WGU D446 NURS 3119 Adult Health II OA READINESS EXAM GUIDE Q & S 2026/2027

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WGU D446 NURS 3119

Adult Health II OA

READINESS EXAM

GUIDE Q & S

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Question 1 The nurse observes an increased number of blood clots in the drainage tubing of a client with continuous bladder irrigation following a transurethral resection of the prostate (TURP). What is the best initial nursing action?

• Stop the continuous bladder irrigation immediately.
• Administer a prescribed PRN analgesic for bladder spasms.
• Increase the flow of the bladder irrigation.
• Document the finding as a normal expected outcome.

Correct Answer: C) Increase the flow of the bladder irrigation.

Rationale: This helps to clear blood clots and prevent obstruction in the

catheter.

Question 2 A client with a renal calculus reports severe right flank pain, nausea, and vomiting. Which nursing problem has the highest priority?

• Acute pain related to kidney stone moving through the ureter
• Risk for aspiration related to vomiting
• Impaired urinary elimination related to calculus obstruction
• Deficient fluid volume related to nausea and vomiting

Correct Answer: B) Risk for aspiration related to vomiting

Rationale: According to Maslow's hierarchy of needs, Risk for aspiration related to vomiting is the highest priority because it addresses the immediate potential for airway compromise, which can be life-threatening if the client aspirates vomitus. Ensuring the airway is protected is critical.

Question 3 A 34-year-old male client presents to the emergency department (ED) for an acute asthma attack which began after jogging through a local park. The client

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is able to answer questions, pausing every few words to catch his breath. The client reports using a rescue inhaler three times without relief. Symptoms seem worse outdoors and during exercise. Vital signs: Temp 98.9°F, HR 112, RR 28, BP 130/86, O2 sat 88% on room air, expiratory wheezes present. Based on the client's presentation, which nursing diagnosis is the priority?

• Ineffective coping related to extreme nervousness
• Impaired gas exchange related to bronchoconstriction
• Activity intolerance related to asthma exacerbation
• Ineffective health maintenance related to expired medication

Correct Answer: B) Impaired gas exchange related to bronchoconstriction

Rationale: The client's oxygen saturation is 88% on room air, indicating impaired gas exchange which is a priority airway/breathing issue.

Question 4 A client presents to the emergency department reporting chest pain that is radiating to the left arm, shortness of breath, and diaphoresis. Which medication should the nurse anticipate being prescribed by the healthcare provider?

• Ibuprofen
• Acetaminophen
• Morphine
• Diphenhydramine

Correct Answer: C) Morphine

Rationale: Morphine is often administered in this situation (MONA protocol) to

relieve pain, reduce anxiety, and reduce the workload of the heart.

Question 5

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A patient presents to the clinic with a renal calculus. What is a priority complication the nurse should monitor for due to the severe pain associated with the calculus?

• Respiratory depression
• Renal impairment due to pain and shock
• Hepatic failure
• Bowel obstruction

Correct Answer: B) Renal impairment due to pain

Question 6 A patient just had a lumbar puncture. Which statement by the patient needs immediate intervention by the nurse?

• "My lower back feels a little sore where the needle went in."
• "I feel tired and want to take a nap."
• "I have a headache that gets worse when I sit up."
• "I am feeling thirsty and would like some water."

Correct Answer: C) "I have a headache that gets worse when I sit up."

Question 7 A patient has lower extremity edema, ascites, and hepatomegaly. The nurse recognizes these as signs and symptoms of which condition?

• Left-sided heart failure
• Right-sided heart failure
• Pulmonary embolism
• Myocardial infarction

Correct Answer: B) Right-sided heart failure