Exam (elaborations)
Exam (elaborations) LEWIS MED SURGE
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ENTAILS QUESTIONS AND ANSWERS
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LEWIS MED SURGE EXAM 1 EVOLVE ACTUALEXAM QUESTION BANK COMPLETE QUESTIONS
AND DETAILED SOLUTION
,The nurse evaluates wound healing for a patient with an arm laceration. The nurse
recalls that which deficiency may cause insufficient collagen production by fibroblasts? -
CORRECT ANSWERS-Vitamin C is needed for capillary synthesis and collagen
production by fibroblasts. Zinc deficiency impairs epithelialization in the wound-healing
process. Protein deficiency decreases the supply of amino acids for tissue repair. If a
vitamin B deficiency develops, a disruption of protein, fat, and carbohydrate metabolism
will occur.
A patient who is being treated for an inflammation receives a medication that promotes
healing by preventing the liberation of lysosomes. The nurse recognizes that which drug
has this mechanism of action? - CORRECT ANSWERS-Prednisone is an
antiinflammatory drug that interferes with tissue granulation and induces
immunosuppressive effects; thus this drug prevents the liberation of lysosomes.
Ibuprofen inhibits the synthesis of prostaglandins. Piroxicam is an antiinflammatory drug
that inhibits the synthesis of prostaglandins. Acetaminophen is an antipyretic drug that
lowers body temperature by acting on the heat-regulating center in the hypothalamus.
The nurse is providing care to a patient who is experiencing delayed healing of a
surgical wound. The nurse asks which question to assess for nutritional deficiencies? -
CORRECT ANSWERS-When assessing for nutritional deficiencies related to delayed
wound healing, the nurse should ask the patient about vitamin C, protein, and zinc
consumption. Although smoking, poorly controlled blood glucose levels, and taking
prescribed glucocorticoids can all delay wound healing, these questions are not
appropriate when assessing the patient specifically for nutritional deficiencies.
Decreased tactile fremitus would indicate the patient may be experiencing which
condition? - CORRECT ANSWERS-The nurse assesses fremitus in a patient by
palpating the chest with his or her hands while asking the patient to say a phrase like
"ninety-nine" in a deeper, louder than normal voice. If the patient has pleural effusion,
there will be distance between the lung tissue and the nurse's hand, which will decrease
the vibrations felt. Fremitus would be increased in cases of pneumonia and lung tumors,
because the vibration of sound would be transmitted more through solid tissue. The
nurse would not detect any fremitus in a patient with pneumothorax because the
condition prevents any vibration from transmitting.
The nose serves which primary function? - CORRECT ANSWERS-The nose functions
to protect the lower airway by warming and humidifying air and filtering small particles
before air enters the lungs. The nose does not help with phonation and vocalization or
assist with deep breathing. The nose adds humidification before air enters the lungs.
The epiglottis serves which respiratory function? - CORRECT ANSWERS-The epiglottis
is a small flap located behind the tongue that closes over the larynx during swallowing.
The function of the epiglottis is to prevent solids and liquids from entering the lungs. The
olfactory nerve endings in the roof of the nose are responsible for the sense of smell.
The bronchi and the trachea act as a pathway to conduct gases to the alveoli. The nose
, protects the lower airway by warming and humidifying air and filtering small particles
before the air enters the lungs.
The nurse pays close attention to which most common site for pressure ulcers when
assessing a patient? - CORRECT ANSWERS-Pressure ulcers generally occur over
bony prominences; the sacrum is the most common site, followed by the heels. Elbows
and ankles are less susceptible to pressure ulcers.
Which diagnostic test is used to measure the efficiency of gas transfer in the lung and
tissue oxygenation? - CORRECT ANSWERS-Arterial blood gases are used to assess
the efficiency of gas transfer in the lung and tissue oxygenation, as is pulse oximetry.
Thoracentesis is used to obtain specimens for diagnostic evaluation, remove pleural
fluid, or instill medication into the pleural space. Bronchoscopy is used for diagnostic
purposes, to obtain biopsy specimens, and to assess changes resulting from treatment.
Pulmonary function tests measure lung volumes and airflow to diagnose pulmonary
disease, monitor disease progression, evaluate disability, and evaluate response to
bronchodilators.
In which order do the four stages of pressure injuries to the tissue occur? - CORRECT
ANSWERS-Correct1.Non-blanchable erythema of intact skin
Correct2.Partial-thickness skin loss with exposed dermis
Correct3.Full-thickness skin loss
Correct4.Full-thickness skin-and-tissue loss
Which instructions would the nurse provide to the patient in preparation for a chest x-
ray? - CORRECT ANSWERS-For the chest x-ray, the nurse should instruct the patient
to remove any metal between neck and waist. A chest x-ray does not require a signed
consent, and there is no need to avoid food before the test. The patient is not required
to undress completely; because it is a chest x-ray, undressing to the waist is sufficient.
Based on the surgical documentation of a postoperative head-and-neck case, which
type of voice communication technique will the patient utilize postoperatively? -
CORRECT ANSWERS-Tracheoesophageal puncture communication is done through a
tracheoesophageal fistula when the valve is occluded. Electrolarynx uses a battery-
powered device. Esophageal speech requires learning a technique for intake and
expulsion of air from the esophagus. The patient is not required to be nonverbal if
tracheoesophageal puncture speech is learned.
Which instruction will the nurse include when teaching a patient to use a dry powder
inhaler (DPI)? - CORRECT ANSWERS-The patient should hold the breath for as long
as possible to increase the amount of medication absorbed by the lungs. DPIs are not
shaken prior to use. Since delivery of medication to the airways depends on the
patient's inspiratory effort when using a DPI, a rapid and deep respiration is needed.
The patient's mouth should be sealed around the DPI mouthpiece to maximize delivery
of the medication to the airways.
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