- D. Fast respiratory rate
Answer: B. Silent chest
Explanation: Absence of breath sounds (“silent chest”) indicates severe airway obstruction → medical emergency.
79. Which condition is associated with chronic alcohol use?
- A. Cirrhosis ✅
- B. Renal failure
- C. Stroke
- D. Ulcerative colitis
Answer: A. Cirrhosis
Explanation: Long-term alcohol abuse damages liver cells, leading to cirrhosis and portal hypertension.
80. A patient with multiple sclerosis (MS) is most likely to experience:
- A. Visual disturbances ✅
- B. Constipation only
- C. Decreased blood pressure
- D. Joint deformities
Answer: A. Visual disturbances
Explanation: MS is a demyelinating disease causing optic neuritis, fatigue, weakness, and impaired coordination.
81. Which ECG change is seen in hypokalemia?
- A. Tall peaked T waves
- B. Flattened T waves ✅
- C. Prolonged PR interval
- D. Shortened QT interval
Answer: B. Flattened T waves
Explanation: Low potassium causes flattened or inverted T waves and U waves on ECG.
82. A patient with Addison’s disease is at risk for:
- A. Hypotension ✅
- B. Hypertension
- C. Hypoglycemia
- D. Both A and C
Answer: D. Both A and C
Explanation: Addison’s (adrenal insufficiency) → low cortisol and aldosterone → hypotension and hypoglycemia.
83. Which condition requires droplet precautions?
- A. Tuberculosis
- B. Influenza ✅
- C. MRSA
- D. HIV
Answer: B. Influenza
Explanation: Influenza spreads via droplet. Patients should be placed in droplet isolation with mask use.
84. Which drug is used to reverse opioid overdose?
- A. Naloxone ✅
- B. Atropine
- C. Diazepam
- D. Flumazenil
Answer: A. Naloxone
Explanation: Naloxone is an opioid antagonist that reverses respiratory depression caused by opioids.
85. A patient with deep vein thrombosis (DVT) is at risk for:
- A. Pulmonary embolism ✅
- B. Stroke
- C. Hypertension
- D. Myocardial infarction
Answer: A. Pulmonary embolism
Explanation: A clot in the leg vein can travel to the lungs, causing pulmonary embolism → life-threatening.
86. A nurse teaches a patient with angina pectoris to use nitroglycerin. Which statement is correct?
- A. “I should swallow the tablet whole.”
- B. “I should place the tablet under my tongue.” ✅
- C. “I can take it with milk.”
- D. “I should chew the tablet.”
Answer: B. Sublingual use
Explanation: Nitroglycerin is given sublingually for quick absorption and relief of angina.
87. Which diet is best for a patient with hypertension?
- A. High sodium, low fat
- B. Low sodium, DASH diet ✅
- C. High protein, high carb
- D. Low fiber, high fat
Answer: B. Low sodium, DASH diet
Explanation: DASH diet (Dietary Approaches to Stop Hypertension) emphasizes fruits, vegetables, whole grains, and low sodium.
88. A patient with hyperthyroidism is treated with radioactive iodine. What is the main precaution?
- A. Use of iron-rich diet
- B. Avoid pregnancy and close contact ✅
- C. Increase exercise
- D. Avoid dairy
Answer: B. Avoid pregnancy and close contact
Explanation: Radioactive iodine can expose others to radiation. Patients must limit contact with children and pregnant women.
89. Which nursing intervention is most important after liver biopsy?
- A. Place on left side
- B. Place on right side ✅
- C. Give fluids
- D. Elevate head
Answer: B. Place on right side
Explanation: After liver biopsy, the patient lies on the right side to apply pressure and prevent bleeding.
90. A nurse assesses a patient with chronic renal failure. Which finding is expected?
- A. Hypokalemia
- B. Hyperkalemia ✅
- C. Metabolic alkalosis
- D. Increased urine output
Answer: B. Hyperkalemia
Explanation: Renal failure decreases potassium excretion, leading to hyperkalemia → arrhythmia risk.
91. Which complication is common after thyroidectomy?
- A. Hypocalcemia ✅
- B. Hyperkalemia
- C. Hypoglycemia
- D. Hyponatremia
Answer: A. Hypocalcemia
Explanation: Accidental removal of parathyroid glands can cause low calcium levels → tetany, muscle cramps.
92. A patient with chronic bronchitis typically presents with:
- A. Barrel chest
- B. Productive cough for 3+ months ✅
- C. Weight loss
- D. Hemoptysis
Answer: B. Productive cough
Explanation: Chronic bronchitis = cough with sputum for 3 months per year for 2 years.
93. Which condition is known as the “silent killer”?
- A. Diabetes
- B. Hypertension ✅
- C. Tuberculosis
- D. Hypothyroidism
Answer: B. Hypertension
Explanation: Hypertension is often asymptomatic, hence called the silent killer.
94. Which test confirms HIV infection?
- A. ELISA
- B. Western blot ✅
- C. VDRL
- D. CBC
Answer: B. Western blot
Explanation: ELISA is a screening test, while Western blot is the confirmatory test for HIV.
95. A nurse observes Kussmaul respirations in a diabetic patient. This indicates:
- A. Hypoglycemia
- B. Diabetic ketoacidosis ✅
- C. Hypocalcemia
- D. Renal failure
Answer: B. Diabetic ketoacidosis
Explanation: Kussmaul breathing is deep, rapid breathing seen in DKA due to metabolic acidosis.
96. Which vitamin deficiency causes scurvy?
- A. Vitamin A
- B. Vitamin B12
- C. Vitamin C ✅
- D. Vitamin D
Answer: C. Vitamin C
Explanation: Lack of vitamin C causes scurvy → bleeding gums, poor wound healing.
97. Which drug is given to prevent seizures in patients with preeclampsia?
- A. Diazepam
- B. Magnesium sulfate ✅
- C. Phenytoin
- D. Lorazepam
Answer: B. Magnesium sulfate
Explanation: Magnesium sulfate prevents seizures in preeclampsia by reducing neuromuscular excitability.
98. A patient with hypothyroidism should be educated to:
- A. Take levothyroxine in the morning ✅
- B. Take levothyroxine with meals
- C. Stop medication once symptoms improve
- D. Avoid exercise
Answer: A. Morning dose
Explanation: Levothyroxine is taken early morning on an empty stomach for best absorption.
99. Which condition is associated with H. pylori infection?
- A. Appendicitis
- B. Gastric ulcers ✅
- C. Pancreatitis
- D. Hepatitis
Answer: B. Gastric ulcers
Explanation: Helicobacter pylori causes chronic gastritis and peptic ulcer disease.
100. Which nursing action is priority after abdominal surgery?
- A. Encourage coughing without support
- B. Assess bowel sounds
- C. Encourage deep breathing with splinting ✅
- D. Start early ambulation
Answer: C. Deep breathing with splinting
Explanation: To prevent atelectasis and pneumonia, patients should do deep breathing and incentive spirometry with incision splinting.
This concludes NCLEX Medical-Surgical Nursing MCQs (Part 2: 51–100). By reviewing these questions and explanations, you are reinforcing essential medical-surgical concepts that frequently appear in the NCLEX exam.
Stay consistent and continue with the next sets (Part 3 and Part 4) to complete the full coverage of NCLEX Medical-Surgical Nursing. Keep practicing daily, and you’ll be more confident in handling exam-style clinical scenarios.
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