The nurse is conducting a physical assessment on a client with infective endocarditis (IE). The nurse observes flat, reddened, non-tender maculae on the hands and feet.

What does the nurse understand these to be?

Heberden’s nodes.

Bouchard’s nodes.

Janeway lesions.

Tophi.

Answer and Explanation

The Correct Answer is C

Choice A rationale
Heberden’s nodes are bony swellings that occur at the distal interphalangeal finger joint, a sign of osteoarthritis. They are not associated with infective endocarditis (IE).
Choice B rationale
Bouchard’s nodes are similar to Heberden’s nodes but occur at the proximal interphalangeal finger joint. They are also a sign of osteoarthritis and not associated with IE.
Choice C rationale
Janeway lesions are flat, painless, red or purple spots on the palms of the hands or the soles of the feet. They are associated with IE and are caused by septic emboli which are small clots filled with bacteria. These emboli can lodge in small blood vessels, causing these characteristic lesions.
Choice D rationale
Tophi are hard, uric acid deposits under the skin. They are a sign of chronic gout, not IE.

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Correct Answer is A

Explanation

Choice A rationale
The apical pulse, also known as the point of maximal impulse (PMI), is located at the fifth intercostal space at the left midclavicular line. This is the location where the heartbeat is strongest and is the standard location for assessing the apical heart rate.
Choice B rationale
Placing the stethoscope directly over the heart on the sternum is not the standard method for assessing the apical heart rate. While the sternum is close to the heart, it is not the location where the heartbeat is strongest or most easily heard.
Choice C rationale
The right side at the midclavicular line, fourth intercostal space, is not the standard location for assessing the apical heart rate. The heart is located more towards the left side of the chest, and the apical pulse is typically not as easily heard on the right side.
Choice D rationale
The midaxillary line on the left side is not the standard location for assessing the apical heart rate. While this location is on the left side of the chest, it is not where the heartbeat is strongest or most easily heard.

A. Promoting a diet high in saturated fats. B. Advising smoking cessation. C. Educating about the importance of regular blood pressure monitoring. D. Instructing on the importance of regular cholesterol screenings. E. Encouraging regular physical exercise.

Correct Answer is ["B","C","D","E"]

Explanation

Choice A rationale
Promoting a diet high in saturated fats is not a recommended strategy for preventing cardiovascular disease. Saturated fats can raise the level of cholesterol in your blood and increase your risk of heart disease and stroke.
Choice B rationale
Advising smoking cessation is a crucial intervention in preventing cardiovascular disease. Chemicals in tobacco can damage the heart and blood vessels, leading to narrowing of the arteries (atherosclerosis). Atherosclerosis can ultimately lead to a heart attack.
Choice C rationale
Regular blood pressure monitoring is important because high blood pressure is a significant risk factor for heart disease. It can cause the arteries that supply blood to your heart muscle to harden and narrow, leading to a heart attack.
Choice D rationale
Regular cholesterol screenings are essential because high levels of cholesterol can lead to the buildup of plaques in your arteries, increasing your risk of heart disease.
Choice E rationale
Encouraging regular physical exercise is a key strategy in preventing cardiovascular disease. Regular exercise helps control your weight and reduce your chances of developing other conditions that may put a strain on your heart, such as high blood pressure, high cholesterol, and diabetes.

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The nurse is conducting a physical assessment on a client with infective endocarditis (IE). The nurse observes flat, reddened, non-tender maculae on the hands and feet. What does the nurse understand these to be?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

In the context of interprofessional care of the client and family, where should a nurse position the stethoscope on the chest to assess a client’s apical heart rate?

Correct Answer is A

Explanation

When teaching clients in a community-based setting strategies for preventing cardiovascular disease, which interventions should the nurse include?

Correct Answer is ["B","C","D","E"]

Explanation

Diltiazem (Cardizem) has been prescribed for a patient newly diagnosed with Prinzmetal’s (variant) angina. What accurate action of diltiazem should the nurse include in the teaching plan?

In the context of a patient undergoing IV furosemide (Lasix) treatment for hypertension, which observation is most crucial to communicate to the healthcare provider?

Which patient statement would help the nurse confirm a previous diagnosis of chronic stable angina?

You are providing care to a patient with pericarditis. Which of the following is NOT a proper nursing intervention for this patient?

A patient newly admitted with pulmonary edema is due to receive several medications. Which medication should the nurse efore administration?

What is included in the first-line therapeutic approach to lowering blood pressure in a patient diagnosed with essential hypertension? (Select all that apply)

A nurse in the Emergency Department is evaluating a patient’s cardiac rhythm. What is the correct interpretation of the rhythm and the appropriate treatment?

Given the electrocardiogram tracing below for a client who is unresponsive and without a pulse, what should be the nurse’s priority action?

The nurse is conducting a physical assessment on a client with infective endocarditis (IE). The nurse observes flat, reddened, non-tender maculae on the hands and feet.

What does the nurse understand these to be?