Exam 1: Endocarditis, Pericarditis,

Exam 1: Endocarditis, Pericarditis, &

Cardiac Tamponade (NCLEX) A patient is recovering from a myocardial infarction (MI) and develops chest pain on day

• that increases when taking a deep breath and is relieved by leaning forward. Which

action should the nurse take next?

• Assess the feet for pedal edema.
• Palpate the radial pulses bilaterally.
• Auscultate for a pericardial friction rub.
• Check the heart monitor for dysrhythmias. - Answer C

True or False: Endocarditis only affects the atrioventricular and semi-lunar valves in the heart. - Answer False Which of the following patients are MOST at risk for developing endocarditis? Select-all-

that-apply:

• A 25 year old male who reports using intravenous drugs on a daily basis.
• A 55 year old male who is post-opt from aortic valve replacement.
• A 63 year old female who is newly diagnosed with hyperparathyroidism and is taking

Aspirin.

• A 66 year old female who recently had an invasive dental procedure performed 1

month ago and is having a fever. - Answer ABD A patient is receiving treatment for infective endocarditis. The patient has a history of intravenous drug use and underwent mitral valve replacement a year ago. The patient is scheduled for a transesophageal echocardiogram tomorrow. On assessment, you find tender, red lesions on the patient's hands and feet. You know that this is a common finding in patients with infective endocarditis and is known as?

• Janeway Lesions
• Roth Spots
• Osler's Nodes
• Trousseau's Sign - Answer C

A 30 year old female is being treated for infective endocarditis with IV antibiotics. At the beginning of the hospitalization, the patient's symptoms were severe and sudden with a high fever but are now controlled. She has no significant health history other than 2 cesarean sections in the past. She is being prepped for a central line placement so she can be discharged home with home health to continue the 4 week antibiotic regime.What is type of infective endocarditis this classified as based on the information listed?

• Acute Infective Endocarditis 1 / 2

• Subacute Infective Endocarditis
• Non-infective Endocarditis
• Pericarditis - Answer A

A patient is admitted with sepsis. The patient has a temperature of 104.2 'F and is experiencing chills. On assessment, you note a mitral murmur which the patient states they've never had before, and dark, small lines on the patient's fingernails. The patient has a history of IV drug use in the past. However, the patient states they are no longer using drugs. The physician suspects possible infective endocarditis. What diagnostic test do you expect the physician to order in order to confirm the presence of infective endocarditis?

• Abdominal ultrasound
• Heart catheterization
• Transesophageal echocardiogram
• White blood cell count - Answer C

Select-all-that-apply: What are the typical signs and symptoms of infective endocarditis?

• Hyperthermia
• S4 gallop
• Enlarged Spleen
• Hyperkalemia
• Substernal pain that radiates to the back
• Heart failure
• Cardiac Murmur - Answer ACFG

You're providing discharge teaching to a patient being treated for endocarditis. Which statement by the patient demonstrated they understood your teaching about this condition?

• "I will stop taking the antibiotics once my fever is gone in order to prevent antibiotic

resistance."

• "I will only wash my hands with soap and water."
• "I will inform my dentist about my history of endocarditis prior to any invasive

procedures."

• "I will avoid eating fish and organ meats." - Answer C

A patient being treated for infective endocarditis is complaining of very sharp radiating abdominal pain that goes to the left shoulder and back. As the nurse familiar with complications of infective endocarditis, what do you suspect is the cause of this patient finding?

• Renal embolic event
• Pulmonary embolic event
• Central nervous system embolic event
• / 2