WGU D454 Adult Health III Objective Assessment –Verified Questions
& Answers with Detailed Rationales | 2026 Latest Study Guide
This WGU D454 Adult Health III study resource is built for nursing students preparing for the
Objective Assessment. It provides unique, exam-style questions with verified answers and
detailed rationales, covering cardiovascular, respiratory, neurological, renal,
gastrointestinal, musculoskeletal, oncological, perioperative, and emergency nursing topics.
Use it to practice under exam conditions, identify weak areas, and improve clinical judgment
for OA success.
1. A client with a history of heart failure is admitted with acute shortness
of breath, crackles in both lung bases, and an SpO₂ of 88% on room air.
Which nursing action should the nurse perform first?
A. Administer prescribed IV furosemide
B. Apply supplemental oxygen
C. Place the client in high Fowler's position
D. Obtain a stat chest X-ray
Answer: B. Apply supplemental oxygen
Explanation: The priority is to address airway, breathing, and
circulation (ABCs). Hypoxemia (SpO₂ 88%) is an immediate threat,
so applying oxygen is the first action before other interventions.
,2. A client with COPD is receiving oxygen at 2 L/min via nasal cannula. The
nurse notes the client has become increasingly somnolent. What is the
most likely cause?
A. The client is experiencing an opioid overdose
B. Oxygen-induced hypercarbia has occurred
C. The client is having a stroke
D. The client is experiencing hypoglycemia
Answer: B. Oxygen-induced hypercarbia has occurred
Explanation: In clients with COPD who retain CO₂, high oxygen levels
can suppress their hypoxic respiratory drive, leading to
hypoventilation and CO₂ narcosis.
3. A client receiving a continuous heparin infusion for a pulmonary
embolism has an aPTT of 110 seconds (therapeutic range 60–80 seconds).
What should the nurse do?
A. Increase the infusion rate as per protocol
B. Stop the infusion immediately and notify the provider
C. Slow the infusion rate and prepare to administer protamine sulfate
D. Continue the infusion at the current rate
Answer: B. Stop the infusion immediately and notify the provider
,Explanation: An aPTT of 110 seconds is significantly supratherapeutic
and indicates a high risk for bleeding. The infusion should be stopped
immediately.
4. A client with a major burn injury (40% TBSA) is in the
emergent/resuscitative phase. The nurse anticipates the client's
hematocrit level will be:
A. Increased due to hemoconcentration from fluid shifts
B. Decreased due to hypervolemia
C. Remain stable
D. Decreased due to immediate anemia from the burn
Answer: A. Increased due to hemoconcentration from fluid shifts
Explanation: In the emergent phase, fluid shifts from the
intravascular space into the interstitial space, causing
hemoconcentration and an increased hematocrit.
5. Which finding in a client with cirrhosis is most indicative of worsening
hepatic encephalopathy?
A. Asterixis (liver flap)
B. Jaundiced sclera
, C. Caput medusae
D. Palmar erythema
Answer: A. Asterixis (liver flap)
Explanation: Asterixis, a flapping tremor of the hands, is a classic
neurological sign of hepatic encephalopathy caused by the buildup of
ammonia.
6. A client is brought to the emergency department following a chemical
fire. The client verbalizes no pain in the right arm and the skin appears
charred. The nurse should document the depth of the burn on the client's
right arm as:
A. Superficial
B. Superficial partial-thickness
C. Deep partial-thickness
D. Full-thickness
Answer: D. Full-thickness
Explanation: A full-thickness burn (third-degree) destroys the
epidermis and dermis, leaving the skin charred, white, or leathery.
These burns are often painless because nerve endings have been
destroyed.
& Answers with Detailed Rationales | 2026 Latest Study Guide
This WGU D454 Adult Health III study resource is built for nursing students preparing for the
Objective Assessment. It provides unique, exam-style questions with verified answers and
detailed rationales, covering cardiovascular, respiratory, neurological, renal,
gastrointestinal, musculoskeletal, oncological, perioperative, and emergency nursing topics.
Use it to practice under exam conditions, identify weak areas, and improve clinical judgment
for OA success.
1. A client with a history of heart failure is admitted with acute shortness
of breath, crackles in both lung bases, and an SpO₂ of 88% on room air.
Which nursing action should the nurse perform first?
A. Administer prescribed IV furosemide
B. Apply supplemental oxygen
C. Place the client in high Fowler's position
D. Obtain a stat chest X-ray
Answer: B. Apply supplemental oxygen
Explanation: The priority is to address airway, breathing, and
circulation (ABCs). Hypoxemia (SpO₂ 88%) is an immediate threat,
so applying oxygen is the first action before other interventions.
,2. A client with COPD is receiving oxygen at 2 L/min via nasal cannula. The
nurse notes the client has become increasingly somnolent. What is the
most likely cause?
A. The client is experiencing an opioid overdose
B. Oxygen-induced hypercarbia has occurred
C. The client is having a stroke
D. The client is experiencing hypoglycemia
Answer: B. Oxygen-induced hypercarbia has occurred
Explanation: In clients with COPD who retain CO₂, high oxygen levels
can suppress their hypoxic respiratory drive, leading to
hypoventilation and CO₂ narcosis.
3. A client receiving a continuous heparin infusion for a pulmonary
embolism has an aPTT of 110 seconds (therapeutic range 60–80 seconds).
What should the nurse do?
A. Increase the infusion rate as per protocol
B. Stop the infusion immediately and notify the provider
C. Slow the infusion rate and prepare to administer protamine sulfate
D. Continue the infusion at the current rate
Answer: B. Stop the infusion immediately and notify the provider
,Explanation: An aPTT of 110 seconds is significantly supratherapeutic
and indicates a high risk for bleeding. The infusion should be stopped
immediately.
4. A client with a major burn injury (40% TBSA) is in the
emergent/resuscitative phase. The nurse anticipates the client's
hematocrit level will be:
A. Increased due to hemoconcentration from fluid shifts
B. Decreased due to hypervolemia
C. Remain stable
D. Decreased due to immediate anemia from the burn
Answer: A. Increased due to hemoconcentration from fluid shifts
Explanation: In the emergent phase, fluid shifts from the
intravascular space into the interstitial space, causing
hemoconcentration and an increased hematocrit.
5. Which finding in a client with cirrhosis is most indicative of worsening
hepatic encephalopathy?
A. Asterixis (liver flap)
B. Jaundiced sclera
, C. Caput medusae
D. Palmar erythema
Answer: A. Asterixis (liver flap)
Explanation: Asterixis, a flapping tremor of the hands, is a classic
neurological sign of hepatic encephalopathy caused by the buildup of
ammonia.
6. A client is brought to the emergency department following a chemical
fire. The client verbalizes no pain in the right arm and the skin appears
charred. The nurse should document the depth of the burn on the client's
right arm as:
A. Superficial
B. Superficial partial-thickness
C. Deep partial-thickness
D. Full-thickness
Answer: D. Full-thickness
Explanation: A full-thickness burn (third-degree) destroys the
epidermis and dermis, leaving the skin charred, white, or leathery.
These burns are often painless because nerve endings have been
destroyed.
