WGU D446 ADULT HEALTH II OA REVIEW &
STUDY GUIDE (2026} QUESTIONS AND
CORRECT ANSWERS WITH DETAILED
RATIONALES
Section 1: Fundamentals of Nursing (Questions 1-50)
1. A nurse is preparing to administer an enteral feeding to a client via a
nasogastric (NG) tube. Which of the following actions should the nurse take
first?
A) Flush the tube with 30 mL of air.
B) Verify the placement of the tube.
C) Check the residual volume.
D) Elevate the head of the bed to 30 degrees.
Correct Answer: B
Rationale: Patient safety is paramount. Verifying tube placement (via X-ray or
pH testing) is the priority before any instillation to prevent accidental
administration into the lungs. While flushing, checking residuals, and
elevating the HOB are important, they are secondary to confirming correct
placement.
2. A client is on strict intake and output (I&O) monitoring. Which of the
following should the nurse document as fluid intake?
A) Vomitus
B) Wound drainage
,C) Liquid stool
D) Tube feeding
Correct Answer: D
Rationale: Intake includes all fluids that enter the body, such as oral liquids,
tube feedings, and IV fluids. Output includes vomitus, wound drainage, and
liquid stool (diarrhea).
3. A nurse is caring for a client with a stage 2 pressure injury. Which of the
following wound dressings is most appropriate?
A) Dry gauze
B) Transparent film
C) Hydrocolloid
D) Alginate
Correct Answer: C
Rationale: Stage 2 pressure injuries involve partial-thickness skin loss with a
viable, moist wound bed. Hydrocolloid dressings maintain a moist
environment, are occlusive, and promote autolytic debridement. Dry gauze is
for wounds requiring packing. Transparent film is for superficial wounds or IV
sites. Alginate is for heavily exudating wounds.
4. A nurse is preparing to insert an indwelling urinary catheter for a female
client. Which of the following actions is appropriate?
A) Use sterile gloves only for the procedure.
B) Clean the meatus from the rectum toward the clitoris.
C) Separate the labia with the dominant hand.
D) Advance the catheter 2 to 3 inches until urine is obtained.
Correct Answer: D
,Rationale: After inserting the catheter through the urethral meatus, advance it
2 to 3 inches (5-7.5 cm) until urine flows. Sterile gloves are used, but a sterile
field and equipment are also required. The meatus is cleaned from the clitoris
toward the rectum (front to back) with the non-dominant hand; the dominant
hand maintains sterility and inserts the catheter.
5. A client reports a pain level of 8 on a 0-10 scale post-operatively. Which of
the following is the best initial nursing action?
A) Administer the prescribed PRN analgesic.
B) Reposition the client.
C) Ask about the characteristics of the pain.
D) Notify the provider.
Correct Answer: A
Rationale: A pain score of 8 indicates severe pain. The priority is to alleviate
the pain by administering the prescribed analgesic. Repositioning can help but
is not the primary intervention for severe pain. Asking about characteristics is
for assessment before medication but shouldn't delay administration.
Notifying the provider is for uncontrolled pain or new pain.
6. A nurse is applying restraints to a confused client. Which of the following
actions indicates a violation of client rights?
A) Securing the restraints to the bed frame.
B) Ensuring a provider’s prescription is obtained.
C) Removing the restraints every 2 hours.
D) Applying a vest restraint for convenience.
Correct Answer: D
Rationale: Restraints should never be used for convenience or as punishment.
They are used only to ensure safety when less restrictive measures have
failed. A provider's prescription is required and must be renewed. Restraints
, are secured to the bed frame (not the side rails) and removed for assessment
and range of motion every 2 hours.
7. A nurse is teaching a client about fall prevention. Which of the following
statements indicates a need for further teaching?
A) "I will use the call light when I need to get up."
B) "I will keep my walker close to my bed."
C) "I will walk barefoot to improve my grip."
D) "I will wear my glasses when I get out of bed."
Correct Answer: C
Rationale: Walking barefoot or in socks increases the risk of slipping and
falling. Clients should wear non-skid footwear or slippers. The other
statements are correct fall prevention strategies.
8. A nurse is changing a sterile dressing. Which of the following actions is a
break in sterile technique?
A) Sterile field is above the waist.
B) The nurse turns their back to the sterile field.
C) The nurse uses sterile forceps to handle the dressing.
D) The outer edge of the sterile field is considered contaminated.
Correct Answer: B
Rationale: Sterile fields must remain in the line of sight. Turning your back to
a sterile field contaminates it as you can no longer ensure its sterility. The
field must remain above the waist, and the 1-inch border is considered non-
sterile.
9. A client is receiving oxygen via a nasal cannula at 4 L/min. Which of the
following is a priority nursing action?
STUDY GUIDE (2026} QUESTIONS AND
CORRECT ANSWERS WITH DETAILED
RATIONALES
Section 1: Fundamentals of Nursing (Questions 1-50)
1. A nurse is preparing to administer an enteral feeding to a client via a
nasogastric (NG) tube. Which of the following actions should the nurse take
first?
A) Flush the tube with 30 mL of air.
B) Verify the placement of the tube.
C) Check the residual volume.
D) Elevate the head of the bed to 30 degrees.
Correct Answer: B
Rationale: Patient safety is paramount. Verifying tube placement (via X-ray or
pH testing) is the priority before any instillation to prevent accidental
administration into the lungs. While flushing, checking residuals, and
elevating the HOB are important, they are secondary to confirming correct
placement.
2. A client is on strict intake and output (I&O) monitoring. Which of the
following should the nurse document as fluid intake?
A) Vomitus
B) Wound drainage
,C) Liquid stool
D) Tube feeding
Correct Answer: D
Rationale: Intake includes all fluids that enter the body, such as oral liquids,
tube feedings, and IV fluids. Output includes vomitus, wound drainage, and
liquid stool (diarrhea).
3. A nurse is caring for a client with a stage 2 pressure injury. Which of the
following wound dressings is most appropriate?
A) Dry gauze
B) Transparent film
C) Hydrocolloid
D) Alginate
Correct Answer: C
Rationale: Stage 2 pressure injuries involve partial-thickness skin loss with a
viable, moist wound bed. Hydrocolloid dressings maintain a moist
environment, are occlusive, and promote autolytic debridement. Dry gauze is
for wounds requiring packing. Transparent film is for superficial wounds or IV
sites. Alginate is for heavily exudating wounds.
4. A nurse is preparing to insert an indwelling urinary catheter for a female
client. Which of the following actions is appropriate?
A) Use sterile gloves only for the procedure.
B) Clean the meatus from the rectum toward the clitoris.
C) Separate the labia with the dominant hand.
D) Advance the catheter 2 to 3 inches until urine is obtained.
Correct Answer: D
,Rationale: After inserting the catheter through the urethral meatus, advance it
2 to 3 inches (5-7.5 cm) until urine flows. Sterile gloves are used, but a sterile
field and equipment are also required. The meatus is cleaned from the clitoris
toward the rectum (front to back) with the non-dominant hand; the dominant
hand maintains sterility and inserts the catheter.
5. A client reports a pain level of 8 on a 0-10 scale post-operatively. Which of
the following is the best initial nursing action?
A) Administer the prescribed PRN analgesic.
B) Reposition the client.
C) Ask about the characteristics of the pain.
D) Notify the provider.
Correct Answer: A
Rationale: A pain score of 8 indicates severe pain. The priority is to alleviate
the pain by administering the prescribed analgesic. Repositioning can help but
is not the primary intervention for severe pain. Asking about characteristics is
for assessment before medication but shouldn't delay administration.
Notifying the provider is for uncontrolled pain or new pain.
6. A nurse is applying restraints to a confused client. Which of the following
actions indicates a violation of client rights?
A) Securing the restraints to the bed frame.
B) Ensuring a provider’s prescription is obtained.
C) Removing the restraints every 2 hours.
D) Applying a vest restraint for convenience.
Correct Answer: D
Rationale: Restraints should never be used for convenience or as punishment.
They are used only to ensure safety when less restrictive measures have
failed. A provider's prescription is required and must be renewed. Restraints
, are secured to the bed frame (not the side rails) and removed for assessment
and range of motion every 2 hours.
7. A nurse is teaching a client about fall prevention. Which of the following
statements indicates a need for further teaching?
A) "I will use the call light when I need to get up."
B) "I will keep my walker close to my bed."
C) "I will walk barefoot to improve my grip."
D) "I will wear my glasses when I get out of bed."
Correct Answer: C
Rationale: Walking barefoot or in socks increases the risk of slipping and
falling. Clients should wear non-skid footwear or slippers. The other
statements are correct fall prevention strategies.
8. A nurse is changing a sterile dressing. Which of the following actions is a
break in sterile technique?
A) Sterile field is above the waist.
B) The nurse turns their back to the sterile field.
C) The nurse uses sterile forceps to handle the dressing.
D) The outer edge of the sterile field is considered contaminated.
Correct Answer: B
Rationale: Sterile fields must remain in the line of sight. Turning your back to
a sterile field contaminates it as you can no longer ensure its sterility. The
field must remain above the waist, and the 1-inch border is considered non-
sterile.
9. A client is receiving oxygen via a nasal cannula at 4 L/min. Which of the
following is a priority nursing action?
