Adult Health II (D446) New OA 2 Exam 4
V3 | Adult Health II (D446) New OA 2 Exam
Q&A | WGU
1. A patient with liver cirrhosis is receiving lactulose to treat hepatic encephalopathy. Which
assessment finding indicates the medication is achieving its therapeutic goal?
A. The patient’s serum ammonia levels decrease and mental status improves.
B. The patient exhibits an increased appetite and weight gain.
C. The patient’s bowel movements decrease to one firm stool per day.
D. The patient’s abdominal girth decreases significantly.
Answer: A
Rationale: Lactulose works by promoting the excretion of ammonia through the stool. It is
used in cirrhosis patients to prevent or treat hepatic encephalopathy. Improvement in
cognition and a reduction in serum ammonia indicate effectiveness.
2. A nurse is caring for a patient in the early stages of septic shock. Which clinical
manifestation should the nurse expect to observe?
A. Cool, clammy skin and bradycardia.
B. Hypoventilation and respiratory acidosis.
C. Severe hypotension and oliguria.
,D. Warm, flushed skin and increased cardiac output.
Answer: D
Rationale: In the early or ‘hyperdynamic’ phase of septic shock, the patient typically
presents with warm, flushed skin due to vasodilation. Cardiac output is often increased as a
compensatory mechanism to maintain perfusion. This phase is distinct from later stages
where the skin becomes cool and mottled.
3. Which laboratory value is the most sensitive indicator of acute kidney injury (AKI) in a
critically ill patient?
A. Serum Blood Urea Nitrogen (BUN)
B. Hemoglobin levels
C. Urinary Specific Gravity
D. Serum Creatinine
Answer: D
Rationale: Serum creatinine is more specific and sensitive for assessing kidney function
compared to BUN. BUN can be influenced by diet, hydration, and tissue breakdown, making
it less reliable. A sudden rise in creatinine is a hallmark of acute kidney injury.
4. A patient with a history of heart failure presents with sudden onset of shortness of breath,
pink frothy sputum, and crackles throughout all lung fields. Which condition does the nurse
suspect?
A. Acute Pulmonary Edema
, B. Pulmonary Embolism
C. Spontaneous Pneumothorax
D. Bacterial Pneumonia
Answer: A
Rationale: Pink frothy sputum is a classic sign of pulmonary edema associated with left-
sided heart failure. The presence of diffuse crackles indicates fluid accumulation in the
alveoli. This condition requires immediate intervention to reduce preload and improve gas
exchange.
5. When caring for a patient with Cushing’s Syndrome, which nursing intervention is most
appropriate to manage the risk of skin breakdown?
A. Applying vigorous massage to bony prominences.
B. Handling the patient’s skin gently and avoiding adhesives.
C. Limiting protein intake to prevent metabolic waste buildup.
D. Maintaining the patient in a supine position for most of the day.
Answer: B
Rationale: Cushing’s Syndrome leads to thin, fragile skin due to protein wasting and high
cortisol levels. Nursing care must focus on gentle handling to prevent bruising and tears.
Avoiding tape and other adhesives is crucial to maintain skin integrity.
V3 | Adult Health II (D446) New OA 2 Exam
Q&A | WGU
1. A patient with liver cirrhosis is receiving lactulose to treat hepatic encephalopathy. Which
assessment finding indicates the medication is achieving its therapeutic goal?
A. The patient’s serum ammonia levels decrease and mental status improves.
B. The patient exhibits an increased appetite and weight gain.
C. The patient’s bowel movements decrease to one firm stool per day.
D. The patient’s abdominal girth decreases significantly.
Answer: A
Rationale: Lactulose works by promoting the excretion of ammonia through the stool. It is
used in cirrhosis patients to prevent or treat hepatic encephalopathy. Improvement in
cognition and a reduction in serum ammonia indicate effectiveness.
2. A nurse is caring for a patient in the early stages of septic shock. Which clinical
manifestation should the nurse expect to observe?
A. Cool, clammy skin and bradycardia.
B. Hypoventilation and respiratory acidosis.
C. Severe hypotension and oliguria.
,D. Warm, flushed skin and increased cardiac output.
Answer: D
Rationale: In the early or ‘hyperdynamic’ phase of septic shock, the patient typically
presents with warm, flushed skin due to vasodilation. Cardiac output is often increased as a
compensatory mechanism to maintain perfusion. This phase is distinct from later stages
where the skin becomes cool and mottled.
3. Which laboratory value is the most sensitive indicator of acute kidney injury (AKI) in a
critically ill patient?
A. Serum Blood Urea Nitrogen (BUN)
B. Hemoglobin levels
C. Urinary Specific Gravity
D. Serum Creatinine
Answer: D
Rationale: Serum creatinine is more specific and sensitive for assessing kidney function
compared to BUN. BUN can be influenced by diet, hydration, and tissue breakdown, making
it less reliable. A sudden rise in creatinine is a hallmark of acute kidney injury.
4. A patient with a history of heart failure presents with sudden onset of shortness of breath,
pink frothy sputum, and crackles throughout all lung fields. Which condition does the nurse
suspect?
A. Acute Pulmonary Edema
, B. Pulmonary Embolism
C. Spontaneous Pneumothorax
D. Bacterial Pneumonia
Answer: A
Rationale: Pink frothy sputum is a classic sign of pulmonary edema associated with left-
sided heart failure. The presence of diffuse crackles indicates fluid accumulation in the
alveoli. This condition requires immediate intervention to reduce preload and improve gas
exchange.
5. When caring for a patient with Cushing’s Syndrome, which nursing intervention is most
appropriate to manage the risk of skin breakdown?
A. Applying vigorous massage to bony prominences.
B. Handling the patient’s skin gently and avoiding adhesives.
C. Limiting protein intake to prevent metabolic waste buildup.
D. Maintaining the patient in a supine position for most of the day.
Answer: B
Rationale: Cushing’s Syndrome leads to thin, fragile skin due to protein wasting and high
cortisol levels. Nursing care must focus on gentle handling to prevent bruising and tears.
Avoiding tape and other adhesives is crucial to maintain skin integrity.
