WGU D444 Adult Health I
Objective Assessment Exam
150 Questions and answer key
Name: Date: Score: _______ / 150
________________________ ___________________
Instructions: Select the best answer for each question. Each question is worth 1 point.
No notes, textbooks, or electronic devices are permitted during this exam.
Answer key at the end
1. A client with heart failure reports increasing shortness of breath and needs to sleep
with three pillows to breathe comfortably at night. Which finding supports the diagnosis
of left-sided heart failure?
A. Bilateral ankle edema B. Jugular vein distention
C. Crackles in the lung bases D. Hepatomegaly
2. A nurse is reviewing the laboratory results of a client who has been taking warfarin.
Which result should the nurse report to the provider immediately?
A. INR of 2.5 B. INR of 1.2
C. INR of 5.8 D. INR of 3.0
3. A client admitted with acute myocardial infarction receives morphine sulfate for chest
pain. Which assessment finding indicates the medication is effective?
A. Heart rate increases from 68 to 82 bpm B. Respiratory rate decreases from 22 to
16 breaths/min
C. Blood pressure decreases from 150/90 D. Client reports chest pain rating
to 130/80 mm Hg decreased from 8 to 3
4. A nurse is providing discharge teaching to a client with heart failure. Which statement
by the client indicates an understanding of the teaching?
A. I will drink at least 3 liters of fluid daily,
B. I will weigh myself weekly and report any weight gain,
C. I will take my diuretic in the evening before bed,
1
, D. I will limit my sodium intake to less than 2 grams per day
5. A client with atrial fibrillation is prescribed dabigatran. Which instruction should the
nurse include in the discharge teaching?
A. Take the medication with meals to B. Do not crush or chew the capsules
enhance absorption
C. Expect to have frequent blood draws D. Store the medication in the refrigerator
for monitoring after opening
6. A nurse is caring for a client who is 6 hours postoperative following coronary artery
bypass graft (CABG) surgery. Which finding requires immediate intervention?
A. Serous drainage of 2 cm on the B. Urinary output of 30 mL/hr
incision
C. Temperature of 37.5 degrees C (99.5 D. Cardiac index of 1.8 L/min/m2
degrees F)
7. A client with peripheral arterial disease reports leg pain when walking that is relieved
by rest. The nurse should document this finding using which term?
A. Thromboangiitis obliterans B. Intermittent claudication
C. Chronic venous insufficiency D. Deep vein thrombosis
8. A nurse is assessing a client with aortic stenosis. Which finding is most commonly
associated with this condition?
A. Wide pulse pressure B. Bounding peripheral pulses
C. Systolic murmur heard at the right D. Diastolic murmur heard at the left
upper sternal border lower sternal border
9. A client with hypertension is prescribed lisinopril. Which adverse effect should the
nurse instruct the client to report?
A. Mild dry cough B. Frequent urination
C. Weight gain D. Bradycardia
10. A nurse is caring for a client with infective endocarditis. Which finding is a major
criterion from the Duke Criteria for diagnosis?
A. Fever of 38.2 degrees C (100.8 degrees B. Positive blood culture for typical
F) organism
C. Janeway lesions on the palms D. Splinter hemorrhages under the nails
2
,11. A client presents to the emergency department with sudden onset severe tearing
chest pain that radiates to the back. Blood pressure is 180/110 mm Hg in the right arm
and 110/70 mm Hg in the left arm. Which condition should the nurse suspect?
A. Acute myocardial infarction B. Pulmonary embolism
C. Aortic dissection D. Pneumothorax
12. A nurse is teaching a client about lifestyle modifications for hypertension. Which
statement by the client indicates the teaching was effective?
A. I will restrict my potassium intake,
B. I will limit alcohol to no more than two drinks per day,
C. I will engage in moderate aerobic exercise 30 minutes most days,
D. I will use salt substitutes to flavor my food
13. A client with chronic heart failure is prescribed spironolactone. Which laboratory
value is most important for the nurse to monitor?
A. Sodium B. Potassium
C. Calcium D. Magnesium
14. A nurse is providing preoperative teaching for a client scheduled for a cardiac
catheterization. Which statement by the client indicates a need for further teaching?
A. I will lie flat for several hours after the procedure,
B. I can eat a regular breakfast before coming to the hospital,
C. I should tell the nurse if I feel any chest pain during the procedure,
D. The nurse will check my groin for bleeding after the test
15. A client with heart failure has a B-type natriuretic peptide (BNP) level of 1,200
pg/mL. The nurse recognizes that this result indicates which finding?
A. Mild heart failure B. Moderate heart failure
C. Severe heart failure D. The result is within normal limits
16. A nurse is assessing a client who has a history of myocardial infarction. Which type
of angina is characterized by chest pain that occurs at rest and is not relieved by
nitroglycerin?
A. Stable angina B. Unstable angina
C. Prinzmetal angina D. Variant angina
3
, 17. A client with a history of deep vein thrombosis (DVT) is prescribed enoxaparin.
Which action should the nurse take when administering this medication?
A. Administer intramuscularly in the B. Administer subcutaneously in the
deltoid muscle abdominal tissue
C. Aspirate before injection to check for D. Massage the site after injection to
blood return enhance absorption
18. A client is admitted with hypertensive crisis and has a blood pressure of 220/130 mm
Hg. Which medication does the nurse anticipate administering?
A. Oral hydrochlorothiazide B. Intravenous nitroprusside
C. Sublingual nifedipine D. Intramuscular metoprolol
19. A nurse is monitoring a client who had a permanent pacemaker inserted. Which
finding indicates a potential complication requiring immediate intervention?
A. Slight swelling at the insertion site B. Heart rate of 72 bpm with a pacemaker
set at 70 bpm
C. Muscle twitching near the pacemaker D. Temperature of 37.3 degrees C (99.1
generator degrees F)
20. A client with chronic obstructive pulmonary disease (COPD) has a respiratory rate
of 32 breaths/min and uses accessory muscles to breathe. Which arterial blood gas
(ABG) result would the nurse expect?
A. pH 7.45, PaCO2 30 mm Hg, HCO3 24 B. pH 7.35, PaCO2 50 mm Hg, HCO3 30
mEq/L mEq/L
C. pH 7.48, PaCO2 28 mm Hg, HCO3 22 D. pH 7.30, PaCO2 55 mm Hg, HCO3 28
mEq/L mEq/L
21. A nurse is caring for a client with a pulmonary embolism. Which assessment finding
is most commonly associated with this condition?
A. Productive cough with green sputum
B. Sudden onset dyspnea and pleuritic chest pain
C. Bilateral wheezing on auscultation
D. Gradually increasing shortness of breath over several days
22. A client with asthma is prescribed a metered-dose inhaler (MDI) with a spacer.
Which instruction should the nurse provide?
A. Exhale fully, then inhale the medication slowly over 3 to 5 seconds,
4
Objective Assessment Exam
150 Questions and answer key
Name: Date: Score: _______ / 150
________________________ ___________________
Instructions: Select the best answer for each question. Each question is worth 1 point.
No notes, textbooks, or electronic devices are permitted during this exam.
Answer key at the end
1. A client with heart failure reports increasing shortness of breath and needs to sleep
with three pillows to breathe comfortably at night. Which finding supports the diagnosis
of left-sided heart failure?
A. Bilateral ankle edema B. Jugular vein distention
C. Crackles in the lung bases D. Hepatomegaly
2. A nurse is reviewing the laboratory results of a client who has been taking warfarin.
Which result should the nurse report to the provider immediately?
A. INR of 2.5 B. INR of 1.2
C. INR of 5.8 D. INR of 3.0
3. A client admitted with acute myocardial infarction receives morphine sulfate for chest
pain. Which assessment finding indicates the medication is effective?
A. Heart rate increases from 68 to 82 bpm B. Respiratory rate decreases from 22 to
16 breaths/min
C. Blood pressure decreases from 150/90 D. Client reports chest pain rating
to 130/80 mm Hg decreased from 8 to 3
4. A nurse is providing discharge teaching to a client with heart failure. Which statement
by the client indicates an understanding of the teaching?
A. I will drink at least 3 liters of fluid daily,
B. I will weigh myself weekly and report any weight gain,
C. I will take my diuretic in the evening before bed,
1
, D. I will limit my sodium intake to less than 2 grams per day
5. A client with atrial fibrillation is prescribed dabigatran. Which instruction should the
nurse include in the discharge teaching?
A. Take the medication with meals to B. Do not crush or chew the capsules
enhance absorption
C. Expect to have frequent blood draws D. Store the medication in the refrigerator
for monitoring after opening
6. A nurse is caring for a client who is 6 hours postoperative following coronary artery
bypass graft (CABG) surgery. Which finding requires immediate intervention?
A. Serous drainage of 2 cm on the B. Urinary output of 30 mL/hr
incision
C. Temperature of 37.5 degrees C (99.5 D. Cardiac index of 1.8 L/min/m2
degrees F)
7. A client with peripheral arterial disease reports leg pain when walking that is relieved
by rest. The nurse should document this finding using which term?
A. Thromboangiitis obliterans B. Intermittent claudication
C. Chronic venous insufficiency D. Deep vein thrombosis
8. A nurse is assessing a client with aortic stenosis. Which finding is most commonly
associated with this condition?
A. Wide pulse pressure B. Bounding peripheral pulses
C. Systolic murmur heard at the right D. Diastolic murmur heard at the left
upper sternal border lower sternal border
9. A client with hypertension is prescribed lisinopril. Which adverse effect should the
nurse instruct the client to report?
A. Mild dry cough B. Frequent urination
C. Weight gain D. Bradycardia
10. A nurse is caring for a client with infective endocarditis. Which finding is a major
criterion from the Duke Criteria for diagnosis?
A. Fever of 38.2 degrees C (100.8 degrees B. Positive blood culture for typical
F) organism
C. Janeway lesions on the palms D. Splinter hemorrhages under the nails
2
,11. A client presents to the emergency department with sudden onset severe tearing
chest pain that radiates to the back. Blood pressure is 180/110 mm Hg in the right arm
and 110/70 mm Hg in the left arm. Which condition should the nurse suspect?
A. Acute myocardial infarction B. Pulmonary embolism
C. Aortic dissection D. Pneumothorax
12. A nurse is teaching a client about lifestyle modifications for hypertension. Which
statement by the client indicates the teaching was effective?
A. I will restrict my potassium intake,
B. I will limit alcohol to no more than two drinks per day,
C. I will engage in moderate aerobic exercise 30 minutes most days,
D. I will use salt substitutes to flavor my food
13. A client with chronic heart failure is prescribed spironolactone. Which laboratory
value is most important for the nurse to monitor?
A. Sodium B. Potassium
C. Calcium D. Magnesium
14. A nurse is providing preoperative teaching for a client scheduled for a cardiac
catheterization. Which statement by the client indicates a need for further teaching?
A. I will lie flat for several hours after the procedure,
B. I can eat a regular breakfast before coming to the hospital,
C. I should tell the nurse if I feel any chest pain during the procedure,
D. The nurse will check my groin for bleeding after the test
15. A client with heart failure has a B-type natriuretic peptide (BNP) level of 1,200
pg/mL. The nurse recognizes that this result indicates which finding?
A. Mild heart failure B. Moderate heart failure
C. Severe heart failure D. The result is within normal limits
16. A nurse is assessing a client who has a history of myocardial infarction. Which type
of angina is characterized by chest pain that occurs at rest and is not relieved by
nitroglycerin?
A. Stable angina B. Unstable angina
C. Prinzmetal angina D. Variant angina
3
, 17. A client with a history of deep vein thrombosis (DVT) is prescribed enoxaparin.
Which action should the nurse take when administering this medication?
A. Administer intramuscularly in the B. Administer subcutaneously in the
deltoid muscle abdominal tissue
C. Aspirate before injection to check for D. Massage the site after injection to
blood return enhance absorption
18. A client is admitted with hypertensive crisis and has a blood pressure of 220/130 mm
Hg. Which medication does the nurse anticipate administering?
A. Oral hydrochlorothiazide B. Intravenous nitroprusside
C. Sublingual nifedipine D. Intramuscular metoprolol
19. A nurse is monitoring a client who had a permanent pacemaker inserted. Which
finding indicates a potential complication requiring immediate intervention?
A. Slight swelling at the insertion site B. Heart rate of 72 bpm with a pacemaker
set at 70 bpm
C. Muscle twitching near the pacemaker D. Temperature of 37.3 degrees C (99.1
generator degrees F)
20. A client with chronic obstructive pulmonary disease (COPD) has a respiratory rate
of 32 breaths/min and uses accessory muscles to breathe. Which arterial blood gas
(ABG) result would the nurse expect?
A. pH 7.45, PaCO2 30 mm Hg, HCO3 24 B. pH 7.35, PaCO2 50 mm Hg, HCO3 30
mEq/L mEq/L
C. pH 7.48, PaCO2 28 mm Hg, HCO3 22 D. pH 7.30, PaCO2 55 mm Hg, HCO3 28
mEq/L mEq/L
21. A nurse is caring for a client with a pulmonary embolism. Which assessment finding
is most commonly associated with this condition?
A. Productive cough with green sputum
B. Sudden onset dyspnea and pleuritic chest pain
C. Bilateral wheezing on auscultation
D. Gradually increasing shortness of breath over several days
22. A client with asthma is prescribed a metered-dose inhaler (MDI) with a spacer.
Which instruction should the nurse provide?
A. Exhale fully, then inhale the medication slowly over 3 to 5 seconds,
4
