WGU D446
Adult Health II
Objective Assessment
(2 Full Exams Set)
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
, 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."
Digital preview sample
,Table of Contents
D446 OA EXAM SET 1 ....................................................................... 2
D446 OA EXAM SET 2 ..................................................................... 68
D446 OA Review 250+ Questions & Answer Review ........... 143
D446 OA Study Guide & Clinical Prioritization .................... 181
D446 OA EXAM SET 1
Question 1
A nurse is caring for a client with diabetes insipidus (DI). Which data warrants the
most immediate intervention by the nurse?
Table
Option Response
a. Serum sodium of 185 mEq/L
b. Dry skin with inelastic turgor
c. Apical rate of 110 beats per minute
d. Polyuria and excessive thirst
Correct Answer:
a. Serum sodium of 185 mEq/L
Rationale: Diabetes insipidus is characterized by deficient antidiuretic hormone (ADH)
or renal unresponsiveness to ADH, resulting in massive diuresis and hypernatremia. A
serum sodium of 185 mEq/L represents severe hypernatremia (normal: 135-145
,mEq/L) and indicates profound dehydration with risk of neurological complications,
including seizures, cerebral edema upon correction, and death. This is a life-threatening
electrolyte imbalance requiring immediate intervention. While dry skin (b) and
tachycardia (c) indicate dehydration, and polyuria/thirst (d) are expected findings in DI,
none are as immediately life-threatening as severe hypernatremia.
Question 2
The nurse is obtaining the admission history for a client with suspected peptic
ulcer disease (PUD). Which subjective data reported by the client supports this
medical diagnosis?
Table
Option Response
a. Frequent use of chewable and liquid antacids for indigestion
b. Severe abdominal cramps and diarrhea after eating spicy foods
c. Upper mid-abdominal pain described as gnawing and burning
d. Marked loss of weight and appetite over the last 3 or 4 months
Correct Answer:
c. Upper mid-abdominal pain described as gnawing and burning
Rationale: The classic symptom of PUD is epigastric or upper mid-abdominal pain
described as gnawing, burning, or aching, often occurring 1-3 hours after meals or
during the night. This pain pattern is pathognomonic for ulcer disease. While antacid
use (a) may indicate dyspepsia, it is nonspecific. Severe cramps and diarrhea after
spicy foods (b) suggests food intolerance or irritable bowel syndrome. Marked weight
loss and anorexia over months (d) is more indicative of gastric cancer than
uncomplicated PUD.
Question 3
,The nurse assesses a client who is newly diagnosed with hyperthyroidism and
observes that the client's eyeballs are protuberant, causing a wide-eyed
appearance and eye discomfort. Based on this finding, which action should the
nurse include in this client's plan of care?
Table
Option Response
a. Assess for signs of increased intracranial pressure
b. Prepare to administer intravenous levothyroxine
c. Review the client's serum electrolyte values
d. Obtain a prescription for artificial tear drops
Correct Answer:
d. Obtain a prescription for artificial tear drops
Rationale: Protuberant eyeballs describe exophthalmos, a hallmark of Graves'
ophthalmopathy associated with hyperthyroidism. The protrusion prevents complete
eyelid closure (lagophthalmos), leading to corneal drying, ulceration, and potential
vision loss. Artificial tears and lubricating ointments are essential to maintain corneal
moisture. Levothyroxine (b) is contraindicated—it is used for hypothyroidism, not
hyperthyroidism. Increased ICP (a) and electrolytes (c) are unrelated to this ocular
manifestation.
Question 4
To reduce the risk for pulmonary complications for a client with amyotrophic
lateral sclerosis (ALS), which interventions should the nurse implement? (Select
all that apply)
Table
,Complete the diagram by selecting which condition the client is most likely
experiencing, two actions the nurse should take to address that condition, and
two parameters the nurse should monitor to assess the client's progress.
Table
Category Selection
Potential Condition Rheumatoid arthritis
Actions to Take 1. Educate on disease process and management
2. Consult dietician for nutrition and weight loss
Parameters to Monitor 1. Pain
2. Physical mobility
Rationale: The presentation of bilateral hand/wrist pain with morning stiffness, positive
ANA, elevated ESR, and X-ray findings of marginal erosions is classic for rheumatoid
arthritis. Patient education is essential for disease management. Nutritional consultation
helps manage weight to reduce joint stress. Monitoring pain and physical mobility are
key parameters to assess disease progression and treatment effectiveness.
,Table
CBC Parameters Expected Findings in Pernicious Anemia
Hemoglobin Decreased
Hematocrit Decreased
MCV (Mean Corpuscular Volume) Elevated (>100 fL)—macrocytic
MCH Elevated
RBC count Decreased
WBC/Platelets May be decreased in severe cases
Why increasing fatigue despite treatment?
• Inadequate B12 absorption or dosing
• Folate supplementation masking B12 deficiency hematologically while
neurological damage progresses
• Development of iron deficiency (combined anemia)
• Underlying malignancy (pernicious anemia increases gastric cancer risk)
The CBC provides comprehensive data on anemia status and treatment response.
Platelet count (B) alone is insufficient. Liver enzymes (C) and electrolytes (D) do not
assess hematologic status.
,255. The healthcare provider prescribes high-protein, high-fat, low-carbohydrate
diet with limited fluids during meals for a client recovering from gastric surgery. The
client asks the nurse what the purpose is for this type of diet. Which rationale should
be included in the nurse's explanation to this client?
Answer: It is slow to leave the stomach and prevents dumping syndrome
256. The nurse is planning preoperative teaching for a client who will undergo a
radical neck dissection and total laryngectomy. Which information has the greatest
priority for this client?
Answer: There is a radical change in appearance as a result of this surgery
, # Topic Key Points
10 Cataract Post-Op Prevent ↑IOP (no bending, coughing, lifting)
Priority
11 Cataract Teaching Wear sunglasses + eye shield
123 Glaucoma Acute = pain + halos (emergency)
GASTROINTESTINAL
Table
# Topic Key Points
12 Diverticulitis Diet Acute: NPO/clear liquids. Chronic: High fiber
13 Diverticulitis Pain LLQ pain worse with straining
58 Cholecystitis Pain RUQ after fatty meals
59 Murphy Sign Stops breathing when RUQ pressed
60 Cholecystitis Diet Low fat
71 Peptic Ulcer Gastric: Worse with food. Duodenal: Better with
Difference food
72 Ulcer Emergency Perforation → rigid abdomen
110 SBO vs. LBO SBO = vomiting. LBO = distention
, Signs: Weight gain (moon face, buffalo hump)
Conn Syndrome
Hyperaldosteronism
Hyperpituitarism
Signs: Visual disturbances, severe headaches, back/joint pain, menstrual changes,
increased growth hormone
Diabetes Mellitus
Blood sugar problem
Normal Blood Glucose: 70-115
Fasting Glucose: Under 100
Hemoglobin A1C: 6.5+
Type 1 Diabetes
MNEMONIC: Type ONE = NONE (zero insulin produced)
Type 2 Diabetes
MNEMONIC: Type TWO = FEW insulin (few insulin receptors work)
Metabolic Syndrome (3+ Criteria)
B-BP meds or high BP: Over 130 systolic
B-Blood sugar meds or high blood sugar: 100+ fasting
O-Obese waist size:
L-Lipids: High cholesterol
Insulin Types
Rapid Acting (Aspart, Lispro, Glulisine): 15 min onset; NEVER give without food
Regular/Short Acting (Humulin R, Novolin R): Onset within 30 min; ONLY insulin given IV
NPH/Intermittent (Humulin N, Novolin N): Onset 1.5 hrs; peak 2-5 hrs
Long Acting (Lantus/Glargine): Steady control; once every 24 hrs; DO NOT mix with other
insulins
Hyperglycemia
Levels: Blood glucose over 115; A1C 6.5+
3 P's: Polyuria, Polydipsia, Polyphagia
Adult Health II
Objective Assessment
(2 Full Exams Set)
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
, 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."
Digital preview sample
,Table of Contents
D446 OA EXAM SET 1 ....................................................................... 2
D446 OA EXAM SET 2 ..................................................................... 68
D446 OA Review 250+ Questions & Answer Review ........... 143
D446 OA Study Guide & Clinical Prioritization .................... 181
D446 OA EXAM SET 1
Question 1
A nurse is caring for a client with diabetes insipidus (DI). Which data warrants the
most immediate intervention by the nurse?
Table
Option Response
a. Serum sodium of 185 mEq/L
b. Dry skin with inelastic turgor
c. Apical rate of 110 beats per minute
d. Polyuria and excessive thirst
Correct Answer:
a. Serum sodium of 185 mEq/L
Rationale: Diabetes insipidus is characterized by deficient antidiuretic hormone (ADH)
or renal unresponsiveness to ADH, resulting in massive diuresis and hypernatremia. A
serum sodium of 185 mEq/L represents severe hypernatremia (normal: 135-145
,mEq/L) and indicates profound dehydration with risk of neurological complications,
including seizures, cerebral edema upon correction, and death. This is a life-threatening
electrolyte imbalance requiring immediate intervention. While dry skin (b) and
tachycardia (c) indicate dehydration, and polyuria/thirst (d) are expected findings in DI,
none are as immediately life-threatening as severe hypernatremia.
Question 2
The nurse is obtaining the admission history for a client with suspected peptic
ulcer disease (PUD). Which subjective data reported by the client supports this
medical diagnosis?
Table
Option Response
a. Frequent use of chewable and liquid antacids for indigestion
b. Severe abdominal cramps and diarrhea after eating spicy foods
c. Upper mid-abdominal pain described as gnawing and burning
d. Marked loss of weight and appetite over the last 3 or 4 months
Correct Answer:
c. Upper mid-abdominal pain described as gnawing and burning
Rationale: The classic symptom of PUD is epigastric or upper mid-abdominal pain
described as gnawing, burning, or aching, often occurring 1-3 hours after meals or
during the night. This pain pattern is pathognomonic for ulcer disease. While antacid
use (a) may indicate dyspepsia, it is nonspecific. Severe cramps and diarrhea after
spicy foods (b) suggests food intolerance or irritable bowel syndrome. Marked weight
loss and anorexia over months (d) is more indicative of gastric cancer than
uncomplicated PUD.
Question 3
,The nurse assesses a client who is newly diagnosed with hyperthyroidism and
observes that the client's eyeballs are protuberant, causing a wide-eyed
appearance and eye discomfort. Based on this finding, which action should the
nurse include in this client's plan of care?
Table
Option Response
a. Assess for signs of increased intracranial pressure
b. Prepare to administer intravenous levothyroxine
c. Review the client's serum electrolyte values
d. Obtain a prescription for artificial tear drops
Correct Answer:
d. Obtain a prescription for artificial tear drops
Rationale: Protuberant eyeballs describe exophthalmos, a hallmark of Graves'
ophthalmopathy associated with hyperthyroidism. The protrusion prevents complete
eyelid closure (lagophthalmos), leading to corneal drying, ulceration, and potential
vision loss. Artificial tears and lubricating ointments are essential to maintain corneal
moisture. Levothyroxine (b) is contraindicated—it is used for hypothyroidism, not
hyperthyroidism. Increased ICP (a) and electrolytes (c) are unrelated to this ocular
manifestation.
Question 4
To reduce the risk for pulmonary complications for a client with amyotrophic
lateral sclerosis (ALS), which interventions should the nurse implement? (Select
all that apply)
Table
,Complete the diagram by selecting which condition the client is most likely
experiencing, two actions the nurse should take to address that condition, and
two parameters the nurse should monitor to assess the client's progress.
Table
Category Selection
Potential Condition Rheumatoid arthritis
Actions to Take 1. Educate on disease process and management
2. Consult dietician for nutrition and weight loss
Parameters to Monitor 1. Pain
2. Physical mobility
Rationale: The presentation of bilateral hand/wrist pain with morning stiffness, positive
ANA, elevated ESR, and X-ray findings of marginal erosions is classic for rheumatoid
arthritis. Patient education is essential for disease management. Nutritional consultation
helps manage weight to reduce joint stress. Monitoring pain and physical mobility are
key parameters to assess disease progression and treatment effectiveness.
,Table
CBC Parameters Expected Findings in Pernicious Anemia
Hemoglobin Decreased
Hematocrit Decreased
MCV (Mean Corpuscular Volume) Elevated (>100 fL)—macrocytic
MCH Elevated
RBC count Decreased
WBC/Platelets May be decreased in severe cases
Why increasing fatigue despite treatment?
• Inadequate B12 absorption or dosing
• Folate supplementation masking B12 deficiency hematologically while
neurological damage progresses
• Development of iron deficiency (combined anemia)
• Underlying malignancy (pernicious anemia increases gastric cancer risk)
The CBC provides comprehensive data on anemia status and treatment response.
Platelet count (B) alone is insufficient. Liver enzymes (C) and electrolytes (D) do not
assess hematologic status.
,255. The healthcare provider prescribes high-protein, high-fat, low-carbohydrate
diet with limited fluids during meals for a client recovering from gastric surgery. The
client asks the nurse what the purpose is for this type of diet. Which rationale should
be included in the nurse's explanation to this client?
Answer: It is slow to leave the stomach and prevents dumping syndrome
256. The nurse is planning preoperative teaching for a client who will undergo a
radical neck dissection and total laryngectomy. Which information has the greatest
priority for this client?
Answer: There is a radical change in appearance as a result of this surgery
, # Topic Key Points
10 Cataract Post-Op Prevent ↑IOP (no bending, coughing, lifting)
Priority
11 Cataract Teaching Wear sunglasses + eye shield
123 Glaucoma Acute = pain + halos (emergency)
GASTROINTESTINAL
Table
# Topic Key Points
12 Diverticulitis Diet Acute: NPO/clear liquids. Chronic: High fiber
13 Diverticulitis Pain LLQ pain worse with straining
58 Cholecystitis Pain RUQ after fatty meals
59 Murphy Sign Stops breathing when RUQ pressed
60 Cholecystitis Diet Low fat
71 Peptic Ulcer Gastric: Worse with food. Duodenal: Better with
Difference food
72 Ulcer Emergency Perforation → rigid abdomen
110 SBO vs. LBO SBO = vomiting. LBO = distention
, Signs: Weight gain (moon face, buffalo hump)
Conn Syndrome
Hyperaldosteronism
Hyperpituitarism
Signs: Visual disturbances, severe headaches, back/joint pain, menstrual changes,
increased growth hormone
Diabetes Mellitus
Blood sugar problem
Normal Blood Glucose: 70-115
Fasting Glucose: Under 100
Hemoglobin A1C: 6.5+
Type 1 Diabetes
MNEMONIC: Type ONE = NONE (zero insulin produced)
Type 2 Diabetes
MNEMONIC: Type TWO = FEW insulin (few insulin receptors work)
Metabolic Syndrome (3+ Criteria)
B-BP meds or high BP: Over 130 systolic
B-Blood sugar meds or high blood sugar: 100+ fasting
O-Obese waist size:
L-Lipids: High cholesterol
Insulin Types
Rapid Acting (Aspart, Lispro, Glulisine): 15 min onset; NEVER give without food
Regular/Short Acting (Humulin R, Novolin R): Onset within 30 min; ONLY insulin given IV
NPH/Intermittent (Humulin N, Novolin N): Onset 1.5 hrs; peak 2-5 hrs
Long Acting (Lantus/Glargine): Steady control; once every 24 hrs; DO NOT mix with other
insulins
Hyperglycemia
Levels: Blood glucose over 115; A1C 6.5+
3 P's: Polyuria, Polydipsia, Polyphagia
