NSG 430 Exam 2: (Latest 2026/2027 Update) Valvular Disease,
Pericarditis, Cardiomyopathy, AKI, & Cardiac Emergencies | Q&A | Grade
A | 100% Correct (Verified Answers)
Subject: Advanced Medical-Surgical / Critical Care
Source: NSG 430 Exam 2 – Comprehensive Review Format: Q&A Guide with Clinical Rationale
1: What are the signs and symptoms of Acute Decompensated Heart Failure (ADHF)?
Correct Answer: Fluid overload, SOB, fatigue.
1. Fluid overload leads to JVD, edema, pulmonary rales, and weight gain.
2. SOB includes dyspnea, orthopnea, and paroxysmal nocturnal dyspnea.
3. Fatigue results from decreased cardiac output and tissue perfusion.
2: What can rheumatic heart disease result in?
Correct Answer: Mitral valve stenosis.
1. Rheumatic fever causes inflammation and scarring of mitral valve leaflets.
2. Leaflets fuse and chordae tendineae shorten and thicken.
3. This is the most common cause of mitral stenosis worldwide.
3: What happens in mitral valve stenosis?
Correct Answer: Stiff valve is unable to open sufficiently during left atrial systole (ejection).
1. Normally mitral valve opens during diastole to allow left atrial emptying.
2. Stenosis obstructs blood flow from LA to LV.
3. Results in LA enlargement, elevated pulmonary pressures, and eventual right heart failure.
4: What is the main symptom of mitral valve stenosis?
Correct Answer: Exertional dyspnea (shortness of breath on exertion).
1. Exertion increases heart rate, decreasing diastolic filling time.
2. Reduced filling time worsens LA pressure elevation.
3. Leads to pulmonary congestion and dyspnea.
5: Why do you do prophylactic antibiotic therapy for mitral valve stenosis?
Correct Answer: Prevent recurrent rheumatic fever and infective endocarditis.
1. Prevention of recurrent rheumatic fever requires antibiotic prophylaxis.
2. Mitral stenosis increases risk of infective endocarditis.
3. Antibiotics before dental/invasive procedures for at-risk patients.
, 6: What drug do you teach benefits and side effects for in mitral valve stenosis?
Correct Answer: ACE inhibitors.
1. ACE inhibitors reduce afterload and pulmonary congestion.
2. They improve symptoms and delay disease progression.
3. Teach about cough, angioedema, hyperkalemia, and hypotension.
7: What is surgical therapy for mitral valve stenosis?
Correct Answer: Valve replacement or valvuloplasty.
1. Valvuloplasty is balloon dilation of stenotic valve (percutaneous or surgical).
2. Valve replacement with mechanical or bioprosthetic valve.
3. Mechanical valves require lifelong anticoagulation.
8: What do you need to tell patients after getting a valve replacement?
Correct Answer: Patient will need to be on lifelong anticoagulant therapy because clots
form more easily in artificial replacement valves.
1. Mechanical valves are thrombogenic; require warfarin (INR 2.5-3.5).
2. Bioprosthetic valves require short-term anticoagulation only.
3. Monitor for bleeding signs and avoid activities that increase bleeding risk.
9: What is pericarditis?
Correct Answer: Inflammation of the pericardium.
1. Pericardium is double-layered sac surrounding the heart.
2. Inflammation causes chest pain and friction rub.
3. May lead to pericardial effusion and cardiac tamponade.
10: What does the pericardium do?
Correct Answer: Holds serous fluid and anchors and provides lubrication to decrease
friction between heart contractures.
1. The pericardium stabilizes the heart within the mediastinum.
2. Serous fluid reduces friction during cardiac contractions.
3. Protects against infection and limits cardiac distention.
11: What is the most common cause of pericarditis?
Correct Answer: Infectious (viral & bacterial).
1. Viral causes: Coxsackievirus, echovirus, influenza, HIV.
2. Bacterial: Mycobacterium tuberculosis, pneumococcus.
3. Other causes: post-MI (Dressler), uremia, autoimmune, trauma, malignancy.
Pericarditis, Cardiomyopathy, AKI, & Cardiac Emergencies | Q&A | Grade
A | 100% Correct (Verified Answers)
Subject: Advanced Medical-Surgical / Critical Care
Source: NSG 430 Exam 2 – Comprehensive Review Format: Q&A Guide with Clinical Rationale
1: What are the signs and symptoms of Acute Decompensated Heart Failure (ADHF)?
Correct Answer: Fluid overload, SOB, fatigue.
1. Fluid overload leads to JVD, edema, pulmonary rales, and weight gain.
2. SOB includes dyspnea, orthopnea, and paroxysmal nocturnal dyspnea.
3. Fatigue results from decreased cardiac output and tissue perfusion.
2: What can rheumatic heart disease result in?
Correct Answer: Mitral valve stenosis.
1. Rheumatic fever causes inflammation and scarring of mitral valve leaflets.
2. Leaflets fuse and chordae tendineae shorten and thicken.
3. This is the most common cause of mitral stenosis worldwide.
3: What happens in mitral valve stenosis?
Correct Answer: Stiff valve is unable to open sufficiently during left atrial systole (ejection).
1. Normally mitral valve opens during diastole to allow left atrial emptying.
2. Stenosis obstructs blood flow from LA to LV.
3. Results in LA enlargement, elevated pulmonary pressures, and eventual right heart failure.
4: What is the main symptom of mitral valve stenosis?
Correct Answer: Exertional dyspnea (shortness of breath on exertion).
1. Exertion increases heart rate, decreasing diastolic filling time.
2. Reduced filling time worsens LA pressure elevation.
3. Leads to pulmonary congestion and dyspnea.
5: Why do you do prophylactic antibiotic therapy for mitral valve stenosis?
Correct Answer: Prevent recurrent rheumatic fever and infective endocarditis.
1. Prevention of recurrent rheumatic fever requires antibiotic prophylaxis.
2. Mitral stenosis increases risk of infective endocarditis.
3. Antibiotics before dental/invasive procedures for at-risk patients.
, 6: What drug do you teach benefits and side effects for in mitral valve stenosis?
Correct Answer: ACE inhibitors.
1. ACE inhibitors reduce afterload and pulmonary congestion.
2. They improve symptoms and delay disease progression.
3. Teach about cough, angioedema, hyperkalemia, and hypotension.
7: What is surgical therapy for mitral valve stenosis?
Correct Answer: Valve replacement or valvuloplasty.
1. Valvuloplasty is balloon dilation of stenotic valve (percutaneous or surgical).
2. Valve replacement with mechanical or bioprosthetic valve.
3. Mechanical valves require lifelong anticoagulation.
8: What do you need to tell patients after getting a valve replacement?
Correct Answer: Patient will need to be on lifelong anticoagulant therapy because clots
form more easily in artificial replacement valves.
1. Mechanical valves are thrombogenic; require warfarin (INR 2.5-3.5).
2. Bioprosthetic valves require short-term anticoagulation only.
3. Monitor for bleeding signs and avoid activities that increase bleeding risk.
9: What is pericarditis?
Correct Answer: Inflammation of the pericardium.
1. Pericardium is double-layered sac surrounding the heart.
2. Inflammation causes chest pain and friction rub.
3. May lead to pericardial effusion and cardiac tamponade.
10: What does the pericardium do?
Correct Answer: Holds serous fluid and anchors and provides lubrication to decrease
friction between heart contractures.
1. The pericardium stabilizes the heart within the mediastinum.
2. Serous fluid reduces friction during cardiac contractions.
3. Protects against infection and limits cardiac distention.
11: What is the most common cause of pericarditis?
Correct Answer: Infectious (viral & bacterial).
1. Viral causes: Coxsackievirus, echovirus, influenza, HIV.
2. Bacterial: Mycobacterium tuberculosis, pneumococcus.
3. Other causes: post-MI (Dressler), uremia, autoimmune, trauma, malignancy.
