,WGUD446/WGU D446 Adult Health II Objective
Assessment | OA Exam | Q & A | 2026 Edition
(PDF)
1. The nurse is assessing a client with acute decompensated heart failure (ADHF). Which finding is most
concerning?
A) +2 pitting edema in the lower extremities
B) Jugular venous distention (JVD) at 45 degrees
C) Paroxysmal nocturnal dyspnea (PND)
D) Crackles audible to the midscapular region
Correct Answer: Crackles audible to the midscapular region
Expert Rationale: Crackles extending to the midscapular region indicate severe and widespread
pulmonary edema, signifying imminent respiratory compromise. While peripheral edema, JVD, and PND
are important signs of fluid overload, they are not as immediately life-threatening as extensive
pulmonary edema. Crackles to the midscapular region suggest fluid is accumulating in the upper lung
fields, indicating significant fluid overload.
2. A client with infective endocarditis develops sudden left-sided weakness and slurred speech. What is
the priority action?
A) Administer aspirin 325 mg PO
B) Obtain a STAT CT scan of the head
C) Check the blood glucose level
D) Reorient the client to person, place, and time
Correct Answer: Obtain a STAT CT scan of the head
Expert Rationale: The client is likely experiencing an embolic stroke from a vegetation fragment
dislodged from the heart valve. A STAT CT scan is required to rule out hemorrhage before any
thrombolytics or anticoagulation can be considered. Aspirin could worsen a hemorrhagic stroke, and
checking blood glucose or reorienting the client does not address the underlying emergency.
,3. The MONA protocol for the management of acute myocardial infarction includes which of the
following?
A) Morphine, Oxygen, Nitroglycerin, Aspirin
B) Metoprolol, Oxygen, Naloxone, Amiodarone
C) Morphine, Ondansetron, Nitroglycerin, Atropine
D) Metoprolol, Oxygen, Nitroglycerin, Aspirin
Correct Answer: Morphine, Oxygen, Nitroglycerin, Aspirin
Expert Rationale: MONA stands for Morphine (pain relief and preload reduction), Oxygen (for hypoxia),
Nitroglycerin (vasodilation), and Aspirin (antiplatelet effect). This is the standard protocol for acute MI
management. Aspirin is the priority to prevent further clot formation. If the patient is not hypoxic,
oxygen may not be needed.
4. A client with left-sided heart failure is likely to exhibit which of the following symptoms?
A) Peripheral edema and ascites
B) Dyspnea, orthopnea, and crackles
C) Jugular venous distention and hepatomegaly
D) Weight gain and abdominal distention
Correct Answer: Dyspnea, orthopnea, and crackles
Expert Rationale: Left-sided heart failure causes pulmonary congestion, leading to dyspnea, orthopnea,
and crackles on auscultation. These are pulmonary symptoms resulting from fluid backing up into the
lungs. Peripheral edema, JVD, ascites, and hepatomegaly are signs of right-sided heart failure.
5. Which of the following is a classic sign of right-sided heart failure?
A) Crackles in the lungs
B) Orthopnea
C) Jugular venous distention (JVD)
, D) Paroxysmal nocturnal dyspnea (PND)
Correct Answer: Jugular venous distention (JVD)
Expert Rationale: Right-sided heart failure leads to systemic venous congestion, causing peripheral
edema, jugular venous distention, ascites, and hepatomegaly. Crackles, orthopnea, and PND are signs of
left-sided heart failure. JVD is a classic finding in right-sided failure due to increased central venous
pressure.
6. A client with heart failure is prescribed furosemide. The nurse should monitor for which electrolyte
imbalance?
A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hypermagnesemia
Correct Answer: Hypokalemia
Expert Rationale: Furosemide is a loop diuretic that causes potassium loss, leading to hypokalemia.
Hypokalemia can cause cardiac arrhythmias. Potassium-sparing diuretics (e.g., spironolactone) cause
hyperkalemia. Sodium and magnesium may also be affected, but potassium is the primary concern with
loop diuretics.
7. A client with a history of hypertension is prescribed an ACE inhibitor. Which side effect should the
nurse teach the client to report?
A) Dry cough
B) Hyperkalemia
C) Angioedema
D) All of the above
Correct Answer: All of the above
Assessment | OA Exam | Q & A | 2026 Edition
(PDF)
1. The nurse is assessing a client with acute decompensated heart failure (ADHF). Which finding is most
concerning?
A) +2 pitting edema in the lower extremities
B) Jugular venous distention (JVD) at 45 degrees
C) Paroxysmal nocturnal dyspnea (PND)
D) Crackles audible to the midscapular region
Correct Answer: Crackles audible to the midscapular region
Expert Rationale: Crackles extending to the midscapular region indicate severe and widespread
pulmonary edema, signifying imminent respiratory compromise. While peripheral edema, JVD, and PND
are important signs of fluid overload, they are not as immediately life-threatening as extensive
pulmonary edema. Crackles to the midscapular region suggest fluid is accumulating in the upper lung
fields, indicating significant fluid overload.
2. A client with infective endocarditis develops sudden left-sided weakness and slurred speech. What is
the priority action?
A) Administer aspirin 325 mg PO
B) Obtain a STAT CT scan of the head
C) Check the blood glucose level
D) Reorient the client to person, place, and time
Correct Answer: Obtain a STAT CT scan of the head
Expert Rationale: The client is likely experiencing an embolic stroke from a vegetation fragment
dislodged from the heart valve. A STAT CT scan is required to rule out hemorrhage before any
thrombolytics or anticoagulation can be considered. Aspirin could worsen a hemorrhagic stroke, and
checking blood glucose or reorienting the client does not address the underlying emergency.
,3. The MONA protocol for the management of acute myocardial infarction includes which of the
following?
A) Morphine, Oxygen, Nitroglycerin, Aspirin
B) Metoprolol, Oxygen, Naloxone, Amiodarone
C) Morphine, Ondansetron, Nitroglycerin, Atropine
D) Metoprolol, Oxygen, Nitroglycerin, Aspirin
Correct Answer: Morphine, Oxygen, Nitroglycerin, Aspirin
Expert Rationale: MONA stands for Morphine (pain relief and preload reduction), Oxygen (for hypoxia),
Nitroglycerin (vasodilation), and Aspirin (antiplatelet effect). This is the standard protocol for acute MI
management. Aspirin is the priority to prevent further clot formation. If the patient is not hypoxic,
oxygen may not be needed.
4. A client with left-sided heart failure is likely to exhibit which of the following symptoms?
A) Peripheral edema and ascites
B) Dyspnea, orthopnea, and crackles
C) Jugular venous distention and hepatomegaly
D) Weight gain and abdominal distention
Correct Answer: Dyspnea, orthopnea, and crackles
Expert Rationale: Left-sided heart failure causes pulmonary congestion, leading to dyspnea, orthopnea,
and crackles on auscultation. These are pulmonary symptoms resulting from fluid backing up into the
lungs. Peripheral edema, JVD, ascites, and hepatomegaly are signs of right-sided heart failure.
5. Which of the following is a classic sign of right-sided heart failure?
A) Crackles in the lungs
B) Orthopnea
C) Jugular venous distention (JVD)
, D) Paroxysmal nocturnal dyspnea (PND)
Correct Answer: Jugular venous distention (JVD)
Expert Rationale: Right-sided heart failure leads to systemic venous congestion, causing peripheral
edema, jugular venous distention, ascites, and hepatomegaly. Crackles, orthopnea, and PND are signs of
left-sided heart failure. JVD is a classic finding in right-sided failure due to increased central venous
pressure.
6. A client with heart failure is prescribed furosemide. The nurse should monitor for which electrolyte
imbalance?
A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hypermagnesemia
Correct Answer: Hypokalemia
Expert Rationale: Furosemide is a loop diuretic that causes potassium loss, leading to hypokalemia.
Hypokalemia can cause cardiac arrhythmias. Potassium-sparing diuretics (e.g., spironolactone) cause
hyperkalemia. Sodium and magnesium may also be affected, but potassium is the primary concern with
loop diuretics.
7. A client with a history of hypertension is prescribed an ACE inhibitor. Which side effect should the
nurse teach the client to report?
A) Dry cough
B) Hyperkalemia
C) Angioedema
D) All of the above
Correct Answer: All of the above
