WESTERN GOVERNORS UNIVERSITY · PRELICENSURE NURSING PROGRAM
WGU D446 Adult Health 2
Comprehensive Practice
Question Bank
NCLEX-Style Practice Questions with Rationales
Topic Focus: Adult Health — Perioperative, Renal, Cardiovascular, & Medical-
Surgical Nursing
Edition 1 · September 2026
Table of Contents
1. Instructions for Use 2
2. Practice Questions with Answers & Rationales — Adult Health 2 2
WGU D446 · Western Governors University Page 1
,WGU D446 ADULT HEALTH 2 PRACTICE GUIDE INSTRUCTIONS & PRACTICE QUESTIONS
How to Use This Guide
Read each stem, choose your answer, then check the rationale directly below it. The correct
option is marked, and each wrong option is explained so you understand why it's wrong — not
just that it is.
Category: Adult Health — Perioperative, Renal, Cardiovascular, & Medical-
Surgical Nursing
1. A 55-year-old patient with a history of smoking is scheduled for elective
surgery. Which preoperative assessment finding is most concerning to the
nurse?
A. Pulse oximetry reading of 92%
B. Blood pressure of 138/86 mmHg
C. Heart rate of 88 beats per minute
D. Respiratory rate of 18 breaths per minute
✦ CORRECT ANSWER: A. Pulse oximetry reading of 92%
Rationale:
A pulse oximetry reading of 92% may indicate mild hypoxemia, especially concerning in a patient
with a history of smoking, as it could impact oxygenation during surgery. The nurse should
report this finding for further evaluation. The other options are within normal limits and less
concerning.
,2. During preoperative teaching, a patient expresses fear about anesthesia.
Which response by the nurse best addresses the patient's concern?
A. "Tell me more about what concerns you about the anesthesia."
B. "Don't worry, everything will be fine."
C. "Anesthesia is very safe nowadays."
D. "You'll be asleep and won't feel a thing."
✦ CORRECT ANSWER: A. "Tell me more about what concerns you about the
anesthesia."
Rationale:
This response encourages the patient to verbalize specific fears, allowing the nurse to provide
accurate information and emotional support. It's a patient-centered approach, addressing
individual concerns rather than providing general reassurance.
3. The nurse is in the operating room and notices that a sterile field may have
been contaminated. What is the nurse's best action?
A. Immediately inform the surgical team.
B. Ignore the contamination and continue.
C. Wait to see if anyone else notices.
D. Document the observation after the surgery.
✦ CORRECT ANSWER: A. Immediately inform the surgical team.
Rationale:
Maintaining a sterile environment is crucial to prevent infection. The nurse must inform the
surgical team immediately to ensure corrective actions are taken. Ignoring it or not notifying
others compromises patient safety.
, 4. A patient in the post-anesthesia care unit (PACU) has shallow, irregular
breathing. What should be the nurse's priority intervention?
A. Stimulate the patient to encourage deep breathing.
B. Administer oxygen via nasal cannula.
C. Place the patient in a supine position.
D. Notify the healthcare provider immediately.
✦ CORRECT ANSWER: A. Stimulate the patient to encourage deep breathing.
Rationale:
Encouraging deep breathing helps prevent hypoventilation and increases oxygenation,
addressing the shallow breathing. Other options, while appropriate, are secondary to first
attempting to improve the patient's breathing pattern.
5. A postoperative patient reports pain at the incision site. Which is the most
appropriate nursing intervention?
A. Provide prescribed analgesics as needed.
B. Reassure the patient that pain is expected.
C. Massage the area around the incision.
D. Monitor the pain and wait for it to subside.
✦ CORRECT ANSWER: A. Provide prescribed analgesics as needed.
Rationale:
Postoperative pain is expected, and the nurse should administer pain relief as prescribed to
promote comfort and facilitate healing. Monitoring alone is insufficient, and massage could
disrupt the incision.
WGU D446 Adult Health 2
Comprehensive Practice
Question Bank
NCLEX-Style Practice Questions with Rationales
Topic Focus: Adult Health — Perioperative, Renal, Cardiovascular, & Medical-
Surgical Nursing
Edition 1 · September 2026
Table of Contents
1. Instructions for Use 2
2. Practice Questions with Answers & Rationales — Adult Health 2 2
WGU D446 · Western Governors University Page 1
,WGU D446 ADULT HEALTH 2 PRACTICE GUIDE INSTRUCTIONS & PRACTICE QUESTIONS
How to Use This Guide
Read each stem, choose your answer, then check the rationale directly below it. The correct
option is marked, and each wrong option is explained so you understand why it's wrong — not
just that it is.
Category: Adult Health — Perioperative, Renal, Cardiovascular, & Medical-
Surgical Nursing
1. A 55-year-old patient with a history of smoking is scheduled for elective
surgery. Which preoperative assessment finding is most concerning to the
nurse?
A. Pulse oximetry reading of 92%
B. Blood pressure of 138/86 mmHg
C. Heart rate of 88 beats per minute
D. Respiratory rate of 18 breaths per minute
✦ CORRECT ANSWER: A. Pulse oximetry reading of 92%
Rationale:
A pulse oximetry reading of 92% may indicate mild hypoxemia, especially concerning in a patient
with a history of smoking, as it could impact oxygenation during surgery. The nurse should
report this finding for further evaluation. The other options are within normal limits and less
concerning.
,2. During preoperative teaching, a patient expresses fear about anesthesia.
Which response by the nurse best addresses the patient's concern?
A. "Tell me more about what concerns you about the anesthesia."
B. "Don't worry, everything will be fine."
C. "Anesthesia is very safe nowadays."
D. "You'll be asleep and won't feel a thing."
✦ CORRECT ANSWER: A. "Tell me more about what concerns you about the
anesthesia."
Rationale:
This response encourages the patient to verbalize specific fears, allowing the nurse to provide
accurate information and emotional support. It's a patient-centered approach, addressing
individual concerns rather than providing general reassurance.
3. The nurse is in the operating room and notices that a sterile field may have
been contaminated. What is the nurse's best action?
A. Immediately inform the surgical team.
B. Ignore the contamination and continue.
C. Wait to see if anyone else notices.
D. Document the observation after the surgery.
✦ CORRECT ANSWER: A. Immediately inform the surgical team.
Rationale:
Maintaining a sterile environment is crucial to prevent infection. The nurse must inform the
surgical team immediately to ensure corrective actions are taken. Ignoring it or not notifying
others compromises patient safety.
, 4. A patient in the post-anesthesia care unit (PACU) has shallow, irregular
breathing. What should be the nurse's priority intervention?
A. Stimulate the patient to encourage deep breathing.
B. Administer oxygen via nasal cannula.
C. Place the patient in a supine position.
D. Notify the healthcare provider immediately.
✦ CORRECT ANSWER: A. Stimulate the patient to encourage deep breathing.
Rationale:
Encouraging deep breathing helps prevent hypoventilation and increases oxygenation,
addressing the shallow breathing. Other options, while appropriate, are secondary to first
attempting to improve the patient's breathing pattern.
5. A postoperative patient reports pain at the incision site. Which is the most
appropriate nursing intervention?
A. Provide prescribed analgesics as needed.
B. Reassure the patient that pain is expected.
C. Massage the area around the incision.
D. Monitor the pain and wait for it to subside.
✦ CORRECT ANSWER: A. Provide prescribed analgesics as needed.
Rationale:
Postoperative pain is expected, and the nurse should administer pain relief as prescribed to
promote comfort and facilitate healing. Monitoring alone is insufficient, and massage could
disrupt the incision.
