Which client has the least risk for developing endocarditis?

A 57-year-old with a mechanical mitral valve in need of a tooth extraction.

A 19-year-old college student presents with a sore throat and fever.

A 77-year-old with a history of angina and new onset of chest pain.

A 35-year-old who reports using intravenous drugs on a daily basis.

Answer and Explanation

The Correct Answer is C

A. A 57-year-old with a mechanical mitral valve in need of a tooth extraction: Clients with prosthetic heart valves are at high risk for infective endocarditis, particularly during procedures that can introduce bacteria into the bloodstream, such as dental work. Antibiotic prophylaxis is often indicated.

B. A 19-year-old college student presents with a sore throat and fever: While a sore throat may indicate a streptococcal infection, this client does not have predisposing cardiac conditions. However, untreated strep infections can rarely lead to endocarditis, but the risk is higher in individuals with cardiac abnormalities.

C. A 77-year-old with a history of angina and new onset of chest pain: Angina indicates coronary artery disease but does not directly increase the risk of endocarditis. This client has the least risk among the options because endocarditis is associated with structural heart abnormalities, prosthetic valves, or intravenous drug use rather than ischemic heart disease alone.

D. A 35-year-old who reports using intravenous drugs on a daily basis: Intravenous drug use is a major risk factor for infective endocarditis due to repeated introduction of bacteria into the bloodstream. The tricuspid valve is commonly affected in this population, making this client high-risk.

Nursing Test Bank

Test Bank #1: RN Pharmacology Exams Test Bank #2: RN Medical-Surgical Exams Test Bank #3: RN Fundamentals Exams Test Bank #4: RN Maternal-Newborn Exams Test Bank #5: RN Anatomy and Physiology Exams Test Bank #6: RN Obstetrics and Pediatrics Exams Test Bank #7: RN Fluid and Electrolytes Exams Test Bank #9: RN Adult Health Test Bank #10: RN Dosage Calculation Test Bank #11: RN Community Health Exams Test Bank #12: RN Psychology Exams Test Bank #13: RN Nursing Care Of Children Test Bank #14: RN Foundations of Nursing Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Exam #1: RN Comprehensive predictor 2023 proctored exam Exam #2: Ati rn vati comprehensive predictor proctored exam Exam #3: Ati Rn Comprehensive Predictor Proctored Exam 2023 Exam #4: Rn Comprehensive Predictor 2023 Proctored Exam - St. Joseph Exam #5: RN Comprehensive Predictor Proctored Exam (National U CA San Diego) Exam #6: Ati rn comprehensive predictor 2023 retake proctored exam Exam #7: RN Hesi Exit Proctored Exam Exam #8: Hesi RN Exit proctored exam Exam #9: Hesi rn exit proctored exam Exam #10: Hesi Rn compass exit B proctored exam

Free Nursing Study Resources

Correct Answer is A

Explanation

A. Atrial flutter: The baseline shows a rapid, regular, and "saw-tooth" pattern of atrial activity. These are referred to as F-waves (flutter waves). Atrial flutter is characterized by rapid, regular atrial depolarizations with a consistent ventricular response. The rhythm is usually regular or regularly irregular depending on the AV conduction ratio.

B. Supraventricular Tachycardia: Supraventricular tachycardia (SVT) is a rapid, regular rhythm originating above the ventricles, often with a narrow QRS, but it does not display the characteristic sawtooth flutter waves seen in atrial flutter. SVT documentation would be incorrect if the flutter waves are clearly visible.

C. Atrial fibrillation: Atrial fibrillation presents with an irregularly irregular rhythm and absence of distinct P waves, replaced by chaotic fibrillatory waves. Unlike atrial flutter, atrial fibrillation does not show organized, repetitive atrial activity, making this label inaccurate for the described EKG.

D. Sinus rhythm: Sinus rhythm is defined by a normal P wave before each QRS complex with consistent rate and rhythm. Atrial flutter deviates from normal sinus activity due to abnormal atrial depolarizations and cannot be documented as sinus rhythm.

A. Perform range of motion (ROM) exercises. B. Assess the insertion site. C. Maintain NPO status for 2-6 hours. D. Log roll the client to use the bedpan.

Correct Answer is B

Explanation

A. Perform range of motion (ROM) exercises: While early mobility is important, ROM exercises involving the affected arm should be limited initially to prevent disruption of the radial artery access site. Encouraging movement too soon could increase bleeding or hematoma formation.

B. Assess the insertion site: Frequent assessment of the radial artery access site is essential after a TAVR via the radial approach. The nurse monitors for bleeding, hematoma, swelling, discoloration, or compromised distal circulation, ensuring early detection and management of vascular complications.

C. Maintain NPO status for 2-6 hours: NPO status is typically required for procedures involving sedation, anesthesia, or femoral access to prevent aspiration. After a radial approach TAVR, the client may resume oral intake sooner, and prolonged NPO is usually unnecessary.

D. Log roll the client to use the bedpan: Log-rolling is used to protect the spine or after certain surgeries. For a radial artery access site, rolling the client is not indicated and does not reduce risk at the wrist. Care should focus on protecting the arm and monitoring vascular integrity rather than body positioning maneuvers.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

Which client has the least risk for developing endocarditis?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

How would the nurse document the heart rhythm shown on this EKG strip?

Correct Answer is A

Explanation

A nurse is caring for a client who returned from the catheterization laboratory (cath lab) to recover on the cardiac intermediate care unit status post radial approach transcatheter aortic valve replacement (TAVR). Which intervention would the nurse include in the client's care?

Correct Answer is B

Explanation

A nurse is caring for a client who was admitted with hypertrophic cardiomyopathy (HCM). What order does the nurse anticipate providing?

A client is prescribed diltiazem for the treatment of a cardiac disorder. Which finding would require the nurse to hold the ordered dose and notify the provider for further orders?

The nurse is providing discharge education to a client status post mechanical mitral valve replacement. Which statement made by the client indicates the need for further education?

The nurse is caring for a client with pericarditis. What heart sounds does the nurse expect to hear during the physical assessment?

A client presents to the emergency department with an acute ST elevation myocardial infarction (STEMI) at 1500. The facility has 24-hour catheterization laboratory abilities. To improve client outcomes, by what time would the client have a percutaneous coronary intervention performed?

A nurse is caring for a client following a cardiac catheterization that was inserted through the femoral artery. While turning the client, the nurse discovers ecchymosis underneath the clients lower back. Which priority action would the nurse initiate?