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MED-SURG: LEWIS EXAM QUESTIONS WITH CORRECT VERIFIED ANSWERS AND RATIONALESLATEST VERSION
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Page 1 of 181MED-SURG: LEWIS EXAM QUESTIONS WITH CORRECT
VERIFIED ANSWERS AND RATIONALESLATEST VERSION
2024-2025
LEWIS MED SURGE EXAM A
Q: Which information about a patient who has a recent history of tuberculosis (TB) indicates
that the nurse can discontinue airborne isolation precautions?
a. Chest x-ray shows no upper lobe infiltrates.
b. TB medications have been taken for 6 months.
c. Mantoux testing shows an induration of 10 mm.
d. Three sputum smears for acid-fast bacilli are negative. - CORRECT ANSWER✔✔ANS: D
Negative sputum smears indicate that M. tuberculosis is not present in the sputum, and the
patient cannot transmit the bacteria by the airborne route. Chest x-rays are not used to
determine whether treatment has been successful. Taking medications for 6 months is
necessary, but the multidrug-resistant forms of the disease might not be eradicated after 6
months of therapy. Repeat Mantoux testing would not be done since it will not change even
with effective treatment.
DIF: Cognitive Level: Application REF: 557
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
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Q: The nurse recognizes that the goals of teaching regarding the transmission of pulmonary
tuberculosis (TB) have been met when the patient with TB
a. demonstrates correct use of a nebulizer.
b. washes dishes and personal items after use.
c. covers the mouth and nose when coughing.
d. reports daily to the public health department. - CORRECT ANSWER✔✔ANS: C
Covering the mouth and nose will help decrease airborne transmission of TB. The other actions
will not be effective in decreasing the spread of TB.
DIF: Cognitive Level: Application REF: 557 TOP: Nursing Process: Evaluation
MSC: NCLEX: Health Promotion and Maintenance
Q: Which information will the nurse include in the patient teaching plan for a patient who is
receiving rifampin (Rifadin) for treatment of tuberculosis?
a. "Your urine, sweat, and tears will be orange colored."
b. "Read a newspaper daily to check for changes in vision."
c. "Take vitamin B6 daily to prevent peripheral nerve damage."
d. "Call the health care provider if you notice any hearing loss." - CORRECT ANSWER✔✔ANS: A
Orange-colored body secretions are a side effect of rifampin. The other adverse effects are
associated with other antituberculosis medications.
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DIF: Cognitive Level: Application REF: 555 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity
Q: When teaching the patient who is receiving standard multidrug therapy for tuberculosis (TB)
about possible toxic effects of the antitubercular medications, the nurse will give instructions to
notify the health care provider if the patient develops
a. yellow-tinged skin.
b. changes in hearing.
c. orange-colored sputum.
d. thickening of the fingernails. - CORRECT ANSWER✔✔ANS: A
Noninfectious hepatitis is a toxic effect of isoniazid (INH), rifampin, and pyrazinamide, and
patients who develop hepatotoxicity will need to use other medications. Changes in hearing and
nail thickening are not expected with the four medications used for initial TB drug therapy.
Orange discoloration of body fluids is an expected side effect of rifampin and not an indication
to call the health care provider.
DIF: Cognitive Level: Application REF: 555 | 556
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological IntegrityQ:The nurse
evaluates that discharge teaching for a patient hospitalized with pneumonia has been effective
when the patient makes which statement about measures to prevent a relapse?
, Page 4 of 181
A. "I will seek immediate medical treatment for any upper respiratory infections."
B. "I should continue to do deep-breathing and coughing exercises for at least 12 weeks."
C. "I will increase my food intake to 2400 calories a day to keep my immune system well."
D. "I must have a follow-up chest x-ray in 6 to 8 weeks to evaluate the pneumonia's resolution."
- CORRECT ANSWER✔✔D. "I must have a follow-up chest x-ray in 6 to 8 weeks to evaluate the
pneumonia's resolution."
The follow-up chest x-ray will be done in 6 to 8 weeks to evaluate pneumonia resolution. A
patient should seek medical treatment for upper respiratory infections that persist for more
than 7 days. It may be important for the patient to continue with coughing and deep breathing
exercises for 6 to 8 weeks, not 12 weeks, until all of the infection has cleared from the lungs.
Increased fluid intake, not caloric intake, is required to liquefy secretions.
Q: The nurse assesses the chest of a patient with pneumococcal pneumonia. Which finding
would the nurse expect?
a. Increased tactile fremitus
b. Dry, nonproductive cough
c. Hyperresonance to percussion
d. A grating sound on auscultation - CORRECT ANSWER✔✔ANS: A
Increased tactile fremitus over the area of pulmonary consolidation is expected with bacterial
pneumonias. Dullness to percussion would be expected. Pneumococcal pneumonia typically
presents with a loose, productive cough. Adventitious breath sounds such as crackles and
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