A nurse is assessing a client two months after mitral valve replacement. The client complains of malaise, anorexia, weight loss, chills, and fever. The nurse suspects the client may have endocarditis. What other assessment sign is associated with infectious endocarditis?

Muffled heart sounds

Palpitations

Hives

Splinter hemorrhages

Answer and Explanation

The Correct Answer is D

A. Muffled heart sounds are associated with pericardial effusion or tamponade, not infective endocarditis.
B. Palpitations can occur but are not a classic sign of infective endocarditis.
C. Hives suggest an allergic reaction, not endocarditis.
D. Splinter hemorrhages (tiny, red-brown streaks under the nails) are a classic sign of infective endocarditis due to small emboli from the infected heart valves.

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Correct Answer is A

Explanation

A. In a hypertensive emergency, the goal is to reduce blood pressure gradually over 24 to 48 hours to prevent organ damage while avoiding excessive drops that could cause ischemia.
B. Rapid reduction of blood pressure over a few hours can lead to organ hypoperfusion and ischemic complications, such as stroke or acute kidney injury.
C. A 50% reduction in the first hour is too aggressive and may result in severe adverse effects such as cerebral or myocardial ischemia. The recommended initial reduction is no more than 25% in the first hour.
D. Treating hypertension based solely on symptoms is inappropriate, as some patients may be asymptomatic despite dangerously high blood pressure. The focus is on preventing target organ damage.

A. Murmur B. S3 and S4 C. Friction rub D. Click

Correct Answer is A

Explanation

A. A murmur is the expected heart sound in mitral valve regurgitation, caused by the backflow of blood into the left atrium during systole. It is typically a holosystolic murmur heard best at the apex of the heart.
B. S3 and S4 heart sounds may be heard in heart failure but are not specific for mitral regurgitation.
C. A friction rub is associated with pericarditis, not valvular disease.
D. A click is typically heard in mitral valve prolapse, not mitral regurgitation.

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A nurse is assessing a client two months after mitral valve replacement. The client complains of malaise, anorexia, weight loss, chills, and fever. The nurse suspects the client may have endocarditis. What other assessment sign is associated with infectious endocarditis?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client admitted with hypertensive emergency. The nurse is aware the treatment goals for the patient include which of the following?

Correct Answer is A

Explanation

A nurse is assessing a patient with known mitral valve regurgitation. The nurse should expect to hear which of the following heart sounds?

Correct Answer is A

Explanation

A nurse is caring for a client who is receiving intravenous heparin therapy for deep vein thrombosis. The nurse evaluates for side effects of this drug by observing for:

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