1
WGU D345 NURS 6438
Psychopharmacology OA Final Exam 2025 –
Verified Questions and Answers | Expert
Solutions | Graded A+
Version A (Questions 1–66)
1. A 45-year-old male with a history of alcohol use disorder presents with fatigue, weight
loss, and ascites. Physical exam reveals hepatosplenomegaly and spider nevi. Which test
confirms a diagnosis of cirrhosis?
A. Scleral icterus
B. Hyperbilirubinemia
C. Liver biopsy
D. Elevated prothrombin time
Correct Answer: C
Rationale: A liver biopsy is the gold standard for confirming cirrhosis, as it provides
histological evidence of fibrosis and nodular regeneration. Other options (A, B, D) are
supportive findings but not confirmatory.
2. A 60-year-old female presents with chest pain radiating to her left arm. An ECG shows
ST-segment elevation. What is the most likely diagnosis?
A. Stable angina
B. Acute myocardial infarction
C. Pericarditis
D. Aortic dissection
Correct Answer: B
Rationale: ST-segment elevation on ECG, along with chest pain radiating to the arm, is
characteristic of acute myocardial infarction, indicating acute coronary artery occlusion.
3. A 30-year-old male presents with fever, cough, and hemoptysis. Chest X-ray shows
cavitary lesions. What is the most likely diagnosis?
A. Pneumonia
B. Tuberculosis
C. Lung cancer
D. Pulmonary embolism
Correct Answer: B
Rationale: Cavitary lesions on chest X-ray, combined with fever, cough, and hemoptysis,
are highly suggestive of pulmonary tuberculosis, especially in a younger patient.
4. Which medication is first-line for managing type 2 diabetes mellitus?
A. Insulin
B. Metformin
, 2
C. Sulfonylurea
D. SGLT2 inhibitor
Correct Answer: B
Rationale: Metformin is the first-line therapy for type 2 diabetes due to its efficacy,
safety profile, and low cost. It reduces hepatic glucose production and improves insulin
sensitivity.
5. A 50-year-old male with hypertension presents with a blood pressure of 190/110 mmHg
and reports blurred vision. What is the most appropriate initial treatment?
A. Oral amlodipine
B. Intravenous nitroprusside
C. Sublingual nitroglycerin
D. Oral lisinopril
Correct Answer: B
Rationale: This patient has hypertensive emergency (severe hypertension with end -organ
damage, e.g., blurred vision). Intravenous nitroprusside is indicated for rapid blood
pressure control.
6. A 25-year-old female presents with polyuria, polydipsia, and weight loss. Her blood
glucose is 350 mg/dL. What is the most likely diagnosis?
A. Type 1 diabetes mellitus
B. Type 2 diabetes mellitus
C. Gestational diabetes
D. Cushing’s syndrome
Correct Answer: A
Rationale: The classic triad of polyuria, polydipsia, and weight loss in a young patient
with elevated blood glucose suggests type 1 diabetes, an autoimmune condition leading
to insulin deficiency.
7. A 40-year-old male with a history of smoking presents with dyspnea and chronic cough.
Spirometry shows an FEV1/FVC ratio of 0.65. What is the diagnosis?
A. Asthma
B. Chronic obstructive pulmonary disease
C. Pulmonary fibrosis
D. Pneumothorax
Correct Answer: B
Rationale: An FEV1/FVC ratio <0.70 in a smoker with chronic cough and dyspnea
indicates chronic obstructive pulmonary disease, characterized by airflow limitation.
8. Which vaccine is recommended annually for all adults?
A. Hepatitis B
B. Influenza
C. Tdap
D. Pneumococcal
Correct Answer: B
Rationale: The influenza vaccine is recommended annually for all adults to protect
against seasonal flu strains, as immunity wanes and viral strains change yearly.
9. A 70-year-old female presents with confusion and lethargy. Labs show sodium of 120
mEq/L. What is the most likely cause?
A. Dehydration
, 3
B. Syndrome of inappropriate antidiuretic hormone (SIADH)
C. Hyperaldosteronism
D. Diabetic ketoacidosis
Correct Answer: B
Rationale: Hyponatremia with confusion and lethargy in an elderly patient is often due to
SIADH, which causes water retention and dilutional hyponatremia.
10. A 55-year-old male presents with epigastric pain relieved by food intake. An endoscopy
shows a gastric ulcer. What is the most likely cause?
A. Helicobacter pylori infection
B. Nonsteroidal anti-inflammatory drugs (NSAIDs)
C. Stress
D. Alcohol
Correct Answer: A
Rationale: H. pylori infection is the most common cause of gastric ulcers, leading to
mucosal damage and ulcer formation. Testing for H. pylori is standard in such cases.
11. A 35-year-old female presents with unilateral leg swelling and pain. Doppler ultrasound
confirms deep vein thrombosis. What is the initial treatment?
A. Aspirin
B. Heparin
C. Warfarin
D. Clopidogrel
Correct Answer: B
Rationale: Heparin (unfractionated or low-molecular-weight) is the initial treatment for
acute deep vein thrombosis to prevent clot propagation and embolization.
12. A 28-year-old male presents with jaundice and dark urine. Labs show elevated direct
bilirubin. What is the most likely diagnosis?
A. Hemolytic anemia
B. Hepatitis A
C. Gilbert’s syndrome
D. Choledocholithiasis
Correct Answer: D
Rationale: Elevated direct bilirubin with jaundice and dark urine suggests obstructive
jaundice, often due to choledocholithiasis (gallstone obstructing the common bile duct).
13. A 65-year-old male with atrial fibrillation is prescribed warfarin. What is the target INR
range?
A. 1.0–1.5
B. 2.0–3.0
C. 3.5–4.5
D. 5.0–6.0
Correct Answer: B
Rationale: The therapeutic INR range for atrial fibrillation is 2.0–3.0, balancing
anticoagulation to prevent thromboembolism with the risk of bleeding.
14. A 50-year-old female presents with fatigue and cold intolerance. Labs show elevated
TSH and low T4. What is the diagnosis?
A. Hyperthyroidism
B. Hypothyroidism
, 4
C. Euthyroid sick syndrome
D. Subclinical hyperthyroidism
Correct Answer: B
Rationale: Elevated TSH and low T4 indicate primary hypothyroidism, often due to
autoimmune thyroiditis (Hashimoto’s), causing symptoms like fatigue and cold
intolerance.
15. A 20-year-old male presents with chest pain worse when lying down and relieved by
sitting up. ECG shows diffuse ST elevation. What is the diagnosis?
A. Myocardial infarction
B. Pericarditis
C. Pulmonary embolism
D. Pneumonia
Correct Answer: B
Rationale: Positional chest pain and diffuse ST elevation on ECG are classic for
pericarditis, often due to viral infection or inflammation.
16. Which screening test is recommended for colorectal cancer in adults aged 50–75?
A. Barium enema
B. Colonoscopy
C. Abdominal CT
D. Sigmoidoscopy
Correct Answer: B
Rationale: Colonoscopy is the preferred screening method for colorectal cancer in
average-risk adults aged 50–75, allowing for both detection and removal of polyps.
17. A 40-year-old male presents with recurrent kidney stones. Labs show hypercalcemia.
What is the most likely cause?
A. Hypoparathyroidism
B. Primary hyperparathyroidism
C. Renal tubular acidosis
D. Vitamin D deficiency
Correct Answer: B
Rationale: Hypercalcemia and recurrent kidney stones are commonly caused by primary
hyperparathyroidism, which increases parathyroid hormone levels, leading to elevated
serum calcium.
18. A 30-year-old female presents with anxiety, palpitations, and weight loss. Labs show low
TSH and elevated T4. What is the treatment?
A. Levothyroxine
B. Methimazole
C. Propranolol
D. Radioactive iodine
Correct Answer: B
Rationale: This patient has hyperthyroidism (likely Graves’ disease). Methimazole is a
first-line antithyroid drug to reduce thyroid hormone production. Propranolol (C) may be
used for symptom control but is not primary treatment.
19. A 55-year-old male with type 2 diabetes has an A1C of 8.5%. What is the most
appropriate next step?
A. Continue lifestyle modifications
WGU D345 NURS 6438
Psychopharmacology OA Final Exam 2025 –
Verified Questions and Answers | Expert
Solutions | Graded A+
Version A (Questions 1–66)
1. A 45-year-old male with a history of alcohol use disorder presents with fatigue, weight
loss, and ascites. Physical exam reveals hepatosplenomegaly and spider nevi. Which test
confirms a diagnosis of cirrhosis?
A. Scleral icterus
B. Hyperbilirubinemia
C. Liver biopsy
D. Elevated prothrombin time
Correct Answer: C
Rationale: A liver biopsy is the gold standard for confirming cirrhosis, as it provides
histological evidence of fibrosis and nodular regeneration. Other options (A, B, D) are
supportive findings but not confirmatory.
2. A 60-year-old female presents with chest pain radiating to her left arm. An ECG shows
ST-segment elevation. What is the most likely diagnosis?
A. Stable angina
B. Acute myocardial infarction
C. Pericarditis
D. Aortic dissection
Correct Answer: B
Rationale: ST-segment elevation on ECG, along with chest pain radiating to the arm, is
characteristic of acute myocardial infarction, indicating acute coronary artery occlusion.
3. A 30-year-old male presents with fever, cough, and hemoptysis. Chest X-ray shows
cavitary lesions. What is the most likely diagnosis?
A. Pneumonia
B. Tuberculosis
C. Lung cancer
D. Pulmonary embolism
Correct Answer: B
Rationale: Cavitary lesions on chest X-ray, combined with fever, cough, and hemoptysis,
are highly suggestive of pulmonary tuberculosis, especially in a younger patient.
4. Which medication is first-line for managing type 2 diabetes mellitus?
A. Insulin
B. Metformin
, 2
C. Sulfonylurea
D. SGLT2 inhibitor
Correct Answer: B
Rationale: Metformin is the first-line therapy for type 2 diabetes due to its efficacy,
safety profile, and low cost. It reduces hepatic glucose production and improves insulin
sensitivity.
5. A 50-year-old male with hypertension presents with a blood pressure of 190/110 mmHg
and reports blurred vision. What is the most appropriate initial treatment?
A. Oral amlodipine
B. Intravenous nitroprusside
C. Sublingual nitroglycerin
D. Oral lisinopril
Correct Answer: B
Rationale: This patient has hypertensive emergency (severe hypertension with end -organ
damage, e.g., blurred vision). Intravenous nitroprusside is indicated for rapid blood
pressure control.
6. A 25-year-old female presents with polyuria, polydipsia, and weight loss. Her blood
glucose is 350 mg/dL. What is the most likely diagnosis?
A. Type 1 diabetes mellitus
B. Type 2 diabetes mellitus
C. Gestational diabetes
D. Cushing’s syndrome
Correct Answer: A
Rationale: The classic triad of polyuria, polydipsia, and weight loss in a young patient
with elevated blood glucose suggests type 1 diabetes, an autoimmune condition leading
to insulin deficiency.
7. A 40-year-old male with a history of smoking presents with dyspnea and chronic cough.
Spirometry shows an FEV1/FVC ratio of 0.65. What is the diagnosis?
A. Asthma
B. Chronic obstructive pulmonary disease
C. Pulmonary fibrosis
D. Pneumothorax
Correct Answer: B
Rationale: An FEV1/FVC ratio <0.70 in a smoker with chronic cough and dyspnea
indicates chronic obstructive pulmonary disease, characterized by airflow limitation.
8. Which vaccine is recommended annually for all adults?
A. Hepatitis B
B. Influenza
C. Tdap
D. Pneumococcal
Correct Answer: B
Rationale: The influenza vaccine is recommended annually for all adults to protect
against seasonal flu strains, as immunity wanes and viral strains change yearly.
9. A 70-year-old female presents with confusion and lethargy. Labs show sodium of 120
mEq/L. What is the most likely cause?
A. Dehydration
, 3
B. Syndrome of inappropriate antidiuretic hormone (SIADH)
C. Hyperaldosteronism
D. Diabetic ketoacidosis
Correct Answer: B
Rationale: Hyponatremia with confusion and lethargy in an elderly patient is often due to
SIADH, which causes water retention and dilutional hyponatremia.
10. A 55-year-old male presents with epigastric pain relieved by food intake. An endoscopy
shows a gastric ulcer. What is the most likely cause?
A. Helicobacter pylori infection
B. Nonsteroidal anti-inflammatory drugs (NSAIDs)
C. Stress
D. Alcohol
Correct Answer: A
Rationale: H. pylori infection is the most common cause of gastric ulcers, leading to
mucosal damage and ulcer formation. Testing for H. pylori is standard in such cases.
11. A 35-year-old female presents with unilateral leg swelling and pain. Doppler ultrasound
confirms deep vein thrombosis. What is the initial treatment?
A. Aspirin
B. Heparin
C. Warfarin
D. Clopidogrel
Correct Answer: B
Rationale: Heparin (unfractionated or low-molecular-weight) is the initial treatment for
acute deep vein thrombosis to prevent clot propagation and embolization.
12. A 28-year-old male presents with jaundice and dark urine. Labs show elevated direct
bilirubin. What is the most likely diagnosis?
A. Hemolytic anemia
B. Hepatitis A
C. Gilbert’s syndrome
D. Choledocholithiasis
Correct Answer: D
Rationale: Elevated direct bilirubin with jaundice and dark urine suggests obstructive
jaundice, often due to choledocholithiasis (gallstone obstructing the common bile duct).
13. A 65-year-old male with atrial fibrillation is prescribed warfarin. What is the target INR
range?
A. 1.0–1.5
B. 2.0–3.0
C. 3.5–4.5
D. 5.0–6.0
Correct Answer: B
Rationale: The therapeutic INR range for atrial fibrillation is 2.0–3.0, balancing
anticoagulation to prevent thromboembolism with the risk of bleeding.
14. A 50-year-old female presents with fatigue and cold intolerance. Labs show elevated
TSH and low T4. What is the diagnosis?
A. Hyperthyroidism
B. Hypothyroidism
, 4
C. Euthyroid sick syndrome
D. Subclinical hyperthyroidism
Correct Answer: B
Rationale: Elevated TSH and low T4 indicate primary hypothyroidism, often due to
autoimmune thyroiditis (Hashimoto’s), causing symptoms like fatigue and cold
intolerance.
15. A 20-year-old male presents with chest pain worse when lying down and relieved by
sitting up. ECG shows diffuse ST elevation. What is the diagnosis?
A. Myocardial infarction
B. Pericarditis
C. Pulmonary embolism
D. Pneumonia
Correct Answer: B
Rationale: Positional chest pain and diffuse ST elevation on ECG are classic for
pericarditis, often due to viral infection or inflammation.
16. Which screening test is recommended for colorectal cancer in adults aged 50–75?
A. Barium enema
B. Colonoscopy
C. Abdominal CT
D. Sigmoidoscopy
Correct Answer: B
Rationale: Colonoscopy is the preferred screening method for colorectal cancer in
average-risk adults aged 50–75, allowing for both detection and removal of polyps.
17. A 40-year-old male presents with recurrent kidney stones. Labs show hypercalcemia.
What is the most likely cause?
A. Hypoparathyroidism
B. Primary hyperparathyroidism
C. Renal tubular acidosis
D. Vitamin D deficiency
Correct Answer: B
Rationale: Hypercalcemia and recurrent kidney stones are commonly caused by primary
hyperparathyroidism, which increases parathyroid hormone levels, leading to elevated
serum calcium.
18. A 30-year-old female presents with anxiety, palpitations, and weight loss. Labs show low
TSH and elevated T4. What is the treatment?
A. Levothyroxine
B. Methimazole
C. Propranolol
D. Radioactive iodine
Correct Answer: B
Rationale: This patient has hyperthyroidism (likely Graves’ disease). Methimazole is a
first-line antithyroid drug to reduce thyroid hormone production. Propranolol (C) may be
used for symptom control but is not primary treatment.
19. A 55-year-old male with type 2 diabetes has an A1C of 8.5%. What is the most
appropriate next step?
A. Continue lifestyle modifications
