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 ["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.

A. Serum potassium level is 3.0 mEq/L. B. The current blood pressure reading is 168/94 mm Hg. C. Blood glucose level is at 175 mg/dL. D. There’s an orthostatic systolic BP decrease of 12 mm Hg.

Correct Answer is A

Explanation

Furosemide (Lasix) is a diuretic medication used to treat hypertension and edema. One of the side effects of furosemide is hypokalemia, or low potassium levels. A serum potassium level of 3.0 mEq/L is lower than the normal range (3.5 to 5.0 mEq/L), which can lead to serious complications such as cardiac arrhythmias.

Therefore, this observation is crucial to communicate to the healthcare provider.

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

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

Explanation

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

Correct Answer is A

Explanation

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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?