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D115 / D115 Objective Assessment (Latest Update 2026 Advanced
Pathophysiology for the Advanced Practice Nurse
An advanced practice registered nurse (APRN) is consulting with a teen patient
who has recently learned that she is pregnant. The APRN knows that a certain
medication taken by the patient can contribute to the development of
congenital malformations in the fetus. The APRN reviews the patient's current
medication list and finds one medication that is a concern.
Which medication is the APRN concerned about? - CORRECT ANSWER
Retinoic acid
QUESTION : A newborn's screening for cystic fibrosis is positive. An advanced
practice registered nurse (APRN) is reviewing screening results and taking a
comprehensive genetic screening of the parents. The APRN asks the parents
questions to help determine the transmission of this disease.
Which question should the APRN ask? - CORRECT ANSWER "Are you
both the genetic donor parents?"
QUESTION : A 30-day-old infant presents to the emergency room with
decreased oral intake, decreased urine output, and a fever of 101.8. The infant is
admitted for further evaluation with a workup to include a blood culture, a
urine culture, a spinal tap, and a chest X-ray.
Which issue of innate immunity, as it relates to neonates, is of concern? -
CORRECT ANSWER Relative deficiency of factor B
QUESTION : A 12-year-old African American patient presents with unilateral eye
swelling and lower lip swelling. The patient's parent reports that the swelling is
spontaneous and resolves over several days. The patient does not have
practice exam 2026
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complaints of fever, hives, or vomiting. Serum lab results show hyperactivation
of three plasma protein systems. The APRN suspects hereditary angioedema.
What is the cause of the genetic defect suspected in this situation? -
CORRECT ANSWER C1 esterase inhibitor
QUESTION : The parent of a child diagnosed with Down syndrome expresses
concerns about the child's recurrent respiratory tract infections to an advanced
practice registered nurse (APRN). The infections have occurred regularly since
birth.
What should the APRN tell the parent is the underlying cause of this illness? -
CORRECT ANSWER Gastroesophageal reflux disease causes aspiration
of thin fluids.
QUESTION : A 36-year-old patient is being seen by an advanced practice
registered nurse (APRN) in a primary care clinic for the first time. The patient
reports feeling depressed due to a major life change. Additional symptoms
include weight gain, sedentary activity, and insomnia. The APRN plans on
providing the patient with several exercises to reduce the physiological effect of
stress.
Why is the APRN concerned about relieving this emotional response? -
CORRECT ANSWER It decreases glucose uptake.
QUESTION : An 80-year-old patient brings her grandchildren with her to a
routine medical appointment. The patient has moderate chronic obstructive
pulmonary disease (COPD) and is concerned about developing pneumonia
because of its increased incidence at the senior center.
What should the nurse practitioner recommend for this patient? - CORRECT
ANSWER Getting an annual influenza vaccine
practice exam 2026
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QUESTION : An advanced practice nurse (APRN) is working with a patient who is
choosing to undergo breast removal due to family history of breast cancer. The
patient's genetic testing revealed an abnormal BRCA1. The patient shares with
the APRN that she is relieved that she will not need to worry about cancer once
the breast tissue is removed. The APRN proceeds to educate the patient about
additional risks.
Which other type of cancer is the patient at risk for developing? - CORRECT
ANSWER Ovarian
QUESTION : A patient presents to the hospital complaining of blurred vision,
muscle weaknesses, impaired gait, and fatigue lasting more than 24 hours. The
patient has a history of smoking and vitamin D deficiency. Extensive diagnostic
testing and a comprehensive neurological assessment reveals a diagnosis of
multiple sclerosis.
Which pathological mechanism will support this diagnosis? - CORRECT
ANSWER A loss of myelin sheaths, causing a disruption of nerve
conduction
QUESTION : A child presents to a clinic with a white pupillary reflex noted in the
right eye. The child is constantly crying and rubbing her eyes. An advanced
practice registered nurse (APRN) performs a complete ophthalmologic
examination and orders several diagnostic tests. Based on the findings, a
diagnosis of retinoblastoma is confirmed.
What is the pathological mechanism of this disorder? - CORRECT
ANSWER Mutations of a gene on chromosome 13q14 lead to neoplastic
proliferation of cells
QUESTION : A patient is seen by an advanced practice registered nurse (APRN)
at a primary care clinic for follow-up to discuss abnormal results of testing for
peripheral nervous system impairment.
practice exam 2026
, 4|Page
Which diagnosis should the APRN suspect? - CORRECT ANSWER
Demyelinating polyneuropathy
QUESTION : A patient is seen in the clinic after being a restrained passenger in a
car accident the previous week. The patient continues to have intermittent
headaches and has noticed periods of forgetfulness. Assessment findings
include a BP of 130/82 mm Hg and an apical pulse rate of 72 bpm. An advanced
practice registered nurse (APRN) is concerned that the symptoms might stem
from a specific process.
Which process should the APRN be concerned about? - CORRECT
ANSWER Cerebral concussion
QUESTION : An advanced practice registered nurse (APRN) is examining an
adolescent patient who describes hearing voices telling her to gather weapons
because the government is trying to control her. The patient also describes
feelings of happiness related to a tragic personal event.
What is the probable diagnosis? - CORRECT ANSWER Schizophrenia
QUESTION : A patient is seeing an advanced practice registered nurse (APRN) in
an occupational health setting. The patient has been referred by employee
assistance for reckless and self-destructive behaviors and a violent incident at
work regarding a fellow employee. The APRN suspects post-traumatic stress
disorder (PTSD).
Which diagnostic cluster of PTSD is the patient exhibiting? - CORRECT
ANSWER Arousal
QUESTION : A 45-year-old male patient with altered testosterone levels needs
treatment. An advanced practice registered nurse (APRN) is aware that three
practice exam 2026
D115 / D115 Objective Assessment (Latest Update 2026 Advanced
Pathophysiology for the Advanced Practice Nurse
An advanced practice registered nurse (APRN) is consulting with a teen patient
who has recently learned that she is pregnant. The APRN knows that a certain
medication taken by the patient can contribute to the development of
congenital malformations in the fetus. The APRN reviews the patient's current
medication list and finds one medication that is a concern.
Which medication is the APRN concerned about? - CORRECT ANSWER
Retinoic acid
QUESTION : A newborn's screening for cystic fibrosis is positive. An advanced
practice registered nurse (APRN) is reviewing screening results and taking a
comprehensive genetic screening of the parents. The APRN asks the parents
questions to help determine the transmission of this disease.
Which question should the APRN ask? - CORRECT ANSWER "Are you
both the genetic donor parents?"
QUESTION : A 30-day-old infant presents to the emergency room with
decreased oral intake, decreased urine output, and a fever of 101.8. The infant is
admitted for further evaluation with a workup to include a blood culture, a
urine culture, a spinal tap, and a chest X-ray.
Which issue of innate immunity, as it relates to neonates, is of concern? -
CORRECT ANSWER Relative deficiency of factor B
QUESTION : A 12-year-old African American patient presents with unilateral eye
swelling and lower lip swelling. The patient's parent reports that the swelling is
spontaneous and resolves over several days. The patient does not have
practice exam 2026
,2|Page
complaints of fever, hives, or vomiting. Serum lab results show hyperactivation
of three plasma protein systems. The APRN suspects hereditary angioedema.
What is the cause of the genetic defect suspected in this situation? -
CORRECT ANSWER C1 esterase inhibitor
QUESTION : The parent of a child diagnosed with Down syndrome expresses
concerns about the child's recurrent respiratory tract infections to an advanced
practice registered nurse (APRN). The infections have occurred regularly since
birth.
What should the APRN tell the parent is the underlying cause of this illness? -
CORRECT ANSWER Gastroesophageal reflux disease causes aspiration
of thin fluids.
QUESTION : A 36-year-old patient is being seen by an advanced practice
registered nurse (APRN) in a primary care clinic for the first time. The patient
reports feeling depressed due to a major life change. Additional symptoms
include weight gain, sedentary activity, and insomnia. The APRN plans on
providing the patient with several exercises to reduce the physiological effect of
stress.
Why is the APRN concerned about relieving this emotional response? -
CORRECT ANSWER It decreases glucose uptake.
QUESTION : An 80-year-old patient brings her grandchildren with her to a
routine medical appointment. The patient has moderate chronic obstructive
pulmonary disease (COPD) and is concerned about developing pneumonia
because of its increased incidence at the senior center.
What should the nurse practitioner recommend for this patient? - CORRECT
ANSWER Getting an annual influenza vaccine
practice exam 2026
,3|Page
QUESTION : An advanced practice nurse (APRN) is working with a patient who is
choosing to undergo breast removal due to family history of breast cancer. The
patient's genetic testing revealed an abnormal BRCA1. The patient shares with
the APRN that she is relieved that she will not need to worry about cancer once
the breast tissue is removed. The APRN proceeds to educate the patient about
additional risks.
Which other type of cancer is the patient at risk for developing? - CORRECT
ANSWER Ovarian
QUESTION : A patient presents to the hospital complaining of blurred vision,
muscle weaknesses, impaired gait, and fatigue lasting more than 24 hours. The
patient has a history of smoking and vitamin D deficiency. Extensive diagnostic
testing and a comprehensive neurological assessment reveals a diagnosis of
multiple sclerosis.
Which pathological mechanism will support this diagnosis? - CORRECT
ANSWER A loss of myelin sheaths, causing a disruption of nerve
conduction
QUESTION : A child presents to a clinic with a white pupillary reflex noted in the
right eye. The child is constantly crying and rubbing her eyes. An advanced
practice registered nurse (APRN) performs a complete ophthalmologic
examination and orders several diagnostic tests. Based on the findings, a
diagnosis of retinoblastoma is confirmed.
What is the pathological mechanism of this disorder? - CORRECT
ANSWER Mutations of a gene on chromosome 13q14 lead to neoplastic
proliferation of cells
QUESTION : A patient is seen by an advanced practice registered nurse (APRN)
at a primary care clinic for follow-up to discuss abnormal results of testing for
peripheral nervous system impairment.
practice exam 2026
, 4|Page
Which diagnosis should the APRN suspect? - CORRECT ANSWER
Demyelinating polyneuropathy
QUESTION : A patient is seen in the clinic after being a restrained passenger in a
car accident the previous week. The patient continues to have intermittent
headaches and has noticed periods of forgetfulness. Assessment findings
include a BP of 130/82 mm Hg and an apical pulse rate of 72 bpm. An advanced
practice registered nurse (APRN) is concerned that the symptoms might stem
from a specific process.
Which process should the APRN be concerned about? - CORRECT
ANSWER Cerebral concussion
QUESTION : An advanced practice registered nurse (APRN) is examining an
adolescent patient who describes hearing voices telling her to gather weapons
because the government is trying to control her. The patient also describes
feelings of happiness related to a tragic personal event.
What is the probable diagnosis? - CORRECT ANSWER Schizophrenia
QUESTION : A patient is seeing an advanced practice registered nurse (APRN) in
an occupational health setting. The patient has been referred by employee
assistance for reckless and self-destructive behaviors and a violent incident at
work regarding a fellow employee. The APRN suspects post-traumatic stress
disorder (PTSD).
Which diagnostic cluster of PTSD is the patient exhibiting? - CORRECT
ANSWER Arousal
QUESTION : A 45-year-old male patient with altered testosterone levels needs
treatment. An advanced practice registered nurse (APRN) is aware that three
practice exam 2026
