LEWIS COMPREHENSIVE TEST PAPER 2026
FULL SOLUTION VERIFIED PASS
◉ A nurse is assessing a patient who is receiving a nitroprusside
(Nipride) infusion to treat cardiogenic shock. Which finding
indicates that the medication is effective?
a. No new heart murmurs
b. Decreased troponin level
c. Warm, pink, and dry skin
d. Blood pressure 92/40 mm Hg Answer: ANS: C
Warm, pink, and dry skin indicates that perfusion to tissues is
improved. Since nitroprusside is a vasodilator, the blood pressure
may be low even if the medication is effective. Absence of a heart
murmur and a decrease in troponin level are not indicators of
improvement in shock.
◉ Which assessment information is most important for the nurse to
obtain to evaluate whether treatment of a patient with anaphylactic
shock has been effective?
a. Heart rate
b. Orientation
c. Blood pressure
d. Oxygen saturation Answer: ANS: D
,Because the airway edema that is associated with anaphylaxis can
affect airway and breathing, the oxygen saturation is the most
critical assessment. Improvements in the other assessments will
also be expected with effective treatment of anaphylactic shock.
◉ Which data collected by the nurse caring for a patient who has
cardiogenic shock indicate that the patient may be developing
multiple organ dysfunction syndrome (MODS)?
a. The patient's serum creatinine level is elevated.
b. The patient complains of intermittent chest pressure.
c. The patient's extremities are cool and pulses are weak.
d. The patient has bilateral crackles throughout lung fields. Answer:
ANS: A
The elevated serum creatinine level indicates that the patient has
renal failure as well as heart failure. The crackles, chest pressure,
and cool extremities are all consistent with the patient's diagnosis of
cardiogenic shock.
◉ A patient with septic shock has a BP of 70/46 mm Hg, pulse 136,
respirations 32, temperature 104° F, and blood glucose 246 mg/dL.
Which intervention ordered by the health care provider should the
nurse implement first?
a. Give normal saline IV at 500 mL/hr.
b. Give acetaminophen (Tylenol) 650 mg rectally.
c. Start insulin drip to maintain blood glucose at 110 to 150 mg/dL.
, d. Start norepinephrine (Levophed) to keep systolic blood pressure
>90 mm Hg. Answer: ANS: A
Because of the low systemic vascular resistance (SVR) associated
with septic shock, fluid resuscitation is the initial therapy. The other
actions also are appropriate, and should be initiated quickly as well.
◉ When the nurse educator is evaluating the skills of a new
registered nurse (RN) caring for patients experiencing shock, which
action by the new RN indicates a need for more education?
a. Placing the pulse oximeter on the ear for a patient with septic
shock
b. Keeping the head of the bed flat for a patient with hypovolemic
shock
c. Increasing the nitroprusside (Nipride) infusion rate for a patient
with a high SVR
d. Maintaining the room temperature at 66° to 68° F for a patient
with neurogenic shock Answer: ANS: D
Patients with neurogenic shock may have poikilothermia. The room
temperature should be kept warm to avoid hypothermia. The other
actions by the new RN are appropriate.
◉ The nurse is caring for a patient who has septic shock. Which
assessment finding is most important for the nurse to report to the
health care provider?
a. Blood pressure (BP) 92/56 mm Hg
FULL SOLUTION VERIFIED PASS
◉ A nurse is assessing a patient who is receiving a nitroprusside
(Nipride) infusion to treat cardiogenic shock. Which finding
indicates that the medication is effective?
a. No new heart murmurs
b. Decreased troponin level
c. Warm, pink, and dry skin
d. Blood pressure 92/40 mm Hg Answer: ANS: C
Warm, pink, and dry skin indicates that perfusion to tissues is
improved. Since nitroprusside is a vasodilator, the blood pressure
may be low even if the medication is effective. Absence of a heart
murmur and a decrease in troponin level are not indicators of
improvement in shock.
◉ Which assessment information is most important for the nurse to
obtain to evaluate whether treatment of a patient with anaphylactic
shock has been effective?
a. Heart rate
b. Orientation
c. Blood pressure
d. Oxygen saturation Answer: ANS: D
,Because the airway edema that is associated with anaphylaxis can
affect airway and breathing, the oxygen saturation is the most
critical assessment. Improvements in the other assessments will
also be expected with effective treatment of anaphylactic shock.
◉ Which data collected by the nurse caring for a patient who has
cardiogenic shock indicate that the patient may be developing
multiple organ dysfunction syndrome (MODS)?
a. The patient's serum creatinine level is elevated.
b. The patient complains of intermittent chest pressure.
c. The patient's extremities are cool and pulses are weak.
d. The patient has bilateral crackles throughout lung fields. Answer:
ANS: A
The elevated serum creatinine level indicates that the patient has
renal failure as well as heart failure. The crackles, chest pressure,
and cool extremities are all consistent with the patient's diagnosis of
cardiogenic shock.
◉ A patient with septic shock has a BP of 70/46 mm Hg, pulse 136,
respirations 32, temperature 104° F, and blood glucose 246 mg/dL.
Which intervention ordered by the health care provider should the
nurse implement first?
a. Give normal saline IV at 500 mL/hr.
b. Give acetaminophen (Tylenol) 650 mg rectally.
c. Start insulin drip to maintain blood glucose at 110 to 150 mg/dL.
, d. Start norepinephrine (Levophed) to keep systolic blood pressure
>90 mm Hg. Answer: ANS: A
Because of the low systemic vascular resistance (SVR) associated
with septic shock, fluid resuscitation is the initial therapy. The other
actions also are appropriate, and should be initiated quickly as well.
◉ When the nurse educator is evaluating the skills of a new
registered nurse (RN) caring for patients experiencing shock, which
action by the new RN indicates a need for more education?
a. Placing the pulse oximeter on the ear for a patient with septic
shock
b. Keeping the head of the bed flat for a patient with hypovolemic
shock
c. Increasing the nitroprusside (Nipride) infusion rate for a patient
with a high SVR
d. Maintaining the room temperature at 66° to 68° F for a patient
with neurogenic shock Answer: ANS: D
Patients with neurogenic shock may have poikilothermia. The room
temperature should be kept warm to avoid hypothermia. The other
actions by the new RN are appropriate.
◉ The nurse is caring for a patient who has septic shock. Which
assessment finding is most important for the nurse to report to the
health care provider?
a. Blood pressure (BP) 92/56 mm Hg
