1|Page
WGU D446 – Adult Health II Objective Assessment | OA V1
and V2 | Questions and Answers – 2026 Update | 100%
Correct.
1. A client with acute decompensated heart failure suddenly develops severe
dyspnea, bilateral crackles extending into the upper lung fields, pink frothy
sputum, an oxygen saturation of 82%, and marked anxiety. Which intervention
should the nurse prioritize?
A. Encourage oral fluids to maintain adequate circulating volume.
B. Place the client in a high-Fowler position and administer oxygen as prescribed.
C. Place the client flat with the legs elevated above the level of the heart.
D. Encourage ambulation to improve pulmonary circulation.
Answer: B
2. A client with chronic left-sided heart failure reports increasing fatigue and
difficulty breathing when lying flat and has gained 3 kg over the past several days.
Which assessment finding would most strongly support worsening left-sided heart
failure?
A. Distended abdomen and dependent peripheral edema
B. Jugular venous distention with hepatomegaly
C. Bilateral pulmonary crackles with orthopnea
D. Increased urinary output and decreased respiratory rate
Answer: C
3. A client with atrial fibrillation is receiving warfarin therapy. Which laboratory
result is MOST important for the nurse to monitor when evaluating the therapeutic
effect and bleeding risk associated with this medication?
A. Troponin I
B. INR
C. Serum potassium
D. Creatine kinase
Answer: B
,2|Page
4. A client arrives in the emergency department reporting crushing substernal chest
pressure radiating to the left arm, diaphoresis, nausea, and shortness of breath that
began 45 minutes ago. Which action should the nurse anticipate as a priority in the
initial management?
A. Encourage the client to ambulate to determine whether the pain improves.
B. Administer aspirin as prescribed after assessing for contraindications.
C. Provide a high-fat meal to prevent medication-related nausea.
D. Delay cardiac evaluation until the pain has been present for several hours.
Answer: B
5. A client with COPD has an oxygen saturation of 86% and increasing dyspnea.
The nurse administers supplemental oxygen as prescribed. Which finding requires
the MOST immediate reassessment?
A. Mildly increased respiratory rate
B. Improved ability to speak in complete sentences
C. New confusion and increasing lethargy
D. Oxygen saturation increasing toward the prescribed target
Answer: C
6. A client is experiencing an acute asthma exacerbation with audible wheezing,
respiratory distress, and difficulty speaking in complete sentences. Which
prescribed medication should the nurse anticipate administering first for rapid
bronchodilation?
A. Albuterol
B. Montelukast
C. Salmeterol
D. Fluticasone
Answer: A
7. A client develops sudden dyspnea, pleuritic chest pain, tachycardia, and oxygen
desaturation several days after major orthopedic surgery. Which complication
should the nurse suspect FIRST?
A. Pulmonary embolism
B. Chronic bronchitis
,3|Page
C. Stable angina
D. Left-sided heart failure
Answer: A
8. A client with a chest tube following treatment for a pneumothorax is being
assessed by the nurse. Which finding requires immediate intervention?
A. Tidaling in the water-seal chamber
B. Small amount of drainage documented during the shift
C. Continuous bubbling in the water-seal chamber
D. Mild discomfort at the insertion site
Answer: C
9. A client arrives with sudden right-sided weakness, facial drooping, difficulty
speaking, and an unknown time of symptom onset. Which intervention is the
nurse's priority?
A. Give oral fluids to prevent dehydration.
B. Determine the last-known-well time and prepare for rapid neurologic evaluation
and brain imaging.
C. Administer a sedative to prevent seizure activity.
D. Encourage the client to walk to determine the extent of weakness.
Answer: B
10. A client is being evaluated for possible acute ischemic stroke. Before
thrombolytic therapy is considered, which diagnostic study is particularly
important to distinguish ischemic stroke from intracranial hemorrhage?
A. Noncontrast CT of the head
B. Abdominal ultrasound
C. Chest radiograph
D. Bone scan
Answer: A
11. A client with increased intracranial pressure is being monitored in the intensive
care unit. Which assessment finding should the nurse recognize as particularly
concerning for neurological deterioration?
, 4|Page
A. Mild headache relieved by prescribed medication
B. Increasing level of consciousness and decreasing responsiveness
C. Stable pupil size and equal reaction to light
D. Improved orientation to person and place
Answer: B
12. A client with Parkinson's disease has bradykinesia, rigidity, and difficulty
initiating movement. Which nursing intervention would BEST promote
independence and safety?
A. Complete all activities for the client to prevent fatigue.
B. Encourage rapid movements to overcome rigidity.
C. Allow additional time for activities and provide appropriate assistive devices.
D. Restrict physical activity to prevent muscle deterioration.
Answer: C
13. A client with multiple sclerosis reports worsening fatigue after prolonged
physical activity. Which instruction should the nurse emphasize?
A. Exercise continuously until severe fatigue develops.
B. Schedule activities with rest periods and avoid excessive heat.
C. Avoid all physical activity to prevent disease progression.
D. Increase environmental temperature during exercise.
Answer: B
14. A client with acute kidney injury has a rapidly increasing serum creatinine,
decreased urine output, peripheral edema, and hyperkalemia. Which finding
requires the nurse's MOST immediate attention?
A. Serum potassium of 6.4 mEq/L with electrocardiographic changes
B. Mild dependent edema
C. Decreased appetite
D. Serum creatinine above the client's baseline
Answer: A
WGU D446 – Adult Health II Objective Assessment | OA V1
and V2 | Questions and Answers – 2026 Update | 100%
Correct.
1. A client with acute decompensated heart failure suddenly develops severe
dyspnea, bilateral crackles extending into the upper lung fields, pink frothy
sputum, an oxygen saturation of 82%, and marked anxiety. Which intervention
should the nurse prioritize?
A. Encourage oral fluids to maintain adequate circulating volume.
B. Place the client in a high-Fowler position and administer oxygen as prescribed.
C. Place the client flat with the legs elevated above the level of the heart.
D. Encourage ambulation to improve pulmonary circulation.
Answer: B
2. A client with chronic left-sided heart failure reports increasing fatigue and
difficulty breathing when lying flat and has gained 3 kg over the past several days.
Which assessment finding would most strongly support worsening left-sided heart
failure?
A. Distended abdomen and dependent peripheral edema
B. Jugular venous distention with hepatomegaly
C. Bilateral pulmonary crackles with orthopnea
D. Increased urinary output and decreased respiratory rate
Answer: C
3. A client with atrial fibrillation is receiving warfarin therapy. Which laboratory
result is MOST important for the nurse to monitor when evaluating the therapeutic
effect and bleeding risk associated with this medication?
A. Troponin I
B. INR
C. Serum potassium
D. Creatine kinase
Answer: B
,2|Page
4. A client arrives in the emergency department reporting crushing substernal chest
pressure radiating to the left arm, diaphoresis, nausea, and shortness of breath that
began 45 minutes ago. Which action should the nurse anticipate as a priority in the
initial management?
A. Encourage the client to ambulate to determine whether the pain improves.
B. Administer aspirin as prescribed after assessing for contraindications.
C. Provide a high-fat meal to prevent medication-related nausea.
D. Delay cardiac evaluation until the pain has been present for several hours.
Answer: B
5. A client with COPD has an oxygen saturation of 86% and increasing dyspnea.
The nurse administers supplemental oxygen as prescribed. Which finding requires
the MOST immediate reassessment?
A. Mildly increased respiratory rate
B. Improved ability to speak in complete sentences
C. New confusion and increasing lethargy
D. Oxygen saturation increasing toward the prescribed target
Answer: C
6. A client is experiencing an acute asthma exacerbation with audible wheezing,
respiratory distress, and difficulty speaking in complete sentences. Which
prescribed medication should the nurse anticipate administering first for rapid
bronchodilation?
A. Albuterol
B. Montelukast
C. Salmeterol
D. Fluticasone
Answer: A
7. A client develops sudden dyspnea, pleuritic chest pain, tachycardia, and oxygen
desaturation several days after major orthopedic surgery. Which complication
should the nurse suspect FIRST?
A. Pulmonary embolism
B. Chronic bronchitis
,3|Page
C. Stable angina
D. Left-sided heart failure
Answer: A
8. A client with a chest tube following treatment for a pneumothorax is being
assessed by the nurse. Which finding requires immediate intervention?
A. Tidaling in the water-seal chamber
B. Small amount of drainage documented during the shift
C. Continuous bubbling in the water-seal chamber
D. Mild discomfort at the insertion site
Answer: C
9. A client arrives with sudden right-sided weakness, facial drooping, difficulty
speaking, and an unknown time of symptom onset. Which intervention is the
nurse's priority?
A. Give oral fluids to prevent dehydration.
B. Determine the last-known-well time and prepare for rapid neurologic evaluation
and brain imaging.
C. Administer a sedative to prevent seizure activity.
D. Encourage the client to walk to determine the extent of weakness.
Answer: B
10. A client is being evaluated for possible acute ischemic stroke. Before
thrombolytic therapy is considered, which diagnostic study is particularly
important to distinguish ischemic stroke from intracranial hemorrhage?
A. Noncontrast CT of the head
B. Abdominal ultrasound
C. Chest radiograph
D. Bone scan
Answer: A
11. A client with increased intracranial pressure is being monitored in the intensive
care unit. Which assessment finding should the nurse recognize as particularly
concerning for neurological deterioration?
, 4|Page
A. Mild headache relieved by prescribed medication
B. Increasing level of consciousness and decreasing responsiveness
C. Stable pupil size and equal reaction to light
D. Improved orientation to person and place
Answer: B
12. A client with Parkinson's disease has bradykinesia, rigidity, and difficulty
initiating movement. Which nursing intervention would BEST promote
independence and safety?
A. Complete all activities for the client to prevent fatigue.
B. Encourage rapid movements to overcome rigidity.
C. Allow additional time for activities and provide appropriate assistive devices.
D. Restrict physical activity to prevent muscle deterioration.
Answer: C
13. A client with multiple sclerosis reports worsening fatigue after prolonged
physical activity. Which instruction should the nurse emphasize?
A. Exercise continuously until severe fatigue develops.
B. Schedule activities with rest periods and avoid excessive heat.
C. Avoid all physical activity to prevent disease progression.
D. Increase environmental temperature during exercise.
Answer: B
14. A client with acute kidney injury has a rapidly increasing serum creatinine,
decreased urine output, peripheral edema, and hyperkalemia. Which finding
requires the nurse's MOST immediate attention?
A. Serum potassium of 6.4 mEq/L with electrocardiographic changes
B. Mild dependent edema
C. Decreased appetite
D. Serum creatinine above the client's baseline
Answer: A
