WGU D446 Adult Health II OA Study Guide |
Comprehensive Practice Tests, Correct Answers & Detailed
Explanations 2026/2027
Question 1
A patient with a severe traumatic brain injury develops Cushing's
triad. Which combination of clinical findings specifically characterizes
Cushing's triad?
• A. Hypertension with a widened pulse pressure, bradycardia, and
irregular respiratory patterns.
• B. Hypotension, tachycardia, and tachypnea.
• C. Hypertension with a narrowed pulse pressure, tachycardia, and
Kussmaul respirations.
• D. Hypotension, bradycardia, and shallow respirations.
Correct Answer: A. Hypertension with a widened pulse pressure,
bradycardia, and irregular respiratory patterns.
Detailed Rationale: Cushing's triad is a late sign of severely
elevated intracranial pressure (ICP) reflecting brainstem compression,
classically presenting as systolic hypertension with an expanding pulse
pressure, bradycardia, and irregular respirations.
Question 2
A patient weighing 80 kg sustained partial and full-thickness burns
over 40% of their total body surface area (TBSA). Using the consensus
,Parkland formula (4 mL/kg/% TBSA), what is the total volume of
lactated Ringer's solution required during the first 24 hours post-burn?
• A. 12,800 mL
• B. 6,400 mL
• C. 3,200 mL
• D. 25,600 mL
Correct Answer: A. 12,800 mL
Detailed Rationale: The Parkland formula is calculated as
4 mL × weight in kg × % TBSA. For this patient: 4 × 80 × 40 =
12,800 mL total over 24 hours (with the first half infused in the initial 8
hours).
Question 3
What are the immediate clinical manifestations of a tension
pneumothorax that require emergency needle decompression?
• A. Tracheal deviation away from the affected side, absent breath
sounds on the affected side, severe respiratory distress,
hemodynamic instability, and jugular venous distention.
• B. Tracheal deviation toward the affected side and bilateral equal
breath sounds.
• C. Bradycardia, hypertension, and equal chest wall expansion.
• D. Pinpoint pupils and lower extremity paralysis.
Correct Answer: A. Tracheal deviation away from the affected
side, absent breath sounds on the affected side, severe respiratory
distress, hemodynamic instability, and jugular venous distention.
, Detailed Rationale: A tension pneumothorax creates a one-way
valve trapping air in the pleural space, compressing mediastinal
structures, shifting the trachea, and collapsing venous return, causing
rapid obstructive shock.
Question 4
Which classic clinical findings comprise Beck's triad, indicating
cardiac tamponade?
• A. Hypotension, muffled heart sounds, and jugular venous
distention (JVD).
• B. Hypertension, bounding peripheral pulses, and clear breath
sounds.
• C. High fever, tachypnea, and right upper quadrant abdominal
pain.
• D. Tracheal deviation, unequal pupils, and bradycardia.
Correct Answer: A. Hypotension, muffled heart sounds, and
jugular venous distention (JVD).
Detailed Rationale: Beck's triad represents the classic
hemodynamic signs of cardiac tamponade where fluid in the pericardial
sac restricts ventricular filling and output, lowering blood pressure
while distending jugular veins and muffling heart tones.
Question 5
What is the immediate priority nursing action when a patient with
a T6 spinal cord injury reports a sudden, severe throbbing headache
and nasal congestion, and is found to have a blood pressure of 210/110
mmHg?
, • A. Immediately elevate the head of the bed, check for and
eliminate noxious stimuli (such as a distended bladder or tight
clothing), and administer rapid-acting antihypertensives.
• B. Place the patient flat in bed and administer oral pain
medication.
• C. Perform immediate deep tracheal suctioning without checking
vital signs.
• D. Encourage the patient to ambulate to lower blood pressure.
Correct Answer: A. Immediately elevate the head of the bed,
check for and eliminate noxious stimuli (such as a distended bladder or
tight clothing), and administer rapid-acting antihypertensives.
Detailed Rationale: These symptoms indicate autonomic
dysreflexia, a medical emergency triggered by a noxious stimulus below
the spinal lesion; raising the head utilizes orthostatic principles to
reduce intracranial/blood pressure while the trigger is found and
resolved.
Question 6
How do the clinical manifestations and responses to repetitive
nerve stimulation differentiate Myasthenia Gravis from Lambert-Eaton
Myasthenic Syndrome?
• A. Myasthenia Gravis causes weakness that worsens with
repetitive muscle use; Lambert-Eaton syndrome causes weakness
that improves temporarily with repetitive muscle use.
• B. Myasthenia Gravis strength improves with continuous exercise.
Comprehensive Practice Tests, Correct Answers & Detailed
Explanations 2026/2027
Question 1
A patient with a severe traumatic brain injury develops Cushing's
triad. Which combination of clinical findings specifically characterizes
Cushing's triad?
• A. Hypertension with a widened pulse pressure, bradycardia, and
irregular respiratory patterns.
• B. Hypotension, tachycardia, and tachypnea.
• C. Hypertension with a narrowed pulse pressure, tachycardia, and
Kussmaul respirations.
• D. Hypotension, bradycardia, and shallow respirations.
Correct Answer: A. Hypertension with a widened pulse pressure,
bradycardia, and irregular respiratory patterns.
Detailed Rationale: Cushing's triad is a late sign of severely
elevated intracranial pressure (ICP) reflecting brainstem compression,
classically presenting as systolic hypertension with an expanding pulse
pressure, bradycardia, and irregular respirations.
Question 2
A patient weighing 80 kg sustained partial and full-thickness burns
over 40% of their total body surface area (TBSA). Using the consensus
,Parkland formula (4 mL/kg/% TBSA), what is the total volume of
lactated Ringer's solution required during the first 24 hours post-burn?
• A. 12,800 mL
• B. 6,400 mL
• C. 3,200 mL
• D. 25,600 mL
Correct Answer: A. 12,800 mL
Detailed Rationale: The Parkland formula is calculated as
4 mL × weight in kg × % TBSA. For this patient: 4 × 80 × 40 =
12,800 mL total over 24 hours (with the first half infused in the initial 8
hours).
Question 3
What are the immediate clinical manifestations of a tension
pneumothorax that require emergency needle decompression?
• A. Tracheal deviation away from the affected side, absent breath
sounds on the affected side, severe respiratory distress,
hemodynamic instability, and jugular venous distention.
• B. Tracheal deviation toward the affected side and bilateral equal
breath sounds.
• C. Bradycardia, hypertension, and equal chest wall expansion.
• D. Pinpoint pupils and lower extremity paralysis.
Correct Answer: A. Tracheal deviation away from the affected
side, absent breath sounds on the affected side, severe respiratory
distress, hemodynamic instability, and jugular venous distention.
, Detailed Rationale: A tension pneumothorax creates a one-way
valve trapping air in the pleural space, compressing mediastinal
structures, shifting the trachea, and collapsing venous return, causing
rapid obstructive shock.
Question 4
Which classic clinical findings comprise Beck's triad, indicating
cardiac tamponade?
• A. Hypotension, muffled heart sounds, and jugular venous
distention (JVD).
• B. Hypertension, bounding peripheral pulses, and clear breath
sounds.
• C. High fever, tachypnea, and right upper quadrant abdominal
pain.
• D. Tracheal deviation, unequal pupils, and bradycardia.
Correct Answer: A. Hypotension, muffled heart sounds, and
jugular venous distention (JVD).
Detailed Rationale: Beck's triad represents the classic
hemodynamic signs of cardiac tamponade where fluid in the pericardial
sac restricts ventricular filling and output, lowering blood pressure
while distending jugular veins and muffling heart tones.
Question 5
What is the immediate priority nursing action when a patient with
a T6 spinal cord injury reports a sudden, severe throbbing headache
and nasal congestion, and is found to have a blood pressure of 210/110
mmHg?
, • A. Immediately elevate the head of the bed, check for and
eliminate noxious stimuli (such as a distended bladder or tight
clothing), and administer rapid-acting antihypertensives.
• B. Place the patient flat in bed and administer oral pain
medication.
• C. Perform immediate deep tracheal suctioning without checking
vital signs.
• D. Encourage the patient to ambulate to lower blood pressure.
Correct Answer: A. Immediately elevate the head of the bed,
check for and eliminate noxious stimuli (such as a distended bladder or
tight clothing), and administer rapid-acting antihypertensives.
Detailed Rationale: These symptoms indicate autonomic
dysreflexia, a medical emergency triggered by a noxious stimulus below
the spinal lesion; raising the head utilizes orthostatic principles to
reduce intracranial/blood pressure while the trigger is found and
resolved.
Question 6
How do the clinical manifestations and responses to repetitive
nerve stimulation differentiate Myasthenia Gravis from Lambert-Eaton
Myasthenic Syndrome?
• A. Myasthenia Gravis causes weakness that worsens with
repetitive muscle use; Lambert-Eaton syndrome causes weakness
that improves temporarily with repetitive muscle use.
• B. Myasthenia Gravis strength improves with continuous exercise.
