WGU D454 – Adult Health III Exam
Questions and Correct Answers
(Verified Answers) Plus Rationales 2026
Q&A | Instant Download Pdf.
Question 1
A nurse is caring for a client admitted with septic shock. Which
assessment finding best indicates that fluid resuscitation has been
effective?
A. Heart rate of 118 beats/min
B. Urine output of 35 mL/hr
C. Mean arterial pressure (MAP) of 52 mmHg
D. Respiratory rate of 30 breaths/min
Correct Answer: B. Urine output of 35 mL/hr
Rationale: Adequate urine output (at least 0.5 mL/kg/hr in adults) is a
reliable indicator of improved renal perfusion and effective fluid
resuscitation. A MAP of at least 65 mmHg is also desired, but a urine
output above 30 mL/hr demonstrates sufficient organ perfusion.
Persistent tachycardia, tachypnea, or hypotension suggest ongoing
shock.
Question 2
,A client with acute respiratory distress syndrome (ARDS) is receiving
mechanical ventilation. Which ventilator strategy is most appropriate?
A. High tidal volume ventilation
B. Low tidal volume ventilation with adequate PEEP
C. Elimination of positive end-expiratory pressure (PEEP)
D. High oxygen concentration without PEEP
Correct Answer: B. Low tidal volume ventilation with adequate PEEP
Rationale: Evidence-based management of ARDS includes low tidal
volume ventilation (approximately 6 mL/kg predicted body weight)
combined with appropriate PEEP to prevent alveolar collapse while
minimizing ventilator-induced lung injury.
Question 3
A client experiences sudden crushing chest pain radiating to the left
arm. Which laboratory value is most specific for confirming myocardial
injury?
A. Myoglobin
B. Creatine kinase (CK)
C. Troponin I
D. Lactate dehydrogenase (LDH)
Correct Answer: C. Troponin I
Rationale: Cardiac troponins are the preferred biomarkers for
diagnosing myocardial infarction because they are highly sensitive and
specific for cardiac muscle injury. Troponin levels rise within several
hours after injury and remain elevated for days.
,Question 4
A nurse is caring for a client with heart failure. Which assessment
finding indicates worsening left-sided heart failure?
A. Peripheral edema
B. Hepatomegaly
C. Pulmonary crackles
D. Jugular vein distention
Correct Answer: C. Pulmonary crackles
Rationale: Left-sided heart failure causes pulmonary congestion,
resulting in crackles, dyspnea, orthopnea, and decreased oxygenation.
Peripheral edema, hepatomegaly, and jugular venous distention are
more commonly associated with right-sided heart failure.
Question 5
A client receiving intravenous heparin develops bleeding gums. Which
laboratory test should the nurse review first?
A. INR
B. PT
C. aPTT
D. Platelet count
Correct Answer: C. aPTT
Rationale: Activated partial thromboplastin time (aPTT) is used to
monitor unfractionated heparin therapy. An elevated aPTT may indicate
, excessive anticoagulation and increased bleeding risk. INR and PT
monitor warfarin therapy.
Question 6
Which assessment finding requires immediate intervention for a client
with hyperkalemia?
A. Muscle weakness
B. Abdominal cramping
C. Peaked T waves on ECG
D. Fatigue
Correct Answer: C. Peaked T waves on ECG
Rationale: Peaked T waves are an early sign of hyperkalemia affecting
cardiac conduction. Without prompt treatment, hyperkalemia can
progress to life-threatening arrhythmias, ventricular fibrillation, or
cardiac arrest.
Question 7
A client with diabetic ketoacidosis (DKA) is admitted to the emergency
department. Which intervention should the nurse anticipate first?
A. Administer intravenous insulin
B. Begin potassium replacement
C. Initiate aggressive intravenous fluid therapy
D. Administer sodium bicarbonate
Correct Answer: C. Initiate aggressive intravenous fluid therapy
Questions and Correct Answers
(Verified Answers) Plus Rationales 2026
Q&A | Instant Download Pdf.
Question 1
A nurse is caring for a client admitted with septic shock. Which
assessment finding best indicates that fluid resuscitation has been
effective?
A. Heart rate of 118 beats/min
B. Urine output of 35 mL/hr
C. Mean arterial pressure (MAP) of 52 mmHg
D. Respiratory rate of 30 breaths/min
Correct Answer: B. Urine output of 35 mL/hr
Rationale: Adequate urine output (at least 0.5 mL/kg/hr in adults) is a
reliable indicator of improved renal perfusion and effective fluid
resuscitation. A MAP of at least 65 mmHg is also desired, but a urine
output above 30 mL/hr demonstrates sufficient organ perfusion.
Persistent tachycardia, tachypnea, or hypotension suggest ongoing
shock.
Question 2
,A client with acute respiratory distress syndrome (ARDS) is receiving
mechanical ventilation. Which ventilator strategy is most appropriate?
A. High tidal volume ventilation
B. Low tidal volume ventilation with adequate PEEP
C. Elimination of positive end-expiratory pressure (PEEP)
D. High oxygen concentration without PEEP
Correct Answer: B. Low tidal volume ventilation with adequate PEEP
Rationale: Evidence-based management of ARDS includes low tidal
volume ventilation (approximately 6 mL/kg predicted body weight)
combined with appropriate PEEP to prevent alveolar collapse while
minimizing ventilator-induced lung injury.
Question 3
A client experiences sudden crushing chest pain radiating to the left
arm. Which laboratory value is most specific for confirming myocardial
injury?
A. Myoglobin
B. Creatine kinase (CK)
C. Troponin I
D. Lactate dehydrogenase (LDH)
Correct Answer: C. Troponin I
Rationale: Cardiac troponins are the preferred biomarkers for
diagnosing myocardial infarction because they are highly sensitive and
specific for cardiac muscle injury. Troponin levels rise within several
hours after injury and remain elevated for days.
,Question 4
A nurse is caring for a client with heart failure. Which assessment
finding indicates worsening left-sided heart failure?
A. Peripheral edema
B. Hepatomegaly
C. Pulmonary crackles
D. Jugular vein distention
Correct Answer: C. Pulmonary crackles
Rationale: Left-sided heart failure causes pulmonary congestion,
resulting in crackles, dyspnea, orthopnea, and decreased oxygenation.
Peripheral edema, hepatomegaly, and jugular venous distention are
more commonly associated with right-sided heart failure.
Question 5
A client receiving intravenous heparin develops bleeding gums. Which
laboratory test should the nurse review first?
A. INR
B. PT
C. aPTT
D. Platelet count
Correct Answer: C. aPTT
Rationale: Activated partial thromboplastin time (aPTT) is used to
monitor unfractionated heparin therapy. An elevated aPTT may indicate
, excessive anticoagulation and increased bleeding risk. INR and PT
monitor warfarin therapy.
Question 6
Which assessment finding requires immediate intervention for a client
with hyperkalemia?
A. Muscle weakness
B. Abdominal cramping
C. Peaked T waves on ECG
D. Fatigue
Correct Answer: C. Peaked T waves on ECG
Rationale: Peaked T waves are an early sign of hyperkalemia affecting
cardiac conduction. Without prompt treatment, hyperkalemia can
progress to life-threatening arrhythmias, ventricular fibrillation, or
cardiac arrest.
Question 7
A client with diabetic ketoacidosis (DKA) is admitted to the emergency
department. Which intervention should the nurse anticipate first?
A. Administer intravenous insulin
B. Begin potassium replacement
C. Initiate aggressive intravenous fluid therapy
D. Administer sodium bicarbonate
Correct Answer: C. Initiate aggressive intravenous fluid therapy
