ATI LPN
Lewis's Medical Surgical Nursing in Canada, 5th Edition
Chapter 39 Questions
Question 1 of 5
The nurse is obtaining a health history from a patient with a prosthetic mitral valve who has symptoms of infective endocarditis (IE). Which of the following questions by the nurse is best?
Correct Answer: A
Rationale: Dental procedures place the patient with a prosthetic mitral valve at risk for infective endocarditis (IE). Myocardial infarction (MI), immunizations, and a family history of endocarditis are not risk factors for IE.
Question 2 of 5
The nurse is assessing a patient with infective endocarditis (IE). Which of the following findings should the nurse expect to assess?
Correct Answer: A
Rationale: New regurgitant murmurs occur in IE because vegetation on the valves prevents valve closure. Substernal chest discomfort, rashes, and involuntary muscle movement are clinical manifestations of other cardiac disorders such as angina and rheumatic fever.
Question 3 of 5
The nurse identifies the nursing diagnosis of decreased cardiac output related to valvular insufficiency for the patient with infective endocarditis (IE). Which of the following findings support this diagnosis?
Correct Answer: B
Rationale: Decreased renal perfusion caused by inadequate cardiac output will lead to poor urine output. Petechiae, fever, chills, and diaphoresis are symptoms of IE but are not caused by decreased cardiac output. An increase in pulse rate of 15 beats/minute is normal with exercise.
Question 4 of 5
The nurse is planning care for a patient hospitalized with a streptococcal infective endocarditis (IE). Which of the following interventions should the nurse anticipate?
Correct Answer: B
Rationale: Treatment for IE involves 4-6 weeks of IV antibiotic therapy in order to eradicate the bacteria, which will require a long-term IV catheter such as a peripherally inserted central catheter (PIC
C) line. Rest periods and limiting physical activity to a moderate level are recommended during the treatment for IE. Oral antibiotics are not effective in eradicating the infective bacteria that cause IE. Blood cultures, rather than antibody levels, are used to monitor the effectiveness of antibiotic therapy.
Question 5 of 5
The nurse is admitting a patient with possible acute pericarditis. Which of the following diagnostic assessments should the nurse plan to teach the patient about?
Correct Answer: B
Rationale: Echocardiograms are useful in detecting the presence of the pericardial effusions associated with pericarditis. Blood cultures are not indicated unless the patient has evidence of sepsis. Cardiac catheterization is not a diagnostic procedure for pericarditis. Electrolyte levels are not helpful in making a diagnosis of pericarditis.