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Inflammatory and Structural Heart Disorders EXAM 2

Quiz by Brittany

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40 questions
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  • Q1
    The nurse obtains a health history from an older patient with a prosthetic mitral valve who has symptoms of infective endocarditis (IE). Which question by the nurse is most focused on identifying a risk factor for IE?
    “Is there a family history of endocarditis?”
    “Have you had dental work done recently?”
    “Do you have a history of a heart attack?”
    “Have you had any recent immunizations?”
  • Q2
    During the assessment of a young adult patient with infective endocarditis (IE), the nurse would expect to find
    a new regurgitant murmur.
    a pruritic rash on the chest.
    involuntary muscle movement.
    substernal chest pressure.
  • Q3
    The nurse identifies the nursing diagnosis of decreased cardiac output related to valvular insufficiency for the patient with infective endocarditis (IE) based on which assessment finding(s)?
    Fever, chills, and diaphoresis
    Increase in heart rate of 15 beats/minute with walking
    Petechiae on the inside of the mouth and conjunctiva
    Urine output less than 30 mL/hr
  • Q4
    When planning care for a patient hospitalized with a streptococcal infective endocarditis (IE), which intervention is most appropriate for the nurse to include?
    Teach the importance of completing all oral antibiotics.
    Encourage the patient to begin regular aerobic exercise.
    Monitor labs for levels of streptococcal antibodies.
    Arrange for placement of a long-term IV catheter.
  • Q5
    A patient is admitted to the hospital with possible acute pericarditis. The nurse should plan to teach the patient about the purpose of
    24-hour Holter monitor.
    cardiac catheterization.
    blood cultures.
  • Q6
    To assess the patient with pericarditis for evidence of a pericardial friction rub, the nurse should
    auscultate with the diaphragm of the stethoscope on the lower left sternal border.
    feel the precordial area with the palm of the hand to detect vibrations with cardiac contraction.
    isten for a rumbling, low-pitched, systolic murmur over the left anterior chest.
    ask the patient to cough during auscultation to distinguish the sound from a pleural friction rub.
  • Q7
    The nurse suspects cardiac tamponade in a patient who has acute pericarditis. To assess for the presence of pulsus paradoxus, the nurse should
    listen for a pericardial friction rub that persists when the patient is instructed to stop breathing.
    subtract the diastolic blood pressure from the systolic blood pressure.
    check the electrocardiogram (ECG) for variations in rate during the respiratory cycle.
    note when Korotkoff sounds are auscultated during both inspiration and expiration.
  • Q8
    The nurse has identified a nursing diagnosis of acute pain related to inflammatory process for a patient with acute pericarditis. An appropriate intervention by the nurse for this problem is to
    teach the patient to take deep, slow breaths to control the pain.
    place the patient in Fowler’s position, leaning forward on the overbed table.
    force fluids to 3000 mL/day to decrease fever and inflammation.
    provide a fresh ice bag every hour for the patient to place on the chest.
  • Q9
    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?
    Do you use any illegal IV drugs?”
    “Do you have a family history of congenital heart disease?”
    Have you had a recent sore throat?”
    “Have you injured your chest in the last few weeks?”
  • Q10
    When caring for a patient with mitral valve stenosis, it is most important that the nurse assess for
    shortness of breath on exertion.
    peripheral edema.
    diastolic murmur.
    Right upper quadrant tenderness.
  • Q11
    A 21-yr-old woman is scheduled for percutaneous transluminal balloon valvuloplasty to treat mitral stenosis. Which information should the nurse include when explaining the advantages of valvuloplasty over valve replacement to the patient?
    Lifelong anticoagulant therapy is needed after mechanical valve replacement.
    Mechanical mitral valves need to be replaced sooner than biologic valves.
    Ongoing cardiac care by a health care provider is not necessary after valvuloplasty.
    Biologic valves will require immunosuppressive drugs after surgery.
  • Q12
    During discharge teaching with an older patient who had a mitral valve replacement with a mechanical valve, the nurse must instruct the patient on the
    need for frequent laboratory blood testing.
    correct method for taking the radial pulse.
    use of daily aspirin for anticoagulation.
    need to avoid any physical activity for 1 month.
  • Q13
    A patient recovering from heart surgery develops pericarditis and complains of level 6 (0 to 10 scale) chest pain with deep breathing. Which prescribed PRN medication will be the most appropriate for the nurse to give?
    Oral acetaminophen (Tylenol) 650 mg
    IV morphine sulfate 4 mg
    Oral ibuprofen (Motrin) 600 mg
    Fentanyl 1 mg IV
  • Q14
    When caring for a patient with infective endocarditis of the tricuspid valve, the nurse should monitor the patient for the development of
    mental status changes.
    shortness of breath.
    flank pain.
  • Q15
    A patient admitted with acute dyspnea is newly diagnosed with dilated cardiomyopathy. Which information will the nurse plan to teach the patient about managing this disorder?
    Careful compliance with diet and medications will prevent heart failure.
    A heart transplant should be scheduled as soon as possible.
    Notify the health care provider about symptoms such as shortness of breath.
    Elevating the legs above the heart will help relieve dyspnea

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