A nurse is assessing a client who has infective endocarditis. Which of the following findings should be the priority for the nurse to report to the provider?
Splinter hemorrhages to the nails
Fever
Clusters of petechiae in the mouth
Dyspnea
The Correct Answer is D
A. Splinter hemorrhages are a common sign of infective endocarditis but are not immediately life-threatening.
B. Fever is a typical manifestation of infection and expected in infective endocarditis, not a priority unless unresponsive to treatment.
C. Clusters of petechiae in the mouth indicate microemboli or vascular involvement, but they are not an acute threat.
D. Dyspnea is the priority finding because it may indicate heart failure or pulmonary embolism, both of which are serious complications of infective endocarditis and require immediate intervention.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. A friction rub is the characteristic auscultatory finding in pericarditis. It is a high-pitched, scratchy sound heard best at the left lower sternal border and is caused by the inflamed pericardial layers rubbing against each other.
B. Wheezes are continuous, musical sounds usually associated with airway narrowing, such as in asthma or COPD.
C. Rales (crackles) are heard in conditions like pulmonary edema or pneumonia, not pericarditis.
D. Rhonchi are low-pitched, snoring sounds associated with mucus or obstruction in the larger airways.
Correct Answer is C
Explanation
A. Sinus bradycardia is characterized by a heart rate less than 60 beats/min, but in this case the rate is exactly 60, which is normal lower limit.
B. First degree heart block involves a prolonged PR interval (>0.20 seconds); here, the PR interval is normal (0.16 seconds).
C. Normal sinus rhythm has regular P waves and QRS complexes, a normal PR interval (0.12–0.20 seconds), and a heart rate between 60–100 beats/min.
D. Sick sinus syndrome is characterized by irregular rhythms and abnormal sinus node function, which is not indicated here.
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