Wgu D455 Oa Exit

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Sample questions from Wgu D455 Oa Exit

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

1. 1.At change of shift on a medical-surgical unit, the nurse receives report on four clients. Which client should the nurse assess first?

   • A.A client 6 hours after thyroidectomy who has new inspiratory stridor
   • B.A client with a fractured wrist who reports pain of 8 on a 0-to-10 scale
   • C.A client with pneumonia whose temperature is 38.2 C (100.8 F) and who is due for acetaminophen
   • D.A client with diabetes whose premeal glucose is 220 mg/dL

   Rationale: New inspiratory stridor after thyroid surgery suggests airway obstruction from edema or bleeding and requires immediate assessment and intervention. Fever, pain, and hyperglycemia require care but are not as immediately life-threatening as a threatened airway. The exam takeaway is to prioritize airway compromise over other acute needs.

2. 2.In a rehabilitation unit, an RN is assigning tasks to a newly licensed practical nurse (LPN) and an unlicensed assistive personnel (UAP). Which task is appropriate to assign to the UAP?

   • A.Assess a client who reports new chest discomfort
   • B.Obtain a routine weight for a stable client with heart failure
   • C.Evaluate whether a PRN analgesic relieved a client's pain
   • D.Teach a client how to use a new walker

   Rationale: Obtaining a routine weight for a stable client is a predictable task that can be assigned to a UAP, with the RN responsible for interpreting the result. Teaching, assessment of new symptoms, and evaluation require nursing judgment and should not be delegated to the UAP. The RN should communicate parameters for reporting an unexpected weight change.

3. 3.A client states, "I do not want a blood transfusion for religious reasons," while alert and oriented before a scheduled procedure. Which actions should the nurse take? Select all that apply.

   • A.Document the client's exact statement and the information provided
   • B.Ask the client to sign a refusal form after discussing it with the provider
   • C.Ask the family to override the client's decision
   • D.Clarify the client's understanding of the proposed transfusion and alternatives
   • E.Notify the provider of the client's stated refusal
   • F.Proceed with the transfusion because it is included in the treatment plan

   Rationale: A capable client has the right to refuse treatment, so the nurse clarifies understanding, notifies the provider, supports informed decision-making, and documents the discussion. A refusal form may be used according to facility policy after the client has had an opportunity to discuss the decision. Family members cannot override a competent client's choice, and an order does not authorize treatment against the client's wishes.

4. 4.The provider prescribes a medication that the nurse has not administered before, and the electronic medication record displays a dose outside the usual range. What should the nurse do first?

   • A.Give half the prescribed dose and document the adjustment
   • B.Ask another nurse to administer it instead
   • C.Hold the medication and clarify the dose with the prescriber or pharmacist
   • D.Administer the dose because it is in the electronic medication record

   Answer and rationale are in the full material.

5. 5.During discharge planning for an older adult who lives alone, the client says, "I cannot afford all these prescriptions." Which action should the nurse take first?

   • A.Send the client home with written instructions only
   • B.Request that the family assume responsibility for purchasing the medications
   • C.Tell the client to stop the most expensive medication
   • D.Ask the client to identify which medications are unaffordable and what resources are available

   Answer and rationale are in the full material.