Adult Health II (D446) New OA 2 Final
Exam V3 | Adult Health II (D446) New OA 2
Exam Q&A | WGU
1. A nurse is caring for a client with atrial fibrillation. Which complication should the nurse
monitor for most closely?
A. Hyperglycemia
B. Cardiac tamponade
C. Hypokalemia
D. Cerebrovascular accident
Answer: D
Rationale: Atrial fibrillation leads to blood stasis in the atria, which significantly increases
the risk of clot formation. These clots can travel to the brain and cause an embolic stroke or
cerebrovascular accident. Nurses must prioritize anticoagulation therapy and monitor
neurological status in these patients.
2. A client is diagnosed with Cushing’s syndrome. Which clinical manifestation should the
nurse expect to find?
A. Weight loss and hypotension
,B. Tachycardia and tremors
C. Hyperpigmentation of the skin
D. Truncal obesity and moon face
Answer: D
Rationale: Cushing’s syndrome is characterized by an overproduction of cortisol by the
adrenal cortex. Common symptoms include truncal obesity, a ‘buffalo hump,’ and a rounded
‘moon face’ due to fat redistribution. The nurse should also monitor the client for
hypertension and hyperglycemia associated with high cortisol levels.
3. Which laboratory value is most indicative of acute pancreatitis?
A. Decreased serum calcium
B. Increased serum lipase
C. Decreased blood urea nitrogen
D. Increased serum hemoglobin
Answer: B
Rationale: Serum lipase is highly specific to the pancreas and rises significantly during an
acute inflammatory event. While amylase also rises, lipase stays elevated longer and
provides a more reliable diagnostic indicator. The nurse should also monitor for signs of
hypocalcemia, which can occur as a complication of fat necrosis.
, 4. A client with a history of heart failure presents with a B-type natriuretic peptide (BNP) level
of 900 pg/mL. How should the nurse interpret this finding?
A. The client is in a state of fluid volume deficit.
B. The client is experiencing an exacerbation of heart failure.
C. The client has normal cardiac function.
D. The client is at risk for a myocardial infarction.
Answer: B
Rationale: BNP is a hormone secreted by the ventricles in response to increased stretching
and pressure. A level above 100 pg/mL typically indicates heart failure, and 900 pg/mL is a
significant elevation suggesting acute exacerbation. The nurse should assess for symptoms
like dyspnea, edema, and crackles in the lungs.
5. A nurse is providing discharge instructions to a client with a new prescription for
levothyroxine. What is the most important instruction?
A. Take the medication with a high-calcium snack.
B. Take the medication on an empty stomach in the morning.
C. Take the medication at bedtime with a full meal.
D. Skip the dose if your heart rate is over 60 beats per minute.
Answer: B
Exam V3 | Adult Health II (D446) New OA 2
Exam Q&A | WGU
1. A nurse is caring for a client with atrial fibrillation. Which complication should the nurse
monitor for most closely?
A. Hyperglycemia
B. Cardiac tamponade
C. Hypokalemia
D. Cerebrovascular accident
Answer: D
Rationale: Atrial fibrillation leads to blood stasis in the atria, which significantly increases
the risk of clot formation. These clots can travel to the brain and cause an embolic stroke or
cerebrovascular accident. Nurses must prioritize anticoagulation therapy and monitor
neurological status in these patients.
2. A client is diagnosed with Cushing’s syndrome. Which clinical manifestation should the
nurse expect to find?
A. Weight loss and hypotension
,B. Tachycardia and tremors
C. Hyperpigmentation of the skin
D. Truncal obesity and moon face
Answer: D
Rationale: Cushing’s syndrome is characterized by an overproduction of cortisol by the
adrenal cortex. Common symptoms include truncal obesity, a ‘buffalo hump,’ and a rounded
‘moon face’ due to fat redistribution. The nurse should also monitor the client for
hypertension and hyperglycemia associated with high cortisol levels.
3. Which laboratory value is most indicative of acute pancreatitis?
A. Decreased serum calcium
B. Increased serum lipase
C. Decreased blood urea nitrogen
D. Increased serum hemoglobin
Answer: B
Rationale: Serum lipase is highly specific to the pancreas and rises significantly during an
acute inflammatory event. While amylase also rises, lipase stays elevated longer and
provides a more reliable diagnostic indicator. The nurse should also monitor for signs of
hypocalcemia, which can occur as a complication of fat necrosis.
, 4. A client with a history of heart failure presents with a B-type natriuretic peptide (BNP) level
of 900 pg/mL. How should the nurse interpret this finding?
A. The client is in a state of fluid volume deficit.
B. The client is experiencing an exacerbation of heart failure.
C. The client has normal cardiac function.
D. The client is at risk for a myocardial infarction.
Answer: B
Rationale: BNP is a hormone secreted by the ventricles in response to increased stretching
and pressure. A level above 100 pg/mL typically indicates heart failure, and 900 pg/mL is a
significant elevation suggesting acute exacerbation. The nurse should assess for symptoms
like dyspnea, edema, and crackles in the lungs.
5. A nurse is providing discharge instructions to a client with a new prescription for
levothyroxine. What is the most important instruction?
A. Take the medication with a high-calcium snack.
B. Take the medication on an empty stomach in the morning.
C. Take the medication at bedtime with a full meal.
D. Skip the dose if your heart rate is over 60 beats per minute.
Answer: B
