WGU D446 Adult Health 2 OA Exam
2026/27 Edition | 125 Questions | Answers
& Rationales for All Options
Section 1: Cardiovascular Disorders (25 Questions)
1. A nurse is assessing a client with left-sided heart failure. Which finding is most indicative?
• A) Jugular venous distention
• B) Peripheral edema
• C) Crackles in the lung bases
• D) Hepatomegaly
Answer: C
• A) JVD is caused by increased right ventricular pressure → right-sided failure.
• B) Peripheral edema results from fluid backup in systemic circulation → right-sided failure.
• C) Correct. Left-sided failure causes pulmonary congestion due to inability to pump blood
forward → crackles.
• D) Hepatomegaly occurs from systemic venous congestion → right-sided failure.
2. A client with chronic atrial fibrillation is prescribed warfarin. Which lab value requires immediate
intervention?
• A) INR 2.5
• B) aPTT 35 seconds
• C) Platelets 150,000/mm³
• D) INR 4.8
Answer: D
• A) INR 2.5 is therapeutic for AF (target 2-3). No intervention needed.
, • B) aPTT 35 seconds is normal (30-40 sec). Warfarin does not affect aPTT.
• C) Platelets 150,000 is normal. Warfarin affects clotting factors, not platelets.
• D) Correct. INR 4.8 indicates high bleeding risk; hold warfarin, notify provider.
3. Post-cardiac catheterization, the nurse assesses the femoral insertion site. Which finding is most
concerning?
• A) Small 2cm bruise
• B) Patient reports mild discomfort
• C) Expanding hematoma
• D) Slight oozing with pressure
Answer: C
• A) Small bruise is expected after arterial puncture.
• B) Mild discomfort is expected post-procedure.
• C) Correct. Expanding hematoma indicates retroperitoneal bleeding or pseudoaneurysm.
• D) Slight oozing is common and managed with manual pressure.
4. A client with unstable angina is admitted. Which medication reduces mortality and should be
started within 24 hours?
• A) Metoprolol
• B) Furosemide
• C) Digoxin
• D) Alprazolam
Answer: A
• A) Correct. Beta-blockers reduce myocardial O2 demand, prevent remodeling, and decrease
mortality post-MI/unstable angina.
• B) Loop diuretic for fluid overload, no mortality benefit in angina.
• C) Digoxin for HF with AF, not for unstable angina.
• D) Benzodiazepine for anxiety, no mortality benefit.
5. A client post-MI has a new murmur heard at the apex. What complication should the nurse
suspect?
• A) Pericarditis
• B) Ventricular septal rupture
, • C) Papillary muscle rupture
• D) Dressler syndrome
Answer: C
• A) Pericarditis causes friction rub, not murmur.
• B) VSD causes harsh holosystolic murmur at left sternal border, not apex.
• C) Correct. New apical murmur post-MI = mitral regurgitation from papillary muscle
dysfunction/rupture.
• D) Dressler syndrome is autoimmune pericarditis weeks later, not acute murmur.
6. A client with heart failure has an ejection fraction of 25%. Which classification of HF is this?
• A) HFpEF
• B) HFmrEF
• C) HFrEF
• D) Right-sided failure
Answer: C
• A) HFpEF = preserved EF ≥50%.
• B) HFmrEF = mid-range EF 41-49%.
• C) Correct. HFrEF = reduced EF <40%.
• D) Right-sided failure is a clinical presentation, not an EF classification.
7. The nurse notes a new onset of confusion and hypotension in a client with atrial fibrillation. What
action is priority?
• A) Recheck BP in 15 minutes
• B) Notify provider immediately
• C) Administer prescribed lorazepam
• D) Increase IV fluids
Answer: B
• A) Delays critical intervention; patient is unstable.
• B) Correct. Confusion + hypotension in AF = possible embolic stroke or low cardiac output;
immediate provider notification.
• C) Lorazepam may worsen hypotension/AMS.
• D) May help if hypovolemic, but not priority over identifying cause.
, 8. Which ECG finding is characteristic of a myocardial infarction?
• A) Peaked T waves
• B) ST-segment elevation
• C) U waves
• D) Prolonged PR interval
Answer: B
• A) Peaked T waves = hyperkalemia.
• B) Correct. ST elevation = STEMI (full-thickness infarction).
• C) U waves = hypokalemia.
• D) Prolonged PR = first-degree AV block.
9. A client is started on amiodarone for ventricular tachycardia. Which baseline test is required?
• A) Pulmonary function tests
• B) Liver biopsy
• C) Thyroid function tests
• D) Renal ultrasound
Answer: C
• A) PFTs not routine unless symptoms develop.
• B) Liver biopsy is invasive; LFTs are monitored, not biopsy.
• C) Correct. Amiodarone contains iodine and causes hyperthyroidism or hypothyroidism.
• D) Renal dysfunction is not a primary amiodarone side effect.
10. During cardioversion for a client with unstable tachycardia, the nurse sets the defibrillator to
which mode?
• A) Synchronized mode
• B) Unsynchronized mode
• C) AED mode
• D) Pacemaker mode
Answer: A
• A) Correct. Synchronized mode delivers shock on R wave to avoid R-on-T phenomenon (V-fib).
• B) Unsynchronized is for cardiac arrest with V-fib/pulseless V-tach.
2026/27 Edition | 125 Questions | Answers
& Rationales for All Options
Section 1: Cardiovascular Disorders (25 Questions)
1. A nurse is assessing a client with left-sided heart failure. Which finding is most indicative?
• A) Jugular venous distention
• B) Peripheral edema
• C) Crackles in the lung bases
• D) Hepatomegaly
Answer: C
• A) JVD is caused by increased right ventricular pressure → right-sided failure.
• B) Peripheral edema results from fluid backup in systemic circulation → right-sided failure.
• C) Correct. Left-sided failure causes pulmonary congestion due to inability to pump blood
forward → crackles.
• D) Hepatomegaly occurs from systemic venous congestion → right-sided failure.
2. A client with chronic atrial fibrillation is prescribed warfarin. Which lab value requires immediate
intervention?
• A) INR 2.5
• B) aPTT 35 seconds
• C) Platelets 150,000/mm³
• D) INR 4.8
Answer: D
• A) INR 2.5 is therapeutic for AF (target 2-3). No intervention needed.
, • B) aPTT 35 seconds is normal (30-40 sec). Warfarin does not affect aPTT.
• C) Platelets 150,000 is normal. Warfarin affects clotting factors, not platelets.
• D) Correct. INR 4.8 indicates high bleeding risk; hold warfarin, notify provider.
3. Post-cardiac catheterization, the nurse assesses the femoral insertion site. Which finding is most
concerning?
• A) Small 2cm bruise
• B) Patient reports mild discomfort
• C) Expanding hematoma
• D) Slight oozing with pressure
Answer: C
• A) Small bruise is expected after arterial puncture.
• B) Mild discomfort is expected post-procedure.
• C) Correct. Expanding hematoma indicates retroperitoneal bleeding or pseudoaneurysm.
• D) Slight oozing is common and managed with manual pressure.
4. A client with unstable angina is admitted. Which medication reduces mortality and should be
started within 24 hours?
• A) Metoprolol
• B) Furosemide
• C) Digoxin
• D) Alprazolam
Answer: A
• A) Correct. Beta-blockers reduce myocardial O2 demand, prevent remodeling, and decrease
mortality post-MI/unstable angina.
• B) Loop diuretic for fluid overload, no mortality benefit in angina.
• C) Digoxin for HF with AF, not for unstable angina.
• D) Benzodiazepine for anxiety, no mortality benefit.
5. A client post-MI has a new murmur heard at the apex. What complication should the nurse
suspect?
• A) Pericarditis
• B) Ventricular septal rupture
, • C) Papillary muscle rupture
• D) Dressler syndrome
Answer: C
• A) Pericarditis causes friction rub, not murmur.
• B) VSD causes harsh holosystolic murmur at left sternal border, not apex.
• C) Correct. New apical murmur post-MI = mitral regurgitation from papillary muscle
dysfunction/rupture.
• D) Dressler syndrome is autoimmune pericarditis weeks later, not acute murmur.
6. A client with heart failure has an ejection fraction of 25%. Which classification of HF is this?
• A) HFpEF
• B) HFmrEF
• C) HFrEF
• D) Right-sided failure
Answer: C
• A) HFpEF = preserved EF ≥50%.
• B) HFmrEF = mid-range EF 41-49%.
• C) Correct. HFrEF = reduced EF <40%.
• D) Right-sided failure is a clinical presentation, not an EF classification.
7. The nurse notes a new onset of confusion and hypotension in a client with atrial fibrillation. What
action is priority?
• A) Recheck BP in 15 minutes
• B) Notify provider immediately
• C) Administer prescribed lorazepam
• D) Increase IV fluids
Answer: B
• A) Delays critical intervention; patient is unstable.
• B) Correct. Confusion + hypotension in AF = possible embolic stroke or low cardiac output;
immediate provider notification.
• C) Lorazepam may worsen hypotension/AMS.
• D) May help if hypovolemic, but not priority over identifying cause.
, 8. Which ECG finding is characteristic of a myocardial infarction?
• A) Peaked T waves
• B) ST-segment elevation
• C) U waves
• D) Prolonged PR interval
Answer: B
• A) Peaked T waves = hyperkalemia.
• B) Correct. ST elevation = STEMI (full-thickness infarction).
• C) U waves = hypokalemia.
• D) Prolonged PR = first-degree AV block.
9. A client is started on amiodarone for ventricular tachycardia. Which baseline test is required?
• A) Pulmonary function tests
• B) Liver biopsy
• C) Thyroid function tests
• D) Renal ultrasound
Answer: C
• A) PFTs not routine unless symptoms develop.
• B) Liver biopsy is invasive; LFTs are monitored, not biopsy.
• C) Correct. Amiodarone contains iodine and causes hyperthyroidism or hypothyroidism.
• D) Renal dysfunction is not a primary amiodarone side effect.
10. During cardioversion for a client with unstable tachycardia, the nurse sets the defibrillator to
which mode?
• A) Synchronized mode
• B) Unsynchronized mode
• C) AED mode
• D) Pacemaker mode
Answer: A
• A) Correct. Synchronized mode delivers shock on R wave to avoid R-on-T phenomenon (V-fib).
• B) Unsynchronized is for cardiac arrest with V-fib/pulseless V-tach.
