The nurse is conducting a physical assessment on a client with infective endocarditis (IE). The nurse observes flat, reddened, non-tender maculae on the hands and feet.
What does the nurse understand these to be?
Heberden’s nodes.
Bouchard’s nodes.
Janeway lesions.
Tophi.
The Correct Answer is C
Choice A rationale
Heberden’s nodes are bony swellings that occur at the distal interphalangeal finger joint, a sign of osteoarthritis. They are not associated with infective endocarditis (IE).
Choice B rationale
Bouchard’s nodes are similar to Heberden’s nodes but occur at the proximal interphalangeal finger joint. They are also a sign of osteoarthritis and not associated with IE.
Choice C rationale
Janeway lesions are flat, painless, red or purple spots on the palms of the hands or the soles of the feet. They are associated with IE and are caused by septic emboli which are small clots filled with bacteria. These emboli can lodge in small blood vessels, causing these characteristic lesions.
Choice D rationale
Tophi are hard, uric acid deposits under the skin. They are a sign of chronic gout, not IE.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
The statement “I will call an ambulance if I have pain after taking 3 nitroglycerin 5 minutes apart” indicates that the patient understands the correct use of sublingual nitroglycerin (Nitrostat). If chest pain is not relieved after a total of 3 tablets or sprays, this is an emergency situation and medical help should be sought immediately.
Correct Answer is C
Explanation
Choice A rationale
Furosemide (Lasix) is a diuretic often used in the treatment of pulmonary edema to help remove excess fluid from the body. While it’s important to monitor the patient’s fluid and electrolyte balance, it’s not typically necessary to question this medication.
Choice B rationale
Captopril (Capoten) is an ACE inhibitor used to treat conditions like heart failure and high blood pressure. It can be beneficial in managing pulmonary edema by reducing the workload on the heart. It’s not typically necessary to question this medication.
Choice C rationale
Digoxin (Lanoxin) is a medication used to treat heart failure and atrial fibrillation. It’s important to question this medication before administration because digoxin has a narrow therapeutic index, meaning the difference between a therapeutic dose and a toxic dose is small. Therefore, it’s crucial to ensure the patient’s digoxin levels are within the therapeutic range before administering more of the medication.
Choice D rationale
Carvedilol (Coreg) is a beta-blocker used to treat high blood pressure and heart failure. While it’s important to monitor the patient’s blood pressure and heart rate, it’s not typically necessary to question this medication.
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