Cardio-Pulmonary Exam 3
Test Questions with 100%
Correct Answers | Updated &
Verified
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?
Have you had dental work done recently?
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 new regurgitant murmur
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?
Urine production of 25 mL/hr
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)?
Arrange for placement of a long-term IV catheter.
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?
Echocardiography
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?
Auscultate with the diaphragm of the stethoscope on the lower
left sternal border.
Pericardial friction rubs are best heard with the diaphragm at the
lower left sternal border. The nurse should ask the patient to hold
his or her breath during auscultation to distinguish the sounds
from a pleural friction rub. Friction rubs are not typically low
pitched or rumbling and are not confined to systole. Rubs are not
assessed by palpation.
, The nurse suspects cardiac tamponade in a patient who has
acute pericarditis. How would the nurse assess for the
presence of pulsus paradoxus?
Note when Korotkoff sounds are heard during both inspiration
and expiration.
Pulsus paradoxus exists when there is a gap of greater than 10
mm Hg between when Korotkoff sounds can be heard during only
expiration and when they can be heard throughout the respiratory
cycle. The other methods described would not be useful in
determining the presence of pulsus paradoxus. The difference
between the diastolic blood pressure and the systolic blood
pressure is known as the pulse pressure.
A patient has pain due to acute pericarditis. Which action
would the nurse take?
Place the patient in Fowler's position, leaning forward on the
table.
Sitting upright and leaning forward often will decrease the pain
associated with pericarditis. Forcing fluids will not decrease the
inflammation or pain. Taking deep breaths will tend to increase
pericardial pain. Ice does not decrease this type of inflammation
and pain.
The nurse is admitting a patient with possible rheumatic
fever. Which question on the admission health history focuses
on a pertinent risk factor for rheumatic fever?
Test Questions with 100%
Correct Answers | Updated &
Verified
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?
Have you had dental work done recently?
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 new regurgitant murmur
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?
Urine production of 25 mL/hr
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)?
Arrange for placement of a long-term IV catheter.
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?
Echocardiography
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?
Auscultate with the diaphragm of the stethoscope on the lower
left sternal border.
Pericardial friction rubs are best heard with the diaphragm at the
lower left sternal border. The nurse should ask the patient to hold
his or her breath during auscultation to distinguish the sounds
from a pleural friction rub. Friction rubs are not typically low
pitched or rumbling and are not confined to systole. Rubs are not
assessed by palpation.
, The nurse suspects cardiac tamponade in a patient who has
acute pericarditis. How would the nurse assess for the
presence of pulsus paradoxus?
Note when Korotkoff sounds are heard during both inspiration
and expiration.
Pulsus paradoxus exists when there is a gap of greater than 10
mm Hg between when Korotkoff sounds can be heard during only
expiration and when they can be heard throughout the respiratory
cycle. The other methods described would not be useful in
determining the presence of pulsus paradoxus. The difference
between the diastolic blood pressure and the systolic blood
pressure is known as the pulse pressure.
A patient has pain due to acute pericarditis. Which action
would the nurse take?
Place the patient in Fowler's position, leaning forward on the
table.
Sitting upright and leaning forward often will decrease the pain
associated with pericarditis. Forcing fluids will not decrease the
inflammation or pain. Taking deep breaths will tend to increase
pericardial pain. Ice does not decrease this type of inflammation
and pain.
The nurse is admitting a patient with possible rheumatic
fever. Which question on the admission health history focuses
on a pertinent risk factor for rheumatic fever?
