WGU D027 OA EXAM ACTUAL EXAM TEST BANK
100 QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES|A+ GRADE
Question Set 1: Celiac Disease & Gastroenterology (1-10)
Q1. What is the gold standard for the suspected diagnosis of Celiac Disease?
- A) Blood test for anti-tissue transglutaminase antibodies
- B) Genetic testing for HLA-DQ2/DQ8
- C) Endoscopy with small intestine biopsy
- D) Stool sample analysis
Answer: C) Endoscopy with small intestine biopsy
Rationale: Endoscopy with small intestine biopsy remains the gold standard for confirming
celiac disease because it allows direct visualization and histological confirmation of villous
atrophy, crypt hyperplasia, and increased intraepithelial lymphocytes. While serologic tests
(anti-tTG antibodies) are excellent screening tools, biopsy is required for definitive diagnosis.
Genetic testing for HLA-DQ2/DQ8 can rule out celiac disease but cannot confirm it.
Q2. A 44-year-old woman has been diagnosed with advanced metastatic non-small-cell lung
cancer. Genetic testing comes back positive for a genetic mutation. The APN starts osimertinib
(Tagrisso). What type of genetic mutation does this patient have?
- A) KRAS mutation
- B) EGFR mutation
- C) ALK rearrangement
- D) ROS1 mutation
Answer: B) EGFR mutation
Rationale: Osimertinib (Tagrisso) is a third-generation EGFR tyrosine kinase inhibitor specifically
indicated for non-small cell lung cancer with EGFR mutations (particularly T790M resistance
mutation or as first-line for exon 19 deletions or L858R). KRAS mutations are more common but
do not respond to EGFR inhibitors; ALK and ROS1 mutations are treated with different targeted
agents (crizotinib, alectinib). Starting osimertinib indicates positive EGFR mutation status.
,Q3. A 20-year-old male has slowly progressing symptoms: frequent falling, toe-walking gait
since childhood, and difficulty with running/jumping. He takes longer to change from sitting to
standing and has muscle/joint stiffness in the mornings. Family history is insignificant. Which
condition is likely causing these symptoms?
- A) Duchenne muscular dystrophy
- B) Becker muscular dystrophy
- C) Myotonic dystrophy
- D) Limb-girdle muscular dystrophy
Answer: B) Becker muscular dystrophy
Rationale: Becker muscular dystrophy is an X-linked recessive disorder caused by dystrophin
gene mutations. Unlike Duchenne MD, Becker MD presents with later onset (adolescence to
early adulthood), slower progression, and less severe symptoms. The patient was able to
participate in sports during middle school but not high school, with toe-walking since childhood
and progressive difficulty—classic for Becker MD.
Q4. Which statement should the provider give the patient regarding the pathophysiology of SLE
and its relation to thrombocytopenia?
- A) SLE causes bone marrow failure
- B) SLE disrupts immune homeostasis and promotes development of self-reactive antibodies
- C) SLE directly destroys platelets
- D) SLE is unrelated to autoimmune conditions
Answer: B) SLE disrupts immune homeostasis and promotes development of self-reactive
antibodies
Rationale: In SLE, the immune system produces autoantibodies against nuclear antigens,
forming immune complexes that deposit in tissues. Thrombocytopenia occurs when antiplatelet
antibodies are produced, leading to immune-mediated platelet destruction. The core mechanism
is loss of self-tolerance.
Q5. A female patient presents for follow-up regarding an elevated ferritin level. She has no
previous medical history and is asymptomatic. What should the provider do next?
- A) Order a complete blood count
- B) Order a liver function test
- C) Order iron studies
- D) Reassure and discharge
,Answer: B) Order a liver function test
Rationale: Ferritin is an acute phase reactant elevated in inflammation, infection, liver disease,
and iron overload. Asymptomatic elevated ferritin with no history requires initial evaluation for
liver disease. Liver function tests can help differentiate primary from secondary causes.
Q6. A 75-year-old female presents with an irregular heart rate of 130. What can be ascertained
given limited information?
- A) She needs immediate defibrillation
- B) She is diagnosed with atrial fibrillation and needs rate control with metoprolol
- C) She has ventricular tachycardia
- D) She is in sinus tachycardia
Answer: B) She is diagnosed with atrial fibrillation and needs rate control with metoprolol
Rationale: Irregularly irregular tachycardia in an older adult is most likely atrial fibrillation.
Management includes rate control with beta-blockers (metoprolol) or calcium channel blockers.
Without hemodynamic instability, rate control is appropriate before considering rhythm control.
Q7. A patient with inflammatory bowel disease is started on sulfasalazine. The provider should
monitor which laboratory value due to a known adverse effect?
- A) Serum creatinine
- B) Complete blood count
- C) Liver enzymes
- D) Serum glucose
Answer: B) Complete blood count
Rationale: Sulfasalazine can cause hematologic adverse effects including agranulocytosis,
leukopenia, hemolytic anemia, and thrombocytopenia. CBC monitoring at baseline and
periodically during therapy is recommended.
Q8. Which condition is characterized by recurrent, painful oral and genital ulcers, uveitis, and a
positive pathergy test?
- A) Sjögren's syndrome
- B) Behçet's disease
- C) Crohn's disease
- D) Systemic lupus erythematosus
, Answer: B) Behçet's disease
Rationale: Behçet's disease is a systemic vasculitis of unknown etiology characterized by
recurrent oral and genital ulcers, uveitis, skin lesions, and a positive pathergy test (papule
formation at needle prick site).
Q9. A 32-year-old woman presents with fatigue, joint pain, and a butterfly rash on her face.
Laboratory testing shows positive antinuclear antibody (ANA) and anti-dsDNA antibodies. Which
condition is most likely?
- A) Rheumatoid arthritis
- B) Systemic lupus erythematosus
- C) Scleroderma
- D) Mixed connective tissue disease
Answer: B) Systemic lupus erythematosus
Rationale: The combination of malar "butterfly" rash, fatigue, arthralgias, and positive ANA with
anti-dsDNA antibodies is highly specific for SLE. Anti-dsDNA antibodies are diagnostic of SLE
and correlate with disease activity, particularly lupus nephritis.
Q10. Which genetic condition is caused by an extra X chromosome in males (XXY karyotype)?
- A) Turner syndrome
- B) Klinefelter syndrome
- C) Down syndrome
- D) Triple X syndrome
Answer: B) Klinefelter syndrome
Rationale: Klinefelter syndrome (47,XXY) affects males, presenting with small testes,
gynecomastia, tall stature, and infertility. Testosterone deficiency develops during puberty,
requiring hormone replacement therapy.
Question Set 2: Pathophysiology of Edema & Inflammation (11-20)
Q11. During the body's inflammatory process, what causes edema?
- A) Vasodilation of blood vessels
- B) Emigration of neutrophils
100 QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES|A+ GRADE
Question Set 1: Celiac Disease & Gastroenterology (1-10)
Q1. What is the gold standard for the suspected diagnosis of Celiac Disease?
- A) Blood test for anti-tissue transglutaminase antibodies
- B) Genetic testing for HLA-DQ2/DQ8
- C) Endoscopy with small intestine biopsy
- D) Stool sample analysis
Answer: C) Endoscopy with small intestine biopsy
Rationale: Endoscopy with small intestine biopsy remains the gold standard for confirming
celiac disease because it allows direct visualization and histological confirmation of villous
atrophy, crypt hyperplasia, and increased intraepithelial lymphocytes. While serologic tests
(anti-tTG antibodies) are excellent screening tools, biopsy is required for definitive diagnosis.
Genetic testing for HLA-DQ2/DQ8 can rule out celiac disease but cannot confirm it.
Q2. A 44-year-old woman has been diagnosed with advanced metastatic non-small-cell lung
cancer. Genetic testing comes back positive for a genetic mutation. The APN starts osimertinib
(Tagrisso). What type of genetic mutation does this patient have?
- A) KRAS mutation
- B) EGFR mutation
- C) ALK rearrangement
- D) ROS1 mutation
Answer: B) EGFR mutation
Rationale: Osimertinib (Tagrisso) is a third-generation EGFR tyrosine kinase inhibitor specifically
indicated for non-small cell lung cancer with EGFR mutations (particularly T790M resistance
mutation or as first-line for exon 19 deletions or L858R). KRAS mutations are more common but
do not respond to EGFR inhibitors; ALK and ROS1 mutations are treated with different targeted
agents (crizotinib, alectinib). Starting osimertinib indicates positive EGFR mutation status.
,Q3. A 20-year-old male has slowly progressing symptoms: frequent falling, toe-walking gait
since childhood, and difficulty with running/jumping. He takes longer to change from sitting to
standing and has muscle/joint stiffness in the mornings. Family history is insignificant. Which
condition is likely causing these symptoms?
- A) Duchenne muscular dystrophy
- B) Becker muscular dystrophy
- C) Myotonic dystrophy
- D) Limb-girdle muscular dystrophy
Answer: B) Becker muscular dystrophy
Rationale: Becker muscular dystrophy is an X-linked recessive disorder caused by dystrophin
gene mutations. Unlike Duchenne MD, Becker MD presents with later onset (adolescence to
early adulthood), slower progression, and less severe symptoms. The patient was able to
participate in sports during middle school but not high school, with toe-walking since childhood
and progressive difficulty—classic for Becker MD.
Q4. Which statement should the provider give the patient regarding the pathophysiology of SLE
and its relation to thrombocytopenia?
- A) SLE causes bone marrow failure
- B) SLE disrupts immune homeostasis and promotes development of self-reactive antibodies
- C) SLE directly destroys platelets
- D) SLE is unrelated to autoimmune conditions
Answer: B) SLE disrupts immune homeostasis and promotes development of self-reactive
antibodies
Rationale: In SLE, the immune system produces autoantibodies against nuclear antigens,
forming immune complexes that deposit in tissues. Thrombocytopenia occurs when antiplatelet
antibodies are produced, leading to immune-mediated platelet destruction. The core mechanism
is loss of self-tolerance.
Q5. A female patient presents for follow-up regarding an elevated ferritin level. She has no
previous medical history and is asymptomatic. What should the provider do next?
- A) Order a complete blood count
- B) Order a liver function test
- C) Order iron studies
- D) Reassure and discharge
,Answer: B) Order a liver function test
Rationale: Ferritin is an acute phase reactant elevated in inflammation, infection, liver disease,
and iron overload. Asymptomatic elevated ferritin with no history requires initial evaluation for
liver disease. Liver function tests can help differentiate primary from secondary causes.
Q6. A 75-year-old female presents with an irregular heart rate of 130. What can be ascertained
given limited information?
- A) She needs immediate defibrillation
- B) She is diagnosed with atrial fibrillation and needs rate control with metoprolol
- C) She has ventricular tachycardia
- D) She is in sinus tachycardia
Answer: B) She is diagnosed with atrial fibrillation and needs rate control with metoprolol
Rationale: Irregularly irregular tachycardia in an older adult is most likely atrial fibrillation.
Management includes rate control with beta-blockers (metoprolol) or calcium channel blockers.
Without hemodynamic instability, rate control is appropriate before considering rhythm control.
Q7. A patient with inflammatory bowel disease is started on sulfasalazine. The provider should
monitor which laboratory value due to a known adverse effect?
- A) Serum creatinine
- B) Complete blood count
- C) Liver enzymes
- D) Serum glucose
Answer: B) Complete blood count
Rationale: Sulfasalazine can cause hematologic adverse effects including agranulocytosis,
leukopenia, hemolytic anemia, and thrombocytopenia. CBC monitoring at baseline and
periodically during therapy is recommended.
Q8. Which condition is characterized by recurrent, painful oral and genital ulcers, uveitis, and a
positive pathergy test?
- A) Sjögren's syndrome
- B) Behçet's disease
- C) Crohn's disease
- D) Systemic lupus erythematosus
, Answer: B) Behçet's disease
Rationale: Behçet's disease is a systemic vasculitis of unknown etiology characterized by
recurrent oral and genital ulcers, uveitis, skin lesions, and a positive pathergy test (papule
formation at needle prick site).
Q9. A 32-year-old woman presents with fatigue, joint pain, and a butterfly rash on her face.
Laboratory testing shows positive antinuclear antibody (ANA) and anti-dsDNA antibodies. Which
condition is most likely?
- A) Rheumatoid arthritis
- B) Systemic lupus erythematosus
- C) Scleroderma
- D) Mixed connective tissue disease
Answer: B) Systemic lupus erythematosus
Rationale: The combination of malar "butterfly" rash, fatigue, arthralgias, and positive ANA with
anti-dsDNA antibodies is highly specific for SLE. Anti-dsDNA antibodies are diagnostic of SLE
and correlate with disease activity, particularly lupus nephritis.
Q10. Which genetic condition is caused by an extra X chromosome in males (XXY karyotype)?
- A) Turner syndrome
- B) Klinefelter syndrome
- C) Down syndrome
- D) Triple X syndrome
Answer: B) Klinefelter syndrome
Rationale: Klinefelter syndrome (47,XXY) affects males, presenting with small testes,
gynecomastia, tall stature, and infertility. Testosterone deficiency develops during puberty,
requiring hormone replacement therapy.
Question Set 2: Pathophysiology of Edema & Inflammation (11-20)
Q11. During the body's inflammatory process, what causes edema?
- A) Vasodilation of blood vessels
- B) Emigration of neutrophils
