1
LEWIS MEDICAL SURGICAL NURSING 2025/2026 LATEST
QUESTIONS & ANSWERS 100% ACCURATE SOLUTIONS FOR
GUARANTEED SUCCESS | EXPERT-VERIFIED, GRADED A+
The nurse identifies the nursing diagnosis of decreased cardiac output related to
valvular insufficiency for the patient with infective endocarditis (IE) based on
which assessment finding(s)?
a. Fever, chills, and diaphoresis
b. Urine output less than 30 mL/hr
c. Petechiae on the inside of the mouth and conjunctiva
d. Increase in heart rate of 15 beats/minute with walking
ANS: B
Decreased renal perfusion caused by inadequate cardiac output will lead to
decreased urine output. Petechiae, fever, chills, and diaphoresis are symptoms of
IE, but are not caused by decreased cardiac output. An increase in pulse rate of 15
beats/minute is normal with exercise.
The nurse obtains a health history from a 65-year-old patient with a prosthetic
mitral valve who has symptoms of infective endocarditis (IE). Which question by
the nurse is most appropriate?
a. "Do you have a history of a heart attack?"
, 2
b. "Is there a family history of endocarditis?"
c. "Have you had any recent immunizations?"
d. "Have you had dental work done recently?"
ANS: d.
Dental procedures place the patient with a prosthetic mitral valve at risk for
infective endocarditis (IE). Myocardial infarction (MI), immunizations, and a family
history of endocarditis are not risk factors for IE.
During the assessment of a 25-year-old patient with infective endocarditis (IE), the
nurse would expect to find
a. substernal chest pressure.
b. a new regurgitant murmur.
c. a pruritic rash on the chest.
d. involuntary muscle movement.
ANS: B
New regurgitant murmurs occur in IE because vegetations on the valves prevent
valve closure. Substernal chest discomfort, rashes, and involuntary muscle
movement are clinical manifestations of other cardiac disorders such as angina
and rheumatic fever.
When planning care for a patient hospitalized with a streptococcal infective
endocarditis (IE), which intervention is a priority for the nurse to include?
a. Monitor labs for streptococcal antibodies.
b. Arrange for placement of a long-term IV catheter.
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c. Teach the importance of completing all oral antibiotics.
d. Encourage the patient to begin regular aerobic exercise.
ANS: B
Treatment for IE involves 4 to 6 weeks of IV antibiotic therapy in order to eradicate
the bacteria, which will require a long-term IV catheter such as a peripherally
inserted central catheter (PICC) line. Rest periods and limiting physical activity to a
moderate level are recommended during the treatment for IE. Oral antibiotics are
not effective in eradicating the infective bacteria that cause IE. Blood cultures,
rather than antibody levels, are used to monitor the effectiveness of antibiotic
therapy.
A patient is admitted to the hospital with possible acute pericarditis. The nurse
should plan to teach the patient about the purpose of
a. echocardiography.
b. daily blood cultures.
c. cardiac catheterization.
d. 24-hour Holter monitor.
ANS: A
Echocardiograms are useful in detecting the presence of the pericardial effusions
associated with pericarditis. Blood cultures are not indicated unless the patient
has evidence of sepsis. Cardiac catheterization and 24-hour Holter monitor is not
a diagnostic procedure for pericarditis.
To assess the patient with pericarditis for evidence of a pericardial friction rub, the
nurse should
a. listen for a rumbling, low-pitched, systolic murmur over the left anterior chest.
b. auscultate by placing the diaphragm of the stethoscope on the lower left
sternal border.
LEWIS MEDICAL SURGICAL NURSING 2025/2026 LATEST
QUESTIONS & ANSWERS 100% ACCURATE SOLUTIONS FOR
GUARANTEED SUCCESS | EXPERT-VERIFIED, GRADED A+
The nurse identifies the nursing diagnosis of decreased cardiac output related to
valvular insufficiency for the patient with infective endocarditis (IE) based on
which assessment finding(s)?
a. Fever, chills, and diaphoresis
b. Urine output less than 30 mL/hr
c. Petechiae on the inside of the mouth and conjunctiva
d. Increase in heart rate of 15 beats/minute with walking
ANS: B
Decreased renal perfusion caused by inadequate cardiac output will lead to
decreased urine output. Petechiae, fever, chills, and diaphoresis are symptoms of
IE, but are not caused by decreased cardiac output. An increase in pulse rate of 15
beats/minute is normal with exercise.
The nurse obtains a health history from a 65-year-old patient with a prosthetic
mitral valve who has symptoms of infective endocarditis (IE). Which question by
the nurse is most appropriate?
a. "Do you have a history of a heart attack?"
, 2
b. "Is there a family history of endocarditis?"
c. "Have you had any recent immunizations?"
d. "Have you had dental work done recently?"
ANS: d.
Dental procedures place the patient with a prosthetic mitral valve at risk for
infective endocarditis (IE). Myocardial infarction (MI), immunizations, and a family
history of endocarditis are not risk factors for IE.
During the assessment of a 25-year-old patient with infective endocarditis (IE), the
nurse would expect to find
a. substernal chest pressure.
b. a new regurgitant murmur.
c. a pruritic rash on the chest.
d. involuntary muscle movement.
ANS: B
New regurgitant murmurs occur in IE because vegetations on the valves prevent
valve closure. Substernal chest discomfort, rashes, and involuntary muscle
movement are clinical manifestations of other cardiac disorders such as angina
and rheumatic fever.
When planning care for a patient hospitalized with a streptococcal infective
endocarditis (IE), which intervention is a priority for the nurse to include?
a. Monitor labs for streptococcal antibodies.
b. Arrange for placement of a long-term IV catheter.
, 3
c. Teach the importance of completing all oral antibiotics.
d. Encourage the patient to begin regular aerobic exercise.
ANS: B
Treatment for IE involves 4 to 6 weeks of IV antibiotic therapy in order to eradicate
the bacteria, which will require a long-term IV catheter such as a peripherally
inserted central catheter (PICC) line. Rest periods and limiting physical activity to a
moderate level are recommended during the treatment for IE. Oral antibiotics are
not effective in eradicating the infective bacteria that cause IE. Blood cultures,
rather than antibody levels, are used to monitor the effectiveness of antibiotic
therapy.
A patient is admitted to the hospital with possible acute pericarditis. The nurse
should plan to teach the patient about the purpose of
a. echocardiography.
b. daily blood cultures.
c. cardiac catheterization.
d. 24-hour Holter monitor.
ANS: A
Echocardiograms are useful in detecting the presence of the pericardial effusions
associated with pericarditis. Blood cultures are not indicated unless the patient
has evidence of sepsis. Cardiac catheterization and 24-hour Holter monitor is not
a diagnostic procedure for pericarditis.
To assess the patient with pericarditis for evidence of a pericardial friction rub, the
nurse should
a. listen for a rumbling, low-pitched, systolic murmur over the left anterior chest.
b. auscultate by placing the diaphragm of the stethoscope on the lower left
sternal border.
