WGU D118 OA FINAL STUDY GUIDE 2026
SOLVED QUESTIONS FULLY CORRECT
⫸ 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 Answer: 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?
A. Stool tests for oocysts of cryptosporidium
B. Blood cultures for progressive disseminated histoplasmosis
C. Microscopy for pseudohyphae of Candida albicans
D. A stool for ova and parasites test for giardiasis Answer: A. Stool tests
for oocysts of cryptosporidium. Rationale: The scenario is indicative of
diarrhea due to cryptosporidium which is a protozoan and responsible
for causing severe diarrhea in AIDS. This is seen when CD4+ cell
counts lower than 100 per cubic mm. The diarrhea is of chronic nature
and watery. The diagnosis is based on finding acid fast oocysts in stool
and also by antigen detection. With declining CD4+ counts opportunistic
infections become common. Histoplasmosis usually presents with CD4+
counts usually between 100-200 cubic mm and fever, cough, dyspnea
are the predominant symptoms. Giardiasis has no specific association
with AIDs and presents usually with fatty diarrhea, not watery. Candida
Albicans causes esophagitis at cell counts lower than 100 per cubic mm
which explains the features of epigastric pain and dysphagia but has no
associations with diarrhea.
,⫸ A 45 year old patient with a history of alcohol use disorder has
developed weakness, fatigue, loss of appetite, weight loss and physical
exam reveals ascites, hepatosplenomegaly, spider nevi, clubbing, and
dupuytren contracture. His ALT/AST ratio is 2.7 and hemoglobin is 8.8
mg/dL. His MCV is 104 and ultrasonography detects nodularity and
increased echogenicity of the liver. Which of the following would
confirm a diagnosis of the suspected condition in this patient?
A. Scleral icterus
B. Hyperbilirubinemia
C. Biopsy of the liver tissue
D. Elevated prothrombin time Answer: C. Biopsy of the liver tissue.
Rationale: a liver biopsy is required to confirm cirrhosis . elevated LFTs,
bilirubin and decreased albumin are indicative of cirrhosis but not
confirmatory. predictors of cirrhosis are ascites, platelet count less than
160,000 mm3, spider angiomata, and bonacini cirrhosis discriminant
score greater than 7.
⫸ A 38-year-old woman presents to the clinic with a painful, tender
keratinized lesion on the sole of her right foot. She says that the lesion
developed two months ago and is slowly enlarging. She now has
difficulty bearing weight on her affected foot. Her past medical history
is significant for type II diabetes mellitus managed on rosiglitazone. Her
last menstrual period was three weeks ago. She is sexually active with
three partners, and inconsistently uses condoms. Vital signs are within
normal limits. The examination of the foot shows a hyperkeratotic lesion
with a dark center. The palpation of the lesion causes immense pain.
What cancer is linked with the etiology of this lesion?
, A. Basal Cell Carcinoma
B. Melanoma
C. Cervical Cancer
D. Burkitt's lymphoma Answer: C. Cervical Cancer. Rationale: This
lesion is most likely a plantar wart. However, with skin contact, the HPV
can be transferred to any part of the body. HPV tends to cause genital
warts, flat warts, and palmoplantar warts. Warts are easily transmitted by
direct or indirect contact, especially if there is a disruption of the normal
epithelial barrier. • Plantar warts are caused by human papillomaviruses
(HPV). • HPV serotypes 16 and 18 are associated with carcinogenesis.
Malignant transformation usually is seen in patients with genital warts
and immunocompromised patients. • Cervical cancers are most
commonly attributed to genital infections with HPV serotypes 16 and
18.
⫸ A 58-year-old man presented to the hospital with right-sided
decreased hearing for two years. His wife mentions he has started
snoring recently. He has been a smoker for the last 25 years and smokes
up to 20 cigarettes/day. The provider decides to perform a
nasendoscopy. Which key anatomical area is the pathology most likely
to be situated in?
A. Right Middle Meatus
B. The roof of the nasal cavity
C. Right vallecula
D. Postnasal space Answer: D. Postnasal space. In a patient with recent-
onset unilateral hearing loss and nasal obstruction with a social history
of smoking one must rule out a nasopharyngeal pathology most likely a
SOLVED QUESTIONS FULLY CORRECT
⫸ 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 Answer: 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?
A. Stool tests for oocysts of cryptosporidium
B. Blood cultures for progressive disseminated histoplasmosis
C. Microscopy for pseudohyphae of Candida albicans
D. A stool for ova and parasites test for giardiasis Answer: A. Stool tests
for oocysts of cryptosporidium. Rationale: The scenario is indicative of
diarrhea due to cryptosporidium which is a protozoan and responsible
for causing severe diarrhea in AIDS. This is seen when CD4+ cell
counts lower than 100 per cubic mm. The diarrhea is of chronic nature
and watery. The diagnosis is based on finding acid fast oocysts in stool
and also by antigen detection. With declining CD4+ counts opportunistic
infections become common. Histoplasmosis usually presents with CD4+
counts usually between 100-200 cubic mm and fever, cough, dyspnea
are the predominant symptoms. Giardiasis has no specific association
with AIDs and presents usually with fatty diarrhea, not watery. Candida
Albicans causes esophagitis at cell counts lower than 100 per cubic mm
which explains the features of epigastric pain and dysphagia but has no
associations with diarrhea.
,⫸ A 45 year old patient with a history of alcohol use disorder has
developed weakness, fatigue, loss of appetite, weight loss and physical
exam reveals ascites, hepatosplenomegaly, spider nevi, clubbing, and
dupuytren contracture. His ALT/AST ratio is 2.7 and hemoglobin is 8.8
mg/dL. His MCV is 104 and ultrasonography detects nodularity and
increased echogenicity of the liver. Which of the following would
confirm a diagnosis of the suspected condition in this patient?
A. Scleral icterus
B. Hyperbilirubinemia
C. Biopsy of the liver tissue
D. Elevated prothrombin time Answer: C. Biopsy of the liver tissue.
Rationale: a liver biopsy is required to confirm cirrhosis . elevated LFTs,
bilirubin and decreased albumin are indicative of cirrhosis but not
confirmatory. predictors of cirrhosis are ascites, platelet count less than
160,000 mm3, spider angiomata, and bonacini cirrhosis discriminant
score greater than 7.
⫸ A 38-year-old woman presents to the clinic with a painful, tender
keratinized lesion on the sole of her right foot. She says that the lesion
developed two months ago and is slowly enlarging. She now has
difficulty bearing weight on her affected foot. Her past medical history
is significant for type II diabetes mellitus managed on rosiglitazone. Her
last menstrual period was three weeks ago. She is sexually active with
three partners, and inconsistently uses condoms. Vital signs are within
normal limits. The examination of the foot shows a hyperkeratotic lesion
with a dark center. The palpation of the lesion causes immense pain.
What cancer is linked with the etiology of this lesion?
, A. Basal Cell Carcinoma
B. Melanoma
C. Cervical Cancer
D. Burkitt's lymphoma Answer: C. Cervical Cancer. Rationale: This
lesion is most likely a plantar wart. However, with skin contact, the HPV
can be transferred to any part of the body. HPV tends to cause genital
warts, flat warts, and palmoplantar warts. Warts are easily transmitted by
direct or indirect contact, especially if there is a disruption of the normal
epithelial barrier. • Plantar warts are caused by human papillomaviruses
(HPV). • HPV serotypes 16 and 18 are associated with carcinogenesis.
Malignant transformation usually is seen in patients with genital warts
and immunocompromised patients. • Cervical cancers are most
commonly attributed to genital infections with HPV serotypes 16 and
18.
⫸ A 58-year-old man presented to the hospital with right-sided
decreased hearing for two years. His wife mentions he has started
snoring recently. He has been a smoker for the last 25 years and smokes
up to 20 cigarettes/day. The provider decides to perform a
nasendoscopy. Which key anatomical area is the pathology most likely
to be situated in?
A. Right Middle Meatus
B. The roof of the nasal cavity
C. Right vallecula
D. Postnasal space Answer: D. Postnasal space. In a patient with recent-
onset unilateral hearing loss and nasal obstruction with a social history
of smoking one must rule out a nasopharyngeal pathology most likely a
