WGU D027 Performance Assessment – Advanced
Pathopharmacological Foundations 2026/2027 | Most
Tested Questions & Verified Answers | Latest Update |
Graded A+
1. A client with heart failure has an ejection fraction of 25% and is on
carvedilol, lisinopril, and furosemide. Which statement best describes the
mechanism of carvedilol in heart failure?
A) Increases cardiac contractility
B) Blocks beta-1, beta-2, and alpha-1 receptors, reducing myocardial oxygen
demand and remodeling
C) Dilates coronary arteries
D) Inhibits angiotensin-converting enzyme
Answer B: Blocks beta-1, beta-2, and alpha-1 receptors, reducing myocardial
oxygen demand and remodeling
Rationale: Carvedilol is a non-selective beta-blocker with alpha-1 blocking
activity; it reduces heart rate, contractility, and afterload.
2. A client with type 2 diabetes has an A1c of 8.5% on metformin and
glipizide. Which medication should be added to provide cardiovascular
benefit?
A) Pioglitazone
B) Empagliflozin (SGLT-2 inhibitor)
,C) Insulin glargine
D) Acarbose
Answer B: Empagliflozin (SGLT-2 inhibitor)
Rationale: SGLT-2 inhibitors reduce cardiovascular events and heart failure
hospitalizations in type 2 diabetes.
3. A client with chronic kidney disease (CKD) has a potassium of 6.2 mEq/L.
Which ECG change is expected?
A) Peaked T waves
B) Peaked T waves
C) Prominent U waves
D) Prolonged PR interval
Answer A: Peaked T waves
Rationale: Hyperkalemia causes peaked T waves, widened QRS, and eventually
sine wave.
4. A client with COPD is prescribed tiotropium. Which statement about
tiotropium is correct?
A) It is a short-acting bronchodilator
B) It is a long-acting muscarinic antagonist (LAMA) used once daily
C) It is a corticosteroid
D) It is indicated for acute exacerbations
Answer B: It is a long-acting muscarinic antagonist (LAMA) used once daily
,Rationale: Tiotropium is a LAMA used for maintenance therapy in COPD; it is not
for acute symptom relief.
5. A client with rheumatoid arthritis is prescribed methotrexate. Which
supplement is given to reduce toxicity?
A) Folic acid
B) Folic acid
C) Vitamin B12
D) Iron
Answer A: Folic acid
Rationale: Methotrexate inhibits dihydrofolate reductase; folic acid
supplementation reduces mucositis and cytopenias.
6. A client with atrial fibrillation on warfarin has an INR of 1.2. Which action
is most appropriate?
A) Administer vitamin K
B) Increase warfarin dose or hold and notify provider
C) Continue current dose
D) Discontinue warfarin
Answer B: Increase warfarin dose or hold and notify provider
Rationale: INR 1.2 is subtherapeutic (goal 2-3 for AF); provider should adjust
dose.
, 7. A client with cirrhosis develops ascites and hepatic encephalopathy. Which
medication is used to reduce ammonia?
A) Spironolactone
B) Lactulose
C) Furosemide
D) Rifaximin
Answer B: Lactulose
Rationale: Lactulose acidifies the colon, trapping ammonia and promoting its
excretion.
8. A client with Parkinson’s disease is started on carbidopa-levodopa. Which
dietary instruction is correct?
A) Take with a high-protein meal
B) Avoid high-protein meals near medication times
C) Take on an empty stomach with juice
D) Protein has no effect
Answer B: Avoid high-protein meals near medication times
Rationale: Large neutral amino acids from protein compete with levodopa for
transport into the brain.
9. A client with hyperthyroidism is prescribed methimazole. Which adverse
effect requires immediate discontinuation?
Pathopharmacological Foundations 2026/2027 | Most
Tested Questions & Verified Answers | Latest Update |
Graded A+
1. A client with heart failure has an ejection fraction of 25% and is on
carvedilol, lisinopril, and furosemide. Which statement best describes the
mechanism of carvedilol in heart failure?
A) Increases cardiac contractility
B) Blocks beta-1, beta-2, and alpha-1 receptors, reducing myocardial oxygen
demand and remodeling
C) Dilates coronary arteries
D) Inhibits angiotensin-converting enzyme
Answer B: Blocks beta-1, beta-2, and alpha-1 receptors, reducing myocardial
oxygen demand and remodeling
Rationale: Carvedilol is a non-selective beta-blocker with alpha-1 blocking
activity; it reduces heart rate, contractility, and afterload.
2. A client with type 2 diabetes has an A1c of 8.5% on metformin and
glipizide. Which medication should be added to provide cardiovascular
benefit?
A) Pioglitazone
B) Empagliflozin (SGLT-2 inhibitor)
,C) Insulin glargine
D) Acarbose
Answer B: Empagliflozin (SGLT-2 inhibitor)
Rationale: SGLT-2 inhibitors reduce cardiovascular events and heart failure
hospitalizations in type 2 diabetes.
3. A client with chronic kidney disease (CKD) has a potassium of 6.2 mEq/L.
Which ECG change is expected?
A) Peaked T waves
B) Peaked T waves
C) Prominent U waves
D) Prolonged PR interval
Answer A: Peaked T waves
Rationale: Hyperkalemia causes peaked T waves, widened QRS, and eventually
sine wave.
4. A client with COPD is prescribed tiotropium. Which statement about
tiotropium is correct?
A) It is a short-acting bronchodilator
B) It is a long-acting muscarinic antagonist (LAMA) used once daily
C) It is a corticosteroid
D) It is indicated for acute exacerbations
Answer B: It is a long-acting muscarinic antagonist (LAMA) used once daily
,Rationale: Tiotropium is a LAMA used for maintenance therapy in COPD; it is not
for acute symptom relief.
5. A client with rheumatoid arthritis is prescribed methotrexate. Which
supplement is given to reduce toxicity?
A) Folic acid
B) Folic acid
C) Vitamin B12
D) Iron
Answer A: Folic acid
Rationale: Methotrexate inhibits dihydrofolate reductase; folic acid
supplementation reduces mucositis and cytopenias.
6. A client with atrial fibrillation on warfarin has an INR of 1.2. Which action
is most appropriate?
A) Administer vitamin K
B) Increase warfarin dose or hold and notify provider
C) Continue current dose
D) Discontinue warfarin
Answer B: Increase warfarin dose or hold and notify provider
Rationale: INR 1.2 is subtherapeutic (goal 2-3 for AF); provider should adjust
dose.
, 7. A client with cirrhosis develops ascites and hepatic encephalopathy. Which
medication is used to reduce ammonia?
A) Spironolactone
B) Lactulose
C) Furosemide
D) Rifaximin
Answer B: Lactulose
Rationale: Lactulose acidifies the colon, trapping ammonia and promoting its
excretion.
8. A client with Parkinson’s disease is started on carbidopa-levodopa. Which
dietary instruction is correct?
A) Take with a high-protein meal
B) Avoid high-protein meals near medication times
C) Take on an empty stomach with juice
D) Protein has no effect
Answer B: Avoid high-protein meals near medication times
Rationale: Large neutral amino acids from protein compete with levodopa for
transport into the brain.
9. A client with hyperthyroidism is prescribed methimazole. Which adverse
effect requires immediate discontinuation?
