Adult Health II (D446) OA 2 Exam Q&A | WGU
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This study guide is intended to provide comprehensive preparation for nursing examinations by
focusing on complex disease management, therapeutic nursing interventions, and safe
patient care strategies in adult healthcare environments. The content reflects practical nursing
concepts frequently tested in advanced adult health nursing assessments.
This version contains realistic exam-style questions designed to strengthen understanding of
nursing priorities, patient assessment findings, and interdisciplinary healthcare coordination.
Detailed expert explanations support deeper understanding and practical clinical application.
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Why Use This Exam:
• Strengthens clinical decision-making skills
• Reinforces therapeutic nursing interventions
• Supports safe patient management practices
• Improves understanding of adult health disorders
• Enhances nursing prioritization strategies
• Provides realistic nursing exam simulations
• Encourages analytical and evidence-based thinking
• Helps students prepare for complex clinical scenarios
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1. A patient with ARDS is being mechanically ventilated with high levels of PEEP. Which
assessment finding should the nurse prioritize as a potential complication?
A. Increase in arterial oxygen saturation
B. Decrease in cardiac output
C. Decreased work of breathing
D. Respiratory alkalosis
,Correct Answer: B
Expert Explanation: High levels of Positive End-Expiratory Pressure (PEEP) can increase
intrathoracic pressure, which decreases venous return to the heart, leading to reduced
cardiac output and hypotension.
2. Which clinical manifestation is indicative of the ‘compensatory’ stage of shock?
A. Lethargy and metabolic acidosis
B. Cool, clammy skin and tachycardia
C. Anuria and peripheral edema
D. Refractory hypotension and organ failure
Correct Answer: B
Expert Explanation: In the compensatory stage of shock, the body attempts to maintain
homeostasis through the activation of the sympathetic nervous system, resulting in
tachycardia and vasoconstriction (cool, clammy skin).
3. The nurse is caring for a patient with a suspected cervical spinal cord injury. Which action is
the highest priority?
A. Checking the patient’s blood pressure
B. Assessing for sensation in extremities
C. Maintaining spinal immobilization
D. Administering high-dose corticosteroids
,Correct Answer: C
Expert Explanation: Airway and stabilization are the priorities. Immobilization of the
spine is essential to prevent further neurological damage in a patient with a suspected
spinal cord injury.
4. A patient in the ICU is diagnosed with Septic Shock. The nurse notes a serum lactate level
of 5.2 mmol/L. What does this finding indicate?
A. Adequate tissue perfusion
B. Effective response to fluid resuscitation
C. Metabolic alkalosis from hyperventilation
D. Anaerobic metabolism due to tissue hypoxia
Correct Answer: D
Expert Explanation: Lactic acid levels rise during shock when tissues are not receiving
enough oxygen, forcing cells to switch to anaerobic metabolism.
5. The nurse is assessing a patient with Acute Pancreatitis. Which finding suggests the
presence of Turner’s sign?
A. Bluish discoloration of the periumbilical area
B. Ecchymosis in the flank area
C. Pain in the right lower quadrant
D. Muscle twitching in the face
, Correct Answer: B
Expert Explanation: Turner’s sign is ecchymosis (bruising) in the flank area, suggesting
retroperitoneal hemorrhage associated with severe pancreatitis.
6. In a patient with Acute Kidney Injury (AKI), which electrolyte imbalance is most life-
threatening?
A. Hypercalcemia
B. Hypomagnesemia
C. Hyperkalemia
D. Hyponatremia
Correct Answer: C
Expert Explanation: Hyperkalemia is the most dangerous electrolyte imbalance in renal
failure because it can lead to fatal cardiac dysrhythmias.
7. A patient is admitted with a Glasgow Coma Scale (GCS) score of 6. How should the nurse
interpret this score?
A. The patient is fully alert
B. The patient is in a deep coma or severely impaired
C. The patient has a mild head injury
D. The patient is moderately confused
Correct Answer: B
────────────────────────────────────
This study guide is intended to provide comprehensive preparation for nursing examinations by
focusing on complex disease management, therapeutic nursing interventions, and safe
patient care strategies in adult healthcare environments. The content reflects practical nursing
concepts frequently tested in advanced adult health nursing assessments.
This version contains realistic exam-style questions designed to strengthen understanding of
nursing priorities, patient assessment findings, and interdisciplinary healthcare coordination.
Detailed expert explanations support deeper understanding and practical clinical application.
════════════════════════════════════
Why Use This Exam:
• Strengthens clinical decision-making skills
• Reinforces therapeutic nursing interventions
• Supports safe patient management practices
• Improves understanding of adult health disorders
• Enhances nursing prioritization strategies
• Provides realistic nursing exam simulations
• Encourages analytical and evidence-based thinking
• Helps students prepare for complex clinical scenarios
════════════════════════════════════
1. A patient with ARDS is being mechanically ventilated with high levels of PEEP. Which
assessment finding should the nurse prioritize as a potential complication?
A. Increase in arterial oxygen saturation
B. Decrease in cardiac output
C. Decreased work of breathing
D. Respiratory alkalosis
,Correct Answer: B
Expert Explanation: High levels of Positive End-Expiratory Pressure (PEEP) can increase
intrathoracic pressure, which decreases venous return to the heart, leading to reduced
cardiac output and hypotension.
2. Which clinical manifestation is indicative of the ‘compensatory’ stage of shock?
A. Lethargy and metabolic acidosis
B. Cool, clammy skin and tachycardia
C. Anuria and peripheral edema
D. Refractory hypotension and organ failure
Correct Answer: B
Expert Explanation: In the compensatory stage of shock, the body attempts to maintain
homeostasis through the activation of the sympathetic nervous system, resulting in
tachycardia and vasoconstriction (cool, clammy skin).
3. The nurse is caring for a patient with a suspected cervical spinal cord injury. Which action is
the highest priority?
A. Checking the patient’s blood pressure
B. Assessing for sensation in extremities
C. Maintaining spinal immobilization
D. Administering high-dose corticosteroids
,Correct Answer: C
Expert Explanation: Airway and stabilization are the priorities. Immobilization of the
spine is essential to prevent further neurological damage in a patient with a suspected
spinal cord injury.
4. A patient in the ICU is diagnosed with Septic Shock. The nurse notes a serum lactate level
of 5.2 mmol/L. What does this finding indicate?
A. Adequate tissue perfusion
B. Effective response to fluid resuscitation
C. Metabolic alkalosis from hyperventilation
D. Anaerobic metabolism due to tissue hypoxia
Correct Answer: D
Expert Explanation: Lactic acid levels rise during shock when tissues are not receiving
enough oxygen, forcing cells to switch to anaerobic metabolism.
5. The nurse is assessing a patient with Acute Pancreatitis. Which finding suggests the
presence of Turner’s sign?
A. Bluish discoloration of the periumbilical area
B. Ecchymosis in the flank area
C. Pain in the right lower quadrant
D. Muscle twitching in the face
, Correct Answer: B
Expert Explanation: Turner’s sign is ecchymosis (bruising) in the flank area, suggesting
retroperitoneal hemorrhage associated with severe pancreatitis.
6. In a patient with Acute Kidney Injury (AKI), which electrolyte imbalance is most life-
threatening?
A. Hypercalcemia
B. Hypomagnesemia
C. Hyperkalemia
D. Hyponatremia
Correct Answer: C
Expert Explanation: Hyperkalemia is the most dangerous electrolyte imbalance in renal
failure because it can lead to fatal cardiac dysrhythmias.
7. A patient is admitted with a Glasgow Coma Scale (GCS) score of 6. How should the nurse
interpret this score?
A. The patient is fully alert
B. The patient is in a deep coma or severely impaired
C. The patient has a mild head injury
D. The patient is moderately confused
Correct Answer: B
