LEWIS'S MEDICAL-SURGICAL NURSING EXAM
SCRIPT 2026 QUESTIONS WITH SOLUTIONS
GRADED A+
◉ The nurse is caring for a client infected with Rocky Mountain
spotted fever. The nurse should ask if the client has experienced
which of the following? Answer: Was bitten by a tick
◉ The nurse is caring for a client with a protozoa infection. Which is
the most likely mode of transmission? Answer: Ingestion of
contaminated food or water
◉ The nurse is caring for a client who is recovering from an allergic
reaction. Which leukocyte level would the nurse expect to be the
most elevated? Answer: Eosinophils
◉ The nurse is caring for a client who has an infected wound on the
great toe that is red with a purulent exudate. The nurse expects that
this client has which type of infection? Answer: Localized
◉ The client experienced a fall. Nursing assessment reveals that the
client is experiencing tachycardia, hypotension, confusion,
tachypnea, and flat jugular veins. What should be the nurse's first
response? Answer: Administer oxygen.
,◉ The family wants to know why the nurse is putting a urinary
catheter in a client experiencing shock. What is the nurse's best
response? Answer: "It will help monitor how much urine the kidneys
are able to produce."
◉ A client experiencing shock has had a urinary output of 250 mL in
the last 10 hours. What is the nurse's most appropriate response?
Answer: Notify the physician.
◉ Which client is most likely to be experiencing hypovolemic shock?
Answer: A client who had surgery 24 hours ago and who also has a
nasogastric tube
◉ The physician has ordered arterial blood gases for a client
experiencing shock. The nurse knows that which value indicates
shock? Answer: pH 7.32
◉ A 63-year-old Arab American male states his left leg is "hot." What
is the nurse's best first response? Answer: Assess for pain
◉ The client is complaining of excruciating pain in a foot that has
been amputated. The family tells the nurse that the client is just
addicted to pain medications. What is the nurse's best response?
Answer: "He is experiencing phantom limb pain."
,◉ A client has had abdominal surgery and has orders to be
ambulated three times a day. Oral pain medication has been ordered
for the client. What should the nurse do to facilitate ambulation?
Answer: Mediate 1 hour prior to ambulating the client.
◉ The client reports frequent use of acetaminophen. How should the
nurse best respond? Answer: "Do you drink alcohol?"
◉ A client with chronic pain has been admitted with a fever. The
nursing assessment reveals that the client has a decreased level of
consciousness. What should the nurse ask the family about? Answer:
What medications the client has taken
◉ The practical nurse is reviewing the social history from a client
diagnosed with small cell carcinoma of the lung. Which information
is significant for this disease? Answer: The client has smoked two
(2) packs of cigarettes a day for 20 years
◉ The practical nurse and an unlicensed assistive personnel (UAP)
are caring for a group of clients on a medical unit. Which
information provided by the UAP warrants immediate intervention
by the practical nurse? Answer: The client receiving Procrit (epoetin
alfa) has a T 99.2˚F, P 68, R 24, and BP of 198/102
, ◉ The client diagnosed with lung cancer has been told the cancer
has metastasized to the brain. Which intervention should the
practical nurse expect to implement? Answer: Discuss implementing
an advance directive
◉ The client diagnosed with lung cancer is being discharged. Which
statement made by the client indicates a reiteration of information is
required? Answer: "It doesn't matter if I smoke now. I already have
cancer."
◉ The practical nurse is interviewing clients at the clinic. Which
information provided by a client warrants further investigation?
Answer: The client has been coughing up blood in the mornings
◉ The male client had abdominal surgery and the practical nurse
suspects the client has peritonitis. Which information support the
diagnosis of peritonitis? Answer: Hard, rigid abdomen and white
blood cell count 22,000/mm3
◉ The client who had abdominal surgery tells the practical nurse, "I
felt something give way in my stomach." Which intervention should
the practical nurse implement first? Answer: Inspect the abdominal
wound incision
SCRIPT 2026 QUESTIONS WITH SOLUTIONS
GRADED A+
◉ The nurse is caring for a client infected with Rocky Mountain
spotted fever. The nurse should ask if the client has experienced
which of the following? Answer: Was bitten by a tick
◉ The nurse is caring for a client with a protozoa infection. Which is
the most likely mode of transmission? Answer: Ingestion of
contaminated food or water
◉ The nurse is caring for a client who is recovering from an allergic
reaction. Which leukocyte level would the nurse expect to be the
most elevated? Answer: Eosinophils
◉ The nurse is caring for a client who has an infected wound on the
great toe that is red with a purulent exudate. The nurse expects that
this client has which type of infection? Answer: Localized
◉ The client experienced a fall. Nursing assessment reveals that the
client is experiencing tachycardia, hypotension, confusion,
tachypnea, and flat jugular veins. What should be the nurse's first
response? Answer: Administer oxygen.
,◉ The family wants to know why the nurse is putting a urinary
catheter in a client experiencing shock. What is the nurse's best
response? Answer: "It will help monitor how much urine the kidneys
are able to produce."
◉ A client experiencing shock has had a urinary output of 250 mL in
the last 10 hours. What is the nurse's most appropriate response?
Answer: Notify the physician.
◉ Which client is most likely to be experiencing hypovolemic shock?
Answer: A client who had surgery 24 hours ago and who also has a
nasogastric tube
◉ The physician has ordered arterial blood gases for a client
experiencing shock. The nurse knows that which value indicates
shock? Answer: pH 7.32
◉ A 63-year-old Arab American male states his left leg is "hot." What
is the nurse's best first response? Answer: Assess for pain
◉ The client is complaining of excruciating pain in a foot that has
been amputated. The family tells the nurse that the client is just
addicted to pain medications. What is the nurse's best response?
Answer: "He is experiencing phantom limb pain."
,◉ A client has had abdominal surgery and has orders to be
ambulated three times a day. Oral pain medication has been ordered
for the client. What should the nurse do to facilitate ambulation?
Answer: Mediate 1 hour prior to ambulating the client.
◉ The client reports frequent use of acetaminophen. How should the
nurse best respond? Answer: "Do you drink alcohol?"
◉ A client with chronic pain has been admitted with a fever. The
nursing assessment reveals that the client has a decreased level of
consciousness. What should the nurse ask the family about? Answer:
What medications the client has taken
◉ The practical nurse is reviewing the social history from a client
diagnosed with small cell carcinoma of the lung. Which information
is significant for this disease? Answer: The client has smoked two
(2) packs of cigarettes a day for 20 years
◉ The practical nurse and an unlicensed assistive personnel (UAP)
are caring for a group of clients on a medical unit. Which
information provided by the UAP warrants immediate intervention
by the practical nurse? Answer: The client receiving Procrit (epoetin
alfa) has a T 99.2˚F, P 68, R 24, and BP of 198/102
, ◉ The client diagnosed with lung cancer has been told the cancer
has metastasized to the brain. Which intervention should the
practical nurse expect to implement? Answer: Discuss implementing
an advance directive
◉ The client diagnosed with lung cancer is being discharged. Which
statement made by the client indicates a reiteration of information is
required? Answer: "It doesn't matter if I smoke now. I already have
cancer."
◉ The practical nurse is interviewing clients at the clinic. Which
information provided by a client warrants further investigation?
Answer: The client has been coughing up blood in the mornings
◉ The male client had abdominal surgery and the practical nurse
suspects the client has peritonitis. Which information support the
diagnosis of peritonitis? Answer: Hard, rigid abdomen and white
blood cell count 22,000/mm3
◉ The client who had abdominal surgery tells the practical nurse, "I
felt something give way in my stomach." Which intervention should
the practical nurse implement first? Answer: Inspect the abdominal
wound incision
