A patient presents to the emergency room with a temperature of 101.2 F, heart murmur, muscle aches, heart rate of 118 bpm, hematuria, and abnormalities of the nails. Which of the following conditions does the nurse suspect?
Peptic ulcer disease
Pulmonary Embolism
Endocarditis
Heart Failure
The Correct Answer is C
A. Peptic ulcer disease: PUD primarily presents with epigastric pain, dyspepsia, and sometimes gastrointestinal bleeding. It does not explain heart murmurs, nail abnormalities, or hematuria, making it unlikely in this scenario.
B. Pulmonary embolism: PE typically presents with sudden shortness of breath, chest pain, tachypnea, and sometimes hemoptysis. A heart murmur and nail changes are not characteristic of PE, so this is less likely.
C. Endocarditis: Infective endocarditis often presents with fever, tachycardia, heart murmur, hematuria, myalgias, and nail findings such as splinter hemorrhages. The combination of these systemic and cardiovascular findings strongly suggests endocarditis.
D. Heart failure: Heart failure manifests with dyspnea, edema, fatigue, and sometimes pulmonary congestion. Fever, hematuria, and nail abnormalities are not typical, making it less likely as the primary diagnosis in this case.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. "It helps increase kidney function.": Hydroxychloroquine does not directly improve kidney function. Renal involvement in SLE requires separate management strategies, including immunosuppressive therapy.
B. “It helps prevent blood clots from forming.": Anticoagulants such as warfarin or heparin are used to prevent clotting. Hydroxychloroquine does not serve as a primary anticoagulant, though it may have some indirect effects on thrombosis risk.
C. "It cures lupus if taken regularly.": There is currently no cure for systemic lupus erythematosus. Hydroxychloroquine helps manage symptoms and prevent disease exacerbations, but it does not eliminate the disease.
D. "It reduces joint inflammation and prevents flare-ups.": Hydroxychloroquine is an antimalarial medication used in SLE to reduce inflammation, control fatigue, and prevent disease flare-ups. It helps manage musculoskeletal and cutaneous symptoms and improves long-term disease outcomes.
Correct Answer is B
Explanation
A. Weight loss despite increased appetite: This finding is more consistent with hyperthyroidism, where increased metabolism leads to weight loss despite increased caloric intake. It is not typical in hypothyroidism.
B. Bradycardia and cold intolerance: Hypothyroidism slows metabolic processes, leading to a decreased heart rate (bradycardia) and sensitivity to cold due to reduced heat production. These are classic signs of underactive thyroid function.
C. Heat intolerance and sweating: These symptoms are associated with hyperthyroidism, where increased metabolism generates excess heat and promotes diaphoresis. They are inconsistent with hypothyroidism.
D. Exophthalmos and restlessness: Exophthalmos is a hallmark of Graves’ disease (hyperthyroidism), and restlessness reflects increased sympathetic activity. These are not typical manifestations of hypothyroidism.
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