WGU D027 QUESTIONS AND ANSWERS
What is the gold standard for the suspected diagnosis of Celiac Disease? ** Answers **
Endoscopy with small intestine biopsy
A 44-year-old woman has recently been diagnosed with advanced metastatic non-small-cell
lung cancer. Genetic testing is ordered to determine if the patient's tumor has any genomic
alterations and to guide treatment decisions. A few weeks later, the patient's test results come
back positive for a genetic mutation. The APN starts osimertinib (Tagrisso). Based on this
information, what type of genetic mutation does this patient have? ** Answers ** EGFR
mutation
A 20-year-old male meets with an advanced professional nurse (APN) to discuss symptoms that
have been slowly progressing over the past several years. He is mainly concerned because he
has been falling frequently. Since childhood, his gait has consisted of walking on his toes. During
middle school, he was able to participate in sports but was unable to participate in high school
sports due to difficulty with running and jumping. Lately, he has noticed it takes longer and is
more difficult to change positions from sitting to standing than it used to in the past. He has also
been waking up with muscle and joint stiffness. The APRN notes that his family history is not
significant for any chronic or genetic diseases. Which condition is likely to be the cause of these
symptoms? ** Answers ** Becker muscular dystrophy
--Becker muscular dystrophy (often called Becker MD or BMD) is a form of muscular dystrophy,
a genetic disorder that gradually makes the body's muscles weaker and smaller. It causes less
severe problems than the most common type, Duchenne muscular dystrophy.
Which statement should the provider give the patient regarding the pathophysiology of SLE and
its relation to thrombocytopenia? ** Answers ** SLE disrupts immune homeostasis and
promotes development of self-reactive antibodies.
A female patient presents to an office to establish care. Her previous primary care provider told
her to follow up regarding an elevated ferritin level. She has no previous medical history and is
currently asymptomatic. She is concerned about the elevated ferritin and would like to know if
she should be worried. What should the provider do next for this patient? ** Answers **
Order a liver function test
,A 75-year-old female presents to the emergency department with an irregular heart rate of
130.What can be ascertained about this patient's findings given the limited information? **
Answers ** She is diagnosed with atrial fibrillation and needs her heart rate controlled with
metoprolol (Lopressor).
Which condition from this patient's medical history is contributing to the loss of contractility?
** Answers ** Acute myocardial infarction
Which condition is this patient suffering from? ** Answers ** Diabetic ketoacidosis
A 45-year-old female fears that she is having a stroke and takes herself to an emergency room.
After several diagnostic and laboratory tests, the patient is diagnosed with Cushing disease.
Which lab abnormality would be present in this patient? ** Answers ** Increased cortisol
SOB when lying down, and moving around --Based on the patient's presentation, which disease
process is the patient likely exhibiting? ** Answers ** Asthma
A two-year-old child presents with a clear runny nose and cough which has lasted 3 days. The
child's mother reports the cough sounds like a barking noise. The child is sleeping in the
mother's arms and appears to have stridor. The child's mother also reports an axillary
temperature of 101°F last night. Which management technique is appropriate for this child's
symptoms? ** Answers ** Oral steroids and breathing treatments
Delerium, urinary incontinence, fever-- Which lab and diagnostic tests should be ordered as part
of the patient's assessment? ** Answers ** Complete blood count, complete metabolic
profile, and urinalysis
An 18-year-old male is involved in a motorcycle crash while not wearing a helmet. He is brought
into an emergency room and is immediately taken for a CT scan. The provider tells the patient's
,parents he has bleeding between the dura mater and the skull. What is this patient's condition
called? ** Answers ** Epidural hematoma
-- What is the appropriate diagnosis for this patient? ** Answers ** Crohn's disease
Which diagnostic test is appropriate to order for this patient? ** Answers ** Ultrasound
A 45-year-old male is being seen in the clinic for a yearly check-up and lab work. His history
includes hypertension and hyperlipidemia for which he currently takes Norvasc 5 mg daily and
Lipitor 20 mg nightly. Patient has a family history of diabetes, hypertension, heart disease, and
hyperlipidemia. After obtaining lab work, the provider notices the patient's hgbA1c is elevated
at 7.5. The patient is already on a DASH diet and watching the amount of sweets and
carbohydrates he eats daily. The patient is not overweight and participates in moderate physical
activity at least 4-5 days a week. He was started on Metformin three months ago, and his
hemoglobin A1c is now 6.9. The nurse expects to see a class of medication prescribed which is
proven to reduce the risk of cardiovascular events. Considering the treatment guidelines from
the American College of Cardiology, which medication should be recommended for this patien
** Answers ** Invokana 100 mg daily
--Invokana is a medication used to treat type 2 diabetes. It is a third-line medication to
metformin. It is used together with exercise and diet. It is not recommended in type 1 diabetes.
It is taken by mouth.
A 78-year-old female presents to the clinic for a checkup and refills on her medications. She is
currently taking lisinopril (Zestril), metformin (Glucophage), and levothyroxine (Synthroid). The
patient has a history of hypertension, type 2 diabetes, hypothyroidism, GERD, and gastric ulcers.
The patient is concerned about heart disease and wants to start taking a low-dose aspirin.
Which aspirin regimen recommendation should the advanced professional nurse (APN) give to
the patient? ** Answers ** Low-dose enteric coated aspirin 81 mg daily
A 28-year-old married female presents to primary care accompanied by her husband with
complaints of weight gain, fatigue, muscle aches, bloating, constipation, and difficulty
concentrating. The patient explains that she has been experiencing these symptoms with
increasing frequency over the last two months and reports feeling upset that she has gained 10
, pounds over the past month despite no significant changes in dietary intake or activity level.
The patient holds a bachelor's degree and is employed full time as an accountant. The patient
reports feeling frustrated with her poor concentration and identifies recent work errors to be
due to this symptom. The patient explains that she and her spouse plan to start trying to
conceive soon, and she is worried that she may have trouble becoming pregnant. The patient
reports using over-the-counter laxative products over the last week to combat constipation. The
patient repo ** Answers ** 5.31 mIU/L
A 74- year-old male with Cushing syndrome presents to the emergency department (ED) with
pain in his left leg, and is diagnosed with a deep vein thrombosis (DVT).What is this patient's
symptoms related to? ** Answers ** Elevated Von Willebrand factor
A 42-year-old asthmatic who has been using beta-adrenergic agonists for several years began to
experience premature atrial contractions (PACs). To treat the PACs, metoprolol (Toprol XL)
therapy was started.What is a likely consequence of this patient taking metoprolol (Toprol XL)?
** Answers ** Metoprolol (Toprol XL) worsened asthma symptoms, but improved the PACs.
-- Beta blockers are widely used in the management of cardiac conditions and thyrotoxicosis,
and to reduce perioperative complications. Asthma and chronic obstructive pulmonary disease
(COPD) have been classic contraindications to the use of beta blockers because of their
potential for causing bronchospasm.
Which inhaler prescription would support long-acting treatment for twice-daily use in
controlled asthma management? ** Answers ** Fluticasone propionate/salmeterol (Advair
Diskus)
--Fluticasone and salmeterol is a combination of two medicines that are used to help control the
symptoms of asthma and improve breathing.
A 65-year-old male presents for a visit regarding his type 2 diabetes. He has been dealing with
diabetes for the last 15 years. He has a history of diabetic neuropathy in his feet. Six months ago
his symptoms were mild to almost nonexistent. He currently describes the neuropathy as
painful, and it wakes him up at night. Which medication would be the first line treatment for
this patient? ** Answers ** Pregabalin (Lyrica)
What is the gold standard for the suspected diagnosis of Celiac Disease? ** Answers **
Endoscopy with small intestine biopsy
A 44-year-old woman has recently been diagnosed with advanced metastatic non-small-cell
lung cancer. Genetic testing is ordered to determine if the patient's tumor has any genomic
alterations and to guide treatment decisions. A few weeks later, the patient's test results come
back positive for a genetic mutation. The APN starts osimertinib (Tagrisso). Based on this
information, what type of genetic mutation does this patient have? ** Answers ** EGFR
mutation
A 20-year-old male meets with an advanced professional nurse (APN) to discuss symptoms that
have been slowly progressing over the past several years. He is mainly concerned because he
has been falling frequently. Since childhood, his gait has consisted of walking on his toes. During
middle school, he was able to participate in sports but was unable to participate in high school
sports due to difficulty with running and jumping. Lately, he has noticed it takes longer and is
more difficult to change positions from sitting to standing than it used to in the past. He has also
been waking up with muscle and joint stiffness. The APRN notes that his family history is not
significant for any chronic or genetic diseases. Which condition is likely to be the cause of these
symptoms? ** Answers ** Becker muscular dystrophy
--Becker muscular dystrophy (often called Becker MD or BMD) is a form of muscular dystrophy,
a genetic disorder that gradually makes the body's muscles weaker and smaller. It causes less
severe problems than the most common type, Duchenne muscular dystrophy.
Which statement should the provider give the patient regarding the pathophysiology of SLE and
its relation to thrombocytopenia? ** Answers ** SLE disrupts immune homeostasis and
promotes development of self-reactive antibodies.
A female patient presents to an office to establish care. Her previous primary care provider told
her to follow up regarding an elevated ferritin level. She has no previous medical history and is
currently asymptomatic. She is concerned about the elevated ferritin and would like to know if
she should be worried. What should the provider do next for this patient? ** Answers **
Order a liver function test
,A 75-year-old female presents to the emergency department with an irregular heart rate of
130.What can be ascertained about this patient's findings given the limited information? **
Answers ** She is diagnosed with atrial fibrillation and needs her heart rate controlled with
metoprolol (Lopressor).
Which condition from this patient's medical history is contributing to the loss of contractility?
** Answers ** Acute myocardial infarction
Which condition is this patient suffering from? ** Answers ** Diabetic ketoacidosis
A 45-year-old female fears that she is having a stroke and takes herself to an emergency room.
After several diagnostic and laboratory tests, the patient is diagnosed with Cushing disease.
Which lab abnormality would be present in this patient? ** Answers ** Increased cortisol
SOB when lying down, and moving around --Based on the patient's presentation, which disease
process is the patient likely exhibiting? ** Answers ** Asthma
A two-year-old child presents with a clear runny nose and cough which has lasted 3 days. The
child's mother reports the cough sounds like a barking noise. The child is sleeping in the
mother's arms and appears to have stridor. The child's mother also reports an axillary
temperature of 101°F last night. Which management technique is appropriate for this child's
symptoms? ** Answers ** Oral steroids and breathing treatments
Delerium, urinary incontinence, fever-- Which lab and diagnostic tests should be ordered as part
of the patient's assessment? ** Answers ** Complete blood count, complete metabolic
profile, and urinalysis
An 18-year-old male is involved in a motorcycle crash while not wearing a helmet. He is brought
into an emergency room and is immediately taken for a CT scan. The provider tells the patient's
,parents he has bleeding between the dura mater and the skull. What is this patient's condition
called? ** Answers ** Epidural hematoma
-- What is the appropriate diagnosis for this patient? ** Answers ** Crohn's disease
Which diagnostic test is appropriate to order for this patient? ** Answers ** Ultrasound
A 45-year-old male is being seen in the clinic for a yearly check-up and lab work. His history
includes hypertension and hyperlipidemia for which he currently takes Norvasc 5 mg daily and
Lipitor 20 mg nightly. Patient has a family history of diabetes, hypertension, heart disease, and
hyperlipidemia. After obtaining lab work, the provider notices the patient's hgbA1c is elevated
at 7.5. The patient is already on a DASH diet and watching the amount of sweets and
carbohydrates he eats daily. The patient is not overweight and participates in moderate physical
activity at least 4-5 days a week. He was started on Metformin three months ago, and his
hemoglobin A1c is now 6.9. The nurse expects to see a class of medication prescribed which is
proven to reduce the risk of cardiovascular events. Considering the treatment guidelines from
the American College of Cardiology, which medication should be recommended for this patien
** Answers ** Invokana 100 mg daily
--Invokana is a medication used to treat type 2 diabetes. It is a third-line medication to
metformin. It is used together with exercise and diet. It is not recommended in type 1 diabetes.
It is taken by mouth.
A 78-year-old female presents to the clinic for a checkup and refills on her medications. She is
currently taking lisinopril (Zestril), metformin (Glucophage), and levothyroxine (Synthroid). The
patient has a history of hypertension, type 2 diabetes, hypothyroidism, GERD, and gastric ulcers.
The patient is concerned about heart disease and wants to start taking a low-dose aspirin.
Which aspirin regimen recommendation should the advanced professional nurse (APN) give to
the patient? ** Answers ** Low-dose enteric coated aspirin 81 mg daily
A 28-year-old married female presents to primary care accompanied by her husband with
complaints of weight gain, fatigue, muscle aches, bloating, constipation, and difficulty
concentrating. The patient explains that she has been experiencing these symptoms with
increasing frequency over the last two months and reports feeling upset that she has gained 10
, pounds over the past month despite no significant changes in dietary intake or activity level.
The patient holds a bachelor's degree and is employed full time as an accountant. The patient
reports feeling frustrated with her poor concentration and identifies recent work errors to be
due to this symptom. The patient explains that she and her spouse plan to start trying to
conceive soon, and she is worried that she may have trouble becoming pregnant. The patient
reports using over-the-counter laxative products over the last week to combat constipation. The
patient repo ** Answers ** 5.31 mIU/L
A 74- year-old male with Cushing syndrome presents to the emergency department (ED) with
pain in his left leg, and is diagnosed with a deep vein thrombosis (DVT).What is this patient's
symptoms related to? ** Answers ** Elevated Von Willebrand factor
A 42-year-old asthmatic who has been using beta-adrenergic agonists for several years began to
experience premature atrial contractions (PACs). To treat the PACs, metoprolol (Toprol XL)
therapy was started.What is a likely consequence of this patient taking metoprolol (Toprol XL)?
** Answers ** Metoprolol (Toprol XL) worsened asthma symptoms, but improved the PACs.
-- Beta blockers are widely used in the management of cardiac conditions and thyrotoxicosis,
and to reduce perioperative complications. Asthma and chronic obstructive pulmonary disease
(COPD) have been classic contraindications to the use of beta blockers because of their
potential for causing bronchospasm.
Which inhaler prescription would support long-acting treatment for twice-daily use in
controlled asthma management? ** Answers ** Fluticasone propionate/salmeterol (Advair
Diskus)
--Fluticasone and salmeterol is a combination of two medicines that are used to help control the
symptoms of asthma and improve breathing.
A 65-year-old male presents for a visit regarding his type 2 diabetes. He has been dealing with
diabetes for the last 15 years. He has a history of diabetic neuropathy in his feet. Six months ago
his symptoms were mild to almost nonexistent. He currently describes the neuropathy as
painful, and it wakes him up at night. Which medication would be the first line treatment for
this patient? ** Answers ** Pregabalin (Lyrica)
