LEWIS MEDICAL SURGICAL QUESTIONS AND
ANSWERS SET A+
✔✔The nurse is obtaining a health history from a 24-year-old patient with hypertrophic
cardiomyopathy (HC). Which information obtained by the nurse is most important?
a. The patient has a history of a recent upper respiratory infection.
b. The patient has a family history of coronary artery disease (CAD).
c. The patient reports using cocaine a "couple of times" as a teenager.
d. The patient's 29-year-old brother died from a sudden cardiac arrest. - ✔✔ANS: D
About half of all cases of HC have a genetic basis, and it is the most common cause of
sudden cardiac death in otherwise healthy young people. The information about the
patient's brother will be helpful in planning care (such as an automatic implantable
cardioverter-defibrillator [AICD
✔✔for the patient and in counseling other family members. The patient should be
counseled against the use of stimulant drugs, but the limited past history indicates that
the patient is not at current risk for cocaine use. Viral infections and CAD are risk factors
for dilated cardiomyopathy, but not for HC. - ✔✔...
✔✔The nurse will plan discharge teaching about the need for prophylactic antibiotics
when having dental procedures for which patient?
a. Patient admitted with a large acute myocardial infarction.
b. Patient being discharged after an exacerbation of heart failure.
c. Patient who had a mitral valve replacement with a mechanical valve.
d. Patient being treated for rheumatic fever after a streptococcal infection. - ✔✔ANS: C
Current American Heart Association guidelines recommend the use of prophylactic
antibiotics before dental procedures for patients with prosthetic valves to prevent
infective endocarditis (IE). The other patients are not at risk for IE.
✔✔Which admission order written by the health care provider for a patient admitted with
infective endocarditis (IE) and a fever would be a priority for the nurse to implement?
a. Administer ceftriaxone (Rocephin) 1 g IV.
b. Order blood cultures drawn from two sites.
ANSWERS SET A+
✔✔The nurse is obtaining a health history from a 24-year-old patient with hypertrophic
cardiomyopathy (HC). Which information obtained by the nurse is most important?
a. The patient has a history of a recent upper respiratory infection.
b. The patient has a family history of coronary artery disease (CAD).
c. The patient reports using cocaine a "couple of times" as a teenager.
d. The patient's 29-year-old brother died from a sudden cardiac arrest. - ✔✔ANS: D
About half of all cases of HC have a genetic basis, and it is the most common cause of
sudden cardiac death in otherwise healthy young people. The information about the
patient's brother will be helpful in planning care (such as an automatic implantable
cardioverter-defibrillator [AICD
✔✔for the patient and in counseling other family members. The patient should be
counseled against the use of stimulant drugs, but the limited past history indicates that
the patient is not at current risk for cocaine use. Viral infections and CAD are risk factors
for dilated cardiomyopathy, but not for HC. - ✔✔...
✔✔The nurse will plan discharge teaching about the need for prophylactic antibiotics
when having dental procedures for which patient?
a. Patient admitted with a large acute myocardial infarction.
b. Patient being discharged after an exacerbation of heart failure.
c. Patient who had a mitral valve replacement with a mechanical valve.
d. Patient being treated for rheumatic fever after a streptococcal infection. - ✔✔ANS: C
Current American Heart Association guidelines recommend the use of prophylactic
antibiotics before dental procedures for patients with prosthetic valves to prevent
infective endocarditis (IE). The other patients are not at risk for IE.
✔✔Which admission order written by the health care provider for a patient admitted with
infective endocarditis (IE) and a fever would be a priority for the nurse to implement?
a. Administer ceftriaxone (Rocephin) 1 g IV.
b. Order blood cultures drawn from two sites.
