Medical-Surgical Nursing Ii Nclex-Style Exam Prep Guide 2026

1 | P a g e 100 HIGH-YIELD NCLEX-STYLE QUESTIONS & ANSWERS FOR MEDICAL-SURGICAL NURSING FINAL EXAM- OPENSTAX (2024 EDITION) Clinical Judgment Prioritization Safety Systems-Based Rationales Included 1. A nurse is caring for a client with a serum potassium level of 2.8 mEq/L. Which intervention should the nurse implement first? A. Encourage the client to eat potassium-rich foods B. Place the client on cardiac monitor C. Notify the provider of the lab result D. Administer oral potassium chloride Correct Answer: B. Place the client on cardiac monitor Explanation: Hypokalemia increases the risk of life-threatening arrhythmias. Cardiac monitoring ensures early detection of ECG changes. The nurses priority is safety (QSEN principle). 2. A nurse is assessing a client with COPD who is receiving oxygen at 4 L/min via nasal cannula. The client becomes confused and drowsy. Which action should the nurse take first? A. Increase the oxygen flow rate B. Notify the respiratory therapist C. Lower the oxygen to 2 L/min D. Place the client in a high Fowler position Correct Answer: C. Lower the oxygen to 2 L/min Explanation: High oxygen levels can suppress respiratory drive in clients with COPD. Priority is reducing O2 to prevent CO retention and respiratory