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WGU D118 OBJECTIVE ASSESSMENT FINAL QUESTIONS AND ANSWERS
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WGU D118 OBJECTIVE ASSESSMENT FINAL QUESTIONS AND ANSWERS
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WGU D118 OBJECTIVE ASSESSMENT FINALA 25-year-old female comes to the outpatient clinic complaining of suprapubic
pressure and burning with urination for the past two days. She denies having any
chills but states that she may have had a fever yesterday. The next step will be:
A. Obtain a urine dipstick.
B. Get a urine culture and sensitivity.
C. Ask about previous infections.
D. Refer the patient to a urologist. - ANSWERS-C. The next step in
assessing/treating this patient will depend on whether or not this urinary tract
infection is recurrent or a first occurrence.
If patient has UTI symptoms and states that she has not had any prior urinary
tract infections. The next step will be to:
A. Obtain a urine dipstick.
B. Get a urine culture and sensitivity.
C. Ascertain any drug allergies.
D. Refer the patient to a urologist. - ANSWERS-B. Get a urine culture and
sensitivity. In an uncomplicated or non-recurring urinary tract infection, a
urinalysis (dipstick or microscopic) can adequately identify urinary tract infections.
A urine culture and sensitivity should be performed in the following cases: (1) any
patient with a first febrile infection; (2) a recurrent infection with or without fever
(more than one per year); (3) a urinary calculi; and (4) a congenital defect
,A 52-year-old male patient presents to the office following a brief hospitalization
for pyelonephritis. He is currently on the second day of a 7-day course of
antibiotic. Patient education includes which of the following?
A. If you develop dysuria, increase PO fluids for two days.
B. Continue your antibiotic until you are asymptomatic
C. Return to the office in 7-10 days for a repeat urinalysis, as well as a urine
culture and sensitivity.
D. If you develop urinary frequency, decrease PO fluid intake. - ANSWERS-C. The
patient should complete the entire course of the prescribed antibiotic. If
symptoms of cystitis develop, he should contact his health care provider
immediately. The patient should return to the office for a repeat urinalysis and
urine culture once the antibiotic treatment is completed. Increasing PO fluid
intake is also encouraged.
Which of the following groups should asymptomatic bacteriuria be treated?
A. Patients with diabetes mellitus
B. Patients with spinal cord injuries
C. Patients with indwelling catheters
D. Pregnant women - ANSWERS-D. Pregnant women are at an increased risk of
asymptomatic bacteriuria becoming acute cystitis and/or acute pyelonephritis,
and the maternal and obstetric risk associated with pyelonephritis are great.
However, the Infectious Disease Society of America does not recommend that the
remaining groups in the list undergo treatment of asymptomatic bacteriuria.
,After history and the physical exam, the FNP suspects a 22-year-old female has
infectious mononucleosis. Of the following diagnostic studies that provide the
most specific test, the result will be:
A. A positive heterophile antibody test.
B. A modest elevation of the white blood count.
C. An elevated bilirubin.
D. A decreased lymphocyte count. - ANSWERS-A. The heterophile antibody test is
the confirming test in IM. It is present in 40-60% patients in the first week and 78-
90% of cases by weeks 3-4.
A heavy smoker is in the ER complaining of generalized fatigue. He claims that he
is always out of breath and has no more energy. His only medications are
bronchodilators, which he rarely uses. Auscultation reveals enhanced resonance
of voice sounds in his left chest. What is the most likely cause of this physical
finding?
A. Asthma
B. Pneumonia
C. Emphysema
D. Pneumothorax - ANSWERS-B. Pneumonia. Egophony is an increased resonance
of voice sounds when a medical professional auscultates the lungs. It is most
pronounced in patients with pneumonia and fibrosis. There is enhanced
transmission of high frequency noise across fluid. Similarly, bronchophony and
whispered pectoriloquy can be used to assess the lungs.
, A 35-year old primigravida comes to an antenatal clinic for her first obstetric visit.
Her LMP was five weeks ago. She has a known case of HIV diagnosed 6 years ago
and is adherent to her triple drug ART regimen with an undetectable viral load. At
35 weeks her viral load is still undetectable and she gives birth via normal vaginal
delivery at 39 weeks. At discharge ART regimens for the mother and child are
finalized. Which of the following recommendations about breastfeeding in HIV
positive mothers is most accurate?
A. There is no significant risk of HIV transmission via breastfeeding in mothers
under 30 years of age.
B. In resource rich settings the benefits of breastfeeding outweigh the risk of HIV
transmission
C. Maternal antibodies in breastmilk will protect the infant from HIV infection
D. The risk of HIV transmission from breastmilk makes breastfeeding unadvisable -
ANSWERS-D. The risk of HIV Transmission from breastmilk makes breastfeeding
unadvisable. Rationale: 10%-14% of breastfeeding mothers transmit HIV to the
uninfected infant. The US official guidelines by the panel on treatment of
pregnant women with HIV infection and prevention of perinatal infection state
that HIV positive women must avoid breastfeeding as transmission of HIV through
breastmilk is still possible despite ART therapy. In parts of the world that lack
adequate resources the benefit of breastfeeding may outweigh these risks.
A 43 year old IV drug user who has been on ART treatment complains of
continuous diarrhea that is watery, epigastric pain and difficulty swallowing. His
CBC shows a hemoglobin of 7.0 mg/dl, total leukocyte count of 2900cmm and a
platelet count of 70,000. A CD4+ cell count was requested and it came out to be
90/cmm. Which of the following laboratory investigations would best help with
the further evaluation of his diarrhea?
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