LEWIS MEDICAL-SURGICAL NURSING
PRACTICE PAPER 2026 QUESTIONS WITH
SOLUTIONS GRADED 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. Answer: 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. Answer: ...
◉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. Answer: 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.
c. Give acetaminophen (Tylenol) PRN for fever.
d. Arrange for a transesophageal echocardiogram. Answer: ANS: B
PRACTICE PAPER 2026 QUESTIONS WITH
SOLUTIONS GRADED 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. Answer: 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. Answer: ...
◉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. Answer: 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.
c. Give acetaminophen (Tylenol) PRN for fever.
d. Arrange for a transesophageal echocardiogram. Answer: ANS: B
