Adult Health II (D446) New OA 2 Exam 2
V3 | Adult Health II (D446) New OA 2 Exam
Q&A | WGU
1. A patient with septic shock remains hypotensive after receiving a 30 mL/kg fluid bolus.
Which medication should the nurse anticipate administering next?
A. Norepinephrine
B. Furosemide
C. Amiodarone
D. Nitroprusside
Answer: A
Rationale: In septic shock, if fluid resuscitation does not restore adequate Mean Arterial
Pressure (MAP), vasopressors such as norepinephrine are the first-line choice to increase
systemic vascular resistance. Furosemide would worsen hypotension, and nitroprusside is
a vasodilator.
2. A patient in the ICU has a high-pressure alarm sounding on their mechanical ventilator.
What is the nurse’s first action?
A. Silence the alarm and observe
B. Increase the oxygen concentration
C. Assess the patient’s airway and breath sounds
,D. Change the ventilator settings
Answer: C
Rationale: The nurse must always assess the patient first. High-pressure alarms can be
caused by biting the tube, secretions, or a pneumothorax, and physical assessment is
necessary to identify the cause before taking corrective action.
3. Which clinical manifestation is most indicative of a patient entering the compensatory
stage of shock?
A. Cold, clammy skin
B. Decreased level of consciousness
C. Anuria (urine output < 100 mL/day)
D. Increased heart rate and narrowing pulse pressure
Answer: D
Rationale: During the compensatory stage, the body activates the sympathetic nervous
system, leading to tachycardia and vasoconstriction (narrowed pulse pressure) to maintain
CO. Cold skin and decreased consciousness typically occur in the progressive stage.
4. A nurse is caring for a patient with a T4 spinal cord injury. The patient reports a sudden,
severe headache and has a blood pressure of 190/100 mmHg. What is the priority nursing
action?
A. Administer PRN acetaminophen
, B. Lower the head of the bed
C. Check for bladder distention
D. Notify the provider to request a CT scan
Answer: C
Rationale: These symptoms indicate autonomic dysreflexia, a medical emergency. The
priority is to sit the patient up and then identify and remove the triggering stimulus, most
commonly a distended bladder or impacted bowel.
5. An ABG result shows: pH 7.30, PaCO2 52, HCO3 24. How should the nurse interpret these
results?
A. Metabolic acidosis
B. Respiratory acidosis, uncompensated
C. Respiratory alkalosis, compensated
D. Metabolic alkalosis
Answer: B
Rationale: The pH is low (<7.35), indicating acidosis. The PaCO2 is high (>45), indicating a
respiratory cause. Since the HCO3 is normal, no compensation has occurred.
6. A patient with acute pancreatitis has a positive Trousseau’s sign. Which electrolyte
imbalance does the nurse suspect?
A. Hyperkalemia
V3 | Adult Health II (D446) New OA 2 Exam
Q&A | WGU
1. A patient with septic shock remains hypotensive after receiving a 30 mL/kg fluid bolus.
Which medication should the nurse anticipate administering next?
A. Norepinephrine
B. Furosemide
C. Amiodarone
D. Nitroprusside
Answer: A
Rationale: In septic shock, if fluid resuscitation does not restore adequate Mean Arterial
Pressure (MAP), vasopressors such as norepinephrine are the first-line choice to increase
systemic vascular resistance. Furosemide would worsen hypotension, and nitroprusside is
a vasodilator.
2. A patient in the ICU has a high-pressure alarm sounding on their mechanical ventilator.
What is the nurse’s first action?
A. Silence the alarm and observe
B. Increase the oxygen concentration
C. Assess the patient’s airway and breath sounds
,D. Change the ventilator settings
Answer: C
Rationale: The nurse must always assess the patient first. High-pressure alarms can be
caused by biting the tube, secretions, or a pneumothorax, and physical assessment is
necessary to identify the cause before taking corrective action.
3. Which clinical manifestation is most indicative of a patient entering the compensatory
stage of shock?
A. Cold, clammy skin
B. Decreased level of consciousness
C. Anuria (urine output < 100 mL/day)
D. Increased heart rate and narrowing pulse pressure
Answer: D
Rationale: During the compensatory stage, the body activates the sympathetic nervous
system, leading to tachycardia and vasoconstriction (narrowed pulse pressure) to maintain
CO. Cold skin and decreased consciousness typically occur in the progressive stage.
4. A nurse is caring for a patient with a T4 spinal cord injury. The patient reports a sudden,
severe headache and has a blood pressure of 190/100 mmHg. What is the priority nursing
action?
A. Administer PRN acetaminophen
, B. Lower the head of the bed
C. Check for bladder distention
D. Notify the provider to request a CT scan
Answer: C
Rationale: These symptoms indicate autonomic dysreflexia, a medical emergency. The
priority is to sit the patient up and then identify and remove the triggering stimulus, most
commonly a distended bladder or impacted bowel.
5. An ABG result shows: pH 7.30, PaCO2 52, HCO3 24. How should the nurse interpret these
results?
A. Metabolic acidosis
B. Respiratory acidosis, uncompensated
C. Respiratory alkalosis, compensated
D. Metabolic alkalosis
Answer: B
Rationale: The pH is low (<7.35), indicating acidosis. The PaCO2 is high (>45), indicating a
respiratory cause. Since the HCO3 is normal, no compensation has occurred.
6. A patient with acute pancreatitis has a positive Trousseau’s sign. Which electrolyte
imbalance does the nurse suspect?
A. Hyperkalemia
