WGU D446 Adult Health 2 OA Exam
Study Guide (updated 2025) Questions &
Answers | Latest Already Graded A+
UPDATE 2025|2026
Q1. A patient is admitted with community-acquired pneumonia
(CAP). What underlying pathophysiological process is primarily
responsible for the patient's hypoxemia?
A) Bronchospasm and air trapping
B) Inflammation and fluid leakage into the alveoli
C) Destruction of the alveolar walls
D) Mucus plugging of the upper airways
Correct Answer: B) Inflammation and fluid leakage into the
alveoli
Rationale: In CAP, the inflammatory response increases vascular
permeability, causing fluid, protein, and cells to leak from
capillaries into the alveoli. This fluid-filled alveoli cannot
participate in gas exchange, leading to V/Q mismatch and
hypoxemia .
Q2. A nurse is assessing a patient during an acute asthma
exacerbation. Which finding requires immediate intervention?
A) Expiratory wheezing in all lung fields
B) A silent chest on auscultation
C) A productive cough with clear sputum
D) Respiratory rate of 24 breaths/minute
, Correct Answer: B) A silent chest on auscultation
Rationale: A "silent chest" indicates severe bronchospasm and
such limited airflow that wheezing is no longer audible. This is a
sign of impending respiratory failure and requires immediate
intervention, such as high-dose bronchodilators and potentially
intubation .
Q3. A patient with COPD has an SpO₂ of 86% on room air. You
initiate supplemental oxygen. What is the target SpO₂ range for
this patient to balance oxygenation and ventilation?
A) 90% to 92%
B) 94% to 96%
C) 88% to 92%
D) 100%
Correct Answer: C) 88% to 92%
Rationale: For patients with chronic hypercapnic respiratory
failure (common in severe COPD), the hypoxic drive is often a
back-up system. The goal is to maintain adequate tissue
oxygenation (SpO₂ >88%) while avoiding knocking out their
hypoxic drive, which can lead to worsened hypercapnia and
acidosis .
Q4. A patient with tuberculosis (TB) is being admitted. Which type
of precaution should the nurse initiate?
A) Contact Precautions
B) Droplet Precautions
C) Airborne Precautions
D) Protective Environment
, Correct Answer: C) Airborne Precautions
Rationale: TB is transmitted via small droplet nuclei that can
remain airborne for extended periods. Patients require an airborne
infection isolation room (AIIR) with negative pressure, and staff
must wear an N95 respirator .
Cardiovascular Disorders
Q5. A patient reports chest pain that started while mowing the
lawn, lasted 5 minutes, and resolved completely with rest. This
presentation is most consistent with:
A) Unstable angina
B) Myocardial infarction (MI)
C) Stable angina
D) Pericarditis
Correct Answer: C) Stable angina
Rationale: Stable angina is chest discomfort that is predictable,
occurring with exertion or stress, and is relieved by rest or
nitroglycerin. In contrast, an MI involves pain that is not fully
relieved by rest and is often accompanied by diaphoresis and
elevated troponin .
Q6. A patient is admitted with acute decompensated heart failure.
On assessment, you note crackles in the lung bases, an S3 gallop,
and orthopnea. These findings are classic signs of:
A) Right-sided heart failure
B) Left-sided heart failure
C) Pericardial effusion
D) Cor pulmonale
, Correct Answer: B) Left-sided heart failure
Rationale: Left-sided heart failure causes blood to back up into
the pulmonary circulation, leading to pulmonary symptoms such
as crackles, dyspnea, orthopnea, and an S3 heart sound. Right-
sided failure presents with peripheral symptoms like edema and
JVD .
Q7. A patient is receiving a blood transfusion. Fifteen minutes
after initiation, the patient reports chills and lower back pain.
What is the nurse's priority action?
A) Slow the infusion rate and monitor vital signs
B) Stop the transfusion and maintain IV access with normal saline
C) Administer acetaminophen as ordered for the chills
D) Notify the provider after checking the vital signs
Correct Answer: B) Stop the transfusion and maintain IV
access with normal saline
Rationale: Chills and back pain are hallmark signs of an acute
hemolytic transfusion reaction. The priority is to stop the infusion
immediately to prevent further reaction, disconnect the tubing,
and maintain a patent IV line with normal saline for potential
emergency medications .
Neurological Disorders
Q8. A patient presents with sudden-onset right-sided weakness,
facial droop, and slurred speech. The patient's last known well
time was 90 minutes ago. What is the nurse's priority action?
A) Obtain a stat CT scan of the head
B) Start two large-bore IV lines
Study Guide (updated 2025) Questions &
Answers | Latest Already Graded A+
UPDATE 2025|2026
Q1. A patient is admitted with community-acquired pneumonia
(CAP). What underlying pathophysiological process is primarily
responsible for the patient's hypoxemia?
A) Bronchospasm and air trapping
B) Inflammation and fluid leakage into the alveoli
C) Destruction of the alveolar walls
D) Mucus plugging of the upper airways
Correct Answer: B) Inflammation and fluid leakage into the
alveoli
Rationale: In CAP, the inflammatory response increases vascular
permeability, causing fluid, protein, and cells to leak from
capillaries into the alveoli. This fluid-filled alveoli cannot
participate in gas exchange, leading to V/Q mismatch and
hypoxemia .
Q2. A nurse is assessing a patient during an acute asthma
exacerbation. Which finding requires immediate intervention?
A) Expiratory wheezing in all lung fields
B) A silent chest on auscultation
C) A productive cough with clear sputum
D) Respiratory rate of 24 breaths/minute
, Correct Answer: B) A silent chest on auscultation
Rationale: A "silent chest" indicates severe bronchospasm and
such limited airflow that wheezing is no longer audible. This is a
sign of impending respiratory failure and requires immediate
intervention, such as high-dose bronchodilators and potentially
intubation .
Q3. A patient with COPD has an SpO₂ of 86% on room air. You
initiate supplemental oxygen. What is the target SpO₂ range for
this patient to balance oxygenation and ventilation?
A) 90% to 92%
B) 94% to 96%
C) 88% to 92%
D) 100%
Correct Answer: C) 88% to 92%
Rationale: For patients with chronic hypercapnic respiratory
failure (common in severe COPD), the hypoxic drive is often a
back-up system. The goal is to maintain adequate tissue
oxygenation (SpO₂ >88%) while avoiding knocking out their
hypoxic drive, which can lead to worsened hypercapnia and
acidosis .
Q4. A patient with tuberculosis (TB) is being admitted. Which type
of precaution should the nurse initiate?
A) Contact Precautions
B) Droplet Precautions
C) Airborne Precautions
D) Protective Environment
, Correct Answer: C) Airborne Precautions
Rationale: TB is transmitted via small droplet nuclei that can
remain airborne for extended periods. Patients require an airborne
infection isolation room (AIIR) with negative pressure, and staff
must wear an N95 respirator .
Cardiovascular Disorders
Q5. A patient reports chest pain that started while mowing the
lawn, lasted 5 minutes, and resolved completely with rest. This
presentation is most consistent with:
A) Unstable angina
B) Myocardial infarction (MI)
C) Stable angina
D) Pericarditis
Correct Answer: C) Stable angina
Rationale: Stable angina is chest discomfort that is predictable,
occurring with exertion or stress, and is relieved by rest or
nitroglycerin. In contrast, an MI involves pain that is not fully
relieved by rest and is often accompanied by diaphoresis and
elevated troponin .
Q6. A patient is admitted with acute decompensated heart failure.
On assessment, you note crackles in the lung bases, an S3 gallop,
and orthopnea. These findings are classic signs of:
A) Right-sided heart failure
B) Left-sided heart failure
C) Pericardial effusion
D) Cor pulmonale
, Correct Answer: B) Left-sided heart failure
Rationale: Left-sided heart failure causes blood to back up into
the pulmonary circulation, leading to pulmonary symptoms such
as crackles, dyspnea, orthopnea, and an S3 heart sound. Right-
sided failure presents with peripheral symptoms like edema and
JVD .
Q7. A patient is receiving a blood transfusion. Fifteen minutes
after initiation, the patient reports chills and lower back pain.
What is the nurse's priority action?
A) Slow the infusion rate and monitor vital signs
B) Stop the transfusion and maintain IV access with normal saline
C) Administer acetaminophen as ordered for the chills
D) Notify the provider after checking the vital signs
Correct Answer: B) Stop the transfusion and maintain IV
access with normal saline
Rationale: Chills and back pain are hallmark signs of an acute
hemolytic transfusion reaction. The priority is to stop the infusion
immediately to prevent further reaction, disconnect the tubing,
and maintain a patent IV line with normal saline for potential
emergency medications .
Neurological Disorders
Q8. A patient presents with sudden-onset right-sided weakness,
facial droop, and slurred speech. The patient's last known well
time was 90 minutes ago. What is the nurse's priority action?
A) Obtain a stat CT scan of the head
B) Start two large-bore IV lines
