WGU D446 Adult Health II
Objective Assessment (OA) Review & Study Guide (2026)
250+ High-Yield Questions | Advanced Med-Surg & Critical Care Focus
TOPIC: Cardiac - Dysrhythmias & EKG | Q-1
A nurse notes a patient's EKG monitor shows a sawtooth pattern with a ventricular rate of
80 bpm. The patient is asymptomatic. What is the priority nursing action?
A. Defibrillate at 200 Joules
B. Administer Adenosine IV push rapidly
C. Assess the patient and monitor for hemodynamic instability
D. Perform immediate synchronized cardioversion
Correct Answer: C
Rationale: Sawtooth waves indicate Atrial Flutter. Since the patient is stable (asymptomatic, heart rate
within normal limits), the priority is assessment and monitoring. Cardioversion is reserved for unstable
patients.
TOPIC: Respiratory - Ventilator Management | Q-2
A patient on mechanical ventilation triggers the high-pressure alarm. Which of the
following should the nurse investigate first?
A. A leak in the ventilator tubing
B. The patient has become disconnected from the ventilator
C. Excess secretions or the patient biting the ETT
D. Displacement of the endotracheal tube into the esophagus
Correct Answer: C
Rationale: High-pressure alarms are triggered by increased resistance. Common causes include
biting the tube, secretions requiring suctioning, or coughing. Low-pressure alarms are typically
triggered by disconnections or leaks.
WGU D446 Adult Health II OA Review - Page 1
,TOPIC: Critical Care - Hemodynamics | Q-3
A patient in septic shock has a MAP of 55 mmHg despite fluid resuscitation. The provider
orders Norepinephrine. What is the primary goal of this medication?
A. Increase cardiac output by increasing heart rate
B. Induce vasodilation to improve organ perfusion
C. Increase systemic vascular resistance (SVR) to raise blood pressure
D. Decrease the workload of the heart
Correct Answer: C
Rationale: Norepinephrine is a potent vasoconstrictor (alpha-1 agonist) used in shock to increase SVR
and MAP to ensure vital organ perfusion (Goal MAP >65 mmHg).
TOPIC: Renal - AKI & Electrolytes | Q-4
A patient with Acute Kidney Injury (AKI) has a potassium level of 6.8 mEq/L and EKG
changes (peaked T waves). Which medication should be administered first to protect the
heart?
A. Sodium Polystyrene Sulfonate (Kayexalate)
B. Calcium Gluconate
C. Regular Insulin and Dextrose
D. Furosemide (Lasix)
Correct Answer: B
Rationale: Calcium gluconate does not lower potassium, but it antagonizes the effects of
hyperkalemia on the myocardium, stabilizing the cardiac membrane to prevent lethal arrhythmias.
WGU D446 Adult Health II OA Review - Page 2
,TOPIC: Endocrine - DKA vs HHS | Q-5
Which clinical finding is unique to Diabetic Ketoacidosis (DKA) and typically absent in
Hyperosmolar Hyperglycemic Syndrome (HHS)?
A. Blood glucose >600 mg/dL
B. Severe dehydration
C. Kussmaul respirations and fruity breath
D. Altered mental status
Correct Answer: C
Rationale: Kussmaul respirations (deep, rapid breathing) and fruity breath (acetone) are
compensatory mechanisms for metabolic acidosis caused by ketone production. HHS typically involves
higher glucose levels but lacks significant ketosis.
TOPIC: Cardiac - Dysrhythmias & EKG | Q-6
A nurse notes a patient's EKG monitor shows a sawtooth pattern with a ventricular rate of
80 bpm. The patient is asymptomatic. What is the priority nursing action?
A. Defibrillate at 200 Joules
B. Administer Adenosine IV push rapidly
C. Assess the patient and monitor for hemodynamic instability
D. Perform immediate synchronized cardioversion
Correct Answer: C
Rationale: Sawtooth waves indicate Atrial Flutter. Since the patient is stable (asymptomatic, heart rate
within normal limits), the priority is assessment and monitoring. Cardioversion is reserved for unstable
patients.
WGU D446 Adult Health II OA Review - Page 3
, TOPIC: Respiratory - Ventilator Management | Q-7
A patient on mechanical ventilation triggers the high-pressure alarm. Which of the
following should the nurse investigate first?
A. A leak in the ventilator tubing
B. The patient has become disconnected from the ventilator
C. Excess secretions or the patient biting the ETT
D. Displacement of the endotracheal tube into the esophagus
Correct Answer: C
Rationale: High-pressure alarms are triggered by increased resistance. Common causes include
biting the tube, secretions requiring suctioning, or coughing. Low-pressure alarms are typically
triggered by disconnections or leaks.
TOPIC: Critical Care - Hemodynamics | Q-8
A patient in septic shock has a MAP of 55 mmHg despite fluid resuscitation. The provider
orders Norepinephrine. What is the primary goal of this medication?
A. Increase cardiac output by increasing heart rate
B. Induce vasodilation to improve organ perfusion
C. Increase systemic vascular resistance (SVR) to raise blood pressure
D. Decrease the workload of the heart
Correct Answer: C
Rationale: Norepinephrine is a potent vasoconstrictor (alpha-1 agonist) used in shock to increase SVR
and MAP to ensure vital organ perfusion (Goal MAP >65 mmHg).
WGU D446 Adult Health II OA Review - Page 4
Objective Assessment (OA) Review & Study Guide (2026)
250+ High-Yield Questions | Advanced Med-Surg & Critical Care Focus
TOPIC: Cardiac - Dysrhythmias & EKG | Q-1
A nurse notes a patient's EKG monitor shows a sawtooth pattern with a ventricular rate of
80 bpm. The patient is asymptomatic. What is the priority nursing action?
A. Defibrillate at 200 Joules
B. Administer Adenosine IV push rapidly
C. Assess the patient and monitor for hemodynamic instability
D. Perform immediate synchronized cardioversion
Correct Answer: C
Rationale: Sawtooth waves indicate Atrial Flutter. Since the patient is stable (asymptomatic, heart rate
within normal limits), the priority is assessment and monitoring. Cardioversion is reserved for unstable
patients.
TOPIC: Respiratory - Ventilator Management | Q-2
A patient on mechanical ventilation triggers the high-pressure alarm. Which of the
following should the nurse investigate first?
A. A leak in the ventilator tubing
B. The patient has become disconnected from the ventilator
C. Excess secretions or the patient biting the ETT
D. Displacement of the endotracheal tube into the esophagus
Correct Answer: C
Rationale: High-pressure alarms are triggered by increased resistance. Common causes include
biting the tube, secretions requiring suctioning, or coughing. Low-pressure alarms are typically
triggered by disconnections or leaks.
WGU D446 Adult Health II OA Review - Page 1
,TOPIC: Critical Care - Hemodynamics | Q-3
A patient in septic shock has a MAP of 55 mmHg despite fluid resuscitation. The provider
orders Norepinephrine. What is the primary goal of this medication?
A. Increase cardiac output by increasing heart rate
B. Induce vasodilation to improve organ perfusion
C. Increase systemic vascular resistance (SVR) to raise blood pressure
D. Decrease the workload of the heart
Correct Answer: C
Rationale: Norepinephrine is a potent vasoconstrictor (alpha-1 agonist) used in shock to increase SVR
and MAP to ensure vital organ perfusion (Goal MAP >65 mmHg).
TOPIC: Renal - AKI & Electrolytes | Q-4
A patient with Acute Kidney Injury (AKI) has a potassium level of 6.8 mEq/L and EKG
changes (peaked T waves). Which medication should be administered first to protect the
heart?
A. Sodium Polystyrene Sulfonate (Kayexalate)
B. Calcium Gluconate
C. Regular Insulin and Dextrose
D. Furosemide (Lasix)
Correct Answer: B
Rationale: Calcium gluconate does not lower potassium, but it antagonizes the effects of
hyperkalemia on the myocardium, stabilizing the cardiac membrane to prevent lethal arrhythmias.
WGU D446 Adult Health II OA Review - Page 2
,TOPIC: Endocrine - DKA vs HHS | Q-5
Which clinical finding is unique to Diabetic Ketoacidosis (DKA) and typically absent in
Hyperosmolar Hyperglycemic Syndrome (HHS)?
A. Blood glucose >600 mg/dL
B. Severe dehydration
C. Kussmaul respirations and fruity breath
D. Altered mental status
Correct Answer: C
Rationale: Kussmaul respirations (deep, rapid breathing) and fruity breath (acetone) are
compensatory mechanisms for metabolic acidosis caused by ketone production. HHS typically involves
higher glucose levels but lacks significant ketosis.
TOPIC: Cardiac - Dysrhythmias & EKG | Q-6
A nurse notes a patient's EKG monitor shows a sawtooth pattern with a ventricular rate of
80 bpm. The patient is asymptomatic. What is the priority nursing action?
A. Defibrillate at 200 Joules
B. Administer Adenosine IV push rapidly
C. Assess the patient and monitor for hemodynamic instability
D. Perform immediate synchronized cardioversion
Correct Answer: C
Rationale: Sawtooth waves indicate Atrial Flutter. Since the patient is stable (asymptomatic, heart rate
within normal limits), the priority is assessment and monitoring. Cardioversion is reserved for unstable
patients.
WGU D446 Adult Health II OA Review - Page 3
, TOPIC: Respiratory - Ventilator Management | Q-7
A patient on mechanical ventilation triggers the high-pressure alarm. Which of the
following should the nurse investigate first?
A. A leak in the ventilator tubing
B. The patient has become disconnected from the ventilator
C. Excess secretions or the patient biting the ETT
D. Displacement of the endotracheal tube into the esophagus
Correct Answer: C
Rationale: High-pressure alarms are triggered by increased resistance. Common causes include
biting the tube, secretions requiring suctioning, or coughing. Low-pressure alarms are typically
triggered by disconnections or leaks.
TOPIC: Critical Care - Hemodynamics | Q-8
A patient in septic shock has a MAP of 55 mmHg despite fluid resuscitation. The provider
orders Norepinephrine. What is the primary goal of this medication?
A. Increase cardiac output by increasing heart rate
B. Induce vasodilation to improve organ perfusion
C. Increase systemic vascular resistance (SVR) to raise blood pressure
D. Decrease the workload of the heart
Correct Answer: C
Rationale: Norepinephrine is a potent vasoconstrictor (alpha-1 agonist) used in shock to increase SVR
and MAP to ensure vital organ perfusion (Goal MAP >65 mmHg).
WGU D446 Adult Health II OA Review - Page 4
