1 | P a g e WGU D115 OBJECTIVE ASSESSMENT 2 LATEST VERSIONS 2024 ACTUAL EXAM COMPLETE 400 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ WGU D115 OBJECTIVE ASSESSMENT VERSION A A 68 -year-old female with heart failure presents with tachycardia, S3 heart sound, and basilar crackles bilaterally. blood pressure is 90/68, BUN is 58 mg/dL, creatinine is 2.4 mg/dL. This clinical presentation is most consistent with: A) prerenal azotemia B) acute glomerulonephritis C) tubular necrosis D) postrenal azotemia - ANSWER - A) prerenal azotemia Rationale; Prerenal azotemia refers to elevations in BUN and creatinine levels resulting from problems in the systemic circulation that decrease flow to the kidneys. Diagnostic confirmation of glomerulonephritis typically requires: A) UA plus a CBC with differential B) Abdominal CT C) Renal US 2 | P a g e D) Renal biopsy - ANSWER - D) Renal biopsy Rationale; Diagnosis of glomerular disease is confirmed by abnormal UA and renal biopsy to confirm specific renal injury and type of pathologic condition. The FNP understands that which of the following patients would be at the highest risk for developing disseminated intravascular coagulation (DIC)? A) A 35 -year-old pregnant patient with placenta previa B) A 42 -year-old client with a pulmonary embolus C) A 60 -year-old client receiving hemodialysis 3 days a week D) A 78 -year-old patient diagnosed with septicemia - ANSWER - D) A 78-year-old patient diagnosed with septicemia Rationale; DIC is a clinical syndrome that develops as a complication of a wide variety of other disorders, with sepsis being the most common cause. Disseminated Intravascular Coagulation (DIC) - ANSWER - Complex, acquired disorder in which clotting and hemorrhage simultaneously occur. The underlying cause is usually due to inflammation, infection (sepsis), or cancer. The FNP is evaluating a 65 -year-old patient with diabetes and hypertension, who has known kidney disease. the patient's blood pressure at today's visit is 142/88. The patient's GFR is 42 and the serum albumin level is 3.9g/dL. 3 | P a g e A) Stage 1 B) Stage 2 C) Stage 3 D) Stage 4 E) Stage 5 - ANSWER - C) Stage 3 Rationale; A GFR of 42 indicates stage 3 chronic kidney disease. A serum albumin level of 4.1 g/dL or lower is associated with an increased risk of end stage renal disease. serum albumin - ANSWER - Albumin helps move many small molecules through the blood, including bilirubin, calcium, progesterone, and medicines.Abnormal low amounts may suggest a problem with the liver or kidneys. Abnormal high amounts may indicate dehydratio n or severe diarrhea. The normal range is 3.4 to 5.4 g/dL The FNP is educating the mother of a child with sickle cell anemia regarding immunization schedules. Due to the high risk of infection, septicemia, and risk for meningitis, the mother should be educated that the child should receive which of the following immunizations before age 2? A) MMR B) IPV C) Pneumococcal D) Varicella - ANSWER - C) Pneumococcal 4 | P a g e Rationale; Fatality is high and the risk of infection is greatest among children who are not vaccinated against pneumococcal serotype. S3 heart sound - ANSWER - Results from increased atrial pressure leading to increased flow rates, as seen in congestive heart failure, which is the most common cause of a S3. S4 heart sound - ANSWER - The characteristic sound of an S4 is created by the movement of blood during diastole from the atria flowing against a stiff ventricular wall caused by hypertension, pulmonary hypertension, ventricular outflow obstruction, or ische mic heart disease. An advanced practice registered nurse (APRN) is consulting with a teen patient who has recently learned that she is pregnant. The APRN knows that a certain medication taken by the patient can contribute to the development of congenital malformations in the fetus. The APRN reviews the patient's current medication list and finds one medication that is a concern. Which medication is the APRN concerned about? A) Bisphenol A B) Retinoic Acid C) Benzoyl peroxide D) Clindamycin - ANSWER - B) Retinoic Acid A newborn's screening for cystic fibrosis is positive. An advanced practice registered nurse (APRN) is reviewing screening results and
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