WGU D444 Adult Health 1 Objective Assessment
OA V1 and V2 -- Questions and Answers | 2026 Update | 100% Correct
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VERSION 1
SECTION 1: CARDIOVASCULAR DISORDERS (14 Questions)
Q1: A nurse is caring for a client with newly diagnosed Stage 1 hypertension (BP 138/86
mmHg). The client asks about first-line medication therapy. Which medication class does the
nurse anticipate the provider will prescribe?
• A. Beta-blocker (metoprolol)
• B. Thiazide diuretic, ACE inhibitor, ARB, or calcium channel blocker
• C. Alpha-2 agonist (clonidine)
• D. Direct renin inhibitor (aliskiren)
Correct Answer: B
Rationale: Correct because per JNC 8 and ACC/AHA guidelines, first-line pharmacologic
therapy for Stage 1 hypertension includes thiazide diuretics, ACE inhibitors, ARBs, or calcium
channel blockers. Beta-blockers are not first-line unless post-MI or heart failure.
Q2: A client taking lisinopril for hypertension reports a persistent dry cough. Which action by
the nurse is most appropriate?
• A. Advise the client to switch to losartan
• B. Instruct the client to take an over-the-counter cough suppressant
• C. Recommend discontinuing the medication immediately
• D. Suggest the client tolerate the cough as it is harmless
Correct Answer: A
Rationale: Correct because ACE inhibitor-induced dry cough is caused by bradykinin
accumulation and is a common reason for switching to an ARB such as losartan, which does
not affect bradykinin metabolism and typically resolves the cough.
Q3: A client presents with a blood pressure of 190/118 mmHg, headache, and blurred vision
but no evidence of acute target organ damage. The nurse recognizes this as which condition?
• A. Hypertensive emergency
• B. Hypertensive urgency
,• C. Secondary hypertension
• D. Malignant hypertension
Correct Answer: B
Rationale: Correct because hypertensive urgency is defined as severe hypertension
(>=180/>=120 mmHg) without evidence of acute target organ damage such as
encephalopathy, retinal hemorrhage, acute kidney injury, MI, pulmonary edema, or aortic
dissection.
Q4: A nurse is teaching a client with heart failure about daily weight monitoring. The nurse
instructs the client to report weight gain of how many pounds in one week?
• A. Greater than 1 pound
• B. Greater than 2-3 pounds in 24 hours or 5 pounds in one week
• C. Greater than 10 pounds
• D. Any weight gain at all
Correct Answer: B
Rationale: Correct because in heart failure management, a weight gain greater than 2-3
pounds in 24 hours or 5 pounds in one week indicates fluid retention and requires prompt
provider notification for possible diuretic adjustment.
Q5: A client with HFrEF has been started on guideline-directed medical therapy. Which
medication combination represents the foundational quadruple therapy?
• A. Digoxin, furosemide, hydralazine, and isosorbide dinitrate
• B. Sacubitril/valsartan, beta-blocker, MRA, and SGLT2 inhibitor
• C. ACE inhibitor, beta-blocker, digoxin, and furosemide
• D. ARB, beta-blocker, aldosterone antagonist, and hydralazine
Correct Answer: B
Rationale: Correct because current ACC/AHA guidelines recommend the quadruple therapy
of ARNI (sacubitril/valsartan), beta-blocker (carvedilol, metoprolol succinate, or bisoprolol),
mineralocorticoid receptor antagonist (spironolactone or eplerenone), and SGLT2 inhibitor
for HFrEF to reduce mortality and hospitalization.
Q6: A nurse is monitoring a client receiving IV furosemide for acute heart failure exacerbation.
Which electrolyte imbalance is the nurse most concerned about?
• A. Hyperkalemia
• B. Hyponatremia, hypokalemia, and hypomagnesemia
• C. Hypernatremia
,• D. Hypercalcemia
Correct Answer: B
Rationale: Correct because loop diuretics such as furosemide cause renal wasting of sodium,
potassium, and magnesium, leading to hyponatremia, hypokalemia, and hypomagnesemia,
which can precipitate life-threatening cardiac arrhythmias.
Q7: A client with acute coronary syndrome is experiencing crushing chest pain unrelieved by
rest. The nurse administers sublingual nitroglycerin 0.4 mg. Before administering, which
assessment is the nurse's highest priority?
• A. Auscultate lung sounds for crackles
• B. Verify systolic blood pressure is greater than 90 mmHg
• C. Check the client's potassium level
• D. Assess for jugular venous distention
Correct Answer: B
Rationale: Correct because nitroglycerin causes vasodilation and can precipitate profound
hypotension; therefore, the nurse must verify systolic blood pressure is greater than 90
mmHg before each dose and withhold if below this threshold.
Q8: A client with STEMI arrives in the emergency department. The nurse prepares the client
for primary PCI. What is the target door-to-balloon time?
• A. <=30 minutes
• B. <=60 minutes
• C. <=90 minutes
• D. <=120 minutes
Correct Answer: C
Rationale: Correct because the American College of Cardiology/American Heart Association
guideline recommends a door-to-balloon time of 90 minutes or less for primary
percutaneous coronary intervention in STEMI to optimize myocardial salvage and reduce
mortality.
Q9: A nurse is caring for a client post-MI who received a drug-eluting stent. The nurse provides
discharge teaching about dual antiplatelet therapy. For how long should the client continue
aspirin plus a P2Y12 inhibitor?
• A. 1 month
• B. 3 months
• C. 6-12 months
, • D. Indefinitely
Correct Answer: C
Rationale: Correct because current guidelines recommend dual antiplatelet therapy with
aspirin plus a P2Y12 inhibitor (ticagrelor or clopidogrel) for 6-12 months following drug-
eluting stent placement to prevent stent thrombosis and recurrent cardiovascular events.
Q10: A client with atrial fibrillation has a CHA2DS2-VASc score of 3. Which intervention is
indicated?
• A. Aspirin 81 mg daily
• B. Anticoagulation with warfarin or DOAC
• C. Rate control with diltiazem only
• D. Electrical cardioversion without anticoagulation
Correct Answer: B
Rationale: Correct because a CHA2DS2-VASc score of 2 or greater in men or 3 or greater in
women indicates high risk for thromboembolic stroke and requires anticoagulation with
warfarin (target INR 2-3) or a direct oral anticoagulant such as apixaban or rivaroxaban.
Q11: A client with new-onset atrial fibrillation and rapid ventricular response becomes
hypotensive with altered mental status. Which intervention does the nurse anticipate?
• A. Adenosine 6 mg rapid IV push
• B. Synchronized cardioversion
• C. Amiodarone 150 mg IV over 10 minutes
• D. Carotid sinus massage
Correct Answer: B
Rationale: Correct because unstable atrial fibrillation with hypotension and altered mental
status is an indication for immediate synchronized cardioversion (50-100 J) to restore
hemodynamic stability, as pharmacologic rate control would be insufficient and potentially
harmful.
Q12: A nurse is monitoring a client on the telemetry unit who develops ventricular tachycardia
with a pulse but is unstable. Which action does the nurse take first?
• A. Administer amiodarone 150 mg IV over 10 minutes
• B. Prepare for synchronized cardioversion at 100-200 J
• C. Begin CPR immediately
• D. Give lidocaine 1-1.5 mg/kg IV push
Correct Answer: B
OA V1 and V2 -- Questions and Answers | 2026 Update | 100% Correct
────────────────────────────────────────────────────────────
VERSION 1
SECTION 1: CARDIOVASCULAR DISORDERS (14 Questions)
Q1: A nurse is caring for a client with newly diagnosed Stage 1 hypertension (BP 138/86
mmHg). The client asks about first-line medication therapy. Which medication class does the
nurse anticipate the provider will prescribe?
• A. Beta-blocker (metoprolol)
• B. Thiazide diuretic, ACE inhibitor, ARB, or calcium channel blocker
• C. Alpha-2 agonist (clonidine)
• D. Direct renin inhibitor (aliskiren)
Correct Answer: B
Rationale: Correct because per JNC 8 and ACC/AHA guidelines, first-line pharmacologic
therapy for Stage 1 hypertension includes thiazide diuretics, ACE inhibitors, ARBs, or calcium
channel blockers. Beta-blockers are not first-line unless post-MI or heart failure.
Q2: A client taking lisinopril for hypertension reports a persistent dry cough. Which action by
the nurse is most appropriate?
• A. Advise the client to switch to losartan
• B. Instruct the client to take an over-the-counter cough suppressant
• C. Recommend discontinuing the medication immediately
• D. Suggest the client tolerate the cough as it is harmless
Correct Answer: A
Rationale: Correct because ACE inhibitor-induced dry cough is caused by bradykinin
accumulation and is a common reason for switching to an ARB such as losartan, which does
not affect bradykinin metabolism and typically resolves the cough.
Q3: A client presents with a blood pressure of 190/118 mmHg, headache, and blurred vision
but no evidence of acute target organ damage. The nurse recognizes this as which condition?
• A. Hypertensive emergency
• B. Hypertensive urgency
,• C. Secondary hypertension
• D. Malignant hypertension
Correct Answer: B
Rationale: Correct because hypertensive urgency is defined as severe hypertension
(>=180/>=120 mmHg) without evidence of acute target organ damage such as
encephalopathy, retinal hemorrhage, acute kidney injury, MI, pulmonary edema, or aortic
dissection.
Q4: A nurse is teaching a client with heart failure about daily weight monitoring. The nurse
instructs the client to report weight gain of how many pounds in one week?
• A. Greater than 1 pound
• B. Greater than 2-3 pounds in 24 hours or 5 pounds in one week
• C. Greater than 10 pounds
• D. Any weight gain at all
Correct Answer: B
Rationale: Correct because in heart failure management, a weight gain greater than 2-3
pounds in 24 hours or 5 pounds in one week indicates fluid retention and requires prompt
provider notification for possible diuretic adjustment.
Q5: A client with HFrEF has been started on guideline-directed medical therapy. Which
medication combination represents the foundational quadruple therapy?
• A. Digoxin, furosemide, hydralazine, and isosorbide dinitrate
• B. Sacubitril/valsartan, beta-blocker, MRA, and SGLT2 inhibitor
• C. ACE inhibitor, beta-blocker, digoxin, and furosemide
• D. ARB, beta-blocker, aldosterone antagonist, and hydralazine
Correct Answer: B
Rationale: Correct because current ACC/AHA guidelines recommend the quadruple therapy
of ARNI (sacubitril/valsartan), beta-blocker (carvedilol, metoprolol succinate, or bisoprolol),
mineralocorticoid receptor antagonist (spironolactone or eplerenone), and SGLT2 inhibitor
for HFrEF to reduce mortality and hospitalization.
Q6: A nurse is monitoring a client receiving IV furosemide for acute heart failure exacerbation.
Which electrolyte imbalance is the nurse most concerned about?
• A. Hyperkalemia
• B. Hyponatremia, hypokalemia, and hypomagnesemia
• C. Hypernatremia
,• D. Hypercalcemia
Correct Answer: B
Rationale: Correct because loop diuretics such as furosemide cause renal wasting of sodium,
potassium, and magnesium, leading to hyponatremia, hypokalemia, and hypomagnesemia,
which can precipitate life-threatening cardiac arrhythmias.
Q7: A client with acute coronary syndrome is experiencing crushing chest pain unrelieved by
rest. The nurse administers sublingual nitroglycerin 0.4 mg. Before administering, which
assessment is the nurse's highest priority?
• A. Auscultate lung sounds for crackles
• B. Verify systolic blood pressure is greater than 90 mmHg
• C. Check the client's potassium level
• D. Assess for jugular venous distention
Correct Answer: B
Rationale: Correct because nitroglycerin causes vasodilation and can precipitate profound
hypotension; therefore, the nurse must verify systolic blood pressure is greater than 90
mmHg before each dose and withhold if below this threshold.
Q8: A client with STEMI arrives in the emergency department. The nurse prepares the client
for primary PCI. What is the target door-to-balloon time?
• A. <=30 minutes
• B. <=60 minutes
• C. <=90 minutes
• D. <=120 minutes
Correct Answer: C
Rationale: Correct because the American College of Cardiology/American Heart Association
guideline recommends a door-to-balloon time of 90 minutes or less for primary
percutaneous coronary intervention in STEMI to optimize myocardial salvage and reduce
mortality.
Q9: A nurse is caring for a client post-MI who received a drug-eluting stent. The nurse provides
discharge teaching about dual antiplatelet therapy. For how long should the client continue
aspirin plus a P2Y12 inhibitor?
• A. 1 month
• B. 3 months
• C. 6-12 months
, • D. Indefinitely
Correct Answer: C
Rationale: Correct because current guidelines recommend dual antiplatelet therapy with
aspirin plus a P2Y12 inhibitor (ticagrelor or clopidogrel) for 6-12 months following drug-
eluting stent placement to prevent stent thrombosis and recurrent cardiovascular events.
Q10: A client with atrial fibrillation has a CHA2DS2-VASc score of 3. Which intervention is
indicated?
• A. Aspirin 81 mg daily
• B. Anticoagulation with warfarin or DOAC
• C. Rate control with diltiazem only
• D. Electrical cardioversion without anticoagulation
Correct Answer: B
Rationale: Correct because a CHA2DS2-VASc score of 2 or greater in men or 3 or greater in
women indicates high risk for thromboembolic stroke and requires anticoagulation with
warfarin (target INR 2-3) or a direct oral anticoagulant such as apixaban or rivaroxaban.
Q11: A client with new-onset atrial fibrillation and rapid ventricular response becomes
hypotensive with altered mental status. Which intervention does the nurse anticipate?
• A. Adenosine 6 mg rapid IV push
• B. Synchronized cardioversion
• C. Amiodarone 150 mg IV over 10 minutes
• D. Carotid sinus massage
Correct Answer: B
Rationale: Correct because unstable atrial fibrillation with hypotension and altered mental
status is an indication for immediate synchronized cardioversion (50-100 J) to restore
hemodynamic stability, as pharmacologic rate control would be insufficient and potentially
harmful.
Q12: A nurse is monitoring a client on the telemetry unit who develops ventricular tachycardia
with a pulse but is unstable. Which action does the nurse take first?
• A. Administer amiodarone 150 mg IV over 10 minutes
• B. Prepare for synchronized cardioversion at 100-200 J
• C. Begin CPR immediately
• D. Give lidocaine 1-1.5 mg/kg IV push
Correct Answer: B
