WGU D589 Chronic and Infectious
Diseases Exam with correct answers
and rationale graded A+ updated
2026 new!!
Questions
Section A: Chronic Disease Pathophysiology (Questions 1–25)
1. Which of the following statements about chronic diseases is TRUE?
A. Chronic diseases are typically defined by their cause, while infectious diseases are
defined by duration.
B. Chronic diseases generally have a long duration and are often related to lifestyle,
nutrition, and genetics.
C. Chronic diseases are always curable with appropriate pharmacologic therapy.
D. Chronic diseases resolve spontaneously within 6 months.
Answer: B
Rationale: Chronic diseases are characterized by prolonged duration and are often
multifactorial, involving lifestyle factors such as nutrition, physical activity, and
genetic predisposition. Unlike infectious diseases, which are typically defined by their
causative agent, chronic diseases are not always caused by a single identifiable
pathogen.
2. A patient presents with chronic productive cough for more than 3 months
over 2 successive years. This presentation is most consistent with:
A. Emphysema
B. Chronic bronchitis
C. Asthma
D. Bronchiectasis
Answer: B
Rationale: Chronic bronchitis is clinically defined as the presence of a chronic
productive cough for more than 3 months over a period of more than 2 successive
,years. Emphysema is characterized by enlargement of air spaces and destruction of
lung parenchyma, while asthma is typically episodic and reversible.
3. The most common cause of congestive heart failure is:
A. Hypertension
B. Valvular heart disease
C. Coronary artery disease
D. Cardiomyopathy
Answer: C
Rationale: While hypertension, valvular disease, and cardiomyopathy all contribute to
heart failure, coronary artery disease (CAD) is by far the leading cause. CAD causes
direct injury to the myocardium, leading to impaired pumping function.
4. Which medication has been shown to be the mainstay in treating any patient
diagnosed with congestive heart failure (NYHA classes I–IV)?
A. Digoxin
B. Amiodarone
C. Angiotensin-converting enzyme (ACE) inhibitors
D. Calcium channel blockers
Answer: C
Rationale: ACE inhibitors decrease mortality and improve symptoms in all classes of
heart failure. Digoxin is used for symptom control but does not reduce mortality.
Amiodarone is used for arrhythmias, and calcium channel blockers are generally
avoided in systolic heart failure.
5. A 30-year-old man presents with recurrent pneumonias, chronic cough with
foul-smelling purulent sputum worse in the morning, and clubbing of fingers.
The most likely diagnosis is:
A. Disseminated pulmonary tuberculosis
B. Chronic obstructive emphysema
C. Bronchiectasis
D. Pulmonary neoplasm
,Answer: C
Rationale: Recurrent pneumonias, chronic cough with foul-smelling sputum that
worsens when lying down (due to pooling of secretions), and clubbing are classic
features of bronchiectasis. This condition involves irreversible dilation of bronchi and
bronchioles.
6. Biguanides (e.g., metformin) control hyperglycemia in type 2 diabetes
primarily by:
A. Increasing insulin secretion from pancreatic beta cells
B. Decreasing hepatic gluconeogenesis
C. Inhibiting intestinal carbohydrate absorption
D. Increasing insulin sensitivity in adipose tissue only
Answer: B
Rationale: Metformin works primarily by decreasing hepatic gluconeogenesis. While
it has some effect on insulin resistance at the tissue level, it does not primarily
increase insulin levels or action, which is why it is not associated with weight gain.
7. A 46-year-old patient with a history of a femoral fracture 10 years ago
presents with recurrent inflammation, fistula formation, and discharge of pus
with small bone fragments. What complication of the fracture is this?
A. Bone tuberculosis
B. Chronic osteomyelitis
C. Soft tissue phlegmon
D. False joint
Answer: B
Rationale: Chronic osteomyelitis is characterized by persistent infection of bone,
often following trauma or surgery. It can present with fistula formation, purulent
discharge, and bone fragments (sequestra) draining through the skin.
8. Which of the following is a true statement concerning chronic abdominal
pain and irritable bowel syndrome (IBS) in adolescents?
A. It is rare in adolescents.
B. There is no gender predilection.
, C. It is unlikely to be associated with depression.
D. It is seldom severe enough to restrict activity.
Answer: B
Rationale: Recurrent abdominal pain and IBS are common in adolescents and show
no significant gender association. These conditions are often associated with anxiety
and depression, and pain can be severe enough to restrict activity.
9. A client with chronic kidney disease is on a fluid restriction of 1,500 mL per
day. Which statement indicates the client understands the teaching?
A. "I will measure all my liquids, including ice cubes and gelatin."
B. "I can drink as much as I want as long as I take my diuretic."
C. "I will skip fluids on days I am not thirsty."
D. "I can include soup as part of my fluid allowance."
Answer: A
Rationale: All liquids at room temperature count toward fluid restriction, including ice
cubes (which melt to water), gelatin, popsicles, soup, and liquids in medications.
Diuretics do not allow unrestricted intake, and consistent measured intake—not
skipping—is the goal.
10. Which assessment finding indicates that a client with COPD is experiencing
inadequate oxygenation?
A. Pulse oximetry 92%
B. Respiratory rate 20 breaths per minute
C. Use of accessory muscles
D. Ability to speak full sentences
Answer: C
Rationale: Use of accessory muscles (e.g., sternocleidomastoid, intercostal muscles)
indicates increased work of breathing and inadequate oxygenation. A pulse oximetry
of 92% may be acceptable in COPD, and speaking full sentences suggests adequate
air movement.
Diseases Exam with correct answers
and rationale graded A+ updated
2026 new!!
Questions
Section A: Chronic Disease Pathophysiology (Questions 1–25)
1. Which of the following statements about chronic diseases is TRUE?
A. Chronic diseases are typically defined by their cause, while infectious diseases are
defined by duration.
B. Chronic diseases generally have a long duration and are often related to lifestyle,
nutrition, and genetics.
C. Chronic diseases are always curable with appropriate pharmacologic therapy.
D. Chronic diseases resolve spontaneously within 6 months.
Answer: B
Rationale: Chronic diseases are characterized by prolonged duration and are often
multifactorial, involving lifestyle factors such as nutrition, physical activity, and
genetic predisposition. Unlike infectious diseases, which are typically defined by their
causative agent, chronic diseases are not always caused by a single identifiable
pathogen.
2. A patient presents with chronic productive cough for more than 3 months
over 2 successive years. This presentation is most consistent with:
A. Emphysema
B. Chronic bronchitis
C. Asthma
D. Bronchiectasis
Answer: B
Rationale: Chronic bronchitis is clinically defined as the presence of a chronic
productive cough for more than 3 months over a period of more than 2 successive
,years. Emphysema is characterized by enlargement of air spaces and destruction of
lung parenchyma, while asthma is typically episodic and reversible.
3. The most common cause of congestive heart failure is:
A. Hypertension
B. Valvular heart disease
C. Coronary artery disease
D. Cardiomyopathy
Answer: C
Rationale: While hypertension, valvular disease, and cardiomyopathy all contribute to
heart failure, coronary artery disease (CAD) is by far the leading cause. CAD causes
direct injury to the myocardium, leading to impaired pumping function.
4. Which medication has been shown to be the mainstay in treating any patient
diagnosed with congestive heart failure (NYHA classes I–IV)?
A. Digoxin
B. Amiodarone
C. Angiotensin-converting enzyme (ACE) inhibitors
D. Calcium channel blockers
Answer: C
Rationale: ACE inhibitors decrease mortality and improve symptoms in all classes of
heart failure. Digoxin is used for symptom control but does not reduce mortality.
Amiodarone is used for arrhythmias, and calcium channel blockers are generally
avoided in systolic heart failure.
5. A 30-year-old man presents with recurrent pneumonias, chronic cough with
foul-smelling purulent sputum worse in the morning, and clubbing of fingers.
The most likely diagnosis is:
A. Disseminated pulmonary tuberculosis
B. Chronic obstructive emphysema
C. Bronchiectasis
D. Pulmonary neoplasm
,Answer: C
Rationale: Recurrent pneumonias, chronic cough with foul-smelling sputum that
worsens when lying down (due to pooling of secretions), and clubbing are classic
features of bronchiectasis. This condition involves irreversible dilation of bronchi and
bronchioles.
6. Biguanides (e.g., metformin) control hyperglycemia in type 2 diabetes
primarily by:
A. Increasing insulin secretion from pancreatic beta cells
B. Decreasing hepatic gluconeogenesis
C. Inhibiting intestinal carbohydrate absorption
D. Increasing insulin sensitivity in adipose tissue only
Answer: B
Rationale: Metformin works primarily by decreasing hepatic gluconeogenesis. While
it has some effect on insulin resistance at the tissue level, it does not primarily
increase insulin levels or action, which is why it is not associated with weight gain.
7. A 46-year-old patient with a history of a femoral fracture 10 years ago
presents with recurrent inflammation, fistula formation, and discharge of pus
with small bone fragments. What complication of the fracture is this?
A. Bone tuberculosis
B. Chronic osteomyelitis
C. Soft tissue phlegmon
D. False joint
Answer: B
Rationale: Chronic osteomyelitis is characterized by persistent infection of bone,
often following trauma or surgery. It can present with fistula formation, purulent
discharge, and bone fragments (sequestra) draining through the skin.
8. Which of the following is a true statement concerning chronic abdominal
pain and irritable bowel syndrome (IBS) in adolescents?
A. It is rare in adolescents.
B. There is no gender predilection.
, C. It is unlikely to be associated with depression.
D. It is seldom severe enough to restrict activity.
Answer: B
Rationale: Recurrent abdominal pain and IBS are common in adolescents and show
no significant gender association. These conditions are often associated with anxiety
and depression, and pain can be severe enough to restrict activity.
9. A client with chronic kidney disease is on a fluid restriction of 1,500 mL per
day. Which statement indicates the client understands the teaching?
A. "I will measure all my liquids, including ice cubes and gelatin."
B. "I can drink as much as I want as long as I take my diuretic."
C. "I will skip fluids on days I am not thirsty."
D. "I can include soup as part of my fluid allowance."
Answer: A
Rationale: All liquids at room temperature count toward fluid restriction, including ice
cubes (which melt to water), gelatin, popsicles, soup, and liquids in medications.
Diuretics do not allow unrestricted intake, and consistent measured intake—not
skipping—is the goal.
10. Which assessment finding indicates that a client with COPD is experiencing
inadequate oxygenation?
A. Pulse oximetry 92%
B. Respiratory rate 20 breaths per minute
C. Use of accessory muscles
D. Ability to speak full sentences
Answer: C
Rationale: Use of accessory muscles (e.g., sternocleidomastoid, intercostal muscles)
indicates increased work of breathing and inadequate oxygenation. A pulse oximetry
of 92% may be acceptable in COPD, and speaking full sentences suggests adequate
air movement.
