D446 Objective Assessment – WGU Adult Health II OA
(2026/2027) Actual Questions & Study Guide |
Guarantee Pass
250 QUESTIONS
TABLE OF CONTENTS
# TOPIC
1 Cardiovascular
2 Respiratory
3 Renal
4 Endocrine
5 Gastrointestinal
6 Neurological
7 Musculoskeletal
8 Hematologic & Oncologic
9 Immune & Infectious
10 Perioperative & Emergency
,Q1
A client with heart failure is prescribed spironolactone. Which laboratory value requires immediate
notification of the provider?
A) Potassium 4.0 mEq/L
B) Potassium 5.8 mEq/L CORRECT
C) Sodium 138 mEq/L
D) Creatinine 1.0 mg/dL
Rationale
Spironolactone is potassium-sparing; hyperkalemia >5.5 mEq/L can cause arrhythmias.
Q2
A client with COPD is using a metered-dose inhaler (MDI) with a spacer. Which action indicates
correct technique?
A) Inhale rapidly after pressing the canister
B) Inhale slowly and deeply over 3-5 seconds CORRECT
C) Exhale into the spacer before inhaling
D) Use the MDI without shaking it
Rationale
Slow, deep inhalation ensures proper drug deposition in the airways.
Q3
A client with acute kidney injury has a urine output of 20 mL/hr. Which finding is most
concerning?
A) Blood urea nitrogen 30 mg/dL
B) Serum potassium 6.2 mEq/L CORRECT
C) Serum sodium 135 mEq/L
2
,D) Creatinine 1.8 mg/dL
Rationale
Hyperkalemia is a life-threatening complication of AKI; requires immediate treatment.
Q4
A client with diabetes mellitus type 1 is found unresponsive with a blood glucose of 28 mg/dL.
Which action should the nurse take first?
A) Give oral glucose gel
B) Administer glucagon IM CORRECT
C) Start an IV with D5W
D) Notify the provider
Rationale
Unconscious hypoglycemia requires glucagon IM if no IV access; D50W IV if available.
Q5
A client with a pulmonary embolism is receiving alteplase. Which finding requires immediate
discontinuation of the infusion?
A) Blood pressure 110/70 mmHg
B) Sudden severe headache and confusion CORRECT
C) Heart rate 100 bpm
D) Oxygen saturation 94%
Rationale
These signs suggest intracranial hemorrhage, a major complication of thrombolytics.
3
, Q6
A client with cirrhosis has a serum ammonia level of 150 mcg/dL. Which finding is most consistent
with this value?
A) Bradycardia
B) Asterixis (flapping tremor) CORRECT
C) Hypertension
D) Hyperreflexia
Rationale
Elevated ammonia causes hepatic encephalopathy with asterixis, confusion, and lethargy.
Q7
A client with a stroke has right-sided hemiparesis. Which finding is most concerning for increased
intracranial pressure?
A) Blood pressure 140/80 mmHg
B) Decerebrate posturing CORRECT
C) Pupils equal and reactive
D) Glasgow Coma Scale 15
Rationale
Decerebrate posturing indicates severe brainstem damage and increased ICP.
Q8
A client with pneumonia has a fever of 38.9°C and a productive cough. Which intervention is
priority?
A) Administer antipyretics
B) Encourage coughing and deep breathing CORRECT
C) Provide a cool compress
4
(2026/2027) Actual Questions & Study Guide |
Guarantee Pass
250 QUESTIONS
TABLE OF CONTENTS
# TOPIC
1 Cardiovascular
2 Respiratory
3 Renal
4 Endocrine
5 Gastrointestinal
6 Neurological
7 Musculoskeletal
8 Hematologic & Oncologic
9 Immune & Infectious
10 Perioperative & Emergency
,Q1
A client with heart failure is prescribed spironolactone. Which laboratory value requires immediate
notification of the provider?
A) Potassium 4.0 mEq/L
B) Potassium 5.8 mEq/L CORRECT
C) Sodium 138 mEq/L
D) Creatinine 1.0 mg/dL
Rationale
Spironolactone is potassium-sparing; hyperkalemia >5.5 mEq/L can cause arrhythmias.
Q2
A client with COPD is using a metered-dose inhaler (MDI) with a spacer. Which action indicates
correct technique?
A) Inhale rapidly after pressing the canister
B) Inhale slowly and deeply over 3-5 seconds CORRECT
C) Exhale into the spacer before inhaling
D) Use the MDI without shaking it
Rationale
Slow, deep inhalation ensures proper drug deposition in the airways.
Q3
A client with acute kidney injury has a urine output of 20 mL/hr. Which finding is most
concerning?
A) Blood urea nitrogen 30 mg/dL
B) Serum potassium 6.2 mEq/L CORRECT
C) Serum sodium 135 mEq/L
2
,D) Creatinine 1.8 mg/dL
Rationale
Hyperkalemia is a life-threatening complication of AKI; requires immediate treatment.
Q4
A client with diabetes mellitus type 1 is found unresponsive with a blood glucose of 28 mg/dL.
Which action should the nurse take first?
A) Give oral glucose gel
B) Administer glucagon IM CORRECT
C) Start an IV with D5W
D) Notify the provider
Rationale
Unconscious hypoglycemia requires glucagon IM if no IV access; D50W IV if available.
Q5
A client with a pulmonary embolism is receiving alteplase. Which finding requires immediate
discontinuation of the infusion?
A) Blood pressure 110/70 mmHg
B) Sudden severe headache and confusion CORRECT
C) Heart rate 100 bpm
D) Oxygen saturation 94%
Rationale
These signs suggest intracranial hemorrhage, a major complication of thrombolytics.
3
, Q6
A client with cirrhosis has a serum ammonia level of 150 mcg/dL. Which finding is most consistent
with this value?
A) Bradycardia
B) Asterixis (flapping tremor) CORRECT
C) Hypertension
D) Hyperreflexia
Rationale
Elevated ammonia causes hepatic encephalopathy with asterixis, confusion, and lethargy.
Q7
A client with a stroke has right-sided hemiparesis. Which finding is most concerning for increased
intracranial pressure?
A) Blood pressure 140/80 mmHg
B) Decerebrate posturing CORRECT
C) Pupils equal and reactive
D) Glasgow Coma Scale 15
Rationale
Decerebrate posturing indicates severe brainstem damage and increased ICP.
Q8
A client with pneumonia has a fever of 38.9°C and a productive cough. Which intervention is
priority?
A) Administer antipyretics
B) Encourage coughing and deep breathing CORRECT
C) Provide a cool compress
4
