WGU D444 (NURS 3117) Adult Health I Objective Assessment
Review – 200 Original Practice Questions with Rationales |
2026 Edition
WGU D444 Adult Health I – 20 Practice Questions (2026 Update)
1. A patient with heart failure has jugular venous distention, 3+ pitting edema, and crackles in the lung
bases. Which medication does the nurse expect to administer first?
• A) Digoxin
• B) Furosemide
• C) Metoprolol
• D) Spironolactone
Answer: B) Furosemide
Rationale: Furosemide is a loop diuretic that rapidly reduces preload, relieving pulmonary congestion
and edema. Digoxin improves contractility but not immediate fluid removal. Metoprolol is for chronic
management. Spironolactone is potassium-sparing and less potent for acute overload.
2. A patient with type 2 diabetes and hypertension has a urine albumin-to-creatinine ratio of 300
mg/g. Which class of medication is most beneficial to slow nephropathy progression?
• A) ACE inhibitor
• B) Beta blocker
• C) Thiazide diuretic
• D) Calcium channel blocker
Answer: A) ACE inhibitor
Rationale: ACE inhibitors (or ARBs) reduce intraglomerular pressure and proteinuria, slowing diabetic
kidney disease progression, even without hypertension. Beta blockers (B) and thiazides (C) do not have
this specific renoprotective effect.
3. A patient with a new colostomy asks about foods that help thicken stool. Which food does the
nurse recommend?
• A) Prune juice
• B) Raw spinach
, • C) Applesauce and white rice
• D) Bran cereal
Answer: C) Applesauce and white rice
Rationale: Low-fiber, binding foods (BRAT diet: bananas, rice, applesauce, toast) thicken stool. Prune
juice (A) and raw spinach (B) increase output. Bran (D) adds bulk but may not thicken.
4. A patient with a history of alcohol use disorder is admitted with agitation, tremors, and
hallucinations 48 hours after last drink. Which medication does the nurse anticipate?
• A) Haloperidol
• B) Lorazepam
• C) Thiamine
• D) Naltrexone
Answer: B) Lorazepam
Rationale: Benzodiazepines (lorazepam, diazepam) are first-line for alcohol withdrawal delirium to
prevent seizures and death. Haloperidol (A) may be adjunctive but not first-line. Thiamine (C) prevents
Wernicke’s but does not treat agitation.
5. A patient with a new ileostomy has output of 1800 mL in 12 hours and reports lightheadedness.
Which intervention is most important?
• A) Encourage clear fluids and electrolyte solutions
• B) Administer loperamide
• C) Increase fiber intake
• D) Notify the provider stat
Answer: A) Encourage clear fluids and electrolyte solutions
Rationale: High output can cause dehydration. Oral rehydration is first-line if patient can drink.
Loperamide (B) may be used but does not replace fluids. Notify provider if severe, but immediate action
is rehydration.
6. A patient with a spinal cord injury at T6 reports a severe headache, hypertension (190/100), and
bradycardia (48 bpm). The indwelling urinary catheter is draining. What is the priority action?
• A) Administer hydralazine IV
• B) Sit the patient upright
• C) Check for fecal impaction
, • D) Notify the provider
Answer: C) Check for fecal impaction
Rationale: Autonomic dysreflexia is most often triggered by bladder distention or fecal impaction.
Catheter is patent, so next check rectum. Sitting upright (B) helps but removing trigger is priority.
7. A patient with a traumatic brain injury has a Glasgow Coma Scale (GCS) of 6 and ICP of 24 mm Hg.
Which nursing intervention is contraindicated?
• A) Elevate head of bed to 30 degrees
• B) Suction as needed with pre-oxygenation
• C) Cluster all cares to minimize stimulation
• D) Administer mannitol as ordered
Answer: C) Cluster all cares to minimize stimulation
Rationale: Clustering cares increases stimulation and can spike ICP. Space out interventions. HOB
elevation (A) promotes venous drainage. Suctioning (B) is needed but pre-oxygenate.
8. A patient with heart failure is on a low-sodium diet. Which meal selection indicates understanding?
• A) Ham sandwich with pickles
• B) Grilled chicken breast with steamed rice and green beans
• C) Canned vegetable soup
• D) Frozen lasagna
Answer: B) Grilled chicken breast with steamed rice and green beans
Rationale: Fresh meat and unprocessed vegetables are low in sodium. Ham (A), canned soup (C), and
frozen lasagna (D) are high in sodium.
9. A patient with a new permanent pacemaker asks about restrictions. Which statement indicates
correct understanding?
• A) "I cannot use a microwave oven."
• B) "I should avoid MRI machines unless cleared."
• C) "I can lift my arm above my head immediately."
• D) "I must take my pulse once a month only."
, Answer: B) I should avoid MRI machines unless cleared.
Rationale: MRI can interfere with pacemaker function if not MRI-compatible. Microwaves (A) are safe.
Avoid lifting arm above head for 4-6 weeks (C). Check pulse daily (D).
10. A patient with cirrhosis and ascites has a paracentesis. After removal of 4 L of fluid, the nurse
monitors for which complication?
• A) Hypovolemia and hypotension
• B) Hypernatremia
• C) Metabolic alkalosis
• D) Respiratory acidosis
Answer: A) Hypovolemia and hypotension
Rationale: Large-volume paracentesis can shift fluid from intravascular space, causing hypovolemia and
hypotension. Monitor vital signs. Hypernatremia (B) is not typical.
11. A patient with a history of gout presents with a swollen, painful right great toe. Which medication
does the nurse expect to administer for the acute flare?
• A) Allopurinol
• B) Colchicine
• C) Probenecid
• D) Febuxostat
Answer: B) Colchicine
Rationale: Acute gout flare: NSAIDs, colchicine, or corticosteroids. Allopurinol (A) and probenecid (C) are
for chronic urate-lowering and may worsen acute flare if started during flare.
12. A patient receiving IV vancomycin develops a red rash on the chest and neck, with itching. The
nurse’s priority action is:
• A) Slow the infusion rate
• B) Stop the infusion immediately
• C) Administer diphenhydramine
• D) Document as non-allergic reaction
Answer: B) Stop the infusion immediately
Rationale: Symptoms suggest Red Man Syndrome (histamine release) or anaphylaxis. Stop infusion first.
Then slow rate and give antihistamine if ordered. Stopping is priority.
Review – 200 Original Practice Questions with Rationales |
2026 Edition
WGU D444 Adult Health I – 20 Practice Questions (2026 Update)
1. A patient with heart failure has jugular venous distention, 3+ pitting edema, and crackles in the lung
bases. Which medication does the nurse expect to administer first?
• A) Digoxin
• B) Furosemide
• C) Metoprolol
• D) Spironolactone
Answer: B) Furosemide
Rationale: Furosemide is a loop diuretic that rapidly reduces preload, relieving pulmonary congestion
and edema. Digoxin improves contractility but not immediate fluid removal. Metoprolol is for chronic
management. Spironolactone is potassium-sparing and less potent for acute overload.
2. A patient with type 2 diabetes and hypertension has a urine albumin-to-creatinine ratio of 300
mg/g. Which class of medication is most beneficial to slow nephropathy progression?
• A) ACE inhibitor
• B) Beta blocker
• C) Thiazide diuretic
• D) Calcium channel blocker
Answer: A) ACE inhibitor
Rationale: ACE inhibitors (or ARBs) reduce intraglomerular pressure and proteinuria, slowing diabetic
kidney disease progression, even without hypertension. Beta blockers (B) and thiazides (C) do not have
this specific renoprotective effect.
3. A patient with a new colostomy asks about foods that help thicken stool. Which food does the
nurse recommend?
• A) Prune juice
• B) Raw spinach
, • C) Applesauce and white rice
• D) Bran cereal
Answer: C) Applesauce and white rice
Rationale: Low-fiber, binding foods (BRAT diet: bananas, rice, applesauce, toast) thicken stool. Prune
juice (A) and raw spinach (B) increase output. Bran (D) adds bulk but may not thicken.
4. A patient with a history of alcohol use disorder is admitted with agitation, tremors, and
hallucinations 48 hours after last drink. Which medication does the nurse anticipate?
• A) Haloperidol
• B) Lorazepam
• C) Thiamine
• D) Naltrexone
Answer: B) Lorazepam
Rationale: Benzodiazepines (lorazepam, diazepam) are first-line for alcohol withdrawal delirium to
prevent seizures and death. Haloperidol (A) may be adjunctive but not first-line. Thiamine (C) prevents
Wernicke’s but does not treat agitation.
5. A patient with a new ileostomy has output of 1800 mL in 12 hours and reports lightheadedness.
Which intervention is most important?
• A) Encourage clear fluids and electrolyte solutions
• B) Administer loperamide
• C) Increase fiber intake
• D) Notify the provider stat
Answer: A) Encourage clear fluids and electrolyte solutions
Rationale: High output can cause dehydration. Oral rehydration is first-line if patient can drink.
Loperamide (B) may be used but does not replace fluids. Notify provider if severe, but immediate action
is rehydration.
6. A patient with a spinal cord injury at T6 reports a severe headache, hypertension (190/100), and
bradycardia (48 bpm). The indwelling urinary catheter is draining. What is the priority action?
• A) Administer hydralazine IV
• B) Sit the patient upright
• C) Check for fecal impaction
, • D) Notify the provider
Answer: C) Check for fecal impaction
Rationale: Autonomic dysreflexia is most often triggered by bladder distention or fecal impaction.
Catheter is patent, so next check rectum. Sitting upright (B) helps but removing trigger is priority.
7. A patient with a traumatic brain injury has a Glasgow Coma Scale (GCS) of 6 and ICP of 24 mm Hg.
Which nursing intervention is contraindicated?
• A) Elevate head of bed to 30 degrees
• B) Suction as needed with pre-oxygenation
• C) Cluster all cares to minimize stimulation
• D) Administer mannitol as ordered
Answer: C) Cluster all cares to minimize stimulation
Rationale: Clustering cares increases stimulation and can spike ICP. Space out interventions. HOB
elevation (A) promotes venous drainage. Suctioning (B) is needed but pre-oxygenate.
8. A patient with heart failure is on a low-sodium diet. Which meal selection indicates understanding?
• A) Ham sandwich with pickles
• B) Grilled chicken breast with steamed rice and green beans
• C) Canned vegetable soup
• D) Frozen lasagna
Answer: B) Grilled chicken breast with steamed rice and green beans
Rationale: Fresh meat and unprocessed vegetables are low in sodium. Ham (A), canned soup (C), and
frozen lasagna (D) are high in sodium.
9. A patient with a new permanent pacemaker asks about restrictions. Which statement indicates
correct understanding?
• A) "I cannot use a microwave oven."
• B) "I should avoid MRI machines unless cleared."
• C) "I can lift my arm above my head immediately."
• D) "I must take my pulse once a month only."
, Answer: B) I should avoid MRI machines unless cleared.
Rationale: MRI can interfere with pacemaker function if not MRI-compatible. Microwaves (A) are safe.
Avoid lifting arm above head for 4-6 weeks (C). Check pulse daily (D).
10. A patient with cirrhosis and ascites has a paracentesis. After removal of 4 L of fluid, the nurse
monitors for which complication?
• A) Hypovolemia and hypotension
• B) Hypernatremia
• C) Metabolic alkalosis
• D) Respiratory acidosis
Answer: A) Hypovolemia and hypotension
Rationale: Large-volume paracentesis can shift fluid from intravascular space, causing hypovolemia and
hypotension. Monitor vital signs. Hypernatremia (B) is not typical.
11. A patient with a history of gout presents with a swollen, painful right great toe. Which medication
does the nurse expect to administer for the acute flare?
• A) Allopurinol
• B) Colchicine
• C) Probenecid
• D) Febuxostat
Answer: B) Colchicine
Rationale: Acute gout flare: NSAIDs, colchicine, or corticosteroids. Allopurinol (A) and probenecid (C) are
for chronic urate-lowering and may worsen acute flare if started during flare.
12. A patient receiving IV vancomycin develops a red rash on the chest and neck, with itching. The
nurse’s priority action is:
• A) Slow the infusion rate
• B) Stop the infusion immediately
• C) Administer diphenhydramine
• D) Document as non-allergic reaction
Answer: B) Stop the infusion immediately
Rationale: Symptoms suggest Red Man Syndrome (histamine release) or anaphylaxis. Stop infusion first.
Then slow rate and give antihistamine if ordered. Stopping is priority.
