NR 571 FINAL PRACTICE SOLUTION SET 2026
TESTED QUESTIONS AND CORRECT ANSWERS
◉ osler's nodules. Answer: painful, red nodules in the distal
phalanges, indicative of endocarditis
◉ janeway lesions. Answer: non-tender hemorrhagic lesions -
fingers, toes, nose, earlobes - associated with endocarditis
◉ Subungual Hemorrhages. Answer: splinter hemorrhages under
the nails
◉ Roth's spots. Answer: white centered hemorrhagic retinal lesions
◉ Diagnostic testing for infective endocarditis. Answer: Blood
cultures
CXR
Trans-esophageal echocardiogram
◉ risk factors for infective endocarditis. Answer: DM
HIV
poor dental hygiene
,congenital heart disease
MV prolapse
aortic stenosis
hemodialysis
prosthetic heart valve
IVDA
◉ What is modified Duke criteria used for?. Answer: Diagnosis of
infective endocarditis
◉ Major Duke criteria. Answer: -two blood cultures positive for
causative organism out of at least three separate blood cultures
drawn from 3 separate sites within 1 hour
-blood cultures persistently positive for an organism from cultures
drawn more than 12 hours apart
-echocardiogram positive for IE, documented by an oscillating
intracardiac mass on a valve or supporting structures, in the path of
regurgitant jets, or on implanted material in the absence of an
alternative anatomical explanation
-myocardial abscess
-development of partial dehiscence of a prosthetic valve
-new-onset valvular regurgitation
◉ Minor Duke Criteria. Answer: 1) > 100.4°F (38°C)
,2) History of IVDU or predisposing heart condition
3) Vascular phenomena
4) Immunological phenomena
5) Positive BCx or serology not typical organism
◉ Prophylactic infective endocarditis (IE) tx. Answer: vancomycin or
ampicillin/sulbactam (Unasyn)
aminoglycoside
rifampin - prosthetic valves
◉ when IE is suspected outpatient you..... Answer: refer patient to
ED
◉ Inpatient treatment of IE. Answer: Consult ID and Cardiology
draw x3 Bld Cx over 1 hour before empiric ABX
x2 sets Blc Cx q1-2 days until negative
if hemodynamically stable, may wait to start ABX until Cx result and
TEE done
◉ Surgical indications in IE. Answer: valve perforation, dehiscence,
fistula, or rupture
large peri-valvular abscess
, ◉ consider surgical intervention for IE. Answer: fungal infection
left-sided infection caused by gram negative
persistent infection with positive Bld Cx after 1 week of ABX
embolic events in first 2 weeks of ABX
infection with aggressing resistant bacteria
◉ causes of pericarditis. Answer: viruses
TB
post-MI
renal failure
hypothyroidism
drug-induced
trauma
neoplasm/radiation
collagen disease
idiopathic
◉ Objective signs of pericarditis. Answer: pericardial or pleural
friction rub
fever
EKG changes
TESTED QUESTIONS AND CORRECT ANSWERS
◉ osler's nodules. Answer: painful, red nodules in the distal
phalanges, indicative of endocarditis
◉ janeway lesions. Answer: non-tender hemorrhagic lesions -
fingers, toes, nose, earlobes - associated with endocarditis
◉ Subungual Hemorrhages. Answer: splinter hemorrhages under
the nails
◉ Roth's spots. Answer: white centered hemorrhagic retinal lesions
◉ Diagnostic testing for infective endocarditis. Answer: Blood
cultures
CXR
Trans-esophageal echocardiogram
◉ risk factors for infective endocarditis. Answer: DM
HIV
poor dental hygiene
,congenital heart disease
MV prolapse
aortic stenosis
hemodialysis
prosthetic heart valve
IVDA
◉ What is modified Duke criteria used for?. Answer: Diagnosis of
infective endocarditis
◉ Major Duke criteria. Answer: -two blood cultures positive for
causative organism out of at least three separate blood cultures
drawn from 3 separate sites within 1 hour
-blood cultures persistently positive for an organism from cultures
drawn more than 12 hours apart
-echocardiogram positive for IE, documented by an oscillating
intracardiac mass on a valve or supporting structures, in the path of
regurgitant jets, or on implanted material in the absence of an
alternative anatomical explanation
-myocardial abscess
-development of partial dehiscence of a prosthetic valve
-new-onset valvular regurgitation
◉ Minor Duke Criteria. Answer: 1) > 100.4°F (38°C)
,2) History of IVDU or predisposing heart condition
3) Vascular phenomena
4) Immunological phenomena
5) Positive BCx or serology not typical organism
◉ Prophylactic infective endocarditis (IE) tx. Answer: vancomycin or
ampicillin/sulbactam (Unasyn)
aminoglycoside
rifampin - prosthetic valves
◉ when IE is suspected outpatient you..... Answer: refer patient to
ED
◉ Inpatient treatment of IE. Answer: Consult ID and Cardiology
draw x3 Bld Cx over 1 hour before empiric ABX
x2 sets Blc Cx q1-2 days until negative
if hemodynamically stable, may wait to start ABX until Cx result and
TEE done
◉ Surgical indications in IE. Answer: valve perforation, dehiscence,
fistula, or rupture
large peri-valvular abscess
, ◉ consider surgical intervention for IE. Answer: fungal infection
left-sided infection caused by gram negative
persistent infection with positive Bld Cx after 1 week of ABX
embolic events in first 2 weeks of ABX
infection with aggressing resistant bacteria
◉ causes of pericarditis. Answer: viruses
TB
post-MI
renal failure
hypothyroidism
drug-induced
trauma
neoplasm/radiation
collagen disease
idiopathic
◉ Objective signs of pericarditis. Answer: pericardial or pleural
friction rub
fever
EKG changes
