WGU D446 Adult Health 2 OA Exam | Latest Update
2026/2027 | 200 Questions and Verified Answers | NGNStyle
Q&A | A+ Graded
SECTION 1: CARDIOVASCULAR DISORDERS (Questions 135)
1. A nurse is assessing a client with acute decompensated heart failure (ADHF). Which finding is most
concerning?
A) +2 pitting edema in lower extremities
B) Jugular venous distension (JVD) at 45 degrees
C) Paroxysmal nocturnal dyspnea (PND)
D) Crackles audible to the midscapular region
Answer: D) Crackles audible to the midscapular region
Explanation: Crackles that extend to the midscapular region indicate severe, widespread pulmonary
edema, signifying imminent respiratory compromise. While peripheral edema, JVD, and PND are
important signs of fluid overload, they are not as immediately lifethreatening as extensive pulmonary
edema.
2. A client with infective endocarditis develops sudden leftsided weakness and slurred speech. What is
the priority action?
A) Administer aspirin 325 mg PO
B) Obtain a STAT CT scan of the head
C) Check blood glucose level
D) Reorient the client to person, place, time
Answer: B) Obtain a STAT CT scan of the head
,Explanation: The client is likely experiencing an embolic stroke from a vegetation fragment. A STAT CT
scan is required to rule out hemorrhage before any thrombolytics or anticoagulation can be considered.
Aspirin could worsen a hemorrhagic stroke.
3. A client on amiodarone for atrial fibrillation reports new bluishgray discoloration on the face. Which
action is most appropriate?
A) Discontinue the amiodarone immediately
B) Document the finding and continue to monitor
C) Notify the healthcare provider of this adverse effect
D) Apply a topical cream to the affected area
Answer: C) Notify the healthcare provider of this adverse effect
Explanation: Bluishgray discoloration of the skin (slategray cyanosis) is a known adverse effect of
longterm amiodarone therapy due to iodine deposition in the skin. The healthcare provider should be
notified for evaluation.
4. A client is admitted with acute myocardial infarction (MI). Which medication from the MONA protocol
should the nurse administer first?
A) Morphine
B) Oxygen
C) Nitroglycerin
D) Aspirin
Answer: D) Aspirin
,Explanation: The MONA protocol (Morphine, Oxygen, Nitroglycerin, Aspirin) is the standard for MI
management; however, aspirin is the priority to prevent further clot formation. If the patient is not
hypoxic, oxygen may not be needed.
5. Which symptom is characteristic of leftsided heart failure?
A) Peripheral edema
B) Jugular venous distension
C) Dyspnea and crackles
D) Ascites
Answer: C) Dyspnea and crackles
Explanation: Leftsided heart failure results in pulmonary congestion, leading to pulmonary symptoms
such as dyspnea, orthopnea, and crackles. Rightsided heart failure produces peripheral symptoms
including edema, ascites, and JVD.
6. A client with heart failure is prescribed furosemide. Which laboratory value should the nurse monitor
most closely?
A) Sodium
B) Potassium
C) Calcium
D) Magnesium
Answer: B) Potassium
Explanation: Furosemide is a potassiumwasting diuretic. The nurse should monitor serum potassium
levels closely for hypokalemia, which can lead to cardiac arrhythmias.
, 7. A client is prescribed spironolactone for heart failure. Which statement indicates the client
understands the medication teaching?
A) "I should eat plenty of bananas and oranges"
B) "I should avoid salt substitutes"
C) "I can stop taking this medication if I feel better"
D) "This medication will make me urinate frequently"
Answer: B) "I should avoid salt substitutes"
Explanation: Spironolactone is a potassiumsparing diuretic. Salt substitutes often contain potassium and
should be avoided to prevent hyperkalemia. Bananas and oranges are high in potassium and should be
limited.
8. A client with unstable angina reports chest pain. Which finding differentiates this from a myocardial
infarction?
A) Pain relieved with rest
B) Pain lasting longer than 20 minutes
C) Elevated troponin levels
D) Diaphoresis and nausea
Answer: C) Elevated troponin levels
Explanation: Myocardial infarction is differentiated from angina by elevated cardiac biomarkers
(troponin), persistent pain, and diaphoresis. Unstable angina may have prolonged pain but troponin
levels remain normal.
2026/2027 | 200 Questions and Verified Answers | NGNStyle
Q&A | A+ Graded
SECTION 1: CARDIOVASCULAR DISORDERS (Questions 135)
1. A nurse is assessing a client with acute decompensated heart failure (ADHF). Which finding is most
concerning?
A) +2 pitting edema in lower extremities
B) Jugular venous distension (JVD) at 45 degrees
C) Paroxysmal nocturnal dyspnea (PND)
D) Crackles audible to the midscapular region
Answer: D) Crackles audible to the midscapular region
Explanation: Crackles that extend to the midscapular region indicate severe, widespread pulmonary
edema, signifying imminent respiratory compromise. While peripheral edema, JVD, and PND are
important signs of fluid overload, they are not as immediately lifethreatening as extensive pulmonary
edema.
2. A client with infective endocarditis develops sudden leftsided weakness and slurred speech. What is
the priority action?
A) Administer aspirin 325 mg PO
B) Obtain a STAT CT scan of the head
C) Check blood glucose level
D) Reorient the client to person, place, time
Answer: B) Obtain a STAT CT scan of the head
,Explanation: The client is likely experiencing an embolic stroke from a vegetation fragment. A STAT CT
scan is required to rule out hemorrhage before any thrombolytics or anticoagulation can be considered.
Aspirin could worsen a hemorrhagic stroke.
3. A client on amiodarone for atrial fibrillation reports new bluishgray discoloration on the face. Which
action is most appropriate?
A) Discontinue the amiodarone immediately
B) Document the finding and continue to monitor
C) Notify the healthcare provider of this adverse effect
D) Apply a topical cream to the affected area
Answer: C) Notify the healthcare provider of this adverse effect
Explanation: Bluishgray discoloration of the skin (slategray cyanosis) is a known adverse effect of
longterm amiodarone therapy due to iodine deposition in the skin. The healthcare provider should be
notified for evaluation.
4. A client is admitted with acute myocardial infarction (MI). Which medication from the MONA protocol
should the nurse administer first?
A) Morphine
B) Oxygen
C) Nitroglycerin
D) Aspirin
Answer: D) Aspirin
,Explanation: The MONA protocol (Morphine, Oxygen, Nitroglycerin, Aspirin) is the standard for MI
management; however, aspirin is the priority to prevent further clot formation. If the patient is not
hypoxic, oxygen may not be needed.
5. Which symptom is characteristic of leftsided heart failure?
A) Peripheral edema
B) Jugular venous distension
C) Dyspnea and crackles
D) Ascites
Answer: C) Dyspnea and crackles
Explanation: Leftsided heart failure results in pulmonary congestion, leading to pulmonary symptoms
such as dyspnea, orthopnea, and crackles. Rightsided heart failure produces peripheral symptoms
including edema, ascites, and JVD.
6. A client with heart failure is prescribed furosemide. Which laboratory value should the nurse monitor
most closely?
A) Sodium
B) Potassium
C) Calcium
D) Magnesium
Answer: B) Potassium
Explanation: Furosemide is a potassiumwasting diuretic. The nurse should monitor serum potassium
levels closely for hypokalemia, which can lead to cardiac arrhythmias.
, 7. A client is prescribed spironolactone for heart failure. Which statement indicates the client
understands the medication teaching?
A) "I should eat plenty of bananas and oranges"
B) "I should avoid salt substitutes"
C) "I can stop taking this medication if I feel better"
D) "This medication will make me urinate frequently"
Answer: B) "I should avoid salt substitutes"
Explanation: Spironolactone is a potassiumsparing diuretic. Salt substitutes often contain potassium and
should be avoided to prevent hyperkalemia. Bananas and oranges are high in potassium and should be
limited.
8. A client with unstable angina reports chest pain. Which finding differentiates this from a myocardial
infarction?
A) Pain relieved with rest
B) Pain lasting longer than 20 minutes
C) Elevated troponin levels
D) Diaphoresis and nausea
Answer: C) Elevated troponin levels
Explanation: Myocardial infarction is differentiated from angina by elevated cardiac biomarkers
(troponin), persistent pain, and diaphoresis. Unstable angina may have prolonged pain but troponin
levels remain normal.
