LEWIS'S MEDICAL-SURGICAL NURSING FINAL
PAPER EXAM 2026 FULL QUESTIONS AND
CORRECT ANSWERS GRADED A+
◉ A male client with chronic atrial fibrillation and a slow ventricular
response is scheduled for surgical placement of a permanent
pacemaker. The client asks the nurse how this devise will help him.
How should the nurse explain the action of a synchronous
pacemaker?
A. an impulse is fired every second to maintain a heart rate of 60
beats per minute
B. ectopic stimulus in the atria is suppressed by the device of
usurping depolarization
C. ventricular irritability is prevented by the constant rate setting of
a pacemaker
D. an electrical stimulus is discharged when no ventricular response
is sensed. Answer: D. an electrical stimulus is discharged when no
ventricular response is sensed
The artificial cardiac pacemaker is an electronic device used to pace
the heart when the normal conduction pathway is damaged or
diseased, such as a symptomatic dysrhythmia like atrial fibrillation
with a slow ventricular response. Pacing modes that are
synchronous (impulse generated on demand or as needed according
to the patient's intrinsic rhythm) send an electrical signal from the
,pacemaker to the wall of the myocardium stimulating it to contract
when no ventricular depolarization is sensed
◉ A man who smokes two packs of cigarettes a day wants to know if
smoking is contributing to the difficulty that he and his wife are
having getting pregnant. what information is best for the nurse to
provide?
A. smoking can decrease the quantity and quality of sperm
B. the first semen analysis should be repeated to confirm sperm
counts
C. only marijuana cigarettes affect sperm count
D. cessation of smoking improves general health and fertility
E. sperm specimens should be collected in 2 subsequent days.
Answer: A, B, and D
Use of tobacco, alcohol, and marijuana may affect sperm counts.
Sperm counts vary from day to day and are dependent on emotional
and physical status and sexual activity, so a single analysis may be
inconclusive. A minimum o two analyses should be performed
several weeks apart to assess male fertility.
◉ A couple trying to cope with an infertility problem wants to know
what can be done to preserve emotional equilibrium. What is the
best response for the nurse to provide?
,A. "talk only to other friends who are infertile since only they can
help"
B. "tell your friends and family so that they can help you"
C. "get involved in a support group. I will give you some names"
D. "start adoption proceedings immediately since obtaining an infant
is very difficult". Answer: C
A support group provides a safe haven for the couple to share
experiences and gain insight from others' experiences. Although
talking about feelings may unburden the couple of negative feelings,
infertility is a major stressor that affects the couple's relationships,
so discussion with family and friends should be minimal. Limiting
interaction to other infertile couples may address some psychosocial
needs, but depending on where the other couples are in the recovery
process, it may not be helpful. Giving an opinion about adoption is
not therapeutic nor supportive of the psychosocial needs.
◉ The nurse is providing post-operative instructions for a female
client after a mastectomy. Which information should the nurse
include in the teaching plan?
A. avoid lifting more than 4.5 kg (10 lb) or reaching above her head
B. empty surgical drains once a week using procedural gloves
C. report inflammation of the incision site or the affected arm
D. wearing clothing with snug sleeves over the arm on the operative
side. Answer: A and D
, Part of the client's teaching plan should include reporting evidence
of inflammation at the incision or of the affected arm and to avoid
lifting or reaching, which places the client at risk for injury to the
extremity that may have compromised lymphatic drainage. the client
should be instructed to empty surgical drains daily, no weekly.
Activity that decreases circulation in the affected arm, such as
carrying a handbag over the shoulder, wearing tight clothing, or tight
jewelry, should be avoided.
◉ the nurse directs an unlicensed assisstive personnel (UAP) to
obtain vital signs for a client who returns to the unit after having a
mastectomy for cancer. What information should the nurse provide
the UAP?
A. elevate the arm with an IV infusing on the operative side with a
pillow
B. apply the blood pressure cuff to the arm on the non-operative side
C. position the arm on the operative side close to the body
D. collect a fingerstick blood specimen from the arm on the
operative side. Answer: B.
Blood pressure reading should be obtained from the arm on the
unoperative side to reduce the risk of injury of the extremity that
may have compromised lymphatic drainage postoperatively. The
arm on the operative side of the mastectomy should be elevated on a
pillow above the level of the right atrium to facilitate lymphatic
PAPER EXAM 2026 FULL QUESTIONS AND
CORRECT ANSWERS GRADED A+
◉ A male client with chronic atrial fibrillation and a slow ventricular
response is scheduled for surgical placement of a permanent
pacemaker. The client asks the nurse how this devise will help him.
How should the nurse explain the action of a synchronous
pacemaker?
A. an impulse is fired every second to maintain a heart rate of 60
beats per minute
B. ectopic stimulus in the atria is suppressed by the device of
usurping depolarization
C. ventricular irritability is prevented by the constant rate setting of
a pacemaker
D. an electrical stimulus is discharged when no ventricular response
is sensed. Answer: D. an electrical stimulus is discharged when no
ventricular response is sensed
The artificial cardiac pacemaker is an electronic device used to pace
the heart when the normal conduction pathway is damaged or
diseased, such as a symptomatic dysrhythmia like atrial fibrillation
with a slow ventricular response. Pacing modes that are
synchronous (impulse generated on demand or as needed according
to the patient's intrinsic rhythm) send an electrical signal from the
,pacemaker to the wall of the myocardium stimulating it to contract
when no ventricular depolarization is sensed
◉ A man who smokes two packs of cigarettes a day wants to know if
smoking is contributing to the difficulty that he and his wife are
having getting pregnant. what information is best for the nurse to
provide?
A. smoking can decrease the quantity and quality of sperm
B. the first semen analysis should be repeated to confirm sperm
counts
C. only marijuana cigarettes affect sperm count
D. cessation of smoking improves general health and fertility
E. sperm specimens should be collected in 2 subsequent days.
Answer: A, B, and D
Use of tobacco, alcohol, and marijuana may affect sperm counts.
Sperm counts vary from day to day and are dependent on emotional
and physical status and sexual activity, so a single analysis may be
inconclusive. A minimum o two analyses should be performed
several weeks apart to assess male fertility.
◉ A couple trying to cope with an infertility problem wants to know
what can be done to preserve emotional equilibrium. What is the
best response for the nurse to provide?
,A. "talk only to other friends who are infertile since only they can
help"
B. "tell your friends and family so that they can help you"
C. "get involved in a support group. I will give you some names"
D. "start adoption proceedings immediately since obtaining an infant
is very difficult". Answer: C
A support group provides a safe haven for the couple to share
experiences and gain insight from others' experiences. Although
talking about feelings may unburden the couple of negative feelings,
infertility is a major stressor that affects the couple's relationships,
so discussion with family and friends should be minimal. Limiting
interaction to other infertile couples may address some psychosocial
needs, but depending on where the other couples are in the recovery
process, it may not be helpful. Giving an opinion about adoption is
not therapeutic nor supportive of the psychosocial needs.
◉ The nurse is providing post-operative instructions for a female
client after a mastectomy. Which information should the nurse
include in the teaching plan?
A. avoid lifting more than 4.5 kg (10 lb) or reaching above her head
B. empty surgical drains once a week using procedural gloves
C. report inflammation of the incision site or the affected arm
D. wearing clothing with snug sleeves over the arm on the operative
side. Answer: A and D
, Part of the client's teaching plan should include reporting evidence
of inflammation at the incision or of the affected arm and to avoid
lifting or reaching, which places the client at risk for injury to the
extremity that may have compromised lymphatic drainage. the client
should be instructed to empty surgical drains daily, no weekly.
Activity that decreases circulation in the affected arm, such as
carrying a handbag over the shoulder, wearing tight clothing, or tight
jewelry, should be avoided.
◉ the nurse directs an unlicensed assisstive personnel (UAP) to
obtain vital signs for a client who returns to the unit after having a
mastectomy for cancer. What information should the nurse provide
the UAP?
A. elevate the arm with an IV infusing on the operative side with a
pillow
B. apply the blood pressure cuff to the arm on the non-operative side
C. position the arm on the operative side close to the body
D. collect a fingerstick blood specimen from the arm on the
operative side. Answer: B.
Blood pressure reading should be obtained from the arm on the
unoperative side to reduce the risk of injury of the extremity that
may have compromised lymphatic drainage postoperatively. The
arm on the operative side of the mastectomy should be elevated on a
pillow above the level of the right atrium to facilitate lymphatic
