Chapter 37: Nursing Management: Inflammatory and Structural Heart Disorders

Chapter 37: Nursing Management: Inflammatory and Structural Heart Disorders

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE
1. The nurse obtains a health history from a patient with a prosthetic mitral valve who has
symptoms of infective endocarditis (IE). Which question by the nurse is most
appropriate?
a. “Have you been to the dentist lately?”
b. “Do you have a history of a heart attack?”
c. “Is there a family history of endocarditis?”
d. “Have you had any recent immunizations?”
ANS: A
Dental procedures place the patient with a prosthetic mitral valve at risk for infective
endocarditis (IE). Myocardial infarction (MI), immunizations, and a family history of
endocarditis are not risk factors for IE.
DIF: Cognitive Level: Application REF: 844 | 845-846
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
2. During the assessment of a patient with infective endocarditis (IE), the nurse would
expect to find
a. a new regurgitant murmur.
b. a pruritic rash on the trunk.
c. involuntary muscle movement.
d. substernal chest pain and pressure.
ANS: A
New regurgitant murmurs occur in IE because vegetation on the valves prevents valve
closure. Substernal chest discomfort, rashes, and involuntary muscle movement are
clinical manifestations of other cardiac disorders such as angina and rheumatic fever.
DIF: Cognitive Level: Comprehension REF: 842-843
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
3. The nurse identifies the nursing diagnosis of decreased cardiac output related to valvular
insufficiency for the patient with infective endocarditis (IE) based on the assessment
finding of
a. fever, chills, and diaphoresis.
b. urine output less than 30 mL/hr.
c. petechiae of the buccal mucosa and conjunctiva.
d. increase in pulse rate of 15 beats/minute with activity.
ANS: B
Test Bank 37-2
Decreased renal perfusion caused by inadequate cardiac output will lead to poor urine
output. Petechiae, fever, chills, and diaphoresis are symptoms of IE but are not caused by
decreased cardiac output. An increase in pulse rate of 15 beats/minute is normal with
exercise
DIF: Cognitive Level: Application REF: 845-846 TOP: Nursing Process:
Diagnosis
MSC: NCLEX: Physiological Integrity
4. When planning care for a patient hospitalized with a streptococcal infective endocarditis
(IE), which intervention will the nurse include?
a. Monitor labs for streptococcal antibodies.
b. Arrange for insertion of a long-term IV catheter.
c. Encourage the patient to get regular aerobic exercise.
d. Teach the importance of completing all oral antibiotics.
ANS: B
Treatment for IE involves 4 to 6 weeks of IV antibiotic therapy in order to eradicate the
bacteria, which will require a long-term IV catheter such as a peripherally inserted central
catheter (PICC) line. Rest periods and limiting physical activity to a moderate level are
recommended during the treatment for IE. Oral antibiotics are not effective in eradicating
the infective bacteria that cause IE. Blood cultures, rather than antibody levels, are used
to monitor the effectiveness of antibiotic therapy.
DIF: Cognitive Level: Application REF: 844-845 TOP: Nursing Process:
Planning
MSC: NCLEX: Physiological Integrity