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