WGU D027 Objective Assessment Study Guide (Latest 2024/
2025 Update) Advanced Pathopharmacological Foundations|
Questions and Verified Answers| 100% Correct| Grade A
A 23-year-old woman comes in for prenatal counseling. While completing her family history, she reports
her brother has cystic fibrosis. She does not know if she is a carrier. She asks if her children will be
affected by the disease.
What is an accurate way to determine the likelihood of this patient's children being affected?
A genetic or a carrier test
A 31-year-old man comes into the office for an exam. He is 6' 5 " with a high-pitched voice, and he has a
moderate degree of mental impairment. It is discovered upon exam that his body hair is sparse, his
testes are small, and he has gynecomastia.
Which genetic disorder should this patient be tested for?
kleinfelters
sign of becker muscle dystrophy in kids?
may begin to waddle, walk on their toes or push their abdomen forward when walking
A six-month-old female infant with failure to thrive comes in to the office with her parents. It is noticed
upon exam that the patient has facial deformities and is jaundiced. A complete blood count (CBC) is
ordered, which reveals anemia. When that patient's blood is examined under a microscope, the red
blood cells appear small and abnormally shaped. A mutational analysis is ordered, and alpha thalassemia
is diagnosed.
What is the likelihood of incidence of these parent's future children having alpha thalassemia?
100%
A 64-year-old male truck driver comes in complaining of pain in his lower left calf. He states he drives
eight to ten hours per day. Upon exam, swelling and mottled coloring are noted in the patient's calf. A D-
dimer test is ordered and comes back positive.
Which additional test should be ordered to confirm a diagnosis in this patient?
Doppler U/S
A 54-year-old man comes into a clinic for a routine visit. His initial BP is 148/92. After a recheck 15
minutes later, his BP is 140/90. He states he suffers from "white coat hypertension." He states he has no
history of high blood pressure and no family history of high blood pressure.
Which nursing intervention would assist this patient in receiving a clinical diagnosis of hypertension?
Completing an ambulatory blood pressure assessment
A 58-year-old woman comes in complaining of retrosternal chest pain, worsening with recumbent
position. She states she has had a low-grade fever for two days. Upon exam, the patient has a friction
,rub. An EKG reveals sinus tachycardia with inflammatory changes. An ultrasound is performed, and she is
diagnosed with an acute pericarditis.
Which condition would make pericarditis more likely in this patient?
Lupus
A 54-year-old Caucasian man comes in for a lab review. His lipids reveal an LDL of 180, an HDL of 52, and
triglycerides of 326. He has no history of atherosclerotic cardiovascular disease (ASCVD) or diabetes. His
blood pressure is 118/64. He has a pulse rate of 64, and he weighs 320 lb. He smokes one pack of
cigarettes per day, and his ASCVD risk score is 12.8.
Which medication should this patient be started on?
Lipitor 20 mg
A 73-year-old man with Systolic congestive heart failure (CHF) with reduced ejection fraction (HFrEF)
comes to a clinic complaining of shortness of breath. He is currently taking 6.25 mg carvedilol (Coreg)
twice a day and 50 mg losartan (Cozaar) and 20 mg furosemide (Lasix) daily. His oxygen saturation is
95%, and he has a pulse of 64. His BP is 138/82, and his BNP is 1150.
Using the 2017 heart failure guidelines, which medication change should be recommended for this
patient?
Stop angiotensin receptor blockers (ARB) and add sacubitril/valsartan (Entresto), if BNP high replace ARB
w/ ACE or ARNI
A 78-year-old man comes in with stable angina. He reports he has been having more angina recently. He
is currently taking the following medications: lisinopril (Zestril), atorvastatin (Lipitor), aspirin, and
nitrostat PRN for chest pain. He has a history of COPD with bronchospasm. His blood pressure is 145/88,
and he has a pulse of 74.
Which class of medications should be avoided for this patient?
BBs, BB contraindicated in pts w/ COPD/ asthma
A 45-year-old Muslim woman presents to a clinic for an intervention for her type 2 diabetes. She is
prescribed metformin (Glucophage) 500 mg BID. During a follow-up phone call a week later, it is
discovered she has not been taking the metformin. A second visit is scheduled. During this visit, she
states that she cannot take the medication as prescribed because it is Ramadan, a month-long period of
religious observances. Due to her religious beliefs, she fasts from dawn to sunset. When the pharmacist
told her to take metformin with breakfast and dinner, she decided not to start the medication due to her
fasting.
Which nursing intervention should be made for this patient?
Start metformin XR (Glucophage XR) 250 mg once a day and reevaluate after Ramadan
A 45-year-old Jewish man is visiting a clinic for an adjustment of his diabetes medications. Though the
patient is taking oral medications, his blood sugar levels continue to increase, and a decision is made to
start him on insulin. Although the patient is comfortable with the concept of starting insulin, he is
concerned with the formulation of the insulin saying, "I heard insulin was made from pigs. If that is the
,case, I cannot take it due to my faith."
Which response should be given to this patient?
While insulin did have porcine sources in the past, it is now synthetically made.
A 45-year-old man reports his preference for natural methods of treating illness. He states he takes
natural supplements that he orders from China to boost his health and well-being. One of the
supplements he takes daily is red yeast rice.
Which medication should be avoided with this patient's supplement?
Lovastatin (Mevacor), red yeast rice contains this
A 40-year-old man presents to a clinic with an onset of a frequent cough. The patient states the cough
started when he started his new blood pressure medication two weeks ago. The patient does not
remember the name of the drug that was started. After a thorough assessment, it is determined the
cough is not being caused by an infection. It is determined the likely cause of the frequent cough is the
new blood pressure medication.
Which medication is the likely cause of this patient's symptoms?
Lisinopril
A 68-year-old female patient on a medical surgical floor received a dose of morphine (Duramorph) 30
minutes ago for postoperative pain into an IV in her left hand. She has been on the floor for two days
and has received several doses of morphine over that time. The patient's call light is now lit. When the
nurse goes into the room, the patient has several complaints.
Which complaint should be addressed first in this patient?
A rash around the injection site going up the left arm
An advanced practice nurse (APN) is floated to a medical or surgical floor midshift to assist an
understaffed unit. After receiving a brief report, the APN assumes care of four individuals for the
remainder of the shift. No recent assessment has been completed on these patients.
Which patient should the APN assess first?
A 65-year-old man with dementia who is one day post-operation of a transurethral resection of his
prostate and is sometimes passing blood-tinged urine through his foley, d/t cognitive issues and being
post-op
A 55-year-old female patient presents to a clinic for exacerbation of her chronic low back pain. She is
taking morphine extended-release tablets (MS Contin), hydrocodone (Vicodin) PRN, and duloxetine
(Cymbalta). The patient denies any drug allergies. She rates her pain at a ten out of ten and is requesting
something stronger for pain.
When considering adding a medication for this patient's pain, which medication could have a significant
interaction with her current medications?
tramadol, d/t serotonin syndrome
A 45-year-old female patient presents to a clinic complaining of chronic generalized pain and wishes to
be evaluated for fibromyalgia and chronic pain syndrome. A thorough history and physical is conducted,
and the findings are negative. The patient is not taking any medications, has no allergies to medicines,
, and has a negative past medical history.
What is an appropriate first intervention for this patient?
Assess the patient's sleep hygiene and make recommendations.
A 55-year-old male patient is on a medical floor for respite care. He is currently in hospice for end-stage
pancreatic cancer. During assessment, a nurse notices that he is diaphoretic, moaning, and clutching his
abdomen. He rates his pain at a nine out of ten. The nurse notes that his abdomen is distended, and he
has rebound tenderness in all four quadrants.
What is an appropriate nursing intervention for this patient?
Giving a dose of intravenous morphine (Duramorph)
What fluid for nutrient changes/ osmolality changes?
0.9 NS
What fluid for hypernatremia, hyperchloremia, dehydration?
D5 or 0.45 NS
what fluids for hyponatremia w/o fluid overload/edema?
3% NS until Na 130
Med uncomplicated peds otitis media?
Amoxicillin
who is at risk for tay-sachs?
Ashkenazi Jews
What is Tay-Sachs disease?
a dysfunctional enzyme causes an accumulation of lipids in the brain
s/s of tay-sachs?
cherry red spot, loss of muscle control/ motor skills, vision/hearing loss
What is beta thalassemia?
Reduced or absent amounts of hemoglobin
s/s of beta thalsemia?
yellow eyes, low BP, palpitaitons, pale, cold, SOB, high HR, growth delay
bela thalsemia most common in what people?
Mediteranean and African people
tx for beta thalsemia?
