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 D

Explanation

Choice A rationale
Iron supplements for anemia do not typically interact with warfarin (Coumadin). Iron is a mineral that is essential for the production of red blood cells, and supplements are often prescribed to patients with anemia to increase their iron levels. While it’s important for healthcare providers to be aware of all medications and supplements a patient is taking, iron supplements are not known to diminish the effects of warfarin.
Choice B rationale
Furosemide (Lasix) is a diuretic medication used to treat fluid retention. It works by causing the kidneys to get rid of unneeded water and salt from the body into the urine. While furosemide can interact with other medications, it is not known to diminish the effects of warfarin.
Choice C rationale
Simvastatin (Zocor) is a medication used to control cholesterol levels. It works by slowing the production of cholesterol in the body to decrease the amount of cholesterol that may build up on the walls of the arteries and block blood flow to the heart, brain, and other parts of the body. Simvastatin does not typically interact with warfarin to diminish its effects.
Choice D rationale
Yaz (drospirenone/estradiol) is an oral contraceptive that contains estrogen. Estrogen can potentially increase the effects of warfarin, leading to an increased risk of bleeding. Therefore, if a patient taking warfarin also takes Yaz, it could potentially diminish the effects of warfarin, making it less effective. This is why it’s important for healthcare providers to be aware of all medications a patient is taking, including oral contraceptives.

A. Rheumatoid arthritis. B. Coarctation of the aorta. C. Increased intracranial pressure (ICP). D. Renal disease. E. Colon cancer.

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

Explanation

Choice A rationale
Rheumatoid arthritis is an autoimmune disease that primarily affects the joints. While it can increase the risk of cardiovascular disease due to systemic inflammation, it is not typically considered a direct cause of secondary hypertension.
Choice B rationale
Coarctation of the aorta, a congenital condition characterized by a narrowing of the aorta, can cause secondary hypertension. This is because the narrowing can increase resistance to blood flow, leading to increased pressure.
Choice C rationale
Increased intracranial pressure (ICP) can cause secondary hypertension as part of Cushing’s reflex, a physiological response to protect the brain from damage. This reflex can lead to an increase in systemic blood pressure in an attempt to maintain cerebral perfusion.
Choice D rationale
Renal disease is a common cause of secondary hypertension. The kidneys play a crucial role in regulating blood pressure, and damage to the kidneys can lead to hypertension.
Choice E rationale
Colon cancer is not typically associated with secondary hypertension. While some cancers can produce substances that increase blood pressure, colon cancer is not commonly associated with this phenomenon.

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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

Which medication, when noted in a patient’s history, will diminish the effects of Warfarin (Coumadin)?

Correct Answer is D

Explanation

Which of the following conditions are potential causes of secondary hypertension? (Select all that apply)

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

Explanation

The standard policy on the cardiac unit states, “Notify the health care provider for mean arterial pressure (MAP) less than 70 mm Hg.”. Which patient should the nurse call the health care provider about?

A patient with angina pectoris is experiencing chest pain at rest and needs to take three nitroglycerin (NTG) pills to relieve the pain. What should the nurse consider this as a major symptom of?

The nurse is reviewing the laboratory test results for a patient who has recently been diagnosed with hypertension. Which result is most important to communicate to the health care provider?

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?

What is the primary therapeutic goal for secondary hypertension?

Which sequence best describes the direction of blood flow through the heart and lungs?

A patient with severe pericarditis has developed a large pericardial effusion and is symptomatic. What type of procedure should the physician order to help treat this condition?

When assessing a male patient in the telemetry unit who is experiencing persistent, crushing chest pain, which symptoms would lead the nurse to suspect a myocardial infarction?

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?