The nurse obtains a health history from an older adult with a prosthetic mitral valve who has symptoms
of infective endocarditis (IE). Which question by the nurse helps identify a risk factor for IE?
a. ―Do you have a history of a heart attack?‖
b. ―Have you had dental work done recently?‖
c. ―Have you had any recent immunizations?‖
d. ―Do you have a family history of endocarditis?‖ - ANSWER ANS: B Dental procedures place the
patient with a prosthetic mitral valve at risk for IE. Myocardial infarction, immunizations, and a family
history of endocarditis are not risk factors for IE
Which finding would the nurse expect when assessing a young adult with infective endocarditis (IE)?
a. Substernal chest pressure
b. A new regurgitant murmur
c. A pruritic rash on the chest
,d. Involuntary muscle movement - ANSWER ANS: B New regurgitant murmurs occur in IE because
vegetations on the valves prevent valve closure. Substernal chest discomfort, rashes, and involuntary
muscle movement are clinical manifestations of other cardiac disorders such as angina and rheumatic
fever.
Which assessment finding indicates to the nurse that a patient with infective endocarditis has impaired
cardiac function?
a. Prolonged fever with chills
b. Urine production of 25 mL/hr
c. Increase in heart rate of 15 beats/min with walking
d. Petechiae on the inside of the mouth and conjunctiva - ANSWER ANS: B Decreased renal perfusion
caused by inadequate cardiac output will lead to decreased 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/min is normal with exercise.
Which intervention would the nurse include when planning care for a patient hospitalized with a
streptococcal infective endocarditis (IE)?
a. Arrange for placement of a long-term IV catheter.
b. Monitor labs for levels of streptococcal antibodies.
c. Teach the importance of completing all oral antibiotics.
, d. Encourage the patient to begin regular aerobic exercise. - ANSWER ANS: A Treatment for IE involves 4
to 6 weeks of IV antibiotic therapy to eradicate the bacteria, which will require a long-term IV catheter
such as a peripherally inserted central catheter (PICC) 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
A patient is admitted to the hospital with possible acute pericarditis. Which diagnostic test would the
nurse expect the patient to undergo?
a. Blood cultures
b. Echocardiography
c. Cardiac catheterization
d. 24-hour Holter monitor - ANSWER ANS: B 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 diagnostic for pericarditis. The 12-lead EKG may show
changes with pericarditis, but a 24-hour Holter monitor would not be needed.
How would the nurse assess the patient with pericarditis for a pericardial friction rub?
a. Auscultate with the diaphragm of the stethoscope on the lower left sternal border.
b. Auscultate for a rumbling, low-pitched, systolic murmur over the left anterior chest.
c. Feel the precordial area with the palm of the hand to detect vibrations with cardiac contraction.
of infective endocarditis (IE). Which question by the nurse helps identify a risk factor for IE?
a. ―Do you have a history of a heart attack?‖
b. ―Have you had dental work done recently?‖
c. ―Have you had any recent immunizations?‖
d. ―Do you have a family history of endocarditis?‖ - ANSWER ANS: B Dental procedures place the
patient with a prosthetic mitral valve at risk for IE. Myocardial infarction, immunizations, and a family
history of endocarditis are not risk factors for IE
Which finding would the nurse expect when assessing a young adult with infective endocarditis (IE)?
a. Substernal chest pressure
b. A new regurgitant murmur
c. A pruritic rash on the chest
,d. Involuntary muscle movement - ANSWER ANS: B New regurgitant murmurs occur in IE because
vegetations on the valves prevent valve closure. Substernal chest discomfort, rashes, and involuntary
muscle movement are clinical manifestations of other cardiac disorders such as angina and rheumatic
fever.
Which assessment finding indicates to the nurse that a patient with infective endocarditis has impaired
cardiac function?
a. Prolonged fever with chills
b. Urine production of 25 mL/hr
c. Increase in heart rate of 15 beats/min with walking
d. Petechiae on the inside of the mouth and conjunctiva - ANSWER ANS: B Decreased renal perfusion
caused by inadequate cardiac output will lead to decreased 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/min is normal with exercise.
Which intervention would the nurse include when planning care for a patient hospitalized with a
streptococcal infective endocarditis (IE)?
a. Arrange for placement of a long-term IV catheter.
b. Monitor labs for levels of streptococcal antibodies.
c. Teach the importance of completing all oral antibiotics.
, d. Encourage the patient to begin regular aerobic exercise. - ANSWER ANS: A Treatment for IE involves 4
to 6 weeks of IV antibiotic therapy to eradicate the bacteria, which will require a long-term IV catheter
such as a peripherally inserted central catheter (PICC) 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
A patient is admitted to the hospital with possible acute pericarditis. Which diagnostic test would the
nurse expect the patient to undergo?
a. Blood cultures
b. Echocardiography
c. Cardiac catheterization
d. 24-hour Holter monitor - ANSWER ANS: B 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 diagnostic for pericarditis. The 12-lead EKG may show
changes with pericarditis, but a 24-hour Holter monitor would not be needed.
How would the nurse assess the patient with pericarditis for a pericardial friction rub?
a. Auscultate with the diaphragm of the stethoscope on the lower left sternal border.
b. Auscultate for a rumbling, low-pitched, systolic murmur over the left anterior chest.
c. Feel the precordial area with the palm of the hand to detect vibrations with cardiac contraction.
