Testbank for medical surgical nursing 12th edition by Marrian M Harding

LEWIS MEDICAL –SURGICAL NURSING 12TH
EDITION BY MARIANN M. HARDING TEST
BANK UPDATED 2025.
1.A nurse is caring for a client who has a chest tube following a lobectomy. Which of the
following items should the nurse keep easily accessible for the client?

A. Extra drainage system

B. Suture removal kit

C. Container of sterile water

D. Nonadherent pads
- RATIONALE-C. Container of sterile water


2.A. Nurse should empty the collection chamber in the drainage system or replace it before the
drainage reaches the bottom of the tube.
B. The nurse should retrieve a suture removal set when the chest tube is removed.
C. The nurse should have a container of sterile water in a location that is easily accessible for this
client. The nurse should plan to place the open end of the tubing into the sterile water if the
tubing becomes disconnected in order to prevent a pneumothorax.
RATIONALE-C. The nurse should provide nonadherent, air tight sterile petrolatum gauze
when the chest tube is removed.

3.A nurse in the emergency department is caring for a client who is experiencing acute
respiratory failure. Which of the following laboratory findings should the nurse expect?

A. Arterial pH 7.50

B. PaCO2 25 mmHg

C. SaO2 92%

D. PaO2 58 mm Hg - RATIONALE-D. PaO2 58 mm Hg

Rationale:
A. Resp failure can cause resp acidosis, decreasing pH.
B. CO2 should rise
C. SaO2 should decrease
D. The nurse should expect the client who has acute respiratory failure to have lower partial
pressures of oxygen, Normal range is 80-100 mmHg.

,LEWIS MEDICAL –SURGICAL NURSING 12TH
EDITION BY MARIANN M. HARDING TEST
BANK UPDATED 2025.

4.A nurse is assessing a client who has a chest tube in place following thoracic surgery. For
which of the following findings should the nurse notify the provider?

A. Fluctuation of drainage in the tubing with inspiration

B. Continuous bubbling in the water seal chamber

C. Drainage of 75 mL in the first hour after surgery

D. Several small, dark-red blood clots in the tubing
- RATIONALE-B. Continuous bubbling in the water seal chamber

A, C, D. Expected findings
B. Continuous bubbling in the water seal chamber suggests an air leak and requires
notification of the provider. The nurse should check the system for external, correctable leaks
while she is waiting for instructions from the provider.

5.A nurse is caring for a client who is in respiratory distress and requires endotracheal
suctioning. Which of the following actions should the nurse take?

A. Use clean technique when suctioning the client's endotracheal tube.


B. Use a rotating motion when removing the suction catheter.


C. Suction the oropharyngeal cavity prior to suctioning the endotracheal tube.


D. Suction the client's endotracheal tube every 2 hr.
- RATIONALE-B. Use a rotating motion when removing the suction catheter.


A. Use sterile technique.
B. The nurse should rotate the suction catheter during withdrawal to reduce the risk of tissue
trauma.
C. Suction ET tube prior to oropharyngeal cavity to prevent cross contamination.
D. Only PRN to prevent hypoxia, tissue damage, and bronchospasms.

,LEWIS MEDICAL –SURGICAL NURSING 12TH
EDITION BY MARIANN M. HARDING TEST
BANK UPDATED 2025.

6.A nurse is caring for a newly-admitted client who has emphysema. The nurse should place the
client in which of the following positions to promote effective breathing?

A. Lateral position with a pillow at the back and over the chest to support the arm


B. High-Fowler's position with the arms supported on the over-bed table


C. Semi-Fowler's position with pillows supporting both arms


D. Supine position with the head of the bed elevated to 15°
- RATIONALE-B. High-Fowler's position with the arms supported on the over-bed table
A. Lateral position promotes alignment of the back and can be a good position for sleeping,
does not promote maximum chest expansion.
B. The nurse should place the client in a position that allows for greater expansion of the
chest, such as sitting upright and leaning slightly forward while supporting both arms with
pillows for comfort on the over-bed table.
C. Does not promote maximum chest expansion.
D. Allows diaphragm and abd organs to place pressure on thoracic cavity and compromise
chest expansion.

7.A nurse is caring for a client who is postoperative and has a respiratory rate of 9/min secondary
to general anesthesia effects and incisional pain. Which of the following ABG values indicates
the client is experiencing respiratory acidosis?

A. pH 7.50, PO2 95 mm Hg, PaCO2 25 mmHg, HCO3- 22 mEq/L

B. pH 7.50, PO2 87 mm Hg, PaCO2 35 mmHg, HCO3- 30 mEq/L

C. pH 7.30, PO2 90 mm Hg, PaCO2 35 mmHg, HCO3- 20 mEq/L

D. pH 7.30, PO2 80 mmHg, PaCO2 55 mmHg, HCO3- 22 mEq/L
- RATIONALE-D. pH 7.30, PO2 80 mmHg, PaCO2 55 mmHg, HCO3- 22 mEq/L

Rationale:
A. Indicates respiratory alkalosis.

, LEWIS MEDICAL –SURGICAL NURSING 12TH
EDITION BY MARIANN M. HARDING TEST
BANK UPDATED 2025.
B. Indicates metabolic alkalosis.
C. Indicates metabolic acidosis. D. These ABG values indicate respiratory acidosis. The pH is
less than 7.35 and the PaCO2 is greater than 45 mm Hg, which indicates respiratory acidosis.

8.A nurse is caring for a client who is in respiratory distress. Which of the following low-flow
delivery devices should the nurse use to provide the client with the highest level of oxygen?

A. Nasal cannula

B. Nonrebreather mask

C. Simple face mask

D. Partial rebreather mask
- RATIONALE-B. Nonrebreather mask

Rationale:
A. Provides O2 concentration of 24-44%.
B. A non-rebreather mask is made up of a reservoir bag from which the client obtains the
oxygen, a one-way valve to prevent exhaled air from entering the reservoir bag, and
exhalation ports with flaps that prevent room air from entering the mask. This device delivers
greater than 90% FiO2.
C. Provided FiO2 of 40-60%.
D. Provided FiO2 of 60-75%.

9.A nurse is admitting a client who has active tuberculosis. Which of the following isolation
precautions should the nurse implement?

A. Airborne

B. Neutropenic

C. Contact

D. Droplet
- RATIONALE-A. Airborne

10.A. The nurse should initiate airborne precautions for the client who has tuberculosis because
tuberculosis is a respiratory infection that is spread through the air. The client should be placed