Examl 1:l NSG223/l NSGl 223l (NEWl 2025/l
2026l Update)l Medical-Surgicall Nursingl IIl
Review|l Questionsl &l Answers|l Gradel A|l
100%l Correctl (Verifiedl Solutions)-l
Herzing
QUESTION
Pathophysiologyl ofl infectivel endocarditis
Answer:
Al deformityl orl injuryl ofl thel endocardiuml leadsl tol accumulationl ofl fibrinl andl plateletsl
(clotl formation)l onl thel endocardium
-accumulationl ofl fibrinl andl plateletsl clusterl asl vegetationsl onl endocardiuml
-vegetationl mayl causel clottingl andl newl clotsl canl growl overl thel organisml andl bel
maskedl froml body'sl defensel system
-thesel organismsl canl erodel thel endocardiuml andl valvel leaflets
QUESTION
Symptomsl ofl infectivel endocarditis
Answer:
feverl orl murmursl willl bel commonl atl first
-petechiael mayl occurl overl thel bodyl
-Janewayl lesions
-painfull nodulesl onl fingers
-headache,l cerebrall ischemia
-embolization
-splinterl hemorrhagesl
-cardiomegaly,l heartl failure,l splenomegaly,l tachycardia
,QUESTION
Medicall managementl ofl infectivel endocarditis
Answer:
Antibioticl therapyl usuallyl isl givenl forl 2l tol 6l weeksl everyl 4l hoursl orl continuouslyl byl
IVl infusion.
-Obtainl seruml levelsl ofl antibioticl andl bloodl culturel tol seel howl antibioticsl arel working
-monitorl templ often
-psychosociall supportl atl thel endl ofl therapyl becausel ofl beingl inl thel hospitall forl al longl
period
QUESTION
Diagnosingl infectivel endocarditis
Answer:
Al definitivel diagnosisl isl madel whenl al microorganisml isl foundl inl twol separatel bloodl
cultures,l orl inl vegetationl orl abscess.l Atl leastl 2l setsl ofl bloodl culturesl (withl eachl setl
includingl onel aerobicl andl onel anaerobicl culture)l drawnl froml differentl venipuncturel sitesl
overl al 24-hourl periodl (eachl setl atl leastl 12l hoursl apart),l orl everyl 30l minutesl ifl thel
patient'sl conditionl isl unstable,l shouldl bel obtainedl beforel administrationl ofl anyl
antimicrobiall agents
-sometimesl mistakenl forl influenza
-patientsl mayl bel anemic,l havel al positivel rheumatoidl factor,l andl anl elevatedl erythrocytel
sedimentationl ratel (ESR)l orl C-reactivel protein,l highl WBC.
QUESTION
rheumaticl endocarditisl s/s
Answer:
Feverl (38.9°-40°Cl [101°-104°F])
Chills
Sorel throatl (suddenl inl onset)l whichl mayl causel severel painl withl swallowing
Diffusel rednessl ofl throatl withl exudatel onl oropharynxl (mayl notl appearl untill afterl thel
firstl day)
,Petechiael onl thel roofl ofl thel mouth
Enlargedl andl tenderl lymphl nodes
Abdominall painl (morel commonl inl children)
Acutel sinusitisl andl acutel otitisl medial (mayl causel orl resultl froml streptococcall
pharyngitis)
Sandpaperlikel rash
QUESTION
Diagnosingl andl treatmentl forl rheumaticl endocarditis
Answer:
Ifl signsl andl symptomsl ofl streptococcall pharyngitisl arel present,l al throatl culturel isl
necessaryl tol makel anl accuratel diagnosis
ifl positivel culture,l penicillinl isl prescribed
QUESTION
Whenl isl aorticl orl mitrall valvel débridement,l excision,l orl replacementl requiredl (infectivel
endocarditis)?
Answer:
Developl congestivel heartl failurel despitel adequatel medicall treatment
Havel morel thanl onel seriousl systemicl embolicl episode
Developl al valvel obstruction
Developl al periannularl (heartl valve),l myocardial,l orl aorticl abscess
Havel uncontrolledl infection,l persistentl orl recurrentl infection,l orl fungall endocarditis
QUESTION
Whenl willl surgicall interventionl bel neededl forl infectivel endocarditis?
Answer:
, Surgicall interventionl mayl bel requiredl ifl thel infectionl doesl notl respondl tol medicationsl
orl thel patientl hasl prostheticl heartl valvel endocarditis,l hasl al mobilel vegetation,l hasl heartl
failure,l hasl heartl block,l orl developsl complicationsl suchl asl al septall perforation
QUESTION
Surgicall interventionl optionsl forl infectivel endocarditis?
Answer:
Surgicall interventionsl includel valvel débridementl orl excision,l débridementl ofl vegetations,l
débridementl andl closurel ofl anl abscess,l andl closurel ofl al fistula.
QUESTION
Whol mightl developl myocarditis?
Answer:
virall (e.g.,l coxsackievirusl Al andl B,l humanl immunel deficiencyl virus,l influenzal A),l
bacterial,l rickettsial,l fungal,l parasitic,l metazoal,l protozoall (e.g.,l Chagasl disease),l orl
spirochetall infection
-peoplel takingl immunosuppressivel therapy
-patientsl withl infectivel endocarditis,l Crohn's,l lupus,l rheumaticl fever
QUESTION
myocarditisl pathophysiology
Answer:
Myocarditisl mayl resultl froml anl inflammatoryl reactionl tol toxinsl suchl asl pharmacologicl
agentsl usedl inl thel treatmentl ofl otherl diseases
-mayl beginl inl al smalll areal andl spreadl acrossl myocardium
-Myocardiall inflammationl andl necrosisl occur->collagenl andl elastinl destruction
2026l Update)l Medical-Surgicall Nursingl IIl
Review|l Questionsl &l Answers|l Gradel A|l
100%l Correctl (Verifiedl Solutions)-l
Herzing
QUESTION
Pathophysiologyl ofl infectivel endocarditis
Answer:
Al deformityl orl injuryl ofl thel endocardiuml leadsl tol accumulationl ofl fibrinl andl plateletsl
(clotl formation)l onl thel endocardium
-accumulationl ofl fibrinl andl plateletsl clusterl asl vegetationsl onl endocardiuml
-vegetationl mayl causel clottingl andl newl clotsl canl growl overl thel organisml andl bel
maskedl froml body'sl defensel system
-thesel organismsl canl erodel thel endocardiuml andl valvel leaflets
QUESTION
Symptomsl ofl infectivel endocarditis
Answer:
feverl orl murmursl willl bel commonl atl first
-petechiael mayl occurl overl thel bodyl
-Janewayl lesions
-painfull nodulesl onl fingers
-headache,l cerebrall ischemia
-embolization
-splinterl hemorrhagesl
-cardiomegaly,l heartl failure,l splenomegaly,l tachycardia
,QUESTION
Medicall managementl ofl infectivel endocarditis
Answer:
Antibioticl therapyl usuallyl isl givenl forl 2l tol 6l weeksl everyl 4l hoursl orl continuouslyl byl
IVl infusion.
-Obtainl seruml levelsl ofl antibioticl andl bloodl culturel tol seel howl antibioticsl arel working
-monitorl templ often
-psychosociall supportl atl thel endl ofl therapyl becausel ofl beingl inl thel hospitall forl al longl
period
QUESTION
Diagnosingl infectivel endocarditis
Answer:
Al definitivel diagnosisl isl madel whenl al microorganisml isl foundl inl twol separatel bloodl
cultures,l orl inl vegetationl orl abscess.l Atl leastl 2l setsl ofl bloodl culturesl (withl eachl setl
includingl onel aerobicl andl onel anaerobicl culture)l drawnl froml differentl venipuncturel sitesl
overl al 24-hourl periodl (eachl setl atl leastl 12l hoursl apart),l orl everyl 30l minutesl ifl thel
patient'sl conditionl isl unstable,l shouldl bel obtainedl beforel administrationl ofl anyl
antimicrobiall agents
-sometimesl mistakenl forl influenza
-patientsl mayl bel anemic,l havel al positivel rheumatoidl factor,l andl anl elevatedl erythrocytel
sedimentationl ratel (ESR)l orl C-reactivel protein,l highl WBC.
QUESTION
rheumaticl endocarditisl s/s
Answer:
Feverl (38.9°-40°Cl [101°-104°F])
Chills
Sorel throatl (suddenl inl onset)l whichl mayl causel severel painl withl swallowing
Diffusel rednessl ofl throatl withl exudatel onl oropharynxl (mayl notl appearl untill afterl thel
firstl day)
,Petechiael onl thel roofl ofl thel mouth
Enlargedl andl tenderl lymphl nodes
Abdominall painl (morel commonl inl children)
Acutel sinusitisl andl acutel otitisl medial (mayl causel orl resultl froml streptococcall
pharyngitis)
Sandpaperlikel rash
QUESTION
Diagnosingl andl treatmentl forl rheumaticl endocarditis
Answer:
Ifl signsl andl symptomsl ofl streptococcall pharyngitisl arel present,l al throatl culturel isl
necessaryl tol makel anl accuratel diagnosis
ifl positivel culture,l penicillinl isl prescribed
QUESTION
Whenl isl aorticl orl mitrall valvel débridement,l excision,l orl replacementl requiredl (infectivel
endocarditis)?
Answer:
Developl congestivel heartl failurel despitel adequatel medicall treatment
Havel morel thanl onel seriousl systemicl embolicl episode
Developl al valvel obstruction
Developl al periannularl (heartl valve),l myocardial,l orl aorticl abscess
Havel uncontrolledl infection,l persistentl orl recurrentl infection,l orl fungall endocarditis
QUESTION
Whenl willl surgicall interventionl bel neededl forl infectivel endocarditis?
Answer:
, Surgicall interventionl mayl bel requiredl ifl thel infectionl doesl notl respondl tol medicationsl
orl thel patientl hasl prostheticl heartl valvel endocarditis,l hasl al mobilel vegetation,l hasl heartl
failure,l hasl heartl block,l orl developsl complicationsl suchl asl al septall perforation
QUESTION
Surgicall interventionl optionsl forl infectivel endocarditis?
Answer:
Surgicall interventionsl includel valvel débridementl orl excision,l débridementl ofl vegetations,l
débridementl andl closurel ofl anl abscess,l andl closurel ofl al fistula.
QUESTION
Whol mightl developl myocarditis?
Answer:
virall (e.g.,l coxsackievirusl Al andl B,l humanl immunel deficiencyl virus,l influenzal A),l
bacterial,l rickettsial,l fungal,l parasitic,l metazoal,l protozoall (e.g.,l Chagasl disease),l orl
spirochetall infection
-peoplel takingl immunosuppressivel therapy
-patientsl withl infectivel endocarditis,l Crohn's,l lupus,l rheumaticl fever
QUESTION
myocarditisl pathophysiology
Answer:
Myocarditisl mayl resultl froml anl inflammatoryl reactionl tol toxinsl suchl asl pharmacologicl
agentsl usedl inl thel treatmentl ofl otherl diseases
-mayl beginl inl al smalll areal andl spreadl acrossl myocardium
-Myocardiall inflammationl andl necrosisl occur->collagenl andl elastinl destruction
