LEWIS: MEDICAL-SURGICAL
NURSING EXAM
LEWIS MED-SURG NURSING FINAL
EXAM VERIFIED QUESTIONS AND
CORRECT DETAILED ANSWERS
GRADED A+ GUARANTEED PASS
(RATIONALES) |
1. A 50-year-old woman weighs 95 kg and has a history of tobacco use, high blood
pressure, high sodium
intake and sedentary lifestyle. When developing an individualised care plan for her,
the nurse determines
A+ TEST BANK 1
, LEWIS: MEDICAL-SURGICAL
NURSING EXAM
that the most important risk factors for peripheral artery disease (PAD) that need
to be modified are
a. weight and diet.
b. activity level and diet.
c. tobacco use and high blood pressure.
d. sedentary lifestyle and high blood pressure. –
Correct Answer :c. tobacco use and high blood pressure.
Significant risk factors for PAD include tobacco use, diabetes,
hyperlipidaemia, elevated C-reactive protein and uncontrolled hypertension, with
the most important
being tobacco use. Nicotine is a vasoconstrictor, and tobacco smoke impairs
transport and cellular use of oxygen, and increases blood viscosity and
homocysteine levels.
2. Rest pain is a symptom of PAD that occurs due to a chronic
a. vasospasm of small cutaneous arteries in the feet.
b. increase in retrograde venous blood flow in the legs.
c. decrease in arterial blood flow to the nerves of the feet.
d. decrease in arterial blood flow to the leg muscles during exercise. –
A+ TEST BANK 2
, LEWIS: MEDICAL-SURGICAL
NURSING EXAM
Correct Answer :c. decrease in arterial blood flow to the nerves of the feet.
Rest pain most often occurs in the foot or toes and is aggravated by limb elevation.
Rest pain occurs when blood flow is insufficient to meet basic metabolic
requirements of the distal tissues. Rest pain occurs more often at night because
cardiac
output tends to drop during sleep and the limbs are at the level of the heart.
3. A patient with infective endocarditis develops sudden left leg pain with pallor,
paraesthesia and a loss
of peripheral pulses. The nurse's initial action should be to
a. elevate the leg to promote venous return.
b. start anticoagulant therapy with IV heparin.
c. notify the doctor of the change in peripheral perfusion.
d. place the bed in reverse Trendelenburg to promote perfusion. –
Correct Answer :c. notify the doctor of the change in peripheral perfusion.
A heart condition in which thrombi can develop includes infective endocarditis.
The thrombi become dislodged and may travel anywhere in the systemic
circulation if they originate in the left side of the heart. Most emboli block an
artery of the lower extremity
in areas where vessels branch. Signs and symptoms of acute arterial ischaemia
include the 'six Ps':
A+ TEST BANK 3
, LEWIS: MEDICAL-SURGICAL
NURSING EXAM
pain, pallor, pulselessness, paraesthesia, paralysis and poikilothermia (adaptation
of the limb to the environmental temperature, most often cool). Without
immediate intervention, ischaemia may progress
to tissue necrosis and gangrene within a few hours.
4. Which signs and symptoms are seen in patients with either Buerger's disease or
Raynaud's phenomenon? (Select all that apply.)
a. Intermittent fevers.
b. Sensitivity to cold temperatures.
c. Gangrenous ulcers on fingertips.
d. Colour changes of fingers and toes.
e. Episodes of superficial vein thrombosis. –
Correct Answer :b. c. d.
Raynaud's phenomenon is an episodic vasospastic disorder of small cutaneous
arteries, most often involving the fingers and toes. Raynaud's phenomenon is
characterised by vasospasm-induced colour changes of fingers, toes, ears and nose
(white, blue and red). Decreased perfusion results in pallor (white). The digits then
appear cyanotic (bluish purple). The patient usually describes coldness and
numbness in the vasoconstrictive phase.
5. A patient is admitted to the hospital with a diagnosis of abdominal aortic
aneurysm. Which signs and
symptoms would suggest that his aneurysm has ruptured?
A+ TEST BANK 4
NURSING EXAM
LEWIS MED-SURG NURSING FINAL
EXAM VERIFIED QUESTIONS AND
CORRECT DETAILED ANSWERS
GRADED A+ GUARANTEED PASS
(RATIONALES) |
1. A 50-year-old woman weighs 95 kg and has a history of tobacco use, high blood
pressure, high sodium
intake and sedentary lifestyle. When developing an individualised care plan for her,
the nurse determines
A+ TEST BANK 1
, LEWIS: MEDICAL-SURGICAL
NURSING EXAM
that the most important risk factors for peripheral artery disease (PAD) that need
to be modified are
a. weight and diet.
b. activity level and diet.
c. tobacco use and high blood pressure.
d. sedentary lifestyle and high blood pressure. –
Correct Answer :c. tobacco use and high blood pressure.
Significant risk factors for PAD include tobacco use, diabetes,
hyperlipidaemia, elevated C-reactive protein and uncontrolled hypertension, with
the most important
being tobacco use. Nicotine is a vasoconstrictor, and tobacco smoke impairs
transport and cellular use of oxygen, and increases blood viscosity and
homocysteine levels.
2. Rest pain is a symptom of PAD that occurs due to a chronic
a. vasospasm of small cutaneous arteries in the feet.
b. increase in retrograde venous blood flow in the legs.
c. decrease in arterial blood flow to the nerves of the feet.
d. decrease in arterial blood flow to the leg muscles during exercise. –
A+ TEST BANK 2
, LEWIS: MEDICAL-SURGICAL
NURSING EXAM
Correct Answer :c. decrease in arterial blood flow to the nerves of the feet.
Rest pain most often occurs in the foot or toes and is aggravated by limb elevation.
Rest pain occurs when blood flow is insufficient to meet basic metabolic
requirements of the distal tissues. Rest pain occurs more often at night because
cardiac
output tends to drop during sleep and the limbs are at the level of the heart.
3. A patient with infective endocarditis develops sudden left leg pain with pallor,
paraesthesia and a loss
of peripheral pulses. The nurse's initial action should be to
a. elevate the leg to promote venous return.
b. start anticoagulant therapy with IV heparin.
c. notify the doctor of the change in peripheral perfusion.
d. place the bed in reverse Trendelenburg to promote perfusion. –
Correct Answer :c. notify the doctor of the change in peripheral perfusion.
A heart condition in which thrombi can develop includes infective endocarditis.
The thrombi become dislodged and may travel anywhere in the systemic
circulation if they originate in the left side of the heart. Most emboli block an
artery of the lower extremity
in areas where vessels branch. Signs and symptoms of acute arterial ischaemia
include the 'six Ps':
A+ TEST BANK 3
, LEWIS: MEDICAL-SURGICAL
NURSING EXAM
pain, pallor, pulselessness, paraesthesia, paralysis and poikilothermia (adaptation
of the limb to the environmental temperature, most often cool). Without
immediate intervention, ischaemia may progress
to tissue necrosis and gangrene within a few hours.
4. Which signs and symptoms are seen in patients with either Buerger's disease or
Raynaud's phenomenon? (Select all that apply.)
a. Intermittent fevers.
b. Sensitivity to cold temperatures.
c. Gangrenous ulcers on fingertips.
d. Colour changes of fingers and toes.
e. Episodes of superficial vein thrombosis. –
Correct Answer :b. c. d.
Raynaud's phenomenon is an episodic vasospastic disorder of small cutaneous
arteries, most often involving the fingers and toes. Raynaud's phenomenon is
characterised by vasospasm-induced colour changes of fingers, toes, ears and nose
(white, blue and red). Decreased perfusion results in pallor (white). The digits then
appear cyanotic (bluish purple). The patient usually describes coldness and
numbness in the vasoconstrictive phase.
5. A patient is admitted to the hospital with a diagnosis of abdominal aortic
aneurysm. Which signs and
symptoms would suggest that his aneurysm has ruptured?
A+ TEST BANK 4
