WGU D446 OBJECTIVE ASSESSMENT FINAL NEWEST
2026 ACTUAL EXAM| D446 ADULT HEALTH 2 OA
FINAL EXAM WITH COMPLETE 250 REAL EXAM
QUESTIONS AND CORRECT VERIFIED ANSWERS/
ALREADY GRADED A+ (MOST RECENT!!)
1. 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
Answer: B
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 .
2. 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
1
,C) A productive cough with clear sputum
D) A respiratory rate of 24 breaths/minute
Answer: B
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 .
3. A patient with severe 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%
Answer: C
Rationale: For patients with chronic hypercapnic respiratory failure
(common in severe COPD), 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 .
2
,4. 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
Answer: C
Rationale: TB is transmitted via airborne droplet nuclei that can
remain suspended in the air. Airborne precautions require an N95
respirator and a negative pressure room .
5. A patient with pneumonia has wheezing noted in both
lobes, pleuritic chest pain, and copious yellow sputum. What
are the priority nursing actions? (Select all that apply)
A) Administer prescribed antibiotics (e.g., ceftriaxone)
B) Provide respiratory treatments (e.g., albuterol)
C) Place patient in supine position
D) Educate on incentive spirometer use
E) Encourage mobility and increased fluid intake
Answer: A, B, D, E
Rationale: Antibiotics treat the infection, respiratory treatments
open airways, incentive spirometry improves lung expansion, and
3
, mobility/fluids help mobilize secretions. Supine positioning may
worsen dyspnea .
6. A patient with COPD asks what kind of diet they should
follow. Which response by the nurse is most appropriate?
A) "You should eat three large meals per day to maintain
energy."
B) "A low-fat, low-calorie diet is best for weight management."
C) "High-protein, high-calorie small meals help maintain energy
without causing shortness of breath."
D) "Clear liquids only during exacerbations."
Answer: C
Rationale: COPD patients have increased metabolic demand. Small,
frequent high-protein, high-calorie meals prevent early satiety and
reduce the work of breathing associated with large meals .
7. The nurse is assessing a patient with suspected
tuberculosis. Which classic signs and symptoms should the
nurse expect to find? (Select all that apply)
A) Night sweats
B) Weight gain
C) Blood-tinged sputum
D) Persistent productive cough
4
2026 ACTUAL EXAM| D446 ADULT HEALTH 2 OA
FINAL EXAM WITH COMPLETE 250 REAL EXAM
QUESTIONS AND CORRECT VERIFIED ANSWERS/
ALREADY GRADED A+ (MOST RECENT!!)
1. 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
Answer: B
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 .
2. 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
1
,C) A productive cough with clear sputum
D) A respiratory rate of 24 breaths/minute
Answer: B
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 .
3. A patient with severe 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%
Answer: C
Rationale: For patients with chronic hypercapnic respiratory failure
(common in severe COPD), 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 .
2
,4. 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
Answer: C
Rationale: TB is transmitted via airborne droplet nuclei that can
remain suspended in the air. Airborne precautions require an N95
respirator and a negative pressure room .
5. A patient with pneumonia has wheezing noted in both
lobes, pleuritic chest pain, and copious yellow sputum. What
are the priority nursing actions? (Select all that apply)
A) Administer prescribed antibiotics (e.g., ceftriaxone)
B) Provide respiratory treatments (e.g., albuterol)
C) Place patient in supine position
D) Educate on incentive spirometer use
E) Encourage mobility and increased fluid intake
Answer: A, B, D, E
Rationale: Antibiotics treat the infection, respiratory treatments
open airways, incentive spirometry improves lung expansion, and
3
, mobility/fluids help mobilize secretions. Supine positioning may
worsen dyspnea .
6. A patient with COPD asks what kind of diet they should
follow. Which response by the nurse is most appropriate?
A) "You should eat three large meals per day to maintain
energy."
B) "A low-fat, low-calorie diet is best for weight management."
C) "High-protein, high-calorie small meals help maintain energy
without causing shortness of breath."
D) "Clear liquids only during exacerbations."
Answer: C
Rationale: COPD patients have increased metabolic demand. Small,
frequent high-protein, high-calorie meals prevent early satiety and
reduce the work of breathing associated with large meals .
7. The nurse is assessing a patient with suspected
tuberculosis. Which classic signs and symptoms should the
nurse expect to find? (Select all that apply)
A) Night sweats
B) Weight gain
C) Blood-tinged sputum
D) Persistent productive cough
4
