WGU D446 OA Adult Health II Exam (2026) –
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SECTION 1: CARDIOVASCULAR SYSTEM
Question 1:
A patient presents with pallor, decreased mean arterial pressure (MAP),
tachycardia, decreased urinary output, increased respiratory rate, hypotension,
decreased pulse pressure, and cold clammy skin. What is this patient most likely
experiencing?
A) Myocardial infarction
B) Hemorrhage
C) Hypertensive crisis
D) Heart failure exacerbation
Answer: B) Hemorrhage
Rationale: These are classic signs and symptoms of hemorrhage, indicating
hypovolemic shock. The body compensates with tachycardia and increased
respiratory rate, while decreased perfusion leads to pallor, cool skin, and
decreased urine output .
Question 2:
A patient with heart failure is prescribed spironolactone. The nurse should
monitor for which electrolyte imbalance?
A) Hypernatremia
B) Hyperkalemia
,C) Hypocalcemia
D) Hypomagnesemia
Answer: B) Hyperkalemia
Rationale: Spironolactone is a potassium-sparing diuretic. Hyperkalemia is a
primary adverse effect requiring regular monitoring. Patients should be educated
about signs of hyperkalemia such as muscle weakness and cardiac arrhythmias .
Question 3:
A client post-myocardial infarction develops cardiogenic shock. The nurse expects
which hemodynamic change?
A) Increased cardiac output
B) Decreased systemic vascular resistance
C) Elevated pulmonary artery wedge pressure
D) Low central venous pressure
Answer: C) Elevated pulmonary artery wedge pressure
Rationale: Left ventricular failure causes backup of fluid into the pulmonary
system, elevating wedge pressure. This reflects increased preload and impaired
left ventricular function .
Question 4:
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 midscapular region
Answer: D) Crackles audible to the midscapular region
,Rationale: Crackles that extend to the midscapular region indicate that pulmonary
edema is severe and widespread, 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 .
Question 5:
A patient is admitted with unstable angina. Which of the following is an important
nursing intervention?
A) Administer nitroglycerin sublingually and assess for relief
B) Prepare the patient for immediate cardiac catheterization
C) Administer thrombolytic therapy
D) Restrict all fluids
Answer: A) Administer nitroglycerin sublingually and assess for relief
Rationale: Unstable angina is an acute coronary syndrome requiring immediate
management. Nitroglycerin is administered sublingually to relieve pain. If pain
persists, additional interventions are needed .
Question 6:
Which ECG change is most concerning for a patient with chest pain?
A) T-wave inversion
B) ST-segment elevation
C) Prolonged PR interval
D) U waves
Answer: B) ST-segment elevation
Rationale: ST-segment elevation indicates acute myocardial injury (STEMI) and
requires immediate reperfusion therapy. This is a time-sensitive medical
emergency .
, Question 7:
A patient with acute coronary syndrome (ACS) should receive which of the
following medications upon arrival? (Select all that apply)
A) Aspirin
B) Nitroglycerin
C) Morphine
D) Heparin
E) Digoxin
Answer: A, B, C, D
Rationale: MONA (Morphine, Oxygen, Nitroglycerin, Aspirin) is the classic initial
management for ACS. Heparin is also often administered to prevent further
clotting. Digoxin is not indicated in acute ACS .
Question 8:
A patient is prescribed lisinopril for hypertension. Which adverse effect should the
nurse monitor for? (Select all that apply)
A) Dry cough
B) Hyperkalemia
C) Angioedema
D) Weight gain
Answer: A, B, C
Rationale: ACE inhibitors like lisinopril can cause a persistent dry cough,
hyperkalemia, and angioedema (a serious allergic reaction). All should be
monitored .
Question 9:
A client with heart failure is prescribed furosemide. Which laboratory values
should be monitored? (Select all that apply)
Actual Questions & Study Guides | Guarantee
Pass
SECTION 1: CARDIOVASCULAR SYSTEM
Question 1:
A patient presents with pallor, decreased mean arterial pressure (MAP),
tachycardia, decreased urinary output, increased respiratory rate, hypotension,
decreased pulse pressure, and cold clammy skin. What is this patient most likely
experiencing?
A) Myocardial infarction
B) Hemorrhage
C) Hypertensive crisis
D) Heart failure exacerbation
Answer: B) Hemorrhage
Rationale: These are classic signs and symptoms of hemorrhage, indicating
hypovolemic shock. The body compensates with tachycardia and increased
respiratory rate, while decreased perfusion leads to pallor, cool skin, and
decreased urine output .
Question 2:
A patient with heart failure is prescribed spironolactone. The nurse should
monitor for which electrolyte imbalance?
A) Hypernatremia
B) Hyperkalemia
,C) Hypocalcemia
D) Hypomagnesemia
Answer: B) Hyperkalemia
Rationale: Spironolactone is a potassium-sparing diuretic. Hyperkalemia is a
primary adverse effect requiring regular monitoring. Patients should be educated
about signs of hyperkalemia such as muscle weakness and cardiac arrhythmias .
Question 3:
A client post-myocardial infarction develops cardiogenic shock. The nurse expects
which hemodynamic change?
A) Increased cardiac output
B) Decreased systemic vascular resistance
C) Elevated pulmonary artery wedge pressure
D) Low central venous pressure
Answer: C) Elevated pulmonary artery wedge pressure
Rationale: Left ventricular failure causes backup of fluid into the pulmonary
system, elevating wedge pressure. This reflects increased preload and impaired
left ventricular function .
Question 4:
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 midscapular region
Answer: D) Crackles audible to the midscapular region
,Rationale: Crackles that extend to the midscapular region indicate that pulmonary
edema is severe and widespread, 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 .
Question 5:
A patient is admitted with unstable angina. Which of the following is an important
nursing intervention?
A) Administer nitroglycerin sublingually and assess for relief
B) Prepare the patient for immediate cardiac catheterization
C) Administer thrombolytic therapy
D) Restrict all fluids
Answer: A) Administer nitroglycerin sublingually and assess for relief
Rationale: Unstable angina is an acute coronary syndrome requiring immediate
management. Nitroglycerin is administered sublingually to relieve pain. If pain
persists, additional interventions are needed .
Question 6:
Which ECG change is most concerning for a patient with chest pain?
A) T-wave inversion
B) ST-segment elevation
C) Prolonged PR interval
D) U waves
Answer: B) ST-segment elevation
Rationale: ST-segment elevation indicates acute myocardial injury (STEMI) and
requires immediate reperfusion therapy. This is a time-sensitive medical
emergency .
, Question 7:
A patient with acute coronary syndrome (ACS) should receive which of the
following medications upon arrival? (Select all that apply)
A) Aspirin
B) Nitroglycerin
C) Morphine
D) Heparin
E) Digoxin
Answer: A, B, C, D
Rationale: MONA (Morphine, Oxygen, Nitroglycerin, Aspirin) is the classic initial
management for ACS. Heparin is also often administered to prevent further
clotting. Digoxin is not indicated in acute ACS .
Question 8:
A patient is prescribed lisinopril for hypertension. Which adverse effect should the
nurse monitor for? (Select all that apply)
A) Dry cough
B) Hyperkalemia
C) Angioedema
D) Weight gain
Answer: A, B, C
Rationale: ACE inhibitors like lisinopril can cause a persistent dry cough,
hyperkalemia, and angioedema (a serious allergic reaction). All should be
monitored .
Question 9:
A client with heart failure is prescribed furosemide. Which laboratory values
should be monitored? (Select all that apply)
