Page 1 of 187
“HSNS270 LEWIS MEDICAL-SURGICAL
NURSING EXAM PRACTICE QUESTIONS
2026 ”LATEST EXAM 2026 – 2027 SOLVED
QUESTIONS & ANSWERS VERIFIED 100%
GRADED A+ (LATEST VERSION) WELL REVISED
100% GUARANTEE PASS
HSNS270 Lewis medical-surgical nursing exam practice questions
A patient is admitted to the hospital with server renal colic. The nurses first
priority in management of the patient is to
a. administer opioids as prescribbed
b. obtain supplies for straining all urine
c. encourage fluid intake of 3-4L/day
d. keep the patient NBM in preparation for surgery
ANS: a
Opioids are effective in the management of pain associated with renal calculi.
The nurse recommends genetic counselling for the children of a patient with
a. nephrotic syndrome
b. chronic pyelonephritis
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c. malignant nephroscleroris
d. adult onset polycystic kidney disease
ANS: b
Many factors are involved in the incidence of chronic pyelonephritis. One factor
relates to genetics. This is particularly true for other renal diseases such as urinary
tract calculi, which may lead to pyelonephritis.
The nurse identifies a risk factor for kidney and bladder cancer in a patient
who relates a history of
a. aspirin use
b. tabacco use
c. chronic alcohol abuse
d. use of artificial sweeteners
ANS: b
Smoking is a major cause of cancer including kidney and bladder cancer.
In planning nursing interventions to increase bladder control in patients with
urinary incentives the nurse includes
a. teaching the patient to use kegel exercises
b. clamping and realising a catheter to increase bladder tone
c. teaching patient beiofeedback mechanism to suppress the urger to void
d. providing advice to the patient absit the cogged of incontinence
containment device
ANS: a
Kegel exercises relate to enhancing pelvic floor muscles. Strengthened pelvic floor
muscles enhance bladder control.
A patient with a ureterolithotomy returns from surgery with a nephrostomy
tube in place. Postoperative nursing care includes
a. encouraging that patient to drink fruit juices and milk
b. encouraging fluids of at least 2-3L/day after nausea has subsisded
c. irrigating the nephrostomy tube with 10ml of normal saline solution is
needed
d. Notify the MO if the nephrostomy tube output id more than 30ml/hr
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ANS: b
If a kidney stone is located, a urterolithotomy is performed. Encouraging fluids is
important to assist the kidney to return to normal function by 'flushing' the kidney.
A patient has had a cystectomy and ill conduit diversion performed. Four days
post operatively, mucous shreds are seen in the drainage bag. The nurse
should?
a. notify the MO
b. notify the nurse IC
c. irrigate the drainage tube
d. document the findings as it is a normal observation
ANS: d
Prevent injury to the stoma and maintain urine output. Advise the patient that mucus
in the urine is a normal occurrence. The mucus is secreted by intestinal mucosa,
used to create the ileal conduit, in response to the irritating effect of urine.
Encourage a high fluid intake to 'flush' the ileal conduit or continent diversion.
Which of the following characterise acute kidney injury? (select more than
one)
a. primary cause of death is infection
b. It is most common in elderly
c. disease course is potentially reversible
d. most common cause of diabetic nephropathy
e. cardiovascular disease is most common cause of death
ANS: a, c
The primary causes of acute kidney injury are commonly reversible, if treated
promptly and early— for example, providing antibiotics for bacterial infection or fluid
for hypovolaemia.
RIFLE defines three stages of AKI based on changes in:
A. blood pressure and urine osmolality
B. fractional excretion of urinary sodium
C. estimation of GFR with the MDRD equation
D. serum creatinine or urine output from baseline
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ANS: d
RIFLE is a classification method to determine the severity of injury, which includes
Risk, Injury,
Failure, Loss and End-stage kidney disease. Both changes in serum creatinine and
urine output are factors associated with risk, injury and failure.
During the oliguric phase of AKI, the nurse monitors the patient for (select all
that apply):
A. hypotension
B. ECG changes
C. hypernatremia
D. pulmonary edema
E. urine with high specific gravity
ANS: b, d
Due to oliguria, a patient's potassium levels may increase, resulting in arrhythmias.
Additionally, with the inability to eliminate fluid, a patient may become fluid
overloaded, resulting in pulmonary oedema.
if a patient is in the diuretic phase of AKI the nurse must monitor for which
serum electrolyte imbalance?
a. hyperkalaemia and hyponatraemia
b. hyperkalaemia and hypernatraemia
c. hypokalaemia and hyponatraemia
d. hypokalaemia and hypernatraemia
ANS: c
Both hypokalaemia and hyponatraemia can occur from massive fluid losses during
this phase.
A patient is admitted to the hospital with CKD. The nurse understands that this
condition is characterised by
a. progressive irreversible destruction to the kidneys
b. a rapid decrease in urine output with an elevated UREA level.
c. an increasing creatine clearance with a decrease in urine output
d. prostration, somnolence and confusion with coma and imminent death
“HSNS270 LEWIS MEDICAL-SURGICAL
NURSING EXAM PRACTICE QUESTIONS
2026 ”LATEST EXAM 2026 – 2027 SOLVED
QUESTIONS & ANSWERS VERIFIED 100%
GRADED A+ (LATEST VERSION) WELL REVISED
100% GUARANTEE PASS
HSNS270 Lewis medical-surgical nursing exam practice questions
A patient is admitted to the hospital with server renal colic. The nurses first
priority in management of the patient is to
a. administer opioids as prescribbed
b. obtain supplies for straining all urine
c. encourage fluid intake of 3-4L/day
d. keep the patient NBM in preparation for surgery
ANS: a
Opioids are effective in the management of pain associated with renal calculi.
The nurse recommends genetic counselling for the children of a patient with
a. nephrotic syndrome
b. chronic pyelonephritis
, Page 2 of 187
c. malignant nephroscleroris
d. adult onset polycystic kidney disease
ANS: b
Many factors are involved in the incidence of chronic pyelonephritis. One factor
relates to genetics. This is particularly true for other renal diseases such as urinary
tract calculi, which may lead to pyelonephritis.
The nurse identifies a risk factor for kidney and bladder cancer in a patient
who relates a history of
a. aspirin use
b. tabacco use
c. chronic alcohol abuse
d. use of artificial sweeteners
ANS: b
Smoking is a major cause of cancer including kidney and bladder cancer.
In planning nursing interventions to increase bladder control in patients with
urinary incentives the nurse includes
a. teaching the patient to use kegel exercises
b. clamping and realising a catheter to increase bladder tone
c. teaching patient beiofeedback mechanism to suppress the urger to void
d. providing advice to the patient absit the cogged of incontinence
containment device
ANS: a
Kegel exercises relate to enhancing pelvic floor muscles. Strengthened pelvic floor
muscles enhance bladder control.
A patient with a ureterolithotomy returns from surgery with a nephrostomy
tube in place. Postoperative nursing care includes
a. encouraging that patient to drink fruit juices and milk
b. encouraging fluids of at least 2-3L/day after nausea has subsisded
c. irrigating the nephrostomy tube with 10ml of normal saline solution is
needed
d. Notify the MO if the nephrostomy tube output id more than 30ml/hr
, Page 3 of 187
ANS: b
If a kidney stone is located, a urterolithotomy is performed. Encouraging fluids is
important to assist the kidney to return to normal function by 'flushing' the kidney.
A patient has had a cystectomy and ill conduit diversion performed. Four days
post operatively, mucous shreds are seen in the drainage bag. The nurse
should?
a. notify the MO
b. notify the nurse IC
c. irrigate the drainage tube
d. document the findings as it is a normal observation
ANS: d
Prevent injury to the stoma and maintain urine output. Advise the patient that mucus
in the urine is a normal occurrence. The mucus is secreted by intestinal mucosa,
used to create the ileal conduit, in response to the irritating effect of urine.
Encourage a high fluid intake to 'flush' the ileal conduit or continent diversion.
Which of the following characterise acute kidney injury? (select more than
one)
a. primary cause of death is infection
b. It is most common in elderly
c. disease course is potentially reversible
d. most common cause of diabetic nephropathy
e. cardiovascular disease is most common cause of death
ANS: a, c
The primary causes of acute kidney injury are commonly reversible, if treated
promptly and early— for example, providing antibiotics for bacterial infection or fluid
for hypovolaemia.
RIFLE defines three stages of AKI based on changes in:
A. blood pressure and urine osmolality
B. fractional excretion of urinary sodium
C. estimation of GFR with the MDRD equation
D. serum creatinine or urine output from baseline
, Page 4 of 187
ANS: d
RIFLE is a classification method to determine the severity of injury, which includes
Risk, Injury,
Failure, Loss and End-stage kidney disease. Both changes in serum creatinine and
urine output are factors associated with risk, injury and failure.
During the oliguric phase of AKI, the nurse monitors the patient for (select all
that apply):
A. hypotension
B. ECG changes
C. hypernatremia
D. pulmonary edema
E. urine with high specific gravity
ANS: b, d
Due to oliguria, a patient's potassium levels may increase, resulting in arrhythmias.
Additionally, with the inability to eliminate fluid, a patient may become fluid
overloaded, resulting in pulmonary oedema.
if a patient is in the diuretic phase of AKI the nurse must monitor for which
serum electrolyte imbalance?
a. hyperkalaemia and hyponatraemia
b. hyperkalaemia and hypernatraemia
c. hypokalaemia and hyponatraemia
d. hypokalaemia and hypernatraemia
ANS: c
Both hypokalaemia and hyponatraemia can occur from massive fluid losses during
this phase.
A patient is admitted to the hospital with CKD. The nurse understands that this
condition is characterised by
a. progressive irreversible destruction to the kidneys
b. a rapid decrease in urine output with an elevated UREA level.
c. an increasing creatine clearance with a decrease in urine output
d. prostration, somnolence and confusion with coma and imminent death
