WGU D444 Adult Health 1 Objective Assessment TEST BANK| OA V1 and V2 – Questions and
Answers | 2026 Update | 100% Correct.
MULTIPLE CHOICES
1. A 68-year-old male with a history of hypertension and smoking presents to the emergency department
with substernal chest pain radiating to his left arm, diaphoresis, and nausea. His ECG shows ST-segment
elevation in leads V1–V4. Which intervention should the nurse anticipate as the priority?
A) Administer sublingual nitroglycerin
B) Prepare for immediate percutaneous coronary intervention
C) Administer aspirin 324 mg chewed
D) Obtain cardiac enzyme levels
Correct Answer: B
Rationale: ST-segment elevation in V1–V4 indicates an anterior ST-elevation myocardial infarction
(STEMI). The priority is immediate reperfusion therapy, preferably percutaneous coronary intervention
(PCI) within 90 minutes of arrival. Aspirin and nitroglycerin are important but should not delay PCI.
2. A 72-year-old female with heart failure is receiving furosemide 40 mg IV push. Which assessment
finding indicates the medication is having the desired therapeutic effect?
A) Decreased jugular venous distension
B) Increased blood pressure
C) Decreased heart rate
D) Increased urine specific gravity
Correct Answer: A
Rationale: Furosemide is a loop diuretic used to reduce fluid volume in heart failure. The desired effect is
decreased venous congestion, reflected by decreased jugular venous distension, reduced peripheral
edema, and improved dyspnea. Increased urine output with decreased specific gravity is expected.
3. A 65-year-old patient with COPD is receiving oxygen at 2 L/min via nasal cannula. The patient's
arterial blood gas results show pH 7.31, PaCO2 68 mmHg, HCO3 32 mEq/L. Which interpretation is
correct?
1|Page SUCCESS!!!
,WGU D444 Adult Health 1 Objective Assessment TEST BANK| OA V1 and V2 – Questions and
Answers | 2026 Update | 100% Correct.
A) Acute respiratory acidosis with metabolic compensation
B) Chronic respiratory acidosis with metabolic compensation
C) Acute respiratory alkalosis
D) Metabolic acidosis with respiratory compensation
Correct Answer: B
Rationale: The ABG shows acidosis (pH 7.31) with elevated PaCO2 (respiratory acidosis) and elevated
HCO3 (metabolic compensation). The elevated HCO3 indicates chronic compensation, as the kidneys
have had time to retain bicarbonate. COPD patients often have chronic respiratory acidosis with
metabolic compensation.
4. A 55-year-old patient with diabetes mellitus type 2 is prescribed metformin 500 mg twice daily. Which
teaching point should the nurse include regarding this medication?
A) Take metformin with meals to reduce gastrointestinal side effects
B) Monitor blood glucose levels once weekly
C) Report any weight gain to the provider
D) Metformin should be taken on an empty stomach
Correct Answer: A
Rationale: Metformin should be taken with meals to reduce gastrointestinal side effects such as nausea,
diarrhea, and abdominal discomfort. Patients should monitor blood glucose regularly and report
symptoms of lactic acidosis (rare but serious).
5. A 78-year-old patient is admitted with acute confusion, fever, and urinary frequency. The urinalysis
shows positive leukocyte esterase and nitrites. Which condition should the nurse suspect?
A) Urinary tract infection with possible delirium
B) Acute kidney injury
2|Page SUCCESS!!!
,WGU D444 Adult Health 1 Objective Assessment TEST BANK| OA V1 and V2 – Questions and
Answers | 2026 Update | 100% Correct.
C) Diabetic ketoacidosis
D) Cerebrovascular accident
Correct Answer: A
Rationale: The presentation of acute confusion in an older adult with fever and urinary symptoms
suggests a urinary tract infection with associated delirium. The positive leukocyte esterase and nitrites
confirm a UTI. Older adults often present with atypical symptoms, including confusion without typical
dysuria.
6. A 45-year-old patient is admitted with acute pancreatitis. The patient reports severe epigastric pain that
radiates to the back, nausea, and vomiting. Which laboratory finding is most consistent with this
diagnosis?
A) Elevated serum amylase and lipase
B) Elevated liver function tests
C) Decreased serum calcium
D) Elevated white blood cell count
Correct Answer: A
Rationale: Acute pancreatitis is diagnosed by elevated serum amylase and lipase, typically three times the
upper limit of normal. Lipase is more specific to the pancreas. Pain radiating to the back is classic for
pancreatitis.
7. A 60-year-old patient with chronic kidney disease stage 4 has a serum potassium of 6.2 mEq/L. Which
ECG change should the nurse anticipate?
A) Peaked T waves
B) Prolonged PR interval
C) Widened QRS complex
D) ST-segment depression
3|Page SUCCESS!!!
, WGU D444 Adult Health 1 Objective Assessment TEST BANK| OA V1 and V2 – Questions and
Answers | 2026 Update | 100% Correct.
Correct Answer: A
Rationale: Hyperkalemia (serum potassium >5.5 mEq/L) causes peaked (tall, tented) T waves on ECG.
As potassium levels rise further, the PR interval may prolong, QRS complex widens, and ventricular
fibrillation may occur. Prompt treatment is required to prevent cardiac arrest.
8. A 50-year-old patient is 2 days post-operative following abdominal surgery. The patient reports
sudden-onset chest pain, dyspnea, and hemoptysis. Oxygen saturation is 88% on room air. Which
condition should the nurse suspect?
A) Pulmonary embolism
B) Atelectasis
C) Pneumonia
D) Myocardial infarction
Correct Answer: A
Rationale: The triad of sudden chest pain, dyspnea, and hemoptysis in a post-operative patient suggests
pulmonary embolism. Immobility and surgery increase the risk of deep vein thrombosis, which can
embolize to the lungs. Immediate interventions include oxygen, anticoagulation, and further diagnostics.
9. A 70-year-old patient with heart failure is receiving a continuous IV infusion of dobutamine. Which
assessment finding indicates the medication is effective?
A) Increased cardiac output
B) Decreased blood pressure
C) Increased heart rate
D) Decreased urine output
Correct Answer: A
4|Page SUCCESS!!!
Answers | 2026 Update | 100% Correct.
MULTIPLE CHOICES
1. A 68-year-old male with a history of hypertension and smoking presents to the emergency department
with substernal chest pain radiating to his left arm, diaphoresis, and nausea. His ECG shows ST-segment
elevation in leads V1–V4. Which intervention should the nurse anticipate as the priority?
A) Administer sublingual nitroglycerin
B) Prepare for immediate percutaneous coronary intervention
C) Administer aspirin 324 mg chewed
D) Obtain cardiac enzyme levels
Correct Answer: B
Rationale: ST-segment elevation in V1–V4 indicates an anterior ST-elevation myocardial infarction
(STEMI). The priority is immediate reperfusion therapy, preferably percutaneous coronary intervention
(PCI) within 90 minutes of arrival. Aspirin and nitroglycerin are important but should not delay PCI.
2. A 72-year-old female with heart failure is receiving furosemide 40 mg IV push. Which assessment
finding indicates the medication is having the desired therapeutic effect?
A) Decreased jugular venous distension
B) Increased blood pressure
C) Decreased heart rate
D) Increased urine specific gravity
Correct Answer: A
Rationale: Furosemide is a loop diuretic used to reduce fluid volume in heart failure. The desired effect is
decreased venous congestion, reflected by decreased jugular venous distension, reduced peripheral
edema, and improved dyspnea. Increased urine output with decreased specific gravity is expected.
3. A 65-year-old patient with COPD is receiving oxygen at 2 L/min via nasal cannula. The patient's
arterial blood gas results show pH 7.31, PaCO2 68 mmHg, HCO3 32 mEq/L. Which interpretation is
correct?
1|Page SUCCESS!!!
,WGU D444 Adult Health 1 Objective Assessment TEST BANK| OA V1 and V2 – Questions and
Answers | 2026 Update | 100% Correct.
A) Acute respiratory acidosis with metabolic compensation
B) Chronic respiratory acidosis with metabolic compensation
C) Acute respiratory alkalosis
D) Metabolic acidosis with respiratory compensation
Correct Answer: B
Rationale: The ABG shows acidosis (pH 7.31) with elevated PaCO2 (respiratory acidosis) and elevated
HCO3 (metabolic compensation). The elevated HCO3 indicates chronic compensation, as the kidneys
have had time to retain bicarbonate. COPD patients often have chronic respiratory acidosis with
metabolic compensation.
4. A 55-year-old patient with diabetes mellitus type 2 is prescribed metformin 500 mg twice daily. Which
teaching point should the nurse include regarding this medication?
A) Take metformin with meals to reduce gastrointestinal side effects
B) Monitor blood glucose levels once weekly
C) Report any weight gain to the provider
D) Metformin should be taken on an empty stomach
Correct Answer: A
Rationale: Metformin should be taken with meals to reduce gastrointestinal side effects such as nausea,
diarrhea, and abdominal discomfort. Patients should monitor blood glucose regularly and report
symptoms of lactic acidosis (rare but serious).
5. A 78-year-old patient is admitted with acute confusion, fever, and urinary frequency. The urinalysis
shows positive leukocyte esterase and nitrites. Which condition should the nurse suspect?
A) Urinary tract infection with possible delirium
B) Acute kidney injury
2|Page SUCCESS!!!
,WGU D444 Adult Health 1 Objective Assessment TEST BANK| OA V1 and V2 – Questions and
Answers | 2026 Update | 100% Correct.
C) Diabetic ketoacidosis
D) Cerebrovascular accident
Correct Answer: A
Rationale: The presentation of acute confusion in an older adult with fever and urinary symptoms
suggests a urinary tract infection with associated delirium. The positive leukocyte esterase and nitrites
confirm a UTI. Older adults often present with atypical symptoms, including confusion without typical
dysuria.
6. A 45-year-old patient is admitted with acute pancreatitis. The patient reports severe epigastric pain that
radiates to the back, nausea, and vomiting. Which laboratory finding is most consistent with this
diagnosis?
A) Elevated serum amylase and lipase
B) Elevated liver function tests
C) Decreased serum calcium
D) Elevated white blood cell count
Correct Answer: A
Rationale: Acute pancreatitis is diagnosed by elevated serum amylase and lipase, typically three times the
upper limit of normal. Lipase is more specific to the pancreas. Pain radiating to the back is classic for
pancreatitis.
7. A 60-year-old patient with chronic kidney disease stage 4 has a serum potassium of 6.2 mEq/L. Which
ECG change should the nurse anticipate?
A) Peaked T waves
B) Prolonged PR interval
C) Widened QRS complex
D) ST-segment depression
3|Page SUCCESS!!!
, WGU D444 Adult Health 1 Objective Assessment TEST BANK| OA V1 and V2 – Questions and
Answers | 2026 Update | 100% Correct.
Correct Answer: A
Rationale: Hyperkalemia (serum potassium >5.5 mEq/L) causes peaked (tall, tented) T waves on ECG.
As potassium levels rise further, the PR interval may prolong, QRS complex widens, and ventricular
fibrillation may occur. Prompt treatment is required to prevent cardiac arrest.
8. A 50-year-old patient is 2 days post-operative following abdominal surgery. The patient reports
sudden-onset chest pain, dyspnea, and hemoptysis. Oxygen saturation is 88% on room air. Which
condition should the nurse suspect?
A) Pulmonary embolism
B) Atelectasis
C) Pneumonia
D) Myocardial infarction
Correct Answer: A
Rationale: The triad of sudden chest pain, dyspnea, and hemoptysis in a post-operative patient suggests
pulmonary embolism. Immobility and surgery increase the risk of deep vein thrombosis, which can
embolize to the lungs. Immediate interventions include oxygen, anticoagulation, and further diagnostics.
9. A 70-year-old patient with heart failure is receiving a continuous IV infusion of dobutamine. Which
assessment finding indicates the medication is effective?
A) Increased cardiac output
B) Decreased blood pressure
C) Increased heart rate
D) Decreased urine output
Correct Answer: A
4|Page SUCCESS!!!
