NCLEX Medical-Surgical Nursing: High-Yield Topics Review

Medical-surgical nursing makes up one of the largest portions of the NCLEX exam. Because med‑surg covers so many systems—cardiac, respiratory, endocrine, neuro, renal, and more—the questions often test your ability to prioritize, recognize emergencies, and apply clinical judgment. This high-yield **NCLEX med-surg** review focuses on the core topics every nursing student must master before test day.

Why Med-Surg Is Critical for NCLEX Success

Med-surg conditions commonly involve unstable patients, sudden changes, and safety‑critical symptoms. The NCLEX evaluates whether you can:

Identify early signs of deterioration
Prioritize based on urgency
Apply ABCs and Maslow
Recognize complications
Perform safe nursing interventions

High-Yield Med-Surg Topics for NCLEX

1. Respiratory Disorders
Conditions like COPD, asthma, pneumonia, and pulmonary embolism (PE) appear frequently.
Key priorities:
- Assess airway first
- Administer oxygen as needed
- Recognize respiratory distress (retractions, wheezing, gasping)
PE red flag signs: sudden dyspnea, chest pain, feeling of doom.
2. Cardiac Emergencies
Know the difference between stable vs. unstable cardiac rhythms.
High-yield points:
- Chest pain → ECG, oxygen, nitro
- HF symptoms: crackles, edema, orthopnea
- MI symptoms: sweating, nausea, left-arm pain
3. Endocrine Disorders
Memorize the differences between DKA and HHS:
- DKA: young patients, ketones, Kussmaul respirations
- HHS: older adults, severe dehydration, no ketones
Know thyroid storm (fever, hypertension) vs. myxedema coma (cold, low HR).
4. Neuro Conditions
Common topics: stroke, seizure care, increased ICP.
Priority interventions:
- Keep HOB 30°
- Avoid suctioning unless needed
- Monitor pupils
- Maintain airway during seizures
5. Renal & Electrolytes
Electrolyte imbalances show up often.
Memorize:
- Hyperkalemia → peaked T waves, risk of arrhythmia
- Hypokalemia → muscle weakness, flat T waves
- Sodium imbalance → confusion, seizures
6. GI Conditions
Key issues like pancreatitis, liver failure, ulcers, and GI bleeds.
- Upper GI bleed → hematemesis
- Lower GI bleed → melena
- Pancreatitis → severe epigastric pain radiating to back
7. Postoperative Priorities
Always assess ABCs first.
Watch for:
- Hemorrhage
- Infection
- Pulmonary embolism
- Urinary retention
- Dehiscence/evisceration

Example NCLEX Med-Surg Question

A post-op patient suddenly develops chest pain and shortness of breath. What is the priority?

✔ Apply oxygen and assess airway—possible pulmonary embolism.

Tips to Succeed in Med-Surg NCLEX Questions

Base every decision on ABCs
Learn common disease complications
Focus on early vs. late symptoms
Review lab values and red-flag signs
Practice NGN case studies daily

Final Thoughts