Adult Health II (D446) New OA 2 Exam 3
V2 | Adult Health II (D446) New OA 2 Exam
Q&A | WGU
1. A nurse is caring for a patient who develops ventricular tachycardia (VT) with a pulse.
Which of the following is the priority intervention?
A. Immediate defibrillation at 200 Joules
B. Administration of Amiodarone 150 mg IV over 10 minutes
C. Synchronized cardioversion
D. Carotid sinus massage
Answer: C
Rationale: Synchronized cardioversion is the treatment of choice for a patient with stable
or unstable ventricular tachycardia who still has a pulse. This procedure delivers a shock
timed with the R-wave to prevent the R-on-T phenomenon which could lead to ventricular
fibrillation. Unlike defibrillation, which is used for pulseless rhythms, cardioversion
requires the machine to be in ‘sync’ mode.
2. A patient is admitted with a diagnosis of Septic Shock. The nurse notes a Blood Pressure of
82/46 mmHg and a Heart Rate of 124 bpm. Which order should the nurse implement first?
A. Start Norepinephrine infusion at 2 mcg/min
,B. Administer Broad-spectrum antibiotics
C. Obtain blood cultures from two different sites
D. Administer 30 mL/kg of Isotonic Crystalloid IV bolus
Answer: D
Rationale: Fluid resuscitation is the initial priority in the management of septic shock to
restore intravascular volume and improve organ perfusion. According to the Surviving
Sepsis Campaign, a 30 mL/kg crystalloid bolus is recommended before starting
vasopressors. While blood cultures and antibiotics are critical, they follow initial volume
replacement in the sequence of immediate stabilization.
3. A nurse is monitoring a patient on a mechanical ventilator and hears the high-pressure
alarm. Which action should the nurse take first?
A. Check the patient’s oxygen saturation
B. Suction the patient’s airway for secretions
C. Check for kinks in the ventilator tubing
D. Assess the patient for signs of a pneumothorax
Answer: C
Rationale: A high-pressure alarm indicates that the ventilator is encountering resistance
while trying to deliver the breath. The nurse should first check for simple, external causes
such as kinks in the tubing or the patient biting the ET tube. If no external cause is found,
, the nurse should then assess the patient for secretions or more serious complications like a
pneumothorax.
4. Which of the following clinical manifestations is most indicative of Cardiac Tamponade?
A. Hypertension, Bradycardia, and widened pulse pressure
B. Flattened neck veins and tachycardia
C. ST-segment elevation in all leads
D. Muffled heart sounds, Jugular Venous Distension, and Hypotension
Answer: D
Rationale: These three signs are known as Beck’s Triad, which is classic for cardiac
tamponade. Muffled heart sounds occur because fluid in the pericardial sac insulates the
heart, while hypotension results from decreased stroke volume. Jugular venous distension
occurs because the heart cannot fill properly, leading to backflow into the venous system.
5. A patient with a burn injury weighing 70kg has 40% Total Body Surface Area (TBSA) burned.
Using the Parkland Formula, calculate the total fluid volume for the first 24 hours.
A. 11,200 mL
B. 5,600 mL
C. 2,800 mL
D. 8,400 mL
Answer: A
V2 | Adult Health II (D446) New OA 2 Exam
Q&A | WGU
1. A nurse is caring for a patient who develops ventricular tachycardia (VT) with a pulse.
Which of the following is the priority intervention?
A. Immediate defibrillation at 200 Joules
B. Administration of Amiodarone 150 mg IV over 10 minutes
C. Synchronized cardioversion
D. Carotid sinus massage
Answer: C
Rationale: Synchronized cardioversion is the treatment of choice for a patient with stable
or unstable ventricular tachycardia who still has a pulse. This procedure delivers a shock
timed with the R-wave to prevent the R-on-T phenomenon which could lead to ventricular
fibrillation. Unlike defibrillation, which is used for pulseless rhythms, cardioversion
requires the machine to be in ‘sync’ mode.
2. A patient is admitted with a diagnosis of Septic Shock. The nurse notes a Blood Pressure of
82/46 mmHg and a Heart Rate of 124 bpm. Which order should the nurse implement first?
A. Start Norepinephrine infusion at 2 mcg/min
,B. Administer Broad-spectrum antibiotics
C. Obtain blood cultures from two different sites
D. Administer 30 mL/kg of Isotonic Crystalloid IV bolus
Answer: D
Rationale: Fluid resuscitation is the initial priority in the management of septic shock to
restore intravascular volume and improve organ perfusion. According to the Surviving
Sepsis Campaign, a 30 mL/kg crystalloid bolus is recommended before starting
vasopressors. While blood cultures and antibiotics are critical, they follow initial volume
replacement in the sequence of immediate stabilization.
3. A nurse is monitoring a patient on a mechanical ventilator and hears the high-pressure
alarm. Which action should the nurse take first?
A. Check the patient’s oxygen saturation
B. Suction the patient’s airway for secretions
C. Check for kinks in the ventilator tubing
D. Assess the patient for signs of a pneumothorax
Answer: C
Rationale: A high-pressure alarm indicates that the ventilator is encountering resistance
while trying to deliver the breath. The nurse should first check for simple, external causes
such as kinks in the tubing or the patient biting the ET tube. If no external cause is found,
, the nurse should then assess the patient for secretions or more serious complications like a
pneumothorax.
4. Which of the following clinical manifestations is most indicative of Cardiac Tamponade?
A. Hypertension, Bradycardia, and widened pulse pressure
B. Flattened neck veins and tachycardia
C. ST-segment elevation in all leads
D. Muffled heart sounds, Jugular Venous Distension, and Hypotension
Answer: D
Rationale: These three signs are known as Beck’s Triad, which is classic for cardiac
tamponade. Muffled heart sounds occur because fluid in the pericardial sac insulates the
heart, while hypotension results from decreased stroke volume. Jugular venous distension
occurs because the heart cannot fill properly, leading to backflow into the venous system.
5. A patient with a burn injury weighing 70kg has 40% Total Body Surface Area (TBSA) burned.
Using the Parkland Formula, calculate the total fluid volume for the first 24 hours.
A. 11,200 mL
B. 5,600 mL
C. 2,800 mL
D. 8,400 mL
Answer: A
