WGU D446 Adult Health II Objective Assessment
(OA) Practice Exam Test Bank | Comprehensive
Practice Exam Questions with Verified Answers and
Detailed Rationales (100% Correct Solutions) | Latest
Update 2026/2027 -Already Graded A+
Question 1
The nurse is evaluating a function of the limbic system as a part of the neurological status
of a client. What would the nurse assess?
A. Experience of pain
B. Response to verbal stimuli
C. Altered mental status
D. Affect or emotions
Answer: D
Rationale: The limbic system is responsible for emotional responses, behavior, and
memory. Assessing affect or emotions evaluates limbic system function.
Question 2
A client with a recent history of blood in the stools is scheduled for a
proctosigmoidoscopy. The nurse should implement which protocols to prepare the client
for this procedure? (Select all that apply.)
A. Provide a clear path for ambulation without obstacles
B. Provide the client with a soft toothbrush
C. Instruct the client to use an electric razor
D. Monitor all secretions for frank or occult blood
E. Provide a clear-liquid diet 48 hours before the procedure
F. Obtain consent for the procedure
G. Begin fast the morning of the procedure
H. Administer an enema before the procedure
pg. 1
,Answer: E, F, G, H
Rationale: Preparation for proctosigmoidoscopy includes clear-liquid diet 48 hours prior,
obtaining informed consent, fasting the morning of the procedure, and administering an
enema to cleanse the bowel.
Question 3
The nurse is reviewing the discharge instructions for the client who had a skin biopsy of a
suspected cancer lesion. Which statement, if made by the client, would indicate a need for
further instruction?
A. "I will return tomorrow to have the sutures removed."
B. "I will report any redness or swelling around the site."
C. "I will keep the dressing clean and dry."
D. "I will avoid touching the biopsy site with my hands."
Answer: A
Rationale: Sutures from a skin biopsy are typically removed in 7-14 days, not the next
day. Returning tomorrow indicates a need for further teaching.
Question 4
The nurse assesses a client with advanced cirrhosis of the liver for signs of hepatic
encephalopathy. Which finding would the nurse consider an indication of progressive
hepatic encephalopathy?
A. Hypertension and bounding pulse
B. Flushed skin and headache
C. Painful liver enlargement
D. Difficulty in handwriting
Answer: D
Rationale: Difficulty in handwriting (asterixis or "flapping tremor") is an early sign of
progressive hepatic encephalopathy, indicating impaired liver function affecting the brain.
Question 5
The nurse is monitoring a child with burns during treatment. Which assessment provides
the most accurate guide to determine the adequacy of fluid resuscitation?
pg. 2
,A. Amount of fluid tolerated within 24 hours
B. Adequacy of capillary filling
C. Amount of fluid tolerated in 24 hours
D. Level of edema at burn site
Answer: B
Rationale: Adequacy of capillary filling (capillary refill) is the most accurate guide to
determine fluid resuscitation adequacy in burn patients.
Question 6
A client who has a chronic cough with blood-tinged sputum returns to the unit after a
bronchoscopy. Which nursing intervention should be implemented in the immediate post-
procedural period?
A. Notify the healthcare provider
B. Chest x-ray indicating a mediastinal shift
C. Allow the client nothing by mouth until the gag reflex returns
D. Tell the client to carry a medic alert card stating that he is a total neck breather
Answer: C
Rationale: After bronchoscopy, the client should have nothing by mouth until the gag
reflex returns to prevent aspiration. The gag reflex is suppressed by the local anesthetic
used during the procedure.
Question 7
The nurse is planning care for a client with newly diagnosed diabetes mellitus that
requires insulin. Which assessment should the nurse identify before beginning the
teaching session?
A. Intelligence and developmental level of the client
B. The client's preferred time of day for meals
C. The client's family history of diabetes
D. The client's current weight and height
Answer: A
Rationale: Assessing the client's intelligence and developmental level is essential before
beginning teaching to ensure the education is appropriate and effective.
pg. 3
, Question 8
The nurse is initiating the client's fourth dose of gentamicin sulfate IV. The health care
provider (HCP) has prescribed peak and trough levels. Which is the most important
action for the nurse to implement next?
A. Draw the trough 5 minutes before and the peak 30 minutes after the next dose
B. Administer the dose and draw the trough level 1 hour after completion
C. Hold the dose until the peak and trough results are available
D. Administer the dose and draw the peak level immediately after
Answer: A
Rationale: Trough levels should be drawn immediately before the next dose (5 minutes
prior), and peak levels should be drawn 30 minutes after IV administration to monitor
therapeutic and toxic levels.
Question 9
A client who is receiving the sixth unit of packed red blood cell transfusion is
demonstrating signs and symptoms of a febrile, nonhemolytic reaction. Which
assessment finding is most important for the nurse to identify?
A. Reports of feeling cold
B. Flushed skin and headache
C. Chills, fever, headache, and flushing
D. Complaints of feeling cold
Answer: C
Rationale: Febrile nonhemolytic transfusion reactions present with chills, fever,
headache, and flushing. Identifying these symptoms early helps differentiate from more
serious hemolytic reactions.
Question 10
The nurse is assessing a client admitted from the emergency department with
gastrointestinal bleeding related to peptic ulcer disease (PUD). Which physiological
factors can produce ulceration? (Select all that apply.)
pg. 4
(OA) Practice Exam Test Bank | Comprehensive
Practice Exam Questions with Verified Answers and
Detailed Rationales (100% Correct Solutions) | Latest
Update 2026/2027 -Already Graded A+
Question 1
The nurse is evaluating a function of the limbic system as a part of the neurological status
of a client. What would the nurse assess?
A. Experience of pain
B. Response to verbal stimuli
C. Altered mental status
D. Affect or emotions
Answer: D
Rationale: The limbic system is responsible for emotional responses, behavior, and
memory. Assessing affect or emotions evaluates limbic system function.
Question 2
A client with a recent history of blood in the stools is scheduled for a
proctosigmoidoscopy. The nurse should implement which protocols to prepare the client
for this procedure? (Select all that apply.)
A. Provide a clear path for ambulation without obstacles
B. Provide the client with a soft toothbrush
C. Instruct the client to use an electric razor
D. Monitor all secretions for frank or occult blood
E. Provide a clear-liquid diet 48 hours before the procedure
F. Obtain consent for the procedure
G. Begin fast the morning of the procedure
H. Administer an enema before the procedure
pg. 1
,Answer: E, F, G, H
Rationale: Preparation for proctosigmoidoscopy includes clear-liquid diet 48 hours prior,
obtaining informed consent, fasting the morning of the procedure, and administering an
enema to cleanse the bowel.
Question 3
The nurse is reviewing the discharge instructions for the client who had a skin biopsy of a
suspected cancer lesion. Which statement, if made by the client, would indicate a need for
further instruction?
A. "I will return tomorrow to have the sutures removed."
B. "I will report any redness or swelling around the site."
C. "I will keep the dressing clean and dry."
D. "I will avoid touching the biopsy site with my hands."
Answer: A
Rationale: Sutures from a skin biopsy are typically removed in 7-14 days, not the next
day. Returning tomorrow indicates a need for further teaching.
Question 4
The nurse assesses a client with advanced cirrhosis of the liver for signs of hepatic
encephalopathy. Which finding would the nurse consider an indication of progressive
hepatic encephalopathy?
A. Hypertension and bounding pulse
B. Flushed skin and headache
C. Painful liver enlargement
D. Difficulty in handwriting
Answer: D
Rationale: Difficulty in handwriting (asterixis or "flapping tremor") is an early sign of
progressive hepatic encephalopathy, indicating impaired liver function affecting the brain.
Question 5
The nurse is monitoring a child with burns during treatment. Which assessment provides
the most accurate guide to determine the adequacy of fluid resuscitation?
pg. 2
,A. Amount of fluid tolerated within 24 hours
B. Adequacy of capillary filling
C. Amount of fluid tolerated in 24 hours
D. Level of edema at burn site
Answer: B
Rationale: Adequacy of capillary filling (capillary refill) is the most accurate guide to
determine fluid resuscitation adequacy in burn patients.
Question 6
A client who has a chronic cough with blood-tinged sputum returns to the unit after a
bronchoscopy. Which nursing intervention should be implemented in the immediate post-
procedural period?
A. Notify the healthcare provider
B. Chest x-ray indicating a mediastinal shift
C. Allow the client nothing by mouth until the gag reflex returns
D. Tell the client to carry a medic alert card stating that he is a total neck breather
Answer: C
Rationale: After bronchoscopy, the client should have nothing by mouth until the gag
reflex returns to prevent aspiration. The gag reflex is suppressed by the local anesthetic
used during the procedure.
Question 7
The nurse is planning care for a client with newly diagnosed diabetes mellitus that
requires insulin. Which assessment should the nurse identify before beginning the
teaching session?
A. Intelligence and developmental level of the client
B. The client's preferred time of day for meals
C. The client's family history of diabetes
D. The client's current weight and height
Answer: A
Rationale: Assessing the client's intelligence and developmental level is essential before
beginning teaching to ensure the education is appropriate and effective.
pg. 3
, Question 8
The nurse is initiating the client's fourth dose of gentamicin sulfate IV. The health care
provider (HCP) has prescribed peak and trough levels. Which is the most important
action for the nurse to implement next?
A. Draw the trough 5 minutes before and the peak 30 minutes after the next dose
B. Administer the dose and draw the trough level 1 hour after completion
C. Hold the dose until the peak and trough results are available
D. Administer the dose and draw the peak level immediately after
Answer: A
Rationale: Trough levels should be drawn immediately before the next dose (5 minutes
prior), and peak levels should be drawn 30 minutes after IV administration to monitor
therapeutic and toxic levels.
Question 9
A client who is receiving the sixth unit of packed red blood cell transfusion is
demonstrating signs and symptoms of a febrile, nonhemolytic reaction. Which
assessment finding is most important for the nurse to identify?
A. Reports of feeling cold
B. Flushed skin and headache
C. Chills, fever, headache, and flushing
D. Complaints of feeling cold
Answer: C
Rationale: Febrile nonhemolytic transfusion reactions present with chills, fever,
headache, and flushing. Identifying these symptoms early helps differentiate from more
serious hemolytic reactions.
Question 10
The nurse is assessing a client admitted from the emergency department with
gastrointestinal bleeding related to peptic ulcer disease (PUD). Which physiological
factors can produce ulceration? (Select all that apply.)
pg. 4
