Adult Health 2 Final Questions And Answers Update

Adult Health 2 Final Questions And Answers ( ) Update

The nurse obtains a health history from a patient with a prosthetic mitral valve who has
symptoms of infective endocarditis. Which question by the nurse is most appropriate?
a. "Do you have a history of a heart attack?"
b. "Have you any recent immunizations?"
c. "Have you been to the dentist lately?"
d. "Is there a family history of endocarditis?" - Answer-C
Rationale: Dental procedures place the patient with a prosthetic mitral valve at risk for
infectious endocarditis (IE). Myocardial infarction (MI), immunizations, and a family
history of endocarditis are not risk factors for IE.
The health care provider writes the following admitting orders for a patient with
suspected IE who has fever and chills: ceftriaxone (Rocephin) 1.0 g intravenous
piggyback (IVPB) q12hr, acetylsalicylic acid (ASA) for temperature above 102° F (38.9°
C), and blood cultures 2, complete blood cell count (CBC), and electrocardiogram
(ECG). When admitting the patient, the nurse gives the highest priority to
a. obtaining the blood cultures.
b. initiating the IV antibiotic.
c. scheduling the ECG.
d. administering the ASA. - Answer-A
Rationale: Treatment of the IE with antibiotics should be started as quickly as possible,
but it is essential to obtain blood cultures before initiating antibiotic therapy to obtain
accurate sensitivity results. The ECG and ASA should also be accomplished rapidly, but
the blood cultures (and then administration of the antibiotic) have highest priority.
During the assessment of a patient with IE, the nurse would expect to find
a. substernal chest pain and pressure.
b. splinter hemorrhages of the lips.
c. dyspnea and a dry, hacking cough.
d. a new regurgitant murmur. - Answer-D
Rationale: New regurgitant murmurs occur in IE because vegetation on the valves
prevents valve closure. Splinter hemorrhages occur on the nailbeds. Chest pain for
pressure is not typical for the patient with IE and would be more consistent with angina
or MI. Although dyspnea may occur as a result of heart failure, a moist cough would be
expected rather than a dry, hacking cough.
A patient hospitalized with IE develops sharp left flank pain and hematuria. The nurse
notifies the health care provider, recognizing that these symptoms may indicate
a. septicemia.
b. acute pyelonephritis.
c. vegetative embolization.
d. glomerulonephritis. - Answer-C