TEST BANK FOR LEWIS MEDICAL
SURGICAL NURSING 12TH EDITION
BY MARIANN M. HARDING,
JEFFREY KWONG, DEBRA HAGLER
ALL CHAPTERS COVERED
(CHAPTERS 1 TO 69) EXAMWITH
ACTUAL QUESTIONS AND
COMPLETE 100%CORRECT
ANSWERS WITH VERIFIED AND
WELL EXPLAINED RATIONALES
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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?" 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 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." 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.
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
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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.
b. peripheral edema.
c. right upper quadrant tenderness.
d. complaints of shortness of breath. ANS: d
The pressure gradient changes in mitral stenosis lead to fluid backup into the lungs, resulting in
hypoxemia and dyspnea. The other findings also may be associated with mitral valve disease
but are not indicators of possible hypoxemia.
After a patient experienced a brief episode of tinnitus, diplopia, and dysarthria with no residual
effects, the nurse anticipates teaching the patient about
a. cerebral aneurysm clipping.
b. heparin intravenous infusion.
c. oral low-dose aspirin therapy.
d. tissue plasminogen activator (tPA). ANS: C
The patient's symptoms are consistent with transient ischemic attack (TIA), and drugs that
inhibit platelet aggregation are prescribed after a TIA to prevent a stroke. Continuous heparin
infusion is not routinely used after TIA or with acute ischemic stroke. The patient's symptoms
are not consistent with a cerebral aneurysm. tPA is used only for acute ischemic stroke, not for
TIA.
A patient is being admitted with a possible stroke. Which information from the assessment
indicates that the nurse should consult with the health care provider before giving the
prescribed aspirin?
a. The patient has dysphasia.
b. The patient has atrial fibrillation.
c. The patient reports that symptoms began with a severe headache.
d. The patient has a history of brief episodes of right-sided hemiplegia. ANS: C
A sudden onset headache is typical of a subarachnoid hemorrhage, and aspirin is
contraindicated. Atrial fibrillation, dysphasia, and transient ischemic attack are not
contraindications to aspirin use.
A patient with a stroke experiences facial drooping on the right side and right-sided arm and
leg paralysis. When admitting the patient, which clinical manifestation will the nurse expect to
find?
a. Impulsive behavior
b. Right-sided neglect
c. Hyperactive left-sided tendon reflexes
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SURGICAL NURSING 12TH EDITION
BY MARIANN M. HARDING,
JEFFREY KWONG, DEBRA HAGLER
ALL CHAPTERS COVERED
(CHAPTERS 1 TO 69) EXAMWITH
ACTUAL QUESTIONS AND
COMPLETE 100%CORRECT
ANSWERS WITH VERIFIED AND
WELL EXPLAINED RATIONALES
ALREADY GRADED A+ BY EXPERTS
|LATEST VERSION 2024 WITH
GUARANTEED SUCCESS AFTER
DOWNLOAD ALREADY
PASSED!!!!!!! (PROVEN ITS ALL YOU
NEED TO EXCEL IN YOUR EXAMS
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illegal $103 per month?
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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?" 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 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." 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.
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
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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.
b. peripheral edema.
c. right upper quadrant tenderness.
d. complaints of shortness of breath. ANS: d
The pressure gradient changes in mitral stenosis lead to fluid backup into the lungs, resulting in
hypoxemia and dyspnea. The other findings also may be associated with mitral valve disease
but are not indicators of possible hypoxemia.
After a patient experienced a brief episode of tinnitus, diplopia, and dysarthria with no residual
effects, the nurse anticipates teaching the patient about
a. cerebral aneurysm clipping.
b. heparin intravenous infusion.
c. oral low-dose aspirin therapy.
d. tissue plasminogen activator (tPA). ANS: C
The patient's symptoms are consistent with transient ischemic attack (TIA), and drugs that
inhibit platelet aggregation are prescribed after a TIA to prevent a stroke. Continuous heparin
infusion is not routinely used after TIA or with acute ischemic stroke. The patient's symptoms
are not consistent with a cerebral aneurysm. tPA is used only for acute ischemic stroke, not for
TIA.
A patient is being admitted with a possible stroke. Which information from the assessment
indicates that the nurse should consult with the health care provider before giving the
prescribed aspirin?
a. The patient has dysphasia.
b. The patient has atrial fibrillation.
c. The patient reports that symptoms began with a severe headache.
d. The patient has a history of brief episodes of right-sided hemiplegia. ANS: C
A sudden onset headache is typical of a subarachnoid hemorrhage, and aspirin is
contraindicated. Atrial fibrillation, dysphasia, and transient ischemic attack are not
contraindications to aspirin use.
A patient with a stroke experiences facial drooping on the right side and right-sided arm and
leg paralysis. When admitting the patient, which clinical manifestation will the nurse expect to
find?
a. Impulsive behavior
b. Right-sided neglect
c. Hyperactive left-sided tendon reflexes
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