WGU D444 Adult Health 1 Objective Assessment | OA V1 and
V2 – Questions and Answers | 2026 Update | 100% Correct.
1. A 72-year-old man with a history of hypertension and CAD presents with worsening dyspnea
on exertion, orthopnea, and 3+ pitting edema in the lower extremities. Lung auscultation
reveals fine crackles in the bases. His BP is 150/90, HR 88, RR 22, SpO2 91% on room air. An
ECG shows left ventricular hypertrophy. Which assessment finding is the BEST indicator of the
severity of his heart failure?
A. The presence of S3 gallop on auscultation
B. The degree of peripheral edema graded as 3+
C. The oxygen saturation of 91% on room air
D. The blood pressure reading of 150/90 mm Hg
Answer: A. The presence of S3 gallop on auscultation
2. A 58-year-old woman with type 2 diabetes is being evaluated for a routine physical. Her BP is
138/88, BMI 31.2, and fasting glucose 142 mg/dL. She reports no symptoms of urinary urgency
or frequency. A urine dipstick shows protein 2+, and a spot urine albumin-to-creatinine ratio is
300 mg/g. Which laboratory or assessment finding is the earliest indicator of diabetic
nephropathy?
A. Elevated creatinine with decreased GFR
B. Microalbuminuria in the range of 30-300 mg/g
C. Macroalbuminuria with proteinuria exceeding 300 mg/g
D. Presence of glucose and ketones in the urine
Answer: B. Microalbuminuria in the range of 30-300 mg/g
3. A 64-year-old male with end-stage COPD is admitted with an acute exacerbation. He is
confused and lethargic. ABG reveals pH 7.22, PaCO2 68 mm Hg, HCO3 30 mEq/L, PaO2 50 mm
Hg. The nurse prepares to administer oxygen. Which oxygen delivery method is SAFEST to use
initially?
A. Non-rebreather mask at 15 L/min
B. Nasal cannula at 2 L/min
C. Venturi mask at 24% FiO2
D. Simple face mask at 6 L/min
Answer: C. Venturi mask at 24% FiO2
4. A 45-year-old woman presents with chest pain, fatigue, and palpitations. She has been taking
an over-the-counter supplement for weight loss for 3 months. Laboratory findings show TSH
0.1 mIU/L (low), free T4 2.8 ng/dL (high), and T3 220 ng/dL (high). Which assessment finding
would be MOST consistent with hyperthyroidism?
A. Decreased deep tendon reflexes with muscle weakness
B. Cold intolerance and weight gain
C. Dry, brittle hair and constipation
D. Warm, moist skin and fine hand tremor
Answer: D. Warm, moist skin and fine hand tremor
5. A 76-year-old man with chronic kidney disease (stage 4) is admitted with fatigue and
,confusion. Laboratory results: Na+ 130 mEq/L, K+ 5.8 mEq/L, Cl- 98 mEq/L, HCO3- 18 mEq/L,
BUN 80 mg/dL, Cr 4.2 mg/dL, Ca2+ 8.0 mg/dL, Mg2+ 2.8 mEq/L. Which electrolyte abnormality is
the MOST IMMEDIATE threat to life?
A. Hyponatremia at 130 mEq/L
B. Hyperkalemia at 5.8 mEq/L
C. Hypocalcemia at 8.0 mg/dL
D. Hypermagnesemia at 2.8 mEq/L
Answer: B. Hyperkalemia at 5.8 mEq/L
6. A 52-year-old man with cirrhosis presents with abdominal distension, confusion, and
asterixis. He has ascites and has been taking spironolactone and furosemide. Laboratory
values: Na+ 128 mEq/L, K+ 3.0 mEq/L, BUN 28 mg/dL, Cr 1.2 mg/dL, ammonia 78 mcg/dL. Which
clinical finding is the BEST indicator of hepatic encephalopathy?
A. The presence of ascites on abdominal exam
B. Confusion and asterixis
C. Elevated ammonia level of 78 mcg/dL
D. Hyponatremia of 128 mEq/L
Answer: B. Confusion and asterixis
7. A 68-year-old woman is admitted with severe dehydration and weakness. Her labs show Na+
152 mEq/L, K+ 3.8 mEq/L, Cl- 115 mEq/L, BUN 46 mg/dL, Cr 1.8 mg/dL, and urine osmolality 800
mOsm/kg. She is alert but complains of thirst. Which assessment finding indicates the patient
is at risk for complications from hypernatremia?
A. Serum sodium level of 152 mEq/L
B. Urine osmolality of 800 mOsm/kg
C. Presence of severe thirst
D. BUN of 46 mg/dL
Answer: B. Urine osmolality of 800 mOsm/kg
8. A 60-year-old man is diagnosed with syndrome of inappropriate antidiuretic hormone
(SIADH) secondary to small cell lung cancer. He presents with headache, nausea, and
confusion. Labs: Na+ 124 mEq/L, urine sodium 40 mEq/L, serum osmolality 260 mOsm/kg,
urine osmolality 600 mOsm/kg. Which initial treatment is MOST appropriate?
A. Administer 0.9% normal saline at 100 mL/hr
B. Restrict fluid intake to 1000 mL/day
C. Administer hypertonic saline 3% at 25 mL/hr
D. Provide furosemide 40 mg IV once
Answer: C. Administer hypertonic saline 3% at 25 mL/hr
9. A 49-year-old woman with a history of gastric bypass surgery presents with diarrhea, fatigue,
and muscle cramps. Labs show: Na+ 136 mEq/L, K+ 3.2 mEq/L, Cl- 102 mEq/L, HCO3- 18 mEq/L,
Mg2+ 1.6 mEq/L, Ca2+ 8.2 mg/dL. Which electrolyte replacement is the FIRST priority?
A. Potassium chloride 40 mEq IV over 2 hours
B. Magnesium sulfate 2 g IV over 1 hour
C. Calcium gluconate 1 g IV over 15 minutes
D. Sodium bicarbonate 50 mEq IV
Answer: B. Magnesium sulfate 2 g IV over 1 hour
, 10. A 55-year-old man with rheumatoid arthritis on long-term prednisone is admitted with
confusion and hypotension. Labs: Na+ 128 mEq/L, K+ 5.9 mEq/L, BUN 45 mg/dL, Cr 2.2 mg/dL,
glucose 75 mg/dL, cortisol level 12 mcg/dL (low). Which medication should the nurse anticipate
administering?
A. Hydrocortisone 100 mg IV bolus
B. Insulin 10 units IV
C. Normal saline 0.9% bolus
D. Fludrocortisone 0.1 mg orally
Answer: A. Hydrocortisone 100 mg IV bolus
11. A 63-year-old man with a history of peptic ulcer disease is admitted with melena and
dizziness. He is on warfarin for atrial fibrillation with an INR of 4.5. Hemoglobin is 7.2 g/dL.
Which intervention should the nurse perform FIRST?
A. Administer vitamin K 10 mg IV
B. Transfuse packed red blood cells
C. Hold warfarin and monitor INR
D. Start proton pump inhibitor infusion
Answer: B. Transfuse packed red blood cells
12. A 40-year-old woman with Crohn's disease is admitted with severe abdominal pain,
vomiting, and high-pitched bowel sounds. An abdominal X-ray shows dilated loops of small
bowel with multiple air-fluid levels. Which assessment finding warrants IMMEDIATE notification
of the provider?
A. Worsening abdominal pain that is now constant and severe
B. A decrease in bowel sound frequency to hypoactive
C. Emesis that is bilious and dark green
D. An increase in heart rate from 90 to 110 bpm
Answer: A. Worsening abdominal pain that is now constant and severe
13. A 72-year-old woman with a history of gastroesophageal reflux disease (GERD) presents
with progressive dysphagia, weight loss, and regurgitation of undigested food. She has no
heartburn. Which test is indicated to rule out esophageal cancer?
A. Upper GI endoscopy with biopsy
B. Barium swallow study
C. Esophageal manometry
D. 24-hour pH monitoring
Answer: A. Upper GI endoscopy with biopsy
14. A 67-year-old man with Parkinson's disease is admitted with altered mental status, fever,
and muscle rigidity. He was recently started on levodopa/carbidopa and haloperidol for
psychosis. The nurse suspects neuroleptic malignant syndrome (NMS). Which laboratory
finding supports this diagnosis?
A. Decreased creatine kinase level
B. Elevated white blood cell count without infection
C. Low serum sodium of 125 mEq/L
D. Negative urine myoglobin test
Answer: B. Elevated white blood cell count without infection
V2 – Questions and Answers | 2026 Update | 100% Correct.
1. A 72-year-old man with a history of hypertension and CAD presents with worsening dyspnea
on exertion, orthopnea, and 3+ pitting edema in the lower extremities. Lung auscultation
reveals fine crackles in the bases. His BP is 150/90, HR 88, RR 22, SpO2 91% on room air. An
ECG shows left ventricular hypertrophy. Which assessment finding is the BEST indicator of the
severity of his heart failure?
A. The presence of S3 gallop on auscultation
B. The degree of peripheral edema graded as 3+
C. The oxygen saturation of 91% on room air
D. The blood pressure reading of 150/90 mm Hg
Answer: A. The presence of S3 gallop on auscultation
2. A 58-year-old woman with type 2 diabetes is being evaluated for a routine physical. Her BP is
138/88, BMI 31.2, and fasting glucose 142 mg/dL. She reports no symptoms of urinary urgency
or frequency. A urine dipstick shows protein 2+, and a spot urine albumin-to-creatinine ratio is
300 mg/g. Which laboratory or assessment finding is the earliest indicator of diabetic
nephropathy?
A. Elevated creatinine with decreased GFR
B. Microalbuminuria in the range of 30-300 mg/g
C. Macroalbuminuria with proteinuria exceeding 300 mg/g
D. Presence of glucose and ketones in the urine
Answer: B. Microalbuminuria in the range of 30-300 mg/g
3. A 64-year-old male with end-stage COPD is admitted with an acute exacerbation. He is
confused and lethargic. ABG reveals pH 7.22, PaCO2 68 mm Hg, HCO3 30 mEq/L, PaO2 50 mm
Hg. The nurse prepares to administer oxygen. Which oxygen delivery method is SAFEST to use
initially?
A. Non-rebreather mask at 15 L/min
B. Nasal cannula at 2 L/min
C. Venturi mask at 24% FiO2
D. Simple face mask at 6 L/min
Answer: C. Venturi mask at 24% FiO2
4. A 45-year-old woman presents with chest pain, fatigue, and palpitations. She has been taking
an over-the-counter supplement for weight loss for 3 months. Laboratory findings show TSH
0.1 mIU/L (low), free T4 2.8 ng/dL (high), and T3 220 ng/dL (high). Which assessment finding
would be MOST consistent with hyperthyroidism?
A. Decreased deep tendon reflexes with muscle weakness
B. Cold intolerance and weight gain
C. Dry, brittle hair and constipation
D. Warm, moist skin and fine hand tremor
Answer: D. Warm, moist skin and fine hand tremor
5. A 76-year-old man with chronic kidney disease (stage 4) is admitted with fatigue and
,confusion. Laboratory results: Na+ 130 mEq/L, K+ 5.8 mEq/L, Cl- 98 mEq/L, HCO3- 18 mEq/L,
BUN 80 mg/dL, Cr 4.2 mg/dL, Ca2+ 8.0 mg/dL, Mg2+ 2.8 mEq/L. Which electrolyte abnormality is
the MOST IMMEDIATE threat to life?
A. Hyponatremia at 130 mEq/L
B. Hyperkalemia at 5.8 mEq/L
C. Hypocalcemia at 8.0 mg/dL
D. Hypermagnesemia at 2.8 mEq/L
Answer: B. Hyperkalemia at 5.8 mEq/L
6. A 52-year-old man with cirrhosis presents with abdominal distension, confusion, and
asterixis. He has ascites and has been taking spironolactone and furosemide. Laboratory
values: Na+ 128 mEq/L, K+ 3.0 mEq/L, BUN 28 mg/dL, Cr 1.2 mg/dL, ammonia 78 mcg/dL. Which
clinical finding is the BEST indicator of hepatic encephalopathy?
A. The presence of ascites on abdominal exam
B. Confusion and asterixis
C. Elevated ammonia level of 78 mcg/dL
D. Hyponatremia of 128 mEq/L
Answer: B. Confusion and asterixis
7. A 68-year-old woman is admitted with severe dehydration and weakness. Her labs show Na+
152 mEq/L, K+ 3.8 mEq/L, Cl- 115 mEq/L, BUN 46 mg/dL, Cr 1.8 mg/dL, and urine osmolality 800
mOsm/kg. She is alert but complains of thirst. Which assessment finding indicates the patient
is at risk for complications from hypernatremia?
A. Serum sodium level of 152 mEq/L
B. Urine osmolality of 800 mOsm/kg
C. Presence of severe thirst
D. BUN of 46 mg/dL
Answer: B. Urine osmolality of 800 mOsm/kg
8. A 60-year-old man is diagnosed with syndrome of inappropriate antidiuretic hormone
(SIADH) secondary to small cell lung cancer. He presents with headache, nausea, and
confusion. Labs: Na+ 124 mEq/L, urine sodium 40 mEq/L, serum osmolality 260 mOsm/kg,
urine osmolality 600 mOsm/kg. Which initial treatment is MOST appropriate?
A. Administer 0.9% normal saline at 100 mL/hr
B. Restrict fluid intake to 1000 mL/day
C. Administer hypertonic saline 3% at 25 mL/hr
D. Provide furosemide 40 mg IV once
Answer: C. Administer hypertonic saline 3% at 25 mL/hr
9. A 49-year-old woman with a history of gastric bypass surgery presents with diarrhea, fatigue,
and muscle cramps. Labs show: Na+ 136 mEq/L, K+ 3.2 mEq/L, Cl- 102 mEq/L, HCO3- 18 mEq/L,
Mg2+ 1.6 mEq/L, Ca2+ 8.2 mg/dL. Which electrolyte replacement is the FIRST priority?
A. Potassium chloride 40 mEq IV over 2 hours
B. Magnesium sulfate 2 g IV over 1 hour
C. Calcium gluconate 1 g IV over 15 minutes
D. Sodium bicarbonate 50 mEq IV
Answer: B. Magnesium sulfate 2 g IV over 1 hour
, 10. A 55-year-old man with rheumatoid arthritis on long-term prednisone is admitted with
confusion and hypotension. Labs: Na+ 128 mEq/L, K+ 5.9 mEq/L, BUN 45 mg/dL, Cr 2.2 mg/dL,
glucose 75 mg/dL, cortisol level 12 mcg/dL (low). Which medication should the nurse anticipate
administering?
A. Hydrocortisone 100 mg IV bolus
B. Insulin 10 units IV
C. Normal saline 0.9% bolus
D. Fludrocortisone 0.1 mg orally
Answer: A. Hydrocortisone 100 mg IV bolus
11. A 63-year-old man with a history of peptic ulcer disease is admitted with melena and
dizziness. He is on warfarin for atrial fibrillation with an INR of 4.5. Hemoglobin is 7.2 g/dL.
Which intervention should the nurse perform FIRST?
A. Administer vitamin K 10 mg IV
B. Transfuse packed red blood cells
C. Hold warfarin and monitor INR
D. Start proton pump inhibitor infusion
Answer: B. Transfuse packed red blood cells
12. A 40-year-old woman with Crohn's disease is admitted with severe abdominal pain,
vomiting, and high-pitched bowel sounds. An abdominal X-ray shows dilated loops of small
bowel with multiple air-fluid levels. Which assessment finding warrants IMMEDIATE notification
of the provider?
A. Worsening abdominal pain that is now constant and severe
B. A decrease in bowel sound frequency to hypoactive
C. Emesis that is bilious and dark green
D. An increase in heart rate from 90 to 110 bpm
Answer: A. Worsening abdominal pain that is now constant and severe
13. A 72-year-old woman with a history of gastroesophageal reflux disease (GERD) presents
with progressive dysphagia, weight loss, and regurgitation of undigested food. She has no
heartburn. Which test is indicated to rule out esophageal cancer?
A. Upper GI endoscopy with biopsy
B. Barium swallow study
C. Esophageal manometry
D. 24-hour pH monitoring
Answer: A. Upper GI endoscopy with biopsy
14. A 67-year-old man with Parkinson's disease is admitted with altered mental status, fever,
and muscle rigidity. He was recently started on levodopa/carbidopa and haloperidol for
psychosis. The nurse suspects neuroleptic malignant syndrome (NMS). Which laboratory
finding supports this diagnosis?
A. Decreased creatine kinase level
B. Elevated white blood cell count without infection
C. Low serum sodium of 125 mEq/L
D. Negative urine myoglobin test
Answer: B. Elevated white blood cell count without infection
