WGU D446 – Adult Health II Objective
Assessment | OA V1 and V2 | Questions
and Answers – 2026 Update | 100%
Correct.
SECTION 1: CARDIOVASCULAR DISORDERS
Question 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
Rationales>..: 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.
,Question 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
Rationales>..: 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.
Question 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
Rationales>..: 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 immediately dangerous.
Question 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 white blood cell count
Correct Answer: A) Elevated B-type natriuretic peptide (BNP)
Rationales>..: BNP is released by the ventricles in response to increased wall
tension and volume overload. Elevated BNP is a hallmark laboratory finding in heart
failure. Troponin elevation indicates myocardial injury, not heart failure.
Question 5
A client with a history of heart failure is receiving digoxin. Which assessment finding
indicates digoxin toxicity?
A) Heart rate of 72 bpm
B) Serum potassium of 4.0 mEq/L
C) Yellow-green halos around lights
D) Blood pressure of 130/80 mmHg
, Correct Answer: C) Yellow-green halos around lights
Rationales>..: Visual disturbances, including yellow-green halos around lights
(xanthopsia), are classic signs of digoxin toxicity. Other signs include nausea,
vomiting, bradycardia, and cardiac dysrhythmias.
Question 6
The MONA protocol for management of acute myocardial infarction includes:
A) Morphine, oxygen, nitroglycerin, aspirin
B) Metoprolol, oxygen, naloxone, amiodarone
C) Morphine, ondansetron, nitroglycerin, atropine
D) Metoprolol, oxygen, nitroglycerin, aspirin
Correct Answer: A) Morphine, oxygen, nitroglycerin, aspirin
Rationales>..: MONA stands for Morphine (pain relief and preload reduction),
Oxygen (for hypoxia), Nitroglycerin (vasodilation and chest pain relief), and Aspirin
(antiplatelet effect to prevent further clot formation).
Question 7
A client post-myocardial infarction develops a pericardial friction rub 3 weeks after
the event. This finding is most consistent with:
A) Cardiac tamponade
B) Dressler syndrome
Assessment | OA V1 and V2 | Questions
and Answers – 2026 Update | 100%
Correct.
SECTION 1: CARDIOVASCULAR DISORDERS
Question 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
Rationales>..: 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.
,Question 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
Rationales>..: 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.
Question 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
Rationales>..: 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 immediately dangerous.
Question 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 white blood cell count
Correct Answer: A) Elevated B-type natriuretic peptide (BNP)
Rationales>..: BNP is released by the ventricles in response to increased wall
tension and volume overload. Elevated BNP is a hallmark laboratory finding in heart
failure. Troponin elevation indicates myocardial injury, not heart failure.
Question 5
A client with a history of heart failure is receiving digoxin. Which assessment finding
indicates digoxin toxicity?
A) Heart rate of 72 bpm
B) Serum potassium of 4.0 mEq/L
C) Yellow-green halos around lights
D) Blood pressure of 130/80 mmHg
, Correct Answer: C) Yellow-green halos around lights
Rationales>..: Visual disturbances, including yellow-green halos around lights
(xanthopsia), are classic signs of digoxin toxicity. Other signs include nausea,
vomiting, bradycardia, and cardiac dysrhythmias.
Question 6
The MONA protocol for management of acute myocardial infarction includes:
A) Morphine, oxygen, nitroglycerin, aspirin
B) Metoprolol, oxygen, naloxone, amiodarone
C) Morphine, ondansetron, nitroglycerin, atropine
D) Metoprolol, oxygen, nitroglycerin, aspirin
Correct Answer: A) Morphine, oxygen, nitroglycerin, aspirin
Rationales>..: MONA stands for Morphine (pain relief and preload reduction),
Oxygen (for hypoxia), Nitroglycerin (vasodilation and chest pain relief), and Aspirin
(antiplatelet effect to prevent further clot formation).
Question 7
A client post-myocardial infarction develops a pericardial friction rub 3 weeks after
the event. This finding is most consistent with:
A) Cardiac tamponade
B) Dressler syndrome
