1
WGU D444 ADULT HEALTH 1 OA 2026 | V1 &
V2 Objective Assessment | 100% Correct
Answers | Pass Guaranteed - A+ Graded
Section 1: Cardiovascular System Disorders (Questions 1-14)
Q1. A 58-year-old male with a history of hypertension presents to the clinic for a
follow-up visit. His current medications include lisinopril 10 mg daily and
hydrochlorothiazide 25 mg daily. His blood pressure today is 168/102 mmHg. He
reports occasional dizziness and a persistent dry cough. Which nursing
intervention is the priority?
A. Increase the hydrochlorothiazide dose to 50 mg daily
B. Add a calcium channel blocker to the regimen
C. Notify the provider about the dry cough and elevated BP for possible ACE inhibitor
discontinuation [CORRECT]
D. Advise the patient to reduce sodium intake and return in 3 months
Rationale: A persistent dry cough is a classic adverse effect of ACE inhibitors
(lisinopril). The elevated BP (168/102) indicates inadequate control. The nurse should
notify the provider, as the ACE inhibitor may need to be discontinued and replaced
with an ARB. Option A increases diuretic risk without addressing the cough. Option B
adds a third agent before evaluating the cough. Option D delays necessary
medication adjustment.
Correct Answer: C
,2
Q2. A nurse is caring for a patient admitted with acute decompensated heart
failure. The patient has crackles bilaterally, dyspnea at rest, and a weight gain of
4.5 kg over 3 days. Which assessment finding requires immediate intervention?
A. Oxygen saturation of 92% on 2 L nasal cannula
B. Urine output of 30 mL/hr
C. Development of pink, frothy sputum [CORRECT]
D. Blood pressure of 148/92 mmHg
Rationale: Pink, frothy sputum indicates acute pulmonary edema, a life-threatening
complication of decompensated heart failure requiring immediate intervention (e.g.,
high-flow oxygen, diuretics, morphine, nitrates). Option A is acceptable on low-flow
oxygen. Option B is low-normal but not emergent. Option D is elevated but stable.
Correct Answer: C
Q3. A patient with chronic heart failure is prescribed furosemide 40 mg PO twice
daily, lisinopril 5 mg daily, and carvedilol 3.125 mg twice daily. The nurse
provides discharge education. Which patient statement indicates understanding
of the medication regimen?
A. "I should take my furosemide at bedtime to avoid daytime urination."
B. "I will weigh myself every morning after urinating and before eating, and call if I
gain 2 pounds in one day." [CORRECT]
C. "I can stop the carvedilol if my heart rate drops below 60 beats per minute."
D. "I should increase my salt intake to replace what the diuretic removes."
Rationale: Daily morning weights (same time, same conditions) with a 2-3 lb gain in
one day or 5 lb in a week is standard heart failure self-monitoring. Option A is
incorrect—diuretics should be taken in the morning/early afternoon. Option C is
dangerous; beta-blockers should never be stopped abruptly. Option D is
contraindicated; sodium restriction is essential.
Correct Answer: B
,3
Q4. A 67-year-old patient with coronary artery disease reports chest pain
radiating to the left arm during exertion, relieved by rest and sublingual
nitroglycerin. The nurse is educating the patient about nitroglycerin use. Which
instruction is correct?
A. "Store nitroglycerin tablets in a clear plastic pillbox for easy access."
B. "If chest pain is not relieved after one tablet, call 911 immediately."
C. "Take nitroglycerin while sitting or lying down to prevent orthostatic hypotension."
[CORRECT]
D. "Nitroglycerin is effective for up to 2 years after the prescription is filled."
Rationale: Nitroglycerin causes vasodilation and can precipitate orthostatic
hypotension; patients should sit or lie down when taking it. Option A is incorrect—
nitroglycerin must be stored in the original dark, airtight container. Option B is
incorrect—up to 3 tablets may be taken 5 minutes apart before calling 911 (if pain
persists after 3 tablets, call 911). Option D is incorrect—nitroglycerin loses potency
after 6 months once the bottle is opened.
Correct Answer: C
Q5. A patient is admitted with an ST-elevation myocardial infarction (STEMI). The
emergency department nurse prepares for reperfusion therapy. Which action is
the priority within the first 90 minutes?
A. Administer morphine 2 mg IV for pain relief
B. Obtain a 12-lead ECG and activate the cardiac catheterization lab for percutaneous
coronary intervention (PCI) [CORRECT]
C. Begin thrombolytic therapy without waiting for cardiac catheterization availability
D. Start beta-blocker therapy orally to reduce myocardial oxygen demand
Rationale: The goal for STEMI is door-to-balloon time of ≤90 minutes. PCI is the
preferred reperfusion strategy when available within that window. Option A
addresses pain but is not the priority. Option C is incorrect—thrombolytics are
second-line when PCI cannot be performed within 120 minutes. Option D is
important but secondary to reperfusion.
Correct Answer: B
, 4
Q6. A nurse is monitoring a patient 24 hours post-MI who suddenly develops a
new systolic murmur at the apex, crackles in the lung bases, and hypotension.
Which complication should the nurse suspect?
A. Papillary muscle rupture causing acute mitral regurgitation [CORRECT]
B. Ventricular free wall rupture
C. Dressler's syndrome
D. Right ventricular infarction
Rationale: A new systolic murmur at the apex with pulmonary congestion and
hypotension 2-7 days post-MI suggests papillary muscle rupture and acute mitral
regurgitation. Option B (free wall rupture) presents with sudden cardiac tamponade
and electromechanical dissociation. Option C is a late pericarditis complication.
Option D presents with JVD and clear lungs, not crackles.
Correct Answer: A
Q7. A patient with stage C heart failure is prescribed spironolactone 25 mg daily.
Which laboratory value requires the most frequent monitoring?
A. Blood urea nitrogen (BUN)
B. Serum potassium [CORRECT]
C. Hemoglobin
D. Serum albumin
Rationale: Spironolactone is a potassium-sparing diuretic that can cause
hyperkalemia, especially in patients with renal impairment or those taking ACE
inhibitors. Serum potassium must be monitored closely. While BUN may be
monitored, hyperkalemia is the most dangerous and immediate risk. Options C and D
are not primary concerns with spironolactone.
Correct Answer: B
WGU D444 ADULT HEALTH 1 OA 2026 | V1 &
V2 Objective Assessment | 100% Correct
Answers | Pass Guaranteed - A+ Graded
Section 1: Cardiovascular System Disorders (Questions 1-14)
Q1. A 58-year-old male with a history of hypertension presents to the clinic for a
follow-up visit. His current medications include lisinopril 10 mg daily and
hydrochlorothiazide 25 mg daily. His blood pressure today is 168/102 mmHg. He
reports occasional dizziness and a persistent dry cough. Which nursing
intervention is the priority?
A. Increase the hydrochlorothiazide dose to 50 mg daily
B. Add a calcium channel blocker to the regimen
C. Notify the provider about the dry cough and elevated BP for possible ACE inhibitor
discontinuation [CORRECT]
D. Advise the patient to reduce sodium intake and return in 3 months
Rationale: A persistent dry cough is a classic adverse effect of ACE inhibitors
(lisinopril). The elevated BP (168/102) indicates inadequate control. The nurse should
notify the provider, as the ACE inhibitor may need to be discontinued and replaced
with an ARB. Option A increases diuretic risk without addressing the cough. Option B
adds a third agent before evaluating the cough. Option D delays necessary
medication adjustment.
Correct Answer: C
,2
Q2. A nurse is caring for a patient admitted with acute decompensated heart
failure. The patient has crackles bilaterally, dyspnea at rest, and a weight gain of
4.5 kg over 3 days. Which assessment finding requires immediate intervention?
A. Oxygen saturation of 92% on 2 L nasal cannula
B. Urine output of 30 mL/hr
C. Development of pink, frothy sputum [CORRECT]
D. Blood pressure of 148/92 mmHg
Rationale: Pink, frothy sputum indicates acute pulmonary edema, a life-threatening
complication of decompensated heart failure requiring immediate intervention (e.g.,
high-flow oxygen, diuretics, morphine, nitrates). Option A is acceptable on low-flow
oxygen. Option B is low-normal but not emergent. Option D is elevated but stable.
Correct Answer: C
Q3. A patient with chronic heart failure is prescribed furosemide 40 mg PO twice
daily, lisinopril 5 mg daily, and carvedilol 3.125 mg twice daily. The nurse
provides discharge education. Which patient statement indicates understanding
of the medication regimen?
A. "I should take my furosemide at bedtime to avoid daytime urination."
B. "I will weigh myself every morning after urinating and before eating, and call if I
gain 2 pounds in one day." [CORRECT]
C. "I can stop the carvedilol if my heart rate drops below 60 beats per minute."
D. "I should increase my salt intake to replace what the diuretic removes."
Rationale: Daily morning weights (same time, same conditions) with a 2-3 lb gain in
one day or 5 lb in a week is standard heart failure self-monitoring. Option A is
incorrect—diuretics should be taken in the morning/early afternoon. Option C is
dangerous; beta-blockers should never be stopped abruptly. Option D is
contraindicated; sodium restriction is essential.
Correct Answer: B
,3
Q4. A 67-year-old patient with coronary artery disease reports chest pain
radiating to the left arm during exertion, relieved by rest and sublingual
nitroglycerin. The nurse is educating the patient about nitroglycerin use. Which
instruction is correct?
A. "Store nitroglycerin tablets in a clear plastic pillbox for easy access."
B. "If chest pain is not relieved after one tablet, call 911 immediately."
C. "Take nitroglycerin while sitting or lying down to prevent orthostatic hypotension."
[CORRECT]
D. "Nitroglycerin is effective for up to 2 years after the prescription is filled."
Rationale: Nitroglycerin causes vasodilation and can precipitate orthostatic
hypotension; patients should sit or lie down when taking it. Option A is incorrect—
nitroglycerin must be stored in the original dark, airtight container. Option B is
incorrect—up to 3 tablets may be taken 5 minutes apart before calling 911 (if pain
persists after 3 tablets, call 911). Option D is incorrect—nitroglycerin loses potency
after 6 months once the bottle is opened.
Correct Answer: C
Q5. A patient is admitted with an ST-elevation myocardial infarction (STEMI). The
emergency department nurse prepares for reperfusion therapy. Which action is
the priority within the first 90 minutes?
A. Administer morphine 2 mg IV for pain relief
B. Obtain a 12-lead ECG and activate the cardiac catheterization lab for percutaneous
coronary intervention (PCI) [CORRECT]
C. Begin thrombolytic therapy without waiting for cardiac catheterization availability
D. Start beta-blocker therapy orally to reduce myocardial oxygen demand
Rationale: The goal for STEMI is door-to-balloon time of ≤90 minutes. PCI is the
preferred reperfusion strategy when available within that window. Option A
addresses pain but is not the priority. Option C is incorrect—thrombolytics are
second-line when PCI cannot be performed within 120 minutes. Option D is
important but secondary to reperfusion.
Correct Answer: B
, 4
Q6. A nurse is monitoring a patient 24 hours post-MI who suddenly develops a
new systolic murmur at the apex, crackles in the lung bases, and hypotension.
Which complication should the nurse suspect?
A. Papillary muscle rupture causing acute mitral regurgitation [CORRECT]
B. Ventricular free wall rupture
C. Dressler's syndrome
D. Right ventricular infarction
Rationale: A new systolic murmur at the apex with pulmonary congestion and
hypotension 2-7 days post-MI suggests papillary muscle rupture and acute mitral
regurgitation. Option B (free wall rupture) presents with sudden cardiac tamponade
and electromechanical dissociation. Option C is a late pericarditis complication.
Option D presents with JVD and clear lungs, not crackles.
Correct Answer: A
Q7. A patient with stage C heart failure is prescribed spironolactone 25 mg daily.
Which laboratory value requires the most frequent monitoring?
A. Blood urea nitrogen (BUN)
B. Serum potassium [CORRECT]
C. Hemoglobin
D. Serum albumin
Rationale: Spironolactone is a potassium-sparing diuretic that can cause
hyperkalemia, especially in patients with renal impairment or those taking ACE
inhibitors. Serum potassium must be monitored closely. While BUN may be
monitored, hyperkalemia is the most dangerous and immediate risk. Options C and D
are not primary concerns with spironolactone.
Correct Answer: B
