Lewis Med-Surg EXAM QUESTIONS (82 TERMS)
WITH VERIFIED DEFINITIONS UPDATED 2024
1). The nurse evaluates wound healing for a patient with an arm laceration. the nurse recalls
that which deficiency may cause insufficient collagen production by fibroblasts?
Ans: Vitamin C is needed for capillary synthesis and collagen production by fibroblasts.
Zinc deficiency impairs epithelialization in the wound-healing process. Protein deficiency
decreases the supply of amino acids for tissue repair. If a vitamin B deficiency develops, a
disruption of protein, fat, and carbohydrate metabolism will occur.
2). A patient who is being treated for an inflammation receives a medication that promotes
healing by preventing the liberation of lysosomes. the nurse recognizes that which drug has
this mechanism of action?
Ans: Prednisone is an antiinflammatory drug that interferes with tissue granulation and
induces immunosuppressive effects; thus this drug prevents the liberation of lysosomes.
Ibuprofen inhibits the synthesis of prostaglandins. Piroxicam is an antiinflammatory drug
that inhibits the synthesis of prostaglandins. Acetaminophen is an antipyretic drug that
lowers body temperature by acting on the heat-regulating center in the hypothalamus.
3). The nurse is providing care to a patient who is experiencing delayed healing of a surgical
wound. the nurse asks which question to assess for nutritional deficiencies?
Ans: When assessing for nutritional deficiencies related to delayed wound healing, the
nurse should ask the patient about vitamin C, protein, and zinc consumption. Although
smoking, poorly controlled blood glucose levels, and taking prescribed glucocorticoids
can all delay wound healing, these questions are not appropriate when assessing the
patient specifically for nutritional deficiencies.
4). Decreased tactile fremitus would indicate the patient may be experiencing which condition?
Ans: The nurse assesses fremitus in a patient by palpating the chest with his or her
hands while asking the patient to say a phrase like "ninety-nine" in a deeper, louder than
normal voice. If the patient has pleural effusion, there will be distance between the lung
tissue and the nurse's hand, which will decrease the vibrations felt. Fremitus would be
increased in cases of pneumonia and lung tumors, because the vibration of sound would
be transmitted more through solid tissue. The nurse would not detect any fremitus in a
PaperStoc.com Page 1 of 19
, patient with pneumothorax because the condition prevents any vibration from
transmitting.
5). The nose serves which primary function?
Ans: The nose functions to protect the lower airway by warming and humidifying air
and filtering small particles before air enters the lungs. The nose does not help with
phonation and vocalization or assist with deep breathing. The nose adds humidification
before air enters the lungs.
6). The epiglottis serves which respiratory function?
Ans: The epiglottis is a small flap located behind the tongue that closes over the larynx
during swallowing. The function of the epiglottis is to prevent solids and liquids from
entering the lungs. The olfactory nerve endings in the roof of the nose are responsible for
the sense of smell. The bronchi and the trachea act as a pathway to conduct gases to the
alveoli. The nose protects the lower airway by warming and humidifying air and filtering
small particles before the air enters the lungs.
7). The nurse pays close attention to which most common site for pressure ulcers when
assessing a patient?
Ans: Pressure ulcers generally occur over bony prominences; the sacrum is the most
common site, followed by the heels. Elbows and ankles are less susceptible to pressure
ulcers.
8). Which diagnostic test is used to measure the efficiency of gas transfer in the lung and
tissue oxygenation?
Ans: Arterial blood gases are used to assess the efficiency of gas transfer in the lung
and tissue oxygenation, as is pulse oximetry. Thoracentesis is used to obtain specimens
for diagnostic evaluation, remove pleural fluid, or instill medication into the pleural space.
Bronchoscopy is used for diagnostic purposes, to obtain biopsy specimens, and to assess
changes resulting from treatment. Pulmonary function tests measure lung volumes and
airflow to diagnose pulmonary disease, monitor disease progression, evaluate disability,
and evaluate response to bronchodilators.
PaperStoc.com Page 2 of 19
, 9). In which order do the four stages of pressure injuries to the tissue occur?
Ans: Correct1.Non-blanchable erythema of intact skin
Correct2.Partial-thickness skin loss with exposed dermis
Correct3.Full-thickness skin loss
Correct4.Full-thickness skin-and-tissue loss
10). Which instructions would the nurse provide to the patient in preparation for a chest x-ray?
Ans: For the chest x-ray, the nurse should instruct the patient to remove any metal
between neck and waist. A chest x-ray does not require a signed consent, and there is no
need to avoid food before the test. The patient is not required to undress completely;
because it is a chest x-ray, undressing to the waist is sufficient.
11). Based on the surgical documentation of a postoperative head-and-neck case, which type of
voice communication technique will the patient utilize postoperatively?
Ans: Tracheoesophageal puncture communication is done through a
tracheoesophageal fistula when the valve is occluded. Electrolarynx uses a battery-
powered device. Esophageal speech requires learning a technique for intake and
expulsion of air from the esophagus. The patient is not required to be nonverbal if
tracheoesophageal puncture speech is learned.
12). Which instruction will the nurse include when teaching a patient to use a dry powder inhaler
(dpi)?
Ans: The patient should hold the breath for as long as possible to increase the amount
of medication absorbed by the lungs. DPIs are not shaken prior to use. Since delivery of
medication to the airways depends on the patient's inspiratory effort when using a DPI, a
rapid and deep respiration is needed. The patient's mouth should be sealed around the
DPI mouthpiece to maximize delivery of the medication to the airways.
13). Which assessment finding by the nurse indicates a common adverse effect of a patient's
prescribed albuterol inhaler?
Ans: Tachycardia is a common adverse effect of the use of inhaled β2-adrenergic
agonists because of its stimulant effect. Headache is not a common adverse effect of
albuterol. Diarrhea is not commonly seen with albuterol use. Oral candidiasis may be seen
with inhaled corticosteroid use, but it is not an adverse effect with albuterol.
14). Which information will the nurse include when educating a patient with asthma about use of
a peak flow meter?
PaperStoc.com Page 3 of 19
WITH VERIFIED DEFINITIONS UPDATED 2024
1). The nurse evaluates wound healing for a patient with an arm laceration. the nurse recalls
that which deficiency may cause insufficient collagen production by fibroblasts?
Ans: Vitamin C is needed for capillary synthesis and collagen production by fibroblasts.
Zinc deficiency impairs epithelialization in the wound-healing process. Protein deficiency
decreases the supply of amino acids for tissue repair. If a vitamin B deficiency develops, a
disruption of protein, fat, and carbohydrate metabolism will occur.
2). A patient who is being treated for an inflammation receives a medication that promotes
healing by preventing the liberation of lysosomes. the nurse recognizes that which drug has
this mechanism of action?
Ans: Prednisone is an antiinflammatory drug that interferes with tissue granulation and
induces immunosuppressive effects; thus this drug prevents the liberation of lysosomes.
Ibuprofen inhibits the synthesis of prostaglandins. Piroxicam is an antiinflammatory drug
that inhibits the synthesis of prostaglandins. Acetaminophen is an antipyretic drug that
lowers body temperature by acting on the heat-regulating center in the hypothalamus.
3). The nurse is providing care to a patient who is experiencing delayed healing of a surgical
wound. the nurse asks which question to assess for nutritional deficiencies?
Ans: When assessing for nutritional deficiencies related to delayed wound healing, the
nurse should ask the patient about vitamin C, protein, and zinc consumption. Although
smoking, poorly controlled blood glucose levels, and taking prescribed glucocorticoids
can all delay wound healing, these questions are not appropriate when assessing the
patient specifically for nutritional deficiencies.
4). Decreased tactile fremitus would indicate the patient may be experiencing which condition?
Ans: The nurse assesses fremitus in a patient by palpating the chest with his or her
hands while asking the patient to say a phrase like "ninety-nine" in a deeper, louder than
normal voice. If the patient has pleural effusion, there will be distance between the lung
tissue and the nurse's hand, which will decrease the vibrations felt. Fremitus would be
increased in cases of pneumonia and lung tumors, because the vibration of sound would
be transmitted more through solid tissue. The nurse would not detect any fremitus in a
PaperStoc.com Page 1 of 19
, patient with pneumothorax because the condition prevents any vibration from
transmitting.
5). The nose serves which primary function?
Ans: The nose functions to protect the lower airway by warming and humidifying air
and filtering small particles before air enters the lungs. The nose does not help with
phonation and vocalization or assist with deep breathing. The nose adds humidification
before air enters the lungs.
6). The epiglottis serves which respiratory function?
Ans: The epiglottis is a small flap located behind the tongue that closes over the larynx
during swallowing. The function of the epiglottis is to prevent solids and liquids from
entering the lungs. The olfactory nerve endings in the roof of the nose are responsible for
the sense of smell. The bronchi and the trachea act as a pathway to conduct gases to the
alveoli. The nose protects the lower airway by warming and humidifying air and filtering
small particles before the air enters the lungs.
7). The nurse pays close attention to which most common site for pressure ulcers when
assessing a patient?
Ans: Pressure ulcers generally occur over bony prominences; the sacrum is the most
common site, followed by the heels. Elbows and ankles are less susceptible to pressure
ulcers.
8). Which diagnostic test is used to measure the efficiency of gas transfer in the lung and
tissue oxygenation?
Ans: Arterial blood gases are used to assess the efficiency of gas transfer in the lung
and tissue oxygenation, as is pulse oximetry. Thoracentesis is used to obtain specimens
for diagnostic evaluation, remove pleural fluid, or instill medication into the pleural space.
Bronchoscopy is used for diagnostic purposes, to obtain biopsy specimens, and to assess
changes resulting from treatment. Pulmonary function tests measure lung volumes and
airflow to diagnose pulmonary disease, monitor disease progression, evaluate disability,
and evaluate response to bronchodilators.
PaperStoc.com Page 2 of 19
, 9). In which order do the four stages of pressure injuries to the tissue occur?
Ans: Correct1.Non-blanchable erythema of intact skin
Correct2.Partial-thickness skin loss with exposed dermis
Correct3.Full-thickness skin loss
Correct4.Full-thickness skin-and-tissue loss
10). Which instructions would the nurse provide to the patient in preparation for a chest x-ray?
Ans: For the chest x-ray, the nurse should instruct the patient to remove any metal
between neck and waist. A chest x-ray does not require a signed consent, and there is no
need to avoid food before the test. The patient is not required to undress completely;
because it is a chest x-ray, undressing to the waist is sufficient.
11). Based on the surgical documentation of a postoperative head-and-neck case, which type of
voice communication technique will the patient utilize postoperatively?
Ans: Tracheoesophageal puncture communication is done through a
tracheoesophageal fistula when the valve is occluded. Electrolarynx uses a battery-
powered device. Esophageal speech requires learning a technique for intake and
expulsion of air from the esophagus. The patient is not required to be nonverbal if
tracheoesophageal puncture speech is learned.
12). Which instruction will the nurse include when teaching a patient to use a dry powder inhaler
(dpi)?
Ans: The patient should hold the breath for as long as possible to increase the amount
of medication absorbed by the lungs. DPIs are not shaken prior to use. Since delivery of
medication to the airways depends on the patient's inspiratory effort when using a DPI, a
rapid and deep respiration is needed. The patient's mouth should be sealed around the
DPI mouthpiece to maximize delivery of the medication to the airways.
13). Which assessment finding by the nurse indicates a common adverse effect of a patient's
prescribed albuterol inhaler?
Ans: Tachycardia is a common adverse effect of the use of inhaled β2-adrenergic
agonists because of its stimulant effect. Headache is not a common adverse effect of
albuterol. Diarrhea is not commonly seen with albuterol use. Oral candidiasis may be seen
with inhaled corticosteroid use, but it is not an adverse effect with albuterol.
14). Which information will the nurse include when educating a patient with asthma about use of
a peak flow meter?
PaperStoc.com Page 3 of 19
