Chapter 36 - Inflammatory Cardiac Disorders - 35 Nursing
MCQs with Answers and Rationales
1. A patient with acute pericarditis reports sharp chest pain that improves when leaning
forward. The nurse recognizes this as:
Answer: C. Classic pericarditis pain pattern
Rationale: Pericarditis pain is pleuritic, sharp, and relieved by sitting up and leaning forward, which reduces
pressure of the heart against the parietal pericardium.
2. The hallmark assessment finding in pericarditis is:
Answer: B. Pericardial friction rub
Rationale: A scratchy, high-pitched pericardial friction rub heard at the left lower sternal border is hallmark,
caused by inflamed pericardial layers rubbing.
3. A patient with pericarditis has ECG changes. What do you expect?
Answer: A. ST elevation in all leads
Rationale: Acute pericarditis causes diffuse ST elevation and PR depression due to widespread epicardial
inflammation, unlike MI which is localized.
4. Cardiac tamponade is a complication of pericarditis. Which is NOT part of Beck's triad?
Answer: D. Hypertension
Rationale: Beck's triad = hypotension, JVD, muffled heart sounds due to compression of heart by fluid.
5. Pulsus paradoxus in cardiac tamponade is:
Answer: B. Decrease in SBP >10 mmHg on inspiration
Rationale: Decrease >10 mmHg systolic on inspiration due to impaired ventricular filling.
6. First-line drug therapy for acute pericarditis is:
Answer: B. NSAIDs + Colchicine
Rationale: NSAIDs (ibuprofen) reduce inflammation, colchicine prevents recurrence.
7. A nurse caring for a patient with myocarditis should prioritize monitoring for:
Answer: B. Heart failure and dysrhythmias
Rationale: Inflamed myocardium weakens contractility leading to HF and irritable myocardium causing
dysrhythmias.
, 8. Most common cause of myocarditis in the US is:
Answer: B. Viral infection
Rationale: Coxsackievirus B, influenza, COVID-19 are most common viral causes.
9. A patient with myocarditis reports recent flu-like illness, fatigue, dyspnea, and chest
discomfort. Lab expected:
Answer: B. Elevated troponin, BNP, CRP
Rationale: Myocardial injury elevates troponin, HF elevates BNP, inflammation elevates CRP/ESR.
10. Nursing intervention for myocarditis is:
Answer: B. Bed rest and limiting activity to reduce cardiac workload
Rationale: Rest reduces myocardial oxygen demand and allows healing.
11. Infective endocarditis is an infection of:
Answer: C. Endocardium and heart valves
Rationale: Endocardium lining chambers and valves, vegetation forms on valves.
12. Highest risk factor for infective endocarditis:
Answer: B. IV drug use and prosthetic valves
Rationale: Bacteria introduced via blood, adheres to damaged or prosthetic valves.
13. Classic peripheral manifestations of endocarditis include all EXCEPT:
Answer: D. Clubbing
Rationale: Osler nodes (painful fingertips), Janeway (painless palms/soles), splinter hemorrhages are
embolic/immunologic signs.
14. Osler nodes are:
Answer: B. Painful tender nodules on finger pads
Rationale: Painful, immunologic phenomenon.
15. Janeway lesions are:
Answer: B. Painless, flat, erythematous on palms/soles
Rationale: Painless septic emboli, differentiate from painful Osler nodes.
16. Gold standard for diagnosing infective endocarditis:
MCQs with Answers and Rationales
1. A patient with acute pericarditis reports sharp chest pain that improves when leaning
forward. The nurse recognizes this as:
Answer: C. Classic pericarditis pain pattern
Rationale: Pericarditis pain is pleuritic, sharp, and relieved by sitting up and leaning forward, which reduces
pressure of the heart against the parietal pericardium.
2. The hallmark assessment finding in pericarditis is:
Answer: B. Pericardial friction rub
Rationale: A scratchy, high-pitched pericardial friction rub heard at the left lower sternal border is hallmark,
caused by inflamed pericardial layers rubbing.
3. A patient with pericarditis has ECG changes. What do you expect?
Answer: A. ST elevation in all leads
Rationale: Acute pericarditis causes diffuse ST elevation and PR depression due to widespread epicardial
inflammation, unlike MI which is localized.
4. Cardiac tamponade is a complication of pericarditis. Which is NOT part of Beck's triad?
Answer: D. Hypertension
Rationale: Beck's triad = hypotension, JVD, muffled heart sounds due to compression of heart by fluid.
5. Pulsus paradoxus in cardiac tamponade is:
Answer: B. Decrease in SBP >10 mmHg on inspiration
Rationale: Decrease >10 mmHg systolic on inspiration due to impaired ventricular filling.
6. First-line drug therapy for acute pericarditis is:
Answer: B. NSAIDs + Colchicine
Rationale: NSAIDs (ibuprofen) reduce inflammation, colchicine prevents recurrence.
7. A nurse caring for a patient with myocarditis should prioritize monitoring for:
Answer: B. Heart failure and dysrhythmias
Rationale: Inflamed myocardium weakens contractility leading to HF and irritable myocardium causing
dysrhythmias.
, 8. Most common cause of myocarditis in the US is:
Answer: B. Viral infection
Rationale: Coxsackievirus B, influenza, COVID-19 are most common viral causes.
9. A patient with myocarditis reports recent flu-like illness, fatigue, dyspnea, and chest
discomfort. Lab expected:
Answer: B. Elevated troponin, BNP, CRP
Rationale: Myocardial injury elevates troponin, HF elevates BNP, inflammation elevates CRP/ESR.
10. Nursing intervention for myocarditis is:
Answer: B. Bed rest and limiting activity to reduce cardiac workload
Rationale: Rest reduces myocardial oxygen demand and allows healing.
11. Infective endocarditis is an infection of:
Answer: C. Endocardium and heart valves
Rationale: Endocardium lining chambers and valves, vegetation forms on valves.
12. Highest risk factor for infective endocarditis:
Answer: B. IV drug use and prosthetic valves
Rationale: Bacteria introduced via blood, adheres to damaged or prosthetic valves.
13. Classic peripheral manifestations of endocarditis include all EXCEPT:
Answer: D. Clubbing
Rationale: Osler nodes (painful fingertips), Janeway (painless palms/soles), splinter hemorrhages are
embolic/immunologic signs.
14. Osler nodes are:
Answer: B. Painful tender nodules on finger pads
Rationale: Painful, immunologic phenomenon.
15. Janeway lesions are:
Answer: B. Painless, flat, erythematous on palms/soles
Rationale: Painless septic emboli, differentiate from painful Osler nodes.
16. Gold standard for diagnosing infective endocarditis:
