WGU D446 Adult Health II Final Exam | Comprehensive
Practice Questions, Answers & Detailed Rationales 2026/2027
Question 1
A patient in the intensive care unit has a pulmonary artery
catheter in place. Which hemodynamic parameter reflects the
resistance against which the left ventricle must pump to eject blood?
• A. Systemic vascular resistance (SVR)
• B. Pulmonary vascular resistance (PVR)
• C. Central venous pressure (CVP)
• D. Pulmonary artery wedge pressure (PAWP)
Correct Answer: A. Systemic vascular resistance (SVR)
Detailed Rationale: SVR measures the afterload of the left
ventricle, representing the vascular tone and resistance of the systemic
circulation. PVR measures right ventricular afterload, while CVP and
PAWP measure preload.
Question 2
What is the primary characteristic of Pressure Support Ventilation
(PSV)?
• A. The ventilator delivers a preset pressure to assist spontaneous
patient breaths, with the patient controlling respiratory rate,
inspiratory time, and tidal volume.
, • B. The ventilator delivers mandatory breaths at a fixed time
interval regardless of patient effort.
• C. The patient breathes entirely unassisted against continuous
negative airway pressure.
• D. The ventilator guarantees a fixed tidal volume by altering peak
airway pressure with every breath.
Correct Answer: A. The ventilator delivers a preset pressure to
assist spontaneous patient breaths, with the patient controlling
respiratory rate, inspiratory time, and tidal volume.
Detailed Rationale: PSV is a supportive mode where the patient
initiates every breath, and the ventilator provides a pre-set positive
pressure boost during inspiration to overcome the resistance of the
endotracheal tube and work of breathing.
Question 3
When leveling an external ventricular drain (EVD) connected to a
ventriculostomy for intracranial pressure (ICP) monitoring, where must
the transducer's zero reference point (the phlebostatic axis equivalent
for ICP) be positioned?
• A. Level with the foramen of Monro, typically referenced
externally at the tragus of the ear or the external auditory meatus.
• B. Level with the fourth intercostal space at the midaxillary line.
• C. Level with the superior sagittal sinus at the crown of the head.
• D. Level with the clavicular notch.
, Correct Answer: A. Level with the foramen of Monro, typically
referenced externally at the tragus of the ear or the external auditory
meatus.
Detailed Rationale: Accurate ICP measurement requires aligning
the EVD transducer with the foramen of Monro, clinically identified by
the external auditory meatus or tragus, to reflect true intracranial
pressure accurately.
Question 4
What is a mandatory exclusion criterion before administering
intravenous recombinant tissue plasminogen activator (rt-PA) to an
adult patient presenting with acute ischemic stroke symptoms?
• A. Blood pressure consistently exceeding 185/110 mmHg despite
medical management.
• B. Age greater than 60 years old.
• C. Blood glucose of 140 mg/dL.
• D. Mild unilateral facial droop.
Correct Answer: A. Blood pressure consistently exceeding
185/110 mmHg despite medical management.
Detailed Rationale: Severe hypertension (BP > 185/110 mmHg)
significantly increases the risk of intracranial hemorrhage following
thrombolytic therapy, making it a strict contraindication unless lowered
safely.
Question 5
, What clinical finding most reliably differentiates cardiac
tamponade from acute graft failure following coronary artery bypass
graft (CABG) surgery?
• A. Cardiac tamponade presents with muffled heart sounds, jugular
venous distention, and hypotension (Beck's triad), whereas acute
graft failure typically presents with acute regional wall motion
abnormalities, severe chest pain, and ischemic ECG changes.
• B. Cardiac tamponade presents with high fever and productive
cough.
• C. Acute graft failure presents with absent breath sounds and
tracheal deviation.
• D. Both conditions present with identical clinical and laboratory
profiles.
Correct Answer: A. Cardiac tamponade presents with muffled
heart sounds, jugular venous distention, and hypotension (Beck's triad),
whereas acute graft failure typically presents with acute regional wall
motion abnormalities, severe chest pain, and ischemic ECG changes.
Detailed Rationale: Tamponade is an obstructive mechanical
complication from pericardial fluid compression, whereas graft failure is
an ischemic coronary event manifesting with myocardial injury patterns
and heart failure.
Question 6
What diagnostic paracentesis result confirms Spontaneous
Bacterial Peritonitis (SBP) in a patient with cirrhosis and ascites?
Practice Questions, Answers & Detailed Rationales 2026/2027
Question 1
A patient in the intensive care unit has a pulmonary artery
catheter in place. Which hemodynamic parameter reflects the
resistance against which the left ventricle must pump to eject blood?
• A. Systemic vascular resistance (SVR)
• B. Pulmonary vascular resistance (PVR)
• C. Central venous pressure (CVP)
• D. Pulmonary artery wedge pressure (PAWP)
Correct Answer: A. Systemic vascular resistance (SVR)
Detailed Rationale: SVR measures the afterload of the left
ventricle, representing the vascular tone and resistance of the systemic
circulation. PVR measures right ventricular afterload, while CVP and
PAWP measure preload.
Question 2
What is the primary characteristic of Pressure Support Ventilation
(PSV)?
• A. The ventilator delivers a preset pressure to assist spontaneous
patient breaths, with the patient controlling respiratory rate,
inspiratory time, and tidal volume.
, • B. The ventilator delivers mandatory breaths at a fixed time
interval regardless of patient effort.
• C. The patient breathes entirely unassisted against continuous
negative airway pressure.
• D. The ventilator guarantees a fixed tidal volume by altering peak
airway pressure with every breath.
Correct Answer: A. The ventilator delivers a preset pressure to
assist spontaneous patient breaths, with the patient controlling
respiratory rate, inspiratory time, and tidal volume.
Detailed Rationale: PSV is a supportive mode where the patient
initiates every breath, and the ventilator provides a pre-set positive
pressure boost during inspiration to overcome the resistance of the
endotracheal tube and work of breathing.
Question 3
When leveling an external ventricular drain (EVD) connected to a
ventriculostomy for intracranial pressure (ICP) monitoring, where must
the transducer's zero reference point (the phlebostatic axis equivalent
for ICP) be positioned?
• A. Level with the foramen of Monro, typically referenced
externally at the tragus of the ear or the external auditory meatus.
• B. Level with the fourth intercostal space at the midaxillary line.
• C. Level with the superior sagittal sinus at the crown of the head.
• D. Level with the clavicular notch.
, Correct Answer: A. Level with the foramen of Monro, typically
referenced externally at the tragus of the ear or the external auditory
meatus.
Detailed Rationale: Accurate ICP measurement requires aligning
the EVD transducer with the foramen of Monro, clinically identified by
the external auditory meatus or tragus, to reflect true intracranial
pressure accurately.
Question 4
What is a mandatory exclusion criterion before administering
intravenous recombinant tissue plasminogen activator (rt-PA) to an
adult patient presenting with acute ischemic stroke symptoms?
• A. Blood pressure consistently exceeding 185/110 mmHg despite
medical management.
• B. Age greater than 60 years old.
• C. Blood glucose of 140 mg/dL.
• D. Mild unilateral facial droop.
Correct Answer: A. Blood pressure consistently exceeding
185/110 mmHg despite medical management.
Detailed Rationale: Severe hypertension (BP > 185/110 mmHg)
significantly increases the risk of intracranial hemorrhage following
thrombolytic therapy, making it a strict contraindication unless lowered
safely.
Question 5
, What clinical finding most reliably differentiates cardiac
tamponade from acute graft failure following coronary artery bypass
graft (CABG) surgery?
• A. Cardiac tamponade presents with muffled heart sounds, jugular
venous distention, and hypotension (Beck's triad), whereas acute
graft failure typically presents with acute regional wall motion
abnormalities, severe chest pain, and ischemic ECG changes.
• B. Cardiac tamponade presents with high fever and productive
cough.
• C. Acute graft failure presents with absent breath sounds and
tracheal deviation.
• D. Both conditions present with identical clinical and laboratory
profiles.
Correct Answer: A. Cardiac tamponade presents with muffled
heart sounds, jugular venous distention, and hypotension (Beck's triad),
whereas acute graft failure typically presents with acute regional wall
motion abnormalities, severe chest pain, and ischemic ECG changes.
Detailed Rationale: Tamponade is an obstructive mechanical
complication from pericardial fluid compression, whereas graft failure is
an ischemic coronary event manifesting with myocardial injury patterns
and heart failure.
Question 6
What diagnostic paracentesis result confirms Spontaneous
Bacterial Peritonitis (SBP) in a patient with cirrhosis and ascites?
