WGU D027 OA – ADVANCED PRACTICE TEST (FULL&REALISTIC
QUESTIONS AND ANSWERS WITH SUFFICIENT RATIONALES) <A
REASSURING DOCUMENT TO YOUR DESIRED GRADE!!>
1. Beta-Blocker Safety
A 58-year-old patient with hypertension and a history of asthma is prescribed propranolol. During a
follow-up visit, the patient reports increased shortness of breath and wheezing. Which action should the
nurse take?
A. Reassure the patient that this is an expected side effect
B. Advise the patient to continue medication and use inhaler as needed
C. Notify the provider and anticipate a change to a selective beta-blocker
D. Instruct the patient to double the dose for better BP control
Answer: C
Rationale: Non-selective beta-blockers (like propranolol) can cause bronchoconstriction, worsening
asthma.
2. ACE Inhibitors
A patient taking lisinopril reports a persistent dry cough. What is the best nursing response?
A. “This indicates lung infection.”
B. “This is a common side effect; provider may change medication.”
C. “Stop medication immediately without consulting provider.”
D. “Increase fluid intake only.”
Answer: B
Rationale: ACE inhibitors commonly cause dry cough due to bradykinin accumulation.
3. Digoxin Toxicity
A patient on digoxin presents with nausea, bradycardia (HR 48), and blurred vision. What is the priority
action?
A. Administer next dose as scheduled
B. Hold medication and notify provider
C. Encourage fluids
D. Administer potassium supplements immediately
Answer: B
Rationale: Signs of digoxin toxicity → hold drug.
4. Warfarin Therapy
,A patient on warfarin has an INR of 5.5. What should the nurse anticipate?
A. Continue medication
B. Administer vitamin K
C. Increase dose
D. Encourage leafy greens
Answer: B
Rationale: High INR → bleeding risk → vitamin K reversal.
5. Insulin Administration
A patient receives regular insulin IV. Which outcome indicates effectiveness?
A. Increased potassium
B. Decreased blood glucose
C. Increased BP
D. Increased appetite
Answer: B
Rationale: Insulin lowers blood glucose levels.
6. Opioid Overdose
A patient receiving morphine becomes unresponsive with RR 6/min. What is priority?
A. Administer naloxone
B. Increase oxygen only
C. Call family
D. Document findings
Answer: A
Rationale: Naloxone reverses opioid-induced respiratory depression.
7. Antibiotic Therapy
A patient stops antibiotics early when symptoms improve. Nurse response?
A. “That’s fine.”
B. “Restart only if symptoms return.”
C. “Complete full course to prevent resistance.”
D. “Take double next time.”
Answer: C
Rationale: Prevents antibiotic resistance.
8. Heparin Monitoring
, Which lab monitors heparin therapy?
A. INR
B. PT
C. aPTT
D. Platelets only
Answer: C
Rationale: Heparin → monitored by aPTT.
9. Corticosteroids
Long-term prednisone use requires monitoring for:
A. Hypoglycemia
B. Infection risk
C. Bradycardia
D. Dehydration
Answer: B
Rationale: Steroids suppress immune system.
10. Potassium Imbalance
A patient on furosemide reports weakness. What lab is priority?
A. Sodium
B. Potassium
C. Calcium
D. Glucose
Answer: B
Rationale: Loop diuretics cause hypokalemia.
11. Antidepressants (SSRIs)
Which symptom indicates serotonin syndrome?
A. Bradycardia
B. Hyperthermia and agitation
C. Hypotension
D. Constipation
Answer: B
Rationale: Life-threatening serotonin excess.
12. Lithium Therapy
QUESTIONS AND ANSWERS WITH SUFFICIENT RATIONALES) <A
REASSURING DOCUMENT TO YOUR DESIRED GRADE!!>
1. Beta-Blocker Safety
A 58-year-old patient with hypertension and a history of asthma is prescribed propranolol. During a
follow-up visit, the patient reports increased shortness of breath and wheezing. Which action should the
nurse take?
A. Reassure the patient that this is an expected side effect
B. Advise the patient to continue medication and use inhaler as needed
C. Notify the provider and anticipate a change to a selective beta-blocker
D. Instruct the patient to double the dose for better BP control
Answer: C
Rationale: Non-selective beta-blockers (like propranolol) can cause bronchoconstriction, worsening
asthma.
2. ACE Inhibitors
A patient taking lisinopril reports a persistent dry cough. What is the best nursing response?
A. “This indicates lung infection.”
B. “This is a common side effect; provider may change medication.”
C. “Stop medication immediately without consulting provider.”
D. “Increase fluid intake only.”
Answer: B
Rationale: ACE inhibitors commonly cause dry cough due to bradykinin accumulation.
3. Digoxin Toxicity
A patient on digoxin presents with nausea, bradycardia (HR 48), and blurred vision. What is the priority
action?
A. Administer next dose as scheduled
B. Hold medication and notify provider
C. Encourage fluids
D. Administer potassium supplements immediately
Answer: B
Rationale: Signs of digoxin toxicity → hold drug.
4. Warfarin Therapy
,A patient on warfarin has an INR of 5.5. What should the nurse anticipate?
A. Continue medication
B. Administer vitamin K
C. Increase dose
D. Encourage leafy greens
Answer: B
Rationale: High INR → bleeding risk → vitamin K reversal.
5. Insulin Administration
A patient receives regular insulin IV. Which outcome indicates effectiveness?
A. Increased potassium
B. Decreased blood glucose
C. Increased BP
D. Increased appetite
Answer: B
Rationale: Insulin lowers blood glucose levels.
6. Opioid Overdose
A patient receiving morphine becomes unresponsive with RR 6/min. What is priority?
A. Administer naloxone
B. Increase oxygen only
C. Call family
D. Document findings
Answer: A
Rationale: Naloxone reverses opioid-induced respiratory depression.
7. Antibiotic Therapy
A patient stops antibiotics early when symptoms improve. Nurse response?
A. “That’s fine.”
B. “Restart only if symptoms return.”
C. “Complete full course to prevent resistance.”
D. “Take double next time.”
Answer: C
Rationale: Prevents antibiotic resistance.
8. Heparin Monitoring
, Which lab monitors heparin therapy?
A. INR
B. PT
C. aPTT
D. Platelets only
Answer: C
Rationale: Heparin → monitored by aPTT.
9. Corticosteroids
Long-term prednisone use requires monitoring for:
A. Hypoglycemia
B. Infection risk
C. Bradycardia
D. Dehydration
Answer: B
Rationale: Steroids suppress immune system.
10. Potassium Imbalance
A patient on furosemide reports weakness. What lab is priority?
A. Sodium
B. Potassium
C. Calcium
D. Glucose
Answer: B
Rationale: Loop diuretics cause hypokalemia.
11. Antidepressants (SSRIs)
Which symptom indicates serotonin syndrome?
A. Bradycardia
B. Hyperthermia and agitation
C. Hypotension
D. Constipation
Answer: B
Rationale: Life-threatening serotonin excess.
12. Lithium Therapy
