A nurse is assessing a client two months after mitral valve replacement. The client complains of malaise, anorexia, weight loss, chills, and fever. The nurse suspects the client may have endocarditis. What other assessment sign is associated with infectious endocarditis?

Muffled heart sounds

Palpitations

Hives

Splinter hemorrhages

Answer and Explanation

The Correct Answer is D

A. Muffled heart sounds are associated with pericardial effusion or tamponade, not infective endocarditis.
B. Palpitations can occur but are not a classic sign of infective endocarditis.
C. Hives suggest an allergic reaction, not endocarditis.
D. Splinter hemorrhages (tiny, red-brown streaks under the nails) are a classic sign of infective endocarditis due to small emboli from the infected heart valves.

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Free Nursing Study Resources

Correct Answer is ["10"]

Explanation

Determine the heparin concentration:
- You have 25,000 units of heparin in 250 mL of normal saline.
- Concentration = 25,000 units / 250 mL = 100 units/mL
Calculate the mL/hr rate:
- The order is for 1,000 units/hour.
- Drip rate (mL/hr) = 1,000 units/hour / 100 units/mL = 10 mL/hour

Answer = 10mL/hr

A. Count how many QRS complexes occur in a 6-second strip B. Measure the T waves C. Read the monitor or electrocardiogram interpretation D. Look for P waves on the strip

Correct Answer is A

Explanation

A. Counting the number of QRS complexes in a 6-second strip and multiplying by 10 provides an estimate of the heart rate per minute.
B. Measuring T waves is used to assess repolarization abnormalities, not to determine heart rate.
C. While the monitor provides a heart rate reading, manual calculation is essential for verifying accuracy.
D. P waves indicate atrial activity but are not used to calculate the overall heart rate.

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A nurse is assessing a client two months after mitral valve replacement. The client complains of malaise, anorexia, weight loss, chills, and fever. The nurse suspects the client may have endocarditis. What other assessment sign is associated with infectious endocarditis?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A Nurse is preparing to start a heparin drip on a client with acute coronary syndrome. Ordered: Give Heparin 1000 units per hour, standard dilution of 25,000 units in 250 mL of normal saline. What is the correct drip setting for the pump in mL/hr?

Correct Answer is ["10"]

Explanation

A nurse is teaching a newly licensed nurse about evaluating cardiac rhythms. Which of the following best explains calculation of the heart rate?

Correct Answer is A

Explanation

A nurse is caring for a patient diagnosed with infectious endocarditis. The nurse is aware that which of the following are potential assessment findings? (SELECT ALL THAT APPLY)

A nurse is reviewing blood pressure classifications with a group of nurses at an in-service meeting. Which of the following should the nurse include as a risk factor for the development of hypertension?

A nurse is caring for a client who is in pulseless ventricular tachycardia (V-Tach). The nurse recognizes the need for which priority intervention?

A nurse is caring for a patient with a history of hypertension. The client reports compliance with the prescribed thiazide medication but is complaining of generalized weakness and palpitations. The nurse should monitor the client for which potential complications of diuretics?

A nurse is caring for a client who has hypertension and has a potassium level of 6.8 mEq/L. Which of the following actions should the nurse take?

A nurse is caring for a client who is scheduled for an exercise stress test. Which of the following medications should the nurse hold the morning of the stress test?

Identify the following Cardiac Rhythm:

A nurse in an urgent care center is assessing a client who reports a sudden onset of irregular palpitations, fatigue, and dizziness. The nurse finds a rapid and irregular heart rate with a significant pulse deficit. Which of the following dysrhythmias should the nurse expect to find on the ECG?