Adult Health II (D446) New OA 2 Exam 1
V3 | Adult Health II (D446) New OA 2 Exam
Q&A | WGU
1. A nurse is caring for a patient with Acute Respiratory Distress Syndrome (ARDS) on
mechanical ventilation. The ventilator is set to deliver Positive End-Expiratory Pressure
(PEEP). What is the primary purpose of PEEP in this patient?
A. To keep the alveoli open and improve oxygenation
B. To increase the fraction of inspired oxygen (FiO2) delivered
C. To prevent the patient from breathing against the ventilator
D. To decrease the risk of barotrauma to the lungs
Answer: A
Rationale: PEEP is used in ARDS to prevent alveolar collapse at the end of expiration,
thereby increasing the surface area for gas exchange and improving oxygenation. While it
can increase pressure, its primary goal is recruitment of alveoli.
2. A patient is admitted with a suspected C4 spinal cord injury. Which assessment finding is
the nurse’s highest priority?
A. Heart rate of 52 beats per minute
B. Absence of sensation in the lower extremities
C. Bladder distension
,D. Respiratory rate and effort
Answer: D
Rationale: Injuries at or above C4 affect the phrenic nerve, which controls the diaphragm.
Respiratory failure is the most immediate life-threatening complication for this patient.
3. The nurse is monitoring a patient in the ICU with an arterial line. The nurse notes that the
pressure waveform has become dampened or ‘flat.’ Which action should the nurse take first?
A. Check the pressure bag for adequate inflation
B. Check for kinks in the tubing or a blood clot
C. Perform a square wave test
D. Zero the transducer at the phlebostatic axis
Answer: B
Rationale: A dampened waveform is often caused by mechanical issues such as kinks in
the tubing or a clot in the catheter. Checking the integrity of the line is the first physical
assessment step.
4. A patient with a traumatic brain injury (TBI) has an intracranial pressure (ICP) of 22 mmHg.
Which of the following provider orders should the nurse implement first?
A. Administer a scheduled dose of Famotidine
B. Administer Mannitol 25% IV bolus
C. Perform a detailed neurological assessment
, D. Increase the room temperature to prevent shivering
Answer: B
Rationale: Normal ICP is 5-15 mmHg. An ICP of 22 is elevated. Mannitol is an osmotic
diuretic that helps shift fluid from the brain tissue into the vascular space to reduce brain
swelling and ICP quickly.
5. Which clinical manifestation is a hallmark sign of the ‘compensatory stage’ of shock?
A. Refractory hypotension
B. Mean Arterial Pressure (MAP) below 60 mmHg
C. Anuria and metabolic acidosis
D. Cool, clammy skin and tachycardia
Answer: D
Rationale: During the compensatory stage, the body activates the sympathetic nervous
system to maintain cardiac output, leading to tachycardia and peripheral vasoconstriction
(cool, clammy skin).
6. A patient in the ICU is being treated for Septic Shock. The nurse notes a high Cardiac
Output (CO) but low Systemic Vascular Resistance (SVR). Which phase of septic shock is this
patient likely in?
A. The hyperdynamic (warm) phase
B. The cold phase
V3 | Adult Health II (D446) New OA 2 Exam
Q&A | WGU
1. A nurse is caring for a patient with Acute Respiratory Distress Syndrome (ARDS) on
mechanical ventilation. The ventilator is set to deliver Positive End-Expiratory Pressure
(PEEP). What is the primary purpose of PEEP in this patient?
A. To keep the alveoli open and improve oxygenation
B. To increase the fraction of inspired oxygen (FiO2) delivered
C. To prevent the patient from breathing against the ventilator
D. To decrease the risk of barotrauma to the lungs
Answer: A
Rationale: PEEP is used in ARDS to prevent alveolar collapse at the end of expiration,
thereby increasing the surface area for gas exchange and improving oxygenation. While it
can increase pressure, its primary goal is recruitment of alveoli.
2. A patient is admitted with a suspected C4 spinal cord injury. Which assessment finding is
the nurse’s highest priority?
A. Heart rate of 52 beats per minute
B. Absence of sensation in the lower extremities
C. Bladder distension
,D. Respiratory rate and effort
Answer: D
Rationale: Injuries at or above C4 affect the phrenic nerve, which controls the diaphragm.
Respiratory failure is the most immediate life-threatening complication for this patient.
3. The nurse is monitoring a patient in the ICU with an arterial line. The nurse notes that the
pressure waveform has become dampened or ‘flat.’ Which action should the nurse take first?
A. Check the pressure bag for adequate inflation
B. Check for kinks in the tubing or a blood clot
C. Perform a square wave test
D. Zero the transducer at the phlebostatic axis
Answer: B
Rationale: A dampened waveform is often caused by mechanical issues such as kinks in
the tubing or a clot in the catheter. Checking the integrity of the line is the first physical
assessment step.
4. A patient with a traumatic brain injury (TBI) has an intracranial pressure (ICP) of 22 mmHg.
Which of the following provider orders should the nurse implement first?
A. Administer a scheduled dose of Famotidine
B. Administer Mannitol 25% IV bolus
C. Perform a detailed neurological assessment
, D. Increase the room temperature to prevent shivering
Answer: B
Rationale: Normal ICP is 5-15 mmHg. An ICP of 22 is elevated. Mannitol is an osmotic
diuretic that helps shift fluid from the brain tissue into the vascular space to reduce brain
swelling and ICP quickly.
5. Which clinical manifestation is a hallmark sign of the ‘compensatory stage’ of shock?
A. Refractory hypotension
B. Mean Arterial Pressure (MAP) below 60 mmHg
C. Anuria and metabolic acidosis
D. Cool, clammy skin and tachycardia
Answer: D
Rationale: During the compensatory stage, the body activates the sympathetic nervous
system to maintain cardiac output, leading to tachycardia and peripheral vasoconstriction
(cool, clammy skin).
6. A patient in the ICU is being treated for Septic Shock. The nurse notes a high Cardiac
Output (CO) but low Systemic Vascular Resistance (SVR). Which phase of septic shock is this
patient likely in?
A. The hyperdynamic (warm) phase
B. The cold phase
