Adult Health: Lewis’s Medical-
Surgical Nursing – 12th Edition
Practice Questions, Comprehensive
Review, and Exam Preparation
Guide
When caring for a patient with acute a. auscultating lung
sounds. bronchitis, the nurse will prioritize
interventions by:
a.Auscultating lung sounds.
b. Encouraging fluid restriction.
c. Administering antibiotic therapy.
d.Teaching the patient to avoid
cough suppressants.
,Which patient(s) have the greatest risk for b. Patient with acute opioid use.
aspiration pneumonia? (Select all that d. Patient who is receiving nasogastric enteral feeding.
apply). e. Patient who has a traumatic brain injury from blunt
trauma.
a.Patient who had thoracic surgery.
b. Patient with acute opioid use.
c. Patient who had a myocardial infarction.
d. Patient who is receiving
nasogastric enteral feeding.
e. Patient who has a traumatic brain
injury from blunt trauma.
An appropriate nursing intervention to help d. Teach them how to cough effectively
and expectorate a patient with pneumonia manage thick secretions.
purulent secretions would be to:
a.Perform postural drainage Q1 hour.
b. Provide analgesics Q3 hours.
c. Administer O2 as prescribed to
maintain optimal O2 levels.
d.Teach them how to cough
effectively and expectorate
secretions.
A patient with TB is admitted to the hospital c. Adherence to precautions includes
coughing into a paper and placed in a single patient room on tissue.
airborne precautions. What should the nurse d. Take all medications for full length of
time to prevent teach the patient? (Select all that apply). multidrug-resistant TB.
e. Wear a standard isolation mask if leaving the airborne
a.No visitors will be allowed while in infection isolation
room. airborne isolation.
b. Expect regular TB skin testing to
evaluate for infection.
c. Adherence to precautions
includes coughing into a paper
tissue.
d.Take all medications for full length
of time to prevent multidrug-resistant
TB.
e.Wear a standard isolation mask if
leaving the airborne infection
isolation room.
When caring for a patient with a lung b. Antibiotic
administration abscess, what is the nurse's priority
intervention? A lung abscess is typically caused by a bacterial
infection that leads to localized tissue destruction
and pus formation. The
a.Postural drainage priority intervention in treating a lung abscess is
addressing
b.Antibiotic administration the infection to prevent further complications, such as
sepsis
c. Obtaining a sputum specimen or spreading of the infection. Antibiotics directly target
the
d.Asking the patient about a family history causative pathogens and are the
most critical initial of lung cancer intervention.
,The patient with a right-side pleural effusion b. Administering
analgesia as ordered. has stable vital signs and O2 at 6 L/min via c.
Maintaining High-Fowler's position.
nasal cannula. A right-side chest tube is d. Encouraging deep breathing and coughing.
attached to straight drainage. Which actions e. Monitoring color and amount of
chest tube draining would the nurse include in the plan of care?
(Select all that apply).
a.Placing the patient on NPO status.
b.Administering analgesia as ordered.
c. Maintaining High-Fowler's position.
d. Encouraging deep breathing
and coughing.
e. Monitoring color and amount of
chest tube draining
You are caring for a patient with several c. Paradoxical chest movement during
respirations. traumatic injuries after a multiple-vehicle
accident. Which assessment finding
would lead you to suspect a flail
chest?
a.Chest-tube is draining bright red blood.
b.Tracheal deviation to the unaffected side.
c. Paradoxical chest movement
during respirations.
d. Limited to no movement of the
involved chest wall.
When planning care for a patient at high risk b. Using intermittent pneumatic
compression devices. for pulmonary embolism, the nurse
prioritizes:
a.Maintaining the patient on strict bed rest.
b. Using intermittent
pneumatic compression
devices.
c. Encouraging the patient to
cough and deep breath.
d. Encouraging a fluid intake of 2000
mL per 8-hour shift.
The nurse would closely monitor patients a. pulmonary
edema exposed to a chlorine leak from a local
factory for:
a.pulmonary edema
b.Anaphylactic shock
c. Respiratory acidosis
d.Acute tubular necrosis
, Management of a patient after a lung a. Mechanical ventilation in the early
postoperative period. transplant includes which measures? (Select b. Assisting with lung
biopsy if acute rejection is suspected. all that apply). c. IV fluid therapy accompanied by
accurate intake and
output.
a.Mechanical ventilation in the early d. Pulmonary clearance measures, including deep
breathing postoperative period. and coughing.
b.Assisting with lung biopsy if
acute rejection is suspected.
c. IV fluid therapy accompanied by
accurate intake and output.
d. Pulmonary clearance measures,
including deep breathing and
coughing.
Nursing care of a patient with Stage 4 lung a. Coordinating a referral to
palliative care. cancer would include:
a.Coordinating a referral to palliative care.
b. Limiting visitors to decrease infection risk.
c. NPO status and starting
parenteral nutrition.
d.Avoiding talking about the
cancer diagnosis.
The nurse is caring for a patient with d. Increase fluid intake to 3 L/day if tolerated.
impaired airway clearance. What is the
priority nursing action to assist the patient Although several interventions may help the
patient
to expectorate thick lung secretions? expectorate mucus, the highest priority should be on
increasing fluid intake, which will liquefy the secretions
so that
a.Humidify the oxygen as able. the patient can expectorate them more easily.
Humidifying the
b.Administer a cough suppressant q4hr. oxygen is also helpful but is not the primary intervention.
c.Teach patient to splint the affected area. Teaching the patient to splint the affected area may also
be
d. Increase fluid intake to 3 L/day if helpful in decreasing discomfort but does not
assist in tolerated. expectoration of thick secretions.
A patient with idiopathic pulmonary d. Bronchiolitis obliterans (BOS)
fibrosis had bilateral lung transplantation
and now has exertional dyspnea, BOS is a manifestation of chronic rejection and is
nonproductive cough, and wheezing. What characterized by airflow obstruction
progressing over time does the nurse determine is most likely with a gradual onset of
exertional dyspnea, nonproductive occurring in this patient? cough, wheezing, and/or
low-grade fever. Pulmonary
infarction occurs with lack of blood flow to the
bronchial
a.Pulmonary infarction tissue or preexisting lung disease. With pulmonary
b. Pulmonary hypertension hypertension, the pulmonary pressures are elevated and
can
c. Cytomegalovirus (CMV) be idiopathic or secondarily due to parenchymal lung
disease
d. Bronchiolitis obliterans (BOS) that causes anatomic or vascular changes leading to
pulmonary hypertension. CMV pneumonia is the
most common opportunistic infection 1 to 4
months after lung transplant.
Surgical Nursing – 12th Edition
Practice Questions, Comprehensive
Review, and Exam Preparation
Guide
When caring for a patient with acute a. auscultating lung
sounds. bronchitis, the nurse will prioritize
interventions by:
a.Auscultating lung sounds.
b. Encouraging fluid restriction.
c. Administering antibiotic therapy.
d.Teaching the patient to avoid
cough suppressants.
,Which patient(s) have the greatest risk for b. Patient with acute opioid use.
aspiration pneumonia? (Select all that d. Patient who is receiving nasogastric enteral feeding.
apply). e. Patient who has a traumatic brain injury from blunt
trauma.
a.Patient who had thoracic surgery.
b. Patient with acute opioid use.
c. Patient who had a myocardial infarction.
d. Patient who is receiving
nasogastric enteral feeding.
e. Patient who has a traumatic brain
injury from blunt trauma.
An appropriate nursing intervention to help d. Teach them how to cough effectively
and expectorate a patient with pneumonia manage thick secretions.
purulent secretions would be to:
a.Perform postural drainage Q1 hour.
b. Provide analgesics Q3 hours.
c. Administer O2 as prescribed to
maintain optimal O2 levels.
d.Teach them how to cough
effectively and expectorate
secretions.
A patient with TB is admitted to the hospital c. Adherence to precautions includes
coughing into a paper and placed in a single patient room on tissue.
airborne precautions. What should the nurse d. Take all medications for full length of
time to prevent teach the patient? (Select all that apply). multidrug-resistant TB.
e. Wear a standard isolation mask if leaving the airborne
a.No visitors will be allowed while in infection isolation
room. airborne isolation.
b. Expect regular TB skin testing to
evaluate for infection.
c. Adherence to precautions
includes coughing into a paper
tissue.
d.Take all medications for full length
of time to prevent multidrug-resistant
TB.
e.Wear a standard isolation mask if
leaving the airborne infection
isolation room.
When caring for a patient with a lung b. Antibiotic
administration abscess, what is the nurse's priority
intervention? A lung abscess is typically caused by a bacterial
infection that leads to localized tissue destruction
and pus formation. The
a.Postural drainage priority intervention in treating a lung abscess is
addressing
b.Antibiotic administration the infection to prevent further complications, such as
sepsis
c. Obtaining a sputum specimen or spreading of the infection. Antibiotics directly target
the
d.Asking the patient about a family history causative pathogens and are the
most critical initial of lung cancer intervention.
,The patient with a right-side pleural effusion b. Administering
analgesia as ordered. has stable vital signs and O2 at 6 L/min via c.
Maintaining High-Fowler's position.
nasal cannula. A right-side chest tube is d. Encouraging deep breathing and coughing.
attached to straight drainage. Which actions e. Monitoring color and amount of
chest tube draining would the nurse include in the plan of care?
(Select all that apply).
a.Placing the patient on NPO status.
b.Administering analgesia as ordered.
c. Maintaining High-Fowler's position.
d. Encouraging deep breathing
and coughing.
e. Monitoring color and amount of
chest tube draining
You are caring for a patient with several c. Paradoxical chest movement during
respirations. traumatic injuries after a multiple-vehicle
accident. Which assessment finding
would lead you to suspect a flail
chest?
a.Chest-tube is draining bright red blood.
b.Tracheal deviation to the unaffected side.
c. Paradoxical chest movement
during respirations.
d. Limited to no movement of the
involved chest wall.
When planning care for a patient at high risk b. Using intermittent pneumatic
compression devices. for pulmonary embolism, the nurse
prioritizes:
a.Maintaining the patient on strict bed rest.
b. Using intermittent
pneumatic compression
devices.
c. Encouraging the patient to
cough and deep breath.
d. Encouraging a fluid intake of 2000
mL per 8-hour shift.
The nurse would closely monitor patients a. pulmonary
edema exposed to a chlorine leak from a local
factory for:
a.pulmonary edema
b.Anaphylactic shock
c. Respiratory acidosis
d.Acute tubular necrosis
, Management of a patient after a lung a. Mechanical ventilation in the early
postoperative period. transplant includes which measures? (Select b. Assisting with lung
biopsy if acute rejection is suspected. all that apply). c. IV fluid therapy accompanied by
accurate intake and
output.
a.Mechanical ventilation in the early d. Pulmonary clearance measures, including deep
breathing postoperative period. and coughing.
b.Assisting with lung biopsy if
acute rejection is suspected.
c. IV fluid therapy accompanied by
accurate intake and output.
d. Pulmonary clearance measures,
including deep breathing and
coughing.
Nursing care of a patient with Stage 4 lung a. Coordinating a referral to
palliative care. cancer would include:
a.Coordinating a referral to palliative care.
b. Limiting visitors to decrease infection risk.
c. NPO status and starting
parenteral nutrition.
d.Avoiding talking about the
cancer diagnosis.
The nurse is caring for a patient with d. Increase fluid intake to 3 L/day if tolerated.
impaired airway clearance. What is the
priority nursing action to assist the patient Although several interventions may help the
patient
to expectorate thick lung secretions? expectorate mucus, the highest priority should be on
increasing fluid intake, which will liquefy the secretions
so that
a.Humidify the oxygen as able. the patient can expectorate them more easily.
Humidifying the
b.Administer a cough suppressant q4hr. oxygen is also helpful but is not the primary intervention.
c.Teach patient to splint the affected area. Teaching the patient to splint the affected area may also
be
d. Increase fluid intake to 3 L/day if helpful in decreasing discomfort but does not
assist in tolerated. expectoration of thick secretions.
A patient with idiopathic pulmonary d. Bronchiolitis obliterans (BOS)
fibrosis had bilateral lung transplantation
and now has exertional dyspnea, BOS is a manifestation of chronic rejection and is
nonproductive cough, and wheezing. What characterized by airflow obstruction
progressing over time does the nurse determine is most likely with a gradual onset of
exertional dyspnea, nonproductive occurring in this patient? cough, wheezing, and/or
low-grade fever. Pulmonary
infarction occurs with lack of blood flow to the
bronchial
a.Pulmonary infarction tissue or preexisting lung disease. With pulmonary
b. Pulmonary hypertension hypertension, the pulmonary pressures are elevated and
can
c. Cytomegalovirus (CMV) be idiopathic or secondarily due to parenchymal lung
disease
d. Bronchiolitis obliterans (BOS) that causes anatomic or vascular changes leading to
pulmonary hypertension. CMV pneumonia is the
most common opportunistic infection 1 to 4
months after lung transplant.
