WGU D446 Adult Health II OA Review & Study Guide (2026) | 250+ Practice Questions
Practice Questions 1–250
Section 1: Cardiovascular Disorders (Questions 1–60)
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 midscapular region
Answer D: Crackles audible to the midscapular region
Rationale: Crackles extending to the midscapular region indicate severe, widespread
pulmonary edema, signifying imminent respiratory compromise. This is a more life-
threatening finding than peripheral edema, JVD, or PND. ---
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
Answer B: Obtain a STAT CT scan of the head
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 initiating
thrombolytic therapy. ---
3. 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, increased respiratory rate, and
peripheral vasoconstriction. ---
4. A patient is admitted with a diagnosis of unstable angina. Which 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. ---
5. 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 is a critical indicator of STEMI and signifies an
emergency situation requiring immediate reperfusion therapy. ---
6. Chest pain lasting >20 minutes with diaphoresis, nausea, and anxiety that is
unrelieved by rest or nitroglycerin is a hallmark of:
A) Stable angina
B) Myocardial infarction
C) Pericarditis
D) Pulmonary embolism
Answer B: Myocardial infarction
, Rationale: Myocardial infarction presents with chest pain lasting >20 minutes,
diaphoresis, nausea, anxiety, and is unrelieved by rest or nitroglycerin. Stable angina is
relieved by rest or nitroglycerin. ---
7. A client with heart failure is in high Fowler's position. What is the primary rationale
for this intervention?
A) To prevent skin breakdown
B) To improve ventilation and reduce venous return
C) To decrease anxiety
D) To promote urinary output
Answer B: To improve ventilation and reduce venous return
Rationale: High Fowler's position (60-90 degrees) achieves two therapeutic goals
simultaneously: (1) Improves ventilation by allowing gravity-assisted diaphragmatic
descent and lung expansion, reducing work of breathing; and (2) Reduces venous return
(preload) by promoting venous pooling in the lower extremities, thereby decreasing
cardiac workload. ---
8. A nurse is caring for a client with heart failure. Which finding indicates worsening
fluid overload?
A) Weight loss of 1 kg in 24 hours
B) Jugular venous distention at 45 degrees
C) Clear breath sounds
D) Decreased peripheral edema
Answer B: Jugular venous distention at 45 degrees
Practice Questions 1–250
Section 1: Cardiovascular Disorders (Questions 1–60)
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 midscapular region
Answer D: Crackles audible to the midscapular region
Rationale: Crackles extending to the midscapular region indicate severe, widespread
pulmonary edema, signifying imminent respiratory compromise. This is a more life-
threatening finding than peripheral edema, JVD, or PND. ---
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
Answer B: Obtain a STAT CT scan of the head
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 initiating
thrombolytic therapy. ---
3. 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, increased respiratory rate, and
peripheral vasoconstriction. ---
4. A patient is admitted with a diagnosis of unstable angina. Which 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. ---
5. 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 is a critical indicator of STEMI and signifies an
emergency situation requiring immediate reperfusion therapy. ---
6. Chest pain lasting >20 minutes with diaphoresis, nausea, and anxiety that is
unrelieved by rest or nitroglycerin is a hallmark of:
A) Stable angina
B) Myocardial infarction
C) Pericarditis
D) Pulmonary embolism
Answer B: Myocardial infarction
, Rationale: Myocardial infarction presents with chest pain lasting >20 minutes,
diaphoresis, nausea, anxiety, and is unrelieved by rest or nitroglycerin. Stable angina is
relieved by rest or nitroglycerin. ---
7. A client with heart failure is in high Fowler's position. What is the primary rationale
for this intervention?
A) To prevent skin breakdown
B) To improve ventilation and reduce venous return
C) To decrease anxiety
D) To promote urinary output
Answer B: To improve ventilation and reduce venous return
Rationale: High Fowler's position (60-90 degrees) achieves two therapeutic goals
simultaneously: (1) Improves ventilation by allowing gravity-assisted diaphragmatic
descent and lung expansion, reducing work of breathing; and (2) Reduces venous return
(preload) by promoting venous pooling in the lower extremities, thereby decreasing
cardiac workload. ---
8. A nurse is caring for a client with heart failure. Which finding indicates worsening
fluid overload?
A) Weight loss of 1 kg in 24 hours
B) Jugular venous distention at 45 degrees
C) Clear breath sounds
D) Decreased peripheral edema
Answer B: Jugular venous distention at 45 degrees
