WGU D446 – Adult Health II Objective
Assessment | OA V1 and V2 | Questions
and Answers – 2026 Update | 100%
Correct.
1. A nurse is assessing a client with acute decompensated heart failure
(ADHF). Which finding is most concerning?
• A) +2 pitting edema in lower extremities
• B) Jugular venous distension (JVD) at 45 degrees
• C) Paroxysmal nocturnal dyspnea (PND)
• D) Crackles audible to the midscapular region
Correct Answer: D) Crackles audible to the midscapular region
Rationale: Crackles that extend to the midscapular region indicate that pulmonary
edema is severe and widespread, signifying imminent respiratory compromise.
While peripheral edema, JVD, and PND are important signs of fluid overload, they
are not as immediately life-threatening as extensive pulmonary edema.
2. A client with infective endocarditis develops sudden left-sided weakness
and slurred speech. What is the priority action?
• A) Administer aspirin 325 mg PO
• B) Obtain a STAT CT scan of the head
• C) Check blood glucose level
• D) Reorient the client to person, place, time
,Correct Answer: B) Obtain a STAT CT scan of the head
Rationale: The client is likely experiencing an embolic stroke from a vegetation
fragment. A STAT CT scan is required to rule out hemorrhage before any
thrombolytics or anticoagulation can be considered. Aspirin could worsen a
hemorrhagic stroke.
3. A client on amiodarone for atrial fibrillation reports new bluish-gray
discoloration on the face. Which action is most appropriate?
• A) Discontinue the amiodarone immediately
• B) Document the finding and continue to monitor
• C) Notify the healthcare provider of this adverse effect
• D) Apply a topical cream to the affected area
Correct Answer: C) Notify the healthcare provider of this adverse effect
Rationale: Bluish-gray discoloration of the skin (slate-gray cyanosis) is a known
adverse effect of long-term amiodarone therapy due to iodine deposition in the
skin. The healthcare provider should be notified for evaluation, though the
discoloration is often irreversible and not dangerous.
4. Which laboratory finding is most consistent with a diagnosis of left-sided
heart failure?
• A) Elevated B-type natriuretic peptide (BNP)
• B) Decreased troponin I
• C) Elevated hemoglobin
, • D) Decreased serum creatinine
Correct Answer: A) Elevated B-type natriuretic peptide (BNP)
Rationale: BNP is secreted by the ventricles in response to increased wall tension
(stretch) from fluid overload, making it a key biomarker for heart failure. Troponin is
for myocardial injury, not specifically heart failure.
5. A nurse is caring for a client post-coronary artery bypass grafting (CABG)
with a chest tube set to -20 cm H₂O suction. The nurse notes continuous
bubbling in the suction control chamber. What is the correct interpretation?
• A) Normal finding indicating proper suction level
• B) Air leak in the system, likely at the chest tube insertion site
• C) The water seal chamber has lost its fluid level
• D) The suction pressure is too high
Correct Answer: A) Normal finding indicating proper suction level
Rationale: Bubbling in the suction control chamber is expected with wall suction
and indicates that the desired suction pressure is being applied. The water seal
chamber should have intermittent bubbling with exhalation, not continuous
bubbling.
6. A client is admitted with acute myocardial infarction (MI). The provider
orders the MONA protocol. Which medication in MONA is the priority to
prevent further clot formation?
, • A) Morphine
• B) Oxygen
• C) Nitroglycerin
• D) Aspirin
Correct Answer: D) Aspirin
Rationale: The MONA protocol (Morphine, Oxygen, Nitroglycerin, Aspirin) is the
standard for acute MI management. Aspirin is the priority to prevent further platelet
aggregation and clot formation. If the patient is not hypoxic, oxygen may not be
needed.
7. A client with heart failure has been prescribed furosemide (Lasix). Which
assessment finding indicates the medication is effective?
• A) Decreased daily weight
• B) Increased blood pressure
• C) Increased peripheral edema
• D) Decreased urine output
Correct Answer: A) Decreased daily weight
Rationale: Furosemide is a loop diuretic used to reduce fluid overload in heart
failure. A decrease in daily weight indicates effective diuresis and fluid removal.
8. A client with atrial fibrillation is prescribed warfarin (Coumadin). Which
laboratory value should the nurse monitor to evaluate therapeutic
effectiveness?
Assessment | OA V1 and V2 | Questions
and Answers – 2026 Update | 100%
Correct.
1. A nurse is assessing a client with acute decompensated heart failure
(ADHF). Which finding is most concerning?
• A) +2 pitting edema in lower extremities
• B) Jugular venous distension (JVD) at 45 degrees
• C) Paroxysmal nocturnal dyspnea (PND)
• D) Crackles audible to the midscapular region
Correct Answer: D) Crackles audible to the midscapular region
Rationale: Crackles that extend to the midscapular region indicate that pulmonary
edema is severe and widespread, signifying imminent respiratory compromise.
While peripheral edema, JVD, and PND are important signs of fluid overload, they
are not as immediately life-threatening as extensive pulmonary edema.
2. A client with infective endocarditis develops sudden left-sided weakness
and slurred speech. What is the priority action?
• A) Administer aspirin 325 mg PO
• B) Obtain a STAT CT scan of the head
• C) Check blood glucose level
• D) Reorient the client to person, place, time
,Correct Answer: B) Obtain a STAT CT scan of the head
Rationale: The client is likely experiencing an embolic stroke from a vegetation
fragment. A STAT CT scan is required to rule out hemorrhage before any
thrombolytics or anticoagulation can be considered. Aspirin could worsen a
hemorrhagic stroke.
3. A client on amiodarone for atrial fibrillation reports new bluish-gray
discoloration on the face. Which action is most appropriate?
• A) Discontinue the amiodarone immediately
• B) Document the finding and continue to monitor
• C) Notify the healthcare provider of this adverse effect
• D) Apply a topical cream to the affected area
Correct Answer: C) Notify the healthcare provider of this adverse effect
Rationale: Bluish-gray discoloration of the skin (slate-gray cyanosis) is a known
adverse effect of long-term amiodarone therapy due to iodine deposition in the
skin. The healthcare provider should be notified for evaluation, though the
discoloration is often irreversible and not dangerous.
4. Which laboratory finding is most consistent with a diagnosis of left-sided
heart failure?
• A) Elevated B-type natriuretic peptide (BNP)
• B) Decreased troponin I
• C) Elevated hemoglobin
, • D) Decreased serum creatinine
Correct Answer: A) Elevated B-type natriuretic peptide (BNP)
Rationale: BNP is secreted by the ventricles in response to increased wall tension
(stretch) from fluid overload, making it a key biomarker for heart failure. Troponin is
for myocardial injury, not specifically heart failure.
5. A nurse is caring for a client post-coronary artery bypass grafting (CABG)
with a chest tube set to -20 cm H₂O suction. The nurse notes continuous
bubbling in the suction control chamber. What is the correct interpretation?
• A) Normal finding indicating proper suction level
• B) Air leak in the system, likely at the chest tube insertion site
• C) The water seal chamber has lost its fluid level
• D) The suction pressure is too high
Correct Answer: A) Normal finding indicating proper suction level
Rationale: Bubbling in the suction control chamber is expected with wall suction
and indicates that the desired suction pressure is being applied. The water seal
chamber should have intermittent bubbling with exhalation, not continuous
bubbling.
6. A client is admitted with acute myocardial infarction (MI). The provider
orders the MONA protocol. Which medication in MONA is the priority to
prevent further clot formation?
, • A) Morphine
• B) Oxygen
• C) Nitroglycerin
• D) Aspirin
Correct Answer: D) Aspirin
Rationale: The MONA protocol (Morphine, Oxygen, Nitroglycerin, Aspirin) is the
standard for acute MI management. Aspirin is the priority to prevent further platelet
aggregation and clot formation. If the patient is not hypoxic, oxygen may not be
needed.
7. A client with heart failure has been prescribed furosemide (Lasix). Which
assessment finding indicates the medication is effective?
• A) Decreased daily weight
• B) Increased blood pressure
• C) Increased peripheral edema
• D) Decreased urine output
Correct Answer: A) Decreased daily weight
Rationale: Furosemide is a loop diuretic used to reduce fluid overload in heart
failure. A decrease in daily weight indicates effective diuresis and fluid removal.
8. A client with atrial fibrillation is prescribed warfarin (Coumadin). Which
laboratory value should the nurse monitor to evaluate therapeutic
effectiveness?
