2026 LATEST COMPLETE WGU D118 EXAM|ACTUAL EXAM WITH
CORRECT EXPLAINED ANSWERS. GUARANTEED EXAM
EXCELLENCE
First-line medication for uncomplicated hypertension
......ANSWER......Thiazide diuretic or ACE inhibitor - Thiazides and ACE-Is
are first-line; ACE-I preferred in diabetes for renal protection
Next step for ACE inhibitor-induced angioedema
......ANSWER......Discontinue ACE inhibitor immediately - Angioedema is
life-threatening and ACE-Is are permanently contraindicated
Labs to check before starting an ACE inhibitor ......ANSWER......Serum
creatinine and potassium - Risk of renal dysfunction and hyperkalemia
Low back pain red flag requiring imaging ......ANSWER......New urinary
retention - Suggests cauda equina syndrome
Next step for acute monoarticular arthritis with fever
......ANSWER......Joint aspiration - Must rule out septic arthritis before
treating gout
First-line treatment for acute gout flare ......ANSWER......NSAIDs - First-
line unless contraindicated
pg. 1
,Diagnostic confirmation of gout ......ANSWER......Monosodium urate
crystals on synovial fluid - Serum uric acid is not diagnostic
Initial test for suspected PE in low-risk patient ......ANSWER......D-dimer -
Negative result rules out PE
Next step after positive D-dimer ......ANSWER......CT pulmonary
angiography - Required to confirm PE
First-line treatment for mild persistent asthma ......ANSWER......Low-
dose inhaled corticosteroid - Cornerstone therapy
Asthma hospitalization red flag ......ANSWER......Peak flow <50%
predicted - Indicates severe exacerbation
Preferred colon cancer screening at age 45
......ANSWER......Colonoscopy - Gold standard and diagnostic
COPD patient with frequent exacerbations next step
......ANSWER......Add inhaled corticosteroid - Reduces exacerbation
frequency
Diagnostic test confirming COPD ......ANSWER......Spirometry showing
FEV1/FVC <0.70 - Confirms airflow obstruction
pg. 2
, First-line medication for type 2 diabetes ......ANSWER......Metformin -
Improves insulin sensitivity with CV benefit
Metformin contraindication ......ANSWER......eGFR <30 - Risk of lactic
acidosis
Lab monitoring long-term glucose control ......ANSWER......Hemoglobin
A1c - Reflects 3-month average
First-line hypothyroidism treatment ......ANSWER......Levothyroxine -
Synthetic T4 replacement
Labs confirming primary hypothyroidism ......ANSWER......Elevated TSH
and low free T4 - Pituitary compensation
Headache red flag requiring imaging ......ANSWER......New headache
with focal neurologic deficits - Possible intracranial pathology
Initial imaging for suspected stroke ......ANSWER......Non-contrast CT
head - Rules out hemorrhage
Treatment for ischemic stroke within 4.5 hours ......ANSWER......IV
alteplase (tPA) - Time-sensitive reperfusion therapy
pg. 3
CORRECT EXPLAINED ANSWERS. GUARANTEED EXAM
EXCELLENCE
First-line medication for uncomplicated hypertension
......ANSWER......Thiazide diuretic or ACE inhibitor - Thiazides and ACE-Is
are first-line; ACE-I preferred in diabetes for renal protection
Next step for ACE inhibitor-induced angioedema
......ANSWER......Discontinue ACE inhibitor immediately - Angioedema is
life-threatening and ACE-Is are permanently contraindicated
Labs to check before starting an ACE inhibitor ......ANSWER......Serum
creatinine and potassium - Risk of renal dysfunction and hyperkalemia
Low back pain red flag requiring imaging ......ANSWER......New urinary
retention - Suggests cauda equina syndrome
Next step for acute monoarticular arthritis with fever
......ANSWER......Joint aspiration - Must rule out septic arthritis before
treating gout
First-line treatment for acute gout flare ......ANSWER......NSAIDs - First-
line unless contraindicated
pg. 1
,Diagnostic confirmation of gout ......ANSWER......Monosodium urate
crystals on synovial fluid - Serum uric acid is not diagnostic
Initial test for suspected PE in low-risk patient ......ANSWER......D-dimer -
Negative result rules out PE
Next step after positive D-dimer ......ANSWER......CT pulmonary
angiography - Required to confirm PE
First-line treatment for mild persistent asthma ......ANSWER......Low-
dose inhaled corticosteroid - Cornerstone therapy
Asthma hospitalization red flag ......ANSWER......Peak flow <50%
predicted - Indicates severe exacerbation
Preferred colon cancer screening at age 45
......ANSWER......Colonoscopy - Gold standard and diagnostic
COPD patient with frequent exacerbations next step
......ANSWER......Add inhaled corticosteroid - Reduces exacerbation
frequency
Diagnostic test confirming COPD ......ANSWER......Spirometry showing
FEV1/FVC <0.70 - Confirms airflow obstruction
pg. 2
, First-line medication for type 2 diabetes ......ANSWER......Metformin -
Improves insulin sensitivity with CV benefit
Metformin contraindication ......ANSWER......eGFR <30 - Risk of lactic
acidosis
Lab monitoring long-term glucose control ......ANSWER......Hemoglobin
A1c - Reflects 3-month average
First-line hypothyroidism treatment ......ANSWER......Levothyroxine -
Synthetic T4 replacement
Labs confirming primary hypothyroidism ......ANSWER......Elevated TSH
and low free T4 - Pituitary compensation
Headache red flag requiring imaging ......ANSWER......New headache
with focal neurologic deficits - Possible intracranial pathology
Initial imaging for suspected stroke ......ANSWER......Non-contrast CT
head - Rules out hemorrhage
Treatment for ischemic stroke within 4.5 hours ......ANSWER......IV
alteplase (tPA) - Time-sensitive reperfusion therapy
pg. 3
