NURSING OBJECTIVE ASSESSMENT
WGU D444 Adult Health 1 A+
Objective Assessment
2026/2027 Official Exam
A+ 5 100%
QUESTIONS VERIFIED EXAM DOMAINS COVERED RATIONALES INCLUDED
CATEGORIES
■ 1. HEENT & Integumentary Conditions
■ 2. Fluid & Electrolytes, Acid-Base & Respiratory Conditions
■ 3. Gastrointestinal, Hepatic, Genitourinary & Reproductive Conditions
■ 4. Pain, Inflammation, Immunity & Infection
■ 5. Clinical Judgment, Prioritization & Multisystem Application
Passing Score: 75% | Marks: 1 per question | Format: Multiple Choice (A–D)
STUVIAACTUALEXAM
, SECTION 1 — HEENT & Integumentary Conditions
Q1. A 68-year-old client reports sudden unilateral hearing loss and tinnitus after a recent upper respiratory infection. The nurse
notes the tympanic membrane is intact and the Weber test lateralizes to the unaffected ear. Which nursing action takes priority
while awaiting further evaluation?
A. Irrigate the affected ear with warm water to remove possible cerumen
B. Place the client in a high-Fowler position and encourage forceful nose-blowing
C. Protect the client from injury related to balance disturbance and notify the provider of possible sensorineural involvement
D. Administer an over-the-counter decongestant and reassess in 24 hours
Correct Answer: C
Rationale: Sudden sensorineural hearing loss is an otologic emergency. Lateralization away from the affected ear on Weber testing supports
sensorineural rather than conductive loss. Fall precautions and prompt provider notification are essential.
Q2. A client with a newly diagnosed basal cell carcinoma on the nose asks about expected treatment. The nurse provides accurate
teaching when stating that this lesion is typically managed by which approach?
A. Watchful waiting only, because basal cell lesions spontaneously resolve
B. Systemic chemotherapy as first-line therapy for all facial lesions
C. High-dose systemic corticosteroids to shrink the lesion
D. Surgical excision or Mohs micrographic surgery because basal cell carcinoma rarely metastasizes but can be locally invasive
Correct Answer: D
Rationale: Basal cell carcinoma is locally invasive but seldom metastasizes. Mohs surgery or excision with clear margins is the standard approach
for facial lesions to preserve tissue and ensure complete removal.
Q3. During a focused eye assessment the nurse observes a client with cataracts has difficulty with glare and night driving. Which
teaching point is most appropriate before surgical evaluation?
A. Cataracts are reversed with daily high-dose vitamin A drops
B. The cloudiness will clear within weeks with improved lighting alone
C. Only clients younger than 50 are candidates for cataract surgery
D. Avoid driving at night and report any sudden vision changes; surgical removal is the definitive treatment when function is impaired
Correct Answer: D
Rationale: Cataracts produce progressive lens opacity that increases glare and impairs night vision. Surgery is indicated when visual function
interferes with daily activities; interim safety teaching is essential.
Q4. A client presents with facial pain, nasal congestion, and purulent nasal discharge for 12 days. The nurse anticipates which
priority collaborative intervention for acute bacterial sinusitis?
A. Supportive care and, when bacterial infection is likely, an appropriate antibiotic course guided by guidelines
B. Immediate CT of the sinuses for all clients with facial pain
C. Emergency surgical drainage before any medical therapy
D. Lifelong daily oral antihistamines as primary therapy
Correct Answer: A
Rationale: Most acute sinusitis is viral; bacterial infection is more likely after 10 days of persistent symptoms. Antibiotics are reserved for probable
bacterial disease; supportive measures remain foundational.
Q5. A nurse is caring for a client with a stage 3 pressure injury over the sacrum. The wound bed contains visible subcutaneous
tissue and moderate exudate. Which intervention is the priority for local wound management?
A. Massage the surrounding reddened tissue vigorously to improve circulation
B. Apply a dry gauze dressing changed only once weekly
C. Pack the wound tightly with dry cotton to promote desiccation
D. Cleanse the wound with an appropriate solution, maintain a moist wound environment, and relieve pressure
Correct Answer: D
Rationale: Stage 3 injuries require gentle cleansing, a moist healing environment, and strict pressure redistribution. Dry dressings and massage of
compromised tissue are harmful.
STUVIAACTUALEXAM | Page 2 of 16
, Q6. A client reports progressive bilateral hearing loss and a family history of otosclerosis. The nurse recognizes that this condition
primarily affects which structure?
A. The stapes footplate and oval window, leading to conductive hearing loss
B. The cochlear hair cells exclusively
C. The external auditory canal cartilage
D. The tympanic membrane only
Correct Answer: A
Rationale: Otosclerosis involves abnormal bone growth that fixes the stapes, impairing sound transmission and producing conductive hearing loss.
Surgical stapedectomy may be considered.
Q7. A client with psoriasis asks why topical corticosteroids are prescribed in addition to emollients. The nurse explains that the
primary therapeutic goal of the corticosteroid is to:
A. Reduce local inflammation and slow epidermal hyperproliferation
B. Provide systemic immunosuppression equivalent to oral agents
C. Eliminate the need for any future skin care
D. Permanently cure the underlying genetic tendency
Correct Answer: A
Rationale: Topical corticosteroids decrease inflammation and suppress the accelerated keratinocyte turnover that produces the characteristic
plaques of psoriasis.
Q8. While assessing a client after nasal surgery the nurse notes frequent swallowing and a steady trickle of blood from the nose.
Which action is the priority?
A. Elevate the head of the bed, apply gentle pressure as ordered, and notify the surgeon of possible ongoing hemorrhage
B. Have the client blow the nose forcefully to clear clots
C. Place the client in Trendelenburg position immediately
D. Reassure the client that mild bleeding is expected and continue observation only
Correct Answer: A
Rationale: Frequent swallowing can indicate occult posterior bleeding. Elevating the head, applying ordered pressure, and prompt surgical
notification address potential hemorrhage.
Q9. A client with Ménière disease experiences acute vertigo, tinnitus, and fluctuating hearing loss. Which nursing intervention is
most important during an acute attack?
A. Withhold all fluids to reduce endolymph volume immediately
B. Perform vigorous head exercises during the peak of symptoms
C. Provide a quiet, darkened environment, assist with safe positioning, and administer prescribed antiemetics or vestibular
suppressants
D. Encourage rapid ambulation to habituate the vestibular system
Correct Answer: C
Rationale: During an acute attack, minimizing sensory stimulation, ensuring safety, and using prescribed medications reduce symptom intensity
and fall risk.
Q10. A nurse teaches a client with atopic dermatitis about skin care. Which statement by the client indicates correct
understanding?
A. I will apply emollients immediately after bathing and avoid known triggers
B. I will scrub the affected areas with a rough cloth to remove scales
C. I will take long hot showers twice daily to open the pores
D. I will stop all moisturizers once the rash improves
Correct Answer: A
Rationale: Frequent moisturization after brief lukewarm bathing and trigger avoidance are core strategies to restore the skin barrier in atopic
dermatitis.
STUVIAACTUALEXAM | Page 3 of 16
WGU D444 Adult Health 1 A+
Objective Assessment
2026/2027 Official Exam
A+ 5 100%
QUESTIONS VERIFIED EXAM DOMAINS COVERED RATIONALES INCLUDED
CATEGORIES
■ 1. HEENT & Integumentary Conditions
■ 2. Fluid & Electrolytes, Acid-Base & Respiratory Conditions
■ 3. Gastrointestinal, Hepatic, Genitourinary & Reproductive Conditions
■ 4. Pain, Inflammation, Immunity & Infection
■ 5. Clinical Judgment, Prioritization & Multisystem Application
Passing Score: 75% | Marks: 1 per question | Format: Multiple Choice (A–D)
STUVIAACTUALEXAM
, SECTION 1 — HEENT & Integumentary Conditions
Q1. A 68-year-old client reports sudden unilateral hearing loss and tinnitus after a recent upper respiratory infection. The nurse
notes the tympanic membrane is intact and the Weber test lateralizes to the unaffected ear. Which nursing action takes priority
while awaiting further evaluation?
A. Irrigate the affected ear with warm water to remove possible cerumen
B. Place the client in a high-Fowler position and encourage forceful nose-blowing
C. Protect the client from injury related to balance disturbance and notify the provider of possible sensorineural involvement
D. Administer an over-the-counter decongestant and reassess in 24 hours
Correct Answer: C
Rationale: Sudden sensorineural hearing loss is an otologic emergency. Lateralization away from the affected ear on Weber testing supports
sensorineural rather than conductive loss. Fall precautions and prompt provider notification are essential.
Q2. A client with a newly diagnosed basal cell carcinoma on the nose asks about expected treatment. The nurse provides accurate
teaching when stating that this lesion is typically managed by which approach?
A. Watchful waiting only, because basal cell lesions spontaneously resolve
B. Systemic chemotherapy as first-line therapy for all facial lesions
C. High-dose systemic corticosteroids to shrink the lesion
D. Surgical excision or Mohs micrographic surgery because basal cell carcinoma rarely metastasizes but can be locally invasive
Correct Answer: D
Rationale: Basal cell carcinoma is locally invasive but seldom metastasizes. Mohs surgery or excision with clear margins is the standard approach
for facial lesions to preserve tissue and ensure complete removal.
Q3. During a focused eye assessment the nurse observes a client with cataracts has difficulty with glare and night driving. Which
teaching point is most appropriate before surgical evaluation?
A. Cataracts are reversed with daily high-dose vitamin A drops
B. The cloudiness will clear within weeks with improved lighting alone
C. Only clients younger than 50 are candidates for cataract surgery
D. Avoid driving at night and report any sudden vision changes; surgical removal is the definitive treatment when function is impaired
Correct Answer: D
Rationale: Cataracts produce progressive lens opacity that increases glare and impairs night vision. Surgery is indicated when visual function
interferes with daily activities; interim safety teaching is essential.
Q4. A client presents with facial pain, nasal congestion, and purulent nasal discharge for 12 days. The nurse anticipates which
priority collaborative intervention for acute bacterial sinusitis?
A. Supportive care and, when bacterial infection is likely, an appropriate antibiotic course guided by guidelines
B. Immediate CT of the sinuses for all clients with facial pain
C. Emergency surgical drainage before any medical therapy
D. Lifelong daily oral antihistamines as primary therapy
Correct Answer: A
Rationale: Most acute sinusitis is viral; bacterial infection is more likely after 10 days of persistent symptoms. Antibiotics are reserved for probable
bacterial disease; supportive measures remain foundational.
Q5. A nurse is caring for a client with a stage 3 pressure injury over the sacrum. The wound bed contains visible subcutaneous
tissue and moderate exudate. Which intervention is the priority for local wound management?
A. Massage the surrounding reddened tissue vigorously to improve circulation
B. Apply a dry gauze dressing changed only once weekly
C. Pack the wound tightly with dry cotton to promote desiccation
D. Cleanse the wound with an appropriate solution, maintain a moist wound environment, and relieve pressure
Correct Answer: D
Rationale: Stage 3 injuries require gentle cleansing, a moist healing environment, and strict pressure redistribution. Dry dressings and massage of
compromised tissue are harmful.
STUVIAACTUALEXAM | Page 2 of 16
, Q6. A client reports progressive bilateral hearing loss and a family history of otosclerosis. The nurse recognizes that this condition
primarily affects which structure?
A. The stapes footplate and oval window, leading to conductive hearing loss
B. The cochlear hair cells exclusively
C. The external auditory canal cartilage
D. The tympanic membrane only
Correct Answer: A
Rationale: Otosclerosis involves abnormal bone growth that fixes the stapes, impairing sound transmission and producing conductive hearing loss.
Surgical stapedectomy may be considered.
Q7. A client with psoriasis asks why topical corticosteroids are prescribed in addition to emollients. The nurse explains that the
primary therapeutic goal of the corticosteroid is to:
A. Reduce local inflammation and slow epidermal hyperproliferation
B. Provide systemic immunosuppression equivalent to oral agents
C. Eliminate the need for any future skin care
D. Permanently cure the underlying genetic tendency
Correct Answer: A
Rationale: Topical corticosteroids decrease inflammation and suppress the accelerated keratinocyte turnover that produces the characteristic
plaques of psoriasis.
Q8. While assessing a client after nasal surgery the nurse notes frequent swallowing and a steady trickle of blood from the nose.
Which action is the priority?
A. Elevate the head of the bed, apply gentle pressure as ordered, and notify the surgeon of possible ongoing hemorrhage
B. Have the client blow the nose forcefully to clear clots
C. Place the client in Trendelenburg position immediately
D. Reassure the client that mild bleeding is expected and continue observation only
Correct Answer: A
Rationale: Frequent swallowing can indicate occult posterior bleeding. Elevating the head, applying ordered pressure, and prompt surgical
notification address potential hemorrhage.
Q9. A client with Ménière disease experiences acute vertigo, tinnitus, and fluctuating hearing loss. Which nursing intervention is
most important during an acute attack?
A. Withhold all fluids to reduce endolymph volume immediately
B. Perform vigorous head exercises during the peak of symptoms
C. Provide a quiet, darkened environment, assist with safe positioning, and administer prescribed antiemetics or vestibular
suppressants
D. Encourage rapid ambulation to habituate the vestibular system
Correct Answer: C
Rationale: During an acute attack, minimizing sensory stimulation, ensuring safety, and using prescribed medications reduce symptom intensity
and fall risk.
Q10. A nurse teaches a client with atopic dermatitis about skin care. Which statement by the client indicates correct
understanding?
A. I will apply emollients immediately after bathing and avoid known triggers
B. I will scrub the affected areas with a rough cloth to remove scales
C. I will take long hot showers twice daily to open the pores
D. I will stop all moisturizers once the rash improves
Correct Answer: A
Rationale: Frequent moisturization after brief lukewarm bathing and trigger avoidance are core strategies to restore the skin barrier in atopic
dermatitis.
STUVIAACTUALEXAM | Page 3 of 16
