Download NURS 316B Exam 2 2025: Valvular Heart Disease, Neurological Disorders, and Epilepsy and more Exams Nursing in PDF only on Docsity!
NURS 316B Exam 2 2025 LATEST UPDATE
MULTIPLE CHOICE EXAM WITH RATIONALE
CSUSM 100% ACCURATE SPRING SUMMER
TERM GRADED A (150 QUESTIONS)
What is a characteristic of stenosis in valvular heart disease? A) Loose valve B) Narrowed valve opening C) Valve does not seal properly D) Blood flows backward B) Narrowed valve opening Rationale: Narrowed valve opening, resulting in high resistance to blood flow, is a characteristic of stenosis in valvular heart disease. Loose valve, valve does not seal properly and blood flowing backwards are all characteristics of regurgitant (incompetent) valvular dysfunctions. What is a common cause of acute rheumatic fever? A) Viral infection
B) Group A streptococcal pharyngitis C) Bacterial endocarditis D) Congenital heart defect B) Group A streptococcal pharyngitis Rationale: Acute rheumatic fever occurs in response to untreated and often undiagnosed group A streptococcal pharyngitis. Which of the following is NOT a known etiology of valvular disorders? A) Atherosclerosis B) Hypotension C) MI D) Congenital defects B) Hypotension
Which treatment is used to reduce blood volume overload in valvular disorders? A) Nitrates B) Beta-adrenergic blockers C) Anticoagulants D) Diuretics D) Diuretics Rationale: Diuretics are prescribed for valvular disorders to reduce blood volume overload. Nitrates are used to reduce ischemic chest pain by causing vasodilation. Beta-adrenergic blockers decrease heart rate and decrease peripheral resistance. Anticoagulants reduce clot risk. What is a common symptom of mitral stenosis? A) Abdominal pain B) Dyspnea with exertion C) Chest pain D) Leg pain B) Dyspnea with exertion
Rationale: Clinical presentation of mitral stenosis includes dyspnea with exertion, paroxysmal nocturnal dyspnea, orthopnea, hemoptysis, pitting edema and hepatomegaly. Symptoms related to abnormal breathing are caused by back-up of blood happening from the left atrium back into the lungs. What is a characteristic of mitral insufficiency? A) Narrowed valve opening B) Valve does not close properly C) Valve is too tight D) Blood flows forward efficiently B) Valve does not close properly Rationale: Mitral insufficiency results in "floppy" valves which leads to the valves failing to close. What is a common cause of aortic stenosis? A) Aortic sclerosis B) Diabetes
What is the most common cause of infectious endocarditis? A) Streptococcus pneumoniae B) Staphylococcus aureus C) Escherichia coli D) Pseudomonas aeruginosa B) Staphylococcus aureus No further rationale. Which of the following is part of the pathophysiologic process of infectious endocarditis? A) Smooth surfaces on heart valves B) Formation of vegetations on lining of blood vessels C) Development of septic emboli D) Hypocoagulability C) Development of septic emboli Rationale: Turbulent blood flow → endothelial damage, rough areas cause platelet aggregation and bacteria to accumulate. Vegetation forms on valves.
What is a common sign of infectious endocarditis? A) Abdominal pain B) New heart murmur C) Severe headache D) Leg pain B) New heart murmur Rationale: Sx related to infection (fever), signs of heart failure (fatigue, SOB), or embolism What is a common treatment for infectious endocarditis? A) Antivirals B) High dose antibiotics C) Antifungals D) Antihypertensives B) High dose antibiotics
C) Wernicke sign D) Pulsus paradoxus B) Beck's triad Rationale: Increased pressure on the heart causes these symptoms. Which neurotransmitter is primarily inhibitory in the CNS? A) Acetylcholine B) Dopamine C) Gamma amino butyric acid (GABA) D) Norepinephrine C) Gamma amino butyric acid (GABA) Rationale: In the neurotransmitter table, GABA is the only NT listed that is exclusively inhibitory and acts solely on the CNS. Acetylcholine and Dopamine are modulators (excitatory or inhibitory), while NE is excitatory.
What occurs during depolarization in neurons? A) Potassium efflux B) Sodium influx C) Resting membrane potential D) Refractory period B) Sodium influx Rationale: Positively charged sodium comes in, causing the membrane potential to rise (depolarization). Potassium efflux causes repolarization (positive charge leaving the cell, membrane potential lowers). What is an example of a neurological ion channel disorder? A) Epilepsy B) Multiple Sclerosis (MS) C) Stroke D) Alzheimer's disease A) Epilepsy
D) Hypoglycemia B) Head trauma Rationale: Head trauma is the most common cause of seizures in adults. Febrile seizures are more common with children. Congenital malformation associated seizures develop in infancy. Hypoglycemia as a cause of seizures is associated with degenerative brain disorders, such as Alzheimer's disease. What is a characteristic of tonic seizures? A) Sudden loss of muscle tone B) Stiffening of muscles, loss of consciousness C) Sustained rhythmical jerking D) Brief jerking or stiffening B) Stiffening of muscles, loss of consciousness Rationale: Sustained jerking = clonus, brief jerking = myoclonic, sudden loss of tone = atonic. What is a common cause of status epilepticus in children?
A) Trauma B) Tumor C) Febrile seizures D) Alcohol withdrawal C) Febrile seizures Rationale: Trauma, Tumor, and ETOH withdrawal are common causes for adults. Fever is a common cause of seizures in children. What is a characteristic of ketogenic diet in epilepsy treatment? A) High carbohydrates B) Very-low carbohydrates C) High protein D) Low fat B) Very-low carbohydrates
B) CNS depression C) Hyperactivity D) Increased appetite B) CNS depression Rationale: Phenobarbital depresses the CNS by enhancing GABA (inhibitory). Neuron excitability is reduced. Can cause dependency. Which benzodiazepine is used for status epilepticus? A) Clonazepam (Klonopin) B) Valproic acid C) Diazepam (Valium) D) Alprazolam (Xanax) .C) Diazepam (Valium) Rationale: Valium and Ativan can be used for status epilepticus. Klonopin (Clonazepam) is a benzo used for absence and myoclonic seizures.
What is a common cause of aneurysms? A) Diabetes B) Atherosclerosis C) Hypotension D) Hyperlipidemia B) Atherosclerosis Rationale: Atherosclerosis, smoking, HTN, genetic predisposition and connective tissue disorders (Marfan's syndrome) and complication MI are the common causes of aneurysms. Which location is most commonly associated with aortic aneurysms? A) Cerebral arteries B) Thoracic aorta C) Abdominal aorta D) Femoral arteries C) Abdominal aorta
D) Leg pain A) Abdominal bruit Rationale: The turbulent blood flow of an abdominal aortic aneurysm causes a bruit to be auscultated. A severe headache is a symptom of a specific type of cerebral aneurysm, Subarachnoid hemorrhage (SAH). Chest pain or angina is listed as signs or symptoms of a few valvular heart disease. Leg pain is not listed as a sign or symptom for any infection/inflammatory cardiac conditions or arterial disorders. What is a common cause of aortic dissection? A) Hypotension B) Atherosclerosis C) Diabetes D) Hyperlipidemia B) Atherosclerosis
Rationale: Atherosclerosis weakens the aortic walls creating a risk for dissection. Aortic dissection is a life-threatening condition that occurs when the inner wall of the aorta tears, allowing blood to flow between the layers of the artery wall. The 3 etiologies of aortic dissection listed are HTN, atherosclerosis and genetic predisposition. What sound might a patient hear during an aortic dissection? A) Clicking B) Ripping or tearing C) Humming D) Whistling B) Ripping or tearing Rationale: Aortic dissection presentation includes that patient hears "ripping" or "tearing" sound. Which valve is most affected by valvular heart disease? A) Tricuspid valve and aortic valve B) Pulmonary valve and tricuspid valve
