Adult Health II (D446) New OA 2 Exam 1
V1 | Adult Health II (D446) New OA 2 Exam
Q&A | WGU
1. A patient with septic shock has a blood pressure of 82/46 mmHg and a heart rate of 128
bpm. Which intervention should the nurse prioritize first?
A. Initiating a norepinephrine infusion
B. Administering broad-spectrum antibiotics
C. Obtaining blood cultures from two different sites
D. Administering a 30 mL/kg isotonic crystalloid bolus
Answer: D
Rationale: Initial management for sepsis-induced hypotension requires rapid fluid
resuscitation with at least 30 mL/kg of IV crystalloid. Fluids must be initiated before
vasopressors like norepinephrine to ensure adequate circulating volume. While cultures
and antibiotics are vital, stabilizing hemodynamics with volume is the immediate priority
in the resuscitation bundle.
2. A patient is admitted with Diabetic Ketoacidosis (DKA). The current lab results show a
blood glucose of 450 mg/dL and a potassium level of 3.2 mEq/L. What is the nurse’s priority
action?
A. Administer IV potassium replacement
,B. Start a continuous insulin infusion at 0.1 units/kg/hr
C. Initiate a bolus of 0.9% Normal Saline
D. Obtain an arterial blood gas (ABG) sample
Answer: A
Rationale: In DKA, insulin drives potassium into the cells, which can cause life-threatening
hypokalemia. If the potassium level is below 3.3 mEq/L, it must be replaced before starting
insulin therapy. Failure to address low potassium before giving insulin can lead to cardiac
dysrhythmias and arrest.
3. A patient with a T6 spinal cord injury reports a sudden, throbbing headache and is found to
have a blood pressure of 210/110 mmHg. What is the first nursing action?
A. Administer prescribed hydralazine IV
B. Check for bladder distension or a kinked catheter
C. Notify the healthcare provider immediately
D. Elevate the head of the bed to 90 degrees
Answer: D
Rationale: The patient is exhibiting signs of autonomic dysreflexia, a medical emergency.
The first action is to sit the patient upright (90 degrees) to utilize orthostatic pressure to
lower blood pressure. Once the patient is positioned, the nurse should then assess for
triggers like bladder distension or fecal impaction.
, 4. A nurse is monitoring a patient on mechanical ventilation with Positive End-Expiratory
Pressure (PEEP) of 15 cm H2O. Which assessment finding is most concerning?
A. A respiratory rate of 18 breaths per minute
B. SpO2 of 93% on 40% FiO2
C. An inspiratory pressure of 25 cm H2O
D. Decreased cardiac output and hypotension
Answer: D
Rationale: High levels of PEEP increase intrathoracic pressure, which can compress the
heart and decrease venous return. This leads to a drop in cardiac output and hypotension.
Nurses must closely monitor hemodynamic status when PEEP is increased to ensure organ
perfusion is maintained.
5. A patient with Acute Respiratory Distress Syndrome (ARDS) is placed in the prone position.
What is the primary rationale for this intervention?
A. To prevent ventilator-associated pneumonia
B. To facilitate better drainage of oral secretions
C. To reduce the risk of skin breakdown on the sacrum
D. To improve oxygenation by recruiting posterior alveoli
Answer: D
V1 | Adult Health II (D446) New OA 2 Exam
Q&A | WGU
1. A patient with septic shock has a blood pressure of 82/46 mmHg and a heart rate of 128
bpm. Which intervention should the nurse prioritize first?
A. Initiating a norepinephrine infusion
B. Administering broad-spectrum antibiotics
C. Obtaining blood cultures from two different sites
D. Administering a 30 mL/kg isotonic crystalloid bolus
Answer: D
Rationale: Initial management for sepsis-induced hypotension requires rapid fluid
resuscitation with at least 30 mL/kg of IV crystalloid. Fluids must be initiated before
vasopressors like norepinephrine to ensure adequate circulating volume. While cultures
and antibiotics are vital, stabilizing hemodynamics with volume is the immediate priority
in the resuscitation bundle.
2. A patient is admitted with Diabetic Ketoacidosis (DKA). The current lab results show a
blood glucose of 450 mg/dL and a potassium level of 3.2 mEq/L. What is the nurse’s priority
action?
A. Administer IV potassium replacement
,B. Start a continuous insulin infusion at 0.1 units/kg/hr
C. Initiate a bolus of 0.9% Normal Saline
D. Obtain an arterial blood gas (ABG) sample
Answer: A
Rationale: In DKA, insulin drives potassium into the cells, which can cause life-threatening
hypokalemia. If the potassium level is below 3.3 mEq/L, it must be replaced before starting
insulin therapy. Failure to address low potassium before giving insulin can lead to cardiac
dysrhythmias and arrest.
3. A patient with a T6 spinal cord injury reports a sudden, throbbing headache and is found to
have a blood pressure of 210/110 mmHg. What is the first nursing action?
A. Administer prescribed hydralazine IV
B. Check for bladder distension or a kinked catheter
C. Notify the healthcare provider immediately
D. Elevate the head of the bed to 90 degrees
Answer: D
Rationale: The patient is exhibiting signs of autonomic dysreflexia, a medical emergency.
The first action is to sit the patient upright (90 degrees) to utilize orthostatic pressure to
lower blood pressure. Once the patient is positioned, the nurse should then assess for
triggers like bladder distension or fecal impaction.
, 4. A nurse is monitoring a patient on mechanical ventilation with Positive End-Expiratory
Pressure (PEEP) of 15 cm H2O. Which assessment finding is most concerning?
A. A respiratory rate of 18 breaths per minute
B. SpO2 of 93% on 40% FiO2
C. An inspiratory pressure of 25 cm H2O
D. Decreased cardiac output and hypotension
Answer: D
Rationale: High levels of PEEP increase intrathoracic pressure, which can compress the
heart and decrease venous return. This leads to a drop in cardiac output and hypotension.
Nurses must closely monitor hemodynamic status when PEEP is increased to ensure organ
perfusion is maintained.
5. A patient with Acute Respiratory Distress Syndrome (ARDS) is placed in the prone position.
What is the primary rationale for this intervention?
A. To prevent ventilator-associated pneumonia
B. To facilitate better drainage of oral secretions
C. To reduce the risk of skin breakdown on the sacrum
D. To improve oxygenation by recruiting posterior alveoli
Answer: D
