Wgu D455

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Sample questions from Wgu D455

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.A 68-year-old patient on a medical-surgical unit is 2 hours postoperative after abdominal surgery. The patient is restless, has a respiratory rate of 30/min, oxygen saturation of 86% on room air, and shallow respirations. Which action should the nurse take first?

   • A.A. Apply oxygen and assess airway and breathing
   • B.B. Administer the prescribed opioid for incisional pain
   • C.C. Notify the surgeon that the patient is restless
   • D.D. Encourage the patient to use the incentive spirometer

   Rationale: The low oxygen saturation and tachypnea indicate an immediate breathing problem, so the nurse should support oxygenation and rapidly reassess airway and breathing. Opioids could worsen respiratory depression, and calling the surgeon should not delay initial stabilization. Incentive spirometry is useful for prevention and recovery but is not the first response to acute hypoxemia.

2. 2.A 74-year-old patient with heart failure is admitted to a medical unit. The patient is newly confused, has crackles, a respiratory rate of 28/min, and oxygen saturation of 89% on 2 L/min. Which task is appropriate for the RN to delegate to an experienced unlicensed assistive personnel (UAP)?

   • A.A. Assess the patient's lung sounds and determine whether the diuretic is effective
   • B.B. Obtain and report the patient's current vital signs
   • C.C. Teach the patient how to follow a low-sodium diet
   • D.D. Evaluate the patient's response to oxygen therapy

   Rationale: Obtaining and reporting vital signs is a predictable task that may be delegated, while the RN retains responsibility for interpreting the findings and acting on them. Lung assessment, teaching, and evaluation of treatment response require nursing judgment. The RN should promptly assess the acute respiratory changes rather than relying on delegated data alone.

3. 3.A 57-year-old patient with diabetes is admitted with fever and a painful, draining foot ulcer. Temperature is 38.8 C (101.8 F), heart rate 116/min, blood pressure 88/54 mm Hg, and lactate 3.4 mmol/L. Which action has the highest priority?

   • A.A. Obtain a wound culture before starting any treatment
   • B.B. Initiate the sepsis response and promptly administer prescribed IV fluids
   • C.C. Apply a warm compress to the affected foot
   • D.D. Teach the patient about daily foot inspections

   Rationale: Hypotension, tachycardia, fever, and elevated lactate suggest sepsis with impaired perfusion, requiring immediate escalation and prescribed resuscitation. Cultures are important but should not delay urgent treatment; obtain them promptly if doing so does not delay therapy. Wound care and teaching are appropriate later, after stabilization.

4. 4.A 62-year-old patient is admitted with chest pressure, diaphoresis, and nausea. Blood pressure is 148/86 mm Hg, heart rate 104/min, and oxygen saturation 97% on room air. The patient has no aspirin allergy or active bleeding. Which prescribed intervention should the nurse implement first?

   • A.A. Give chewable aspirin
   • B.B. Apply oxygen at 2 L/min by nasal cannula
   • C.C. Provide a meal tray to prevent nausea
   • D.D. Assist the patient to walk to reduce anxiety

   Answer and rationale are in the full material.

5. 5.A 45-year-old patient with a history of asthma arrives at urgent care with wheezing, difficulty speaking, and oxygen saturation of 90% on room air. Which medication should the nurse expect to administer first?

   • A.A. Inhaled short-acting beta2 agonist
   • B.B. Inhaled corticosteroid for long-term control
   • C.C. Oral leukotriene receptor antagonist
   • D.D. A long-acting beta2 agonist alone

   Answer and rationale are in the full material.