WGU D446 Adult Health 2 OA | 200 Actual Exam
Study Questions and Answers + Expert Rationales |
2026/27 Updated | 100% correct
1. A nurse is assessing a client with acute decompensated heart failure (ADHF). Which finding
is most concerning?
A) +2 pitting edema in lower extremities
B) Jugular venous distension (JVD) at 45 degrees
C) Paroxysmal nocturnal dyspnea (PND)
D) Crackles audible to the mi scapular region
Correct Answer: D
Expert Rationale: Crackles extending to the mi scapular region indicate severe, 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.
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 blood glucose level
D) Reorient the client to person, place, time
Correct Answer: B
Expert Rationale: The client is likely experiencing an embolic stroke from a vegetation fragment
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.
3. A client on amiodarone for atrial fibrillation reports new bluish-gray discoloration on the
face. Which action is most appropriate?
A) Discontinue the amiodarone immediately
B) Document the finding and continue to monitor
,C) Notify the healthcare provider of this adverse effect
D) Apply a topical cream to the affected area
Correct Answer: C
Expert Rationale: Bluish-gray discoloration of the skin (slate-gray cyanosis) is a known adverse
effect of long-term amiodarone therapy due to iodine deposition in the skin. The healthcare
provider should be notified for evaluation, though the medication is not typically discontinued
solely for this reason.
4. Which of the following is a classic symptom of left-sided heart failure?
A) Peripheral edema
B) Ascites
C) Dyspnea and crackles
D) Jugular venous distension
Correct Answer: C
Expert Rationale: Left-sided heart failure results in pulmonary symptoms including dyspnea,
orthopnea, paroxysmal nocturnal dyspnea, and crackles due to fluid backing up into the lungs.
Right-sided heart failure presents with peripheral symptoms such as edema, ascites, and JVD.
5. Which of the following is a classic symptom of right-sided heart failure?
A) Dyspnea and crackles
B) Orthopnea
C) Paroxysmal nocturnal dyspnea
D) Peripheral edema and JVD
Correct Answer: D
Expert Rationale: Right-sided heart failure results in systemic venous congestion with symptoms
including peripheral edema, jugular venous distension (JVD), ascites, and weight gain. Left-sided
failure causes pulmonary congestion.
6. A client on digoxin therapy reports nausea, vomiting, and visual disturbances. What should
the nurse suspect?
,A) Therapeutic drug level
B) Digoxin toxicity
C) Allergic reaction
D) Medication noncompliance
Correct Answer: B
Expert Rationale: Nausea, vomiting, anorexia, and visual disturbances (yellow-green halos) are
classic signs of digoxin toxicity. The nurse should assess serum digoxin levels and notify the
healthcare provider. Serum digoxin levels should be monitored (therapeutic range 0.8-2.0
ng/mL).
7. A client with atrial fibrillation is prescribed warfarin. Which laboratory value should the
nurse monitor to evaluate therapeutic effectiveness?
A) PT/INR
B) aPTT
C) Platelet count
D) Hemoglobin
Correct Answer: A
Expert Rationale: Warfarin therapy is monitored using PT (prothrombin time) and INR
(international normalized ratio). The therapeutic INR range for atrial fibrillation is typically 2.0–
3.0. aPTT is used to monitor heparin therapy.
8. A client presents with chest pain radiating to the left arm, diaphoresis, and nausea. Which
medication should the nurse anticipate administering first?
A) Morphine
B) Nitroglycerin
C) Aspirin
D) Oxygen
Correct Answer: C
Expert Rationale: Aspirin should be administered immediately upon suspicion of myocardial
infarction (MI) due to its antiplatelet effects. The MONA protocol (Morphine, Oxygen,
Nitroglycerin, Aspirin) is the standard; however, aspirin is the priority to prevent further clot
formation. If the patient is not hypoxic, oxygen may not be needed.
, 9. The MONA protocol for management of acute myocardial infarction includes:
A) Morphine, oxygen, nitroglycerin, aspirin
B) Metoprolol, oxygen, naloxone, amiodarone
C) Morphine, ondansetron, nitroglycerin, atropine
D) Metoprolol, oxygen, nitroglycerin, aspirin
Correct Answer: A
Expert Rationale: MONA stands for Morphine (pain relief and reduced preload), Oxygen (if
hypoxic), Nitroglycerin (vasodilation), and Aspirin (antiplatelet effects). This is the standard
protocol for acute MI management. Recent guidelines recommend more selective use of oxygen
(only if SpO₂ < 90%) and morphine (only if nitroglycerin is ineffective).
10. How can a nurse differentiate myocardial infarction (MI) from angina?
A) Angina pain is always relieved by rest
B) MI pain is typically persistent, accompanied by diaphoresis and elevated troponin
C) Angina always presents with ST-segment elevation
D) MI pain is always located in the left arm only
Correct Answer: B
Expert Rationale: Myocardial infarction is differentiated from angina by persistent pain not
relieved by rest, diaphoresis, nausea, and elevated cardiac biomarkers such as troponin. Angina
is typically transient and relieved by rest or nitroglycerin. Unstable angina may not be relieved
by rest and is a warning sign of impending MI.
11. A client is prescribed a beta-blocker for heart failure. What is the primary therapeutic
effect of this medication?
A) Vasodilation
B) Reduced heart rate and myocardial oxygen demand
C) Increased cardiac contractility
D) Potassium sparing
Correct Answer: B
Study Questions and Answers + Expert Rationales |
2026/27 Updated | 100% correct
1. A nurse is assessing a client with acute decompensated heart failure (ADHF). Which finding
is most concerning?
A) +2 pitting edema in lower extremities
B) Jugular venous distension (JVD) at 45 degrees
C) Paroxysmal nocturnal dyspnea (PND)
D) Crackles audible to the mi scapular region
Correct Answer: D
Expert Rationale: Crackles extending to the mi scapular region indicate severe, 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.
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 blood glucose level
D) Reorient the client to person, place, time
Correct Answer: B
Expert Rationale: The client is likely experiencing an embolic stroke from a vegetation fragment
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.
3. A client on amiodarone for atrial fibrillation reports new bluish-gray discoloration on the
face. Which action is most appropriate?
A) Discontinue the amiodarone immediately
B) Document the finding and continue to monitor
,C) Notify the healthcare provider of this adverse effect
D) Apply a topical cream to the affected area
Correct Answer: C
Expert Rationale: Bluish-gray discoloration of the skin (slate-gray cyanosis) is a known adverse
effect of long-term amiodarone therapy due to iodine deposition in the skin. The healthcare
provider should be notified for evaluation, though the medication is not typically discontinued
solely for this reason.
4. Which of the following is a classic symptom of left-sided heart failure?
A) Peripheral edema
B) Ascites
C) Dyspnea and crackles
D) Jugular venous distension
Correct Answer: C
Expert Rationale: Left-sided heart failure results in pulmonary symptoms including dyspnea,
orthopnea, paroxysmal nocturnal dyspnea, and crackles due to fluid backing up into the lungs.
Right-sided heart failure presents with peripheral symptoms such as edema, ascites, and JVD.
5. Which of the following is a classic symptom of right-sided heart failure?
A) Dyspnea and crackles
B) Orthopnea
C) Paroxysmal nocturnal dyspnea
D) Peripheral edema and JVD
Correct Answer: D
Expert Rationale: Right-sided heart failure results in systemic venous congestion with symptoms
including peripheral edema, jugular venous distension (JVD), ascites, and weight gain. Left-sided
failure causes pulmonary congestion.
6. A client on digoxin therapy reports nausea, vomiting, and visual disturbances. What should
the nurse suspect?
,A) Therapeutic drug level
B) Digoxin toxicity
C) Allergic reaction
D) Medication noncompliance
Correct Answer: B
Expert Rationale: Nausea, vomiting, anorexia, and visual disturbances (yellow-green halos) are
classic signs of digoxin toxicity. The nurse should assess serum digoxin levels and notify the
healthcare provider. Serum digoxin levels should be monitored (therapeutic range 0.8-2.0
ng/mL).
7. A client with atrial fibrillation is prescribed warfarin. Which laboratory value should the
nurse monitor to evaluate therapeutic effectiveness?
A) PT/INR
B) aPTT
C) Platelet count
D) Hemoglobin
Correct Answer: A
Expert Rationale: Warfarin therapy is monitored using PT (prothrombin time) and INR
(international normalized ratio). The therapeutic INR range for atrial fibrillation is typically 2.0–
3.0. aPTT is used to monitor heparin therapy.
8. A client presents with chest pain radiating to the left arm, diaphoresis, and nausea. Which
medication should the nurse anticipate administering first?
A) Morphine
B) Nitroglycerin
C) Aspirin
D) Oxygen
Correct Answer: C
Expert Rationale: Aspirin should be administered immediately upon suspicion of myocardial
infarction (MI) due to its antiplatelet effects. The MONA protocol (Morphine, Oxygen,
Nitroglycerin, Aspirin) is the standard; however, aspirin is the priority to prevent further clot
formation. If the patient is not hypoxic, oxygen may not be needed.
, 9. The MONA protocol for management of acute myocardial infarction includes:
A) Morphine, oxygen, nitroglycerin, aspirin
B) Metoprolol, oxygen, naloxone, amiodarone
C) Morphine, ondansetron, nitroglycerin, atropine
D) Metoprolol, oxygen, nitroglycerin, aspirin
Correct Answer: A
Expert Rationale: MONA stands for Morphine (pain relief and reduced preload), Oxygen (if
hypoxic), Nitroglycerin (vasodilation), and Aspirin (antiplatelet effects). This is the standard
protocol for acute MI management. Recent guidelines recommend more selective use of oxygen
(only if SpO₂ < 90%) and morphine (only if nitroglycerin is ineffective).
10. How can a nurse differentiate myocardial infarction (MI) from angina?
A) Angina pain is always relieved by rest
B) MI pain is typically persistent, accompanied by diaphoresis and elevated troponin
C) Angina always presents with ST-segment elevation
D) MI pain is always located in the left arm only
Correct Answer: B
Expert Rationale: Myocardial infarction is differentiated from angina by persistent pain not
relieved by rest, diaphoresis, nausea, and elevated cardiac biomarkers such as troponin. Angina
is typically transient and relieved by rest or nitroglycerin. Unstable angina may not be relieved
by rest and is a warning sign of impending MI.
11. A client is prescribed a beta-blocker for heart failure. What is the primary therapeutic
effect of this medication?
A) Vasodilation
B) Reduced heart rate and myocardial oxygen demand
C) Increased cardiac contractility
D) Potassium sparing
Correct Answer: B
