LEWIS'S MEDICAL-SURGICAL NURSING
COMPREHENSIVE TEST 2026 QUESTIONS
WITH ANSWERS GRADED A+
◉ The nurse is planning pre-operative teaching for a client who will
undergo a radical neck dissection and total laryngectomy. Which
information has the greatest priority for this client?
A. prognosis after treatment is excellent
B. the stoma should never be covered after this type of surgery
C. there is a radical change in appearance as a result of this surgery
D. techniques for esophageal speech are relatively easy to learn with
practice. Answer: C
Radical neck dissection is the removal of lymphatic drainage channel
and nodes, sternocleidomastoid muscle, spinal accessory nerve,
jugular vein, and submandibular area. The overall outcome of this
type of surgery causes the neck to be disfigured.
◉ In planning care for a client with an acute stroke resulting in
right-side hemiplegia, which positioning should the nurse use to
maintain optimal functioning?
A. supine with trochanter rolls to the hips
B. left lateral, supine, brief periods on the right side, and prone
,C. sim's position alternated with right lateral position q2 hours
D. mid-fowler's with knees supported. Answer: B
After an acute stroke, a positioning and turning schedule that
minimizes lying on the affected side, which can impair circulation
and cause pain, and include the prone position to help prevent
flexion contractures of the hips, prepares the client for optimal
functioning and ambulating.
◉ The nurse is caring for a client who is admitted with a
hemorrhagic stroke. Which nursing action should be included in the
plan of care?
A. perform active range of motion three times daily
B. monitor for Battle's sign every four hours
C. teach measures to avoid the Valsalva maneuver
D. maintain the head of bed in a flat position. Answer: C
The Valsalva maneuver, straining with bowel movements while
holding one's breath, increases intracerebral pressure (ICP) which
may induce bleeding or rupture of cerebral blood vessels. Passive,
not active ROM is performed to avoid ICP, bleeding and rupture.
Battle's sign, bruising noted behind the ear, is a manifestation that
may be seen with a basilar skull fracture, not hemorrhagic stroke.
The flat position for the head of the bed is avoided because it
increase venous congestion and ICP
, ◉ A client with a recent history of blood in his stools is scheduled
for a proctosigmoidoscopy. The nurse should implement which
protocols to prepare the client for this procedure?
A. provide a clear-liquid diet 48 hours before the procedure
B. initiate pre-operative sedation
C. begins fast the morning of the procedure
D. administer an enema before the procedure
E. obtain consent for the procedure. Answer: A, C, D, E
The usual pre-operative preparation for this procedure entails
obtaining the client's consent to the procedure, a clear-liquid diet
24-48 hours prior to the procedure, administration of an enema, and
fasting on the morning of the procedure. Pre-operative sedation is
not he norm for this procedure, although some healthcare providers
administer a mild tranquilizer
◉ The nurse is assessing a client admitted from the emergency room
with gastrointestinal bleeding related to peptic ulcer disease (PUD).
Which physiological factors can produce ulceration?
A. hypersecretion of hydrochloric acid
B. vagal stimulation
C. an increased level of stress
D. an increased number of parietal cells
COMPREHENSIVE TEST 2026 QUESTIONS
WITH ANSWERS GRADED A+
◉ The nurse is planning pre-operative teaching for a client who will
undergo a radical neck dissection and total laryngectomy. Which
information has the greatest priority for this client?
A. prognosis after treatment is excellent
B. the stoma should never be covered after this type of surgery
C. there is a radical change in appearance as a result of this surgery
D. techniques for esophageal speech are relatively easy to learn with
practice. Answer: C
Radical neck dissection is the removal of lymphatic drainage channel
and nodes, sternocleidomastoid muscle, spinal accessory nerve,
jugular vein, and submandibular area. The overall outcome of this
type of surgery causes the neck to be disfigured.
◉ In planning care for a client with an acute stroke resulting in
right-side hemiplegia, which positioning should the nurse use to
maintain optimal functioning?
A. supine with trochanter rolls to the hips
B. left lateral, supine, brief periods on the right side, and prone
,C. sim's position alternated with right lateral position q2 hours
D. mid-fowler's with knees supported. Answer: B
After an acute stroke, a positioning and turning schedule that
minimizes lying on the affected side, which can impair circulation
and cause pain, and include the prone position to help prevent
flexion contractures of the hips, prepares the client for optimal
functioning and ambulating.
◉ The nurse is caring for a client who is admitted with a
hemorrhagic stroke. Which nursing action should be included in the
plan of care?
A. perform active range of motion three times daily
B. monitor for Battle's sign every four hours
C. teach measures to avoid the Valsalva maneuver
D. maintain the head of bed in a flat position. Answer: C
The Valsalva maneuver, straining with bowel movements while
holding one's breath, increases intracerebral pressure (ICP) which
may induce bleeding or rupture of cerebral blood vessels. Passive,
not active ROM is performed to avoid ICP, bleeding and rupture.
Battle's sign, bruising noted behind the ear, is a manifestation that
may be seen with a basilar skull fracture, not hemorrhagic stroke.
The flat position for the head of the bed is avoided because it
increase venous congestion and ICP
, ◉ A client with a recent history of blood in his stools is scheduled
for a proctosigmoidoscopy. The nurse should implement which
protocols to prepare the client for this procedure?
A. provide a clear-liquid diet 48 hours before the procedure
B. initiate pre-operative sedation
C. begins fast the morning of the procedure
D. administer an enema before the procedure
E. obtain consent for the procedure. Answer: A, C, D, E
The usual pre-operative preparation for this procedure entails
obtaining the client's consent to the procedure, a clear-liquid diet
24-48 hours prior to the procedure, administration of an enema, and
fasting on the morning of the procedure. Pre-operative sedation is
not he norm for this procedure, although some healthcare providers
administer a mild tranquilizer
◉ The nurse is assessing a client admitted from the emergency room
with gastrointestinal bleeding related to peptic ulcer disease (PUD).
Which physiological factors can produce ulceration?
A. hypersecretion of hydrochloric acid
B. vagal stimulation
C. an increased level of stress
D. an increased number of parietal cells
