WGU D446
Adult Health II
Objective Assessment
(2 Full Exams)
Actual Questions with Verified Answers
Pass the Exam with Confidence
What You Will Get:
➢160+ OA Exam Questions w/ Answers
➢Expert Rationales included.
➢250+ OA Review Questions & Answers
➢OA Study Guide & Clinical Prioritization
, D446 Adult Health II OA Exam
Preview Pages Below
Get the Complete PDF After Purchase
"If you require further clarification or in need of any
study resources, feel free to Message me."
Preview sample - complete PDF available after purchase
,Table of Contents
D446 OA EXAM SET 1 ............................................................ 2
D446 OA EXAM SET 2 .......................................................... 44
D446 OA Review 250+ Questions & Answer Review ......... 91
D446 OA Study Guide & Clinical Prioritization ................. 129
D446 OA EXAM SET 1
Question 1
While caring for a client with amyotrophic lateral sclerosis (ALS), the nurse
performs a neurological assessment every four hours. Which assessment finding
warrants immediate intervention by the nurse?
A. Muscle weakness in the lower extremities
B. Weakened cough
C. Difficulty swallowing
D. Slurred speech
Correct Answer:
B. Weakened cough
Rationale: A weakened cough is the most critical finding in a client with ALS, as it can
lead to ineffective airway clearance and increase the risk of aspiration pneumonia.
Immediate intervention, such as suctioning or respiratory support, may be necessary to
maintain airway patency and prevent complications. While all options are concerning in
ALS, the weakened cough directly threatens the airway and requires the most urgent
response.
Question 2
,A client with stage 4 bone cancer is admitted to the hospital and verbalizes
continuous, severe pain of 8 on a 0 to 10 scale. Which intervention should the
nurse implement?
A. Administer non-opioid medication only
B. Administer opioid medication only
C. Administer opioid and non-opioid medication
D. Apply heat therapy and reposition the client
Correct Answer:
C. Administer opioid and non-opioid medication
Rationale: Both opioids and non-opioids are appropriate for managing severe cancer
pain. This multimodal approach addresses pain from multiple pathways and provides
more effective pain relief. Opioids target the central nervous system for severe pain,
while non-opioids (such as NSAIDs or acetaminophen) address peripheral pain
mechanisms and can reduce the total opioid dose needed.
Question 3
A 59-year-old male client presents to the clinic reporting pain in the right great
toe. The client says that the pain feels like it is another attack of gout, which he
has had on 2 other occasions in the last 4 months. The client tells the nurse that
the pain started about 9 days ago in the evening and that it got very painful and
swollen shortly thereafter. In the past, the gout attacks have resolved without
treatment after about 5 days, but the client reports that his condition has not
improved. The nurse reviews the following assessment data:
Table
Assessment Finding Value
Temperature 100.5°F
Heart rate 97 beats/minute
Respirations 18 breaths/minute
Blood pressure 151/87 mm Hg
,A. Obesity
B. Hypertension
C. Drinks beer nightly
D. Daily aspirin use
E. Sleep apnea
Correct Answers:
A, B, C, D, E
Rationale:
• A. Obesity: Obesity is a significant risk factor for gout as it can increase uric acid
production and decrease its excretion.
• B. Hypertension: Hypertension is commonly associated with gout, potentially
due to shared risk factors including kidney health and certain medications that
can raise uric acid levels.
• C. Drinks beer nightly: Alcohol, especially beer, is a well-known trigger for gout
attacks because it increases uric acid production and reduces its excretion.
• D. Daily aspirin: Low doses of aspirin can increase uric acid levels by reducing
its excretion through the kidneys.
• E. Sleep apnea: Sleep apnea is associated with an increased risk of gout,
possibly through the effects of intermittent hypoxia on uric acid levels.
Question 9
A 59-year-old male client presents to the clinic reporting pain in the right great toe
consistent with gout. Which dietary choices are NOT part of the recommended
diet for a client with gout? (Select 3.)
A. Chicken breast
B. Liver
C. Shrimp
D. Sardines
E. Brown rice
Correct Answers:
B, C, D
Rationale:
, D446 OA EXAM SET 2
1. A client is admitted to the hospital with a fractured tibia and is being monitored
for signs of compartment syndrome. Which of the following findings is MOST
indicative of compartment syndrome?
A. Increased pain that is unrelieved by analgesics
B. Visible swelling and bruising at the fracture site
C. Capillary refill time of 3 seconds
D. Mild paresthesia in the toes
Correct Answer:
A
Rationale: The hallmark sign of compartment syndrome is pain that is disproportionate
to the injury and unrelieved by opioid analgesics (pain out of proportion). This results
from increased pressure within the fascial compartment compromising blood flow and
nerve function. The "6 Ps" of compartment syndrome are: Pain (out of proportion),
Pallor, Pulselessness, Paresthesia, Paralysis, and Poikilothermia (coolness). While
swelling (Option B) and paresthesia (Option D) may occur, they are not as specific.
Capillary refill >3 seconds (Option C) indicates vascular compromise but is a later sign.
2. John, a 28-year-old male, is admitted to the emergency department with
complaints of worsening shortness of breath, chest tightness, and a dry cough
for the past 24 hours. He has a history of asthma but admits to inconsistent use
of his prescribed inhalers, particularly the corticosteroid inhaler. On examination,
his respiratory rate is 24 breaths/minute, heart rate is 104 beats/minute, blood
pressure is 130/80 mmHg, oxygen saturation is 93%, and he has bilateral
expiratory wheezing on auscultation. A peak flow measurement reveals 60% of
his personal best. What is the priority nursing intervention for John at this time?
A. Administer a nebulized bronchodilator (e.g., albuterol)
B. Obtain a chest X-ray immediately
C. Start supplemental oxygen at 4 L/min via nasal cannula
D. Prepare for endotracheal intubation
, D446 OA Review 250+ Questions & Answer Review
1. A client is being transferred to the nursing unit from the postanesthesia care
unit after spinal fusion with rod insertion to treat spinal instability from severe
arthritis. The nurse would prepare to transfer the client from the stretcher to the
bed by using which best method?
Answer: Transfer (slider) board and the assistance of three people
2. Which finding noted in the client on continuous ambulatory peritoneal dialysis
(CAPD) would be reported to the primary health care provider (PHCP)?
Answer: Cloudy yellow dialysate output
3. A client with a history of myasthenia gravis presents at a clinic with bilateral
ptosis and is drooling, and myasthenic crisis is suspected. The nurse assesses
the client for which precipitating factor?
Answer: Omitting doses of medication
4. The nurse is providing teaching to a client with breast cancer who will undergo
chemotherapy for cancer, and alopecia is expected from the chemotherapeutic
agent. Which statement made by the client indicates a need for further teaching?
Answer: I can't believe my hair loss is going to be permanent. (Chemotherapy-
induced alopecia is usually temporary, not permanent.)
5. A client is admitted to the nursing unit after a left below-the-knee amputation
after a crush injury to the foot and lower leg. The client tells the nurse, I think I'm
going crazy. I can feel my left foot itching. How would the nurse interpret this
client statement?
Answer: Normal response that indicates the presence of phantom limb sensation
6. The nurse is reviewing teaching materials about colorectal cancer. Which risk
factor for colorectal cancer would the nurse include?
,41. The nurse provides discharge instructions to a client after skin patch testing
to assess for allergies. Which instruction would be included on the discharge
sheet for the client?
Answer: Keep the test sites dry and avoid scratching
42. A client has just had a cast removed, and the underlying skin is yellow-brown
and crusted. The nurse gives the client instructions for skin care. The nurse
determines that the client needs further teaching of the directions if which
statement is made?
Answer: I need to scrub the skin vigorously with soap and water. (Gentle cleansing
is recommended; vigorous scrubbing can damage the skin.)
43. The nurse has given activity guidelines to a client with chronic low back pain.
The nurse determines that the client understands the instructions if the client
states to do which activities? (Select all that apply.)
Answer: Lying prone, Sitting using a lumbar roll or pillow, Standing with one foot on
a step or stool
44. The nurse is monitoring a client newly diagnosed with diabetes mellitus for
signs of complications. Which sign or symptom, if exhibited in the client,
indicates that the client is at risk for chronic complications of diabetes if the
blood glucose is not adequately managed?
Answer: Pedal edema (may indicate nephropathy or cardiovascular complications)
45. A client with acute kidney injury has a serum potassium level of 7.0 mEq/L
(7.0 mmol/L). The nurse would plan which actions as a priority? (Select all that
apply.)
Answer: Place the client on a cardiac monitor, Notify the primary health care
provider (PHCP), Review the client's medications to determine whether any contain
or retain potassium
46. The nurse is providing home care instructions to the client with a diagnosis of
Cushing's syndrome and prepares a list of instructions for the client. Which
instructions would be included on the list? (Select all that apply.)
Answer: The signs and symptoms of hypoadrenalism, Instructions to take the
medications exactly as prescribed, The importance of maintaining regular outpatient
, D446 OA Study Guide & Clinical Prioritization
RESPIRATORY
Table
# Topic Key Points
1 TB Latent vs. Latent: Asymptomatic, non-contagious, +TST,
Active normal CXR. Active: Symptomatic (fever, night
sweats, weight loss, hemoptysis), contagious
2 TB Precautions Airborne precautions: N95 + negative pressure
room
3 TB Medications RIPE = Rifampin, Isoniazid, Pyrazinamide,
Ethambutol
4 Rifampin Side Orange urine/tears (normal)
Effect
5 Isoniazid Side Peripheral neuropathy → give vitamin B6
Effect
6 Ethambutol Side Optic neuritis → blurred vision
Effect
7 TB Compliance Directly Observed Therapy (DOT)
Gold Standard
41 Thoracentesis Sitting leaning forward
Position
, Arterial Steal Syndrome: Vascular insufficiency after fistula creation — pallor,
diminished pulse, hand pain
Disequilibrium Syndrome
Caused by rapid removal of solutes during hemodialysis
Signs: Headache, nausea, restlessness, mental confusion, decreased LOC, vomiting,
twitching, possible seizure
End-Stage Renal Disease (ESRD)
Definition: Kidneys lost ability to remove waste and balance fluids (kidney failure)
Signs: Restless leg, asterixis (hand flap tremor), nocturnal leg cramps, muscle twitching
Treatment: Dialysis, kidney transplant
Nephrectomy
Kidney removal; recovery takes 3-6 weeks
May experience pain, bruising, or redness around incisions
Radical Nephrectomy
Removal of kidney, adrenal gland, surrounding fascia, and draining lymph nodes
Dystopic Lithotripsy
Uses ultrasonic lithotrite to destroy renal stones
Ileal Conduit
Surgical urinary diversion used to treat painful bladder syndrome
Marsupialization
Creation of permanent opening of a diverticular sac in vagina
Adult Health II
Objective Assessment
(2 Full Exams)
Actual Questions with Verified Answers
Pass the Exam with Confidence
What You Will Get:
➢160+ OA Exam Questions w/ Answers
➢Expert Rationales included.
➢250+ OA Review Questions & Answers
➢OA Study Guide & Clinical Prioritization
, D446 Adult Health II OA Exam
Preview Pages Below
Get the Complete PDF After Purchase
"If you require further clarification or in need of any
study resources, feel free to Message me."
Preview sample - complete PDF available after purchase
,Table of Contents
D446 OA EXAM SET 1 ............................................................ 2
D446 OA EXAM SET 2 .......................................................... 44
D446 OA Review 250+ Questions & Answer Review ......... 91
D446 OA Study Guide & Clinical Prioritization ................. 129
D446 OA EXAM SET 1
Question 1
While caring for a client with amyotrophic lateral sclerosis (ALS), the nurse
performs a neurological assessment every four hours. Which assessment finding
warrants immediate intervention by the nurse?
A. Muscle weakness in the lower extremities
B. Weakened cough
C. Difficulty swallowing
D. Slurred speech
Correct Answer:
B. Weakened cough
Rationale: A weakened cough is the most critical finding in a client with ALS, as it can
lead to ineffective airway clearance and increase the risk of aspiration pneumonia.
Immediate intervention, such as suctioning or respiratory support, may be necessary to
maintain airway patency and prevent complications. While all options are concerning in
ALS, the weakened cough directly threatens the airway and requires the most urgent
response.
Question 2
,A client with stage 4 bone cancer is admitted to the hospital and verbalizes
continuous, severe pain of 8 on a 0 to 10 scale. Which intervention should the
nurse implement?
A. Administer non-opioid medication only
B. Administer opioid medication only
C. Administer opioid and non-opioid medication
D. Apply heat therapy and reposition the client
Correct Answer:
C. Administer opioid and non-opioid medication
Rationale: Both opioids and non-opioids are appropriate for managing severe cancer
pain. This multimodal approach addresses pain from multiple pathways and provides
more effective pain relief. Opioids target the central nervous system for severe pain,
while non-opioids (such as NSAIDs or acetaminophen) address peripheral pain
mechanisms and can reduce the total opioid dose needed.
Question 3
A 59-year-old male client presents to the clinic reporting pain in the right great
toe. The client says that the pain feels like it is another attack of gout, which he
has had on 2 other occasions in the last 4 months. The client tells the nurse that
the pain started about 9 days ago in the evening and that it got very painful and
swollen shortly thereafter. In the past, the gout attacks have resolved without
treatment after about 5 days, but the client reports that his condition has not
improved. The nurse reviews the following assessment data:
Table
Assessment Finding Value
Temperature 100.5°F
Heart rate 97 beats/minute
Respirations 18 breaths/minute
Blood pressure 151/87 mm Hg
,A. Obesity
B. Hypertension
C. Drinks beer nightly
D. Daily aspirin use
E. Sleep apnea
Correct Answers:
A, B, C, D, E
Rationale:
• A. Obesity: Obesity is a significant risk factor for gout as it can increase uric acid
production and decrease its excretion.
• B. Hypertension: Hypertension is commonly associated with gout, potentially
due to shared risk factors including kidney health and certain medications that
can raise uric acid levels.
• C. Drinks beer nightly: Alcohol, especially beer, is a well-known trigger for gout
attacks because it increases uric acid production and reduces its excretion.
• D. Daily aspirin: Low doses of aspirin can increase uric acid levels by reducing
its excretion through the kidneys.
• E. Sleep apnea: Sleep apnea is associated with an increased risk of gout,
possibly through the effects of intermittent hypoxia on uric acid levels.
Question 9
A 59-year-old male client presents to the clinic reporting pain in the right great toe
consistent with gout. Which dietary choices are NOT part of the recommended
diet for a client with gout? (Select 3.)
A. Chicken breast
B. Liver
C. Shrimp
D. Sardines
E. Brown rice
Correct Answers:
B, C, D
Rationale:
, D446 OA EXAM SET 2
1. A client is admitted to the hospital with a fractured tibia and is being monitored
for signs of compartment syndrome. Which of the following findings is MOST
indicative of compartment syndrome?
A. Increased pain that is unrelieved by analgesics
B. Visible swelling and bruising at the fracture site
C. Capillary refill time of 3 seconds
D. Mild paresthesia in the toes
Correct Answer:
A
Rationale: The hallmark sign of compartment syndrome is pain that is disproportionate
to the injury and unrelieved by opioid analgesics (pain out of proportion). This results
from increased pressure within the fascial compartment compromising blood flow and
nerve function. The "6 Ps" of compartment syndrome are: Pain (out of proportion),
Pallor, Pulselessness, Paresthesia, Paralysis, and Poikilothermia (coolness). While
swelling (Option B) and paresthesia (Option D) may occur, they are not as specific.
Capillary refill >3 seconds (Option C) indicates vascular compromise but is a later sign.
2. John, a 28-year-old male, is admitted to the emergency department with
complaints of worsening shortness of breath, chest tightness, and a dry cough
for the past 24 hours. He has a history of asthma but admits to inconsistent use
of his prescribed inhalers, particularly the corticosteroid inhaler. On examination,
his respiratory rate is 24 breaths/minute, heart rate is 104 beats/minute, blood
pressure is 130/80 mmHg, oxygen saturation is 93%, and he has bilateral
expiratory wheezing on auscultation. A peak flow measurement reveals 60% of
his personal best. What is the priority nursing intervention for John at this time?
A. Administer a nebulized bronchodilator (e.g., albuterol)
B. Obtain a chest X-ray immediately
C. Start supplemental oxygen at 4 L/min via nasal cannula
D. Prepare for endotracheal intubation
, D446 OA Review 250+ Questions & Answer Review
1. A client is being transferred to the nursing unit from the postanesthesia care
unit after spinal fusion with rod insertion to treat spinal instability from severe
arthritis. The nurse would prepare to transfer the client from the stretcher to the
bed by using which best method?
Answer: Transfer (slider) board and the assistance of three people
2. Which finding noted in the client on continuous ambulatory peritoneal dialysis
(CAPD) would be reported to the primary health care provider (PHCP)?
Answer: Cloudy yellow dialysate output
3. A client with a history of myasthenia gravis presents at a clinic with bilateral
ptosis and is drooling, and myasthenic crisis is suspected. The nurse assesses
the client for which precipitating factor?
Answer: Omitting doses of medication
4. The nurse is providing teaching to a client with breast cancer who will undergo
chemotherapy for cancer, and alopecia is expected from the chemotherapeutic
agent. Which statement made by the client indicates a need for further teaching?
Answer: I can't believe my hair loss is going to be permanent. (Chemotherapy-
induced alopecia is usually temporary, not permanent.)
5. A client is admitted to the nursing unit after a left below-the-knee amputation
after a crush injury to the foot and lower leg. The client tells the nurse, I think I'm
going crazy. I can feel my left foot itching. How would the nurse interpret this
client statement?
Answer: Normal response that indicates the presence of phantom limb sensation
6. The nurse is reviewing teaching materials about colorectal cancer. Which risk
factor for colorectal cancer would the nurse include?
,41. The nurse provides discharge instructions to a client after skin patch testing
to assess for allergies. Which instruction would be included on the discharge
sheet for the client?
Answer: Keep the test sites dry and avoid scratching
42. A client has just had a cast removed, and the underlying skin is yellow-brown
and crusted. The nurse gives the client instructions for skin care. The nurse
determines that the client needs further teaching of the directions if which
statement is made?
Answer: I need to scrub the skin vigorously with soap and water. (Gentle cleansing
is recommended; vigorous scrubbing can damage the skin.)
43. The nurse has given activity guidelines to a client with chronic low back pain.
The nurse determines that the client understands the instructions if the client
states to do which activities? (Select all that apply.)
Answer: Lying prone, Sitting using a lumbar roll or pillow, Standing with one foot on
a step or stool
44. The nurse is monitoring a client newly diagnosed with diabetes mellitus for
signs of complications. Which sign or symptom, if exhibited in the client,
indicates that the client is at risk for chronic complications of diabetes if the
blood glucose is not adequately managed?
Answer: Pedal edema (may indicate nephropathy or cardiovascular complications)
45. A client with acute kidney injury has a serum potassium level of 7.0 mEq/L
(7.0 mmol/L). The nurse would plan which actions as a priority? (Select all that
apply.)
Answer: Place the client on a cardiac monitor, Notify the primary health care
provider (PHCP), Review the client's medications to determine whether any contain
or retain potassium
46. The nurse is providing home care instructions to the client with a diagnosis of
Cushing's syndrome and prepares a list of instructions for the client. Which
instructions would be included on the list? (Select all that apply.)
Answer: The signs and symptoms of hypoadrenalism, Instructions to take the
medications exactly as prescribed, The importance of maintaining regular outpatient
, D446 OA Study Guide & Clinical Prioritization
RESPIRATORY
Table
# Topic Key Points
1 TB Latent vs. Latent: Asymptomatic, non-contagious, +TST,
Active normal CXR. Active: Symptomatic (fever, night
sweats, weight loss, hemoptysis), contagious
2 TB Precautions Airborne precautions: N95 + negative pressure
room
3 TB Medications RIPE = Rifampin, Isoniazid, Pyrazinamide,
Ethambutol
4 Rifampin Side Orange urine/tears (normal)
Effect
5 Isoniazid Side Peripheral neuropathy → give vitamin B6
Effect
6 Ethambutol Side Optic neuritis → blurred vision
Effect
7 TB Compliance Directly Observed Therapy (DOT)
Gold Standard
41 Thoracentesis Sitting leaning forward
Position
, Arterial Steal Syndrome: Vascular insufficiency after fistula creation — pallor,
diminished pulse, hand pain
Disequilibrium Syndrome
Caused by rapid removal of solutes during hemodialysis
Signs: Headache, nausea, restlessness, mental confusion, decreased LOC, vomiting,
twitching, possible seizure
End-Stage Renal Disease (ESRD)
Definition: Kidneys lost ability to remove waste and balance fluids (kidney failure)
Signs: Restless leg, asterixis (hand flap tremor), nocturnal leg cramps, muscle twitching
Treatment: Dialysis, kidney transplant
Nephrectomy
Kidney removal; recovery takes 3-6 weeks
May experience pain, bruising, or redness around incisions
Radical Nephrectomy
Removal of kidney, adrenal gland, surrounding fascia, and draining lymph nodes
Dystopic Lithotripsy
Uses ultrasonic lithotrite to destroy renal stones
Ileal Conduit
Surgical urinary diversion used to treat painful bladder syndrome
Marsupialization
Creation of permanent opening of a diverticular sac in vagina
