NURS 5220 EXAM 2 ACTUAL 2026/2027 PREMIUM HIGH
YIELD PRACTICE QUESTIONS AND STUDY GUIDE
COMPLETE ACCURATE EXAM APPROVED QUESTIONS
AND CORRECT VERIFIED ANSWERS WITH DETAILED
RATIONALES (RELIABLE ANSWERS) CURRENTLY
UPDATED VERSION 2026 EDITION |GUARANTEED PASS A+ |
JUST RELEASED NURS 5220 EXAM 2 REAL EXAM | INSTANT
PDF ACCESS
1. A 65-year-old with chronic heart failure develops worsening dyspnea,
jugular venous distention, and a third heart sound (S3). Which
pathophysiologic mechanism is most directly responsible for the S3?
A) Increased atrial contraction force
B) Decreased left ventricular compliance
C) Rapid ventricular filling into a noncompliant ventricle (CORRECT
ANSWER)
D) Aortic valve stenosis
Rationale: S3 occurs when blood rapidly fills a dilated or noncompliant
ventricle during early diastole, causing vibrations. It is a marker of increased
filling pressure.
2. A client with cirrhosis has ascites and peripheral edema. Which pressure
change best explains this?
A) Decreased plasma oncotic pressure (CORRECT ANSWER)
B) Increased plasma oncotic pressure
,C) Decreased capillary hydrostatic pressure
D) Increased interstitial oncotic pressure
Rationale: Liver failure reduces albumin synthesis, decreasing plasma oncotic
pressure, leading to fluid shifts into interstitial space.
3. A client with diabetic ketoacidosis has an anion gap of 28 mEq/L (normal
8–12). Which of the following best accounts for this elevation?
A) Increased chloride
B) Increased bicarbonate
C) Increased unmeasured anions (ketoacids) (CORRECT ANSWER)
D) Increased lactate
Rationale: Elevated anion gap in DKA is due to accumulation of acetoacetate
and beta-hydroxybutyrate (unmeasured anions).
4. A client with sepsis has a serum lactate of 6.5 mmol/L. This finding most
directly indicates:
A) Hepatic failure
B) Anaerobic metabolism due to tissue hypoxia (CORRECT ANSWER)
C) Renal failure
D) Respiratory alkalosis
Rationale: Elevated lactate in sepsis reflects inadequate tissue oxygenation and
shift to anaerobic glycolysis.
5. A client with chronic kidney disease (CKD) has a serum calcium of 7.2
mg/dL and phosphorus of 6.5 mg/dL. The pathophysiologic mechanism is:
,A) Increased PTH secretion
B) Decreased calcitriol leading to reduced intestinal calcium absorption
C) Increased fibroblast growth factor 23 (FGF23)
D) All of the above (CORRECT ANSWER)
Rationale: CKD causes hyperphosphatemia, reduced calcitriol, hypocalcemia,
secondary hyperparathyroidism, and elevated FGF23.
6. A client with a myocardial infarction develops a new holosystolic murmur
at the apex radiating to the axilla. This suggests:
A) Ventricular septal defect
B) Mitral regurgitation (CORRECT ANSWER)
C) Aortic stenosis
D) Tricuspid stenosis
Rationale: A holosystolic murmur at the apex radiating to the axilla is
characteristic of mitral regurgitation.
7. Mr. Green returns to your office with his son 3 months after his CVA. The
son questions when his father's speech will improve. Which of the following
areas of the brain are integral to motor speech?
A) Broca area (frontal lobe) (CORRECT ANSWER)
B) Reticular activating system
C) Limbic system
D) Insula
, Rationale: Broca area (frontal lobe) contains the motor cortex, which is
associated with speech formation, as well as decision making, problem solving,
the ability to concentrate, and short-term memory.
8. A 32-year-old woman tells the examiner that when she goes running, she
dribbles urine. Which problem should the examiner consider?
A) Hydronephrosis
B) Renal abscess
C) Stress incontinence (CORRECT ANSWER)
D) Overflow incontinence
Rationale: Stress incontinence is small volume incontinence with coughing,
sneezing, laughing, running; history of prior pelvic surgery.
9. Laboratory tests should be used to:
A) confirm a presumed diagnosis. (CORRECT ANSWER)
B) develop a list of potential problems.
C) rule out all possible causes of symptoms and clinical findings.
D) assist the examiner only when the data do not point to a specific problem.
Rationale: After a match between the data (both subjective and objective) and
a presumed diagnosis is made, consider the appropriate laboratory or
radiologic studies to confirm the diagnosis.
10. Mrs. Bates is a 56-year-old patient who presents to your office with her son.
He states she has had a change in mental status. On examination, you note
that her judgment is poor. With which problem is poor judgment most closely
associated?
YIELD PRACTICE QUESTIONS AND STUDY GUIDE
COMPLETE ACCURATE EXAM APPROVED QUESTIONS
AND CORRECT VERIFIED ANSWERS WITH DETAILED
RATIONALES (RELIABLE ANSWERS) CURRENTLY
UPDATED VERSION 2026 EDITION |GUARANTEED PASS A+ |
JUST RELEASED NURS 5220 EXAM 2 REAL EXAM | INSTANT
PDF ACCESS
1. A 65-year-old with chronic heart failure develops worsening dyspnea,
jugular venous distention, and a third heart sound (S3). Which
pathophysiologic mechanism is most directly responsible for the S3?
A) Increased atrial contraction force
B) Decreased left ventricular compliance
C) Rapid ventricular filling into a noncompliant ventricle (CORRECT
ANSWER)
D) Aortic valve stenosis
Rationale: S3 occurs when blood rapidly fills a dilated or noncompliant
ventricle during early diastole, causing vibrations. It is a marker of increased
filling pressure.
2. A client with cirrhosis has ascites and peripheral edema. Which pressure
change best explains this?
A) Decreased plasma oncotic pressure (CORRECT ANSWER)
B) Increased plasma oncotic pressure
,C) Decreased capillary hydrostatic pressure
D) Increased interstitial oncotic pressure
Rationale: Liver failure reduces albumin synthesis, decreasing plasma oncotic
pressure, leading to fluid shifts into interstitial space.
3. A client with diabetic ketoacidosis has an anion gap of 28 mEq/L (normal
8–12). Which of the following best accounts for this elevation?
A) Increased chloride
B) Increased bicarbonate
C) Increased unmeasured anions (ketoacids) (CORRECT ANSWER)
D) Increased lactate
Rationale: Elevated anion gap in DKA is due to accumulation of acetoacetate
and beta-hydroxybutyrate (unmeasured anions).
4. A client with sepsis has a serum lactate of 6.5 mmol/L. This finding most
directly indicates:
A) Hepatic failure
B) Anaerobic metabolism due to tissue hypoxia (CORRECT ANSWER)
C) Renal failure
D) Respiratory alkalosis
Rationale: Elevated lactate in sepsis reflects inadequate tissue oxygenation and
shift to anaerobic glycolysis.
5. A client with chronic kidney disease (CKD) has a serum calcium of 7.2
mg/dL and phosphorus of 6.5 mg/dL. The pathophysiologic mechanism is:
,A) Increased PTH secretion
B) Decreased calcitriol leading to reduced intestinal calcium absorption
C) Increased fibroblast growth factor 23 (FGF23)
D) All of the above (CORRECT ANSWER)
Rationale: CKD causes hyperphosphatemia, reduced calcitriol, hypocalcemia,
secondary hyperparathyroidism, and elevated FGF23.
6. A client with a myocardial infarction develops a new holosystolic murmur
at the apex radiating to the axilla. This suggests:
A) Ventricular septal defect
B) Mitral regurgitation (CORRECT ANSWER)
C) Aortic stenosis
D) Tricuspid stenosis
Rationale: A holosystolic murmur at the apex radiating to the axilla is
characteristic of mitral regurgitation.
7. Mr. Green returns to your office with his son 3 months after his CVA. The
son questions when his father's speech will improve. Which of the following
areas of the brain are integral to motor speech?
A) Broca area (frontal lobe) (CORRECT ANSWER)
B) Reticular activating system
C) Limbic system
D) Insula
, Rationale: Broca area (frontal lobe) contains the motor cortex, which is
associated with speech formation, as well as decision making, problem solving,
the ability to concentrate, and short-term memory.
8. A 32-year-old woman tells the examiner that when she goes running, she
dribbles urine. Which problem should the examiner consider?
A) Hydronephrosis
B) Renal abscess
C) Stress incontinence (CORRECT ANSWER)
D) Overflow incontinence
Rationale: Stress incontinence is small volume incontinence with coughing,
sneezing, laughing, running; history of prior pelvic surgery.
9. Laboratory tests should be used to:
A) confirm a presumed diagnosis. (CORRECT ANSWER)
B) develop a list of potential problems.
C) rule out all possible causes of symptoms and clinical findings.
D) assist the examiner only when the data do not point to a specific problem.
Rationale: After a match between the data (both subjective and objective) and
a presumed diagnosis is made, consider the appropriate laboratory or
radiologic studies to confirm the diagnosis.
10. Mrs. Bates is a 56-year-old patient who presents to your office with her son.
He states she has had a change in mental status. On examination, you note
that her judgment is poor. With which problem is poor judgment most closely
associated?
