NURS 5220 EXAM /NURS 5220 ADVANCED HEALTH ASSESSMENT
AND DIAGNOSTIC REASONING EXAM 2 ACTUAL 2026/2027
PRACTICE QUESTIONS AND STUDY GUIDE ACCURATE EXAM
COMPLETE APPROVED QUESTIONS WITH WELL ELABORATED
ANSWERS AND DETAILED RATIONALES (RELIABLE SOLUTIONS)
LATEST UPDATED VERSION 2026 EDITION |GUARANTEED PASS
A+ |JUST RELEASED
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
D) Aortic valve stenosis
Correct Answer: C – 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
B) Increased plasma oncotic pressure
,C) Decreased capillary hydrostatic pressure
D) Increased interstitial oncotic pressure
Correct Answer: A – Liver failure reduces albumin synthesis,
decreasing plasma oncotic pressure, leading to fluid shifts into the
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)
D) Increased lactate
Correct Answer: C – 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
,C) Renal failure
D) Respiratory alkalosis
Correct Answer: B – 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: D – 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
, C) Aortic stenosis
D) Tricuspid regurgitation
Correct Answer: B – A holosystolic murmur at the apex radiating to
the axilla is classic for mitral regurgitation, which can occur as a
complication of myocardial infarction due to papillary muscle
dysfunction.
7. Which of the following regulates the levels of wakefulness or
arousal?
A) Limbic System
B) Cerebrum
C) Reticular Activating System
D) Hypothalamus
Correct Answer: C – The Reticular Activating System (RAS)
regulates wakefulness and arousal. It maintains consciousness and
alertness.
8. A patient is unable to identify their right from their left eye. Which
of the following is this?
A) Agnosia
B) Apraxia
AND DIAGNOSTIC REASONING EXAM 2 ACTUAL 2026/2027
PRACTICE QUESTIONS AND STUDY GUIDE ACCURATE EXAM
COMPLETE APPROVED QUESTIONS WITH WELL ELABORATED
ANSWERS AND DETAILED RATIONALES (RELIABLE SOLUTIONS)
LATEST UPDATED VERSION 2026 EDITION |GUARANTEED PASS
A+ |JUST RELEASED
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
D) Aortic valve stenosis
Correct Answer: C – 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
B) Increased plasma oncotic pressure
,C) Decreased capillary hydrostatic pressure
D) Increased interstitial oncotic pressure
Correct Answer: A – Liver failure reduces albumin synthesis,
decreasing plasma oncotic pressure, leading to fluid shifts into the
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)
D) Increased lactate
Correct Answer: C – 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
,C) Renal failure
D) Respiratory alkalosis
Correct Answer: B – 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: D – 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
, C) Aortic stenosis
D) Tricuspid regurgitation
Correct Answer: B – A holosystolic murmur at the apex radiating to
the axilla is classic for mitral regurgitation, which can occur as a
complication of myocardial infarction due to papillary muscle
dysfunction.
7. Which of the following regulates the levels of wakefulness or
arousal?
A) Limbic System
B) Cerebrum
C) Reticular Activating System
D) Hypothalamus
Correct Answer: C – The Reticular Activating System (RAS)
regulates wakefulness and arousal. It maintains consciousness and
alertness.
8. A patient is unable to identify their right from their left eye. Which
of the following is this?
A) Agnosia
B) Apraxia
