WGU D455 Exit HESI HCV2 Exam -
Comprehensive 150-Question and Correct
Answers with Rationale | Professional Nursing
Role Transition | New 2026/2027 Update
Exam Blueprint Distribution:
• Medical-Surgical Nursing:
• Psychiatric/Mental Health:
• Pediatric Nursing:
• Maternity & Newborn Care:
• Fundamentals & Geriatrics:
• Management of Care/Leadership:
SECTION 1: MEDICAL-SURGICAL NURSING (55 Questions)
Cardiovascular System (15 Questions)
Question 1
A client with heart failure is prescribed digoxin. Which assessment finding
indicates the client is experiencing digoxin toxicity?
• A. Heart rate of 72 beats/min
• B. Blood pressure 130/80 mmHg
• C. Visual disturbances with yellow-green halos ✓
• D. Respiratory rate of 18 breaths/min
,Expert Rationale: Visual disturbances (yellow-green halos, blurred vision) are
classic signs of digoxin toxicity. Digoxin toxicity can also cause nausea, vomiting,
and cardiac dysrhythmias. The nurse should monitor serum digoxin levels
(therapeutic range 0.8-2.0 ng/mL) and potassium levels (hypokalemia increases
toxicity risk).
Question 2
A client with angina pectoris is prescribed sublingual nitroglycerin. Which
instruction should the nurse include in the teaching plan?
• A. Swallow the tablet with a full glass of water
• B. Place the tablet under the tongue and allow it to dissolve ✓
• C. Chew the tablet for faster absorption
• D. Take the tablet with food to prevent nausea
Expert Rationale: Sublingual nitroglycerin should be placed under the tongue and
allowed to dissolve completely. It is absorbed through the oral mucosa and should
not be swallowed, chewed, or taken with food. The client should take up to 3
tablets 5 minutes apart and seek emergency care if pain persists.
Question 3
The nurse is caring for a client with left-sided heart failure. Which finding is most
consistent with this condition?
• A. Jugular venous distention
• B. Peripheral edema
• C. Crackles auscultated in the lung bases ✓
• D. Hepatomegaly
Expert Rationale: Left-sided heart failure causes pulmonary congestion due to
increased pressure in the pulmonary vasculature. Crackles in the lung bases are
,characteristic. Right-sided heart failure (options A, B, D) causes systemic
congestion with JVD, peripheral edema, and hepatomegaly.
Question 4
A client is 2 days post-myocardial infarction. Which laboratory value should the
nurse monitor to evaluate for cardiac damage?
• A. BUN
• B. Creatinine
• C. Potassium
• D. Troponin I ✓
Expert Rationale: Troponin I is a highly specific and sensitive marker for
myocardial injury. It rises 3-6 hours after MI, peaks at 12-24 hours, and remains
elevated for 5-10 days. BUN and creatinine assess renal function; potassium
monitors electrolyte balance.
Question 5
The nurse is assessing a client with pericarditis. Which finding is most
characteristic of this condition?
• A. Crushing chest pain relieved by rest
• B. Chest pain that worsens with inspiration
• C. Sharp chest pain that improves when leaning forward ✓
• D. Substernal chest pain radiating to the left arm
Expert Rationale: Pericarditis pain is typically sharp, pleuritic, and improves with
leaning forward (because this reduces pressure on the pericardial sac). The pain
worsens with lying flat and deep inspiration. Option A describes angina; option B
is pleuritic pain; option D is typical of MI.
, Question 6
A client with hypertension is prescribed lisinopril. The nurse should monitor the
client for which adverse effect?
• A. Hyperkalemia
• B. Dry cough ✓
• C. Hypoglycemia
• D. Tachycardia
Expert Rationale: Lisinopril (an ACE inhibitor) commonly causes a persistent, dry,
nonproductive cough due to bradykinin accumulation. This adverse effect may
necessitate switching to an ARB. Hyperkalemia can also occur but is less common
than cough.
Question 7
The nurse is preparing to administer a beta-blocker to a client. Which
assessment finding should cause the nurse to question the order?
• A. Blood pressure 140/90 mmHg
• B. Heart rate 52 beats/min ✓
• C. Respiratory rate 20 breaths/min
• D. Temperature 98.6°F
Expert Rationale: Beta-blockers decrease heart rate and contractility. A heart rate
of 52 beats/min (bradycardia) is a relative contraindication, and the nurse should
contact the healthcare provider before administering the medication.
Question 8
A client with peripheral arterial disease (PAD) reports leg pain that occurs with
walking. What is the best nursing intervention?
• A. Encourage the client to rest with legs elevated
Comprehensive 150-Question and Correct
Answers with Rationale | Professional Nursing
Role Transition | New 2026/2027 Update
Exam Blueprint Distribution:
• Medical-Surgical Nursing:
• Psychiatric/Mental Health:
• Pediatric Nursing:
• Maternity & Newborn Care:
• Fundamentals & Geriatrics:
• Management of Care/Leadership:
SECTION 1: MEDICAL-SURGICAL NURSING (55 Questions)
Cardiovascular System (15 Questions)
Question 1
A client with heart failure is prescribed digoxin. Which assessment finding
indicates the client is experiencing digoxin toxicity?
• A. Heart rate of 72 beats/min
• B. Blood pressure 130/80 mmHg
• C. Visual disturbances with yellow-green halos ✓
• D. Respiratory rate of 18 breaths/min
,Expert Rationale: Visual disturbances (yellow-green halos, blurred vision) are
classic signs of digoxin toxicity. Digoxin toxicity can also cause nausea, vomiting,
and cardiac dysrhythmias. The nurse should monitor serum digoxin levels
(therapeutic range 0.8-2.0 ng/mL) and potassium levels (hypokalemia increases
toxicity risk).
Question 2
A client with angina pectoris is prescribed sublingual nitroglycerin. Which
instruction should the nurse include in the teaching plan?
• A. Swallow the tablet with a full glass of water
• B. Place the tablet under the tongue and allow it to dissolve ✓
• C. Chew the tablet for faster absorption
• D. Take the tablet with food to prevent nausea
Expert Rationale: Sublingual nitroglycerin should be placed under the tongue and
allowed to dissolve completely. It is absorbed through the oral mucosa and should
not be swallowed, chewed, or taken with food. The client should take up to 3
tablets 5 minutes apart and seek emergency care if pain persists.
Question 3
The nurse is caring for a client with left-sided heart failure. Which finding is most
consistent with this condition?
• A. Jugular venous distention
• B. Peripheral edema
• C. Crackles auscultated in the lung bases ✓
• D. Hepatomegaly
Expert Rationale: Left-sided heart failure causes pulmonary congestion due to
increased pressure in the pulmonary vasculature. Crackles in the lung bases are
,characteristic. Right-sided heart failure (options A, B, D) causes systemic
congestion with JVD, peripheral edema, and hepatomegaly.
Question 4
A client is 2 days post-myocardial infarction. Which laboratory value should the
nurse monitor to evaluate for cardiac damage?
• A. BUN
• B. Creatinine
• C. Potassium
• D. Troponin I ✓
Expert Rationale: Troponin I is a highly specific and sensitive marker for
myocardial injury. It rises 3-6 hours after MI, peaks at 12-24 hours, and remains
elevated for 5-10 days. BUN and creatinine assess renal function; potassium
monitors electrolyte balance.
Question 5
The nurse is assessing a client with pericarditis. Which finding is most
characteristic of this condition?
• A. Crushing chest pain relieved by rest
• B. Chest pain that worsens with inspiration
• C. Sharp chest pain that improves when leaning forward ✓
• D. Substernal chest pain radiating to the left arm
Expert Rationale: Pericarditis pain is typically sharp, pleuritic, and improves with
leaning forward (because this reduces pressure on the pericardial sac). The pain
worsens with lying flat and deep inspiration. Option A describes angina; option B
is pleuritic pain; option D is typical of MI.
, Question 6
A client with hypertension is prescribed lisinopril. The nurse should monitor the
client for which adverse effect?
• A. Hyperkalemia
• B. Dry cough ✓
• C. Hypoglycemia
• D. Tachycardia
Expert Rationale: Lisinopril (an ACE inhibitor) commonly causes a persistent, dry,
nonproductive cough due to bradykinin accumulation. This adverse effect may
necessitate switching to an ARB. Hyperkalemia can also occur but is less common
than cough.
Question 7
The nurse is preparing to administer a beta-blocker to a client. Which
assessment finding should cause the nurse to question the order?
• A. Blood pressure 140/90 mmHg
• B. Heart rate 52 beats/min ✓
• C. Respiratory rate 20 breaths/min
• D. Temperature 98.6°F
Expert Rationale: Beta-blockers decrease heart rate and contractility. A heart rate
of 52 beats/min (bradycardia) is a relative contraindication, and the nurse should
contact the healthcare provider before administering the medication.
Question 8
A client with peripheral arterial disease (PAD) reports leg pain that occurs with
walking. What is the best nursing intervention?
• A. Encourage the client to rest with legs elevated
