,D444 Adult Health I Exam Prep — Comprehensive
Review + Practice MCQs — Western Governors
University 2025/2026
1. A nurse is caring for a client who develops sudden shortness of breath and chest pain. Which action should
the nurse take first?
A. Administer morphine sulfate
B. Obtain a 12-lead ECG
C. Apply supplemental oxygen
D. Notify the healthcare provider
Correct Answer: C. Apply supplemental oxygen
Rationale: Using the ABC framework, oxygenation is the priority. Sudden shortness of breath and chest pain
may indicate myocardial infarction or pulmonary embolism. Applying oxygen first addresses potential
hypoxemia while preparing for further diagnostic measures .
2. A client with acute decompensated heart failure presents with severe dyspnea, bilateral crackles, oxygen
saturation of 86% on room air, and pink frothy sputum. Which action is the priority?
A. Administer IV furosemide
B. Place the client in high Fowler's position and administer oxygen
C. Obtain a chest X-ray
D. Administer morphine sulfate
Correct Answer: B. Place the client in high Fowler's position and administer oxygen
,Rationale: Pink frothy sputum indicates pulmonary edema. Immediate interventions include positioning the
client upright to improve ventilation and administering oxygen to correct hypoxemia. These are the most
immediate ABC interventions .
3. A client with chronic heart failure has gained 3 kg in the past 2 days. Which finding is most important to
report to the provider?
A. Heart rate 88/min
B. Respiratory rate 20/min
C. Weight gain of 3 kg in 2 days
D. Blood pressure 110/70 mm Hg
Correct Answer: C. Weight gain of 3 kg in 2 days
Rationale: Rapid weight gain (greater than 2–3 pounds in 24 hours or 5 pounds in a week) indicates fluid
retention and worsening heart failure. This requires prompt intervention to prevent acute decompensation .
4. A nurse is assessing a client with suspected fluid volume excess. Which findings should the nurse expect?
(Select all that apply.)
A. Distended neck veins
B. Hypotension
C. Crackles in the lungs
D. Weight loss
E. Bounding pulse
, Correct Answer: A, C, E
Rationale: Fluid volume excess manifests with distended neck veins, crackles in the lungs, bounding pulse,
hypertension, and weight gain. Hypotension and weight loss indicate fluid deficit .
5. A client is experiencing malignant hyperthermia during surgery. Which medication should the nurse
anticipate administering?
A. Dantrolene
B. Epinephrine
C. Atropine
D. Sodium bicarbonate
Correct Answer: A. Dantrolene
Rationale: Malignant hyperthermia is a life-threatening reaction to certain anesthetic agents. Dantrolene is the
specific antidote that acts by inhibiting calcium release from the sarcoplasmic reticulum .
6. A nurse is verifying informed consent for a client scheduled for surgery. Which of the following is the nurse's
primary responsibility?
A. Explaining the surgical procedure to the client
B. Witnessing the client's signature and ensuring voluntary consent
C. Obtaining the surgeon's signature
D. Determining the client's competence to consent
Review + Practice MCQs — Western Governors
University 2025/2026
1. A nurse is caring for a client who develops sudden shortness of breath and chest pain. Which action should
the nurse take first?
A. Administer morphine sulfate
B. Obtain a 12-lead ECG
C. Apply supplemental oxygen
D. Notify the healthcare provider
Correct Answer: C. Apply supplemental oxygen
Rationale: Using the ABC framework, oxygenation is the priority. Sudden shortness of breath and chest pain
may indicate myocardial infarction or pulmonary embolism. Applying oxygen first addresses potential
hypoxemia while preparing for further diagnostic measures .
2. A client with acute decompensated heart failure presents with severe dyspnea, bilateral crackles, oxygen
saturation of 86% on room air, and pink frothy sputum. Which action is the priority?
A. Administer IV furosemide
B. Place the client in high Fowler's position and administer oxygen
C. Obtain a chest X-ray
D. Administer morphine sulfate
Correct Answer: B. Place the client in high Fowler's position and administer oxygen
,Rationale: Pink frothy sputum indicates pulmonary edema. Immediate interventions include positioning the
client upright to improve ventilation and administering oxygen to correct hypoxemia. These are the most
immediate ABC interventions .
3. A client with chronic heart failure has gained 3 kg in the past 2 days. Which finding is most important to
report to the provider?
A. Heart rate 88/min
B. Respiratory rate 20/min
C. Weight gain of 3 kg in 2 days
D. Blood pressure 110/70 mm Hg
Correct Answer: C. Weight gain of 3 kg in 2 days
Rationale: Rapid weight gain (greater than 2–3 pounds in 24 hours or 5 pounds in a week) indicates fluid
retention and worsening heart failure. This requires prompt intervention to prevent acute decompensation .
4. A nurse is assessing a client with suspected fluid volume excess. Which findings should the nurse expect?
(Select all that apply.)
A. Distended neck veins
B. Hypotension
C. Crackles in the lungs
D. Weight loss
E. Bounding pulse
, Correct Answer: A, C, E
Rationale: Fluid volume excess manifests with distended neck veins, crackles in the lungs, bounding pulse,
hypertension, and weight gain. Hypotension and weight loss indicate fluid deficit .
5. A client is experiencing malignant hyperthermia during surgery. Which medication should the nurse
anticipate administering?
A. Dantrolene
B. Epinephrine
C. Atropine
D. Sodium bicarbonate
Correct Answer: A. Dantrolene
Rationale: Malignant hyperthermia is a life-threatening reaction to certain anesthetic agents. Dantrolene is the
specific antidote that acts by inhibiting calcium release from the sarcoplasmic reticulum .
6. A nurse is verifying informed consent for a client scheduled for surgery. Which of the following is the nurse's
primary responsibility?
A. Explaining the surgical procedure to the client
B. Witnessing the client's signature and ensuring voluntary consent
C. Obtaining the surgeon's signature
D. Determining the client's competence to consent
