WGU D444 ADULT HEALTH II (OA) EXAM
ACTUAL EXAM QUESTIONS AND CORRECT VERIFIED
ANSWERS WITH RATIONALES 100% GUARANTEED PASS!!
<LATEST VERSION>
1. A nurse is caring for four clients on a medical-surgical unit. Which client should
the nurse assess first?
A. A client with heart failure who has 2+ bilateral ankle edema and a potassium
level of 3.4 mEq/L
B. A client with COPD whose oxygen saturation is 90% on 2 L/min by nasal
cannula and reports mild exertional dyspnea
C. A client with asthma who is increasingly restless, has minimal air movement
bilaterally, and can speak only one or two words at a time
D. A client with chronic kidney disease whose blood pressure is 168/92 mm Hg
and reports a mild headache
Answer: C
Rationale: Minimal or absent air movement in a client with severe asthma may
indicate critically reduced airflow, sometimes described as a “silent chest.”
Restlessness, inability to speak normally, and worsening respiratory effort suggest
impending respiratory failure. Airway and breathing take priority over the other
findings.
,2. A client with severe asthma has received repeated nebulized albuterol
treatments. Initially, the arterial blood gas results were pH 7.48, PaCO₂ 30 mm Hg,
and PaO₂ 72 mm Hg. Two hours later, the results are pH 7.36, PaCO₂ 43 mm Hg,
and PaO₂ 68 mm Hg. Which interpretation is most appropriate?
A. The client is improving because the PaCO₂ is approaching normal
B. The client may be tiring and developing ventilatory failure
C. The client has developed metabolic alkalosis from albuterol
D. The client has adequate ventilation because the pH remains within the normal
range
Answer: B
Rationale: In a severe asthma exacerbation, patients commonly hyperventilate
initially, producing a low PaCO₂. A rising PaCO₂ toward normal or above normal
can indicate respiratory muscle fatigue and worsening ventilation. The trend is
more concerning than the apparently normal pH.
3. A client with chronic obstructive pulmonary disease is receiving oxygen at 6
L/min by nasal cannula. The client becomes increasingly drowsy. The oxygen
saturation is 98%. Which action should the nurse take first?
A. Increase the oxygen flow rate
B. Position the client supine
C. Assess respiratory status and notify the provider about the change in condition
D. Encourage the client to ambulate to improve ventilation
Answer: C
Rationale: A sudden change in level of consciousness in a client with COPD can
reflect worsening ventilation and carbon dioxide retention. The nurse should
immediately reassess respiratory status and escalate care as indicated. Oxygen
should be carefully titrated to the prescribed target rather than automatically
increased.
,4. A client with COPD has poor appetite, dyspnea while eating, and an
unintentional 6-kg weight loss over the past several months. Which meal plan
should the nurse recommend?
A. Three large meals high in carbohydrates
B. Small, frequent meals that are high in calories and protein
C. Three meals consisting primarily of clear liquids
D. High-volume meals with increased fluid intake during meals
Answer: B
Rationale: Eating can increase oxygen consumption and fatigue in clients with
advanced COPD. Small, frequent, energy-dense meals can improve nutritional
intake while reducing the work associated with large meals. Adequate protein
supports maintenance of muscle mass.
5. A client arrives in the emergency department reporting crushing substernal chest
pain that began 30 minutes ago. The client is pale and diaphoretic. Which
prescription should the nurse anticipate administering promptly, assuming no
contraindication is present?
A. Oral aspirin
B. Warfarin
C. Digoxin
D. Potassium chloride
Answer: A
Rationale: Aspirin is an important early treatment for suspected acute coronary
syndrome because it inhibits platelet aggregation. Rapid treatment helps reduce
further thrombus formation. Other medications may be appropriate depending on
the clinical situation but are not the initial antiplatelet intervention.
, 6. A client with suspected acute myocardial infarction has a troponin level that is
significantly above the laboratory reference range. The client asks why this test is
important. Which response by the nurse is most accurate?
A. “Troponin directly measures how much fluid is in your bloodstream.”
B. “Troponin increases when myocardial cells are injured.”
C. “Troponin measures how effectively your ventricles contract.”
D. “Troponin determines whether your heart rhythm is regular.”
Answer: B
Rationale: Cardiac troponins are biomarkers released into the bloodstream when
myocardial cells are injured. An elevated troponin supports the diagnosis of
myocardial injury when interpreted with the clinical presentation and other
diagnostic findings.
7. A client with left-sided heart failure suddenly develops severe dyspnea, bilateral
crackles, and pink, frothy sputum. Which action has the highest priority?
A. Place the client in high-Fowler position and administer oxygen as prescribed
B. Encourage oral fluids to loosen pulmonary secretions
C. Place the client flat with the legs elevated
D. Obtain a daily weight before initiating treatment
Answer: A
Rationale: The findings are consistent with acute pulmonary edema, a life-
threatening manifestation of left-sided heart failure. Sitting upright improves lung
expansion and reduces venous return, while oxygen supports impaired gas
exchange. Immediate respiratory support takes priority over routine assessment
measures.
ACTUAL EXAM QUESTIONS AND CORRECT VERIFIED
ANSWERS WITH RATIONALES 100% GUARANTEED PASS!!
<LATEST VERSION>
1. A nurse is caring for four clients on a medical-surgical unit. Which client should
the nurse assess first?
A. A client with heart failure who has 2+ bilateral ankle edema and a potassium
level of 3.4 mEq/L
B. A client with COPD whose oxygen saturation is 90% on 2 L/min by nasal
cannula and reports mild exertional dyspnea
C. A client with asthma who is increasingly restless, has minimal air movement
bilaterally, and can speak only one or two words at a time
D. A client with chronic kidney disease whose blood pressure is 168/92 mm Hg
and reports a mild headache
Answer: C
Rationale: Minimal or absent air movement in a client with severe asthma may
indicate critically reduced airflow, sometimes described as a “silent chest.”
Restlessness, inability to speak normally, and worsening respiratory effort suggest
impending respiratory failure. Airway and breathing take priority over the other
findings.
,2. A client with severe asthma has received repeated nebulized albuterol
treatments. Initially, the arterial blood gas results were pH 7.48, PaCO₂ 30 mm Hg,
and PaO₂ 72 mm Hg. Two hours later, the results are pH 7.36, PaCO₂ 43 mm Hg,
and PaO₂ 68 mm Hg. Which interpretation is most appropriate?
A. The client is improving because the PaCO₂ is approaching normal
B. The client may be tiring and developing ventilatory failure
C. The client has developed metabolic alkalosis from albuterol
D. The client has adequate ventilation because the pH remains within the normal
range
Answer: B
Rationale: In a severe asthma exacerbation, patients commonly hyperventilate
initially, producing a low PaCO₂. A rising PaCO₂ toward normal or above normal
can indicate respiratory muscle fatigue and worsening ventilation. The trend is
more concerning than the apparently normal pH.
3. A client with chronic obstructive pulmonary disease is receiving oxygen at 6
L/min by nasal cannula. The client becomes increasingly drowsy. The oxygen
saturation is 98%. Which action should the nurse take first?
A. Increase the oxygen flow rate
B. Position the client supine
C. Assess respiratory status and notify the provider about the change in condition
D. Encourage the client to ambulate to improve ventilation
Answer: C
Rationale: A sudden change in level of consciousness in a client with COPD can
reflect worsening ventilation and carbon dioxide retention. The nurse should
immediately reassess respiratory status and escalate care as indicated. Oxygen
should be carefully titrated to the prescribed target rather than automatically
increased.
,4. A client with COPD has poor appetite, dyspnea while eating, and an
unintentional 6-kg weight loss over the past several months. Which meal plan
should the nurse recommend?
A. Three large meals high in carbohydrates
B. Small, frequent meals that are high in calories and protein
C. Three meals consisting primarily of clear liquids
D. High-volume meals with increased fluid intake during meals
Answer: B
Rationale: Eating can increase oxygen consumption and fatigue in clients with
advanced COPD. Small, frequent, energy-dense meals can improve nutritional
intake while reducing the work associated with large meals. Adequate protein
supports maintenance of muscle mass.
5. A client arrives in the emergency department reporting crushing substernal chest
pain that began 30 minutes ago. The client is pale and diaphoretic. Which
prescription should the nurse anticipate administering promptly, assuming no
contraindication is present?
A. Oral aspirin
B. Warfarin
C. Digoxin
D. Potassium chloride
Answer: A
Rationale: Aspirin is an important early treatment for suspected acute coronary
syndrome because it inhibits platelet aggregation. Rapid treatment helps reduce
further thrombus formation. Other medications may be appropriate depending on
the clinical situation but are not the initial antiplatelet intervention.
, 6. A client with suspected acute myocardial infarction has a troponin level that is
significantly above the laboratory reference range. The client asks why this test is
important. Which response by the nurse is most accurate?
A. “Troponin directly measures how much fluid is in your bloodstream.”
B. “Troponin increases when myocardial cells are injured.”
C. “Troponin measures how effectively your ventricles contract.”
D. “Troponin determines whether your heart rhythm is regular.”
Answer: B
Rationale: Cardiac troponins are biomarkers released into the bloodstream when
myocardial cells are injured. An elevated troponin supports the diagnosis of
myocardial injury when interpreted with the clinical presentation and other
diagnostic findings.
7. A client with left-sided heart failure suddenly develops severe dyspnea, bilateral
crackles, and pink, frothy sputum. Which action has the highest priority?
A. Place the client in high-Fowler position and administer oxygen as prescribed
B. Encourage oral fluids to loosen pulmonary secretions
C. Place the client flat with the legs elevated
D. Obtain a daily weight before initiating treatment
Answer: A
Rationale: The findings are consistent with acute pulmonary edema, a life-
threatening manifestation of left-sided heart failure. Sitting upright improves lung
expansion and reduces venous return, while oxygen supports impaired gas
exchange. Immediate respiratory support takes priority over routine assessment
measures.
