STUDY NOTES & REFERENCE GUIDE
WGU D444 OA ··
EXAM
ADULT HEALTH 1 ··
ACTUAL QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES
2026 \2027 UPDATED
Fundamentals of Nursing
1
LecClara Stuvia | Page 1 of 117
, STUDY NOTES & REFERENCE GUIDE
A client diagnosed with chronic obstructive pulmonary disease (COPD) is given a new
···
prescription for tiotropium via an inhalation device. Which statement indicates that the
·
client understands the instructions for using this medication? - Correct Answer✅-I ··
should use this medication in its hand inhaler every day
··
A client has a nasogastric (NG) tube placed during abdominal surgery. During
···
postoperative convalescence, the nurse identifies that the client is manifesting a hand
···
tremor, muscle twitching, and confusion. Which arterial blood gases consistent with
···
metabolic alkalosis should the nurse report to the healthcare provider? - Correct
··
Answer✅-pH 7.46, PCO, 55 mm Hg, HCO, 36 mEq/L (36 mmol/L), PO, 95 mm Hg. 50%
·
pH 7.46, PCO2 55 mm Hg, HCO3 36 mEq/L, PO2 95 mm Hg.
·
A client has been administered lactulose for several days. Which therapeutic response
should the nurse expect for a client with hepatic encephalopathy? - Correct Answer✅-
Lactulose- works by reducing serum ammonia levels through the promotion of
ammonia excretion in the feces, leading to improved cognitive function and mental
status in individuals with hepatic encephalopathy
A client is being cared for in the emergency department with acute abdominal pain and
a provisional diagnosis of pancreatitis. The nurse assesses the client and obtains the
results from laboratory studies. Which information is most valuable in reporting the
client's status to the healthcare provider? - Correct Answer✅-Severity of nausea and
vomiting and serum amylase results
A client is recovering from the surgical removal of glass in the right eye. Which
intervention should the nurse implement immediately following the procedure? -
Correct Answer✅-Provide an eye shield to be worn while sleeping
A client presents to the emergency department vomiting dark brown emesis and in
severe abdominal pain. The client reports to the nurse of recently being diagnosed with
adenocarcinoma of the small intestine. After auscultating bowel sounds and obtaining
vital signs, which prescription should the nurse implement next? - Correct Answer✅-
Insert a nasogastric tube (NGT) and attach to low intermittent suction
A client presents to the emergency department with muscle aches, headache, fever, and
describes a recent loss of taste and smell. The nurse obtains a nasal swab for COVID-19
testing.Which action is most important for the nurse to take? - Correct Answer✅-
Isolate the client from other clients, family, and healthcare workers not wearing proper
personal protective equipment (PPE)
A client receives a prescription for ophthalmic ketorolac, Prior to administering the
medication, the nurse should review the medical record for which condition? - Correct
Answer✅-Corneal abrasion
A client receives a prescription for vancomycin 500 mg IV every 8 hours. The
medication is provided in "500 mg per 100 mL of dextrose 5% in water." To administer
the medication for over an hour, the nurse should set the infusion pump to deliver how
many mL/hr? (Enter numerical value only.) - Correct Answer✅-100 ml/hr-
2
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, STUDY NOTES & REFERENCE GUIDE
Vancomycin dosage: 500 mg Concentration of vancomycin solution: 500 mg per 100 mL
Total volume of solution for each dose: 100 mL (since the concentration is 500 mg per
100 mL) To administer 500 mg of vancomycin, we need 100 mL of the solution. To
administer the medication for over 1 hour, we need to deliver the entire 100 mL over 1
hour. Therefore, the infusion rate (in mL/hr) would be 100 mL/hr.
A client who has had a laryngectomy and tracheostomy frequently expects copious
amounts of purulent secretions. When changing the lines of the tracheostomy tube,
which action is most important for the nurse to take? - Correct Answer✅-Leave the
old ties in place until the new ones are secure
A client who is experiencing respiratory distress is admitted with respiratory acidosis.
Which pathophysiological process supports the client's respiratory acidosis? - Correct
Answer✅-High levels of carbon dioxide have accumulated in the blood 34. The nurse is
admitting a client with possible tuberculosis
A client who is newly diagnosed with erosive esophagitis secondary to
gastroesophageal reflux disease (GERD) reports to the home health nurse that there has
been only a minimal reduction in symptoms after taking lansoprazole PO for one full
week. Which action should the nurse take? - Correct Answer✅-Advise the client that
healing typically takes several weeks to occur.
A client with a history of asthma and bronchitis arrives at the clinic with shortness of
breath, a productive cough with thickened, tenacious mucous, and the inability to walk
up a flight of stairs without experiencing breathlessness. Which action is most
important for the nurse to instruct the client about self-care? - Correct Answer✅-
Increase the daily intake of oral fluids to liquefy secretions.
A client with a history of chronic obstructive pulmonary disease (COPD) receives a new
prescription for an ipratropium inhaler. Which action indicates to the nurse that
additional teaching is needed? - Correct Answer✅-Primes the inhaler with 7 pumps.
A client with cholelithiasis(gallstone) lodged in the common bile duct and is unable to
eat or drink without becoming nauseated and vomiting. Which finding should the nurse
report to the healthcare provider? - Correct Answer✅-Yellow sclera(yellow eyes)
A client with chronic cirrhosis has esophageal varices. It is most important for the nurse
to monitor the client for the onset of which problem? - Correct Answer✅-
Hematemesis(bloody vomit)
A client with emphysema reports difficulty breathing and exhibits audible wheezing.
The nurse administers albuterol as prescribed for the third time within the last 12
hours. Which assessment finding warrants Immediate intervention by the nurse? -
Correct Answer✅-Irregular rapid heartbeat
A client with myasthenia gravis (muscle weakness)receives a new prescription for
pyridostigmine(cholinergic muscle stimulant). Which information should the nurse
3
LecClara Stuvia | Page 3 of 117
, STUDY NOTES & REFERENCE GUIDE
obtain to prior to administering the medication? - Correct Answer✅-Difficulty with
urination
A client with newly diagnosed Crohn's disease asks the nurse about dietary restrictions.
How should the nurse respond? - Correct Answer✅-Describe the use of an elimination
diet to find trigger foods
A client with open-angle glaucoma asks the nurse how long the prescribed eye drops
will need to be used. Which response made by the nurse is accurate? - Correct
Answer✅-For long-term control of pain and swelling
A client with psoriasis returns to the clinic reporting the persistence of several silvery,
scaly areas on the elbows and palms that frequently burn and sometimes bleed. Which
prescription should the nurse teach the client to use for the skin condition? - Correct
Answer✅-Topical corticosteroids
A client with symptoms of influenza that started the previous day asks the clinic nurse
about taking oseltamivir to treat the infection. Which response should the nurse
provide? - Correct Answer✅-Refer the client to the healthcare provider at the clinic to
obtain a medication prescription.
A teenage client is admitted to the emergency department following a bee sting. The
client arrives with a body rash and 30 minutes later becomes short of breath. The nurse
obtains the client's vital signs as a heart rate of 130 beats/minute, respirations of 40
breaths/minute, and a blood pressure of 90/52 mm Hg. The client is exhibiting clinical
manifestations of which type of immune reaction? - Correct Answer✅-IgE response
hypersensitivity
An adult client is admitted with AIDS and oral Candide albicans manifested by several
painful mouth ulcers. The nurse delegates oral care to the unlicensed assistive
personnel (UAP) and discusses how to assist the client. Which instruction should the
nurse provide to the UAP? - Correct Answer✅-Provide a soft-bristled toothbrush for
the client to use during oral care. In the case of oral candidiasis, using a toothbrush with
soft bristles is essential to prevent further irritation and damage to the already
compromised oral mucosa.
An adult client who was admitted yesterday with bilateral pneumonia has congested
breath sounds, an oxygen saturation of 94% on room air, and an oral temperature of
100° F (37.8° C). The client has a weak cough effort and is using accessory muscles to
breathe. Which intervention should the nurse implement first? - Correct Answer✅-
Suction to clear secretions from the airway.
An adult client with multiple sclerosis (MS) fell while walking to the bathroom. On
transfer to the intensive care unit, the client is confused and has had projectile vomiting
twice. Which intervention should the nurse implement first? - Correct Answer✅-
Complete head-to-toe neurological assessment. (should be to assess and stabilize the
patient's immediate medical needs)
4
LecClara Stuvia | Page 4 of 117
WGU D444 OA ··
EXAM
ADULT HEALTH 1 ··
ACTUAL QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES
2026 \2027 UPDATED
Fundamentals of Nursing
1
LecClara Stuvia | Page 1 of 117
, STUDY NOTES & REFERENCE GUIDE
A client diagnosed with chronic obstructive pulmonary disease (COPD) is given a new
···
prescription for tiotropium via an inhalation device. Which statement indicates that the
·
client understands the instructions for using this medication? - Correct Answer✅-I ··
should use this medication in its hand inhaler every day
··
A client has a nasogastric (NG) tube placed during abdominal surgery. During
···
postoperative convalescence, the nurse identifies that the client is manifesting a hand
···
tremor, muscle twitching, and confusion. Which arterial blood gases consistent with
···
metabolic alkalosis should the nurse report to the healthcare provider? - Correct
··
Answer✅-pH 7.46, PCO, 55 mm Hg, HCO, 36 mEq/L (36 mmol/L), PO, 95 mm Hg. 50%
·
pH 7.46, PCO2 55 mm Hg, HCO3 36 mEq/L, PO2 95 mm Hg.
·
A client has been administered lactulose for several days. Which therapeutic response
should the nurse expect for a client with hepatic encephalopathy? - Correct Answer✅-
Lactulose- works by reducing serum ammonia levels through the promotion of
ammonia excretion in the feces, leading to improved cognitive function and mental
status in individuals with hepatic encephalopathy
A client is being cared for in the emergency department with acute abdominal pain and
a provisional diagnosis of pancreatitis. The nurse assesses the client and obtains the
results from laboratory studies. Which information is most valuable in reporting the
client's status to the healthcare provider? - Correct Answer✅-Severity of nausea and
vomiting and serum amylase results
A client is recovering from the surgical removal of glass in the right eye. Which
intervention should the nurse implement immediately following the procedure? -
Correct Answer✅-Provide an eye shield to be worn while sleeping
A client presents to the emergency department vomiting dark brown emesis and in
severe abdominal pain. The client reports to the nurse of recently being diagnosed with
adenocarcinoma of the small intestine. After auscultating bowel sounds and obtaining
vital signs, which prescription should the nurse implement next? - Correct Answer✅-
Insert a nasogastric tube (NGT) and attach to low intermittent suction
A client presents to the emergency department with muscle aches, headache, fever, and
describes a recent loss of taste and smell. The nurse obtains a nasal swab for COVID-19
testing.Which action is most important for the nurse to take? - Correct Answer✅-
Isolate the client from other clients, family, and healthcare workers not wearing proper
personal protective equipment (PPE)
A client receives a prescription for ophthalmic ketorolac, Prior to administering the
medication, the nurse should review the medical record for which condition? - Correct
Answer✅-Corneal abrasion
A client receives a prescription for vancomycin 500 mg IV every 8 hours. The
medication is provided in "500 mg per 100 mL of dextrose 5% in water." To administer
the medication for over an hour, the nurse should set the infusion pump to deliver how
many mL/hr? (Enter numerical value only.) - Correct Answer✅-100 ml/hr-
2
LecClara Stuvia | Page 2 of 117
, STUDY NOTES & REFERENCE GUIDE
Vancomycin dosage: 500 mg Concentration of vancomycin solution: 500 mg per 100 mL
Total volume of solution for each dose: 100 mL (since the concentration is 500 mg per
100 mL) To administer 500 mg of vancomycin, we need 100 mL of the solution. To
administer the medication for over 1 hour, we need to deliver the entire 100 mL over 1
hour. Therefore, the infusion rate (in mL/hr) would be 100 mL/hr.
A client who has had a laryngectomy and tracheostomy frequently expects copious
amounts of purulent secretions. When changing the lines of the tracheostomy tube,
which action is most important for the nurse to take? - Correct Answer✅-Leave the
old ties in place until the new ones are secure
A client who is experiencing respiratory distress is admitted with respiratory acidosis.
Which pathophysiological process supports the client's respiratory acidosis? - Correct
Answer✅-High levels of carbon dioxide have accumulated in the blood 34. The nurse is
admitting a client with possible tuberculosis
A client who is newly diagnosed with erosive esophagitis secondary to
gastroesophageal reflux disease (GERD) reports to the home health nurse that there has
been only a minimal reduction in symptoms after taking lansoprazole PO for one full
week. Which action should the nurse take? - Correct Answer✅-Advise the client that
healing typically takes several weeks to occur.
A client with a history of asthma and bronchitis arrives at the clinic with shortness of
breath, a productive cough with thickened, tenacious mucous, and the inability to walk
up a flight of stairs without experiencing breathlessness. Which action is most
important for the nurse to instruct the client about self-care? - Correct Answer✅-
Increase the daily intake of oral fluids to liquefy secretions.
A client with a history of chronic obstructive pulmonary disease (COPD) receives a new
prescription for an ipratropium inhaler. Which action indicates to the nurse that
additional teaching is needed? - Correct Answer✅-Primes the inhaler with 7 pumps.
A client with cholelithiasis(gallstone) lodged in the common bile duct and is unable to
eat or drink without becoming nauseated and vomiting. Which finding should the nurse
report to the healthcare provider? - Correct Answer✅-Yellow sclera(yellow eyes)
A client with chronic cirrhosis has esophageal varices. It is most important for the nurse
to monitor the client for the onset of which problem? - Correct Answer✅-
Hematemesis(bloody vomit)
A client with emphysema reports difficulty breathing and exhibits audible wheezing.
The nurse administers albuterol as prescribed for the third time within the last 12
hours. Which assessment finding warrants Immediate intervention by the nurse? -
Correct Answer✅-Irregular rapid heartbeat
A client with myasthenia gravis (muscle weakness)receives a new prescription for
pyridostigmine(cholinergic muscle stimulant). Which information should the nurse
3
LecClara Stuvia | Page 3 of 117
, STUDY NOTES & REFERENCE GUIDE
obtain to prior to administering the medication? - Correct Answer✅-Difficulty with
urination
A client with newly diagnosed Crohn's disease asks the nurse about dietary restrictions.
How should the nurse respond? - Correct Answer✅-Describe the use of an elimination
diet to find trigger foods
A client with open-angle glaucoma asks the nurse how long the prescribed eye drops
will need to be used. Which response made by the nurse is accurate? - Correct
Answer✅-For long-term control of pain and swelling
A client with psoriasis returns to the clinic reporting the persistence of several silvery,
scaly areas on the elbows and palms that frequently burn and sometimes bleed. Which
prescription should the nurse teach the client to use for the skin condition? - Correct
Answer✅-Topical corticosteroids
A client with symptoms of influenza that started the previous day asks the clinic nurse
about taking oseltamivir to treat the infection. Which response should the nurse
provide? - Correct Answer✅-Refer the client to the healthcare provider at the clinic to
obtain a medication prescription.
A teenage client is admitted to the emergency department following a bee sting. The
client arrives with a body rash and 30 minutes later becomes short of breath. The nurse
obtains the client's vital signs as a heart rate of 130 beats/minute, respirations of 40
breaths/minute, and a blood pressure of 90/52 mm Hg. The client is exhibiting clinical
manifestations of which type of immune reaction? - Correct Answer✅-IgE response
hypersensitivity
An adult client is admitted with AIDS and oral Candide albicans manifested by several
painful mouth ulcers. The nurse delegates oral care to the unlicensed assistive
personnel (UAP) and discusses how to assist the client. Which instruction should the
nurse provide to the UAP? - Correct Answer✅-Provide a soft-bristled toothbrush for
the client to use during oral care. In the case of oral candidiasis, using a toothbrush with
soft bristles is essential to prevent further irritation and damage to the already
compromised oral mucosa.
An adult client who was admitted yesterday with bilateral pneumonia has congested
breath sounds, an oxygen saturation of 94% on room air, and an oral temperature of
100° F (37.8° C). The client has a weak cough effort and is using accessory muscles to
breathe. Which intervention should the nurse implement first? - Correct Answer✅-
Suction to clear secretions from the airway.
An adult client with multiple sclerosis (MS) fell while walking to the bathroom. On
transfer to the intensive care unit, the client is confused and has had projectile vomiting
twice. Which intervention should the nurse implement first? - Correct Answer✅-
Complete head-to-toe neurological assessment. (should be to assess and stabilize the
patient's immediate medical needs)
4
LecClara Stuvia | Page 4 of 117
