1|Page
WGU D344 OBJECTIVE ASSESSMENT 2 NEWEST 2026
ACTUAL EXAM| D344 ASSESSMENT AND
DIAGNOSTIC PROCESSES OA 2 EXAM WITH
COMPLETE REAL EXAM QUESTIONS AND CORRECT
VERIFIED ANSWERS/ GRADED A+ (MOST RECENT!!)
A 42-year-old woman reports increasing fatigue over the past four
months. She notes difficulty concentrating at work, constipation, dry
skin, and a 12-pound weight gain despite no changes in diet or physical
activity. She denies fever, gastrointestinal bleeding, or depressive
symptoms. Examination reveals coarse hair, delayed relaxation of deep
tendon reflexes, and mild periorbital puffiness. Her pulse is 54 bpm, and
blood pressure is 128/78 mmHg.
Which laboratory study would provide the greatest diagnostic value as
the initial evaluation?
a) Serum cortisol
b) Thyroid-stimulating hormone (TSH)
c) Vitamin B12 level
d) Serum ferritin - Correct Answer - b)
The patient's presentation strongly suggests primary hypothyroidism.
Serum TSH is the preferred initial screening test and is typically
elevated.
A 58-year-old man with a 45-pack-year smoking history presents with
progressively worsening productive cough, dyspnea on exertion, and
occasional wheezing over the past several years. Lung examination
demonstrates prolonged expiration and diminished breath sounds
bilaterally. Pulse oximetry is 95% on room air. Chest radiograph shows
hyperinflation without infiltrates.
,2|Page
Which diagnostic test is required to confirm the suspected diagnosis?
a) Arterial blood gas
b) Pulmonary function testing with spirometry
c) High-resolution chest CT
d) Sputum culture - Correct Answer - b)
Spirometry demonstrating persistent airflow obstruction is required to
diagnose chronic obstructive pulmonary disease (COPD).
A 28-year-old woman presents with sudden-onset dysuria, urinary
frequency, and urinary urgency for two days. She denies flank pain,
fever, nausea, vomiting, or vaginal discharge. She is sexually active with
one partner. Temperature is 98.7°F (37.1°C). Costovertebral angle
tenderness is absent.
Which diagnostic study should be obtained first?
a) CT abdomen and pelvis
b) Renal ultrasound
c) Urinalysis with urine culture if indicated
d) Cystoscopy - Correct Answer - c)
Symptoms are consistent with uncomplicated cystitis. Urinalysis is the
appropriate initial diagnostic test, with urine culture obtained when
clinically indicated.
A 73-year-old woman is brought to the emergency department after
suddenly developing right facial droop, right arm weakness, and slurred
speech 40 minutes ago. Blood glucose is 108 mg/dL. Blood pressure is
176/94 mmHg. She has no history of trauma.
Before determining eligibility for reperfusion therapy, which diagnostic
study has the highest immediate priority?
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a) Brain MRI with contrast
b) Non-contrast CT of the head
c) Carotid ultrasound
d) Electroencephalogram - Correct Answer - b)
A non-contrast head CT rapidly distinguishes ischemic from
hemorrhagic stroke and guides emergent treatment decisions.
A 51-year-old man presents for an annual wellness visit. He denies
symptoms but reports his father died from colon cancer at age 59. He
has never undergone colorectal cancer screening. Physical examination
is normal.
Which recommendation is most appropriate?
a) Begin colorectal cancer screening now
b) Delay screening until age 60
c) Obtain abdominal CT annually
d) Screen only if symptoms develop - Correct Answer - a)
Individuals at increased risk due to family history should begin
colorectal cancer screening earlier than average-risk adults.
A 39-year-old woman complains of intermittent palpitations and heat
intolerance for three months. She has unintentionally lost 15 pounds
despite an increased appetite. Physical examination demonstrates a fine
tremor, brisk reflexes, and a diffusely enlarged thyroid gland. Heart rate
is 112 bpm.
Which laboratory pattern most strongly supports the suspected
diagnosis?
a) Decreased TSH, elevated free T4
, 4|Page
b) Elevated TSH, decreased free T4
c) Elevated TSH, elevated cortisol
d) Normal TSH, elevated ferritin - Correct Answer - a)
Primary hyperthyroidism suppresses pituitary TSH while increasing
circulating thyroid hormone.
A 61-year-old man with long-standing hypertension presents with
progressively worsening bilateral lower-extremity edema, orthopnea,
and exertional dyspnea. Physical examination reveals elevated jugular
venous pressure, bibasilar crackles, and an S3 gallop.
Which diagnostic study would provide the most useful assessment of
cardiac structure and function?
a) Abdominal ultrasound
b) Pulmonary angiography
c) Upper endoscopy
d) Echocardiography - Correct Answer - d) Echocardiography
Echocardiography evaluates ventricular function, chamber size, valvular
abnormalities, and ejection fraction in suspected heart failure.
A 64-year-old man with type 2 diabetes mellitus presents with increasing
fatigue, decreased urine output, and bilateral ankle swelling. Laboratory
results reveal:
Serum Creatinine: 2.6 mg/dL
BUN: 46 mg/dL
Potassium: 5.8 mEq/L
Estimated GFR: 28 mL/min/1.73 m²
Hemoglobin A1c: 8.5%
WGU D344 OBJECTIVE ASSESSMENT 2 NEWEST 2026
ACTUAL EXAM| D344 ASSESSMENT AND
DIAGNOSTIC PROCESSES OA 2 EXAM WITH
COMPLETE REAL EXAM QUESTIONS AND CORRECT
VERIFIED ANSWERS/ GRADED A+ (MOST RECENT!!)
A 42-year-old woman reports increasing fatigue over the past four
months. She notes difficulty concentrating at work, constipation, dry
skin, and a 12-pound weight gain despite no changes in diet or physical
activity. She denies fever, gastrointestinal bleeding, or depressive
symptoms. Examination reveals coarse hair, delayed relaxation of deep
tendon reflexes, and mild periorbital puffiness. Her pulse is 54 bpm, and
blood pressure is 128/78 mmHg.
Which laboratory study would provide the greatest diagnostic value as
the initial evaluation?
a) Serum cortisol
b) Thyroid-stimulating hormone (TSH)
c) Vitamin B12 level
d) Serum ferritin - Correct Answer - b)
The patient's presentation strongly suggests primary hypothyroidism.
Serum TSH is the preferred initial screening test and is typically
elevated.
A 58-year-old man with a 45-pack-year smoking history presents with
progressively worsening productive cough, dyspnea on exertion, and
occasional wheezing over the past several years. Lung examination
demonstrates prolonged expiration and diminished breath sounds
bilaterally. Pulse oximetry is 95% on room air. Chest radiograph shows
hyperinflation without infiltrates.
,2|Page
Which diagnostic test is required to confirm the suspected diagnosis?
a) Arterial blood gas
b) Pulmonary function testing with spirometry
c) High-resolution chest CT
d) Sputum culture - Correct Answer - b)
Spirometry demonstrating persistent airflow obstruction is required to
diagnose chronic obstructive pulmonary disease (COPD).
A 28-year-old woman presents with sudden-onset dysuria, urinary
frequency, and urinary urgency for two days. She denies flank pain,
fever, nausea, vomiting, or vaginal discharge. She is sexually active with
one partner. Temperature is 98.7°F (37.1°C). Costovertebral angle
tenderness is absent.
Which diagnostic study should be obtained first?
a) CT abdomen and pelvis
b) Renal ultrasound
c) Urinalysis with urine culture if indicated
d) Cystoscopy - Correct Answer - c)
Symptoms are consistent with uncomplicated cystitis. Urinalysis is the
appropriate initial diagnostic test, with urine culture obtained when
clinically indicated.
A 73-year-old woman is brought to the emergency department after
suddenly developing right facial droop, right arm weakness, and slurred
speech 40 minutes ago. Blood glucose is 108 mg/dL. Blood pressure is
176/94 mmHg. She has no history of trauma.
Before determining eligibility for reperfusion therapy, which diagnostic
study has the highest immediate priority?
,3|Page
a) Brain MRI with contrast
b) Non-contrast CT of the head
c) Carotid ultrasound
d) Electroencephalogram - Correct Answer - b)
A non-contrast head CT rapidly distinguishes ischemic from
hemorrhagic stroke and guides emergent treatment decisions.
A 51-year-old man presents for an annual wellness visit. He denies
symptoms but reports his father died from colon cancer at age 59. He
has never undergone colorectal cancer screening. Physical examination
is normal.
Which recommendation is most appropriate?
a) Begin colorectal cancer screening now
b) Delay screening until age 60
c) Obtain abdominal CT annually
d) Screen only if symptoms develop - Correct Answer - a)
Individuals at increased risk due to family history should begin
colorectal cancer screening earlier than average-risk adults.
A 39-year-old woman complains of intermittent palpitations and heat
intolerance for three months. She has unintentionally lost 15 pounds
despite an increased appetite. Physical examination demonstrates a fine
tremor, brisk reflexes, and a diffusely enlarged thyroid gland. Heart rate
is 112 bpm.
Which laboratory pattern most strongly supports the suspected
diagnosis?
a) Decreased TSH, elevated free T4
, 4|Page
b) Elevated TSH, decreased free T4
c) Elevated TSH, elevated cortisol
d) Normal TSH, elevated ferritin - Correct Answer - a)
Primary hyperthyroidism suppresses pituitary TSH while increasing
circulating thyroid hormone.
A 61-year-old man with long-standing hypertension presents with
progressively worsening bilateral lower-extremity edema, orthopnea,
and exertional dyspnea. Physical examination reveals elevated jugular
venous pressure, bibasilar crackles, and an S3 gallop.
Which diagnostic study would provide the most useful assessment of
cardiac structure and function?
a) Abdominal ultrasound
b) Pulmonary angiography
c) Upper endoscopy
d) Echocardiography - Correct Answer - d) Echocardiography
Echocardiography evaluates ventricular function, chamber size, valvular
abnormalities, and ejection fraction in suspected heart failure.
A 64-year-old man with type 2 diabetes mellitus presents with increasing
fatigue, decreased urine output, and bilateral ankle swelling. Laboratory
results reveal:
Serum Creatinine: 2.6 mg/dL
BUN: 46 mg/dL
Potassium: 5.8 mEq/L
Estimated GFR: 28 mL/min/1.73 m²
Hemoglobin A1c: 8.5%
