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 C

Explanation

A. Holding all medications is not necessary; only certain medications that affect heart rate or blood pressure are held.
B. Keflex (Cephalexin) is an antibiotic and does not affect stress test results, so it should not be held.
C. Tenormin (Atenolol) is a beta-blocker that reduces heart rate and can interfere with the stress test by blunting the expected heart rate response. Beta-blockers are typically held before an exercise stress test.
D. Heparin is an anticoagulant and does not impact the stress test results.

A. Mix potassium in 1 liter of normal saline. B. Call the physician for order clarification. C. Prepare 20 mEq of Potassium to give IV push. D. Give the medication as ordered.

Correct Answer is B

Explanation

A. While potassium is typically diluted in IV fluids, the concentration and infusion rate must be clarified before administration. A standard dilution is 10 mEq in 100 mL or 40 mEq in 1L, but this must be verified.
B. Calling the physician for clarification is the safest step. IV potassium should never be given undiluted or as an IV push due to the risk of fatal cardiac arrhythmias.
C. IV push potassium is never appropriate as it can cause cardiac arrest.
D. Administering the undiluted 20 mEq/mL solution is dangerous and requires proper dilution before administration.

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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 who is scheduled for an exercise stress test. Which of the following medications should the nurse hold the morning of the stress test?

Correct Answer is C

Explanation

A nurse is caring for a client who is ordered Potassium 40 mEq IV. On hand is Potassium Chloride 20 mEq/mL. What is the nurse’s next action?

Correct Answer is B

Explanation

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