NURSING EXAM
LEWIS MED-SURG NURSING FINAL
EXAM VERIFIED QUESTIONS AND
CORRECT DETAILED ANSWERS
(RATIONALES) |ALREADY GRADED A+
A ,55-year-old ,black ,male ,is ,found to have a blood pressure of 150/90 mm Hg during
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a work site health
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screening. What should the nurse do?
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A. Consider this to be a normal finding for his age and race.
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B. Recommend he have his blood pressure rechecked in 1 year.
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C. Recommend he have his blood pressure rechecked within 2 weeks.
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D. Recommend he go to the emergency department for further evaluation. –
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A+ TEST BANK 1
, LEWIS: MEDICAL-SURGICAL
NURSING EXAM
Correct Answer :C. Recommend he have his blood pressure rechecked within 2
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weeks.
Rationale: A BP of 150/90 mm Hg should be rechecked within 2 weeks according to
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current recommendations. If confirmed, assessment and treatment should be
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initiated by the practitioner. L L L
Option A is incorrect because although hypertension is more prevalent among
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blacks, a BP of 150/90 mm Hg isn't considered normal. Option B is incorrect because
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a person with a BP
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of 150/90 mm Hg shouldn't wait as long as 1 year to have it rechecked.
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Option D is incorrect because he doesn't need to be treated on an emergency basis,
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but he should have his BP monitored.
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The nurse is administering warfarin (Coumadin) to a patient with deep vein
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thrombophlebitis. Which laboratory L L
value indicates warfarin is at therapeutic levels?
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A. PTT 1½ to 2 times the control
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B. PT 1½ to 2 times the control
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C. INR of 3 to 4 L L L L
D. Hematocrit of 32% - L L L
Correct Answer :B. PT 1½ to 2 times the control
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Rationale: Warfarin is at therapeutic levels when the patient's PT is 1½ to 2 times the
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control.
A+ TEST BANK 2
, LEWIS: MEDICAL-SURGICAL
NURSING EXAM
Higher values indicate increased risk of bleeding and hemorrhage, and lower values
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indicate increased risk of blood clot formation.
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Option A is incorrect because heparin, not warfarin, prolongs PTT.
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Option C is incorrect because although the INR may also be used to determine if
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warfarin is at a therapeutic level, an INR should be 2-3.
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Option D is incorrect because hematocrit doesn't provide information on the
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effectiveness of warfarin; however, a falling hematocrit in a patient taking warfarin
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may be a sign of hemorrhage.
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A patient is receiving captopril for heart failure. The nurse should notify the
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practitioner that the L L
medication therapy is ineffective if an assessment reveals:
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A. a skin rash.
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B. peripheral edema. L
C. a dry cough.
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D. postural hypotension – L L
Correct Answer :B. peripheral edema.
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Rationale: Peripheral edema is a sign of fluid volume overload and worsening heart
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failure. ,The ,other ,options ,(a ,skin ,rash, ,dry ,cough, ,and ,postural ,hypotension) ,are
adverse ,reactions ,to ,captopril, ,but ,they ,don't ,indicate ,that ,therapy ,isn't ,effective.
A 60-year-old male patient is suspected of having coronary artery disease. Which
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noninvasive diagnostic L
A+ TEST BANK 3
, LEWIS: MEDICAL-SURGICAL
NURSING EXAM
method would the nurse expect to be ordered to evaluate cardiac changes?
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A. Cardiac biopsy L
B. Cardiac catheterization L
C. MRI
D. Pericardiocentesis – L
Correct Answer :C. MRI L L L
Rationale: MRI is a noninvasive procedure that aids in the diagnosis and detection of
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thoracic
aortic aneurysm and evaluation of coronary artery disease, pericardial disease, and
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cardiac masses. L
Cardiac biopsy (Option A), cardiac catheterization (Option B), and pericardiocentesis
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(Option D) are invasive L L L
techniques used to evaluate cardiac changes. L L L L L
When evaluating an ECG strip of a patient on a telemetry unit, the nurse notices the
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patient is having premature
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ventricular contractions (PVCs). What criterion on the ECG strip does the nurse use to
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evaluate the presence L L
of PVCs?
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A. An indiscernible PR interval
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B. P waves that appear erratic
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C. P waves that have a saw tooth configuration
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D. A QRS complex followed by a compensatory pause –
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A+ TEST BANK 4