The client hospitalized with infective endocarditis develops sharp flank pain and hematuria. The nurse notifies the physician, recognizing that these clinical manifestations may indicate:

vegetative embolization to the kidneys.

hemolysis of red blood cells by hemolytic microorganisms.

septicemia resulting in decreased glomerular blood flow.

bacterial infection in the kidneys.

Answer and Explanation

The Correct Answer is A

A. vegetative embolization to the kidneys: Infective endocarditis is an infection of the heart valves or the endocardium. Vegetations (clumps of bacteria, fibrin, and platelets) can form on the damaged heart structures. These vegetations are fragile and can break off, forming emboli that travel through the bloodstream to various organs. Embolization to the kidneys can cause renal infarction, leading to sharp flank pain due to ischemia or infarction of kidney tissue and hematuria.

B. hemolysis of red blood cells by hemolytic microorganisms: While some bacteria can cause hemolysis, it is not typically associated with localized flank pain. Hemolysis would present with systemic signs such as jaundice, fatigue, and anemia, not acute flank pain and visible hematuria.

C. septicemia resulting in decreased glomerular blood flow: Septicemia may impair renal perfusion over time but would more likely lead to generalized signs of acute kidney injury, such as oliguria and rising creatinine levels, rather than acute flank pain and hematuria.

D. bacterial infection in the kidneys: Acute pyelonephritis can cause flank pain and hematuria, but in the context of infective endocarditis, embolic events are a more likely and urgent explanation for new-onset symptoms, particularly sharp localized pain.

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Correct Answer is C

Explanation

A. Administer an antidiarrheal medication: Atropine is an anticholinergic agent that reduces gastrointestinal motility, often leading to constipation rather than diarrhea. Administering an antidiarrheal would not be appropriate and could cause harmful effects if unnecessary.

B. Assess the pupils for constriction: Atropine causes pupil dilation (mydriasis), not constriction. Checking for constriction would not align with the expected pharmacologic effects of the drug and is not a priority assessment after administration.

C. Provide frequent oral care: Atropine inhibits secretions as part of its anticholinergic effects, often leading to dry mouth (xerostomia). Frequent oral care helps maintain mucous membrane integrity and client comfort, making this an appropriate nursing action following administration.

D. Insert an indwelling catheter: Although atropine can cause urinary retention, especially in older adults, catheter insertion is not routinely required after administration; a single 0.5 mg IV dose is less likely to cause significant urinary retention requiring catheterization. It should only be considered if the client shows clinical signs of acute urinary retention.

Correct Answer is ["125"]

Explanation

Calculate the total volume to be infused in drops.

Total drops = Total volume (mL) × Drop factor (gtts/mL)

= 1000 mL × 60 gtts/mL

= 60000 gtts

Calculate the total infusion time in minutes.

Total infusion time (minutes) = Total hours × 60 minutes/hour

= 8 hours × 60 minutes/hour

= 480 minutes

Calculate the IV flow rate in drops per minute (gtts/min).

IV rate (gtts/min) = Total drops / Total infusion time (minutes)

= 60000 gtts / 480 minutes

= 125

=125 gtts/min

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The client hospitalized with infective endocarditis develops sharp flank pain and hematuria. The nurse notifies the physician, recognizing that these clinical manifestations may indicate:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse administers atropine 0.5 mg IV to a client. Which action should be performed after the client has received this medication?

Correct Answer is C

Explanation

A client is to receive LR 1000 ml over 8 hours. The IV tubing drop rate is 60 gtts/ml. What is the correct rate (gtts/min)? DOCUMENT ANSWER AS: RATE gtts/min (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Correct Answer is ["125"]

Explanation

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