Adult Health II (D446) New OA 2 Exam 3
V1 | Adult Health II (D446) New OA 2 Exam
Q&A | WGU
1. A patient with chronic kidney disease (CKD) has a potassium level of 6.8 mEq/L. Which
medication should the nurse expect to administer first to protect the heart?
A. Sodium polystyrene sulfonate
B. Calcium gluconate
C. Furosemide
D. Regular insulin and dextrose
Answer: B
Rationale: Calcium gluconate is the priority intervention because it stabilizes the
myocardial cell membrane to prevent life-threatening dysrhythmias. While insulin and
sodium polystyrene sulfonate help lower potassium levels, they do not provide immediate
cardiac protection. The nurse must monitor the heart rhythm continuously during
administration to ensure effectiveness.
2. Which clinical finding is most characteristic of the early stage of Acute Respiratory Distress
Syndrome (ARDS)?
A. Bradypnea and hypercapnia
,B. Hypoxemia refractory to supplemental oxygen
C. Decreased tactile fremitus
D. Tracheal deviation to the unaffected side
Answer: B
Rationale: The hallmark of ARDS is hypoxemia that does not improve even with high
concentrations of supplemental oxygen. This occurs due to severe ventilation-perfusion
mismatching and intrapulmonary shunting. Early recognition is vital because the patient’s
condition can deteriorate rapidly into respiratory failure.
3. A nurse is caring for a patient with a chest tube. What should the nurse do if continuous
bubbling is observed in the water-seal chamber?
A. Document this as a normal finding for a patient with a pneumothorax
B. Check the system for an air leak starting from the insertion site
C. Increase the suction pressure on the regulator
D. Clamp the chest tube for 24 hours to see if it stops
Answer: B
Rationale: Continuous bubbling in the water-seal chamber usually indicates an air leak in
the drainage system or at the insertion site. Intermittent bubbling is expected in patients
with a pneumothorax, but continuous bubbling requires immediate troubleshooting. The
nurse should check all connections and the dressing to ensure the system is airtight.
, 4. A patient is admitted with autonomic dysreflexia. Which nursing intervention should be
prioritized first?
A. Administering prescribed antihypertensive medication
B. Raising the head of the bed to 45 degrees or higher
C. Lowering the head of the bed to a flat position
D. Checking the patient for bladder distension or impaction
Answer: B
Rationale: Elevating the head of the bed is the first action to help lower blood pressure
through orthostatic changes. After positioning the patient, the nurse should then identify
and remove the noxious stimulus, such as a full bladder. This condition is a medical
emergency that occurs in patients with spinal cord injuries at T6 or above.
5. A patient with Acute Kidney Injury (AKI) is in the diuretic phase. What is the nurse’s
primary concern during this stage?
A. Metabolic acidosis and hyperkalemia
B. Hypovolemia and electrolyte imbalances
C. Weight gain and peripheral edema
D. Decreased blood urea nitrogen (BUN) levels
Answer: B
V1 | Adult Health II (D446) New OA 2 Exam
Q&A | WGU
1. A patient with chronic kidney disease (CKD) has a potassium level of 6.8 mEq/L. Which
medication should the nurse expect to administer first to protect the heart?
A. Sodium polystyrene sulfonate
B. Calcium gluconate
C. Furosemide
D. Regular insulin and dextrose
Answer: B
Rationale: Calcium gluconate is the priority intervention because it stabilizes the
myocardial cell membrane to prevent life-threatening dysrhythmias. While insulin and
sodium polystyrene sulfonate help lower potassium levels, they do not provide immediate
cardiac protection. The nurse must monitor the heart rhythm continuously during
administration to ensure effectiveness.
2. Which clinical finding is most characteristic of the early stage of Acute Respiratory Distress
Syndrome (ARDS)?
A. Bradypnea and hypercapnia
,B. Hypoxemia refractory to supplemental oxygen
C. Decreased tactile fremitus
D. Tracheal deviation to the unaffected side
Answer: B
Rationale: The hallmark of ARDS is hypoxemia that does not improve even with high
concentrations of supplemental oxygen. This occurs due to severe ventilation-perfusion
mismatching and intrapulmonary shunting. Early recognition is vital because the patient’s
condition can deteriorate rapidly into respiratory failure.
3. A nurse is caring for a patient with a chest tube. What should the nurse do if continuous
bubbling is observed in the water-seal chamber?
A. Document this as a normal finding for a patient with a pneumothorax
B. Check the system for an air leak starting from the insertion site
C. Increase the suction pressure on the regulator
D. Clamp the chest tube for 24 hours to see if it stops
Answer: B
Rationale: Continuous bubbling in the water-seal chamber usually indicates an air leak in
the drainage system or at the insertion site. Intermittent bubbling is expected in patients
with a pneumothorax, but continuous bubbling requires immediate troubleshooting. The
nurse should check all connections and the dressing to ensure the system is airtight.
, 4. A patient is admitted with autonomic dysreflexia. Which nursing intervention should be
prioritized first?
A. Administering prescribed antihypertensive medication
B. Raising the head of the bed to 45 degrees or higher
C. Lowering the head of the bed to a flat position
D. Checking the patient for bladder distension or impaction
Answer: B
Rationale: Elevating the head of the bed is the first action to help lower blood pressure
through orthostatic changes. After positioning the patient, the nurse should then identify
and remove the noxious stimulus, such as a full bladder. This condition is a medical
emergency that occurs in patients with spinal cord injuries at T6 or above.
5. A patient with Acute Kidney Injury (AKI) is in the diuretic phase. What is the nurse’s
primary concern during this stage?
A. Metabolic acidosis and hyperkalemia
B. Hypovolemia and electrolyte imbalances
C. Weight gain and peripheral edema
D. Decreased blood urea nitrogen (BUN) levels
Answer: B
