NURS 5220 QUIZ 2 REVIEW QUESTIONS
AND CORRECT ANSWERS | 2026
UPDATED | 100% CORRECT - UTA.
95 Questions with Answers and Detailed Rationales
100 PERCENT GUARANTEED PASS
INSTANT DOWNLOAD ANSWERS INCLUDED
IMPORTANCE OF THIS DOCUMENT
This comprehensive examination preparation guide has been meticulously developed to help you succeed in the
NURS 5220 QUIZ 2 REVIEW QUESTIONS AND CORRECT ANSWERS | 2026 UPDATED | 100% CORRECT -
UTA.. It contains 95 carefully selected questions that reflect the most current exam content and testing strategies.
Each question is accompanied by a correct answer and a detailed rationale that explains the underlying
pathophysiology, pharmacology, or clinical reasoning.
Self-Assessment – Test your knowledge and Exam Preparation – Familiarize yourself with the
identify areas requiring further question format and content
study areas
Concept Reinforcement – Deepen your Confidence Building – Develop test-taking
understanding through strategies and reduce
evidence-based exam anxiety
rationales
Time Management – Practice answering
questions under simulated
exam conditions
Review Summary 95 Questions
Foundations - Application - NURS 5220 2 Review AND Correct 2026 Updated 100 Correct - UTA Nursing
Pharmacology AND Therapeutics Graduate
All answers with rationales
,Table of Contents
Content Area Questions Key Topics
Health Assessment 1-16 Explains, Phenytoin, Chronic, Effect, Warfarin
Techniques
Cardiovascular System 17-32 Appropriate, Infusion, Heart, Prescribed, Combination
Respiratory System 33-48 Heart Failure, Diabetes, Reduced Ejection Fraction, Appropriate,
Considered
Neurological System 49-64 Likely, Medication, Concentration, Cause, Receiving
Gastrointestinal System 65-80 Effect, Explains, Disease, Therapy, Adverse
Musculoskeletal System 81-95 Started, Effect, Explains, Important, Therapy
TOTAL 95 All questions include answers and detailed rationales
,Section A - Health Assessment Techniques
Q1.
Which of the following best explains why a patient with chronic heart failure may require
higher doses of loop diuretics to achieve the same diuretic effect as a healthy individual?
A. Decreased renal blood flow leads to B. Upregulation of sodium-chloride
reduced delivery of the drug to its site of symporters in the thick ascending limb
action. increases drug target availability.
C. Increased albuminuria enhances renal D. Enhanced tubular secretion of organic
clearance of the drug. acids competes with the drug for transport.
Correct: A - Decreased renal blood flow leads to reduced delivery of the drug to its site of
action.
Rationale:In chronic heart failure, reduced cardiac output decreases renal perfusion, limiting
the amount of loop diuretic reaching the tubular lumen where it acts. This pharmacokinetic
alteration reduces diuretic efficacy, necessitating higher doses. The other options do not
accurately describe the pathophysiologic adaptation in heart failure.
Why the other answers are wrong:
B. Loop diuretics inhibit the Na+-K+-2Cl- symporter; upregulation would increase, not
decrease, sensitivity.
C. Albuminuria does not significantly alter loop diuretic pharmacokinetics.
D. Loop diuretics are secreted via organic anion transporters; competition would reduce, not
increase, the required dose.
Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th ed., Ch. 40.
Q2.
A patient on warfarin is started on a short course of trimethoprim-sulfamethoxazole for a
urinary tract infection. Which of the following mechanisms most directly contributes to the
enhanced anticoagulant effect?
A. Trimethoprim inhibits CYP2C9, reducing B. Sulfamethoxazole displaces warfarin from
warfarin metabolism. plasma albumin.
C. The antibiotic disrupts gut flora, D. Trimethoprim inhibits renal tubular
decreasing vitamin K synthesis. secretion of warfarin.
Correct: A - Trimethoprim inhibits CYP2C9, reducing warfarin metabolism.
Page 3
, Section A - Health Assessment Techniques
Rationale: Trimethoprim-sulfamethoxazole, particularly trimethoprim, inhibits CYP2C9, the
major enzyme responsible for metabolizing the more potent S-enantiomer of warfarin. This
inhibition increases warfarin levels and INR. While sulfonamides can displace protein-bound
drugs and antibiotics may reduce vitamin K production, the primary and most direct
mechanism is CYP2C9 inhibition.
Why the other answers are wrong:
B. Protein binding displacement is transient and rarely causes clinically significant bleeding.
C. Although possible, the effect on vitamin K is less direct and slower than enzyme inhibition.
D. Warfarin is not significantly renally secreted; this is not a relevant mechanism.
Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th ed., Ch. 34.
Q3.
A patient with type 2 diabetes and chronic kidney disease (eGFR 25 mL/min) is prescribed
metformin. Which of the following statements is most accurate regarding this therapy?
A. Metformin is contraindicated due to B. Metformin is safe if the dose is reduced
increased risk of lactic acidosis. and renal function is monitored.
C. Metformin should be avoided because it D. Metformin is ineffective in advanced
is nephrotoxic. chronic kidney disease due to reduced renal
gluconeogenesis.
Correct: B - Metformin is safe if the dose is reduced and renal function is monitored.
Rationale:Current guidelines (e.g., ADA, KDIGO) allow metformin use in patients with eGFR
down to 30 mL/min, provided the dose is reduced and renal function is closely monitored. The
risk of lactic acidosis is low with proper dosing, and metformin is not directly nephrotoxic. It
remains effective in reducing hepatic glucose production even in CKD.
Why the other answers are wrong:
A. Absolute contraindication is outdated; risk is manageable with dose adjustment.
C. Metformin is not nephrotoxic; it is renally cleared but does not damage the kidney.
D. Metformin's efficacy is not dependent on renal gluconeogenesis.
Reference: ADA Standards of Medical Care in Diabetes, 2026; Lehne, R.A. (2026). Pharmacology for
Nursing Care, 12th ed., Ch. 45.
Q4.
Which of the following findings is most indicative of serotonin syndrome rather than
neuroleptic malignant syndrome in a patient receiving both an SSRI and a typical
antipsychotic?
A. Hyperreflexia and clonus B. Lead-pipe rigidity
C. Elevated creatine kinase levels D. Slowly progressive onset over days
Correct: A - Hyperreflexia and clonus
Page 4
AND CORRECT ANSWERS | 2026
UPDATED | 100% CORRECT - UTA.
95 Questions with Answers and Detailed Rationales
100 PERCENT GUARANTEED PASS
INSTANT DOWNLOAD ANSWERS INCLUDED
IMPORTANCE OF THIS DOCUMENT
This comprehensive examination preparation guide has been meticulously developed to help you succeed in the
NURS 5220 QUIZ 2 REVIEW QUESTIONS AND CORRECT ANSWERS | 2026 UPDATED | 100% CORRECT -
UTA.. It contains 95 carefully selected questions that reflect the most current exam content and testing strategies.
Each question is accompanied by a correct answer and a detailed rationale that explains the underlying
pathophysiology, pharmacology, or clinical reasoning.
Self-Assessment – Test your knowledge and Exam Preparation – Familiarize yourself with the
identify areas requiring further question format and content
study areas
Concept Reinforcement – Deepen your Confidence Building – Develop test-taking
understanding through strategies and reduce
evidence-based exam anxiety
rationales
Time Management – Practice answering
questions under simulated
exam conditions
Review Summary 95 Questions
Foundations - Application - NURS 5220 2 Review AND Correct 2026 Updated 100 Correct - UTA Nursing
Pharmacology AND Therapeutics Graduate
All answers with rationales
,Table of Contents
Content Area Questions Key Topics
Health Assessment 1-16 Explains, Phenytoin, Chronic, Effect, Warfarin
Techniques
Cardiovascular System 17-32 Appropriate, Infusion, Heart, Prescribed, Combination
Respiratory System 33-48 Heart Failure, Diabetes, Reduced Ejection Fraction, Appropriate,
Considered
Neurological System 49-64 Likely, Medication, Concentration, Cause, Receiving
Gastrointestinal System 65-80 Effect, Explains, Disease, Therapy, Adverse
Musculoskeletal System 81-95 Started, Effect, Explains, Important, Therapy
TOTAL 95 All questions include answers and detailed rationales
,Section A - Health Assessment Techniques
Q1.
Which of the following best explains why a patient with chronic heart failure may require
higher doses of loop diuretics to achieve the same diuretic effect as a healthy individual?
A. Decreased renal blood flow leads to B. Upregulation of sodium-chloride
reduced delivery of the drug to its site of symporters in the thick ascending limb
action. increases drug target availability.
C. Increased albuminuria enhances renal D. Enhanced tubular secretion of organic
clearance of the drug. acids competes with the drug for transport.
Correct: A - Decreased renal blood flow leads to reduced delivery of the drug to its site of
action.
Rationale:In chronic heart failure, reduced cardiac output decreases renal perfusion, limiting
the amount of loop diuretic reaching the tubular lumen where it acts. This pharmacokinetic
alteration reduces diuretic efficacy, necessitating higher doses. The other options do not
accurately describe the pathophysiologic adaptation in heart failure.
Why the other answers are wrong:
B. Loop diuretics inhibit the Na+-K+-2Cl- symporter; upregulation would increase, not
decrease, sensitivity.
C. Albuminuria does not significantly alter loop diuretic pharmacokinetics.
D. Loop diuretics are secreted via organic anion transporters; competition would reduce, not
increase, the required dose.
Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th ed., Ch. 40.
Q2.
A patient on warfarin is started on a short course of trimethoprim-sulfamethoxazole for a
urinary tract infection. Which of the following mechanisms most directly contributes to the
enhanced anticoagulant effect?
A. Trimethoprim inhibits CYP2C9, reducing B. Sulfamethoxazole displaces warfarin from
warfarin metabolism. plasma albumin.
C. The antibiotic disrupts gut flora, D. Trimethoprim inhibits renal tubular
decreasing vitamin K synthesis. secretion of warfarin.
Correct: A - Trimethoprim inhibits CYP2C9, reducing warfarin metabolism.
Page 3
, Section A - Health Assessment Techniques
Rationale: Trimethoprim-sulfamethoxazole, particularly trimethoprim, inhibits CYP2C9, the
major enzyme responsible for metabolizing the more potent S-enantiomer of warfarin. This
inhibition increases warfarin levels and INR. While sulfonamides can displace protein-bound
drugs and antibiotics may reduce vitamin K production, the primary and most direct
mechanism is CYP2C9 inhibition.
Why the other answers are wrong:
B. Protein binding displacement is transient and rarely causes clinically significant bleeding.
C. Although possible, the effect on vitamin K is less direct and slower than enzyme inhibition.
D. Warfarin is not significantly renally secreted; this is not a relevant mechanism.
Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th ed., Ch. 34.
Q3.
A patient with type 2 diabetes and chronic kidney disease (eGFR 25 mL/min) is prescribed
metformin. Which of the following statements is most accurate regarding this therapy?
A. Metformin is contraindicated due to B. Metformin is safe if the dose is reduced
increased risk of lactic acidosis. and renal function is monitored.
C. Metformin should be avoided because it D. Metformin is ineffective in advanced
is nephrotoxic. chronic kidney disease due to reduced renal
gluconeogenesis.
Correct: B - Metformin is safe if the dose is reduced and renal function is monitored.
Rationale:Current guidelines (e.g., ADA, KDIGO) allow metformin use in patients with eGFR
down to 30 mL/min, provided the dose is reduced and renal function is closely monitored. The
risk of lactic acidosis is low with proper dosing, and metformin is not directly nephrotoxic. It
remains effective in reducing hepatic glucose production even in CKD.
Why the other answers are wrong:
A. Absolute contraindication is outdated; risk is manageable with dose adjustment.
C. Metformin is not nephrotoxic; it is renally cleared but does not damage the kidney.
D. Metformin's efficacy is not dependent on renal gluconeogenesis.
Reference: ADA Standards of Medical Care in Diabetes, 2026; Lehne, R.A. (2026). Pharmacology for
Nursing Care, 12th ed., Ch. 45.
Q4.
Which of the following findings is most indicative of serotonin syndrome rather than
neuroleptic malignant syndrome in a patient receiving both an SSRI and a typical
antipsychotic?
A. Hyperreflexia and clonus B. Lead-pipe rigidity
C. Elevated creatine kinase levels D. Slowly progressive onset over days
Correct: A - Hyperreflexia and clonus
Page 4
