WGU D118 ACTUAL PAPER SOLVED
QUESTIONS WITH VERIFIED ANSWERS
◉ Next step for ACE inhibitor-induced angioedema
Answer: Discontinue ACE inhibitor immediately - Angioedema is
life-threatening and ACE-Is are permanently contraindicated
◉ Labs to check before starting an ACE inhibitor
Answer: Serum creatinine and potassium - Risk of renal
dysfunction and hyperkalemia
◉ Low back pain red flag requiring imaging
Answer: New urinary retention - Suggests cauda equina syndrome
◉ Next step for acute monoarticular arthritis with fever
Answer: Joint aspiration - Must rule out septic arthritis before
treating gout
◉ First-line treatment for acute gout flare
Answer: NSAIDs - First-line unless contraindicated
◉ Diagnostic confirmation of gout
,Answer: Monosodium urate crystals on synovial fluid - Serum uric
acid is not diagnostic
◉ Initial test for suspected PE in low-risk patient
Answer: D-dimer - Negative result rules out PE
◉ Next step after positive D-dimer
Answer: CT pulmonary angiography - Required to confirm PE
◉ First-line treatment for mild persistent asthma
Answer: Low-dose inhaled corticosteroid - Cornerstone therapy
◉ Asthma hospitalization red flag
Answer: Peak flow <50% predicted - Indicates severe
exacerbation
◉ Preferred colon cancer screening at age 45
Answer: Colonoscopy - Gold standard and diagnostic
◉ COPD patient with frequent exacerbations next step
Answer: Add inhaled corticosteroid - Reduces exacerbation
frequency
◉ Diagnostic test confirming COPD
, Answer: Spirometry showing FEV1/FVC <0.70 - Confirms airflow
obstruction
◉ First-line medication for type 2 diabetes
Answer: Metformin - Improves insulin sensitivity with CV benefit
◉ Metformin contraindication
Answer: eGFR <30 - Risk of lactic acidosis
◉ Lab monitoring long-term glucose control
Answer: Hemoglobin A1c - Reflects 3-month average
◉ First-line hypothyroidism treatment
Answer: Levothyroxine - Synthetic T4 replacement
◉ Labs confirming primary hypothyroidism
Answer: Elevated TSH and low free T4 - Pituitary compensation
◉ Headache red flag requiring imaging
Answer: New headache with focal neurologic deficits - Possible
intracranial pathology
◉ Initial imaging for suspected stroke
Answer: Non-contrast CT head - Rules out hemorrhage
QUESTIONS WITH VERIFIED ANSWERS
◉ Next step for ACE inhibitor-induced angioedema
Answer: Discontinue ACE inhibitor immediately - Angioedema is
life-threatening and ACE-Is are permanently contraindicated
◉ Labs to check before starting an ACE inhibitor
Answer: Serum creatinine and potassium - Risk of renal
dysfunction and hyperkalemia
◉ Low back pain red flag requiring imaging
Answer: New urinary retention - Suggests cauda equina syndrome
◉ Next step for acute monoarticular arthritis with fever
Answer: Joint aspiration - Must rule out septic arthritis before
treating gout
◉ First-line treatment for acute gout flare
Answer: NSAIDs - First-line unless contraindicated
◉ Diagnostic confirmation of gout
,Answer: Monosodium urate crystals on synovial fluid - Serum uric
acid is not diagnostic
◉ Initial test for suspected PE in low-risk patient
Answer: D-dimer - Negative result rules out PE
◉ Next step after positive D-dimer
Answer: CT pulmonary angiography - Required to confirm PE
◉ First-line treatment for mild persistent asthma
Answer: Low-dose inhaled corticosteroid - Cornerstone therapy
◉ Asthma hospitalization red flag
Answer: Peak flow <50% predicted - Indicates severe
exacerbation
◉ Preferred colon cancer screening at age 45
Answer: Colonoscopy - Gold standard and diagnostic
◉ COPD patient with frequent exacerbations next step
Answer: Add inhaled corticosteroid - Reduces exacerbation
frequency
◉ Diagnostic test confirming COPD
, Answer: Spirometry showing FEV1/FVC <0.70 - Confirms airflow
obstruction
◉ First-line medication for type 2 diabetes
Answer: Metformin - Improves insulin sensitivity with CV benefit
◉ Metformin contraindication
Answer: eGFR <30 - Risk of lactic acidosis
◉ Lab monitoring long-term glucose control
Answer: Hemoglobin A1c - Reflects 3-month average
◉ First-line hypothyroidism treatment
Answer: Levothyroxine - Synthetic T4 replacement
◉ Labs confirming primary hypothyroidism
Answer: Elevated TSH and low free T4 - Pituitary compensation
◉ Headache red flag requiring imaging
Answer: New headache with focal neurologic deficits - Possible
intracranial pathology
◉ Initial imaging for suspected stroke
Answer: Non-contrast CT head - Rules out hemorrhage
