WGU D454
Adult Health III
Objective Assessment
(2 Full Exams)
Actual Questions with Verified Answers
Take and pass the OA :)
What You Will Get:
➢150+ OA Exam Questions w/ Answers
➢Expert Rationales included.
➢OA Study Guide QS & Clinical Prioritization
➢AH III EXAM HINTS
, Preview Pages Below
Get the Complete PDF After Purchase
"If you require further clarification or in need of any study resources,
feel free to Message me."
Digital preview sample
,Table of Contents
D454 OA EXAM SET 1 ............................................................ 2
D454 OA EXAM SET 2 .......................................................... 37
D454 AH III EXAM HINTS .................................................... 94
D454 AH III Study Guide Qs w/ Ans .................................. 113
D454 OA EXAM SET 1
Question 1
The nurse is assessing a burn victim who suffered destruction of the epidermis
and some of the dermis of the entire right arm and half of the length of the right
leg. How should the nurse document the burn assessment findings?
A. Superficial, 18% total body surface area (TBSA)
B. Superficial partial thickness, 18% TBSA
C. Deep partial thickness, 27% TBSA
D. Full thickness, 27% TBSA
Correct Answer:
B. Superficial partial thickness, 18% TBSA
Rationale: A superficial partial-thickness burn involves destruction of the epidermis
layer and some of the dermis layer. The %TBSA is easily calculated by using the rule of
nines method. In this case, involvement of one arm is calculated as 9% TBSA, one-half
of a leg is 9% TBSA, for a combined total of 18% TBSA. Total leg involvement is 18%
TBSA.
,Question 2
A client with a history of chronic alcoholism is admitted with pneumonia. The
nurse inserts two large bore IV catheters and starts an infusion of 0.9% sodium
chloride at 75 mL/hour and titrates the client's oxygen to 60% by nonrebreather
mask. The cardiac monitor displays sinus tachycardia with multifocal premature
ventricular contractions. Which client's serum laboratory value requires
immediate intervention by the nurse?
A. Sodium 138 mEq/L
B. Hemoglobin 9 g/dL
C. Magnesium 1.0 mg/dL
D. Potassium 5.5 mEq/L
Correct Answer:
C. Magnesium 1.0 mg/dL
Rationale: Normal magnesium level is 1.7 to 2.2 mg/dL. Hypomagnesemia is critical
and may cause a lethal ventricular arrhythmia, torsades de pointes, and requires
immediate intervention. Chronic alcoholism is a risk factor for hypomagnesemia due to
poor nutritional intake and increased renal excretion.
Question 3
The nurse is providing care to a client who is comatose following cardiac arrest
24 hours ago. Which physical assessment finding should the nurse determine to
be a predictor of a poor outcome?
A. Lack of response to a sternal rub
B. Lack of corneal or papillary response
C. Lack of purposeful motor response
D. Lack of response to verbal stimulation
Correct Answer:
B. Lack of corneal or papillary response
Rationale: The two best predictors of a poor outcome for a comatose client who
experienced cardiac arrest are lack of corneal or papillary response at 24 hours and
lack of motor movement at 72 hours. These responses are mediated by the brainstem.
Question 4
,A client's vital signs are: temperature 97.4°F (36.3°C), blood pressure 88/50
mmHg, heart rate 76 beats/minute, and respirations 18 breaths/minute. How
should the nurse document the mean arterial pressure (MAP)?
(Fill in the blank. Enter numerical value only. If rounding is required, round to the
nearest whole value.)
Correct Answer:
63
Rationale: The mean arterial pressure (MAP) can be calculated using the following
formula: MAP = [Diastolic blood pressure × 2 + Systolic blood pressure] ÷ 3. This client's
MAP = (50 + 50) + 88 = 188 ÷ 3 = 62.66 = 63 mmHg. A normal MAP should be between
70 to 105 mm Hg. A low MAP means low perfusion to body tissues.
Question 5
A client arrives in the emergency department reporting chest palpitations, feeling
weak and dizzy, and having a blood pressure of 100/60 mmHg. What action is
most important for the nurse to implement based on this electrocardiogram
(EKG) tracing if the client becomes unstable? (EKG showing atrial flutter)
A. Monitor vital signs and prepare for synchronized cardioversion
B. Call the healthcare provider for drug prescriptions
C. Instruct the client to perform Valsalva maneuvers
D. Document the interpretation of the EKG and the client's subjective symptoms
Correct Answer:
A. Monitor vital signs and prepare for synchronized cardioversion
Rationale: The EKG is showing atrial flutter. When the client experiences atrial flutter
and is symptomatically unstable, the Advance Cardiac Life Support (ACLS) algorithm
recommends the client be treated the same way as a person with atrial fibrillation, and
immediate cardioversion be administered. Drugs are not recommended for unstable
,into the collection bag 250 mL of pale yellow urine in the last 30 minutes. After
reporting these findings to the healthcare provider, which action should the nurse
implement?
A. Identify the underlying cause of this condition
B. Prepare to administer desmopressin
C. Decrease the intravenous fluids to a maintenance rate
D. Replace fluid losses with D5W every shift
Correct Answer:
B. Prepare to administer desmopressin
Rationale: Neurogenic diabetes insipidus (DI) is a condition that can occur when there
is trauma to the brain such as tumors or injury to the pituitary or hypothalamus areas in
particular. DI can also occur with cerebral edema present. The antidiuretic hormone
(ADH) deficiency occurs rapidly and results in polyuria of anywhere between 5 to 40
liters of urine/24 hours. The client demonstrates signs and symptoms of hypovolemia.
Electrolyte imbalances include hypernatremia, along with hypokalemia and
hypercalcemia when it has a neurogenic etiology. Clients with neurogenic DI are
primarily treated with administration of exogenous ADH preparations, of which DDAVP
is most commonly used. Fluid output is carefully monitored and fluids are replaced
every hour.
, D454 AH III EXAM HINTS
1. An unexpected, catastrophic pulmonary complication with no previous
pulmonary moriar or oplems:
ARDS
2. Interventions for ventilated patients with ARDS:
Elevate HOB to at least 30 degrees; sedation vacations; strict oral hygiene;
implement mobilization program
3. Increased risk and mortality rate from ARDS in individuals who have a history
of:
Alcohol abuse
4. Suction only when:
Secretions are present
5. Before drawing a sample for ABGs from the radial artery, perform the ___ to
assess collateral circulation:
Allen test
6. Three most common symptoms of respiratory failure:
Dyspnea/tachypnea, intercostal and sternal retractions, cyanosis
, D454 AH III Study Guide Qs w/ Ans
1. What will be seen on a EKG if a pts potassium is high?
Peaked T waves and ST elevation
2. What are these s/s of? irreg. HR, Respiratory failure, hyperactive bowels,
diarrhea, muscle weakness, cramping, numbness
High potassium
3. Nursing interventions for hyperkalemia?
Monitor EKG, No salt/fruit/green leafy foods
4. What medications are given for hyperkalemia?
Sodium polystyrene sulfonate, sodium bicarb, calcium gluconate, diuretics.
Extreme: Dialysis
5. What is a PE?
Clot or air bubble in lungs
6. Who is at risk for a PE?
DVT, trauma, surgery, pregnancy, immobility
,124. What test is done with invasive monitoring before arterial line insertion?
Allen test before ABG's
125. What is a hypertensive crisis volume?
DBP >120 or MAP >150
126. What is a hypertensive crisis?
Vessels dilate and are unable to constrict
127. What is the tx for hypertensive crisis?
Nitroprusside drip
128. What do you monitor if a pt is on a nitroprusside drip?
Fatigue, nausea, tinnitus, delirium, reflex tachy
129. What is atrial flutter?
Saw-tooth P wave
130. What is a high risk for atrial fib?
COPD
131. What do you do if a pt is in asystole?
Flat line—start CPR
, Troponin level
156. How is severe hyperkalemia demonstrated on a EKG?
Peaked T wave, flattened P wave, widened QRS complex
157. What causes SIADH?
Excess secretion of ADH
158. What is the result of SIADH?
Decreased urine output and dilution hyponatremia
159. What is the tx for SIADH?
Hypertonic solution, fluid restriction
160. What is diabetes insipidus (DI)?
Increased urine output and hypernatremia—too much salt, not enough water
161. What is the tx for diabetes insipidus (DI)?
Fluid replacement, vasopressin or desmopressin, monitor electrolytes—severe
dehydration will occur
162. What's the first thing you do with a pt who has Addison's disease?
Hang IV fluids
Adult Health III
Objective Assessment
(2 Full Exams)
Actual Questions with Verified Answers
Take and pass the OA :)
What You Will Get:
➢150+ OA Exam Questions w/ Answers
➢Expert Rationales included.
➢OA Study Guide QS & Clinical Prioritization
➢AH III EXAM HINTS
, Preview Pages Below
Get the Complete PDF After Purchase
"If you require further clarification or in need of any study resources,
feel free to Message me."
Digital preview sample
,Table of Contents
D454 OA EXAM SET 1 ............................................................ 2
D454 OA EXAM SET 2 .......................................................... 37
D454 AH III EXAM HINTS .................................................... 94
D454 AH III Study Guide Qs w/ Ans .................................. 113
D454 OA EXAM SET 1
Question 1
The nurse is assessing a burn victim who suffered destruction of the epidermis
and some of the dermis of the entire right arm and half of the length of the right
leg. How should the nurse document the burn assessment findings?
A. Superficial, 18% total body surface area (TBSA)
B. Superficial partial thickness, 18% TBSA
C. Deep partial thickness, 27% TBSA
D. Full thickness, 27% TBSA
Correct Answer:
B. Superficial partial thickness, 18% TBSA
Rationale: A superficial partial-thickness burn involves destruction of the epidermis
layer and some of the dermis layer. The %TBSA is easily calculated by using the rule of
nines method. In this case, involvement of one arm is calculated as 9% TBSA, one-half
of a leg is 9% TBSA, for a combined total of 18% TBSA. Total leg involvement is 18%
TBSA.
,Question 2
A client with a history of chronic alcoholism is admitted with pneumonia. The
nurse inserts two large bore IV catheters and starts an infusion of 0.9% sodium
chloride at 75 mL/hour and titrates the client's oxygen to 60% by nonrebreather
mask. The cardiac monitor displays sinus tachycardia with multifocal premature
ventricular contractions. Which client's serum laboratory value requires
immediate intervention by the nurse?
A. Sodium 138 mEq/L
B. Hemoglobin 9 g/dL
C. Magnesium 1.0 mg/dL
D. Potassium 5.5 mEq/L
Correct Answer:
C. Magnesium 1.0 mg/dL
Rationale: Normal magnesium level is 1.7 to 2.2 mg/dL. Hypomagnesemia is critical
and may cause a lethal ventricular arrhythmia, torsades de pointes, and requires
immediate intervention. Chronic alcoholism is a risk factor for hypomagnesemia due to
poor nutritional intake and increased renal excretion.
Question 3
The nurse is providing care to a client who is comatose following cardiac arrest
24 hours ago. Which physical assessment finding should the nurse determine to
be a predictor of a poor outcome?
A. Lack of response to a sternal rub
B. Lack of corneal or papillary response
C. Lack of purposeful motor response
D. Lack of response to verbal stimulation
Correct Answer:
B. Lack of corneal or papillary response
Rationale: The two best predictors of a poor outcome for a comatose client who
experienced cardiac arrest are lack of corneal or papillary response at 24 hours and
lack of motor movement at 72 hours. These responses are mediated by the brainstem.
Question 4
,A client's vital signs are: temperature 97.4°F (36.3°C), blood pressure 88/50
mmHg, heart rate 76 beats/minute, and respirations 18 breaths/minute. How
should the nurse document the mean arterial pressure (MAP)?
(Fill in the blank. Enter numerical value only. If rounding is required, round to the
nearest whole value.)
Correct Answer:
63
Rationale: The mean arterial pressure (MAP) can be calculated using the following
formula: MAP = [Diastolic blood pressure × 2 + Systolic blood pressure] ÷ 3. This client's
MAP = (50 + 50) + 88 = 188 ÷ 3 = 62.66 = 63 mmHg. A normal MAP should be between
70 to 105 mm Hg. A low MAP means low perfusion to body tissues.
Question 5
A client arrives in the emergency department reporting chest palpitations, feeling
weak and dizzy, and having a blood pressure of 100/60 mmHg. What action is
most important for the nurse to implement based on this electrocardiogram
(EKG) tracing if the client becomes unstable? (EKG showing atrial flutter)
A. Monitor vital signs and prepare for synchronized cardioversion
B. Call the healthcare provider for drug prescriptions
C. Instruct the client to perform Valsalva maneuvers
D. Document the interpretation of the EKG and the client's subjective symptoms
Correct Answer:
A. Monitor vital signs and prepare for synchronized cardioversion
Rationale: The EKG is showing atrial flutter. When the client experiences atrial flutter
and is symptomatically unstable, the Advance Cardiac Life Support (ACLS) algorithm
recommends the client be treated the same way as a person with atrial fibrillation, and
immediate cardioversion be administered. Drugs are not recommended for unstable
,into the collection bag 250 mL of pale yellow urine in the last 30 minutes. After
reporting these findings to the healthcare provider, which action should the nurse
implement?
A. Identify the underlying cause of this condition
B. Prepare to administer desmopressin
C. Decrease the intravenous fluids to a maintenance rate
D. Replace fluid losses with D5W every shift
Correct Answer:
B. Prepare to administer desmopressin
Rationale: Neurogenic diabetes insipidus (DI) is a condition that can occur when there
is trauma to the brain such as tumors or injury to the pituitary or hypothalamus areas in
particular. DI can also occur with cerebral edema present. The antidiuretic hormone
(ADH) deficiency occurs rapidly and results in polyuria of anywhere between 5 to 40
liters of urine/24 hours. The client demonstrates signs and symptoms of hypovolemia.
Electrolyte imbalances include hypernatremia, along with hypokalemia and
hypercalcemia when it has a neurogenic etiology. Clients with neurogenic DI are
primarily treated with administration of exogenous ADH preparations, of which DDAVP
is most commonly used. Fluid output is carefully monitored and fluids are replaced
every hour.
, D454 AH III EXAM HINTS
1. An unexpected, catastrophic pulmonary complication with no previous
pulmonary moriar or oplems:
ARDS
2. Interventions for ventilated patients with ARDS:
Elevate HOB to at least 30 degrees; sedation vacations; strict oral hygiene;
implement mobilization program
3. Increased risk and mortality rate from ARDS in individuals who have a history
of:
Alcohol abuse
4. Suction only when:
Secretions are present
5. Before drawing a sample for ABGs from the radial artery, perform the ___ to
assess collateral circulation:
Allen test
6. Three most common symptoms of respiratory failure:
Dyspnea/tachypnea, intercostal and sternal retractions, cyanosis
, D454 AH III Study Guide Qs w/ Ans
1. What will be seen on a EKG if a pts potassium is high?
Peaked T waves and ST elevation
2. What are these s/s of? irreg. HR, Respiratory failure, hyperactive bowels,
diarrhea, muscle weakness, cramping, numbness
High potassium
3. Nursing interventions for hyperkalemia?
Monitor EKG, No salt/fruit/green leafy foods
4. What medications are given for hyperkalemia?
Sodium polystyrene sulfonate, sodium bicarb, calcium gluconate, diuretics.
Extreme: Dialysis
5. What is a PE?
Clot or air bubble in lungs
6. Who is at risk for a PE?
DVT, trauma, surgery, pregnancy, immobility
,124. What test is done with invasive monitoring before arterial line insertion?
Allen test before ABG's
125. What is a hypertensive crisis volume?
DBP >120 or MAP >150
126. What is a hypertensive crisis?
Vessels dilate and are unable to constrict
127. What is the tx for hypertensive crisis?
Nitroprusside drip
128. What do you monitor if a pt is on a nitroprusside drip?
Fatigue, nausea, tinnitus, delirium, reflex tachy
129. What is atrial flutter?
Saw-tooth P wave
130. What is a high risk for atrial fib?
COPD
131. What do you do if a pt is in asystole?
Flat line—start CPR
, Troponin level
156. How is severe hyperkalemia demonstrated on a EKG?
Peaked T wave, flattened P wave, widened QRS complex
157. What causes SIADH?
Excess secretion of ADH
158. What is the result of SIADH?
Decreased urine output and dilution hyponatremia
159. What is the tx for SIADH?
Hypertonic solution, fluid restriction
160. What is diabetes insipidus (DI)?
Increased urine output and hypernatremia—too much salt, not enough water
161. What is the tx for diabetes insipidus (DI)?
Fluid replacement, vasopressin or desmopressin, monitor electrolytes—severe
dehydration will occur
162. What's the first thing you do with a pt who has Addison's disease?
Hang IV fluids
