NURS5220 EXAM 2 NEWEST 2026 ACTUAL EXAM TEST
BANK| COMPLETE 350 REAL EXAM QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED ANSWERS)
ALREADY GRADED A+ (BRAND NEW!!)
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
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.
1
,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
Answer: A – 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
2
,C) Increased unmeasured anions (ketoacids)
D) Increased lactate
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
Answer: B – Elevated lactate in sepsis reflects inadequate tissue
oxygenation and shift to anaerobic glycolysis.
3
, 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
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
4
BANK| COMPLETE 350 REAL EXAM QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED ANSWERS)
ALREADY GRADED A+ (BRAND NEW!!)
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
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.
1
,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
Answer: A – 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
2
,C) Increased unmeasured anions (ketoacids)
D) Increased lactate
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
Answer: B – Elevated lactate in sepsis reflects inadequate tissue
oxygenation and shift to anaerobic glycolysis.
3
, 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
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
4
