WGU D444
WGU D444 Adult Health 1 Objective Assessment |
OA V1 and V2 – 200 Questions and Answers | 2026
Update | 100% Correct.
SECTION 1: CARDIOVASCULAR DISORDERS (Questions 1-20)
Q1. A patient with heart failure has an ejection fraction of 35%. This indicates:
A) Preserved systolic function
B) Reduced systolic function (HFrEF)
C) Normal diastolic function
D) Severe valvular disease
Answer: B) Reduced systolic function (HFrEF)
Rationale: Normal ejection fraction (EF) is 55–70%. An EF of 35% indicates systolic heart failure
with reduced ejection fraction (HFrEF), meaning the left ventricle is not pumping effectively.
Treatment focuses on afterload reduction, diuresis, and inotropic support .
Q2. A patient with heart failure has jugular venous distention, 3+ pitting edema, and crackles in
the lung bases. Which medication should the nurse expect to administer first?
A) Digoxin
B) Furosemide
C) Metoprolol
D) Spironolactone
Answer: B) Furosemide
Rationale: Furosemide is a loop diuretic that rapidly reduces preload, relieving pulmonary
congestion and edema. Metoprolol is for chronic management .
Q3. A patient on amlodipine reports flushing and headache. What is the nurse's best response?
A) "These are expected side effects that often improve with time."
B) "Stop the medication immediately and call 911."
C) "You are having an allergic reaction."
D) "This indicates your blood pressure is now normal."
Answer: A) "These are expected side effects that often improve with time."
Rationale: Amlodipine is a calcium channel blocker that causes vasodilation, leading to flushing,
headache, and peripheral edema. These are common side effects that often diminish over time .
Q4. A patient with hypertension has a blood pressure of 210/120 and reports severe headache and
blurred vision. The nurse recognizes this as:
A) Benign hypertension
B) Hypertensive crisis with target organ damage
, WGU D444
C) Orthostatic hypotension
D) Medication non-adherence
Answer: B) Hypertensive crisis with target organ damage
Rationale: Severe hypertension (SBP >180 or DBP >120) with neurological symptoms such as
headache and blurred vision indicates a hypertensive emergency requiring immediate treatment
to prevent target organ damage .
Q5. A patient with hypertension is prescribed lisinopril. The nurse understands that this
medication works by which mechanism of action?
A) Blocking beta-adrenergic receptors
B) Inhibiting angiotensin-converting enzyme (ACE)
C) Blocking calcium channels in cardiac muscle
D) Decreasing sympathetic outflow from the CNS
Answer: B) Inhibiting angiotensin-converting enzyme (ACE)
Rationale: Lisinopril is an ACE inhibitor that blocks the conversion of angiotensin I to angiotensin II,
a potent vasoconstrictor, leading to vasodilation and decreased blood pressure .
Q6. A 65-year-old patient with heart failure is prescribed furosemide. Which lab value requires
immediate notification of the healthcare provider?
A) Sodium 138 mEq/L
B) Potassium 3.0 mEq/L
C) Calcium 9.2 mg/dL
D) Magnesium 2.0 mg/dL
Answer: B) Potassium 3.0 mEq/L
Rationale: Furosemide is a loop diuretic that causes potassium loss. A level of 3.0 mEq/L indicates
hypokalemia, which can lead to cardiac dysrhythmias (normal range is 3.5-5.0) .
Q7. A patient with a history of deep vein thrombosis (DVT) is on warfarin and reports black, tarry
stools. INR is 4.5. What is the priority action?
A) Administer vitamin K subcutaneously
B) Hold the next dose of warfarin
C) Check hemoglobin and hematocrit
D) Prepare for fresh frozen plasma
Answer: C) Check hemoglobin and hematocrit
Rationale: Black tarry stools suggest GI bleeding. Priority is to assess for hemodynamic
compromise (H&H, vitals). Then hold warfarin and consider reversal agents (vitamin K, FFP) after
assessment .
Q8. A patient with atrial fibrillation is at increased risk for which complication?
, WGU D444
A) Myocardial infarction
B) Stroke (thromboembolism)
C) Heart failure
D) Cardiac tamponade
Answer: B) Stroke (thromboembolism)
Rationale: Atrial fibrillation increases the risk of stroke due to thromboembolism from the left
atrium. Anticoagulation is indicated based on the patient's CHA₂DS₂-VASc score .
Q9. A patient with a pulmonary embolism is on a heparin drip. The aPTT is 110 seconds (control
30). What is the nurse's priority action?
A) Continue the infusion as ordered
B) Decrease the infusion rate
C) Stop the infusion and notify the provider
D) Administer protamine sulfate
Answer: C) Stop the infusion and notify the provider
Rationale: Therapeutic aPTT for heparin is typically 1.5-2.5 times the control value (45-75 seconds).
An aPTT of 110 seconds indicates an overdose with significant bleeding risk. The infusion should be
stopped and the provider notified .
Q10. A patient with heart failure is on a low-sodium diet. Which food choice indicates the patient
understands the dietary teaching?
A) Canned soup
B) Fresh fruits and vegetables
C) Processed cheese
D) Pickles
Answer: B) Fresh fruits and vegetables
Rationale: Fresh fruits and vegetables are naturally low in sodium. Canned soup, processed
cheese, and pickles are high in sodium and should be avoided on a low-sodium diet .
Q11. A patient with heart failure is experiencing dyspnea at rest. How should the nurse position
the patient?
A) Supine position
B) High-Fowler's position
C) Prone position
D) Left lateral position
Answer: B) High-Fowler's position
Rationale: High-Fowler's position (sitting upright) reduces venous return to the heart, decreases
pulmonary congestion, and improves breathing in patients with heart failure .
, WGU D444
Q12. A patient with a history of MI is prescribed a statin. The primary purpose of this medication is
to:
A) Reduce blood pressure
B) Lower LDL cholesterol
C) Prevent blood clots
D) Improve heart rate
Answer: B) Lower LDL cholesterol
Rationale: Statins are HMG-CoA reductase inhibitors that lower LDL cholesterol and reduce the risk
of cardiovascular events. They are a cornerstone of secondary prevention after MI .
Q13. A patient with hypertension is prescribed a beta-blocker. The nurse should monitor for which
side effect? A) Tachycardia
B) Bradycardia
C) Hypotension
D) Both B and C
Answer: D) Both B and C
Rationale: Beta-blockers decrease heart rate and cardiac output, leading to bradycardia and
hypotension. Patients should be monitored for dizziness, fatigue, and signs of heart block .
Q14. For suspected acute coronary syndrome, which intervention is the priority?
A) Administer morphine for pain
B) Obtain a 12-lead EKG
C) Administer aspirin
D) All of the above should be performed rapidly
Answer: D) All of the above should be performed rapidly
Rationale: Priority interventions for ACS include administering aspirin (antiplatelet), obtaining a
12-lead EKG, and administering nitroglycerin and morphine (if ordered) to relieve chest pain. All
actions should be performed rapidly .
Q15. A patient with infective endocarditis is at risk for which complication?
A) Heart failure
B) Systemic embolization
C) Both A and B
D) Pulmonary hypertension
Answer: C) Both A and B
Rationale: Infective endocarditis can lead to heart failure from valvular damage and systemic
embolization from vegetative lesions breaking off. Both are serious complications requiring close
monitoring .
WGU D444 Adult Health 1 Objective Assessment |
OA V1 and V2 – 200 Questions and Answers | 2026
Update | 100% Correct.
SECTION 1: CARDIOVASCULAR DISORDERS (Questions 1-20)
Q1. A patient with heart failure has an ejection fraction of 35%. This indicates:
A) Preserved systolic function
B) Reduced systolic function (HFrEF)
C) Normal diastolic function
D) Severe valvular disease
Answer: B) Reduced systolic function (HFrEF)
Rationale: Normal ejection fraction (EF) is 55–70%. An EF of 35% indicates systolic heart failure
with reduced ejection fraction (HFrEF), meaning the left ventricle is not pumping effectively.
Treatment focuses on afterload reduction, diuresis, and inotropic support .
Q2. A patient with heart failure has jugular venous distention, 3+ pitting edema, and crackles in
the lung bases. Which medication should the nurse expect to administer first?
A) Digoxin
B) Furosemide
C) Metoprolol
D) Spironolactone
Answer: B) Furosemide
Rationale: Furosemide is a loop diuretic that rapidly reduces preload, relieving pulmonary
congestion and edema. Metoprolol is for chronic management .
Q3. A patient on amlodipine reports flushing and headache. What is the nurse's best response?
A) "These are expected side effects that often improve with time."
B) "Stop the medication immediately and call 911."
C) "You are having an allergic reaction."
D) "This indicates your blood pressure is now normal."
Answer: A) "These are expected side effects that often improve with time."
Rationale: Amlodipine is a calcium channel blocker that causes vasodilation, leading to flushing,
headache, and peripheral edema. These are common side effects that often diminish over time .
Q4. A patient with hypertension has a blood pressure of 210/120 and reports severe headache and
blurred vision. The nurse recognizes this as:
A) Benign hypertension
B) Hypertensive crisis with target organ damage
, WGU D444
C) Orthostatic hypotension
D) Medication non-adherence
Answer: B) Hypertensive crisis with target organ damage
Rationale: Severe hypertension (SBP >180 or DBP >120) with neurological symptoms such as
headache and blurred vision indicates a hypertensive emergency requiring immediate treatment
to prevent target organ damage .
Q5. A patient with hypertension is prescribed lisinopril. The nurse understands that this
medication works by which mechanism of action?
A) Blocking beta-adrenergic receptors
B) Inhibiting angiotensin-converting enzyme (ACE)
C) Blocking calcium channels in cardiac muscle
D) Decreasing sympathetic outflow from the CNS
Answer: B) Inhibiting angiotensin-converting enzyme (ACE)
Rationale: Lisinopril is an ACE inhibitor that blocks the conversion of angiotensin I to angiotensin II,
a potent vasoconstrictor, leading to vasodilation and decreased blood pressure .
Q6. A 65-year-old patient with heart failure is prescribed furosemide. Which lab value requires
immediate notification of the healthcare provider?
A) Sodium 138 mEq/L
B) Potassium 3.0 mEq/L
C) Calcium 9.2 mg/dL
D) Magnesium 2.0 mg/dL
Answer: B) Potassium 3.0 mEq/L
Rationale: Furosemide is a loop diuretic that causes potassium loss. A level of 3.0 mEq/L indicates
hypokalemia, which can lead to cardiac dysrhythmias (normal range is 3.5-5.0) .
Q7. A patient with a history of deep vein thrombosis (DVT) is on warfarin and reports black, tarry
stools. INR is 4.5. What is the priority action?
A) Administer vitamin K subcutaneously
B) Hold the next dose of warfarin
C) Check hemoglobin and hematocrit
D) Prepare for fresh frozen plasma
Answer: C) Check hemoglobin and hematocrit
Rationale: Black tarry stools suggest GI bleeding. Priority is to assess for hemodynamic
compromise (H&H, vitals). Then hold warfarin and consider reversal agents (vitamin K, FFP) after
assessment .
Q8. A patient with atrial fibrillation is at increased risk for which complication?
, WGU D444
A) Myocardial infarction
B) Stroke (thromboembolism)
C) Heart failure
D) Cardiac tamponade
Answer: B) Stroke (thromboembolism)
Rationale: Atrial fibrillation increases the risk of stroke due to thromboembolism from the left
atrium. Anticoagulation is indicated based on the patient's CHA₂DS₂-VASc score .
Q9. A patient with a pulmonary embolism is on a heparin drip. The aPTT is 110 seconds (control
30). What is the nurse's priority action?
A) Continue the infusion as ordered
B) Decrease the infusion rate
C) Stop the infusion and notify the provider
D) Administer protamine sulfate
Answer: C) Stop the infusion and notify the provider
Rationale: Therapeutic aPTT for heparin is typically 1.5-2.5 times the control value (45-75 seconds).
An aPTT of 110 seconds indicates an overdose with significant bleeding risk. The infusion should be
stopped and the provider notified .
Q10. A patient with heart failure is on a low-sodium diet. Which food choice indicates the patient
understands the dietary teaching?
A) Canned soup
B) Fresh fruits and vegetables
C) Processed cheese
D) Pickles
Answer: B) Fresh fruits and vegetables
Rationale: Fresh fruits and vegetables are naturally low in sodium. Canned soup, processed
cheese, and pickles are high in sodium and should be avoided on a low-sodium diet .
Q11. A patient with heart failure is experiencing dyspnea at rest. How should the nurse position
the patient?
A) Supine position
B) High-Fowler's position
C) Prone position
D) Left lateral position
Answer: B) High-Fowler's position
Rationale: High-Fowler's position (sitting upright) reduces venous return to the heart, decreases
pulmonary congestion, and improves breathing in patients with heart failure .
, WGU D444
Q12. A patient with a history of MI is prescribed a statin. The primary purpose of this medication is
to:
A) Reduce blood pressure
B) Lower LDL cholesterol
C) Prevent blood clots
D) Improve heart rate
Answer: B) Lower LDL cholesterol
Rationale: Statins are HMG-CoA reductase inhibitors that lower LDL cholesterol and reduce the risk
of cardiovascular events. They are a cornerstone of secondary prevention after MI .
Q13. A patient with hypertension is prescribed a beta-blocker. The nurse should monitor for which
side effect? A) Tachycardia
B) Bradycardia
C) Hypotension
D) Both B and C
Answer: D) Both B and C
Rationale: Beta-blockers decrease heart rate and cardiac output, leading to bradycardia and
hypotension. Patients should be monitored for dizziness, fatigue, and signs of heart block .
Q14. For suspected acute coronary syndrome, which intervention is the priority?
A) Administer morphine for pain
B) Obtain a 12-lead EKG
C) Administer aspirin
D) All of the above should be performed rapidly
Answer: D) All of the above should be performed rapidly
Rationale: Priority interventions for ACS include administering aspirin (antiplatelet), obtaining a
12-lead EKG, and administering nitroglycerin and morphine (if ordered) to relieve chest pain. All
actions should be performed rapidly .
Q15. A patient with infective endocarditis is at risk for which complication?
A) Heart failure
B) Systemic embolization
C) Both A and B
D) Pulmonary hypertension
Answer: C) Both A and B
Rationale: Infective endocarditis can lead to heart failure from valvular damage and systemic
embolization from vegetative lesions breaking off. Both are serious complications requiring close
monitoring .
