WGU D454
Adult Health III
Objective Assessment
(2 Full Exams)
Actual Questions with Verified Answers
Take and pass the OA :)
What You Will Get:
➢150+ OA Exam Questions w/ Answers
➢Expert Rationales included.
➢OA Study Guide QS & Clinical Prioritization
➢AH III EXAM HINTS
, DIGITAL STUDY RESOURCE PREVIEW
Preview Pages Below
Get the Complete PDF After Purchase
If you require further clarification or in need of any study resources, feel
free to Message me.
,Table of Contents
D454 OA EXAM SET 1 ............................................................ 2
D454 OA EXAM SET 2 .......................................................... 37
D454 AH III EXAM HINTS .................................................... 94
D454 AH III Study Guide Qs w/ Ans .................................. 113
D454 OA EXAM SET 1
Question 1
The nurse is assessing a burn victim who suffered destruction of the epidermis
and some of the dermis of the entire right arm and half of the length of the right
leg. How should the nurse document the burn assessment findings?
A. Superficial, 18% total body surface area (TBSA)
B. Superficial partial thickness, 18% TBSA
C. Deep partial thickness, 27% TBSA
D. Full thickness, 27% TBSA
Correct Answer:
B. Superficial partial thickness, 18% TBSA
Rationale: A superficial partial-thickness burn involves destruction of the epidermis
layer and some of the dermis layer. The %TBSA is easily calculated by using the rule of
nines method. In this case, involvement of one arm is calculated as 9% TBSA, one-half
of a leg is 9% TBSA, for a combined total of 18% TBSA. Total leg involvement is 18%
TBSA.
,Question 2
A client with a history of chronic alcoholism is admitted with pneumonia. The
nurse inserts two large bore IV catheters and starts an infusion of 0.9% sodium
chloride at 75 mL/hour and titrates the client's oxygen to 60% by nonrebreather
mask. The cardiac monitor displays sinus tachycardia with multifocal premature
ventricular contractions. Which client's serum laboratory value requires
immediate intervention by the nurse?
A. Sodium 138 mEq/L
B. Hemoglobin 9 g/dL
C. Magnesium 1.0 mg/dL
D. Potassium 5.5 mEq/L
Correct Answer:
C. Magnesium 1.0 mg/dL
Rationale: Normal magnesium level is 1.7 to 2.2 mg/dL. Hypomagnesemia is critical
and may cause a lethal ventricular arrhythmia, torsades de pointes, and requires
immediate intervention. Chronic alcoholism is a risk factor for hypomagnesemia due to
poor nutritional intake and increased renal excretion.
Question 3
The nurse is providing care to a client who is comatose following cardiac arrest
24 hours ago. Which physical assessment finding should the nurse determine to
be a predictor of a poor outcome?
A. Lack of response to a sternal rub
B. Lack of corneal or papillary response
C. Lack of purposeful motor response
D. Lack of response to verbal stimulation
Correct Answer:
B. Lack of corneal or papillary response
Rationale: The two best predictors of a poor outcome for a comatose client who
experienced cardiac arrest are lack of corneal or papillary response at 24 hours and
lack of motor movement at 72 hours. These responses are mediated by the brainstem.
Question 4
,A client's vital signs are: temperature 97.4°F (36.3°C), blood pressure 88/50
mmHg, heart rate 76 beats/minute, and respirations 18 breaths/minute. How
should the nurse document the mean arterial pressure (MAP)?
(Fill in the blank. Enter numerical value only. If rounding is required, round to the
nearest whole value.)
Correct Answer:
63
Rationale: The mean arterial pressure (MAP) can be calculated using the following
formula: MAP = [Diastolic blood pressure × 2 + Systolic blood pressure] ÷ 3. This client's
MAP = (50 + 50) + 88 = 188 ÷ 3 = 62.66 = 63 mmHg. A normal MAP should be between
70 to 105 mm Hg. A low MAP means low perfusion to body tissues.
Question 5
A client arrives in the emergency department reporting chest palpitations, feeling
weak and dizzy, and having a blood pressure of 100/60 mmHg. What action is
most important for the nurse to implement based on this electrocardiogram
(EKG) tracing if the client becomes unstable? (EKG showing atrial flutter)
A. Monitor vital signs and prepare for synchronized cardioversion
B. Call the healthcare provider for drug prescriptions
C. Instruct the client to perform Valsalva maneuvers
D. Document the interpretation of the EKG and the client's subjective symptoms
Correct Answer:
A. Monitor vital signs and prepare for synchronized cardioversion
Rationale: The EKG is showing atrial flutter. When the client experiences atrial flutter
and is symptomatically unstable, the Advance Cardiac Life Support (ACLS) algorithm
recommends the client be treated the same way as a person with atrial fibrillation, and
immediate cardioversion be administered. Drugs are not recommended for unstable
,atrial flutter. It is important for the nurse to be aware that atrial flutter typically requires
the use of fewer joules to cardioconvert the rhythm to normal sinus rhythm as compared
to atrial fibrillation.
Question 6
The nurse is caring for a client with end-stage liver disease who is actively dying.
Some family members are tearful, while other family members are arguing. Which
professional should the nurse consult to help the family?
A. Pastoral care services
B. Security
C. Healthcare provider
D. Bereavement counselor
Correct Answer:
A. Pastoral care services
Rationale: End-of-life issues can place a strain on the family. The nurse should contact
a pastoral care associate to assist with spiritual and emotional needs of a family with a
dying member.
Question 7
The nurse is assigned to care for a client with IV fluids infusing at 100 mL/hr and
a nasogastric tube with enteral feedings infusing at 60 mL/hr. The client is
mechanically ventilated with 40% FiO2. Peak inspiratory pressure (PIP) was 24 cm
H2O four hours ago and is now 62 cm H2O. Which intervention should the nurse
implement?
A. Suction the endotracheal tube
B. Decrease the IV to 50 mL/hr
C. Turn off the enteral feedings
D. Increase the FiO2 to 100%
Correct Answer:
A. Suction the endotracheal tube
Rationale: Normal PIP is 25 to 30 cm H2O. When lung compliance is restricted, PIP
increases and immediate intervention is required. A kink in the ventilator tubing or
secretions in the endotracheal tube will cause an increase in PIP.
, D454 OA EXAM SET 2
Question 1
Two days following cardiac bypass surgery, the nurse places a client's
mediastinal chest tube to water seal. The client is using the incentive spirometer
hourly while awake. Which assessment finding warrants intervention by the
nurse?
a) Serosanguineous fluid in collection container
b) Fluid fluctuation in tubing with respirations
c) Water seal level 2 cm below the water seal fill line
d) Report of chest tube insertion site tenderness
Correct Answer:
C) Water seal level 2 cm below the water seal fill line
Rationale: The water seal chamber should maintain a level at the 2 cm mark ABOVE
the water seal fill line, not below it. A level 2 cm below the fill line indicates a loss of
water seal integrity, which compromises the closed drainage system and can allow air to
re-enter the pleural space. Serosanguineous drainage (A) is expected post-cardiac
surgery. Fluid fluctuation with respirations (B) indicates proper functioning (tidaling).
Insertion site tenderness (D) is common but should be monitored for signs of infection.
Question 2
A client with a demand pacemaker has a telemetry tracing with a pacing spike but
no corresponding QRS complex. The client's myocardium is eliciting a QRS after
a delay of several seconds. Which telemetry interpretation should the nurse
conclude?
a) Loss of capture
b) Ventricular fibrillation
c) Capture from an ectopic focus
d) A normal finding with a demand pacer
,Correct Answer:
A) Loss of capture
Rationale: Loss of capture occurs when the pacemaker fires (pacing spike visible) but
fails to depolarize the myocardium (no QRS complex following the spike). The delayed
intrinsic QRS indicates the heart's own electrical system eventually fired. This requires
immediate intervention—check lead placement, increase output, or notify the provider.
Ventricular fibrillation (B) would show a chaotic rhythm without identifiable QRS
complexes. An ectopic focus (C) would not explain the pacing spike without capture.
Question 3
The nurse is caring for a client who underwent surgical repair of the aorta after
sustaining injuries in a fall. Which finding indicates improved blood flow after the
surgery?
a) Movement of lower extremities
b) Decreased urinary output
c) Maintained blood pressure
d) Blood pressure 90/50 mmHg
Correct Answer:
A) Movement of lower extremities
Rationale: Aortic repair aims to restore blood flow to the lower body and extremities.
Movement of lower extremities indicates restored perfusion to the spinal cord and
lower limbs, which may have been compromised by the injury or during cross-clamping.
Decreased urinary output (B) and hypotension (D) indicate continued poor perfusion.
While maintained blood pressure (C) is important, it does not specifically confirm distal
blood flow restoration.
Question 4
The nurse reports findings to the healthcare provider for a client who was
admitted to the intensive care unit today with chronic obstructive pulmonary
disease (COPD). When the nurse completes the report using the Situation,
Background, Assessment, Recommendation (SBAR) format, which statement
best supports the nurse's reason for calling the healthcare provider?
a) Prescription for an additional respiratory treatment
b) Admission today with difficulty breathing
,c) History of COPD exacerbations
d) Presence of expiratory wheezes in the lower lobes
Correct Answer:
A) Prescription for an additional respiratory treatment
Rationale: The Recommendation component of SBAR is the action the nurse is
requesting from the provider. "Prescription for an additional respiratory treatment" is a
clear recommendation that supports the reason for the call. The other options represent
background (B, C) or assessment (D) data but do not provide the nurse's specific
request for intervention.
Question 5
A client receiving mechanical ventilation asks when the client will be extubated.
Which information should the nurse provide?
a) When the client breathes spontaneously in between mechanical ventilations
b) Once all serum electrolyte and blood chemistry levels normalize
c) At the completion of intravenous antibiotic therapy and the infection is resolved
d) When the chest x-ray shows that the inflammation is resolved
Correct Answer:
A) When the client breathes spontaneously in between mechanical ventilations
Rationale: Weaning and extubation criteria focus on the client's ability to breathe
spontaneously, demonstrated by adequate spontaneous respiratory rate, tidal volume,
and oxygenation during weaning trials (such as spontaneous breathing trials or
pressure support trials). While normalized labs (B) and resolved infection (C) are
important, they are not primary extubation criteria. Chest x-ray resolution (D) is not
required prior to extubation.
Question 6
The decision to wean a client from mechanical ventilation is based on which
factor?
a) The client's spontaneous respiratory rate during trials of interrupted ventilation
b) The client's arterial blood gas results only
c) The length of time on mechanical ventilation
d) The healthcare provider's preference
, D454 AH III EXAM HINTS
1. An unexpected, catastrophic pulmonary complication with no previous
pulmonary moriar or oplems:
ARDS
2. Interventions for ventilated patients with ARDS:
Elevate HOB to at least 30 degrees; sedation vacations; strict oral hygiene;
implement mobilization program
3. Increased risk and mortality rate from ARDS in individuals who have a history
of:
Alcohol abuse
4. Suction only when:
Secretions are present
5. Before drawing a sample for ABGs from the radial artery, perform the ___ to
assess collateral circulation:
Allen test
6. Three most common symptoms of respiratory failure:
Dyspnea/tachypnea, intercostal and sternal retractions, cyanosis
Adult Health III
Objective Assessment
(2 Full Exams)
Actual Questions with Verified Answers
Take and pass the OA :)
What You Will Get:
➢150+ OA Exam Questions w/ Answers
➢Expert Rationales included.
➢OA Study Guide QS & Clinical Prioritization
➢AH III EXAM HINTS
, DIGITAL STUDY RESOURCE PREVIEW
Preview Pages Below
Get the Complete PDF After Purchase
If you require further clarification or in need of any study resources, feel
free to Message me.
,Table of Contents
D454 OA EXAM SET 1 ............................................................ 2
D454 OA EXAM SET 2 .......................................................... 37
D454 AH III EXAM HINTS .................................................... 94
D454 AH III Study Guide Qs w/ Ans .................................. 113
D454 OA EXAM SET 1
Question 1
The nurse is assessing a burn victim who suffered destruction of the epidermis
and some of the dermis of the entire right arm and half of the length of the right
leg. How should the nurse document the burn assessment findings?
A. Superficial, 18% total body surface area (TBSA)
B. Superficial partial thickness, 18% TBSA
C. Deep partial thickness, 27% TBSA
D. Full thickness, 27% TBSA
Correct Answer:
B. Superficial partial thickness, 18% TBSA
Rationale: A superficial partial-thickness burn involves destruction of the epidermis
layer and some of the dermis layer. The %TBSA is easily calculated by using the rule of
nines method. In this case, involvement of one arm is calculated as 9% TBSA, one-half
of a leg is 9% TBSA, for a combined total of 18% TBSA. Total leg involvement is 18%
TBSA.
,Question 2
A client with a history of chronic alcoholism is admitted with pneumonia. The
nurse inserts two large bore IV catheters and starts an infusion of 0.9% sodium
chloride at 75 mL/hour and titrates the client's oxygen to 60% by nonrebreather
mask. The cardiac monitor displays sinus tachycardia with multifocal premature
ventricular contractions. Which client's serum laboratory value requires
immediate intervention by the nurse?
A. Sodium 138 mEq/L
B. Hemoglobin 9 g/dL
C. Magnesium 1.0 mg/dL
D. Potassium 5.5 mEq/L
Correct Answer:
C. Magnesium 1.0 mg/dL
Rationale: Normal magnesium level is 1.7 to 2.2 mg/dL. Hypomagnesemia is critical
and may cause a lethal ventricular arrhythmia, torsades de pointes, and requires
immediate intervention. Chronic alcoholism is a risk factor for hypomagnesemia due to
poor nutritional intake and increased renal excretion.
Question 3
The nurse is providing care to a client who is comatose following cardiac arrest
24 hours ago. Which physical assessment finding should the nurse determine to
be a predictor of a poor outcome?
A. Lack of response to a sternal rub
B. Lack of corneal or papillary response
C. Lack of purposeful motor response
D. Lack of response to verbal stimulation
Correct Answer:
B. Lack of corneal or papillary response
Rationale: The two best predictors of a poor outcome for a comatose client who
experienced cardiac arrest are lack of corneal or papillary response at 24 hours and
lack of motor movement at 72 hours. These responses are mediated by the brainstem.
Question 4
,A client's vital signs are: temperature 97.4°F (36.3°C), blood pressure 88/50
mmHg, heart rate 76 beats/minute, and respirations 18 breaths/minute. How
should the nurse document the mean arterial pressure (MAP)?
(Fill in the blank. Enter numerical value only. If rounding is required, round to the
nearest whole value.)
Correct Answer:
63
Rationale: The mean arterial pressure (MAP) can be calculated using the following
formula: MAP = [Diastolic blood pressure × 2 + Systolic blood pressure] ÷ 3. This client's
MAP = (50 + 50) + 88 = 188 ÷ 3 = 62.66 = 63 mmHg. A normal MAP should be between
70 to 105 mm Hg. A low MAP means low perfusion to body tissues.
Question 5
A client arrives in the emergency department reporting chest palpitations, feeling
weak and dizzy, and having a blood pressure of 100/60 mmHg. What action is
most important for the nurse to implement based on this electrocardiogram
(EKG) tracing if the client becomes unstable? (EKG showing atrial flutter)
A. Monitor vital signs and prepare for synchronized cardioversion
B. Call the healthcare provider for drug prescriptions
C. Instruct the client to perform Valsalva maneuvers
D. Document the interpretation of the EKG and the client's subjective symptoms
Correct Answer:
A. Monitor vital signs and prepare for synchronized cardioversion
Rationale: The EKG is showing atrial flutter. When the client experiences atrial flutter
and is symptomatically unstable, the Advance Cardiac Life Support (ACLS) algorithm
recommends the client be treated the same way as a person with atrial fibrillation, and
immediate cardioversion be administered. Drugs are not recommended for unstable
,atrial flutter. It is important for the nurse to be aware that atrial flutter typically requires
the use of fewer joules to cardioconvert the rhythm to normal sinus rhythm as compared
to atrial fibrillation.
Question 6
The nurse is caring for a client with end-stage liver disease who is actively dying.
Some family members are tearful, while other family members are arguing. Which
professional should the nurse consult to help the family?
A. Pastoral care services
B. Security
C. Healthcare provider
D. Bereavement counselor
Correct Answer:
A. Pastoral care services
Rationale: End-of-life issues can place a strain on the family. The nurse should contact
a pastoral care associate to assist with spiritual and emotional needs of a family with a
dying member.
Question 7
The nurse is assigned to care for a client with IV fluids infusing at 100 mL/hr and
a nasogastric tube with enteral feedings infusing at 60 mL/hr. The client is
mechanically ventilated with 40% FiO2. Peak inspiratory pressure (PIP) was 24 cm
H2O four hours ago and is now 62 cm H2O. Which intervention should the nurse
implement?
A. Suction the endotracheal tube
B. Decrease the IV to 50 mL/hr
C. Turn off the enteral feedings
D. Increase the FiO2 to 100%
Correct Answer:
A. Suction the endotracheal tube
Rationale: Normal PIP is 25 to 30 cm H2O. When lung compliance is restricted, PIP
increases and immediate intervention is required. A kink in the ventilator tubing or
secretions in the endotracheal tube will cause an increase in PIP.
, D454 OA EXAM SET 2
Question 1
Two days following cardiac bypass surgery, the nurse places a client's
mediastinal chest tube to water seal. The client is using the incentive spirometer
hourly while awake. Which assessment finding warrants intervention by the
nurse?
a) Serosanguineous fluid in collection container
b) Fluid fluctuation in tubing with respirations
c) Water seal level 2 cm below the water seal fill line
d) Report of chest tube insertion site tenderness
Correct Answer:
C) Water seal level 2 cm below the water seal fill line
Rationale: The water seal chamber should maintain a level at the 2 cm mark ABOVE
the water seal fill line, not below it. A level 2 cm below the fill line indicates a loss of
water seal integrity, which compromises the closed drainage system and can allow air to
re-enter the pleural space. Serosanguineous drainage (A) is expected post-cardiac
surgery. Fluid fluctuation with respirations (B) indicates proper functioning (tidaling).
Insertion site tenderness (D) is common but should be monitored for signs of infection.
Question 2
A client with a demand pacemaker has a telemetry tracing with a pacing spike but
no corresponding QRS complex. The client's myocardium is eliciting a QRS after
a delay of several seconds. Which telemetry interpretation should the nurse
conclude?
a) Loss of capture
b) Ventricular fibrillation
c) Capture from an ectopic focus
d) A normal finding with a demand pacer
,Correct Answer:
A) Loss of capture
Rationale: Loss of capture occurs when the pacemaker fires (pacing spike visible) but
fails to depolarize the myocardium (no QRS complex following the spike). The delayed
intrinsic QRS indicates the heart's own electrical system eventually fired. This requires
immediate intervention—check lead placement, increase output, or notify the provider.
Ventricular fibrillation (B) would show a chaotic rhythm without identifiable QRS
complexes. An ectopic focus (C) would not explain the pacing spike without capture.
Question 3
The nurse is caring for a client who underwent surgical repair of the aorta after
sustaining injuries in a fall. Which finding indicates improved blood flow after the
surgery?
a) Movement of lower extremities
b) Decreased urinary output
c) Maintained blood pressure
d) Blood pressure 90/50 mmHg
Correct Answer:
A) Movement of lower extremities
Rationale: Aortic repair aims to restore blood flow to the lower body and extremities.
Movement of lower extremities indicates restored perfusion to the spinal cord and
lower limbs, which may have been compromised by the injury or during cross-clamping.
Decreased urinary output (B) and hypotension (D) indicate continued poor perfusion.
While maintained blood pressure (C) is important, it does not specifically confirm distal
blood flow restoration.
Question 4
The nurse reports findings to the healthcare provider for a client who was
admitted to the intensive care unit today with chronic obstructive pulmonary
disease (COPD). When the nurse completes the report using the Situation,
Background, Assessment, Recommendation (SBAR) format, which statement
best supports the nurse's reason for calling the healthcare provider?
a) Prescription for an additional respiratory treatment
b) Admission today with difficulty breathing
,c) History of COPD exacerbations
d) Presence of expiratory wheezes in the lower lobes
Correct Answer:
A) Prescription for an additional respiratory treatment
Rationale: The Recommendation component of SBAR is the action the nurse is
requesting from the provider. "Prescription for an additional respiratory treatment" is a
clear recommendation that supports the reason for the call. The other options represent
background (B, C) or assessment (D) data but do not provide the nurse's specific
request for intervention.
Question 5
A client receiving mechanical ventilation asks when the client will be extubated.
Which information should the nurse provide?
a) When the client breathes spontaneously in between mechanical ventilations
b) Once all serum electrolyte and blood chemistry levels normalize
c) At the completion of intravenous antibiotic therapy and the infection is resolved
d) When the chest x-ray shows that the inflammation is resolved
Correct Answer:
A) When the client breathes spontaneously in between mechanical ventilations
Rationale: Weaning and extubation criteria focus on the client's ability to breathe
spontaneously, demonstrated by adequate spontaneous respiratory rate, tidal volume,
and oxygenation during weaning trials (such as spontaneous breathing trials or
pressure support trials). While normalized labs (B) and resolved infection (C) are
important, they are not primary extubation criteria. Chest x-ray resolution (D) is not
required prior to extubation.
Question 6
The decision to wean a client from mechanical ventilation is based on which
factor?
a) The client's spontaneous respiratory rate during trials of interrupted ventilation
b) The client's arterial blood gas results only
c) The length of time on mechanical ventilation
d) The healthcare provider's preference
, D454 AH III EXAM HINTS
1. An unexpected, catastrophic pulmonary complication with no previous
pulmonary moriar or oplems:
ARDS
2. Interventions for ventilated patients with ARDS:
Elevate HOB to at least 30 degrees; sedation vacations; strict oral hygiene;
implement mobilization program
3. Increased risk and mortality rate from ARDS in individuals who have a history
of:
Alcohol abuse
4. Suction only when:
Secretions are present
5. Before drawing a sample for ABGs from the radial artery, perform the ___ to
assess collateral circulation:
Allen test
6. Three most common symptoms of respiratory failure:
Dyspnea/tachypnea, intercostal and sternal retractions, cyanosis
