WGU D118 OBJECTIVE ASSESSMENT EXAM - ADULT PRIMARY
CARE PRACTICE EXAM - (60 QUESTIONS) UP-TO-DATE ACTUAL
EXAM QUESTIONS AND 100% ACCURATE SOLUTIONS | VERIFIED
ANSWERS - INSTANT PDF DOWNLOAD
Examiner/Administrator: Western Governors University (WGU)
CANDIDATE DETAILS
Name: ____________________________
Candidate ID: _____________________
Date: ____________________________
Testing Location: __________________
INSTRUCTIONS TO CANDIDATES
You are required to complete this competency-based objective assessment
designed to evaluate your clinical reasoning, diagnostic decision-making, and
evidence-based management in adult primary care practice. The exam
consists of approximately 60 multiple-choice questions. You are allocated 120
minutes to complete all questions. Read each clinical scenario carefully and
select the single best answer. No external materials are permitted unless
specified. All responses must reflect current clinical guidelines and safe
practice standards.
CORE COMPETENCY DOMAINS
• Health Promotion & Disease Prevention
• Chronic Disease Management
• Pharmacologic & Non-Pharmacologic Interventions
• Diagnostic Reasoning & Clinical Decision-Making
• Patient Education & Counseling
• Evidence-Based Practice in Adult Care
DISCLAIMER
,This is a simulated assessment created for educational and preparation purposes.
It is not affiliated with or an actual examination administered by Western
Governors University.
This assessment evaluates the learner’s ability to integrate advanced nursing
knowledge into clinical practice within adult primary care settings. Emphasis
is placed on applying diagnostic reasoning, managing chronic and acute
conditions, and implementing evidence-based interventions to promote
optimal patient outcomes.
Q1. A 58-year-old male with a 20-year history of smoking presents with chronic
cough and dyspnea. Spirometry reveals FEV1/FVC ratio of 0.65 post-
bronchodilator. Which is the most appropriate initial pharmacologic treatment?
A. Oral corticosteroids
B. Short-acting beta-agonist (SABA) as needed
C. Long-acting muscarinic antagonist (LAMA)
D. Antibiotics
Correct Answer: C. Long-acting muscarinic antagonist (LAMA)
Explanation: This patient meets criteria for COPD. LAMA is first-line for
persistent symptoms. SABAs are for rescue only. Oral steroids are reserved for
exacerbations. Antibiotics are not indicated without infection.
Q2. A 45-year-old female presents with fatigue, weight gain, and cold
intolerance. Labs show elevated TSH and low free T4. What is the best
treatment?
A. Methimazole
B. Levothyroxine
,C. Propylthiouracil
D. Radioactive iodine
Correct Answer: B. Levothyroxine
Explanation: Primary hypothyroidism requires thyroid hormone
replacement. Methimazole and PTU treat hyperthyroidism. Radioactive iodine
ablates thyroid tissue.
Q3. A patient with type 2 diabetes has an HbA1c of 9.2% despite metformin
therapy. What is the next best step?
A. Discontinue metformin
B. Add basal insulin
C. Start sulfonylurea only
D. Lifestyle changes only
Correct Answer: B. Add basal insulin
Explanation: HbA1c >9% indicates need for insulin. Metformin should be
continued. Sulfonylureas alone may not achieve control. Lifestyle alone is
insufficient.
Q4. A 62-year-old patient presents with sudden unilateral weakness and slurred
speech. What is the priority action?
A. Administer aspirin immediately
B. Order CT scan without contrast
C. Check blood glucose later
D. Begin physical therapy
, Correct Answer: B. Order CT scan without contrast
Explanation: CT scan distinguishes ischemic vs hemorrhagic stroke. Aspirin
is only after ruling out hemorrhage. Glucose should be checked early but
imaging is priority.
Q5. A patient with hypertension is started on lisinopril. Which lab value must
be monitored closely?
A. Sodium
B. Potassium
C. Calcium
D. Magnesium
Correct Answer: B. Potassium
Explanation: ACE inhibitors can cause hyperkalemia. Sodium and calcium
are less affected. Monitoring potassium is essential.
Q6. A 35-year-old woman presents with dysuria and frequency. Urinalysis
shows positive nitrites. Most likely diagnosis?
A. Pyelonephritis
B. Interstitial cystitis
C. Acute uncomplicated UTI
D. Kidney stones
Correct Answer: C. Acute uncomplicated UTI
Explanation: Nitrites indicate bacterial infection (E. coli). Pyelonephritis
includes fever and flank pain. Stones cause hematuria, not nitrites.
CARE PRACTICE EXAM - (60 QUESTIONS) UP-TO-DATE ACTUAL
EXAM QUESTIONS AND 100% ACCURATE SOLUTIONS | VERIFIED
ANSWERS - INSTANT PDF DOWNLOAD
Examiner/Administrator: Western Governors University (WGU)
CANDIDATE DETAILS
Name: ____________________________
Candidate ID: _____________________
Date: ____________________________
Testing Location: __________________
INSTRUCTIONS TO CANDIDATES
You are required to complete this competency-based objective assessment
designed to evaluate your clinical reasoning, diagnostic decision-making, and
evidence-based management in adult primary care practice. The exam
consists of approximately 60 multiple-choice questions. You are allocated 120
minutes to complete all questions. Read each clinical scenario carefully and
select the single best answer. No external materials are permitted unless
specified. All responses must reflect current clinical guidelines and safe
practice standards.
CORE COMPETENCY DOMAINS
• Health Promotion & Disease Prevention
• Chronic Disease Management
• Pharmacologic & Non-Pharmacologic Interventions
• Diagnostic Reasoning & Clinical Decision-Making
• Patient Education & Counseling
• Evidence-Based Practice in Adult Care
DISCLAIMER
,This is a simulated assessment created for educational and preparation purposes.
It is not affiliated with or an actual examination administered by Western
Governors University.
This assessment evaluates the learner’s ability to integrate advanced nursing
knowledge into clinical practice within adult primary care settings. Emphasis
is placed on applying diagnostic reasoning, managing chronic and acute
conditions, and implementing evidence-based interventions to promote
optimal patient outcomes.
Q1. A 58-year-old male with a 20-year history of smoking presents with chronic
cough and dyspnea. Spirometry reveals FEV1/FVC ratio of 0.65 post-
bronchodilator. Which is the most appropriate initial pharmacologic treatment?
A. Oral corticosteroids
B. Short-acting beta-agonist (SABA) as needed
C. Long-acting muscarinic antagonist (LAMA)
D. Antibiotics
Correct Answer: C. Long-acting muscarinic antagonist (LAMA)
Explanation: This patient meets criteria for COPD. LAMA is first-line for
persistent symptoms. SABAs are for rescue only. Oral steroids are reserved for
exacerbations. Antibiotics are not indicated without infection.
Q2. A 45-year-old female presents with fatigue, weight gain, and cold
intolerance. Labs show elevated TSH and low free T4. What is the best
treatment?
A. Methimazole
B. Levothyroxine
,C. Propylthiouracil
D. Radioactive iodine
Correct Answer: B. Levothyroxine
Explanation: Primary hypothyroidism requires thyroid hormone
replacement. Methimazole and PTU treat hyperthyroidism. Radioactive iodine
ablates thyroid tissue.
Q3. A patient with type 2 diabetes has an HbA1c of 9.2% despite metformin
therapy. What is the next best step?
A. Discontinue metformin
B. Add basal insulin
C. Start sulfonylurea only
D. Lifestyle changes only
Correct Answer: B. Add basal insulin
Explanation: HbA1c >9% indicates need for insulin. Metformin should be
continued. Sulfonylureas alone may not achieve control. Lifestyle alone is
insufficient.
Q4. A 62-year-old patient presents with sudden unilateral weakness and slurred
speech. What is the priority action?
A. Administer aspirin immediately
B. Order CT scan without contrast
C. Check blood glucose later
D. Begin physical therapy
, Correct Answer: B. Order CT scan without contrast
Explanation: CT scan distinguishes ischemic vs hemorrhagic stroke. Aspirin
is only after ruling out hemorrhage. Glucose should be checked early but
imaging is priority.
Q5. A patient with hypertension is started on lisinopril. Which lab value must
be monitored closely?
A. Sodium
B. Potassium
C. Calcium
D. Magnesium
Correct Answer: B. Potassium
Explanation: ACE inhibitors can cause hyperkalemia. Sodium and calcium
are less affected. Monitoring potassium is essential.
Q6. A 35-year-old woman presents with dysuria and frequency. Urinalysis
shows positive nitrites. Most likely diagnosis?
A. Pyelonephritis
B. Interstitial cystitis
C. Acute uncomplicated UTI
D. Kidney stones
Correct Answer: C. Acute uncomplicated UTI
Explanation: Nitrites indicate bacterial infection (E. coli). Pyelonephritis
includes fever and flank pain. Stones cause hematuria, not nitrites.
