NSG 430 Adult Health Nursing II Exam 2 Review Questions
and Answers | Verified Solutions with Detailed Rationales
(2026/2027 Edition)
Adult Health Nursing II Examination
Grand Canyon University
NSG 430 – Exam 2
2026/2027 Edition
SECTION 1: Management of Acute Cardiac Disorders Part 1
(Valvular Disorders, Endocarditis, Pericarditis, ADHF, Cardiomyopathy, Pulmonary
Edema)
(10 Questions)
Question 1
A client with severe aortic stenosis reports chest pain. The nurse prepares to administer
nitroglycerin as prescribed. What is the priority nursing action before giving this
medication?
A. Administer the nitroglycerin immediately to relieve chest pain
B. Assess the client's blood pressure and withhold if systolic is below 100 mmHg
C. Verify the prescription and administer with a full glass of water
D. Check the client's oxygen saturation and apply supplemental oxygen
Correct Answer: B
Rationale: In aortic stenosis, the left ventricular outflow obstruction makes the heart
preload-dependent to maintain cardiac output. Nitroglycerin is a venodilator that
reduces preload and can precipitate profound hypotension in these clients. The nurse
must assess blood pressure and withhold the medication if systolic pressure is low.
Option A is incorrect because administering nitroglycerin without assessing
hemodynamic status can cause cardiovascular collapse. Option C is incorrect because
,nitroglycerin is not administered with a full glass of water (it is sublingual or IV). Option
D, while important for chest pain, does not address the specific contraindication of
nitroglycerin in aortic stenosis.
Question 2
Which pathophysiological change best explains why a client with mitral stenosis
develops exertional dyspnea?
A. Left ventricular hypertrophy causing decreased compliance
B. Impaired left atrial emptying leading to increased pulmonary pressures
C. Aortic valve regurgitation causing volume overload
D. Right ventricular dilation leading to systemic congestion
Correct Answer: B
Rationale: Mitral stenosis narrows the mitral valve orifice, impeding blood flow from the
left atrium to the left ventricle. This causes blood to back up into the left atrium and
pulmonary vasculature, increasing pulmonary pressures and causing exertional
dyspnea. Option A describes left ventricular pathology, which is not the primary issue in
mitral stenosis. Option C describes aortic regurgitation, a different valvular disorder.
Option D describes right-sided heart failure, which is a late complication of mitral
stenosis rather than the cause of early exertional dyspnea.
Question 3
A client with a prosthetic mitral valve is scheduled for a dental cleaning. The nurse
recognizes that this procedure places the client at increased risk for which
complication?
A. Acute pulmonary embolism
B. Infective endocarditis
C. Cardiac tamponade
D. Hypertrophic cardiomyopathy
Correct Answer: B
, Rationale: Dental procedures can cause transient bacteremia, which poses a significant
risk for infective endocarditis in clients with prosthetic valves. Current AHA guidelines
recommend antibiotic prophylaxis for these high-risk clients before certain dental
procedures. Option A is incorrect because pulmonary embolism is not directly
associated with dental procedures. Option C is incorrect because cardiac tamponade
results from fluid accumulation in the pericardium, not dental procedures. Option D is
incorrect because hypertrophic cardiomyopathy is a genetic condition unrelated to
dental procedures.
Question 4
A client presents with sharp, pleuritic chest pain that is relieved by leaning forward and
a pericardial friction rub on auscultation. Which condition should the nurse suspect?
A. Acute myocardial infarction
B. Pericarditis
C. Unstable angina
D. Aortic dissection
Correct Answer: B
Rationale: Pleuritic chest pain that is relieved by leaning forward and a pericardial
friction rub are classic findings of pericarditis. The friction rub results from inflamed
pericardial layers rubbing together. Option A is incorrect because MI pain is typically
crushing, substernal, and not relieved by position changes. Option C is incorrect
because unstable angina presents with exertional chest pain, not pleuritic pain. Option
D is incorrect because aortic dissection presents with tearing pain radiating to the back,
not a friction rub.
Question 5
A client post-cardiac surgery develops jugular venous distension to the jaw level,
muffled heart sounds, and hypotension. What is the nurse's immediate priority action?
A. Administer a loop diuretic to reduce fluid overload
and Answers | Verified Solutions with Detailed Rationales
(2026/2027 Edition)
Adult Health Nursing II Examination
Grand Canyon University
NSG 430 – Exam 2
2026/2027 Edition
SECTION 1: Management of Acute Cardiac Disorders Part 1
(Valvular Disorders, Endocarditis, Pericarditis, ADHF, Cardiomyopathy, Pulmonary
Edema)
(10 Questions)
Question 1
A client with severe aortic stenosis reports chest pain. The nurse prepares to administer
nitroglycerin as prescribed. What is the priority nursing action before giving this
medication?
A. Administer the nitroglycerin immediately to relieve chest pain
B. Assess the client's blood pressure and withhold if systolic is below 100 mmHg
C. Verify the prescription and administer with a full glass of water
D. Check the client's oxygen saturation and apply supplemental oxygen
Correct Answer: B
Rationale: In aortic stenosis, the left ventricular outflow obstruction makes the heart
preload-dependent to maintain cardiac output. Nitroglycerin is a venodilator that
reduces preload and can precipitate profound hypotension in these clients. The nurse
must assess blood pressure and withhold the medication if systolic pressure is low.
Option A is incorrect because administering nitroglycerin without assessing
hemodynamic status can cause cardiovascular collapse. Option C is incorrect because
,nitroglycerin is not administered with a full glass of water (it is sublingual or IV). Option
D, while important for chest pain, does not address the specific contraindication of
nitroglycerin in aortic stenosis.
Question 2
Which pathophysiological change best explains why a client with mitral stenosis
develops exertional dyspnea?
A. Left ventricular hypertrophy causing decreased compliance
B. Impaired left atrial emptying leading to increased pulmonary pressures
C. Aortic valve regurgitation causing volume overload
D. Right ventricular dilation leading to systemic congestion
Correct Answer: B
Rationale: Mitral stenosis narrows the mitral valve orifice, impeding blood flow from the
left atrium to the left ventricle. This causes blood to back up into the left atrium and
pulmonary vasculature, increasing pulmonary pressures and causing exertional
dyspnea. Option A describes left ventricular pathology, which is not the primary issue in
mitral stenosis. Option C describes aortic regurgitation, a different valvular disorder.
Option D describes right-sided heart failure, which is a late complication of mitral
stenosis rather than the cause of early exertional dyspnea.
Question 3
A client with a prosthetic mitral valve is scheduled for a dental cleaning. The nurse
recognizes that this procedure places the client at increased risk for which
complication?
A. Acute pulmonary embolism
B. Infective endocarditis
C. Cardiac tamponade
D. Hypertrophic cardiomyopathy
Correct Answer: B
, Rationale: Dental procedures can cause transient bacteremia, which poses a significant
risk for infective endocarditis in clients with prosthetic valves. Current AHA guidelines
recommend antibiotic prophylaxis for these high-risk clients before certain dental
procedures. Option A is incorrect because pulmonary embolism is not directly
associated with dental procedures. Option C is incorrect because cardiac tamponade
results from fluid accumulation in the pericardium, not dental procedures. Option D is
incorrect because hypertrophic cardiomyopathy is a genetic condition unrelated to
dental procedures.
Question 4
A client presents with sharp, pleuritic chest pain that is relieved by leaning forward and
a pericardial friction rub on auscultation. Which condition should the nurse suspect?
A. Acute myocardial infarction
B. Pericarditis
C. Unstable angina
D. Aortic dissection
Correct Answer: B
Rationale: Pleuritic chest pain that is relieved by leaning forward and a pericardial
friction rub are classic findings of pericarditis. The friction rub results from inflamed
pericardial layers rubbing together. Option A is incorrect because MI pain is typically
crushing, substernal, and not relieved by position changes. Option C is incorrect
because unstable angina presents with exertional chest pain, not pleuritic pain. Option
D is incorrect because aortic dissection presents with tearing pain radiating to the back,
not a friction rub.
Question 5
A client post-cardiac surgery develops jugular venous distension to the jaw level,
muffled heart sounds, and hypotension. What is the nurse's immediate priority action?
A. Administer a loop diuretic to reduce fluid overload
