WGU D444 ADULT HEALTH I (OA) EXAM
QUESTIONS AND CORRECT VERIFIED ANSWERS
WITH RATIONALES 100% GUARANTEED PASS!!
<LATEST VERSION>
1. A nurse is caring for a 68-year-old client admitted with community-acquired
pneumonia. The client has a temperature of 39.1°C (102.4°F), productive cough,
crackles in the right lower lobe, and a WBC count of 17,800/mm³. A prescription
for IV antibiotics has been entered. Which action should the nurse take first?
A. Administer the prescribed antibiotic
B. Obtain a sputum specimen for culture and sensitivity
C. Encourage the client to use the incentive spirometer
D. Place the client in a supine position for rest
Answer: B
Rationale: A sputum specimen for culture and sensitivity should be obtained
before antibiotics are administered when possible so the causative organism can
be identified accurately and antibiotic therapy can be appropriately targeted.
Oxygenation and positioning remain important, but obtaining the culture before
antimicrobial therapy is the priority when both can be accomplished promptly.
,2. A client with severe COPD has an oxygen saturation of 84% while receiving
oxygen at 2 L/min via nasal cannula. The client is dyspneic but alert and able to
speak in complete sentences. Which nursing action is most appropriate?
A. Discontinue oxygen because excessive oxygen can suppress respiratory drive
B. Increase oxygen until the saturation reaches 100%
C. Titrate oxygen to achieve a saturation of approximately 88%–92%
D. Place the client on a nonrebreather mask at 15 L/min
Answer: C
Rationale: For many clients with COPD who are at risk for chronic CO₂ retention,
controlled oxygen therapy commonly targets an SpO₂ of approximately 88%–
92%. Oxygen should not be withheld because of concern about respiratory-drive
suppression, nor should it automatically be increased to 100%.
3. A client with asthma develops wheezing, chest tightness, and increasing
difficulty exhaling after exposure to a known trigger. Which prescribed medication
should the nurse expect to administer for rapid relief?
A. Montelukast
B. Fluticasone
C. Albuterol
D. Salmeterol
Answer: C
Rationale: Albuterol, a short-acting β₂-adrenergic agonist, is a rapid-acting rescue
medication used to relieve acute bronchospasm. Inhaled corticosteroids such as
fluticasone are controller medications rather than immediate rescue therapy.
,4. A nurse assesses four clients on a medical-surgical unit. Which client should the
nurse evaluate first?
A. A client with right-sided heart failure and 2+ ankle edema
B. A client with pneumonia whose temperature is 38.2°C (100.8°F)
C. A client with left-sided heart failure who has new-onset severe dyspnea and
bilateral crackles
D. A client with COPD who reports a chronic productive cough
Answer: C
Rationale: New severe dyspnea accompanied by bilateral crackles suggests acute
pulmonary congestion associated with left-sided heart failure and represents an
immediate oxygenation threat. The other findings are clinically important but do
not indicate the same degree of immediate respiratory compromise.
5. Which assessment finding most strongly indicates right-sided heart failure?
A. Bibasilar crackles
B. Orthopnea
C. Pink frothy sputum
D. Jugular venous distention and dependent edema
Answer: D
Rationale: Right-sided heart failure causes systemic venous congestion,
commonly manifested by JVD, peripheral/dependent edema, hepatomegaly,
and weight gain. Left-sided failure more characteristically produces pulmonary
congestion such as crackles, dyspnea, and orthopnea.
, 6. A client with a history of myocardial infarction suddenly develops hypotension,
muffled heart sounds, and distended neck veins. Which complication should the
nurse suspect?
A. Pulmonary embolism
B. Cardiac tamponade
C. Left-sided heart failure
D. Aortic dissection
Answer: B
Rationale: The combination of hypotension, muffled heart sounds, and jugular
venous distention is Beck's triad, which is strongly associated with cardiac
tamponade. Fluid accumulating in the pericardial space restricts ventricular filling
and decreases cardiac output.
7. A client arrives in the emergency department with crushing substernal chest pain
that began 30 minutes ago. The ECG shows changes consistent with acute
myocardial infarction. Which intervention is appropriate as part of initial
management?
A. Encourage ambulation to assess exercise tolerance
B. Administer prescribed aspirin unless contraindicated
C. Give a high-fat meal to prevent hypoglycemia
D. Delay treatment until cardiac enzymes are resulted
Answer: B
Rationale: Aspirin is an important early treatment for suspected acute coronary
syndrome when there is no contraindication because it inhibits platelet aggregation.
Treatment should not be delayed while awaiting laboratory confirmation.
QUESTIONS AND CORRECT VERIFIED ANSWERS
WITH RATIONALES 100% GUARANTEED PASS!!
<LATEST VERSION>
1. A nurse is caring for a 68-year-old client admitted with community-acquired
pneumonia. The client has a temperature of 39.1°C (102.4°F), productive cough,
crackles in the right lower lobe, and a WBC count of 17,800/mm³. A prescription
for IV antibiotics has been entered. Which action should the nurse take first?
A. Administer the prescribed antibiotic
B. Obtain a sputum specimen for culture and sensitivity
C. Encourage the client to use the incentive spirometer
D. Place the client in a supine position for rest
Answer: B
Rationale: A sputum specimen for culture and sensitivity should be obtained
before antibiotics are administered when possible so the causative organism can
be identified accurately and antibiotic therapy can be appropriately targeted.
Oxygenation and positioning remain important, but obtaining the culture before
antimicrobial therapy is the priority when both can be accomplished promptly.
,2. A client with severe COPD has an oxygen saturation of 84% while receiving
oxygen at 2 L/min via nasal cannula. The client is dyspneic but alert and able to
speak in complete sentences. Which nursing action is most appropriate?
A. Discontinue oxygen because excessive oxygen can suppress respiratory drive
B. Increase oxygen until the saturation reaches 100%
C. Titrate oxygen to achieve a saturation of approximately 88%–92%
D. Place the client on a nonrebreather mask at 15 L/min
Answer: C
Rationale: For many clients with COPD who are at risk for chronic CO₂ retention,
controlled oxygen therapy commonly targets an SpO₂ of approximately 88%–
92%. Oxygen should not be withheld because of concern about respiratory-drive
suppression, nor should it automatically be increased to 100%.
3. A client with asthma develops wheezing, chest tightness, and increasing
difficulty exhaling after exposure to a known trigger. Which prescribed medication
should the nurse expect to administer for rapid relief?
A. Montelukast
B. Fluticasone
C. Albuterol
D. Salmeterol
Answer: C
Rationale: Albuterol, a short-acting β₂-adrenergic agonist, is a rapid-acting rescue
medication used to relieve acute bronchospasm. Inhaled corticosteroids such as
fluticasone are controller medications rather than immediate rescue therapy.
,4. A nurse assesses four clients on a medical-surgical unit. Which client should the
nurse evaluate first?
A. A client with right-sided heart failure and 2+ ankle edema
B. A client with pneumonia whose temperature is 38.2°C (100.8°F)
C. A client with left-sided heart failure who has new-onset severe dyspnea and
bilateral crackles
D. A client with COPD who reports a chronic productive cough
Answer: C
Rationale: New severe dyspnea accompanied by bilateral crackles suggests acute
pulmonary congestion associated with left-sided heart failure and represents an
immediate oxygenation threat. The other findings are clinically important but do
not indicate the same degree of immediate respiratory compromise.
5. Which assessment finding most strongly indicates right-sided heart failure?
A. Bibasilar crackles
B. Orthopnea
C. Pink frothy sputum
D. Jugular venous distention and dependent edema
Answer: D
Rationale: Right-sided heart failure causes systemic venous congestion,
commonly manifested by JVD, peripheral/dependent edema, hepatomegaly,
and weight gain. Left-sided failure more characteristically produces pulmonary
congestion such as crackles, dyspnea, and orthopnea.
, 6. A client with a history of myocardial infarction suddenly develops hypotension,
muffled heart sounds, and distended neck veins. Which complication should the
nurse suspect?
A. Pulmonary embolism
B. Cardiac tamponade
C. Left-sided heart failure
D. Aortic dissection
Answer: B
Rationale: The combination of hypotension, muffled heart sounds, and jugular
venous distention is Beck's triad, which is strongly associated with cardiac
tamponade. Fluid accumulating in the pericardial space restricts ventricular filling
and decreases cardiac output.
7. A client arrives in the emergency department with crushing substernal chest pain
that began 30 minutes ago. The ECG shows changes consistent with acute
myocardial infarction. Which intervention is appropriate as part of initial
management?
A. Encourage ambulation to assess exercise tolerance
B. Administer prescribed aspirin unless contraindicated
C. Give a high-fat meal to prevent hypoglycemia
D. Delay treatment until cardiac enzymes are resulted
Answer: B
Rationale: Aspirin is an important early treatment for suspected acute coronary
syndrome when there is no contraindication because it inhibits platelet aggregation.
Treatment should not be delayed while awaiting laboratory confirmation.
