WGU D446 OA Adult Health II Exam
(2026) – Actual Questions & Study
Guides WITH CORRECT ANSWERS WELL
VERIFIED AND IN-DEPTH RATIONALES!
Section 1: Cardiovascular Disorders
1. A nurse is assessing a client with heart failure who has been prescribed digoxin. Which
finding indicates a therapeutic response to the medication?
a) Increased heart rate
b) Decreased shortness of breath
c) Jugular venous distention
d) Decreased urine output
ANSWER: b) Decreased shortness of breath
Rationale: Digoxin is a positive inotrope that increases the force of myocardial
contraction, improving cardiac output. This leads to a reduction in fluid backup in the
lungs, which manifests as decreased shortness of breath and crackles. Option A is
incorrect; digoxin has a negative chronotropic effect (decreases heart rate). Jugular
venous distention (C) and decreased urine output (D) are signs of worsening heart
failure.
2. A client is admitted with acute decompensated heart failure (ADHF). What is the
priority nursing intervention?
a) Administer a bronchodilator.
b) Position the client in a high-Fowler's position.
c) Encourage oral fluid intake.
d) Initiate a cardiac rehabilitation consult.
,ANSWER: b) Position the client in a high-Fowler's position.
Rationale: The priority in ADHF is to manage respiratory distress. High-Fowler's position
uses gravity to reduce venous return to the heart and lungs, decreasing pulmonary
congestion and improving oxygenation. This is an immediate, non-invasive intervention.
Option A is not a standard first-line treatment for pulmonary edema from HF. Option C
would worsen the condition.
3. Which dietary instruction is most important for a client with heart failure?
a) "Increase your intake of citrus fruits."
b) "You should limit your sodium intake to 2 grams per day."
c) "It's best to eat three large meals a day."
d) "You can add salt to your food after it is cooked."
ANSWER: b) "You should limit your sodium intake to 2 grams per day."
Rationale: Sodium restriction (typically < 2g/day) is crucial to reduce fluid retention,
which decreases the workload on the heart. Option D directly contradicts this. Eating
smaller, more frequent meals (C) can help with feelings of fullness but is secondary to
sodium control.
4. A client is diagnosed with coronary artery disease (CAD). Which laboratory value is
considered a major risk factor?
a) High-density lipoprotein (HDL) 60 mg/dL
b) Low-density lipoprotein (LDL) 180 mg/dL
c) Triglycerides 120 mg/dL
d) Total cholesterol 180 mg/dL
ANSWER: b) Low-density lipoprotein (LDL) 180 mg/dL
Rationale: Elevated LDL ("bad" cholesterol) is a primary modifiable risk factor for CAD.
An LDL > 130 mg/dL is considered high. An HDL of 60 mg/dL (A) is considered
protective. Triglycerides (C) and total cholesterol (D) levels are within normal limits.
5. A client reports chest pain that is relieved by rest. This is most characteristic of:
,a) Unstable angina
b) Prinzmetal's angina
c) Stable angina
d) Myocardial infarction
ANSWER: c) Stable angina
Rationale: Stable angina is predictable chest pain that occurs with exertion or stress
and is relieved by rest or sublingual nitroglycerin. Unstable angina (A) is a change in the
pattern and occurs at rest. Prinzmetal's (B) is caused by vasospasm and often occurs at
rest. Myocardial infarction (D) is not relieved by rest alone.
6. A client post-MI is prescribed aspirin and clopidogrel. The nurse teaches the client the
purpose of this therapy is to:
a) Dissolve the existing clot in the coronary artery.
b) Prevent further platelet aggregation and clot formation.
c) Lower the client's blood pressure.
d) Dilate the coronary arteries.
ANSWER: b) Prevent further platelet aggregation and clot formation.
Rationale: Aspirin and clopidogrel are antiplatelet agents. They work by inhibiting
platelet aggregation, preventing new clots from forming. They do not dissolve existing
clots (A) (thrombolytics do). They have minimal effect on blood pressure (C) and do not
directly dilate arteries (D) (nitrates do).
7. A nurse is assessing a client with left-sided heart failure. Which assessment finding is
most indicative of this condition?
a) Peripheral edema
b) Crackles in the lungs
c) Jugular venous distention
d) Hepatomegaly
, ANSWER: b) Crackles in the lungs
Rationale: Left-sided heart failure leads to a backup of blood into the pulmonary
circulation. This results in pulmonary congestion, which manifests as crackles (pulmonary
edema), cough, and dyspnea. Peripheral edema (A), JVD (C), and hepatomegaly (D)
are signs of right-sided heart failure.
8. A client's ECG shows a prolonged PR interval (>0.20 seconds). This indicates:
a) Atrial fibrillation
b) First-degree atrioventricular (AV) block
c) Ventricular tachycardia
d) Normal sinus rhythm
ANSWER: b) First-degree atrioventricular (AV) block
Rationale: A prolonged PR interval (>0.20 seconds) is the hallmark of a first-degree AV
block. It indicates a delay in conduction from the atria to the ventricles. Atrial fibrillation
(A) shows absent P waves. Ventricular tachycardia (C) shows wide, bizarre QRS
complexes.
9. When auscultating a client's heart, the nurse hears a swooshing sound between
beats. This is best documented as:
a) A murmur
b) A bruit
c) An S3 gallop
d) Pericardial friction rub
ANSWER: a) A murmur
Rationale: A murmur is a swooshing or whooshing sound caused by turbulent blood
flow. A bruit (B) is the same sound but auscultated over a major artery (like the carotid).
An S3 gallop (C) is a low-frequency sound ("Ken-tucky") often associated with HF. A
pericardial friction rub (D) is a high-pitched, scratchy sound.
10. A client with infective endocarditis is being discharged. Which instruction is crucial
for the nurse to include?
(2026) – Actual Questions & Study
Guides WITH CORRECT ANSWERS WELL
VERIFIED AND IN-DEPTH RATIONALES!
Section 1: Cardiovascular Disorders
1. A nurse is assessing a client with heart failure who has been prescribed digoxin. Which
finding indicates a therapeutic response to the medication?
a) Increased heart rate
b) Decreased shortness of breath
c) Jugular venous distention
d) Decreased urine output
ANSWER: b) Decreased shortness of breath
Rationale: Digoxin is a positive inotrope that increases the force of myocardial
contraction, improving cardiac output. This leads to a reduction in fluid backup in the
lungs, which manifests as decreased shortness of breath and crackles. Option A is
incorrect; digoxin has a negative chronotropic effect (decreases heart rate). Jugular
venous distention (C) and decreased urine output (D) are signs of worsening heart
failure.
2. A client is admitted with acute decompensated heart failure (ADHF). What is the
priority nursing intervention?
a) Administer a bronchodilator.
b) Position the client in a high-Fowler's position.
c) Encourage oral fluid intake.
d) Initiate a cardiac rehabilitation consult.
,ANSWER: b) Position the client in a high-Fowler's position.
Rationale: The priority in ADHF is to manage respiratory distress. High-Fowler's position
uses gravity to reduce venous return to the heart and lungs, decreasing pulmonary
congestion and improving oxygenation. This is an immediate, non-invasive intervention.
Option A is not a standard first-line treatment for pulmonary edema from HF. Option C
would worsen the condition.
3. Which dietary instruction is most important for a client with heart failure?
a) "Increase your intake of citrus fruits."
b) "You should limit your sodium intake to 2 grams per day."
c) "It's best to eat three large meals a day."
d) "You can add salt to your food after it is cooked."
ANSWER: b) "You should limit your sodium intake to 2 grams per day."
Rationale: Sodium restriction (typically < 2g/day) is crucial to reduce fluid retention,
which decreases the workload on the heart. Option D directly contradicts this. Eating
smaller, more frequent meals (C) can help with feelings of fullness but is secondary to
sodium control.
4. A client is diagnosed with coronary artery disease (CAD). Which laboratory value is
considered a major risk factor?
a) High-density lipoprotein (HDL) 60 mg/dL
b) Low-density lipoprotein (LDL) 180 mg/dL
c) Triglycerides 120 mg/dL
d) Total cholesterol 180 mg/dL
ANSWER: b) Low-density lipoprotein (LDL) 180 mg/dL
Rationale: Elevated LDL ("bad" cholesterol) is a primary modifiable risk factor for CAD.
An LDL > 130 mg/dL is considered high. An HDL of 60 mg/dL (A) is considered
protective. Triglycerides (C) and total cholesterol (D) levels are within normal limits.
5. A client reports chest pain that is relieved by rest. This is most characteristic of:
,a) Unstable angina
b) Prinzmetal's angina
c) Stable angina
d) Myocardial infarction
ANSWER: c) Stable angina
Rationale: Stable angina is predictable chest pain that occurs with exertion or stress
and is relieved by rest or sublingual nitroglycerin. Unstable angina (A) is a change in the
pattern and occurs at rest. Prinzmetal's (B) is caused by vasospasm and often occurs at
rest. Myocardial infarction (D) is not relieved by rest alone.
6. A client post-MI is prescribed aspirin and clopidogrel. The nurse teaches the client the
purpose of this therapy is to:
a) Dissolve the existing clot in the coronary artery.
b) Prevent further platelet aggregation and clot formation.
c) Lower the client's blood pressure.
d) Dilate the coronary arteries.
ANSWER: b) Prevent further platelet aggregation and clot formation.
Rationale: Aspirin and clopidogrel are antiplatelet agents. They work by inhibiting
platelet aggregation, preventing new clots from forming. They do not dissolve existing
clots (A) (thrombolytics do). They have minimal effect on blood pressure (C) and do not
directly dilate arteries (D) (nitrates do).
7. A nurse is assessing a client with left-sided heart failure. Which assessment finding is
most indicative of this condition?
a) Peripheral edema
b) Crackles in the lungs
c) Jugular venous distention
d) Hepatomegaly
, ANSWER: b) Crackles in the lungs
Rationale: Left-sided heart failure leads to a backup of blood into the pulmonary
circulation. This results in pulmonary congestion, which manifests as crackles (pulmonary
edema), cough, and dyspnea. Peripheral edema (A), JVD (C), and hepatomegaly (D)
are signs of right-sided heart failure.
8. A client's ECG shows a prolonged PR interval (>0.20 seconds). This indicates:
a) Atrial fibrillation
b) First-degree atrioventricular (AV) block
c) Ventricular tachycardia
d) Normal sinus rhythm
ANSWER: b) First-degree atrioventricular (AV) block
Rationale: A prolonged PR interval (>0.20 seconds) is the hallmark of a first-degree AV
block. It indicates a delay in conduction from the atria to the ventricles. Atrial fibrillation
(A) shows absent P waves. Ventricular tachycardia (C) shows wide, bizarre QRS
complexes.
9. When auscultating a client's heart, the nurse hears a swooshing sound between
beats. This is best documented as:
a) A murmur
b) A bruit
c) An S3 gallop
d) Pericardial friction rub
ANSWER: a) A murmur
Rationale: A murmur is a swooshing or whooshing sound caused by turbulent blood
flow. A bruit (B) is the same sound but auscultated over a major artery (like the carotid).
An S3 gallop (C) is a low-frequency sound ("Ken-tucky") often associated with HF. A
pericardial friction rub (D) is a high-pitched, scratchy sound.
10. A client with infective endocarditis is being discharged. Which instruction is crucial
for the nurse to include?
