Lewis's Medical Surgical Nursing 11th
Edition Harding Test Bank Exam
Questions and Answers (Latest Update
2026)
After the insertion of an arteriovenous graft in the right forearm, a
patient reports pain and
coldness of the right fingers. Which action should the nurse take?
a. Remind the patient to take a daily low-dose aspirin tablet.
b. Report the patient's symptoms to the health care provider.
c. Elevate the patient's arm on pillows above the heart level.
d. Teach the patient about normal arteriovenous graft function. -
correct answer ✅ANS: B
The patient's problems suggest the development of distal ischemia
(steal syndrome) and may
require revision of the AVG. Elevating the arm above the heart will
further decrease
perfusion. Pain and coolness are not normal after AVG insertion.
Aspirin therapy is not used
to maintain grafts.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological
Integrity
,Lewis's Medical Surgical Nursing 11th
Edition Harding Test Bank Exam
Questions and Answers (Latest Update
2026)
Which assessment finding should the nurse expect when a patient
with acute kidney injury
(AKI) has an arterial blood pH of 7.30?
a. Persistent skin tenting
b. Rapid, deep respirations
c. Hot, flushed face and neck
d. Bounding peripheral pulses -
correct answer ✅ANS: B
Patients with metabolic acidosis caused by AKI may have Kussmaul
respirations to eliminate
carbon dioxide. Bounding pulses and vasodilation are not
associated with metabolic acidosis.
Because the patient is likely to have fluid retention, poor skin turgor
would not be a finding in
AKI.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological
Integrity
,Lewis's Medical Surgical Nursing 11th
Edition Harding Test Bank Exam
Questions and Answers (Latest Update
2026)
The nurse is planning care for a patient with severe heart failure
who has developed increased
blood urea nitrogen (BUN) and creatinine levels. What will be the
primary treatment goal in
the plan?
a. Augmenting fluid volume
b. Maintaining cardiac output
c. Diluting nephrotoxic substances
d. Preventing systemic hypertension -
correct answer ✅ANS: B
The primary goal of treatment for acute kidney injury (AKI) is to
eliminate the cause and
provide supportive care while the kidneys recover. Because this
patient's heart failure is
causing AKI, the care will be directed toward treatment of the heart
failure. For renal failure
caused by hypertension, hypovolemia, or nephrotoxins, the other
responses could be correct.
, Lewis's Medical Surgical Nursing 11th
Edition Harding Test Bank Exam
Questions and Answers (Latest Update
2026)
DIF: Cognitive Level: Apply (application) TOP: Nursing Process:
Planning
MSC: NCLEX: Physiological Integrity
A patient who has acute glomerulonephritis is hospitalized with
hyperkalemia. Which
information will the nurse monitor to evaluate the effectiveness of
the prescribed calcium
gluconate IV?
a. Urine volume
b. Calcium level
c. Cardiac rhythm
d. Neurologic status -
correct answer ✅ANS: C
The calcium gluconate helps prevent dysrhythmias that might be
caused by the hyperkalemia.
The nurse will monitor the other data as well, but these will not be
helpful in determining the
effectiveness of the calcium gluconate.
Edition Harding Test Bank Exam
Questions and Answers (Latest Update
2026)
After the insertion of an arteriovenous graft in the right forearm, a
patient reports pain and
coldness of the right fingers. Which action should the nurse take?
a. Remind the patient to take a daily low-dose aspirin tablet.
b. Report the patient's symptoms to the health care provider.
c. Elevate the patient's arm on pillows above the heart level.
d. Teach the patient about normal arteriovenous graft function. -
correct answer ✅ANS: B
The patient's problems suggest the development of distal ischemia
(steal syndrome) and may
require revision of the AVG. Elevating the arm above the heart will
further decrease
perfusion. Pain and coolness are not normal after AVG insertion.
Aspirin therapy is not used
to maintain grafts.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological
Integrity
,Lewis's Medical Surgical Nursing 11th
Edition Harding Test Bank Exam
Questions and Answers (Latest Update
2026)
Which assessment finding should the nurse expect when a patient
with acute kidney injury
(AKI) has an arterial blood pH of 7.30?
a. Persistent skin tenting
b. Rapid, deep respirations
c. Hot, flushed face and neck
d. Bounding peripheral pulses -
correct answer ✅ANS: B
Patients with metabolic acidosis caused by AKI may have Kussmaul
respirations to eliminate
carbon dioxide. Bounding pulses and vasodilation are not
associated with metabolic acidosis.
Because the patient is likely to have fluid retention, poor skin turgor
would not be a finding in
AKI.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological
Integrity
,Lewis's Medical Surgical Nursing 11th
Edition Harding Test Bank Exam
Questions and Answers (Latest Update
2026)
The nurse is planning care for a patient with severe heart failure
who has developed increased
blood urea nitrogen (BUN) and creatinine levels. What will be the
primary treatment goal in
the plan?
a. Augmenting fluid volume
b. Maintaining cardiac output
c. Diluting nephrotoxic substances
d. Preventing systemic hypertension -
correct answer ✅ANS: B
The primary goal of treatment for acute kidney injury (AKI) is to
eliminate the cause and
provide supportive care while the kidneys recover. Because this
patient's heart failure is
causing AKI, the care will be directed toward treatment of the heart
failure. For renal failure
caused by hypertension, hypovolemia, or nephrotoxins, the other
responses could be correct.
, Lewis's Medical Surgical Nursing 11th
Edition Harding Test Bank Exam
Questions and Answers (Latest Update
2026)
DIF: Cognitive Level: Apply (application) TOP: Nursing Process:
Planning
MSC: NCLEX: Physiological Integrity
A patient who has acute glomerulonephritis is hospitalized with
hyperkalemia. Which
information will the nurse monitor to evaluate the effectiveness of
the prescribed calcium
gluconate IV?
a. Urine volume
b. Calcium level
c. Cardiac rhythm
d. Neurologic status -
correct answer ✅ANS: C
The calcium gluconate helps prevent dysrhythmias that might be
caused by the hyperkalemia.
The nurse will monitor the other data as well, but these will not be
helpful in determining the
effectiveness of the calcium gluconate.
