WGU D446 |1
WGU D446 — Adult Health II | Study Guide | Latest
Update 2026/2027 | Practice Questions and Answers |
Exam Review
Table of Contents
1. Cardiovascular Disorders
2. Respiratory Disorders
3. Endocrine Disorders
4. Renal and Urological Disorders
5. Neurological Disorders
6. Hematologic and Oncologic Disorders
7. Shock, Sepsis, and Multisystem Failure
8. Perioperative and Emergency Nursing Care
9. Fluid, Electrolyte, and Acid-Base Balance
10. Clinical Prioritization and Delegation
, WGU D446 |2
Question 1: A nurse is assessing a client with acute decompensated heart failure (ADHF).
Which finding is most indicative of severe fluid overload and imminent respiratory
compromise?
A) +2 pitting edema in lower extremities
B) Decreased troponin I
C) Elevated hemoglobin
D) Decreased serum creatinine
Correct Answer: A) +2 pitting edema in lower extremities
B-type natriuretic peptide (BNP) is released from the ventricles in response to increased
ventricular wall tension from fluid overload, making it a key biomarker for heart failure.
While edema is a sign of fluid overload, BNP elevation is more specific to heart failure.
Troponin is for myocardial injury, not specifically heart failure.
Question 2: A client with pericarditis reports sharp chest pain that worsens when lying flat.
Which action should the nurse take?
A) Place the client in high-Fowler's position
B) Encourage the client to cough and deep breathe
C) Position the client flat to reduce pain
D) Administer a diuretic as ordered
Correct Answer: A) Place the client in high-Fowler's position
Pericarditis pain is often relieved by sitting up and leaning forward. High-Fowler's position
reduces pressure on the pericardium and can alleviate discomfort.
Question 3: During the acute management of a myocardial infarction, which medication is
given to reduce platelet aggregation?
A) Morphine
B) Aspirin
C) Nitroglycerin
D) Oxygen
Correct Answer: B) Aspirin
, WGU D446 |3
Aspirin irreversibly inhibits cyclooxygenase, reducing thromboxane A2 production and
decreasing platelet aggregation. This helps prevent further clot formation in the coronary
artery. The MONA protocol includes aspirin as a key component.
Question 4: A client with left-sided heart failure is most likely to exhibit which symptom?
A) Peripheral edema
B) Ascites
C) Jugular vein distention
D) Orthopnea
Correct Answer: D) Orthopnea
Left-sided heart failure causes pulmonary congestion, leading to symptoms such as dyspnea,
orthopnea, and crackles. Right-sided heart failure causes peripheral symptoms such as
edema, ascites, and jugular vein distention.
Question 5: Which medication class is prescribed to reduce heart rate in a client with heart
failure?
A) Beta-blockers
B) Calcium channel blockers
C) Diuretics
D) ACE inhibitors
Correct Answer: A) Beta-blockers
Beta-blockers reduce heart rate and decrease myocardial oxygen demand, improving
outcomes in heart failure. Calcium channel blockers cause vasodilation, diuretics reduce
fluid overload, and ACE inhibitors reduce afterload.
Question 6: A nurse is teaching a patient with COPD about oxygen therapy. Which target
SpO₂ range should the nurse include?
A) 85%–88%
B) 88%–92%
C) 92%–95%
D) 95%–100%
Correct Answer: B) 88%–92%
WGU D446 — Adult Health II | Study Guide | Latest
Update 2026/2027 | Practice Questions and Answers |
Exam Review
Table of Contents
1. Cardiovascular Disorders
2. Respiratory Disorders
3. Endocrine Disorders
4. Renal and Urological Disorders
5. Neurological Disorders
6. Hematologic and Oncologic Disorders
7. Shock, Sepsis, and Multisystem Failure
8. Perioperative and Emergency Nursing Care
9. Fluid, Electrolyte, and Acid-Base Balance
10. Clinical Prioritization and Delegation
, WGU D446 |2
Question 1: A nurse is assessing a client with acute decompensated heart failure (ADHF).
Which finding is most indicative of severe fluid overload and imminent respiratory
compromise?
A) +2 pitting edema in lower extremities
B) Decreased troponin I
C) Elevated hemoglobin
D) Decreased serum creatinine
Correct Answer: A) +2 pitting edema in lower extremities
B-type natriuretic peptide (BNP) is released from the ventricles in response to increased
ventricular wall tension from fluid overload, making it a key biomarker for heart failure.
While edema is a sign of fluid overload, BNP elevation is more specific to heart failure.
Troponin is for myocardial injury, not specifically heart failure.
Question 2: A client with pericarditis reports sharp chest pain that worsens when lying flat.
Which action should the nurse take?
A) Place the client in high-Fowler's position
B) Encourage the client to cough and deep breathe
C) Position the client flat to reduce pain
D) Administer a diuretic as ordered
Correct Answer: A) Place the client in high-Fowler's position
Pericarditis pain is often relieved by sitting up and leaning forward. High-Fowler's position
reduces pressure on the pericardium and can alleviate discomfort.
Question 3: During the acute management of a myocardial infarction, which medication is
given to reduce platelet aggregation?
A) Morphine
B) Aspirin
C) Nitroglycerin
D) Oxygen
Correct Answer: B) Aspirin
, WGU D446 |3
Aspirin irreversibly inhibits cyclooxygenase, reducing thromboxane A2 production and
decreasing platelet aggregation. This helps prevent further clot formation in the coronary
artery. The MONA protocol includes aspirin as a key component.
Question 4: A client with left-sided heart failure is most likely to exhibit which symptom?
A) Peripheral edema
B) Ascites
C) Jugular vein distention
D) Orthopnea
Correct Answer: D) Orthopnea
Left-sided heart failure causes pulmonary congestion, leading to symptoms such as dyspnea,
orthopnea, and crackles. Right-sided heart failure causes peripheral symptoms such as
edema, ascites, and jugular vein distention.
Question 5: Which medication class is prescribed to reduce heart rate in a client with heart
failure?
A) Beta-blockers
B) Calcium channel blockers
C) Diuretics
D) ACE inhibitors
Correct Answer: A) Beta-blockers
Beta-blockers reduce heart rate and decrease myocardial oxygen demand, improving
outcomes in heart failure. Calcium channel blockers cause vasodilation, diuretics reduce
fluid overload, and ACE inhibitors reduce afterload.
Question 6: A nurse is teaching a patient with COPD about oxygen therapy. Which target
SpO₂ range should the nurse include?
A) 85%–88%
B) 88%–92%
C) 92%–95%
D) 95%–100%
Correct Answer: B) 88%–92%
