WGU E224 / NURS 3662 – Global and Population
Health | Bachelor of Science in Nursing (RN to BSN)
Original Practice Questions & Answers |
Comprehensive WGU E224 Study Guide &
Assessment Preparation | Population Health, Global
Health, Community Health, Health Disparities,
Social Determinants of Health, Epidemiology,
Disease Prevention, Health Promotion, Healthcare
Access, Public Health Interventions & Detailed
Rationales
Question 1: A nurse is educating a patient with type 2 diabetes about the
importance of foot care. Which statement by the patient indicates a need for
further teaching?
A. "I should inspect my feet daily for any cuts or blisters."
B. "I can use a heating pad to keep my feet warm at night."
C. "I will trim my toenails straight across to prevent ingrown nails."
D. "I should wear white cotton socks to detect drainage."
CORRECT ANSWER: B. "I can use a heating pad to keep my feet warm at
night."
Rationale: Patients with diabetes often have peripheral neuropathy and decreased
sensation, making them susceptible to burns. Using a heating pad or hot water bottle
can cause severe burns without the patient's awareness. Daily inspection, proper nail
trimming, and wearing white socks are all appropriate and safe practices.
Question 2: A patient is prescribed warfarin (Coumadin) for atrial fibrillation.
Which dietary instruction is most important for the nurse to provide?
A. "Increase your intake of leafy green vegetables."
B. "Avoid drinking grapefruit juice."
C. "Maintain a consistent intake of vitamin K-rich foods."
D. "Take an over-the-counter aspirin for headaches."
CORRECT ANSWER: C. "Maintain a consistent intake of vitamin K-rich foods."
Rationale: Warfarin's anticoagulant effect is antagonized by vitamin K. Patients should
maintain a consistent daily intake of vitamin K-rich foods to keep the International
Normalized Ratio (INR) stable. Drastic changes in dietary vitamin K can alter the INR
and increase the risk of bleeding or clotting.
Question 3: A nurse is performing a neurological assessment on a patient who
had a stroke. Which finding indicates damage to the frontal lobe?
A. Inability to recognize familiar faces
B. Difficulty with expressive speech and personality changes
,C. Inability to understand spoken language
D. Loss of peripheral vision
CORRECT ANSWER: B. Difficulty with expressive speech and personality
changes
Rationale: The frontal lobe is responsible for executive functions, personality, and motor
speech (Broca's area). Damage here often results in expressive aphasia and personality
changes. Difficulty recognizing faces (prosopagnosia) involves the temporal lobe, and
understanding speech (Wernicke's aphasia) involves the temporal lobe as well, while
vision issues involve the occipital lobe.
Question 4: A patient with chronic obstructive pulmonary disease (COPD) has
an oxygen saturation of 86% on room air. The nurse administers oxygen via
nasal cannula. What is the most important parameter to monitor?
A. Blood pressure
B. Respiratory rate and depth
C. Level of consciousness
D. Skin color
CORRECT ANSWER: C. Level of consciousness
Rationale: Patients with COPD may rely on a hypoxic drive to breathe. Administering
high-flow oxygen can suppress this drive and lead to hypoventilation, hypercapnia, and
respiratory acidosis. The earliest sign of rising carbon dioxide levels is a decreased level
of consciousness, necessitating vigilant monitoring.
Question 5: A nurse is caring for a patient with a chest tube connected to a
water-seal drainage system. What action is appropriate if the drainage system
becomes disconnected from the chest tube?
A. Clamp the chest tube immediately and call the physician.
B. Place the end of the chest tube in sterile water.
C. Turn the patient to the left side.
D. Increase the suction on the drainage system.
CORRECT ANSWER: B. Place the end of the chest tube in sterile water.
Rationale: If the chest tube becomes disconnected, placing the open end in sterile water
creates a water seal, preventing air from entering the pleural space (which could cause a
tension pneumothorax). Clamping the tube is avoided as it can lead to a tension
pneumothorax, and increasing suction is inappropriate.
Question 6: A patient is receiving IV heparin therapy. The nurse notes a
platelet count of 80,000/µL, down from a baseline of 250,000/µL. What is the
priority nursing action?
A. Continue the heparin drip as prescribed.
B. Discontinue the heparin infusion immediately.
,C. Administer vitamin K as an antidote.
D. Increase the rate of the heparin infusion.
CORRECT ANSWER: B. Discontinue the heparin infusion immediately.
Rationale: A significant drop in platelet count while on heparin therapy is indicative of
Heparin-Induced Thrombocytopenia (HIT), a life-threatening immune reaction that can
cause paradoxical thrombosis. The priority is to stop the heparin infusion immediately
and anticipate the initiation of a non-heparin anticoagulant.
Question 7: A nurse is teaching a patient about a new prescription for
nitroglycerin transdermal patch. Which instruction is correct?
A. "Apply the patch to the same site daily for consistency."
B. "Remove the patch at night for 10 to 12 hours."
C. "Apply the patch to a hairy area for better adhesion."
D. "Cut the patch in half if your blood pressure is low."
CORRECT ANSWER: B. "Remove the patch at night for 10 to 12 hours."
Rationale: Nitroglycerin patches require a nitrate-free period of 10 to 12 hours (usually at
night) to prevent the development of tolerance. The patch should be applied to a
hairless area, sites should be rotated to prevent skin irritation, and patches should never
be cut.
Question 8: A patient with heart failure is prescribed furosemide (Lasix) and
digoxin (Lanoxin). The nurse should monitor the patient for which electrolyte
imbalance that increases the risk of digoxin toxicity?
A. Hypermagnesemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia
CORRECT ANSWER: B. Hypokalemia
Rationale: Furosemide is a loop diuretic that causes potassium wasting. Low serum
potassium (hypokalemia) increases the sensitivity of cardiac muscle to digoxin,
significantly increasing the risk of digoxin toxicity, which can manifest as nausea, visual
disturbances, and cardiac dysrhythmias.
Question 9: A nurse is assessing a patient with appendicitis. Which of the
following is the most common early symptom?
A. Left lower quadrant pain
B. Right upper quadrant pain
C. Periumbilical pain that migrates to the right lower quadrant
D. Diffuse lower back pain
CORRECT ANSWER: C. Periumbilical pain that migrates to the right lower
quadrant
, Rationale: The classic presentation of appendicitis begins with dull, periumbilical pain
due to the visceral innervation of the appendix. As inflammation progresses and irritates
the parietal peritoneum, the pain localizes to the right lower quadrant (McBurney's
point).
Question 10: A patient is exhibiting signs of anaphylaxis after receiving an IV
antibiotic. What is the nurse's priority intervention?
A. Administer diphenhydramine (Benadryl).
B. Administer epinephrine intramuscularly.
C. Start a second IV line.
D. Place the patient in a supine position.
CORRECT ANSWER: B. Administer epinephrine intramuscularly.
Rationale: In anaphylaxis, epinephrine is the first-line treatment. It acts as a potent
bronchodilator and vasopressor, counteracting severe hypotension and bronchospasm.
While other interventions like Benadryl, IV fluids, and positioning are important,
epinephrine is the life-saving priority.
Question 11: A nurse is preparing to administer a blood transfusion. The client
reports chills and flank pain 15 minutes after the start of the infusion. What is
the nurse's first action?
A. Slow the infusion rate.
B. Stop the blood transfusion.
C. Notify the healthcare provider.
D. Flush the IV line with normal saline.
CORRECT ANSWER: B. Stop the blood transfusion.
Rationale: Chills and flank pain are signs of an acute hemolytic transfusion reaction,
which is a medical emergency. The nurse's first action is to stop the transfusion
immediately to prevent further complications, then maintain IV access with normal
saline and notify the provider.
Question 12: A nurse is providing discharge teaching to a patient with a new
ileostomy. Which dietary instruction is most appropriate?
A. "You should avoid high-fiber foods to prevent blockages."
B. "You should increase your intake of nuts and seeds."
C. "You do not need to make any dietary changes."
D. "Chew all foods thoroughly and avoid raw vegetables initially."
CORRECT ANSWER: D. "Chew all foods thoroughly and avoid raw vegetables
initially."
Rationale: Patients with new ileostomies are at risk for food blockages because the
stoma is narrow. They should be instructed to chew food thoroughly and initially avoid
foods that are hard to digest (e.g., nuts, seeds, raw vegetables) to prevent obstruction.
Health | Bachelor of Science in Nursing (RN to BSN)
Original Practice Questions & Answers |
Comprehensive WGU E224 Study Guide &
Assessment Preparation | Population Health, Global
Health, Community Health, Health Disparities,
Social Determinants of Health, Epidemiology,
Disease Prevention, Health Promotion, Healthcare
Access, Public Health Interventions & Detailed
Rationales
Question 1: A nurse is educating a patient with type 2 diabetes about the
importance of foot care. Which statement by the patient indicates a need for
further teaching?
A. "I should inspect my feet daily for any cuts or blisters."
B. "I can use a heating pad to keep my feet warm at night."
C. "I will trim my toenails straight across to prevent ingrown nails."
D. "I should wear white cotton socks to detect drainage."
CORRECT ANSWER: B. "I can use a heating pad to keep my feet warm at
night."
Rationale: Patients with diabetes often have peripheral neuropathy and decreased
sensation, making them susceptible to burns. Using a heating pad or hot water bottle
can cause severe burns without the patient's awareness. Daily inspection, proper nail
trimming, and wearing white socks are all appropriate and safe practices.
Question 2: A patient is prescribed warfarin (Coumadin) for atrial fibrillation.
Which dietary instruction is most important for the nurse to provide?
A. "Increase your intake of leafy green vegetables."
B. "Avoid drinking grapefruit juice."
C. "Maintain a consistent intake of vitamin K-rich foods."
D. "Take an over-the-counter aspirin for headaches."
CORRECT ANSWER: C. "Maintain a consistent intake of vitamin K-rich foods."
Rationale: Warfarin's anticoagulant effect is antagonized by vitamin K. Patients should
maintain a consistent daily intake of vitamin K-rich foods to keep the International
Normalized Ratio (INR) stable. Drastic changes in dietary vitamin K can alter the INR
and increase the risk of bleeding or clotting.
Question 3: A nurse is performing a neurological assessment on a patient who
had a stroke. Which finding indicates damage to the frontal lobe?
A. Inability to recognize familiar faces
B. Difficulty with expressive speech and personality changes
,C. Inability to understand spoken language
D. Loss of peripheral vision
CORRECT ANSWER: B. Difficulty with expressive speech and personality
changes
Rationale: The frontal lobe is responsible for executive functions, personality, and motor
speech (Broca's area). Damage here often results in expressive aphasia and personality
changes. Difficulty recognizing faces (prosopagnosia) involves the temporal lobe, and
understanding speech (Wernicke's aphasia) involves the temporal lobe as well, while
vision issues involve the occipital lobe.
Question 4: A patient with chronic obstructive pulmonary disease (COPD) has
an oxygen saturation of 86% on room air. The nurse administers oxygen via
nasal cannula. What is the most important parameter to monitor?
A. Blood pressure
B. Respiratory rate and depth
C. Level of consciousness
D. Skin color
CORRECT ANSWER: C. Level of consciousness
Rationale: Patients with COPD may rely on a hypoxic drive to breathe. Administering
high-flow oxygen can suppress this drive and lead to hypoventilation, hypercapnia, and
respiratory acidosis. The earliest sign of rising carbon dioxide levels is a decreased level
of consciousness, necessitating vigilant monitoring.
Question 5: A nurse is caring for a patient with a chest tube connected to a
water-seal drainage system. What action is appropriate if the drainage system
becomes disconnected from the chest tube?
A. Clamp the chest tube immediately and call the physician.
B. Place the end of the chest tube in sterile water.
C. Turn the patient to the left side.
D. Increase the suction on the drainage system.
CORRECT ANSWER: B. Place the end of the chest tube in sterile water.
Rationale: If the chest tube becomes disconnected, placing the open end in sterile water
creates a water seal, preventing air from entering the pleural space (which could cause a
tension pneumothorax). Clamping the tube is avoided as it can lead to a tension
pneumothorax, and increasing suction is inappropriate.
Question 6: A patient is receiving IV heparin therapy. The nurse notes a
platelet count of 80,000/µL, down from a baseline of 250,000/µL. What is the
priority nursing action?
A. Continue the heparin drip as prescribed.
B. Discontinue the heparin infusion immediately.
,C. Administer vitamin K as an antidote.
D. Increase the rate of the heparin infusion.
CORRECT ANSWER: B. Discontinue the heparin infusion immediately.
Rationale: A significant drop in platelet count while on heparin therapy is indicative of
Heparin-Induced Thrombocytopenia (HIT), a life-threatening immune reaction that can
cause paradoxical thrombosis. The priority is to stop the heparin infusion immediately
and anticipate the initiation of a non-heparin anticoagulant.
Question 7: A nurse is teaching a patient about a new prescription for
nitroglycerin transdermal patch. Which instruction is correct?
A. "Apply the patch to the same site daily for consistency."
B. "Remove the patch at night for 10 to 12 hours."
C. "Apply the patch to a hairy area for better adhesion."
D. "Cut the patch in half if your blood pressure is low."
CORRECT ANSWER: B. "Remove the patch at night for 10 to 12 hours."
Rationale: Nitroglycerin patches require a nitrate-free period of 10 to 12 hours (usually at
night) to prevent the development of tolerance. The patch should be applied to a
hairless area, sites should be rotated to prevent skin irritation, and patches should never
be cut.
Question 8: A patient with heart failure is prescribed furosemide (Lasix) and
digoxin (Lanoxin). The nurse should monitor the patient for which electrolyte
imbalance that increases the risk of digoxin toxicity?
A. Hypermagnesemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia
CORRECT ANSWER: B. Hypokalemia
Rationale: Furosemide is a loop diuretic that causes potassium wasting. Low serum
potassium (hypokalemia) increases the sensitivity of cardiac muscle to digoxin,
significantly increasing the risk of digoxin toxicity, which can manifest as nausea, visual
disturbances, and cardiac dysrhythmias.
Question 9: A nurse is assessing a patient with appendicitis. Which of the
following is the most common early symptom?
A. Left lower quadrant pain
B. Right upper quadrant pain
C. Periumbilical pain that migrates to the right lower quadrant
D. Diffuse lower back pain
CORRECT ANSWER: C. Periumbilical pain that migrates to the right lower
quadrant
, Rationale: The classic presentation of appendicitis begins with dull, periumbilical pain
due to the visceral innervation of the appendix. As inflammation progresses and irritates
the parietal peritoneum, the pain localizes to the right lower quadrant (McBurney's
point).
Question 10: A patient is exhibiting signs of anaphylaxis after receiving an IV
antibiotic. What is the nurse's priority intervention?
A. Administer diphenhydramine (Benadryl).
B. Administer epinephrine intramuscularly.
C. Start a second IV line.
D. Place the patient in a supine position.
CORRECT ANSWER: B. Administer epinephrine intramuscularly.
Rationale: In anaphylaxis, epinephrine is the first-line treatment. It acts as a potent
bronchodilator and vasopressor, counteracting severe hypotension and bronchospasm.
While other interventions like Benadryl, IV fluids, and positioning are important,
epinephrine is the life-saving priority.
Question 11: A nurse is preparing to administer a blood transfusion. The client
reports chills and flank pain 15 minutes after the start of the infusion. What is
the nurse's first action?
A. Slow the infusion rate.
B. Stop the blood transfusion.
C. Notify the healthcare provider.
D. Flush the IV line with normal saline.
CORRECT ANSWER: B. Stop the blood transfusion.
Rationale: Chills and flank pain are signs of an acute hemolytic transfusion reaction,
which is a medical emergency. The nurse's first action is to stop the transfusion
immediately to prevent further complications, then maintain IV access with normal
saline and notify the provider.
Question 12: A nurse is providing discharge teaching to a patient with a new
ileostomy. Which dietary instruction is most appropriate?
A. "You should avoid high-fiber foods to prevent blockages."
B. "You should increase your intake of nuts and seeds."
C. "You do not need to make any dietary changes."
D. "Chew all foods thoroughly and avoid raw vegetables initially."
CORRECT ANSWER: D. "Chew all foods thoroughly and avoid raw vegetables
initially."
Rationale: Patients with new ileostomies are at risk for food blockages because the
stoma is narrow. They should be instructed to chew food thoroughly and initially avoid
foods that are hard to digest (e.g., nuts, seeds, raw vegetables) to prevent obstruction.
