WGU D453 ADVANCED NURSING SKILLS EXAMINATION
COMPLETE QUESTIONS AND DETAILED SOLUTIONS
LATEST UPDATE THIS YEAR JUST RELEASED
Question 1
A registered nurse is caring for an older adult experiencing sudden confusion after surgery, and
the nurse must determine the priority nursing intervention that best promotes patient safety
while addressing the likely underlying cause of the patient's condition.
A. Apply physical restraints immediately
B. Assess oxygenation, pain, medications, hydration, and infection status
C. Leave the patient alone to reduce stimulation
D. Administer sedatives before completing the assessment
Answer: B
Rationale:
Postoperative confusion may indicate delirium resulting from hypoxia, medication effects,
infection, dehydration, or pain. Performing a comprehensive assessment before implementing
interventions supports patient safety and evidence-based nursing practice.
Question 2
A nurse preparing to administer intravenous potassium chloride notices that the prescribed
concentration exceeds recommended safety guidelines, and the nurse must determine the
most appropriate action before initiating the infusion.
A. Administer the medication slowly without questioning the order
B. Verify the prescription and contact the prescribing provider before administration
C. Dilute the medication without documenting the change
D. Ask another nurse to administer the medication instead
,Answer: B
Rationale:
Potassium chloride is a high-alert medication. Nurses should verify questionable orders with the
provider before administration to prevent potentially fatal complications.
Question 3
A patient receiving opioid analgesics becomes difficult to arouse and demonstrates a
respiratory rate of eight breaths per minute, requiring the nurse to determine the most
appropriate immediate nursing response.
A. Encourage oral fluids
B. Continue monitoring every four hours
C. Stop the opioid, assess airway, provide oxygen, and prepare naloxone if indicated
D. Document the assessment and reassess tomorrow
Answer: C
Rationale:
Respiratory depression is a life-threatening opioid complication requiring immediate
intervention to support airway, breathing, and circulation while reversing opioid effects when
appropriate.
Question 4
During discharge teaching for a patient newly diagnosed with heart failure, the nurse identifies
the statement that demonstrates the patient understands daily self-management
responsibilities after returning home.
A. "I will weigh myself every morning after waking."
B. "I should stop taking medications whenever I feel better."
C. "Weight changes are not important."
D. "Salt intake does not affect my condition."
,Answer: A
Rationale:
Daily weight monitoring helps identify fluid retention early, allowing timely intervention to
reduce complications associated with heart failure.
Question 5
A nurse caring for a patient with suspected sepsis recognizes which assessment finding requires
immediate notification of the healthcare provider because it most strongly suggests worsening
systemic infection.
A. Temperature 39.5°C with hypotension and increasing confusion
B. Mild headache after breakfast
C. Dry skin on elbows
D. Slight appetite reduction
Answer: A
Rationale:
High fever, hypotension, and altered mental status indicate possible septic shock requiring
rapid assessment and treatment.
Question 6
A nurse caring for an immunocompromised patient must determine which intervention most
effectively reduces the risk of healthcare-associated infection during routine patient care.
A. Perform meticulous hand hygiene before and after every patient interaction
B. Wear gloves only during medication administration
C. Keep patient room door open continuously
D. Share equipment between patients without cleaning
Answer: A
, Rationale:
Hand hygiene remains the single most effective intervention for preventing healthcare-
associated infections.
Question 7
A patient with diabetes reports dizziness, sweating, shakiness, and confusion before lunch, and
the nurse must determine the priority intervention based upon these assessment findings.
A. Check the patient's blood glucose immediately
B. Encourage exercise
C. Delay assessment until after lunch
D. Restrict fluid intake
Answer: A
Rationale:
These symptoms strongly suggest hypoglycaemia. Confirming blood glucose guides immediate
treatment.
Question 8
A nurse receives laboratory results indicating a critically elevated serum potassium level in a
patient with renal failure and must identify the highest priority nursing action.
A. Notify the provider immediately while assessing cardiac rhythm
B. Encourage foods high in potassium
C. Delay reporting until morning rounds
D. Discontinue oxygen therapy
Answer: A
Rationale:
Hyperkalaemia increases the risk of life-threatening cardiac dysrhythmias requiring urgent
intervention.
COMPLETE QUESTIONS AND DETAILED SOLUTIONS
LATEST UPDATE THIS YEAR JUST RELEASED
Question 1
A registered nurse is caring for an older adult experiencing sudden confusion after surgery, and
the nurse must determine the priority nursing intervention that best promotes patient safety
while addressing the likely underlying cause of the patient's condition.
A. Apply physical restraints immediately
B. Assess oxygenation, pain, medications, hydration, and infection status
C. Leave the patient alone to reduce stimulation
D. Administer sedatives before completing the assessment
Answer: B
Rationale:
Postoperative confusion may indicate delirium resulting from hypoxia, medication effects,
infection, dehydration, or pain. Performing a comprehensive assessment before implementing
interventions supports patient safety and evidence-based nursing practice.
Question 2
A nurse preparing to administer intravenous potassium chloride notices that the prescribed
concentration exceeds recommended safety guidelines, and the nurse must determine the
most appropriate action before initiating the infusion.
A. Administer the medication slowly without questioning the order
B. Verify the prescription and contact the prescribing provider before administration
C. Dilute the medication without documenting the change
D. Ask another nurse to administer the medication instead
,Answer: B
Rationale:
Potassium chloride is a high-alert medication. Nurses should verify questionable orders with the
provider before administration to prevent potentially fatal complications.
Question 3
A patient receiving opioid analgesics becomes difficult to arouse and demonstrates a
respiratory rate of eight breaths per minute, requiring the nurse to determine the most
appropriate immediate nursing response.
A. Encourage oral fluids
B. Continue monitoring every four hours
C. Stop the opioid, assess airway, provide oxygen, and prepare naloxone if indicated
D. Document the assessment and reassess tomorrow
Answer: C
Rationale:
Respiratory depression is a life-threatening opioid complication requiring immediate
intervention to support airway, breathing, and circulation while reversing opioid effects when
appropriate.
Question 4
During discharge teaching for a patient newly diagnosed with heart failure, the nurse identifies
the statement that demonstrates the patient understands daily self-management
responsibilities after returning home.
A. "I will weigh myself every morning after waking."
B. "I should stop taking medications whenever I feel better."
C. "Weight changes are not important."
D. "Salt intake does not affect my condition."
,Answer: A
Rationale:
Daily weight monitoring helps identify fluid retention early, allowing timely intervention to
reduce complications associated with heart failure.
Question 5
A nurse caring for a patient with suspected sepsis recognizes which assessment finding requires
immediate notification of the healthcare provider because it most strongly suggests worsening
systemic infection.
A. Temperature 39.5°C with hypotension and increasing confusion
B. Mild headache after breakfast
C. Dry skin on elbows
D. Slight appetite reduction
Answer: A
Rationale:
High fever, hypotension, and altered mental status indicate possible septic shock requiring
rapid assessment and treatment.
Question 6
A nurse caring for an immunocompromised patient must determine which intervention most
effectively reduces the risk of healthcare-associated infection during routine patient care.
A. Perform meticulous hand hygiene before and after every patient interaction
B. Wear gloves only during medication administration
C. Keep patient room door open continuously
D. Share equipment between patients without cleaning
Answer: A
, Rationale:
Hand hygiene remains the single most effective intervention for preventing healthcare-
associated infections.
Question 7
A patient with diabetes reports dizziness, sweating, shakiness, and confusion before lunch, and
the nurse must determine the priority intervention based upon these assessment findings.
A. Check the patient's blood glucose immediately
B. Encourage exercise
C. Delay assessment until after lunch
D. Restrict fluid intake
Answer: A
Rationale:
These symptoms strongly suggest hypoglycaemia. Confirming blood glucose guides immediate
treatment.
Question 8
A nurse receives laboratory results indicating a critically elevated serum potassium level in a
patient with renal failure and must identify the highest priority nursing action.
A. Notify the provider immediately while assessing cardiac rhythm
B. Encourage foods high in potassium
C. Delay reporting until morning rounds
D. Discontinue oxygen therapy
Answer: A
Rationale:
Hyperkalaemia increases the risk of life-threatening cardiac dysrhythmias requiring urgent
intervention.
