WGU D027 OBJECTIVE ASSESSMENT (OA) EXAM 2026/2027
AND STUDY GUIDE COMPLETE ACCURATE TEST
APPROVED QUESTIONS AND CORRECT ANSWERS WITH
DETAILED RATIONALES (100% CORRECT VERIFIED
SOLUTIONS) LATEST UPDATED VERSION 2026 EDITION
|GUARANTEED PASS A+
Question 1
A patient present with sudden-onset severe headache, nuchal rigidity, and
photophobia. Which diagnostic test is the priority?
A. Non-contrast CT head
B. MRI brain with contrast
C. Lumbar puncture
D. EEG
Correct Answer: A (Non-contrast CT head) – Rationale: Before lumbar puncture,
non-contrast CT is required to rule out mass effect or increased intracranial
pressure that could cause herniation. CT is rapid and widely available for acute
headache with meningioma’s.
Question 2
A nurse is caring for a client with syndrome of inappropriate antidiuretic hormone
(SIADH). Which laboratory finding is expected?
A. Serum sodium 118 me/L
B. Serum osmolality 310 mom/kg
C. Urine specific gravity 1.002
D. Serum potassium 5.8 me/L
,Correct Answer: A (Serum sodium 118 me/L) – Rationale: SIADH causes water
retention, delusional hyponatremia, low serum osmolality, and concentrated
urine (high specific gravity). Hyponatremia is the hallmark.
Question 3
Which finding in a patient with diabetes insipidus (DI) indicates effective
desmopressin therapy?
A. Increased thirst and polyuria
B. Decreased serum sodium
C. Increased urine specific gravity
D. Decreased blood pressure
Correct Answer: C (Increased urine specific gravity) – Rationale: Desmopressin
replaces ADH, concentrating urine. Increased specific gravity (>1.005) indicates
response; polyuria and thirst should decrease, sodium normalizes.
Question 4
A patient with hyperthyroidism is prescribed propylthiouracil (PTU). The nurse
should monitor for which adverse effect?
A. Bradycardia
B. Agranulocytosis
C. Hypocalcemia
D. Hyperglycemia
,Correct Answer: B (Agranulocytosis) – Rationale: PTU can cause agranulocytosis;
monitor for fever, sore throat. Also hepatotoxicity. Bradycardia is not an adverse
effect; PTU treats hyperthyroidism.
Question 5
In diabetic ketoacidosis (DKA), which intravenous fluid is preferred for initial
resuscitation?
A. 0.9% normal saline
B. 0.45% half-normal saline
C. 5% dextrose in water
D. Lactated Ringer’s solution
Correct Answer: A (0.9% normal saline) – *Rationale: Isotonic saline restores
volume, corrects hypotension, and improves tissue perfusion. Dextrose is added
later when glucose approaches 250 mg/dL. *
Question 6
A patient with chronic kidney disease (CKD) stage 4 has hemoglobin of 8.2 g/ld.
The most likely cause is:
A. Iron deficiency
B. Hemolysis
C. Erythropoietin deficiency
D. Vitamin B12 deficiency
Correct Answer: C (Erythropoietin deficiency) – Rationale: Kidneys produce
erythropoietin; in CKD, deficiency leads to normocytic, normochromic anemia.
ESAs and iron are treatments.
, Question 7
Which acid-base disturbance is expected in a patient with severe vomiting?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
Correct Answer: B (Metabolic alkalosis) – Rationale: Vomiting loses gastric acid
(Hall), increasing serum bicarbonate. Hypochloremia and hypokalemia often
coexist.
Question 8
A patient with myasthenia gravis reports increased weakness and difficulty
swallowing. The nurse administers edrophonium (Tension) and symptoms
improve. This indicates:
A. Cholinergic crisis
B. Myasthenia crisis
C. Lambert-Eaton syndrome
D. Guillain-Barre syndrome
Correct Answer: B (Myasthenia crisis) – Rationale: Edrophonium (short-acting
acetylcholinesterase inhibitor) improves weakness in myasthenia crisis
(undertreated). Cholinergic crisis worsens.
Question 9
AND STUDY GUIDE COMPLETE ACCURATE TEST
APPROVED QUESTIONS AND CORRECT ANSWERS WITH
DETAILED RATIONALES (100% CORRECT VERIFIED
SOLUTIONS) LATEST UPDATED VERSION 2026 EDITION
|GUARANTEED PASS A+
Question 1
A patient present with sudden-onset severe headache, nuchal rigidity, and
photophobia. Which diagnostic test is the priority?
A. Non-contrast CT head
B. MRI brain with contrast
C. Lumbar puncture
D. EEG
Correct Answer: A (Non-contrast CT head) – Rationale: Before lumbar puncture,
non-contrast CT is required to rule out mass effect or increased intracranial
pressure that could cause herniation. CT is rapid and widely available for acute
headache with meningioma’s.
Question 2
A nurse is caring for a client with syndrome of inappropriate antidiuretic hormone
(SIADH). Which laboratory finding is expected?
A. Serum sodium 118 me/L
B. Serum osmolality 310 mom/kg
C. Urine specific gravity 1.002
D. Serum potassium 5.8 me/L
,Correct Answer: A (Serum sodium 118 me/L) – Rationale: SIADH causes water
retention, delusional hyponatremia, low serum osmolality, and concentrated
urine (high specific gravity). Hyponatremia is the hallmark.
Question 3
Which finding in a patient with diabetes insipidus (DI) indicates effective
desmopressin therapy?
A. Increased thirst and polyuria
B. Decreased serum sodium
C. Increased urine specific gravity
D. Decreased blood pressure
Correct Answer: C (Increased urine specific gravity) – Rationale: Desmopressin
replaces ADH, concentrating urine. Increased specific gravity (>1.005) indicates
response; polyuria and thirst should decrease, sodium normalizes.
Question 4
A patient with hyperthyroidism is prescribed propylthiouracil (PTU). The nurse
should monitor for which adverse effect?
A. Bradycardia
B. Agranulocytosis
C. Hypocalcemia
D. Hyperglycemia
,Correct Answer: B (Agranulocytosis) – Rationale: PTU can cause agranulocytosis;
monitor for fever, sore throat. Also hepatotoxicity. Bradycardia is not an adverse
effect; PTU treats hyperthyroidism.
Question 5
In diabetic ketoacidosis (DKA), which intravenous fluid is preferred for initial
resuscitation?
A. 0.9% normal saline
B. 0.45% half-normal saline
C. 5% dextrose in water
D. Lactated Ringer’s solution
Correct Answer: A (0.9% normal saline) – *Rationale: Isotonic saline restores
volume, corrects hypotension, and improves tissue perfusion. Dextrose is added
later when glucose approaches 250 mg/dL. *
Question 6
A patient with chronic kidney disease (CKD) stage 4 has hemoglobin of 8.2 g/ld.
The most likely cause is:
A. Iron deficiency
B. Hemolysis
C. Erythropoietin deficiency
D. Vitamin B12 deficiency
Correct Answer: C (Erythropoietin deficiency) – Rationale: Kidneys produce
erythropoietin; in CKD, deficiency leads to normocytic, normochromic anemia.
ESAs and iron are treatments.
, Question 7
Which acid-base disturbance is expected in a patient with severe vomiting?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
Correct Answer: B (Metabolic alkalosis) – Rationale: Vomiting loses gastric acid
(Hall), increasing serum bicarbonate. Hypochloremia and hypokalemia often
coexist.
Question 8
A patient with myasthenia gravis reports increased weakness and difficulty
swallowing. The nurse administers edrophonium (Tension) and symptoms
improve. This indicates:
A. Cholinergic crisis
B. Myasthenia crisis
C. Lambert-Eaton syndrome
D. Guillain-Barre syndrome
Correct Answer: B (Myasthenia crisis) – Rationale: Edrophonium (short-acting
acetylcholinesterase inhibitor) improves weakness in myasthenia crisis
(undertreated). Cholinergic crisis worsens.
Question 9
