Top Med-Surg NCLEX Topics You Can’t Afford to Miss

Preparing for the NCLEX can feel overwhelming, especially when it comes to medical-surgical (Med-Surg) nursing, which makes up a significant portion of the exam. The NCLEX is designed to test how well you can apply knowledge in real-world clinical settings—not just how much you’ve memorized.

To maximize your preparation, it’s important to focus on the high-yield Med-Surg topics that appear frequently on the exam and are critical to safe nursing practice. Below is a breakdown of the must-know Med-Surg NCLEX topics, along with study tips and resources to help you master them.

1. Cardiovascular Disorders

Cardiac conditions are at the heart of Med-Surg questions because they often involve life-threatening scenarios where prioritization and critical thinking are key.

• Heart Failure: Know the difference between left-sided vs. right-sided heart failure, nursing interventions (daily weights, fluid restriction), and patient teaching.

• Myocardial Infarction (MI): Recognize early warning signs (chest pain, diaphoresis, nausea) and immediate interventions (MONA: Morphine, Oxygen, Nitroglycerin, Aspirin).

• Hypertension: Classifications (primary vs. secondary), lifestyle interventions (DASH diet, exercise), and medications such as ACE inhibitors.

✅ Tip: Practice NCLEX-style scenario questions on nurseclex.com to strengthen your decision-making on cardiac emergencies.

2. Respiratory Disorders

Since oxygenation is a top nursing priority, you can expect many respiratory-related NCLEX questions.

• COPD: Chronic management vs. acute exacerbations, oxygen therapy (low-flow for CO₂ retainers), and patient education (pursed-lip breathing).

• Asthma: Triggers, peak-flow meter use, and differentiating rescue vs. maintenance inhalers.

• Pneumonia: Risk factors, signs (crackles, fever, productive cough), and interventions including antibiotics and incentive spirometry.

???? Study Hack: On Nurseclex, use simulator-style practice tests to strengthen your ability to interpret patient case studies.

3. Endocrine Disorders

Endocrine topics, particularly diabetes, are heavily tested on the NCLEX.

• Diabetes Mellitus (Type 1 vs. Type 2): Insulin types (onset, peak, duration), hypoglycemia vs. hyperglycemia, and complications such as diabetic ketoacidosis (DKA).

• Thyroid Disorders: Signs of hypo- (cold intolerance, weight gain, bradycardia) vs. hyperthyroidism (heat intolerance, weight loss, tachycardia), and nursing interventions.

4. Gastrointestinal (GI) Disorders

GI issues appear frequently because they span nutrition, fluid balance, and surgical nursing.

• Peptic Ulcer Disease: Risk factors (NSAIDs, H. pylori), treatment options, and dietary modifications.

• Inflammatory Bowel Disease (IBD): Compare Crohn’s vs. ulcerative colitis—location, symptoms, and treatment.

• Hepatic Disorders: Cirrhosis complications (ascites, hepatic encephalopathy), lab interpretation, and nursing care.

5. Renal Disorders

Renal health is crucial for fluid and electrolyte management—two high-priority NCLEX themes.

• Acute Kidney Injury (AKI) vs. Chronic Kidney Disease (CKD): Causes, nursing interventions, and lab values (BUN, creatinine, GFR).

• Dialysis: Hemodialysis vs. peritoneal dialysis—pre/post care, complications, and patient teaching.

6. Neurological Disorders

Neuro questions require critical thinking and prioritization.

• Stroke (CVA): Ischemic vs. hemorrhagic stroke, FAST acronym, thrombolytic therapy timing, and nursing priorities.

• Seizures: Types (tonic-clonic, absence), seizure precautions, and care during an active seizure.

• Increased Intracranial Pressure (ICP): Early vs. late signs, interventions (elevate HOB, avoid straining), and medications.

7. Infection Control and Prevention

Safe patient care depends on infection control, a core NCLEX competency.

• Isolation Precautions: Airborne, droplet, and contact—know examples of each disease.

• Antibiotic Stewardship: Recognize risks of resistance and safe medication practices.

8. Fluid and Electrolyte Imbalances

These questions test your ability to identify subtle changes in patient status.

• Hyponatremia & Hypernatremia: Symptoms like confusion, seizures, or weakness.

• Hyperkalemia & Hypokalemia: ECG changes, muscle weakness, and immediate interventions.

• Nursing Actions: IV therapy, monitoring labs, and patient education.

9. Surgical Care and Postoperative Management

NCLEX loves to test perioperative care and complication recognition.

• Pre- and Postoperative Care: Informed consent, NPO guidelines, airway monitoring, and pain management.

• Wound Care: Stages of healing, types of drainage, and recognizing infection vs. normal healing.

• Complications: DVT prevention, pulmonary embolism recognition, and managing hemorrhage.

10. Patient Safety and Quality Improvement

The NCLEX emphasizes safety-first nursing care across all areas.

• Medication Safety: “Five rights” of medication administration, high-alert drugs, and safe calculation skills.

• Fall Prevention & Patient Safety: Bed alarms, hourly rounding, and safety checklists.

• Quality Improvement: Basic awareness of evidence-based practices to improve outcomes.

How to Study Med-Surg Effectively for the NCLEX

While the above topics highlight what’s most important, how you study matters just as much.

1. Use NCLEX Simulators: Platforms like nurseclex.com provide realistic, adaptive practice tests that mirror the actual exam experience.

2. Practice Daily Questions: Answer at least 50–75 questions daily and review explanations in detail.

3. Join a Study Group: Discussing complex Med-Surg cases with peers can deepen understanding.

4. Review Lab Values & Priorities: Med-Surg questions often hinge on recognizing abnormal values and prioritizing interventions.

5. Balance Your Study Plan: Pair content review with practice questions to strengthen both knowledge and application.

Final Thoughts: Stay Focused on What Matters

Med-Surg nursing is broad, but focusing on these top NCLEX topics will help you build a strong foundation and approach the exam with confidence. Remember: the NCLEX isn’t testing if you know everything—it’s testing if you can think like a nurse and keep patients safe.

If you want expertly crafted NCLEX questions, study guides, and simulators, visit nurseclex.com. With the right tools and consistent practice, you’ll be ready to conquer Med-Surg questions and pass the NCLEX on your first try.

✨ Your journey to becoming a registered nurse starts here—study smart, practice well, and let NurseClex guide you every step of the way.