WGU D446 Adult Health II OA Exam | 200 Practice Questions
& Detailed Answers | Objective Assessment Study Guide | A+
Graded
SECTION 1: CARDIOVASCULAR DISORDERS (Questions 1–35)
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
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
,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 medication immediately
B) Instruct the client to apply sunscreen daily
C) Document as a common side effect and continue monitoring
D) Prepare for thyroid function testing
Answer: C
Explanation: Bluishgray skin discoloration (amiodaroneinduced pigment change) is a known side effect
of longterm amiodarone use and is usually harmless, though cosmetically concerning. It is not a reason
to discontinue the drug unless other serious adverse effects develop.
4. A client with chronic atrial fibrillation is prescribed warfarin. Which lab value requires immediate
intervention?
A) INR 2.5
B) aPTT 35 seconds
C) Platelets 150,000/mm³
D) INR 4.8
Answer: D
Explanation: An INR of 4.8 indicates a high risk of bleeding. The target INR for atrial fibrillation is typically
2.0–3.0. An INR above 4.5 may require holding the next dose, administering vitamin K, or even using
fresh frozen plasma depending on the patient's clinical situation.
,5. Postcardiac catheterization, the nurse assesses the femoral insertion site. Which finding is most
concerning?
A) Small 2cm bruise
B) Patient reports mild discomfort
C) Slight oozing with pressure
D) Expanding hematoma with loss of distal pulse
Answer: D
Explanation: An expanding hematoma with loss of distal pulse indicates arterial bleeding and
compromised perfusion. This is a medical emergency requiring immediate intervention. A small bruise,
mild discomfort, and slight oozing are expected findings.
6. A client presents with chest pain that is persistent, accompanied by diaphoresis and nausea. Troponin
levels are elevated. This presentation is most consistent with:
A) Stable angina
B) Myocardial infarction (MI)
C) Musculoskeletal chest pain
D) Gastroesophageal reflux disease (GERD)
Answer: B
Explanation: Persistent chest pain with diaphoresis, nausea, and elevated troponin is characteristic of
myocardial infarction (MI). Unlike angina, MI pain is not relieved by rest and is associated with cardiac
biomarker elevation.
7. A client with leftsided heart failure would most likely exhibit which symptom?
, A) Dyspnea and orthopnea
B) Peripheral edema
C) Jugular venous distension
D) Ascites
Answer: A
Explanation: Leftsided heart failure results in pulmonary congestion, causing dyspnea, orthopnea, and
crackles. Peripheral edema, JVD, and ascites are characteristic of rightsided heart failure.
8. Which medication is classified as a potassiumsparing diuretic?
A) Furosemide
B) Spironolactone
C) Hydrochlorothiazide
D) Bumetanide
Answer: B
Explanation: Spironolactone is a potassiumsparing diuretic. Furosemide, hydrochlorothiazide, and
bumetanide are potassiumwasting diuretics.
9. A client with heart failure is prescribed an ACE inhibitor. Which adverse effect should the nurse
monitor for?
A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hypoglycemia
& Detailed Answers | Objective Assessment Study Guide | A+
Graded
SECTION 1: CARDIOVASCULAR DISORDERS (Questions 1–35)
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
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
,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 medication immediately
B) Instruct the client to apply sunscreen daily
C) Document as a common side effect and continue monitoring
D) Prepare for thyroid function testing
Answer: C
Explanation: Bluishgray skin discoloration (amiodaroneinduced pigment change) is a known side effect
of longterm amiodarone use and is usually harmless, though cosmetically concerning. It is not a reason
to discontinue the drug unless other serious adverse effects develop.
4. A client with chronic atrial fibrillation is prescribed warfarin. Which lab value requires immediate
intervention?
A) INR 2.5
B) aPTT 35 seconds
C) Platelets 150,000/mm³
D) INR 4.8
Answer: D
Explanation: An INR of 4.8 indicates a high risk of bleeding. The target INR for atrial fibrillation is typically
2.0–3.0. An INR above 4.5 may require holding the next dose, administering vitamin K, or even using
fresh frozen plasma depending on the patient's clinical situation.
,5. Postcardiac catheterization, the nurse assesses the femoral insertion site. Which finding is most
concerning?
A) Small 2cm bruise
B) Patient reports mild discomfort
C) Slight oozing with pressure
D) Expanding hematoma with loss of distal pulse
Answer: D
Explanation: An expanding hematoma with loss of distal pulse indicates arterial bleeding and
compromised perfusion. This is a medical emergency requiring immediate intervention. A small bruise,
mild discomfort, and slight oozing are expected findings.
6. A client presents with chest pain that is persistent, accompanied by diaphoresis and nausea. Troponin
levels are elevated. This presentation is most consistent with:
A) Stable angina
B) Myocardial infarction (MI)
C) Musculoskeletal chest pain
D) Gastroesophageal reflux disease (GERD)
Answer: B
Explanation: Persistent chest pain with diaphoresis, nausea, and elevated troponin is characteristic of
myocardial infarction (MI). Unlike angina, MI pain is not relieved by rest and is associated with cardiac
biomarker elevation.
7. A client with leftsided heart failure would most likely exhibit which symptom?
, A) Dyspnea and orthopnea
B) Peripheral edema
C) Jugular venous distension
D) Ascites
Answer: A
Explanation: Leftsided heart failure results in pulmonary congestion, causing dyspnea, orthopnea, and
crackles. Peripheral edema, JVD, and ascites are characteristic of rightsided heart failure.
8. Which medication is classified as a potassiumsparing diuretic?
A) Furosemide
B) Spironolactone
C) Hydrochlorothiazide
D) Bumetanide
Answer: B
Explanation: Spironolactone is a potassiumsparing diuretic. Furosemide, hydrochlorothiazide, and
bumetanide are potassiumwasting diuretics.
9. A client with heart failure is prescribed an ACE inhibitor. Which adverse effect should the nurse
monitor for?
A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hypoglycemia
