LEWISS MEDICAL SURGICAL NURSING IN
CANADA COMPREHENSIVE TEST PAPER 2026
FULL SOLUTION VERIFIED PASS
◉ 3. The nurse expects that management of the patient who
experiences a brief episode of tinnitus, diplopia, and dysarthria with
no residual effects will include which of the following treatments?
a. Oral administration of clopidogrel (Plavix)
b. Heparin via continuous intravenous (IV) infusion
c. Prophylactic clipping of cerebral aneurysms
d. Therapy with tPA Answer: ANS: A
The patient's symptoms are consistent with transient ischemic
attack (TIA), and medications that inhibit platelet aggregation are
prescribed after a TIA to prevent stroke.
PTS: 1 DIF: Cognitive Level: Application REF: page 1676
OBJ: 3 TOP: Nursing Process: Planning MSC: CRNE: CH-44
◉ 4. Aspirin is ordered for a patient who is admitted with a possible
stroke. Which information obtained during the admission
assessment indicates that the nurse should consult with the
physician?
a. The patient has atrial fibrillation.
,b. The patient has dysphasia.
c. The patient states, "I suddenly developed a terrible headache."
d. The patient has a history of brief episodes of right hemiplegia.
Answer: ANS: C
A sudden-onset headache is typical of a subarachnoid hemorrhage
and ruptured aneurysm; the physician should be notified
immediately.
PTS: 1 DIF: Cognitive Level: Comprehension REF: page 1678, Safety
Alert
OBJ: 4 TOP: Nursing Process: Implementation MSC: CRNE: CH-61
◉ 5. A patient with a stroke caused by thrombosis of the middle
cerebral artery experiences left-sided paralysis of the upper and
lower extremities and facial drooping on the left side. When
obtaining admission assessment data about the patient's clinical
manifestations, it is most important for the nurse to assess which of
the following?
a. The patient's ability to follow commands
b. The patient's visual fields
c. The patient's left-sided reflexes
d. The patient's emotional state Answer: ANS: A
Because the patient with a right-sided brain stroke may have
difficulty with comprehension and use of language, it is important to
obtain baseline data about the ability to follow commands.
,PTS: 1 DIF: Cognitive Level: Application REF: page 1679
OBJ: 7 TOP: Nursing Process: Implementation MSC: CRNE: CH-8
◉ 6. On the medical unit, the nurse receives a verbal report from the
emergency department nurse that a patient has an occlusion of the
left posterior cerebral artery. When admitting the patient to the
medical floor, which of the following will the nurse anticipate that
the patient may be experiencing?
a. Visual deficits
b. Dysphasia
c. Confusion
d. Poor judgement Answer: ANS: A
Visual disturbances are expected with posterior cerebral artery
occlusion.
PTS: 1 DIF: Cognitive Level: Comprehension REF: page 1678, Table
60-3
OBJ: 7 TOP: Nursing Process: Planning MSC: CRNE: CH-61
◉ 7. Which one of the following manifestations would the nurse
expect to assess on a patient with right-brain damage from a stroke?
a. Right-sided hemiplegia
b. Slow performance, cautiousness
, c. Aware of deficits, depression
d. Impulsive behaviour Answer: ANS: D
A patient with right-brain damage from a stroke would manifest
impulsive behaviour, thus safety is a main priority of care.
PTS: 1 DIF: Cognitive Level: Application REF: page 1679, Figure 60-5
OBJ: 4 TOP: Nursing Process: Assessment MSC: CRNE: CH-8
◉ 8. The physician recommends a carotid endarterectomy for a
patient with carotid atherosclerosis and a history of TIAs. The
patient asks the nurse whether this procedure involves brain
surgery. In responding to the patient, what should the nurse include
information about?
a. An endarterectomy involves brain surgery because plaques in
arteries at the base of the brain are removed.
b. This surgery involves resection of a diseased portion of the artery
in the brain and replacing it with a synthetic graft.
c. A carotid endarterectomy involves removal of plaques in an artery
in the neck and does not involve surgery in the brain.
d. In this surgery, a burr hole is drilled in the skull to connect an
artery outside the skull to one inside the brain, bypassing a
blockage. Answer: ANS: C
In a carotid endarterectomy, the carotid artery is incised and the
plaque is removed.
CANADA COMPREHENSIVE TEST PAPER 2026
FULL SOLUTION VERIFIED PASS
◉ 3. The nurse expects that management of the patient who
experiences a brief episode of tinnitus, diplopia, and dysarthria with
no residual effects will include which of the following treatments?
a. Oral administration of clopidogrel (Plavix)
b. Heparin via continuous intravenous (IV) infusion
c. Prophylactic clipping of cerebral aneurysms
d. Therapy with tPA Answer: ANS: A
The patient's symptoms are consistent with transient ischemic
attack (TIA), and medications that inhibit platelet aggregation are
prescribed after a TIA to prevent stroke.
PTS: 1 DIF: Cognitive Level: Application REF: page 1676
OBJ: 3 TOP: Nursing Process: Planning MSC: CRNE: CH-44
◉ 4. Aspirin is ordered for a patient who is admitted with a possible
stroke. Which information obtained during the admission
assessment indicates that the nurse should consult with the
physician?
a. The patient has atrial fibrillation.
,b. The patient has dysphasia.
c. The patient states, "I suddenly developed a terrible headache."
d. The patient has a history of brief episodes of right hemiplegia.
Answer: ANS: C
A sudden-onset headache is typical of a subarachnoid hemorrhage
and ruptured aneurysm; the physician should be notified
immediately.
PTS: 1 DIF: Cognitive Level: Comprehension REF: page 1678, Safety
Alert
OBJ: 4 TOP: Nursing Process: Implementation MSC: CRNE: CH-61
◉ 5. A patient with a stroke caused by thrombosis of the middle
cerebral artery experiences left-sided paralysis of the upper and
lower extremities and facial drooping on the left side. When
obtaining admission assessment data about the patient's clinical
manifestations, it is most important for the nurse to assess which of
the following?
a. The patient's ability to follow commands
b. The patient's visual fields
c. The patient's left-sided reflexes
d. The patient's emotional state Answer: ANS: A
Because the patient with a right-sided brain stroke may have
difficulty with comprehension and use of language, it is important to
obtain baseline data about the ability to follow commands.
,PTS: 1 DIF: Cognitive Level: Application REF: page 1679
OBJ: 7 TOP: Nursing Process: Implementation MSC: CRNE: CH-8
◉ 6. On the medical unit, the nurse receives a verbal report from the
emergency department nurse that a patient has an occlusion of the
left posterior cerebral artery. When admitting the patient to the
medical floor, which of the following will the nurse anticipate that
the patient may be experiencing?
a. Visual deficits
b. Dysphasia
c. Confusion
d. Poor judgement Answer: ANS: A
Visual disturbances are expected with posterior cerebral artery
occlusion.
PTS: 1 DIF: Cognitive Level: Comprehension REF: page 1678, Table
60-3
OBJ: 7 TOP: Nursing Process: Planning MSC: CRNE: CH-61
◉ 7. Which one of the following manifestations would the nurse
expect to assess on a patient with right-brain damage from a stroke?
a. Right-sided hemiplegia
b. Slow performance, cautiousness
, c. Aware of deficits, depression
d. Impulsive behaviour Answer: ANS: D
A patient with right-brain damage from a stroke would manifest
impulsive behaviour, thus safety is a main priority of care.
PTS: 1 DIF: Cognitive Level: Application REF: page 1679, Figure 60-5
OBJ: 4 TOP: Nursing Process: Assessment MSC: CRNE: CH-8
◉ 8. The physician recommends a carotid endarterectomy for a
patient with carotid atherosclerosis and a history of TIAs. The
patient asks the nurse whether this procedure involves brain
surgery. In responding to the patient, what should the nurse include
information about?
a. An endarterectomy involves brain surgery because plaques in
arteries at the base of the brain are removed.
b. This surgery involves resection of a diseased portion of the artery
in the brain and replacing it with a synthetic graft.
c. A carotid endarterectomy involves removal of plaques in an artery
in the neck and does not involve surgery in the brain.
d. In this surgery, a burr hole is drilled in the skull to connect an
artery outside the skull to one inside the brain, bypassing a
blockage. Answer: ANS: C
In a carotid endarterectomy, the carotid artery is incised and the
plaque is removed.
