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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Correct Answer is C

Explanation

A. An INR of 2 is within the therapeutic range for anticoagulation but is more relevant for warfarin therapy rather than heparin.
B. An aPTT of 80 seconds is slightly elevated but not immediately life-threatening. The therapeutic range for heparin is typically 1.5 to 2.5 times the normal value (approximately 60-80 seconds).
C. Sudden weakness of one arm and leg suggests a possible embolic stroke, which is a serious complication of atrial fibrillation. This requires immediate assessment and intervention.
D. An irregular heart rate without P waves is characteristic of atrial fibrillation but is not the most urgent concern compared to potential stroke symptoms.

A. Pruritus B. Petechiae C. Confusion D. Slowing pulse rate

Correct Answer is B

Explanation

A. Pruritus is not a common side effect of heparin therapy. While allergic reactions can occur, they are not the primary concern.
B. Petechiae are a sign of bleeding, which is a major side effect of heparin therapy. Heparin increases the risk of bleeding by inhibiting clot formation, and petechiae may indicate early signs of hemorrhage.
C. Confusion is not directly associated with heparin therapy unless it results from severe bleeding leading to hypoxia or shock.
D. A slowing pulse rate is not a known adverse effect of heparin. Instead, monitoring for signs of bleeding, such as bruising, hematuria, and petechiae, is the priority.

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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

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Correct Answer is C

Explanation

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Correct Answer is B

Explanation

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