Test Bank for Lewis’s Medical Surgical Nursing
in Canada 5th Edition all Chapters included
1. A patient with a history of severe vomiting presents with a heart rate of 110 bpm, low
blood pressure, and poor skin turgor. Which intravenous fluid order should the nurse
anticipate first?
, A. 0.45% Sodium Chloride (½ NS)
B. 5% Dextrose in Water (\(D_{5}W\))
C. 0.9% Sodium Chloride (Normal Saline)
D. 5% Dextrose in 0.45% Sodium Chloride
Answer: C. 0.9% Sodium Chloride (Normal Saline) is an isotonic fluid used to expand
extracellular fluid volume in cases of hypovolemia.
2. A patient's arterial blood gas (ABG) results show: pH 7.31, \(PaCO_{2}\) 52 mmHg,
and \(HCO_{3}^{-}\) 26 mEq/L. How should the nurse interpret these results?
A. Respiratory acidosis, uncompensated
B. Metabolic acidosis, fully compensated
C. Respiratory alkalosis, partially compensated
D. Metabolic alkalosis, uncompensated
Answer: A. The low pH indicates acidosis, the high \(PaCO_{2}\) indicates a respiratory
cause, and the normal \(HCO_{3}^{-}\) indicates no metabolic compensation has
occurred yet.
3. A nurse is caring for a patient whose serum potassium level is 6.2 mmol/L. Which
cardiac monitor finding is the most critical priority for the nurse to report immediately?
A. Prominent U waves
B. Tall, peaked T waves
C. Prolonged PR interval
D. Sinus tachycardia
Answer: B. Hyperkalemia causes tall, peaked T waves and can progress to dangerous
ventricular arrhythmias or cardiac arrest.
🏥 Perioperative Care
, 4. During the preoperative assessment of a patient scheduled for major abdominal
surgery, the patient mentions taking a daily garlic supplement. Why is this detail critical
for the surgical team?
A. It increases the risk of postoperative infection.
B. It can prolong the effects of neuromuscular blockers.
C. It increases the risk of perioperative bleeding.
D. It causes severe postoperative nausea and vomiting.
Answer: C. Herbal supplements like garlic, ginger, ginkgo, and ginseng have antiplatelet
properties and increase bleeding risks.
5. A patient in the PACU becomes restless, agitated, and has an oxygen saturation of
88% on room air. What is the nurse's immediate priority action?
A. Administer the prescribed postoperative opioid analgesic.
B. Assess patency of the airway and initiate oxygen therapy.
C. Notify the anesthesiologist immediately.
D. Encourage the patient to perform deep coughing exercises.
Answer: B. Hypoxemia is the most common cause of PACU agitation; establishing an
open airway and delivering oxygen is the first priority.
🫁 Respiratory System
6. A patient with a history of chronic obstructive pulmonary disease (COPD) presents
with worsening shortness of breath and an oxygen saturation of 89% on 2L \(O_{2}\) via
nasal cannula. Which oxygen delivery device is best suited to provide a precise, specific
concentration of oxygen?
A. Simple face mask
B. Non-rebreather mask
C. Venturi mask
D. Partial rebreather mask
, Answer: C. A Venturi mask delivers a highly precise, fixed concentration of oxygen,
which is essential for managing COPD patients who rely on their hypoxic drive.
7. A nurse is assessing a patient 2 hours after a bronchoscopy. Which finding requires
immediate intervention?
A. Dry, hacking cough
B. Small amounts of blood-tinged sputum
C. Absence of a gag reflex
D. New-onset stridor and intercostal retractions
Answer: D. Stridor indicates laryngospasm or airway obstruction, which is a life-
threatening medical emergency.
🫁 Cardiovascular System
8. A patient admitted with acute coronary syndrome (ACS) develops sudden shortness
of breath, bilateral crackles in the lung bases, and an audible \(S_{3}\) heart sound.
What complication does the nurse suspect?
A. Pulmonary embolism
B. Acute left-sided heart failure
C. Pericarditis
D. Dressler's syndrome
Answer: B. Sudden dyspnea, crackles, and an \(S_{3}\) gallop indicate pulmonary
congestion due to acute left ventricular failure.
9. When teaching a patient with hypertension about the newly prescribed medication
enalapril (an ACE inhibitor), which side effect should the nurse instruct the patient to
report immediately?
A. A persistent, dry cough
B. Mild dizziness when standing up quickly
C. Swelling of the lips, tongue, or face
in Canada 5th Edition all Chapters included
1. A patient with a history of severe vomiting presents with a heart rate of 110 bpm, low
blood pressure, and poor skin turgor. Which intravenous fluid order should the nurse
anticipate first?
, A. 0.45% Sodium Chloride (½ NS)
B. 5% Dextrose in Water (\(D_{5}W\))
C. 0.9% Sodium Chloride (Normal Saline)
D. 5% Dextrose in 0.45% Sodium Chloride
Answer: C. 0.9% Sodium Chloride (Normal Saline) is an isotonic fluid used to expand
extracellular fluid volume in cases of hypovolemia.
2. A patient's arterial blood gas (ABG) results show: pH 7.31, \(PaCO_{2}\) 52 mmHg,
and \(HCO_{3}^{-}\) 26 mEq/L. How should the nurse interpret these results?
A. Respiratory acidosis, uncompensated
B. Metabolic acidosis, fully compensated
C. Respiratory alkalosis, partially compensated
D. Metabolic alkalosis, uncompensated
Answer: A. The low pH indicates acidosis, the high \(PaCO_{2}\) indicates a respiratory
cause, and the normal \(HCO_{3}^{-}\) indicates no metabolic compensation has
occurred yet.
3. A nurse is caring for a patient whose serum potassium level is 6.2 mmol/L. Which
cardiac monitor finding is the most critical priority for the nurse to report immediately?
A. Prominent U waves
B. Tall, peaked T waves
C. Prolonged PR interval
D. Sinus tachycardia
Answer: B. Hyperkalemia causes tall, peaked T waves and can progress to dangerous
ventricular arrhythmias or cardiac arrest.
🏥 Perioperative Care
, 4. During the preoperative assessment of a patient scheduled for major abdominal
surgery, the patient mentions taking a daily garlic supplement. Why is this detail critical
for the surgical team?
A. It increases the risk of postoperative infection.
B. It can prolong the effects of neuromuscular blockers.
C. It increases the risk of perioperative bleeding.
D. It causes severe postoperative nausea and vomiting.
Answer: C. Herbal supplements like garlic, ginger, ginkgo, and ginseng have antiplatelet
properties and increase bleeding risks.
5. A patient in the PACU becomes restless, agitated, and has an oxygen saturation of
88% on room air. What is the nurse's immediate priority action?
A. Administer the prescribed postoperative opioid analgesic.
B. Assess patency of the airway and initiate oxygen therapy.
C. Notify the anesthesiologist immediately.
D. Encourage the patient to perform deep coughing exercises.
Answer: B. Hypoxemia is the most common cause of PACU agitation; establishing an
open airway and delivering oxygen is the first priority.
🫁 Respiratory System
6. A patient with a history of chronic obstructive pulmonary disease (COPD) presents
with worsening shortness of breath and an oxygen saturation of 89% on 2L \(O_{2}\) via
nasal cannula. Which oxygen delivery device is best suited to provide a precise, specific
concentration of oxygen?
A. Simple face mask
B. Non-rebreather mask
C. Venturi mask
D. Partial rebreather mask
, Answer: C. A Venturi mask delivers a highly precise, fixed concentration of oxygen,
which is essential for managing COPD patients who rely on their hypoxic drive.
7. A nurse is assessing a patient 2 hours after a bronchoscopy. Which finding requires
immediate intervention?
A. Dry, hacking cough
B. Small amounts of blood-tinged sputum
C. Absence of a gag reflex
D. New-onset stridor and intercostal retractions
Answer: D. Stridor indicates laryngospasm or airway obstruction, which is a life-
threatening medical emergency.
🫁 Cardiovascular System
8. A patient admitted with acute coronary syndrome (ACS) develops sudden shortness
of breath, bilateral crackles in the lung bases, and an audible \(S_{3}\) heart sound.
What complication does the nurse suspect?
A. Pulmonary embolism
B. Acute left-sided heart failure
C. Pericarditis
D. Dressler's syndrome
Answer: B. Sudden dyspnea, crackles, and an \(S_{3}\) gallop indicate pulmonary
congestion due to acute left ventricular failure.
9. When teaching a patient with hypertension about the newly prescribed medication
enalapril (an ACE inhibitor), which side effect should the nurse instruct the patient to
report immediately?
A. A persistent, dry cough
B. Mild dizziness when standing up quickly
C. Swelling of the lips, tongue, or face
