Adult Health II (D446) New OA 2 Final
Exam V2 | Adult Health II (D446) New OA 2
Exam Q&A | WGU
1. A nurse is caring for a patient who has a chest tube connected to a water-seal drainage
system. The nurse notes continuous bubbling in the water-seal chamber. What is the most
appropriate nursing action?
A. Document this as a normal finding for a patient with a pneumothorax.
B. Increase the suction pressure on the wall regulator.
C. Check the system for a leak starting from the insertion site downward.
D. Clamp the chest tube for 24 hours to see if the bubbling stops.
Answer: C
Rationale: Continuous bubbling in the water-seal chamber indicates an air leak in the
system rather than the patient’s pleural space. The nurse should systematically check the
tubing and connections to locate and secure the leak. Normal intermittent bubbling occurs
with expiration or coughing in a patient with a known pneumothorax.
2. A patient is admitted with a suspected diagnosis of Diabetes Insipidus (DI). Which clinical
finding should the nurse anticipate during the assessment?
A. Low urine specific gravity and increased thirst.
B. High urine specific gravity and bradycardia.
,C. Hypoglycemia and peripheral edema.
D. Hypertension and concentrated dark urine.
Answer: A
Rationale: Diabetes Insipidus is characterized by a deficiency of ADH, leading to the
excretion of large volumes of dilute urine. This results in a very low urine specific gravity,
typically less than 1.005. Patients often experience extreme thirst (polydipsia) to
compensate for the massive fluid loss.
3. The nurse is assessing a patient with a Glasgow Coma Scale (GCS) score of 7. How should
the nurse interpret this finding?
A. The patient is alert and oriented but requires assistance with ADLs.
B. The patient is in a moderate coma state.
C. The patient has a severe head injury and requires intubation for airway protection.
D. The patient is fully conscious but has expressive aphasia.
Answer: C
Rationale: A Glasgow Coma Scale score of 8 or less is generally used as the threshold for
defining a coma and severe brain injury. At a score of 7, the patient is unable to protect
their own airway effectively. Standard medical practice dictates that patients with a GCS of
8 or less typically require endotracheal intubation.
, 4. A patient with Acute Respiratory Distress Syndrome (ARDS) is placed on mechanical
ventilation with Positive End-Expiratory Pressure (PEEP). What is the primary purpose of
PEEP?
A. To increase the fraction of inspired oxygen (FiO2) delivered to the patient.
B. To prevent the alveoli from collapsing during expiration.
C. To decrease the patient’s work of breathing by providing pressure support.
D. To clear secretions from the lower bronchial tree.
Answer: B
Rationale: PEEP provides positive pressure at the end of expiration to keep the alveoli
open, which improves oxygenation and gas exchange. By preventing alveolar collapse, it
increases the functional residual capacity of the lungs. This is a critical intervention for
patients with ARDS who suffer from refractory hypoxemia.
5. Which laboratory value is most indicative of a patient entering the oliguric phase of Acute
Kidney Injury (AKI)?
A. Serum Creatinine of 0.8 mg/dL.
B. BUN of 15 mg/dL.
C. Urine output of less than 400 mL in 24 hours.
D. Serum Potassium of 3.4 mEq/L.
Answer: C
Exam V2 | Adult Health II (D446) New OA 2
Exam Q&A | WGU
1. A nurse is caring for a patient who has a chest tube connected to a water-seal drainage
system. The nurse notes continuous bubbling in the water-seal chamber. What is the most
appropriate nursing action?
A. Document this as a normal finding for a patient with a pneumothorax.
B. Increase the suction pressure on the wall regulator.
C. Check the system for a leak starting from the insertion site downward.
D. Clamp the chest tube for 24 hours to see if the bubbling stops.
Answer: C
Rationale: Continuous bubbling in the water-seal chamber indicates an air leak in the
system rather than the patient’s pleural space. The nurse should systematically check the
tubing and connections to locate and secure the leak. Normal intermittent bubbling occurs
with expiration or coughing in a patient with a known pneumothorax.
2. A patient is admitted with a suspected diagnosis of Diabetes Insipidus (DI). Which clinical
finding should the nurse anticipate during the assessment?
A. Low urine specific gravity and increased thirst.
B. High urine specific gravity and bradycardia.
,C. Hypoglycemia and peripheral edema.
D. Hypertension and concentrated dark urine.
Answer: A
Rationale: Diabetes Insipidus is characterized by a deficiency of ADH, leading to the
excretion of large volumes of dilute urine. This results in a very low urine specific gravity,
typically less than 1.005. Patients often experience extreme thirst (polydipsia) to
compensate for the massive fluid loss.
3. The nurse is assessing a patient with a Glasgow Coma Scale (GCS) score of 7. How should
the nurse interpret this finding?
A. The patient is alert and oriented but requires assistance with ADLs.
B. The patient is in a moderate coma state.
C. The patient has a severe head injury and requires intubation for airway protection.
D. The patient is fully conscious but has expressive aphasia.
Answer: C
Rationale: A Glasgow Coma Scale score of 8 or less is generally used as the threshold for
defining a coma and severe brain injury. At a score of 7, the patient is unable to protect
their own airway effectively. Standard medical practice dictates that patients with a GCS of
8 or less typically require endotracheal intubation.
, 4. A patient with Acute Respiratory Distress Syndrome (ARDS) is placed on mechanical
ventilation with Positive End-Expiratory Pressure (PEEP). What is the primary purpose of
PEEP?
A. To increase the fraction of inspired oxygen (FiO2) delivered to the patient.
B. To prevent the alveoli from collapsing during expiration.
C. To decrease the patient’s work of breathing by providing pressure support.
D. To clear secretions from the lower bronchial tree.
Answer: B
Rationale: PEEP provides positive pressure at the end of expiration to keep the alveoli
open, which improves oxygenation and gas exchange. By preventing alveolar collapse, it
increases the functional residual capacity of the lungs. This is a critical intervention for
patients with ARDS who suffer from refractory hypoxemia.
5. Which laboratory value is most indicative of a patient entering the oliguric phase of Acute
Kidney Injury (AKI)?
A. Serum Creatinine of 0.8 mg/dL.
B. BUN of 15 mg/dL.
C. Urine output of less than 400 mL in 24 hours.
D. Serum Potassium of 3.4 mEq/L.
Answer: C
