TEST BANK LEWIS’ MEDICAL-SURGICAL NURSING 10TH
EDITION BY LEWIS, BUTCHER, HEITKEMPER, HARDING,
KWONG & ROBERTS COMPLETE TEST BANK ALL CHAPTERS
(CHAPTER 1-68) FULLY COVERED
1.A client with a history of heart failure is being discharged. Which priority instruction will
assist the client in the prevention of complications associated with heart failure?
A) "Eat six small meals daily instead of three larger meals."
B) "When you feel short of breath, take an additional diuretic."
C) "Avoid drinking more than 3 quarts of liquids each day."
D) "Weigh yourself daily while wearing the same amount of clothing." - Correct Answer -
D
Clients with heart failure are instructed to weigh themselves daily to detect worsening
heart failure early, and thus avoid complications. Other signs of worsening heart failure
include increasing dyspnea, exercise intolerance, cold symptoms, and nocturia.
2. The nurse assesses a client's legs. Which assessment finding indicates arterial
insufficiency?
A) Pain with activity but not while resting
B) Dependent mottling and absence of hair
C) Full veins present in dependent extremity
D) Ankle discoloration and pitting edema - Correct Answer - B
Dependent mottling and absence of hair is an indication of arterial insufficiency. Pain
may be present with activity and at rest. Edema and ankle discoloration would be
indicative of venous insufficiency.
pg. 1
,3. Which intervention in a client with dehydration induced confusion is most likely to
relieve the confusion?
a. increasing the IV flow rate to 250 mL/hr
b. applying oxygen by mask or nasal cannula
c. placing the client in a high Fowler's position
d. Measuring intake and output every four hours - Correct Answer - A
Dehydration most frequently leads to poor cerebra perfusion and cerebral hypoxia,
causing confusion. Applying oxygen can reduce confusion, even if perfusion is still less
than optimum. Increasing the IV flow rate would increase perfusion. However,
depending on the degree of dehydration, rehydrating the person too rapidly with IV
fluids can lead to cerebral edema.
4. Which client is at greatest risk for dehydration?
a. younger adult client on bedrest
b. older adult client receiving hypotonic IV fluid
c. older adult client with cognitive impairment
d. younger adult client receiving hypertonic IV fluid - Correct Answer - C
Older adults, because they have less total body water than younger adults, are at
greater risk for development of dehydration. Anyone who is cognitively impaired and
cannot obtain fluids independently or cannot make his or her need for fluids known is at
high risk for dehydration
5. A nurse is caring for several clients. Which client does the nurse assess most
carefully for hyperkalemia?
a. client with type 2 diabetes taking an oral anti-diabetic agent
b. client with heart failure using a salt substitute
c. client taking a thiazide diuretic for hypertension
d. client taking non-steroidal anti-inflammatory drugs daily - Correct Answer - B
pg. 2
,Many salt substitutes are composed of potassium chloride. Heavy use cna contribute to
the development of hyperkalemia. The client should be taught to read labels and to
choose a salt substitute that does not contain potassium. NSAIDs promote the retention
of sodium but not potassium.
6. An older adult client presents with signs and symptoms related to dig toxicity. Which
age related change may have contributed to this problem?
a. decreased renal blood flow
b. increased gastrointestinal motility
c. decreased ratio of adipose tissue to lean body mass
d. increased total body water - Correct Answer - A
Decreased renal blood flow and reduced glomerular filtration can result in slower
medication excretion time, potentially leading to toxic drug accumulation. Aging results
in decreased total body water and gastrointestinal motility and an increase in the ratio of
adipose tissue to lean body mass, but is not related to dig toxicity.
7. A client is being treated for dehydration. Which statement made by the client indicates
understanding of this condition?
a. I will use a salt substitute when making and eating my meals.
b. I must drink a quart of water or other liquid each day.
c. I will not drink liquids after 6 PM so I won't have to get up at night.
d. I will weigh myself each morning before I eat or drink. - Correct Answer - D
Because 1 L of water weighs 1 kg, change in body weight is a good measure of excess
fluid loss or fluid retention. Weight loss greater than 0.5 lb daily is indicative of
excessive fluid loss. The other statements are not indicative of practices that will
prevent dehydration.
pg. 3
, 8. The nurse notes that the handgrip of the client with hypokalemia has diminished
since the previous assessment one hour ago. Which intervention by the nurse is the
priority?
a. assess the client's respiratory rate, rhythm, and depth
b. document findings and monitor the client
c. measure the client's pulse and blood pressure
d. call the health care provider - Correct Answer - A
In a client with hypokkalemia, progressive skeletal muscle weakness is associated with
increasing severity of hypokalemia. The most life-threatening complication of
hypokalemia is respiratory insufficiency. It is imperative for the nurse to perform a
respiratory assessment first to make sure that the client is not in immediate jeopardy.
Next, the nurse would call the health care provider to obtain orders for potassium
replacement.
9. The nurse is teaching a client with pneumonia ways to clear secretions. Which
intervention is the most effective?
A) Administering an antiemetic medication
B) Increasing fluids to 2 L/day if tolerated
C) Administering an antitussive medication
D) Having the client cough and deep breathe hourly - Correct Answer - B
Increasing fluids has been proven to decrease the thickness of secretions, thus allowing
them to be expectorated quickly. The other interventions would not be as effective.
10. The nurse is assessing a client with left-sided heart failure. What conditions does
the nurse assess for? (Select all that apply.)
A) S3/S4 summation gallop
B) Cough worsens at night
pg. 4
EDITION BY LEWIS, BUTCHER, HEITKEMPER, HARDING,
KWONG & ROBERTS COMPLETE TEST BANK ALL CHAPTERS
(CHAPTER 1-68) FULLY COVERED
1.A client with a history of heart failure is being discharged. Which priority instruction will
assist the client in the prevention of complications associated with heart failure?
A) "Eat six small meals daily instead of three larger meals."
B) "When you feel short of breath, take an additional diuretic."
C) "Avoid drinking more than 3 quarts of liquids each day."
D) "Weigh yourself daily while wearing the same amount of clothing." - Correct Answer -
D
Clients with heart failure are instructed to weigh themselves daily to detect worsening
heart failure early, and thus avoid complications. Other signs of worsening heart failure
include increasing dyspnea, exercise intolerance, cold symptoms, and nocturia.
2. The nurse assesses a client's legs. Which assessment finding indicates arterial
insufficiency?
A) Pain with activity but not while resting
B) Dependent mottling and absence of hair
C) Full veins present in dependent extremity
D) Ankle discoloration and pitting edema - Correct Answer - B
Dependent mottling and absence of hair is an indication of arterial insufficiency. Pain
may be present with activity and at rest. Edema and ankle discoloration would be
indicative of venous insufficiency.
pg. 1
,3. Which intervention in a client with dehydration induced confusion is most likely to
relieve the confusion?
a. increasing the IV flow rate to 250 mL/hr
b. applying oxygen by mask or nasal cannula
c. placing the client in a high Fowler's position
d. Measuring intake and output every four hours - Correct Answer - A
Dehydration most frequently leads to poor cerebra perfusion and cerebral hypoxia,
causing confusion. Applying oxygen can reduce confusion, even if perfusion is still less
than optimum. Increasing the IV flow rate would increase perfusion. However,
depending on the degree of dehydration, rehydrating the person too rapidly with IV
fluids can lead to cerebral edema.
4. Which client is at greatest risk for dehydration?
a. younger adult client on bedrest
b. older adult client receiving hypotonic IV fluid
c. older adult client with cognitive impairment
d. younger adult client receiving hypertonic IV fluid - Correct Answer - C
Older adults, because they have less total body water than younger adults, are at
greater risk for development of dehydration. Anyone who is cognitively impaired and
cannot obtain fluids independently or cannot make his or her need for fluids known is at
high risk for dehydration
5. A nurse is caring for several clients. Which client does the nurse assess most
carefully for hyperkalemia?
a. client with type 2 diabetes taking an oral anti-diabetic agent
b. client with heart failure using a salt substitute
c. client taking a thiazide diuretic for hypertension
d. client taking non-steroidal anti-inflammatory drugs daily - Correct Answer - B
pg. 2
,Many salt substitutes are composed of potassium chloride. Heavy use cna contribute to
the development of hyperkalemia. The client should be taught to read labels and to
choose a salt substitute that does not contain potassium. NSAIDs promote the retention
of sodium but not potassium.
6. An older adult client presents with signs and symptoms related to dig toxicity. Which
age related change may have contributed to this problem?
a. decreased renal blood flow
b. increased gastrointestinal motility
c. decreased ratio of adipose tissue to lean body mass
d. increased total body water - Correct Answer - A
Decreased renal blood flow and reduced glomerular filtration can result in slower
medication excretion time, potentially leading to toxic drug accumulation. Aging results
in decreased total body water and gastrointestinal motility and an increase in the ratio of
adipose tissue to lean body mass, but is not related to dig toxicity.
7. A client is being treated for dehydration. Which statement made by the client indicates
understanding of this condition?
a. I will use a salt substitute when making and eating my meals.
b. I must drink a quart of water or other liquid each day.
c. I will not drink liquids after 6 PM so I won't have to get up at night.
d. I will weigh myself each morning before I eat or drink. - Correct Answer - D
Because 1 L of water weighs 1 kg, change in body weight is a good measure of excess
fluid loss or fluid retention. Weight loss greater than 0.5 lb daily is indicative of
excessive fluid loss. The other statements are not indicative of practices that will
prevent dehydration.
pg. 3
, 8. The nurse notes that the handgrip of the client with hypokalemia has diminished
since the previous assessment one hour ago. Which intervention by the nurse is the
priority?
a. assess the client's respiratory rate, rhythm, and depth
b. document findings and monitor the client
c. measure the client's pulse and blood pressure
d. call the health care provider - Correct Answer - A
In a client with hypokkalemia, progressive skeletal muscle weakness is associated with
increasing severity of hypokalemia. The most life-threatening complication of
hypokalemia is respiratory insufficiency. It is imperative for the nurse to perform a
respiratory assessment first to make sure that the client is not in immediate jeopardy.
Next, the nurse would call the health care provider to obtain orders for potassium
replacement.
9. The nurse is teaching a client with pneumonia ways to clear secretions. Which
intervention is the most effective?
A) Administering an antiemetic medication
B) Increasing fluids to 2 L/day if tolerated
C) Administering an antitussive medication
D) Having the client cough and deep breathe hourly - Correct Answer - B
Increasing fluids has been proven to decrease the thickness of secretions, thus allowing
them to be expectorated quickly. The other interventions would not be as effective.
10. The nurse is assessing a client with left-sided heart failure. What conditions does
the nurse assess for? (Select all that apply.)
A) S3/S4 summation gallop
B) Cough worsens at night
pg. 4
