WGU D027 Exam | Advanced
Pathopharmacological Foundations Exam |
Questions and Answers with Rationale | Rated A+
Latest 2024
A patient in the emergency department is suspected of having a myocardial
infarction (MI). The initial cardiac troponin 1 level was negative. What
action by the healthcare professional is best?
Administer thrombolytic therapy.
Discharge the patient.
Schedule repeat troponin within a few hours.
Prepare the patient for cardiac catheterization.
- Correct Answer - Schedule repeat troponin within a few hours.
Rationale: Several cardiac biomarkers exist including the most specific,
cardiac troponin 1 (cTnI), cTnI begins to rise within 2 to 4 hours after
cardiac injury, so if the initial result is normal, the test should be repeated
within 6 to 9 hours and again at 12 to 24 hours. It is not known yet if the
patient has had an MI so treatment with thrombolytic therapy and/or
catheterization would be premature. The patient should not be discharged
since the professional suspected an MI.
,Which patient would the healthcare professional assess for elevated levels
of antidiuretic hormone (ADH) secretion?
Being treated for small cell carcinoma of the stomach
Taking high dose acetaminophen (Tylenol) for arthritis
Had a hip replacement operation 14 days ago
Has long-standing kidney disease from diabetes
- Correct Answer - Being treated for small cell carcinoma of the stomach
Rationale: A common cause of elevated levels of ADH secretion is
ectopically produced ADH by tumors, such as small cell carcinoma of the
duodenum, stomach, and pancreas; cancers of the bladder, prostate, and
endometrium; lymphomas; and sarcomas. High doses of anti-inflammatory
medications are a risk factor, but acetaminophen is not an anti-
inflammatory medication. Surgery within the last 5 to 7 leads to increased
ADH secretion. Kidney disease does not lead to excess levels of ADH.
A post-operative patient with gallbladder surgery has an epidural infusion of
Astramorph. The patients respiratory rate starts to decline to 9
breaths/minute. Which medication should the healthcare provider anticipate
administering to this patient?
Protamine sulfate
Mucomyst
Naloxone
Solu-Medrol
,- Correct Answer - Naloxone
Rationale: Naloxone is a narcotic antagonist that can reverse the effect of
both adverse and therapeutic use of opioid narcotic analgesics.
A patient is brought to the Emergency Department with a gunshot wound to
the chest. The healthcare professional assesses an abnormality involving a
pleural rupture that acts as a one-way valve, permitting air to enter on
inspiration but preventing its escape by closing during expiration. What
action by the healthcare professional is the priority?
Draw arterial blood gasses.
Assist with a chest tube insertion.
Give the patient low-flow oxygen.
Assess for clubbing of fingernails.
- Correct Answer - Assist with a chest tube insertion.
Rationale: In a tension pneumothorax, the site of pleural rupture acts as a
one-way valve, permitting air to enter on inspiration but preventing its
escape by closing up during expiration. As more and more air enters the
pleural space, air pressure in the pneumothorax begins to exceed
barometric pressure. Air pressure in the pleural space pushes against the
already recoiled lung, causing compression atelectasis, and against the
mediastinum, compressing and displacing the heart, great vessels, and
trachea. This is an emergency condition requiring chest tube insertion or
immediate needle decompression. Arterial blood gas results will not change
the treatment plan. This patient may need oxygen if definitive treatment is
, delayed, but it would need to be high-flow oxygen. Clubbing of fingernails
occurs in chronic hypoxemic conditions. The professional should assist with
immediate needle decompression or chest tube insertion.
A 2-year-old pediatric patient with limited medical history available arrives
to an urgent care with excessive irritability and crying. X-rays were obtained
and noted to have fractures of the metatarsals of the foot and left tibia. On
exam, the nurse notes that the patient seems to have a blue tint to both
sclera, and she didn't seem to react normally when the nurse was talking to
her. Which diagnosis is most likely in this case?
Osteogenesis imperfecta
Calcium deficiency
Non-accidental trauma (physical abuse)
Osteomyelitis
- Correct Answer - Osteogenesis imperfecta
Rationale: Osteogenesis imperfecta (OI) is a genetic abnormality with
predominant autosomal dominant inheritance. OI affects bone integrity
through a variety of collagen defects. Depending on the type of OI, various
manifestations may be concomitant such as appearance of blue sclera,
hearing deficits, short stature and/or dental malformations.
A patient who has chronic kidney disease has hemoglobin of 7.2 mg/dL.
What treatment does the healthcare professional prepare the patient for?
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