Lewis: Medical-Surgical Nursing EXAM NEWEST ACTUAL EXAM
LEWIS: MEDICAL-SURGICAL NURSING EXAM NEWEST ACTUAL
EXAM COMPLETE QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY
GRADED A+||BRAND NEW VERSION!!
A patient with rheumatic fever has subcutaneous nodules, erythema marginatum,
and polyarthritis. Based on these findings, which nursing diagnosis would be most
appropriate?
a. Pain related to permanent joint fixation
b. Activity intolerance related to arthralgia
c. Risk for infection related to open skin lesions
d. Risk for impaired skin integrity related to pruritus - Correct Answer-ANS: B
The patient's joint pain will lead to difficulty with activity. The skin lesions seen
in rheumatic fever are not open or pruritic. Although acute joint pain will be a
problem for this patient, joint inflammation is a temporary clinical manifestation
of rheumatic fever and is not associated with permanent joint changes.
The nurse establishes the nursing diagnosis of ineffective health maintenance
related to lack of knowledge regarding long-term management of rheumatic fever
when a 30-year-old recovering from rheumatic fever without carditis says which of
the following?
a. "I will need prophylactic antibiotic therapy for 5 years."
b. "I will need to take aspirin or ibuprofen (Motrin) to relieve my joint pain."
c. "I will call the doctor if I develop excessive fatigue or difficulty breathing."
d. "I will be immune to further episodes of rheumatic fever after this infection." -
Correct Answer-ANS: D
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, Lewis: Medical-Surgical Nursing EXAM NEWEST ACTUAL EXAM
Patients with a history of rheumatic fever are more susceptible to a second
episode. Patients with rheumatic fever without carditis require prophylaxis until
age 20 and for a minimum of 5 years. The other patient statements are correct
and would not support the nursing diagnosis of ineffective health maintenance.
When developing a community health program to decrease the incidence of
rheumatic fever, which action would be most important for the community health
nurse to include?
a. Vaccinate high-risk groups in the community with streptococcal vaccine.
b. Teach community members to seek treatment for streptococcal pharyngitis.
c. Teach about the importance of monitoring temperature when sore throats
occur.
d. Teach about prophylactic antibiotics to those with a family history of rheumatic
fever. - Correct Answer-ANS: B
The incidence of rheumatic fever is decreased by treatment of streptococcal
infections with antibiotics. Family history is not a risk factor for rheumatic fever.
There is no immunization that is effective in decreasing the incidence of
rheumatic fever. Teaching about monitoring temperature will not decrease the
incidence of rheumatic fever.
When caring for a patient with mitral valve stenosis, it is most important that the
nurse assess for:
a. diastolic murmur.
b. peripheral edema.
c. right upper quadrant tenderness.
d. complaints of shortness of breath. - Correct Answer-ANS: d
2|Page
, Lewis: Medical-Surgical Nursing EXAM NEWEST ACTUAL EXAM
The pressure gradient changes in mitral stenosis lead to fluid backup into the
lungs, resulting in hypoxemia and dyspnea. The other findings also may be
associated with mitral valve disease but are not indicators of possible
hypoxemia.
A 21-year-old woman is scheduled for percutaneous transluminal balloon
valvuloplasty to treat mitral stenosis. When explaining the advantage of
valvuloplasty instead of valve replacement to the patient, which information will
the nurse include?
a. Biologic replacement valves require the use of immunosuppressive drugs.
b. Mechanical mitral valves require replacement approximately every 5 years.
c. Lifelong anticoagulant therapy is needed after mechanical valve replacement.
d. Ongoing cardiac care by a health care provider is unnecessary after
valvuloplasty. - Correct Answer-ANS: c
Long-term anticoagulation therapy is needed after mechanical valve
replacement, and this would restrict decisions about career and childbearing in
this patient. Mechanical valves are durable and last longer than biologic valves.
All valve repair procedures are palliative, not curative, and require lifelong
health care. Biologic valves do not activate the immune system, and
immunosuppressive therapy is not needed.
While caring for a 23-year-old patient with mitral valve prolapse (MVP) without
valvular regurgitation, the nurse determines that discharge teaching has been
effective when the patient states that it will be necessary to
a. take antibiotics before any dental appointments.
3|Page
LEWIS: MEDICAL-SURGICAL NURSING EXAM NEWEST ACTUAL
EXAM COMPLETE QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY
GRADED A+||BRAND NEW VERSION!!
A patient with rheumatic fever has subcutaneous nodules, erythema marginatum,
and polyarthritis. Based on these findings, which nursing diagnosis would be most
appropriate?
a. Pain related to permanent joint fixation
b. Activity intolerance related to arthralgia
c. Risk for infection related to open skin lesions
d. Risk for impaired skin integrity related to pruritus - Correct Answer-ANS: B
The patient's joint pain will lead to difficulty with activity. The skin lesions seen
in rheumatic fever are not open or pruritic. Although acute joint pain will be a
problem for this patient, joint inflammation is a temporary clinical manifestation
of rheumatic fever and is not associated with permanent joint changes.
The nurse establishes the nursing diagnosis of ineffective health maintenance
related to lack of knowledge regarding long-term management of rheumatic fever
when a 30-year-old recovering from rheumatic fever without carditis says which of
the following?
a. "I will need prophylactic antibiotic therapy for 5 years."
b. "I will need to take aspirin or ibuprofen (Motrin) to relieve my joint pain."
c. "I will call the doctor if I develop excessive fatigue or difficulty breathing."
d. "I will be immune to further episodes of rheumatic fever after this infection." -
Correct Answer-ANS: D
1|Page
, Lewis: Medical-Surgical Nursing EXAM NEWEST ACTUAL EXAM
Patients with a history of rheumatic fever are more susceptible to a second
episode. Patients with rheumatic fever without carditis require prophylaxis until
age 20 and for a minimum of 5 years. The other patient statements are correct
and would not support the nursing diagnosis of ineffective health maintenance.
When developing a community health program to decrease the incidence of
rheumatic fever, which action would be most important for the community health
nurse to include?
a. Vaccinate high-risk groups in the community with streptococcal vaccine.
b. Teach community members to seek treatment for streptococcal pharyngitis.
c. Teach about the importance of monitoring temperature when sore throats
occur.
d. Teach about prophylactic antibiotics to those with a family history of rheumatic
fever. - Correct Answer-ANS: B
The incidence of rheumatic fever is decreased by treatment of streptococcal
infections with antibiotics. Family history is not a risk factor for rheumatic fever.
There is no immunization that is effective in decreasing the incidence of
rheumatic fever. Teaching about monitoring temperature will not decrease the
incidence of rheumatic fever.
When caring for a patient with mitral valve stenosis, it is most important that the
nurse assess for:
a. diastolic murmur.
b. peripheral edema.
c. right upper quadrant tenderness.
d. complaints of shortness of breath. - Correct Answer-ANS: d
2|Page
, Lewis: Medical-Surgical Nursing EXAM NEWEST ACTUAL EXAM
The pressure gradient changes in mitral stenosis lead to fluid backup into the
lungs, resulting in hypoxemia and dyspnea. The other findings also may be
associated with mitral valve disease but are not indicators of possible
hypoxemia.
A 21-year-old woman is scheduled for percutaneous transluminal balloon
valvuloplasty to treat mitral stenosis. When explaining the advantage of
valvuloplasty instead of valve replacement to the patient, which information will
the nurse include?
a. Biologic replacement valves require the use of immunosuppressive drugs.
b. Mechanical mitral valves require replacement approximately every 5 years.
c. Lifelong anticoagulant therapy is needed after mechanical valve replacement.
d. Ongoing cardiac care by a health care provider is unnecessary after
valvuloplasty. - Correct Answer-ANS: c
Long-term anticoagulation therapy is needed after mechanical valve
replacement, and this would restrict decisions about career and childbearing in
this patient. Mechanical valves are durable and last longer than biologic valves.
All valve repair procedures are palliative, not curative, and require lifelong
health care. Biologic valves do not activate the immune system, and
immunosuppressive therapy is not needed.
While caring for a 23-year-old patient with mitral valve prolapse (MVP) without
valvular regurgitation, the nurse determines that discharge teaching has been
effective when the patient states that it will be necessary to
a. take antibiotics before any dental appointments.
3|Page
