LEWIS MED SURGE EXAM 1 EVOLVE ACTUAL EXAM
QUESTION BANK COMPLETE 500 QUESTIONS AND
DETAILED SOLUTIONS JUST RELEASED
Question: The nurse notes that a patient who was admitted with diabetic ketoacidosis has rapid,
deep respirations. Which action should the nurse take?
a. Give the prescribed PRN lorazepam (Ativan).
b. Start the prescribed PRN oxygen at 2 to 4 L/min.
c. Administer the prescribed normal saline bolus and insulin.
d. Encourage the patient to take deep, slow breaths with guided imagery. Answer C
Question: An older adult patient who is malnourished presents to the emergency department
with a serum protein level of 5.2 g/dL. The nurse would expect which clinical manifestation?
a. Pallor
b. Edema
c. Confusion
d. Restlessness Answer B
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Question: A patient receives 3% NaCl solution for correction of hyponatremia. Which
assessment is most important for the nurse to monitor for while the patient is receiving this
infusion?
a. Lung sounds
b. Urinary output
c. Peripheral pulses
d. Peripheral edema Answer A
Hypertonic solutions cause water retention, so the patient should be monitored for symptoms
of fluid excess. Crackles in the lungs may indicate the onset of pulmonary edema and are a
serious manifestation of fluid excess. Bounding peripheral pulses, peripheral edema, or changes
in urine output are also important to monitor when administering hypertonic solutions, but
they do not indicate acute respiratory or cardiac decompensation.
Question: The long-term care nurse is evaluating the effectiveness of protein supplements for
an older resident who has a low serum total protein level. Which assessment finding indicates
that the patient's condition has improved?
a. Hematocrit 28%
b. Absence of skin tenting
c. Decreased peripheral edema
d. Blood pressure 110/72 mm Hg Answer C
Edema is caused by low oncotic pressure in individuals with low serum protein levels. The
decrease in edema indicates an improvement in the patient's protein status. Good skin turgor is
an indicator of fluid balance, not protein status. A low hematocrit could be caused by poor
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protein intake. Blood pressure does not provide a useful clinical tool for monitoring protein
status.
Question: A patient who is lethargic and exhibits deep, rapid respirations has the following
arterial blood gas (ABG) results: pH 7.32, PaO2 88 mm Hg, PaCO2 37 mm Hg, and HCO3 16
mEq/L. How should the nurse interpret these results?
a. Metabolic acidosis
b. Metabolic alkalosis
c. Respiratory acidosis
d. Respiratory alkalosis Answer A
The pH and HCO3 indicate that the patient has a metabolic acidosis. The ABGs are inconsistent
with the other responses.
Question: A patient who has been receiving diuretic therapy is admitted to the emergency
department with a serum potassium level of 3.0 mEq/L. The nurse should alert the health care
provider immediately that the patient is on which medication?
a. Oral digoxin (Lanoxin) 0.25 mg daily
b. Ibuprofen (Motrin) 400 mg every 6 hours
c. Metoprolol (Lopressor) 12.5 mg orally daily
d. Lantus insulin 24 U subcutaneously every evening Answer A
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Hypokalemia increases the risk for digoxin toxicity, which can cause serious dysrhythmias. The
nurse will also need to do more assessment regarding the other medications, but they are not
of as much concern with the potassium level.
Question: The nurse is caring for a patient who has a calcium level of 12.1 mg/dL. Which
nursing action should the nurse include on the care plan?
a. Maintain the patient on bed rest.
b. Auscultate lung sounds every 4 hours.
c. Monitor for Trousseau's and Chvostek's signs.
d. Encourage fluid intake up to 4000 mL every day. Answer D
To decrease the risk for renal calculi, the patient should have a fluid intake of 3000 to 4000 mL
daily. Ambulation helps decrease the loss of calcium from bone and is encouraged in patients
with hypercalcemia. Trousseau's and Chvostek's signs are monitored when there is a possibility
of hypocalcemia. There is no indication that the patient needs frequent assessment of lung
sounds, although these would be assessed every shift
Question: When caring for a patient with renal failure on a low phosphate diet, the nurse will
inform unlicensed assistive personnel (UAP) to remove which food from the patient's food tray?
a. Grape juice
b. Milk carton
c. Mixed green salad
d. Fried chicken breast Answer B
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