WGU D446 – Adult Health II Objective Assessment | OA V1 and V2 | Questions
and Answers – 2026 Update | 100% Correct.
Questions 1–20
Question 1
A 64-year-old client is admitted to the telemetry unit with a diagnosis of acute decompensated
heart failure. The client reports increasing shortness of breath, orthopnea, and weight gain of 5
pounds in the past week. Assessment reveals bilateral crackles in the lung bases and 3+ pitting
edema in the lower extremities. Which nursing intervention is the priority?
A. Restrict oral fluids to 2,000 mL per day
B. Administer prescribed IV furosemide
C. Educate the client about sodium restriction
D. Encourage ambulation in the hallway
Correct Answer: B
Rationale:
The client is exhibiting signs of fluid overload. IV furosemide (a loop diuretic) works rapidly to
remove excess fluid and reduce pulmonary congestion. Airway and breathing take priority.
While fluid restriction and education are important, they are not the immediate priority in acute
decompensation.
Question 2
A client with chronic kidney disease stage 5 is scheduled for hemodialysis. Which laboratory
value requires immediate reporting to the provider before initiating dialysis?
A. Hemoglobin 10.2 g/dL
B. Potassium 6.3 mEq/L
C. Creatinine 6.5 mg/dL
D. BUN 72 mg/dL
Correct Answer: B
Rationale:
A potassium level of 6.3 mEq/L indicates severe hyperkalemia, which can lead to life-
threatening cardiac arrhythmias. Although dialysis will help reduce potassium levels, severe
hyperkalemia requires immediate attention and cardiac monitoring.
,Question 3
A nurse is caring for a client 2 hours post–coronary artery bypass graft (CABG). Which finding
requires immediate intervention?
A. Chest tube drainage of 150 mL in the first hour
B. Urine output of 25 mL/hr
C. Temperature of 100.4°F (38°C)
D. Blood pressure of 128/74 mmHg
Correct Answer: B
Rationale:
Urine output less than 30 mL/hr indicates possible decreased renal perfusion or cardiac output
and requires immediate evaluation. Postoperative renal compromise is a serious complication.
Question 4
A client with COPD is receiving oxygen at 4 L/min via nasal cannula. The client becomes
increasingly drowsy and difficult to arouse. What is the most likely cause?
A. Hypoxemia
B. Carbon dioxide retention
C. Dehydration
D. Pulmonary embolism
Correct Answer: B
Rationale:
Clients with COPD may rely on hypoxic drive. Excess oxygen can suppress respiratory drive and
lead to CO₂ retention, resulting in drowsiness and respiratory acidosis.
Question 5
A client with type 1 diabetes mellitus presents with diabetic ketoacidosis (DKA). Which
assessment finding is expected?
A. Bradycardia
B. Kussmaul respirations
,C. Cool, clammy skin
D. Hypokalemia
Correct Answer: B
Rationale:
DKA causes metabolic acidosis. The body compensates with deep, rapid respirations (Kussmaul
breathing) to eliminate carbon dioxide and reduce acidosis.
Question 6
A nurse is administering alteplase to a client experiencing an acute ischemic stroke. Which
finding requires the nurse to stop the infusion immediately?
A. Mild headache
B. Sudden severe headache and vomiting
C. Blood pressure 150/88 mmHg
D. Nausea
Correct Answer: B
Rationale:
Sudden severe headache and vomiting may indicate intracranial hemorrhage, a life-threatening
complication of thrombolytic therapy.
Question 7
A client with cirrhosis develops ascites. Which intervention is appropriate?
A. Encourage high-sodium diet
B. Restrict protein intake for all clients
C. Administer spironolactone as prescribed
D. Encourage supine positioning
Correct Answer: C
Rationale:
Spironolactone is a potassium-sparing diuretic commonly used to treat ascites in cirrhosis.
Sodium restriction is also recommended, not a high-sodium diet.
, Question 8
A client receiving chemotherapy has a neutrophil count of 800/mm³. Which nursing action is
priority?
A. Place client on neutropenic precautions
B. Encourage fresh fruits and vegetables
C. Administer live vaccines
D. Limit fluid intake
Correct Answer: A
Rationale:
Neutrophil count below 1,000/mm³ indicates neutropenia. Protective isolation reduces infection
risk.
Question 9
A client with pulmonary embolism is receiving heparin infusion. Which laboratory test is used to
monitor therapy?
A. INR
B. PT
C. aPTT
D. Platelet count
Correct Answer: C
Rationale:
Activated partial thromboplastin time (aPTT) is used to monitor IV heparin therapy.
Question 10
A client with hyperthyroidism is admitted with thyroid storm. Which medication should the
nurse prepare to administer first?
A. Levothyroxine
B. Propranolol
C. Insulin
D. Calcium gluconate
Correct Answer: B
and Answers – 2026 Update | 100% Correct.
Questions 1–20
Question 1
A 64-year-old client is admitted to the telemetry unit with a diagnosis of acute decompensated
heart failure. The client reports increasing shortness of breath, orthopnea, and weight gain of 5
pounds in the past week. Assessment reveals bilateral crackles in the lung bases and 3+ pitting
edema in the lower extremities. Which nursing intervention is the priority?
A. Restrict oral fluids to 2,000 mL per day
B. Administer prescribed IV furosemide
C. Educate the client about sodium restriction
D. Encourage ambulation in the hallway
Correct Answer: B
Rationale:
The client is exhibiting signs of fluid overload. IV furosemide (a loop diuretic) works rapidly to
remove excess fluid and reduce pulmonary congestion. Airway and breathing take priority.
While fluid restriction and education are important, they are not the immediate priority in acute
decompensation.
Question 2
A client with chronic kidney disease stage 5 is scheduled for hemodialysis. Which laboratory
value requires immediate reporting to the provider before initiating dialysis?
A. Hemoglobin 10.2 g/dL
B. Potassium 6.3 mEq/L
C. Creatinine 6.5 mg/dL
D. BUN 72 mg/dL
Correct Answer: B
Rationale:
A potassium level of 6.3 mEq/L indicates severe hyperkalemia, which can lead to life-
threatening cardiac arrhythmias. Although dialysis will help reduce potassium levels, severe
hyperkalemia requires immediate attention and cardiac monitoring.
,Question 3
A nurse is caring for a client 2 hours post–coronary artery bypass graft (CABG). Which finding
requires immediate intervention?
A. Chest tube drainage of 150 mL in the first hour
B. Urine output of 25 mL/hr
C. Temperature of 100.4°F (38°C)
D. Blood pressure of 128/74 mmHg
Correct Answer: B
Rationale:
Urine output less than 30 mL/hr indicates possible decreased renal perfusion or cardiac output
and requires immediate evaluation. Postoperative renal compromise is a serious complication.
Question 4
A client with COPD is receiving oxygen at 4 L/min via nasal cannula. The client becomes
increasingly drowsy and difficult to arouse. What is the most likely cause?
A. Hypoxemia
B. Carbon dioxide retention
C. Dehydration
D. Pulmonary embolism
Correct Answer: B
Rationale:
Clients with COPD may rely on hypoxic drive. Excess oxygen can suppress respiratory drive and
lead to CO₂ retention, resulting in drowsiness and respiratory acidosis.
Question 5
A client with type 1 diabetes mellitus presents with diabetic ketoacidosis (DKA). Which
assessment finding is expected?
A. Bradycardia
B. Kussmaul respirations
,C. Cool, clammy skin
D. Hypokalemia
Correct Answer: B
Rationale:
DKA causes metabolic acidosis. The body compensates with deep, rapid respirations (Kussmaul
breathing) to eliminate carbon dioxide and reduce acidosis.
Question 6
A nurse is administering alteplase to a client experiencing an acute ischemic stroke. Which
finding requires the nurse to stop the infusion immediately?
A. Mild headache
B. Sudden severe headache and vomiting
C. Blood pressure 150/88 mmHg
D. Nausea
Correct Answer: B
Rationale:
Sudden severe headache and vomiting may indicate intracranial hemorrhage, a life-threatening
complication of thrombolytic therapy.
Question 7
A client with cirrhosis develops ascites. Which intervention is appropriate?
A. Encourage high-sodium diet
B. Restrict protein intake for all clients
C. Administer spironolactone as prescribed
D. Encourage supine positioning
Correct Answer: C
Rationale:
Spironolactone is a potassium-sparing diuretic commonly used to treat ascites in cirrhosis.
Sodium restriction is also recommended, not a high-sodium diet.
, Question 8
A client receiving chemotherapy has a neutrophil count of 800/mm³. Which nursing action is
priority?
A. Place client on neutropenic precautions
B. Encourage fresh fruits and vegetables
C. Administer live vaccines
D. Limit fluid intake
Correct Answer: A
Rationale:
Neutrophil count below 1,000/mm³ indicates neutropenia. Protective isolation reduces infection
risk.
Question 9
A client with pulmonary embolism is receiving heparin infusion. Which laboratory test is used to
monitor therapy?
A. INR
B. PT
C. aPTT
D. Platelet count
Correct Answer: C
Rationale:
Activated partial thromboplastin time (aPTT) is used to monitor IV heparin therapy.
Question 10
A client with hyperthyroidism is admitted with thyroid storm. Which medication should the
nurse prepare to administer first?
A. Levothyroxine
B. Propranolol
C. Insulin
D. Calcium gluconate
Correct Answer: B
