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Chapter 105: Infective Endocarditis
from TEST BANK; Buttaro: Primary Care Interprofessional Collaborative Practice 6TH EDITION. All Chapters
by StudyGuide
Buttaro: Primary Care: A Collaborative Practice, 6th Edition
Multiple Choice
1. A patient who is on renal dialysis is diagnosed with infective endocarditis. What causative organisms are more likely in this patient?
a. Enterococcal organisms b. Neisseria gonorrhea c. Pseudomonas aeruginosa d. Staphylococcus aureus
ANS: D a. Extra-cardiac abscess formation b. Haemophilus infection c. Mycotic aneurysm d. Rheumatic heart fever
This patient is more likely to have a health care–associated endocarditis; most of these are caused by S. aureus. Enterococcal organisms are the second highest cause in this population.
2. A patient has been diagnosed with infective endocarditis and is being treated with empirical antibiotics after blood cultures are inconclusive. The patient develops a severe headache along with transient neurologic changes. What is the likely cause of these symptoms?
ANS: C
Patients with mycotic aneurysms will present with symptoms of severe unrelenting headache, neurological changes, and signs of cranial nerve involvement. Extracardiac abscess formation depends on the organ involved. Haemophilus infections cause larger vegetations in the heart. Rheumatic heart fever has a classic group of symptoms involving the skin.
NURSINGTB.COM a. A beta-lactamase-resistant penicillin and an antifungal drug b. Imipenem-cilastatin and ampicillin c. Penicillin G and an aminoglycoside antibiotic d. Vancomycin and quinupristin-dalfopristin
3. A patient has native valve endocarditis (NVE). While blood cultures are pending, which antibiotics will be ordered as empirical treatment?
ANS: C
The most common organism in NVE is S. aureus; until resistance is known, treatment with penicillin G and an aminoglycoside is needed, although most strains causing NVE are not penicillin-resistant. Antifungal infections are rare and antifungal medications are not part of empirical therapy. Imipenem-cilastatin plus ampicillin is given for identified Enterococcus faecalis infection. Vancomycin and quinupristin-dalfopristin is used, with limited evidence for benefit, for Enterococcus faecium infection.
