WGU D444 Adult Health 1 Objective
Assessment | OA V1 and V2 – Questions
and Answers | 2026 Update | 100%
Correct.
Question 1
A patient has a serum sodium of 118 mEq/L. Which intervention is the priority?
A. Restrict free water intake
B. Administer 3% NaCl
C. Implement seizure precautions
D. Encourage oral fluids
Correct Answer: C
Rationale: Severe hyponatremia (Na < 120 mEq/L) causes cerebral edema and
increases seizure risk. Safety is the priority—implement seizure precautions first.
While free water restriction and hypertonic saline may be indicated, protecting the
patient from injury due to seizures is the immediate priority.
Question 2
A client had a colectomy two days ago and develops wound dehiscence with
evisceration. What should the nurse do first?
A. Cover the wound with sterile saline-soaked dressings
B. Attempt to reinsert the protruding organs
C. Place the client in a supine position with legs elevated
D. Apply an abdominal binder tightly
,Correct Answer: A
Rationale: Evisceration requires covering the protruding organs with sterile saline-
soaked dressings to keep them moist and protect from infection. The nurse should
never attempt to reinsert organs. The patient should be placed in low Fowler's
position with knees bent to reduce intra-abdominal pressure.
Question 3
A patient in the immediate postoperative period has a blood pressure of 88/52
mmHg and heart rate of 118 bpm. What is the priority nursing intervention?
A. Notify the provider immediately
B. Increase IV fluid rate
C. Place the client in High-Fowler's position
D. Document the findings in the chart
Correct Answer: B
Rationale: Hypotension and tachycardia in the immediate postoperative period are
signs of hypovolemia or hemorrhage. Increasing IV fluids is the initial intervention to
restore circulating volume. Notification may follow if no response.
Question 4
A patient is receiving IV fluids and develops crackles in the lungs, jugular venous
distention, and peripheral edema. The nurse suspects:
A. Hypovolemia
B. Fluid volume excess
C. Anaphylactic reaction
D. Pulmonary embolism
,Correct Answer: B
Rationale: Crackles, JVD, and peripheral edema are classic signs of fluid volume
excess (hypervolemia), often due to heart failure or excessive fluid administration.
Hypovolemia would present with hypotension, tachycardia, and dry mucous
membranes.
Question 5
Which laboratory value should the nurse monitor most closely in a client receiving
warfarin therapy?
A. Hemoglobin A1C
B. Serum potassium
C. International Normalized Ratio (INR)
D. White blood cell count
Correct Answer: C
Rationale: Warfarin is an anticoagulant that requires monitoring of INR to maintain
therapeutic levels (typically 2–3 for most indications). INR reflects the patient's
clotting status and guides dose adjustments to prevent bleeding or clotting
complications.
Question 6
A patient with heart failure has an ejection fraction of 35%. This indicates:
A. Preserved systolic function
B. Reduced systolic function (HFrEF)
C. Normal diastolic function
D. Severe valvular disease
, Correct Answer: B
Rationale: Normal ejection fraction (EF) is 55–70%. An EF of 35% indicates systolic
heart failure with reduced ejection fraction (HFrEF). This means the left ventricle is
not pumping effectively, and treatment focuses on afterload reduction, diuresis,
and inotropic support.
Question 7
A patient on amlodipine reports flushing and headache. The nurse's best response
is:
A. "These are expected side effects that often improve with time."
B. "Stop the medication immediately and call 911."
C. "You are having an allergic reaction."
D. "This indicates your blood pressure is now normal."
Correct Answer: A
Rationale: Amlodipine is a calcium channel blocker that causes vasodilation,
leading to flushing, headache, and peripheral edema. These are common side
effects that often resolve as the body adjusts. The patient should not stop abruptly
without consulting the provider.
Question 8
A patient with unstable angina is prescribed clopidogrel. Which teaching point is
most important?
A. "Take with grapefruit juice to increase absorption."
B. "Notify the provider if you notice black, tarry stools."
Assessment | OA V1 and V2 – Questions
and Answers | 2026 Update | 100%
Correct.
Question 1
A patient has a serum sodium of 118 mEq/L. Which intervention is the priority?
A. Restrict free water intake
B. Administer 3% NaCl
C. Implement seizure precautions
D. Encourage oral fluids
Correct Answer: C
Rationale: Severe hyponatremia (Na < 120 mEq/L) causes cerebral edema and
increases seizure risk. Safety is the priority—implement seizure precautions first.
While free water restriction and hypertonic saline may be indicated, protecting the
patient from injury due to seizures is the immediate priority.
Question 2
A client had a colectomy two days ago and develops wound dehiscence with
evisceration. What should the nurse do first?
A. Cover the wound with sterile saline-soaked dressings
B. Attempt to reinsert the protruding organs
C. Place the client in a supine position with legs elevated
D. Apply an abdominal binder tightly
,Correct Answer: A
Rationale: Evisceration requires covering the protruding organs with sterile saline-
soaked dressings to keep them moist and protect from infection. The nurse should
never attempt to reinsert organs. The patient should be placed in low Fowler's
position with knees bent to reduce intra-abdominal pressure.
Question 3
A patient in the immediate postoperative period has a blood pressure of 88/52
mmHg and heart rate of 118 bpm. What is the priority nursing intervention?
A. Notify the provider immediately
B. Increase IV fluid rate
C. Place the client in High-Fowler's position
D. Document the findings in the chart
Correct Answer: B
Rationale: Hypotension and tachycardia in the immediate postoperative period are
signs of hypovolemia or hemorrhage. Increasing IV fluids is the initial intervention to
restore circulating volume. Notification may follow if no response.
Question 4
A patient is receiving IV fluids and develops crackles in the lungs, jugular venous
distention, and peripheral edema. The nurse suspects:
A. Hypovolemia
B. Fluid volume excess
C. Anaphylactic reaction
D. Pulmonary embolism
,Correct Answer: B
Rationale: Crackles, JVD, and peripheral edema are classic signs of fluid volume
excess (hypervolemia), often due to heart failure or excessive fluid administration.
Hypovolemia would present with hypotension, tachycardia, and dry mucous
membranes.
Question 5
Which laboratory value should the nurse monitor most closely in a client receiving
warfarin therapy?
A. Hemoglobin A1C
B. Serum potassium
C. International Normalized Ratio (INR)
D. White blood cell count
Correct Answer: C
Rationale: Warfarin is an anticoagulant that requires monitoring of INR to maintain
therapeutic levels (typically 2–3 for most indications). INR reflects the patient's
clotting status and guides dose adjustments to prevent bleeding or clotting
complications.
Question 6
A patient with heart failure has an ejection fraction of 35%. This indicates:
A. Preserved systolic function
B. Reduced systolic function (HFrEF)
C. Normal diastolic function
D. Severe valvular disease
, Correct Answer: B
Rationale: Normal ejection fraction (EF) is 55–70%. An EF of 35% indicates systolic
heart failure with reduced ejection fraction (HFrEF). This means the left ventricle is
not pumping effectively, and treatment focuses on afterload reduction, diuresis,
and inotropic support.
Question 7
A patient on amlodipine reports flushing and headache. The nurse's best response
is:
A. "These are expected side effects that often improve with time."
B. "Stop the medication immediately and call 911."
C. "You are having an allergic reaction."
D. "This indicates your blood pressure is now normal."
Correct Answer: A
Rationale: Amlodipine is a calcium channel blocker that causes vasodilation,
leading to flushing, headache, and peripheral edema. These are common side
effects that often resolve as the body adjusts. The patient should not stop abruptly
without consulting the provider.
Question 8
A patient with unstable angina is prescribed clopidogrel. Which teaching point is
most important?
A. "Take with grapefruit juice to increase absorption."
B. "Notify the provider if you notice black, tarry stools."
