LEWIS MEDICAL SURGICAL COMPREHENSIVE
QUESTIONS AND ANSWERS SET A+
✔✔What nursing action should the nurse prioritize during the care of a patient who has
recently recovered from rheumatic fever?
A. Teach the patient how to manage his or her physical activity.
B. Teach the patient about the need for ongoing anticoagulation.
C. Teach the patient about the need for continuous antibiotic prophylaxis.
D. Teach the patient about the need to maintain standard infection control procedures. -
✔✔C. Teach the patient about the need for continuous antibiotic prophylaxis.
Patients with a history of rheumatic fever frequently require ongoing antibiotic
prophylaxis, an intervention that necessitates education. This consideration is more
important than activity management in preventing recurrence. Anticoagulation is not
indicated in this patient population. Standard precautions are indicated for all patients.
✔✔The patient with pericarditis is complaining of chest pain. After assessment, which
intervention should the nurse expect to implement to provide pain relief?
A. Corticosteroids
B. Morphine sulfate
C. Proton pump inhibitor
D. Nonsteroidal antiinflammatory drugs - ✔✔D. Nonsteroidal antiinflammatory drugs
Nonsteroidal antiinflammatory drugs (NSAIDs) will control pain and inflammation.
Corticosteroids are reserved for patients already taking corticosteroids for autoimmune
conditions or those who do not respond to NSAIDs. Morphine is not necessary. Proton
pump inhibitors are used to decrease stomach acid to avoid the risk of GI bleeding from
the NSAIDs.
✔✔A 25-year-old patient with a group A streptococcal pharyngitis does not want to take
the antibiotics prescribed. What should the nurse tell the patient to encourage the
patient to take the medications and avoid complications of the infection?
, A. "The complications of this infection will affect the skin, hair, and balance."
B. "You will not feel well if you do not take the medicine and get over this infection."
C. "Without treatment, you could get rheumatic fever, which can lead to rheumatic heart
disease."
D. "You may not want to take the antibiotics for this infection, but you will be sorry if you
do not." - ✔✔C. "Without treatment, you could get rheumatic fever, which can lead to
rheumatic heart disease."
Rheumatic fever (RF) is not common because of effective use of antibiotics to treat
streptococcal infections. Without treatment, RF can occur and lead to rheumatic heart
disease, especially in young adults. The complications do not include hair or balance.
Saying that the patient will not feel well or that the patient will be sorry if the antibiotics
are not taken is threatening to the patient and inappropriate for the nurse to say.
✔✔The patient had a history of rheumatic fever and has been diagnosed with mitral
valve stenosis. The patient is planning to have a biologic valve replacement. What
protective mechanisms should the nurse teach the patient about using after the valve
replacement?
A. Long-term anticoagulation therapy
B. Antibiotic prophylaxis for dental care
C. Exercise plan to increase cardiac tolerance
D. Take β-adrenergic blockers to control palpitations. - ✔✔B. Antibiotic prophylaxis for
dental care
The patient will need to use antibiotic prophylaxis for dental care to prevent
endocarditis. Long-term anticoagulation therapy is not used with biologic valve
replacement unless the patient has atrial fibrillation. An exercise plan to increase
cardiac tolerance is needed for a patient with heart failure. Taking β-adrenergic blockers
to control palpitations is prescribed for mitral valve prolapse, not valve replacement.
✔✔An 80-year-old patient with uncontrolled type 1 diabetes mellitus is diagnosed with
aortic stenosis. When conservative therapy is no longer effective, the nurse knows that
the patient will need to do or have what done?
A. Aortic valve replacement
B. Take nitroglycerin for chest pain.
C. Open commissurotomy (valvulotomy) procedure
D. Percutaneous transluminal balloon valvuloplasty (PTBV) procedure - ✔✔D.
Percutaneous transluminal balloon valvuloplasty (PTBV) procedure
✔✔The patient had myocarditis and is now experiencing fatigue, weakness,
palpitations, and dyspnea at rest. The nurse assesses pulmonary crackles, edema, and
weak peripheral pulses. Sinoatrial tachycardia is evident on the cardiac monitor. The
Doppler echocardiography shows dilated cardiomyopathy. What collaborative and
nursing care of this patient should be done to improve cardiac output and the quality of
life? (Select all that apply.)
QUESTIONS AND ANSWERS SET A+
✔✔What nursing action should the nurse prioritize during the care of a patient who has
recently recovered from rheumatic fever?
A. Teach the patient how to manage his or her physical activity.
B. Teach the patient about the need for ongoing anticoagulation.
C. Teach the patient about the need for continuous antibiotic prophylaxis.
D. Teach the patient about the need to maintain standard infection control procedures. -
✔✔C. Teach the patient about the need for continuous antibiotic prophylaxis.
Patients with a history of rheumatic fever frequently require ongoing antibiotic
prophylaxis, an intervention that necessitates education. This consideration is more
important than activity management in preventing recurrence. Anticoagulation is not
indicated in this patient population. Standard precautions are indicated for all patients.
✔✔The patient with pericarditis is complaining of chest pain. After assessment, which
intervention should the nurse expect to implement to provide pain relief?
A. Corticosteroids
B. Morphine sulfate
C. Proton pump inhibitor
D. Nonsteroidal antiinflammatory drugs - ✔✔D. Nonsteroidal antiinflammatory drugs
Nonsteroidal antiinflammatory drugs (NSAIDs) will control pain and inflammation.
Corticosteroids are reserved for patients already taking corticosteroids for autoimmune
conditions or those who do not respond to NSAIDs. Morphine is not necessary. Proton
pump inhibitors are used to decrease stomach acid to avoid the risk of GI bleeding from
the NSAIDs.
✔✔A 25-year-old patient with a group A streptococcal pharyngitis does not want to take
the antibiotics prescribed. What should the nurse tell the patient to encourage the
patient to take the medications and avoid complications of the infection?
, A. "The complications of this infection will affect the skin, hair, and balance."
B. "You will not feel well if you do not take the medicine and get over this infection."
C. "Without treatment, you could get rheumatic fever, which can lead to rheumatic heart
disease."
D. "You may not want to take the antibiotics for this infection, but you will be sorry if you
do not." - ✔✔C. "Without treatment, you could get rheumatic fever, which can lead to
rheumatic heart disease."
Rheumatic fever (RF) is not common because of effective use of antibiotics to treat
streptococcal infections. Without treatment, RF can occur and lead to rheumatic heart
disease, especially in young adults. The complications do not include hair or balance.
Saying that the patient will not feel well or that the patient will be sorry if the antibiotics
are not taken is threatening to the patient and inappropriate for the nurse to say.
✔✔The patient had a history of rheumatic fever and has been diagnosed with mitral
valve stenosis. The patient is planning to have a biologic valve replacement. What
protective mechanisms should the nurse teach the patient about using after the valve
replacement?
A. Long-term anticoagulation therapy
B. Antibiotic prophylaxis for dental care
C. Exercise plan to increase cardiac tolerance
D. Take β-adrenergic blockers to control palpitations. - ✔✔B. Antibiotic prophylaxis for
dental care
The patient will need to use antibiotic prophylaxis for dental care to prevent
endocarditis. Long-term anticoagulation therapy is not used with biologic valve
replacement unless the patient has atrial fibrillation. An exercise plan to increase
cardiac tolerance is needed for a patient with heart failure. Taking β-adrenergic blockers
to control palpitations is prescribed for mitral valve prolapse, not valve replacement.
✔✔An 80-year-old patient with uncontrolled type 1 diabetes mellitus is diagnosed with
aortic stenosis. When conservative therapy is no longer effective, the nurse knows that
the patient will need to do or have what done?
A. Aortic valve replacement
B. Take nitroglycerin for chest pain.
C. Open commissurotomy (valvulotomy) procedure
D. Percutaneous transluminal balloon valvuloplasty (PTBV) procedure - ✔✔D.
Percutaneous transluminal balloon valvuloplasty (PTBV) procedure
✔✔The patient had myocarditis and is now experiencing fatigue, weakness,
palpitations, and dyspnea at rest. The nurse assesses pulmonary crackles, edema, and
weak peripheral pulses. Sinoatrial tachycardia is evident on the cardiac monitor. The
Doppler echocardiography shows dilated cardiomyopathy. What collaborative and
nursing care of this patient should be done to improve cardiac output and the quality of
life? (Select all that apply.)
