WGU D027 Practice Questions With
100% Correct Answers
A patient has endured several dosage adjustments of his tricyclic antidepressant, so the
provider recommends genetic testing. Which statement correctly describes the rationale for
genetic testing?
a. The CYP2D6 gene influences metabolism of tricyclic antidepressants and certain other drugs
b. The HER2 gene is a tumor marker that impacts metabolism of tricyclic antidepressants
c. The BRCA2 gene influences metabolism of certain drugs and increases the risk for breast
cancer
d. The x-linked OPN1MW gene for male color blindness also slows metabolism of certain drugs -
correct answers ✔✔a. The CYP2D6 gene influences metabolism of tricyclic antidepressants and
certain other drugs
Answer/Rationale: CYP2D6 - page 155 Box 4.3 of Chapter 4 Genes and Genetic Diseases,
McCance & Huether, Unit 2, Genes, Environmental Lifestyle, and Common Diseases. HER2 is a
gene often implicated with cancer, as is BRCA2. OPN1MW is the gene that codes for color
blindness in men. Metabolism of 25% of all prescribed drugs, including tricyclic antidepressants,
beta adrenergic receptor blockers, and neuroleptics, is influenced by variants in a certain gene,
requiring genetic testing to reduce trial-and-error in estimating appropriate drug-dosage levels.
As an advanced practice nurse, you want to learn more about the CDC's initiatives relative to
asthma care and management in order to advocate for asthma sufferers at the state legislative
level. Your goal is to reduce medications costs to patients. Which CDC recommendation
supports your goal?
a. The CDC recommends that payers and employers promote healthy workspaces to decrease
environmental trigger exposures
,b. The CDC recommends that providers prescribe the most cost-efficient long-acting inhalers to
lower patient co-pays
c. The CDC recommends that providers deviate from the stepwise approach to lessen the
financial impact to the patient
d. The CDC recommends that co-pays be removed for inhaled corticosteroids and other
prescribed medications - correct answers ✔✔d. The CDC recommends that co-pays be removed
for inhaled corticosteroids and other prescribed medications
Answer/Rationale: D - The CDC recommends that co-pays be removed for inhaled
corticosteroids and other prescribed medications per the following link,
https://healthpayerintelligence.com/news/top-10-most-expensive-chronic-diseases-for-
healthcare-payers; Genes, Environmental Lifestyle, and Common Diseases; Unit 2
A female patient has been recently diagnosed with invasive ductal carcinoma. As an advanced
practice nurse, you understand that she will be undergoing a multi-faceted treatment approach
that will include one or more medications. Which medication is considered the "gold standard"
endocrine treatment for breast cancer?
a. Fulvestrant (Faslodex), an antiestrogen indicated for metastatic estrogen receptor-positive
breast cancer in post-menopausal women
b. Tamoxifen (Nolvadex), a prodrug that must be converted to active metabolites in order to
block estrogen receptors in breast tissue
c. Trastuzumab (Herceptin), a monoclonal antibody approved for HER2-positive metastatic
breast cancer
d. Lapatinib (Tykerb), an oral inhibitor of HER2 tyrosine kinase and EGFR tyrosine kinase,
resulting in apoptosis and suppression of tumor cell growth - correct answers ✔✔b. Tamoxifen
(Nolvadex), a prodrug that must be converted to active metabolites in order to block estrogen
receptors in breast tissue
Answer/Rationale: Tamoxifen, page 929, Chapter 82 of Lehne, Unit 2, Human Structures for Self
Defense
,A patient reports a maternal family history of Lynch syndrome. Which laboratory finding might
indicate a need for further testing for the presence of Lynch syndrome in this patient?
a. Elevated thyroid-stimulating hormone
b. Low cortisol level
c. Positive heme-occult test
d. Sputum positive for Pseudomonas Aeruginosa - correct answers ✔✔c. Positive heme-occult
test
Answer/Rationale: Positive heme-occult because Lynch syndrome is a hereditary form of
colorectal cancer and colorectal bleeding can be a sign of cancer, per
https://www.healthypeople.gov/2020/topics-objectives/topic/genomics, Unit 2, Human
Structures for Self Defense
Your goal as the intensive care unit coordinator is to reduce falls. Upon review of hospital data,
you find that most of the falls are occurring in the patient population, ages 65 and older. As a
result, you coordinate a fall reduction initiative after researching the etiology of falls in the
elderly. Which action should be included in the protocol?
a. Encourage slow position changes since orthostatic hypotension is a significant risk factor for
falls.
b. Allocate budgetary resources for assistive devices to be in every room at all times since falls
cannot be predicted.
c. Initiate depression screening on all new admissions since depressed affect has been indicated
in fall etiology.
d. Decrease the number of situations that require patient standing and walking, as upright
positions result in higher incidence of falls. - correct answers ✔✔a. Encourage slow position
changes since orthostatic hypotension is a significant risk factor for falls.
, Answer/Rationale: Encourage slow position changes since orthostatic hypotension is a
significant risk factor for falls. From page 1067, chapter 33, McCance & Huether, Causes of
Pathology in the Cardiovascular System, Unit 3
A patient who has lung cancer reports facial and neck swelling so severe that some shirts no
longer fit. What question by the healthcare professional would be most appropriate to screen
for superior vena cava syndrome, a possible complication of cancer tumors?
a. "Have you gained weight recently?"
b. "Are your feet and ankles swollen?"
c. "Does your voice sound hoarse?"
d. "When was your last chemotherapy?" - correct answers ✔✔c. "Does your voice sound
hoarse?"
ANS: C Patients with certain kinds of cancer (small cell and non-small cell cancers of the lung,
and lymphoma) can develop superior vena cava syndrome (SVCS) which is a progressive
occlusion of the superior vena cava. This leads to venous distention in the upper extremities and
head. Other symptoms include hoarse voice, dyspnea, dysphagia, stridor, cough, and chest pain.
The professional should ask about the other symptoms. A large weight gain would occur slowly.
Asking about edema elsewhere would be a question if the patient denied any other symptoms
of SVCS. The date of the last chemotherapy is not relevant. Page 1061, ch 33, McCance &
Huether, Unit 3
A patient is diagnosed with chronic obstructive pulmonary disease (COPD) and has elevated
pulmonary vascular resistance. Which symptom would indicate the need to assess for the
complication of cor pulmonale (right-sided heart failure)?
a. crackles bilaterally
b. generalized arthralgia
c. jugular venous distention
d. occasional constipation - correct answers ✔✔c. jugular venous distention
100% Correct Answers
A patient has endured several dosage adjustments of his tricyclic antidepressant, so the
provider recommends genetic testing. Which statement correctly describes the rationale for
genetic testing?
a. The CYP2D6 gene influences metabolism of tricyclic antidepressants and certain other drugs
b. The HER2 gene is a tumor marker that impacts metabolism of tricyclic antidepressants
c. The BRCA2 gene influences metabolism of certain drugs and increases the risk for breast
cancer
d. The x-linked OPN1MW gene for male color blindness also slows metabolism of certain drugs -
correct answers ✔✔a. The CYP2D6 gene influences metabolism of tricyclic antidepressants and
certain other drugs
Answer/Rationale: CYP2D6 - page 155 Box 4.3 of Chapter 4 Genes and Genetic Diseases,
McCance & Huether, Unit 2, Genes, Environmental Lifestyle, and Common Diseases. HER2 is a
gene often implicated with cancer, as is BRCA2. OPN1MW is the gene that codes for color
blindness in men. Metabolism of 25% of all prescribed drugs, including tricyclic antidepressants,
beta adrenergic receptor blockers, and neuroleptics, is influenced by variants in a certain gene,
requiring genetic testing to reduce trial-and-error in estimating appropriate drug-dosage levels.
As an advanced practice nurse, you want to learn more about the CDC's initiatives relative to
asthma care and management in order to advocate for asthma sufferers at the state legislative
level. Your goal is to reduce medications costs to patients. Which CDC recommendation
supports your goal?
a. The CDC recommends that payers and employers promote healthy workspaces to decrease
environmental trigger exposures
,b. The CDC recommends that providers prescribe the most cost-efficient long-acting inhalers to
lower patient co-pays
c. The CDC recommends that providers deviate from the stepwise approach to lessen the
financial impact to the patient
d. The CDC recommends that co-pays be removed for inhaled corticosteroids and other
prescribed medications - correct answers ✔✔d. The CDC recommends that co-pays be removed
for inhaled corticosteroids and other prescribed medications
Answer/Rationale: D - The CDC recommends that co-pays be removed for inhaled
corticosteroids and other prescribed medications per the following link,
https://healthpayerintelligence.com/news/top-10-most-expensive-chronic-diseases-for-
healthcare-payers; Genes, Environmental Lifestyle, and Common Diseases; Unit 2
A female patient has been recently diagnosed with invasive ductal carcinoma. As an advanced
practice nurse, you understand that she will be undergoing a multi-faceted treatment approach
that will include one or more medications. Which medication is considered the "gold standard"
endocrine treatment for breast cancer?
a. Fulvestrant (Faslodex), an antiestrogen indicated for metastatic estrogen receptor-positive
breast cancer in post-menopausal women
b. Tamoxifen (Nolvadex), a prodrug that must be converted to active metabolites in order to
block estrogen receptors in breast tissue
c. Trastuzumab (Herceptin), a monoclonal antibody approved for HER2-positive metastatic
breast cancer
d. Lapatinib (Tykerb), an oral inhibitor of HER2 tyrosine kinase and EGFR tyrosine kinase,
resulting in apoptosis and suppression of tumor cell growth - correct answers ✔✔b. Tamoxifen
(Nolvadex), a prodrug that must be converted to active metabolites in order to block estrogen
receptors in breast tissue
Answer/Rationale: Tamoxifen, page 929, Chapter 82 of Lehne, Unit 2, Human Structures for Self
Defense
,A patient reports a maternal family history of Lynch syndrome. Which laboratory finding might
indicate a need for further testing for the presence of Lynch syndrome in this patient?
a. Elevated thyroid-stimulating hormone
b. Low cortisol level
c. Positive heme-occult test
d. Sputum positive for Pseudomonas Aeruginosa - correct answers ✔✔c. Positive heme-occult
test
Answer/Rationale: Positive heme-occult because Lynch syndrome is a hereditary form of
colorectal cancer and colorectal bleeding can be a sign of cancer, per
https://www.healthypeople.gov/2020/topics-objectives/topic/genomics, Unit 2, Human
Structures for Self Defense
Your goal as the intensive care unit coordinator is to reduce falls. Upon review of hospital data,
you find that most of the falls are occurring in the patient population, ages 65 and older. As a
result, you coordinate a fall reduction initiative after researching the etiology of falls in the
elderly. Which action should be included in the protocol?
a. Encourage slow position changes since orthostatic hypotension is a significant risk factor for
falls.
b. Allocate budgetary resources for assistive devices to be in every room at all times since falls
cannot be predicted.
c. Initiate depression screening on all new admissions since depressed affect has been indicated
in fall etiology.
d. Decrease the number of situations that require patient standing and walking, as upright
positions result in higher incidence of falls. - correct answers ✔✔a. Encourage slow position
changes since orthostatic hypotension is a significant risk factor for falls.
, Answer/Rationale: Encourage slow position changes since orthostatic hypotension is a
significant risk factor for falls. From page 1067, chapter 33, McCance & Huether, Causes of
Pathology in the Cardiovascular System, Unit 3
A patient who has lung cancer reports facial and neck swelling so severe that some shirts no
longer fit. What question by the healthcare professional would be most appropriate to screen
for superior vena cava syndrome, a possible complication of cancer tumors?
a. "Have you gained weight recently?"
b. "Are your feet and ankles swollen?"
c. "Does your voice sound hoarse?"
d. "When was your last chemotherapy?" - correct answers ✔✔c. "Does your voice sound
hoarse?"
ANS: C Patients with certain kinds of cancer (small cell and non-small cell cancers of the lung,
and lymphoma) can develop superior vena cava syndrome (SVCS) which is a progressive
occlusion of the superior vena cava. This leads to venous distention in the upper extremities and
head. Other symptoms include hoarse voice, dyspnea, dysphagia, stridor, cough, and chest pain.
The professional should ask about the other symptoms. A large weight gain would occur slowly.
Asking about edema elsewhere would be a question if the patient denied any other symptoms
of SVCS. The date of the last chemotherapy is not relevant. Page 1061, ch 33, McCance &
Huether, Unit 3
A patient is diagnosed with chronic obstructive pulmonary disease (COPD) and has elevated
pulmonary vascular resistance. Which symptom would indicate the need to assess for the
complication of cor pulmonale (right-sided heart failure)?
a. crackles bilaterally
b. generalized arthralgia
c. jugular venous distention
d. occasional constipation - correct answers ✔✔c. jugular venous distention
