,NSG 430 Exam 2 | Adult Health Nursing II | Grand
Canyon University | Q & A | 2026/2027 Edition (PDF)
1. A nurse is assessing a patient with mitral stenosis. Which finding is most consistent with this valvular
disorder?
A) A loud, holosystolic murmur at the apex
B) An opening snap and a diastolic rumble murmur at the apex
C) A systolic ejection murmur at the right upper sternal border
D) A continuous murmur heard throughout systole and diastole
Correct Answer: An opening snap and a diastolic rumble murmur at the apex
Rationale: Mitral stenosis is characterized by an opening snap followed by a low-pitched diastolic rumble
murmur heard best at the apex. The obstruction of blood flow from the left atrium to the left ventricle
during diastole creates this murmur. The other options describe murmurs associated with mitral
regurgitation, aortic stenosis, and patent ductus arteriosus, respectively.
2. 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?"
Correct Answer: "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 most common risk factor for IE in this
population.
,3. The nurse identifies the nursing diagnosis of decreased cardiac output related to valvular insufficiency
for a 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
Correct Answer: 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.
Weight gain, tachycardia, and crackles are also signs of heart failure but are not the most direct
indicators of decreased cardiac output.
4. A patient with infective endocarditis is prescribed antibiotics. Which instruction should the nurse
include in the discharge teaching?
A) "You should stop the antibiotics when you feel better."
B) "You should complete the full course of antibiotics."
C) "You should take the antibiotics with food."
D) "You should double the dose if you miss a dose."
Correct Answer: "You should complete the full course of antibiotics."
Rationale: Completing the full course of antibiotics is essential to eradicate the infection and prevent
relapse or complications. Patients should not stop antibiotics early, even if they feel better.
5. A patient with pericarditis is experiencing chest pain. Which intervention is most appropriate for pain
management?
A) Placing the patient in a supine position
B) Administering a nonsteroidal anti-inflammatory drug (NSAID)
C) Encouraging the patient to take deep breaths
, D) Applying a heating pad to the chest
Correct Answer: Administering a nonsteroidal anti-inflammatory drug (NSAID)
Rationale: NSAIDs are the mainstay of treatment for pericarditis to reduce inflammation and relieve
pain. The pain of pericarditis is often relieved by sitting upright and leaning forward, not by lying supine.
Deep breathing can worsen the pain, and heating pads are not the primary treatment.
6. A patient with pericarditis is placed in a high-Fowler's position. The nurse understands that this
position is beneficial because it:
A) Decreases venous return to the heart
B) Increases cardiac output
C) Reduces friction between the pericardial layers
D) Prevents the development of pericardial effusion
Correct Answer: Reduces friction between the pericardial layers
Rationale: High-Fowler's position (sitting upright and leaning forward) reduces friction between the
inflamed pericardial layers by allowing the heart to rest against the chest wall, which decreases the pain
associated with pericarditis. It does not primarily decrease venous return, increase cardiac output, or
prevent pericardial effusion.
7. A patient is diagnosed with acute decompensated heart failure (ADHF). Which assessment finding is
most consistent with this condition?
A) Peripheral edema and weight gain
B) Dry cough and fever
C) Hypotension and bradycardia
D) Hyperglycemia and polyuria
Correct Answer: Peripheral edema and weight gain
Canyon University | Q & A | 2026/2027 Edition (PDF)
1. A nurse is assessing a patient with mitral stenosis. Which finding is most consistent with this valvular
disorder?
A) A loud, holosystolic murmur at the apex
B) An opening snap and a diastolic rumble murmur at the apex
C) A systolic ejection murmur at the right upper sternal border
D) A continuous murmur heard throughout systole and diastole
Correct Answer: An opening snap and a diastolic rumble murmur at the apex
Rationale: Mitral stenosis is characterized by an opening snap followed by a low-pitched diastolic rumble
murmur heard best at the apex. The obstruction of blood flow from the left atrium to the left ventricle
during diastole creates this murmur. The other options describe murmurs associated with mitral
regurgitation, aortic stenosis, and patent ductus arteriosus, respectively.
2. 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?"
Correct Answer: "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 most common risk factor for IE in this
population.
,3. The nurse identifies the nursing diagnosis of decreased cardiac output related to valvular insufficiency
for a 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
Correct Answer: 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.
Weight gain, tachycardia, and crackles are also signs of heart failure but are not the most direct
indicators of decreased cardiac output.
4. A patient with infective endocarditis is prescribed antibiotics. Which instruction should the nurse
include in the discharge teaching?
A) "You should stop the antibiotics when you feel better."
B) "You should complete the full course of antibiotics."
C) "You should take the antibiotics with food."
D) "You should double the dose if you miss a dose."
Correct Answer: "You should complete the full course of antibiotics."
Rationale: Completing the full course of antibiotics is essential to eradicate the infection and prevent
relapse or complications. Patients should not stop antibiotics early, even if they feel better.
5. A patient with pericarditis is experiencing chest pain. Which intervention is most appropriate for pain
management?
A) Placing the patient in a supine position
B) Administering a nonsteroidal anti-inflammatory drug (NSAID)
C) Encouraging the patient to take deep breaths
, D) Applying a heating pad to the chest
Correct Answer: Administering a nonsteroidal anti-inflammatory drug (NSAID)
Rationale: NSAIDs are the mainstay of treatment for pericarditis to reduce inflammation and relieve
pain. The pain of pericarditis is often relieved by sitting upright and leaning forward, not by lying supine.
Deep breathing can worsen the pain, and heating pads are not the primary treatment.
6. A patient with pericarditis is placed in a high-Fowler's position. The nurse understands that this
position is beneficial because it:
A) Decreases venous return to the heart
B) Increases cardiac output
C) Reduces friction between the pericardial layers
D) Prevents the development of pericardial effusion
Correct Answer: Reduces friction between the pericardial layers
Rationale: High-Fowler's position (sitting upright and leaning forward) reduces friction between the
inflamed pericardial layers by allowing the heart to rest against the chest wall, which decreases the pain
associated with pericarditis. It does not primarily decrease venous return, increase cardiac output, or
prevent pericardial effusion.
7. A patient is diagnosed with acute decompensated heart failure (ADHF). Which assessment finding is
most consistent with this condition?
A) Peripheral edema and weight gain
B) Dry cough and fever
C) Hypotension and bradycardia
D) Hyperglycemia and polyuria
Correct Answer: Peripheral edema and weight gain
