WGU D446 Adult Health Ii New Version Question And Answers Latest Update Version 3

WGU D446 Adult Health Ii New Version
Question And Answers Latest Update
2026/2027 Version 3



Question 1

A client is admitted to the intensive care unit with acute respiratory distress syndrome (ARDS)
and is placed on mechanical ventilation. Which ventilator parameter is primarily titrated to
improve arterial oxygenation ($\text{PaO}_2$) while minimizing oxygen toxicity?

 A) Tidal volume ($\text{V}_t$)
 B) Positive end-expiratory pressure (PEEP)
 C) Respiratory rate
 D) Peak inspiratory pressure
 Correct Answer: Positive end-expiratory pressure (PEEP)

Question 2

A client with a history of heart failure is prescribed sacubitril/valsartan. Before initiating this
medication, what crucial washout period must be observed if the client was previously taking
lisinopril?

 A) 12 hours
 B) 24 hours
 C) 36 hours
 D) 7 days
 Correct Answer: 36 hours

Question 3

A client is brought to the emergency department following a motor vehicle collision. Assessment
reveals absent breath sounds on the right side, severe respiratory distress, tracheal deviation to
the left, and hypotension. Which immediate intervention should the nurse anticipate?

,  A) Needle decompression using a large-bore angiocatheter in the second intercostal space
 B) Immediate insertion of a triple-lumen central venous catheter
 C) Preparation for emergency endotracheal intubation and sedation
 D) Administration of a rapid 500 mL crystalloid fluid bolus
 Correct Answer: Needle decompression using a large-bore angiocatheter in the second
intercostal space

Question 4

A client with septic shock has received $30\text{ mL/kg}$ of crystalloid fluids, but remains
hypotensive with a mean arterial pressure (MAP) of $55\text{ mmHg}$ and a serum lactate of
$4.2\text{ mmol/L}$. Which vasoactive agent is the first-line vasopressor of choice?

 A) Dopamine
 B) Norepinephrine
 C) Phenylephrine
 D) Epinephrine
 Correct Answer: Norepinephrine

Question 5

A client with chronic kidney disease (CKD) stages 4 presents with lethargy, muscle twitching,
and an ECG showing tall, peaked T waves and widened QRS complexes. The serum potassium
is $7.4\text{ mEq/L}$. Which medication should the nurse administer first to protect the
myocardium?

 A) Regular insulin and 50% dextrose intravenously
 B) Sodium polystyrene sulfonate orally
 C) Calcium gluconate intravenously
 D) Furosemide intravenously
 Correct Answer: Calcium gluconate intravenously

Question 6

A client with a T4 spinal cord injury suddenly complains of a throbbing headache, blurred
vision, and nasal congestion. The blood pressure is $220/110\text{ mmHg}$ and the heart rate is
$52\text{ beats/min}$. What is the nurse's immediate priority action?

 A) Administer sublingual nifedipine as prescribed.
 B) Elevate the head of the bed to 45 degrees or higher.
 C) Immediately insert an indwelling urinary catheter.
 D) Place the client in a flat, supine position.
 Correct Answer: Elevate the head of the bed to 45 degrees or higher.

, Question 7

A client with diabetic ketoacidosis (DKA) has a blood glucose level of $380\text{ mg/dL}$ and
is receiving an insulin infusion. Arterial blood gas shows $\text{pH } 7.22$, $\text{PaCO}_2
30\text{ mmHg}$, $\text{HCO}_3^- 12\text{ mEq/L}$, and the anion gap is $22\text{
mEq/L}$. When should the nurse anticipate discontinuing the insulin drip?

 A) When the blood glucose reaches exactly $100\text{ mg/dL}$
 B) When the anion gap normalizes and venous blood gas pH is $>7.3$, regardless of
blood glucose
 C) As soon as the client is alert enough to tolerate oral fluids and a diabetic diet
 D) When the serum potassium level returns to a completely normal range
 Correct Answer: When the anion gap normalizes and venous blood gas pH is $>7.3$,
regardless of blood glucose

Question 8

A client undergoing a continuous heparin infusion for a pulmonary embolism develops acute
bleeding from an IV site and petechiae. The aPTT is greater than 120 seconds. Which reversal
agent should the nurse have immediately available?

 A) Vitamin K phytadione
 B) Protamine sulfate
 C) Fresh frozen plasma
 D) Aminocaproic acid
 Correct Answer: Protamine sulfate

Question 9

A client with acute decompensated heart failure is prescribed an infusion of nitroprusside. Which
serious toxic metabolite must the nurse monitor for during prolonged administration?

 A) Lactate accumulation
 B) Cyanide toxicity
 C) Methemoglobinemia
 D) Ammonia toxicity
 Correct Answer: Cyanide toxicity

Question 10

A client with severe acute pancreatitis develops sudden left flank ecchymosis (Grey Turner's
sign). What underlying pathological process does this physical finding suggest?

 A) Rupture of the spleen
 B) Retroperitoneal hemorrhage and pancreatic necrosis
 C) Perforation of the descending colon