Adult Health II (D446) New OA 2 Exam 4
V1 | Adult Health II (D446) New OA 2 Exam
Q&A | WGU
1. A patient arrives at the emergency department with deep partial-thickness burns to the
chest and abdomen. What is the priority nursing action during the emergent phase?
A. Administering IV pain medication
B. Calculating the Parkland formula for fluids
C. Assessing airway patency and oxygen saturation
D. Inserting an indwelling urinary catheter
Answer: C
Rationale: Airway management is always the highest priority in the emergent phase of
burn care, especially with burns to the chest. Potential inhalation injury or airway edema
can quickly lead to respiratory failure. The nurse must ensure the patient has an open
airway before proceeding to fluid resuscitation or pain management.
2. A nurse is caring for a patient in septic shock. Which hemodynamic finding should the
nurse expect?
A. Increased Systemic Vascular Resistance (SVR)
,B. Decreased Central Venous Pressure (CVP)
C. Decreased Cardiac Output
D. Increased Mean Arterial Pressure (MAP)
Answer: B
Rationale: Septic shock typically involves massive vasodilation and capillary leak, leading
to a decrease in preload and CVP. Systemic Vascular Resistance is usually low due to the
inflammatory response causing vasodilation. Monitoring these values helps the clinical
team determine the effectiveness of fluid resuscitation and vasopressor therapy.
3. Using the Parkland formula, calculate the fluid requirements for the first 8 hours for a 70 kg
patient with 40% Total Body Surface Area (TBSA) burned.
A. 5,600 mL
B. 2,800 mL
C. 11,200 mL
D. 4,200 mL
Answer: A
Rationale: The Parkland formula is 4 mL x kg x %TBSA, which equals 11,200 mL for 24
hours. Half of this total volume, 5,600 mL, must be administered within the first 8 hours
from the time of the burn injury. Accurate calculation is vital to prevent hypovolemic shock
and maintain organ perfusion in burn victims.
, 4. A patient in the ICU is diagnosed with Disseminated Intravascular Coagulation (DIC). Which
laboratory result is most consistent with this diagnosis?
A. Decreased D-dimer levels
B. Increased Fibrinogen
C. Elevated Platelet count
D. Prolonged Prothrombin Time (PT)
Answer: D
Rationale: DIC causes an exhaustive consumption of clotting factors, leading to prolonged
PT and PTT times. D-dimer levels would be elevated due to the breakdown of excessive
fibrin clots. This condition represents a paradox of simultaneous clotting and bleeding that
requires rapid intervention.
5. A nurse is performing disaster triage after a mass casualty incident. A patient has a sucking
chest wound and is struggling to breathe. Which color tag should the nurse assign?
A. Red
B. Yellow
C. Green
D. Black
Answer: A
V1 | Adult Health II (D446) New OA 2 Exam
Q&A | WGU
1. A patient arrives at the emergency department with deep partial-thickness burns to the
chest and abdomen. What is the priority nursing action during the emergent phase?
A. Administering IV pain medication
B. Calculating the Parkland formula for fluids
C. Assessing airway patency and oxygen saturation
D. Inserting an indwelling urinary catheter
Answer: C
Rationale: Airway management is always the highest priority in the emergent phase of
burn care, especially with burns to the chest. Potential inhalation injury or airway edema
can quickly lead to respiratory failure. The nurse must ensure the patient has an open
airway before proceeding to fluid resuscitation or pain management.
2. A nurse is caring for a patient in septic shock. Which hemodynamic finding should the
nurse expect?
A. Increased Systemic Vascular Resistance (SVR)
,B. Decreased Central Venous Pressure (CVP)
C. Decreased Cardiac Output
D. Increased Mean Arterial Pressure (MAP)
Answer: B
Rationale: Septic shock typically involves massive vasodilation and capillary leak, leading
to a decrease in preload and CVP. Systemic Vascular Resistance is usually low due to the
inflammatory response causing vasodilation. Monitoring these values helps the clinical
team determine the effectiveness of fluid resuscitation and vasopressor therapy.
3. Using the Parkland formula, calculate the fluid requirements for the first 8 hours for a 70 kg
patient with 40% Total Body Surface Area (TBSA) burned.
A. 5,600 mL
B. 2,800 mL
C. 11,200 mL
D. 4,200 mL
Answer: A
Rationale: The Parkland formula is 4 mL x kg x %TBSA, which equals 11,200 mL for 24
hours. Half of this total volume, 5,600 mL, must be administered within the first 8 hours
from the time of the burn injury. Accurate calculation is vital to prevent hypovolemic shock
and maintain organ perfusion in burn victims.
, 4. A patient in the ICU is diagnosed with Disseminated Intravascular Coagulation (DIC). Which
laboratory result is most consistent with this diagnosis?
A. Decreased D-dimer levels
B. Increased Fibrinogen
C. Elevated Platelet count
D. Prolonged Prothrombin Time (PT)
Answer: D
Rationale: DIC causes an exhaustive consumption of clotting factors, leading to prolonged
PT and PTT times. D-dimer levels would be elevated due to the breakdown of excessive
fibrin clots. This condition represents a paradox of simultaneous clotting and bleeding that
requires rapid intervention.
5. A nurse is performing disaster triage after a mass casualty incident. A patient has a sucking
chest wound and is struggling to breathe. Which color tag should the nurse assign?
A. Red
B. Yellow
C. Green
D. Black
Answer: A
