NSG 430 Exam 2 – GCU Adult Health Nursing II – (2026) Actual Questions &
Answers.
Format: Multiple choice questions with correct answers and detailed rationales
for nursing students preparing for proctored exams.
Section 1: Infective Endocarditis (Questions 1-20)
1. 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 ever wake up at night short of breath?"
B. "Have you had dental work done recently?"
C. "How often do you check your blood pressure at home?"
D. "Have you recently traveled outside the country?"
Answer: B. "Have you had dental work done recently?"
Rationale: Dental procedures can cause transient bacteremia, a major risk factor
for infective endocarditis in patients with prosthetic valves. Identifying this
,potential source helps guide diagnosis and prevention. The other questions are
not directly related to the primary risk factor for IE.
2. 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?
A. Weight gain of 2 lb in 2 days
B. Urine output less than 30 mL/hr
C. Heart rate 102 beats/min
D. Crackles at the lung bases
Answer: B. Urine output less than 30 mL/hr
Rationale: Low urine output indicates decreased renal perfusion, a sensitive
indicator of reduced cardiac output. Valvular insufficiency in IE can impair forward
flow, leading to poor organ perfusion and oliguria. While tachycardia and crackles
may also be present, urine output is a more specific indicator of end-organ
perfusion.
,3. 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 blood pressure every 4 hours
B. Administer scheduled antibiotics on time
C. Restrict fluids to 1500 mL/day
D. Encourage ambulation four times daily
Answer: B. Administer scheduled antibiotics on time
Rationale: Timely administration of IV antibiotics is critical for effective treatment
of IE. Antibiotic therapy must be maintained at consistent serum levels to
eradicate the infection. Blood pressure monitoring is important but not the
priority intervention. Fluid restriction and ambulation are not primary
interventions for IE.
4. During the assessment of a 25-year-old patient with infective endocarditis (IE),
what would the nurse expect to find?
A. Bounding peripheral pulses
B. A new regurgitant murmur
, C. Bradycardia with extra heart sounds
D. Clear heart sounds without murmurs
Answer: B. A new regurgitant murmur
Rationale: IE frequently damages valve leaflets, leading to new or changing
murmurs, especially regurgitant murmurs, which are classic physical findings. The
other options are not characteristic findings in IE.
5. A patient with infective endocarditis develops sudden left-sided weakness and
slurred speech. What should the nurse do first?
A. Reassure the patient and continue monitoring
B. Notify the healthcare provider immediately
C. Administer aspirin as ordered for pain
D. Increase the IV fluid rate
Answer: B. Notify the healthcare provider immediately
Answers.
Format: Multiple choice questions with correct answers and detailed rationales
for nursing students preparing for proctored exams.
Section 1: Infective Endocarditis (Questions 1-20)
1. 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 ever wake up at night short of breath?"
B. "Have you had dental work done recently?"
C. "How often do you check your blood pressure at home?"
D. "Have you recently traveled outside the country?"
Answer: B. "Have you had dental work done recently?"
Rationale: Dental procedures can cause transient bacteremia, a major risk factor
for infective endocarditis in patients with prosthetic valves. Identifying this
,potential source helps guide diagnosis and prevention. The other questions are
not directly related to the primary risk factor for IE.
2. 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?
A. Weight gain of 2 lb in 2 days
B. Urine output less than 30 mL/hr
C. Heart rate 102 beats/min
D. Crackles at the lung bases
Answer: B. Urine output less than 30 mL/hr
Rationale: Low urine output indicates decreased renal perfusion, a sensitive
indicator of reduced cardiac output. Valvular insufficiency in IE can impair forward
flow, leading to poor organ perfusion and oliguria. While tachycardia and crackles
may also be present, urine output is a more specific indicator of end-organ
perfusion.
,3. 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 blood pressure every 4 hours
B. Administer scheduled antibiotics on time
C. Restrict fluids to 1500 mL/day
D. Encourage ambulation four times daily
Answer: B. Administer scheduled antibiotics on time
Rationale: Timely administration of IV antibiotics is critical for effective treatment
of IE. Antibiotic therapy must be maintained at consistent serum levels to
eradicate the infection. Blood pressure monitoring is important but not the
priority intervention. Fluid restriction and ambulation are not primary
interventions for IE.
4. During the assessment of a 25-year-old patient with infective endocarditis (IE),
what would the nurse expect to find?
A. Bounding peripheral pulses
B. A new regurgitant murmur
, C. Bradycardia with extra heart sounds
D. Clear heart sounds without murmurs
Answer: B. A new regurgitant murmur
Rationale: IE frequently damages valve leaflets, leading to new or changing
murmurs, especially regurgitant murmurs, which are classic physical findings. The
other options are not characteristic findings in IE.
5. A patient with infective endocarditis develops sudden left-sided weakness and
slurred speech. What should the nurse do first?
A. Reassure the patient and continue monitoring
B. Notify the healthcare provider immediately
C. Administer aspirin as ordered for pain
D. Increase the IV fluid rate
Answer: B. Notify the healthcare provider immediately
