1
WGU D446 OBJECTIVE ASSESSMENT FINAL NEWEST 2026
ACTUAL EXAM| D446 ADULT HEALTH 2 OA FINAL EXAM WITH
COMPLETE REAL EXAM QUESTIONS AND CORRECT VERIFIED
ANSWERS/ ALREADY GRADED A+ (MOST RECENT!!)
WGU D446 Adult Health 2 OA – Practice Questions and Answers (2026 Update)
Cardiovascular System
1. A patient presents with pallor, decreased mean arterial pressure (MAP),
tachycardia, decreased urinary output, increased respiratory rate, hypotension,
decreased pulse pressure, and cold clammy skin. What is this patient most likely
experiencing?
A) Myocardial infarction
B) Hemorrhage
C) Hypertensive crisis
D) Heart failure exacerbation
Answer-:B) Hemorrhage
Rationale: These are classic signs and symptoms of hemorrhage, indicating
hypovolemic shock. The body compensates with tachycardia and increased
respiratory rate, while decreased perfusion leads to pallor, cool skin, and
decreased urine output .
2. Which medication class is contraindicated in patients with acute heart failure
(HF)?
A) ACE inhibitors
B) Beta blockers
C) Diuretics
D) Calcium channel blockers
Answer-:B) Beta blockers
Rationale: Beta blockers reduce cardiac output and can worsen acute heart
,2
failure. While they are used in chronic, stable HF, they are contraindicated during
acute decompensation .
3. A patient with right-sided heart failure is likely to exhibit which set of
symptoms?
A) Dyspnea, orthopnea, crackles
B) Jugular vein distention, peripheral edema, ascites
C) Chest pain, diaphoresis, nausea
D) Palpitations, syncope, lightheadedness
Answer-:B) Jugular vein distention, peripheral edema, ascites
Rationale: Right-sided heart failure results from fluid backing up into the venous
system. Symptoms include peripheral edema, jugular venous distention (JVD),
ascites, and weight gain .
4. A patient with left-sided heart failure is likely to exhibit which set of
symptoms?
A) Jugular vein distention, peripheral edema, ascites
B) Dyspnea, orthopnea, crackles, frothy sputum
C) Hepatomegaly, splenomegaly
D) Nausea, vomiting, anorexia
Answer-:B) Dyspnea, orthopnea, crackles, frothy sputum
Rationale: Left-sided heart failure causes fluid to back up into the pulmonary
circulation. Symptoms include dyspnea, orthopnea, paroxysmal nocturnal
dyspnea, crackles, and possibly frothy, blood-tinged sputum .
5. What is the priority intervention for a patient with an acute hemolytic
transfusion reaction (AHTR)?
A) Administer antihistamines
B) Slow the infusion and monitor vital signs
C) Discontinue the blood transfusion immediately and flush the IV line with saline
D) Notify the blood bank after the transfusion is complete
Answer-:C) Discontinue the blood transfusion immediately and flush the IV line
with saline
Rationale: If an AHTR is suspected, the priority is to stop the transfusion
immediately to prevent further reaction, maintain IV access with saline, and then
notify the healthcare provider and blood bank .
,3
6. Which findings are characteristic of an acute hemolytic transfusion reaction
(AHTR)? (Select all that apply)
A) Chills and fever
B) Hypertension
C) Pain along the IV line, in the back, or chest
D) Dark urine
E) Bradycardia
Answer-:A, C, D
Rationale: AHTR presents with chills, fever, hypotension (not hypertension), pain
(often along the IV line, back, or chest), and dark urine from hemoglobinuria .
7. What is the difference between angina and a myocardial infarction (heart
attack)?
Answer-:Angina (chest pain) is typically temporary pressure or squeezing that
resolves with rest or nitroglycerin. A myocardial infarction (heart attack) involves
persistent pain not relieved by rest, often accompanied by diaphoresis, nausea,
and elevated cardiac troponin levels .
8. The MONA protocol for a suspected myocardial infarction includes:
A) Morphine, Oxygen, Nitroglycerin, Aspirin
B) Metoprolol, Ondansetron, Nitrates, Atropine
C) Morphine, Omeprazole, Nitroprusside, Amiodarone
D) Metformin, Oxygen, Nicotine patch, Alteplase
Answer-:A) Morphine, Oxygen, Nitroglycerin, Aspirin
Rationale: MONA is the mnemonic for initial management of suspected MI:
Morphine for pain, Oxygen for hypoxia, Nitroglycerin for vasodilation, and Aspirin
for antiplatelet effect .
9. A patient with a history of varicose veins reports ankle edema, increased leg
fatigue, and a feeling of leg fullness with pruritus. These are classic signs of:
A) Arterial insufficiency
B) Deep vein thrombosis
C) Chronic venous insufficiency
D) Peripheral neuropathy
Answer-:C) Chronic venous insufficiency
Rationale: These symptoms, along with visible varicosities, are characteristic of
, 4
chronic venous insufficiency where valves in the veins fail, leading to pooling of
blood .
10. Percutaneous coronary intervention (PCI) is best described as:
A) A surgical bypass of blocked coronary arteries
B) A non-surgical procedure to treat coronary artery blockage using a catheter
C) A medication regimen to dissolve clots
D) A diagnostic test to visualize heart chambers
Answer-:B) A non-surgical procedure to treat coronary artery blockage using a
catheter
Rationale: PCI, such as angioplasty and stenting, is a non-surgical, catheter-based
procedure to open blocked coronary arteries .
11. A patient who had a coronary artery bypass graft (CABG) is being
discharged. Which dietary teaching is appropriate?
A) Encourage large, heavy meals to promote healing
B) Eat small, frequent meals, consume protein first, and avoid sugar, alcohol, and
caffeine
C) Drink fluids with meals to prevent dehydration
D) Resume a regular diet immediately
Answer-:B) Eat small, frequent meals, consume protein first, and avoid sugar,
alcohol, and caffeine
Rationale: Post-bypass patients, especially if they had gastrointestinal
involvement, often tolerate small, frequent meals better and need to prioritize
protein for healing while avoiding substances that can cause dumping syndrome
or irritation .
12. Which assessment finding is most indicative of a myocardial infarction (heart
attack) rather than stable angina?
A) Chest pain that occurs with exertion and resolves with rest
B) Chest pain that is persistent, lasts longer than 20 minutes, and is not relieved
by rest or nitroglycerin
C) A brief, sharp, stabbing chest pain that lasts a few seconds
D) Chest wall tenderness to palpation
Answer-:B) Chest pain that is persistent, lasts longer than 20 minutes, and is not
relieved by rest or nitroglycerin
WGU D446 OBJECTIVE ASSESSMENT FINAL NEWEST 2026
ACTUAL EXAM| D446 ADULT HEALTH 2 OA FINAL EXAM WITH
COMPLETE REAL EXAM QUESTIONS AND CORRECT VERIFIED
ANSWERS/ ALREADY GRADED A+ (MOST RECENT!!)
WGU D446 Adult Health 2 OA – Practice Questions and Answers (2026 Update)
Cardiovascular System
1. A patient presents with pallor, decreased mean arterial pressure (MAP),
tachycardia, decreased urinary output, increased respiratory rate, hypotension,
decreased pulse pressure, and cold clammy skin. What is this patient most likely
experiencing?
A) Myocardial infarction
B) Hemorrhage
C) Hypertensive crisis
D) Heart failure exacerbation
Answer-:B) Hemorrhage
Rationale: These are classic signs and symptoms of hemorrhage, indicating
hypovolemic shock. The body compensates with tachycardia and increased
respiratory rate, while decreased perfusion leads to pallor, cool skin, and
decreased urine output .
2. Which medication class is contraindicated in patients with acute heart failure
(HF)?
A) ACE inhibitors
B) Beta blockers
C) Diuretics
D) Calcium channel blockers
Answer-:B) Beta blockers
Rationale: Beta blockers reduce cardiac output and can worsen acute heart
,2
failure. While they are used in chronic, stable HF, they are contraindicated during
acute decompensation .
3. A patient with right-sided heart failure is likely to exhibit which set of
symptoms?
A) Dyspnea, orthopnea, crackles
B) Jugular vein distention, peripheral edema, ascites
C) Chest pain, diaphoresis, nausea
D) Palpitations, syncope, lightheadedness
Answer-:B) Jugular vein distention, peripheral edema, ascites
Rationale: Right-sided heart failure results from fluid backing up into the venous
system. Symptoms include peripheral edema, jugular venous distention (JVD),
ascites, and weight gain .
4. A patient with left-sided heart failure is likely to exhibit which set of
symptoms?
A) Jugular vein distention, peripheral edema, ascites
B) Dyspnea, orthopnea, crackles, frothy sputum
C) Hepatomegaly, splenomegaly
D) Nausea, vomiting, anorexia
Answer-:B) Dyspnea, orthopnea, crackles, frothy sputum
Rationale: Left-sided heart failure causes fluid to back up into the pulmonary
circulation. Symptoms include dyspnea, orthopnea, paroxysmal nocturnal
dyspnea, crackles, and possibly frothy, blood-tinged sputum .
5. What is the priority intervention for a patient with an acute hemolytic
transfusion reaction (AHTR)?
A) Administer antihistamines
B) Slow the infusion and monitor vital signs
C) Discontinue the blood transfusion immediately and flush the IV line with saline
D) Notify the blood bank after the transfusion is complete
Answer-:C) Discontinue the blood transfusion immediately and flush the IV line
with saline
Rationale: If an AHTR is suspected, the priority is to stop the transfusion
immediately to prevent further reaction, maintain IV access with saline, and then
notify the healthcare provider and blood bank .
,3
6. Which findings are characteristic of an acute hemolytic transfusion reaction
(AHTR)? (Select all that apply)
A) Chills and fever
B) Hypertension
C) Pain along the IV line, in the back, or chest
D) Dark urine
E) Bradycardia
Answer-:A, C, D
Rationale: AHTR presents with chills, fever, hypotension (not hypertension), pain
(often along the IV line, back, or chest), and dark urine from hemoglobinuria .
7. What is the difference between angina and a myocardial infarction (heart
attack)?
Answer-:Angina (chest pain) is typically temporary pressure or squeezing that
resolves with rest or nitroglycerin. A myocardial infarction (heart attack) involves
persistent pain not relieved by rest, often accompanied by diaphoresis, nausea,
and elevated cardiac troponin levels .
8. The MONA protocol for a suspected myocardial infarction includes:
A) Morphine, Oxygen, Nitroglycerin, Aspirin
B) Metoprolol, Ondansetron, Nitrates, Atropine
C) Morphine, Omeprazole, Nitroprusside, Amiodarone
D) Metformin, Oxygen, Nicotine patch, Alteplase
Answer-:A) Morphine, Oxygen, Nitroglycerin, Aspirin
Rationale: MONA is the mnemonic for initial management of suspected MI:
Morphine for pain, Oxygen for hypoxia, Nitroglycerin for vasodilation, and Aspirin
for antiplatelet effect .
9. A patient with a history of varicose veins reports ankle edema, increased leg
fatigue, and a feeling of leg fullness with pruritus. These are classic signs of:
A) Arterial insufficiency
B) Deep vein thrombosis
C) Chronic venous insufficiency
D) Peripheral neuropathy
Answer-:C) Chronic venous insufficiency
Rationale: These symptoms, along with visible varicosities, are characteristic of
, 4
chronic venous insufficiency where valves in the veins fail, leading to pooling of
blood .
10. Percutaneous coronary intervention (PCI) is best described as:
A) A surgical bypass of blocked coronary arteries
B) A non-surgical procedure to treat coronary artery blockage using a catheter
C) A medication regimen to dissolve clots
D) A diagnostic test to visualize heart chambers
Answer-:B) A non-surgical procedure to treat coronary artery blockage using a
catheter
Rationale: PCI, such as angioplasty and stenting, is a non-surgical, catheter-based
procedure to open blocked coronary arteries .
11. A patient who had a coronary artery bypass graft (CABG) is being
discharged. Which dietary teaching is appropriate?
A) Encourage large, heavy meals to promote healing
B) Eat small, frequent meals, consume protein first, and avoid sugar, alcohol, and
caffeine
C) Drink fluids with meals to prevent dehydration
D) Resume a regular diet immediately
Answer-:B) Eat small, frequent meals, consume protein first, and avoid sugar,
alcohol, and caffeine
Rationale: Post-bypass patients, especially if they had gastrointestinal
involvement, often tolerate small, frequent meals better and need to prioritize
protein for healing while avoiding substances that can cause dumping syndrome
or irritation .
12. Which assessment finding is most indicative of a myocardial infarction (heart
attack) rather than stable angina?
A) Chest pain that occurs with exertion and resolves with rest
B) Chest pain that is persistent, lasts longer than 20 minutes, and is not relieved
by rest or nitroglycerin
C) A brief, sharp, stabbing chest pain that lasts a few seconds
D) Chest wall tenderness to palpation
Answer-:B) Chest pain that is persistent, lasts longer than 20 minutes, and is not
relieved by rest or nitroglycerin
