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Infective Endocarditis

Total questions: 10

Worksheet time: 5mins

Name
Class
Date
1.

A 56-year-old male comes to your clinic requesting advice after recent cardiac surgery. The patient had a longstanding murmur and was diagnosed with mitral stenosis. He eventually underwent repair with a prosthetic valve and his symptoms of dyspnea have resolved. He has resumed physical activity and seeks to maintain his current health. He wants advice on future procedures and possible risk of infection. Which procedure will you advise warrants such treatment solely for endocarditis prophylaxis?

a)

Colonoscopy

b)

Wisdom tooth extraction

c)

Dilatation ureteral stricture

d)

Bronchoscopy without biopsy

2.

After teaching a client who is being discharged home after mitral valve replacement surgery, the nurse assesses the clients understanding. Which client statement indicates a need for additional teaching?

a)

I will be able to carry heavy loads after 6 months of rest.

b)

I will have my teeth cleaned by my dentist in 2 weeks.

c)

I must avoid eating foods high in vitamin K, like spinach.

d)

I must use an electric razor instead of a straight razor to shave.

3.

A patient with endocarditis has listed in their medical history “Roth Spots”. You know that this is a complication of infective endocarditis and presents as?

a)

Non-tender spots found on the feet and hands

b)

Red and tender lesions found in the eyes

c)

Retinal hemorrhages with white centers

d)

Purplish spots found on the forearms and groin

4.

A patient being treated for infective endocarditis is complaining of very sharp radiating abdominal pain that goes to the left shoulder and back. As the nurse familiar with complications of infective endocarditis, what do you suspect is the cause of this patient finding?

a)

Renal embolic event

b)

Pulmonary embolic event

c)

Central nervous system embolic event

d)

Splenic embolic event

5.

A patient is admitted with sepsis. The patient has a temperature of 104.2 ‘F and is experiencing chills. On assessment, you note a mitral murmur which the patient states they’ve never had before, and dark, small lines on the patient’s fingernails. The patient has a history of IV drug use in the past. However, the patient states they are no longer using drugs. The physician suspects possible infective endocarditis. What diagnostic test do you expect the physician to order in order to confirm the presence of infective endocarditis?

a)

Abdominal ultrasound

b)

Heart catheterization

c)

Transesophageal echocardiogram

d)

White blood cell count

6.

A 30 year old female is being treated for infective endocarditis with IV antibiotics. At the beginning of the hospitalization, the patient’s symptoms were severe and sudden with a high fever but are now controlled. She has no significant health history other than 2 cesarean sections in the past. She is being prepped for a central line placement so she can be discharged home with home health to continue the 4 week antibiotic regime. What type of infective endocarditis is this classified as based on the information listed?

a)

Acute Infective Endocarditis

b)

Subacute Infective Endocarditis

c)

Non-infective endocarditis

d)

Pericarditis

7.

Which of these wouldn't be an appropriate investigation of IE?

a)

Blood Culture

b)

Cardiac Angiogram

c)

ECG

d)

Echocardiogram

8.

A 64-year-old man presents to the emergency department with chest pain, fever, fatigue, and arthralgias. His past medical history is significant for rheumatic heart disease and a dental procedure a few weeks before admission. He currently shows no "stigmata" of endocarditis on physical examination, although endocarditis is suspected. The most likely organism is:

a)

Viridans streptococci

b)

Staphylococcus aureus

c)

Enterococcus fecalis

d)

Pseudomonas

9.

In a patient with subacute endocarditis, which of the following laboratory findings do not support the diagnosis?

a)

Leukocytosis

b)

Normocytic, normochromic anemia

c)

Decreased erythrocyte sedimentation rate

d)

Elevated C-reactive protein

10.

A nurse cares for a client with infective endocarditis. Which infection control precautions should the nurse use?

a)

Standard Precautions

b)

Bleeding precautions

c)

Reverse isolation

d)

Contact isolation