LEWIS MEDICAL-SURGICAL NURSING
FINAL SCRIPT 2026 QUESTIONS WITH
ANSWERS GRADED A+
◉The nurse is admitting a patient with possible rheumatic fever.
Which question on the admission health history will be most
pertinent to ask?
a. "Do you use any illegal IV drugs?"
b. "Have you had a recent sore throat?"
c. "Have you injured your chest in the last few weeks?"
d. "Do you have a family history of congenital heart disease?"
Answer: ANS: B
Rheumatic fever occurs as a result of an abnormal immune response
to a streptococcal infection. Although illicit IV drug use should be
discussed with the patient before discharge, it is not a risk factor for
rheumatic fever, and would not be as pertinent when admitting the
patient. Family history is not a risk factor for rheumatic fever. Chest
injury would cause musculoskeletal chest pain rather than
rheumatic fever.
◉A patient with rheumatic fever has subcutaneous nodules,
erythema marginatum, and polyarthritis. Based on these findings,
which nursing diagnosis would be most appropriate?
,a. Pain related to permanent joint fixation
b. Activity intolerance related to arthralgia
c. Risk for infection related to open skin lesions
d. Risk for impaired skin integrity related to pruritus Answer: ANS:
B
The patient's joint pain will lead to difficulty with activity. The skin
lesions seen in rheumatic fever are not open or pruritic. Although
acute joint pain will be a problem for this patient, joint inflammation
is a temporary clinical manifestation of rheumatic fever and is not
associated with permanent joint changes.
◉The nurse establishes the nursing diagnosis of ineffective health
maintenance related to lack of knowledge regarding long-term
management of rheumatic fever when a 30-year-old recovering from
rheumatic fever without carditis says which of the following?
a. "I will need prophylactic antibiotic therapy for 5 years."
b. "I will need to take aspirin or ibuprofen (Motrin) to relieve my
joint pain."
c. "I will call the doctor if I develop excessive fatigue or difficulty
breathing."
d. "I will be immune to further episodes of rheumatic fever after this
infection." Answer: ANS: D
Patients with a history of rheumatic fever are more susceptible to a
second episode. Patients with rheumatic fever without carditis
require prophylaxis until age 20 and for a minimum of 5 years. The
, other patient statements are correct and would not support the
nursing diagnosis of ineffective health maintenance.
◉When developing a community health program to decrease the
incidence of rheumatic fever, which action would be most important
for the community health nurse to include?
a. Vaccinate high-risk groups in the community with streptococcal
vaccine.
b. Teach community members to seek treatment for streptococcal
pharyngitis.
c. Teach about the importance of monitoring temperature when sore
throats occur.
d. Teach about prophylactic antibiotics to those with a family history
of rheumatic fever. Answer: ANS: B
The incidence of rheumatic fever is decreased by treatment of
streptococcal infections with antibiotics. Family history is not a risk
factor for rheumatic fever. There is no immunization that is effective
in decreasing the incidence of rheumatic fever. Teaching about
monitoring temperature will not decrease the incidence of
rheumatic fever.
◉When caring for a patient with mitral valve stenosis, it is most
important that the nurse assess for:
a. diastolic murmur.
FINAL SCRIPT 2026 QUESTIONS WITH
ANSWERS GRADED A+
◉The nurse is admitting a patient with possible rheumatic fever.
Which question on the admission health history will be most
pertinent to ask?
a. "Do you use any illegal IV drugs?"
b. "Have you had a recent sore throat?"
c. "Have you injured your chest in the last few weeks?"
d. "Do you have a family history of congenital heart disease?"
Answer: ANS: B
Rheumatic fever occurs as a result of an abnormal immune response
to a streptococcal infection. Although illicit IV drug use should be
discussed with the patient before discharge, it is not a risk factor for
rheumatic fever, and would not be as pertinent when admitting the
patient. Family history is not a risk factor for rheumatic fever. Chest
injury would cause musculoskeletal chest pain rather than
rheumatic fever.
◉A patient with rheumatic fever has subcutaneous nodules,
erythema marginatum, and polyarthritis. Based on these findings,
which nursing diagnosis would be most appropriate?
,a. Pain related to permanent joint fixation
b. Activity intolerance related to arthralgia
c. Risk for infection related to open skin lesions
d. Risk for impaired skin integrity related to pruritus Answer: ANS:
B
The patient's joint pain will lead to difficulty with activity. The skin
lesions seen in rheumatic fever are not open or pruritic. Although
acute joint pain will be a problem for this patient, joint inflammation
is a temporary clinical manifestation of rheumatic fever and is not
associated with permanent joint changes.
◉The nurse establishes the nursing diagnosis of ineffective health
maintenance related to lack of knowledge regarding long-term
management of rheumatic fever when a 30-year-old recovering from
rheumatic fever without carditis says which of the following?
a. "I will need prophylactic antibiotic therapy for 5 years."
b. "I will need to take aspirin or ibuprofen (Motrin) to relieve my
joint pain."
c. "I will call the doctor if I develop excessive fatigue or difficulty
breathing."
d. "I will be immune to further episodes of rheumatic fever after this
infection." Answer: ANS: D
Patients with a history of rheumatic fever are more susceptible to a
second episode. Patients with rheumatic fever without carditis
require prophylaxis until age 20 and for a minimum of 5 years. The
, other patient statements are correct and would not support the
nursing diagnosis of ineffective health maintenance.
◉When developing a community health program to decrease the
incidence of rheumatic fever, which action would be most important
for the community health nurse to include?
a. Vaccinate high-risk groups in the community with streptococcal
vaccine.
b. Teach community members to seek treatment for streptococcal
pharyngitis.
c. Teach about the importance of monitoring temperature when sore
throats occur.
d. Teach about prophylactic antibiotics to those with a family history
of rheumatic fever. Answer: ANS: B
The incidence of rheumatic fever is decreased by treatment of
streptococcal infections with antibiotics. Family history is not a risk
factor for rheumatic fever. There is no immunization that is effective
in decreasing the incidence of rheumatic fever. Teaching about
monitoring temperature will not decrease the incidence of
rheumatic fever.
◉When caring for a patient with mitral valve stenosis, it is most
important that the nurse assess for:
a. diastolic murmur.
