WGU D120 OA Special Populations Primary Care for the
Advanced Up to Date Examination 2026 Question and
Correct Answers with Explanation .
Question 1: A 42-year-old woman presents for preventive care and has never undergone breast-
cancer screening. Which approach is most appropriate?
A. Wait until age 60 because she has no family history.
B. Order annual breast MRI as the only screening test.
C. Discuss and initiate age-appropriate mammography screening.
D. Screening is unnecessary without breast symptoms.
Correct Answer: C — Average-risk women in this age range should receive age-appropriate
mammographic screening rather than waiting for symptoms or relying on MRI alone .
Question 2: A 15-year-old female presents with amenorrhea. Assessment reveals breast development
normal, recent weight loss of 15 lb with BMI of 16.5 kg/m², no drug use. She runs five miles every
day. Which care plan should the APRN recommend?
A. Prescribe oral contraceptives to regulate her cycles.
B. Reassure that amenorrhea is normal for athletes.
C. Review complications, refer to counseling, and refer to nutritionist.
D. Order thyroid function tests.
Correct Answer: C — This patient likely has functional hypothalamic amenorrhea secondary to low body
weight and excessive exercise. The care plan should include education on complications (osteoporosis,
cardiovascular effects), and referrals to counseling and nutrition for weight restoration .
Question 3: A patient presents with foul-smelling vaginal discharge that worsens before menses and
after intercourse. Diagnostic tests reveal vaginal pH >4.5, positive whiff test, and clue cells on wet
prep. Which treatment regimen should the APRN use?
A. Fluconazole 150 mg PO once.
B. Metronidazole 500 mg orally twice a day for seven days.
C. Doxycycline 100 mg bid for 7 days.
D. Miconazole cream intravaginally for 7 days.
Correct Answer: B — Metronidazole 500 mg PO BID for 7 days is the recommended oral regimen for
bacterial vaginosis. Fluconazole is for candidiasis; doxycycline is for chlamydia .
,Question 4: A 27-year-old female presents with intense vulvar and vaginal itching. On exam, there is
vulvar edema, erythema, and excoriation. Which test would be most helpful?
The search result excerpt was truncated, but the correct approach involves a wet mount preparation with
potassium hydroxide (KOH) to identify pseudohyphae and spores, which are diagnostic for vulvovaginal
candidiasis .
Question 5: Which presentation is most consistent with placenta previa?
A. Painful vaginal bleeding with a rigid tender uterus.
B. Painless vaginal bleeding later in pregnancy.
C. Severe vomiting in the first trimester.
D. Fever with dysuria.
Correct Answer: B — Placenta previa classically presents with painless bleeding because placental tissue
overlies or approaches the cervical opening .
Question 6: A patient develops a generalized seizure in the setting of preeclampsia. Which diagnosis
is most likely?
A. Eclampsia.
B. Gestational hypertension.
C. Hyperemesis gravidarum.
D. Placenta previa.
Correct Answer: A — Eclampsia is defined by new-onset seizures associated with a preeclamptic disease
process. Magnesium sulfate is the standard anticonvulsant for seizure prophylaxis and treatment .
Question 7: An 82-year-old patient comes to a clinic for routine care. The patient lives alone and has
no family living close by. Which topic should the APRN discuss as part of the plan of care?
A. Invoking durable power of attorney for healthcare.
B. Reviewing advance directives.
C. Instituting clinical case review.
D. Moving into a nursing home.
Correct Answer: B — Reviewing advance directives is an appropriate topic for an older adult living alone
with no nearby family, as it ensures their healthcare wishes are documented and accessible .
Question 1: A 42-year-old woman presents for preventive care and has never undergone breast-
cancer screening. Which approach is most appropriate?
,A. Wait until age 60 because she has no family history.
B. Order annual breast MRI as the only screening test.
C. Discuss and initiate age-appropriate mammography screening.
D. Screening is unnecessary without breast symptoms.
Correct Answer: C — Average-risk women in this age range should receive age-appropriate
mammographic screening rather than waiting for symptoms or relying on MRI alone .
Question 2: A 15-year-old female presents with amenorrhea. Assessment reveals breast development
normal, recent weight loss of 15 lb with BMI of 16.5 kg/m², no drug use. She runs five miles every
day. Which care plan should the APRN recommend?
A. Prescribe oral contraceptives to regulate her cycles.
B. Reassure that amenorrhea is normal for athletes.
C. Review complications, refer to counseling, and refer to nutritionist.
D. Order thyroid function tests.
Correct Answer: C — This patient likely has functional hypothalamic amenorrhea secondary to low body
weight and excessive exercise. The care plan should include education on complications (osteoporosis,
cardiovascular effects), and referrals to counseling and nutrition for weight restoration .
Question 3: A patient presents with foul-smelling vaginal discharge that worsens before menses and
after intercourse. Diagnostic tests reveal vaginal pH >4.5, positive whiff test, and clue cells on wet
prep. Which treatment regimen should the APRN use?
A. Fluconazole 150 mg PO once.
B. Metronidazole 500 mg orally twice a day for seven days.
C. Doxycycline 100 mg bid for 7 days.
D. Miconazole cream intravaginally for 7 days.
Correct Answer: B — Metronidazole 500 mg PO BID for 7 days is the recommended oral regimen for
bacterial vaginosis. Fluconazole is for candidiasis; doxycycline is for chlamydia .
Question 4: A 27-year-old female presents with intense vulvar and vaginal itching. On exam, there is
vulvar edema, erythema, and excoriation. Which test would be most helpful?
The search result excerpt was truncated, but the correct approach involves a wet mount preparation with
potassium hydroxide (KOH) to identify pseudohyphae and spores, which are diagnostic for vulvovaginal
candidiasis .
Question 5: Which presentation is most consistent with placenta previa?
, A. Painful vaginal bleeding with a rigid tender uterus.
B. Painless vaginal bleeding later in pregnancy.
C. Severe vomiting in the first trimester.
D. Fever with dysuria.
Correct Answer: B — Placenta previa classically presents with painless bleeding because placental tissue
overlies or approaches the cervical opening .
Question 6: A patient develops a generalized seizure in the setting of preeclampsia. Which diagnosis
is most likely?
A. Eclampsia.
B. Gestational hypertension.
C. Hyperemesis gravidarum.
D. Placenta previa.
Correct Answer: A — Eclampsia is defined by new-onset seizures associated with a preeclamptic disease
process. Magnesium sulfate is the standard anticonvulsant for seizure prophylaxis and treatment .
Question 7: An 82-year-old patient comes to a clinic for routine care. The patient lives alone and has
no family living close by. Which topic should the APRN discuss as part of the plan of care?
A. Invoking durable power of attorney for healthcare.
B. Reviewing advance directives.
C. Instituting clinical case review.
D. Moving into a nursing home.
Correct Answer: B — Reviewing advance directives is an appropriate topic for an older adult living alone
with no nearby family, as it ensures their healthcare wishes are documented and accessible .
. A patient with a history of recurrent Clostridioides difficile infection (CDI) requires antibiotic
therapy for a urinary tract infection. Which agent is least likely to precipitate CDI recurrence?
A. Ciprofloxacin
B. Nitrofurantoin
C. Amoxicillin-clavulanate
D. Cefpodoxime
Correct Answer: B
Rationale: Nitrofurantoin has minimal impact on the colonic microbiome and is associated with low CDI
risk. Fluoroquinolones, beta-lactams, and cephalosporins are high-risk agents that disrupt gut flora and
promote C. difficile overgrowth .
Advanced Up to Date Examination 2026 Question and
Correct Answers with Explanation .
Question 1: A 42-year-old woman presents for preventive care and has never undergone breast-
cancer screening. Which approach is most appropriate?
A. Wait until age 60 because she has no family history.
B. Order annual breast MRI as the only screening test.
C. Discuss and initiate age-appropriate mammography screening.
D. Screening is unnecessary without breast symptoms.
Correct Answer: C — Average-risk women in this age range should receive age-appropriate
mammographic screening rather than waiting for symptoms or relying on MRI alone .
Question 2: A 15-year-old female presents with amenorrhea. Assessment reveals breast development
normal, recent weight loss of 15 lb with BMI of 16.5 kg/m², no drug use. She runs five miles every
day. Which care plan should the APRN recommend?
A. Prescribe oral contraceptives to regulate her cycles.
B. Reassure that amenorrhea is normal for athletes.
C. Review complications, refer to counseling, and refer to nutritionist.
D. Order thyroid function tests.
Correct Answer: C — This patient likely has functional hypothalamic amenorrhea secondary to low body
weight and excessive exercise. The care plan should include education on complications (osteoporosis,
cardiovascular effects), and referrals to counseling and nutrition for weight restoration .
Question 3: A patient presents with foul-smelling vaginal discharge that worsens before menses and
after intercourse. Diagnostic tests reveal vaginal pH >4.5, positive whiff test, and clue cells on wet
prep. Which treatment regimen should the APRN use?
A. Fluconazole 150 mg PO once.
B. Metronidazole 500 mg orally twice a day for seven days.
C. Doxycycline 100 mg bid for 7 days.
D. Miconazole cream intravaginally for 7 days.
Correct Answer: B — Metronidazole 500 mg PO BID for 7 days is the recommended oral regimen for
bacterial vaginosis. Fluconazole is for candidiasis; doxycycline is for chlamydia .
,Question 4: A 27-year-old female presents with intense vulvar and vaginal itching. On exam, there is
vulvar edema, erythema, and excoriation. Which test would be most helpful?
The search result excerpt was truncated, but the correct approach involves a wet mount preparation with
potassium hydroxide (KOH) to identify pseudohyphae and spores, which are diagnostic for vulvovaginal
candidiasis .
Question 5: Which presentation is most consistent with placenta previa?
A. Painful vaginal bleeding with a rigid tender uterus.
B. Painless vaginal bleeding later in pregnancy.
C. Severe vomiting in the first trimester.
D. Fever with dysuria.
Correct Answer: B — Placenta previa classically presents with painless bleeding because placental tissue
overlies or approaches the cervical opening .
Question 6: A patient develops a generalized seizure in the setting of preeclampsia. Which diagnosis
is most likely?
A. Eclampsia.
B. Gestational hypertension.
C. Hyperemesis gravidarum.
D. Placenta previa.
Correct Answer: A — Eclampsia is defined by new-onset seizures associated with a preeclamptic disease
process. Magnesium sulfate is the standard anticonvulsant for seizure prophylaxis and treatment .
Question 7: An 82-year-old patient comes to a clinic for routine care. The patient lives alone and has
no family living close by. Which topic should the APRN discuss as part of the plan of care?
A. Invoking durable power of attorney for healthcare.
B. Reviewing advance directives.
C. Instituting clinical case review.
D. Moving into a nursing home.
Correct Answer: B — Reviewing advance directives is an appropriate topic for an older adult living alone
with no nearby family, as it ensures their healthcare wishes are documented and accessible .
Question 1: A 42-year-old woman presents for preventive care and has never undergone breast-
cancer screening. Which approach is most appropriate?
,A. Wait until age 60 because she has no family history.
B. Order annual breast MRI as the only screening test.
C. Discuss and initiate age-appropriate mammography screening.
D. Screening is unnecessary without breast symptoms.
Correct Answer: C — Average-risk women in this age range should receive age-appropriate
mammographic screening rather than waiting for symptoms or relying on MRI alone .
Question 2: A 15-year-old female presents with amenorrhea. Assessment reveals breast development
normal, recent weight loss of 15 lb with BMI of 16.5 kg/m², no drug use. She runs five miles every
day. Which care plan should the APRN recommend?
A. Prescribe oral contraceptives to regulate her cycles.
B. Reassure that amenorrhea is normal for athletes.
C. Review complications, refer to counseling, and refer to nutritionist.
D. Order thyroid function tests.
Correct Answer: C — This patient likely has functional hypothalamic amenorrhea secondary to low body
weight and excessive exercise. The care plan should include education on complications (osteoporosis,
cardiovascular effects), and referrals to counseling and nutrition for weight restoration .
Question 3: A patient presents with foul-smelling vaginal discharge that worsens before menses and
after intercourse. Diagnostic tests reveal vaginal pH >4.5, positive whiff test, and clue cells on wet
prep. Which treatment regimen should the APRN use?
A. Fluconazole 150 mg PO once.
B. Metronidazole 500 mg orally twice a day for seven days.
C. Doxycycline 100 mg bid for 7 days.
D. Miconazole cream intravaginally for 7 days.
Correct Answer: B — Metronidazole 500 mg PO BID for 7 days is the recommended oral regimen for
bacterial vaginosis. Fluconazole is for candidiasis; doxycycline is for chlamydia .
Question 4: A 27-year-old female presents with intense vulvar and vaginal itching. On exam, there is
vulvar edema, erythema, and excoriation. Which test would be most helpful?
The search result excerpt was truncated, but the correct approach involves a wet mount preparation with
potassium hydroxide (KOH) to identify pseudohyphae and spores, which are diagnostic for vulvovaginal
candidiasis .
Question 5: Which presentation is most consistent with placenta previa?
, A. Painful vaginal bleeding with a rigid tender uterus.
B. Painless vaginal bleeding later in pregnancy.
C. Severe vomiting in the first trimester.
D. Fever with dysuria.
Correct Answer: B — Placenta previa classically presents with painless bleeding because placental tissue
overlies or approaches the cervical opening .
Question 6: A patient develops a generalized seizure in the setting of preeclampsia. Which diagnosis
is most likely?
A. Eclampsia.
B. Gestational hypertension.
C. Hyperemesis gravidarum.
D. Placenta previa.
Correct Answer: A — Eclampsia is defined by new-onset seizures associated with a preeclamptic disease
process. Magnesium sulfate is the standard anticonvulsant for seizure prophylaxis and treatment .
Question 7: An 82-year-old patient comes to a clinic for routine care. The patient lives alone and has
no family living close by. Which topic should the APRN discuss as part of the plan of care?
A. Invoking durable power of attorney for healthcare.
B. Reviewing advance directives.
C. Instituting clinical case review.
D. Moving into a nursing home.
Correct Answer: B — Reviewing advance directives is an appropriate topic for an older adult living alone
with no nearby family, as it ensures their healthcare wishes are documented and accessible .
. A patient with a history of recurrent Clostridioides difficile infection (CDI) requires antibiotic
therapy for a urinary tract infection. Which agent is least likely to precipitate CDI recurrence?
A. Ciprofloxacin
B. Nitrofurantoin
C. Amoxicillin-clavulanate
D. Cefpodoxime
Correct Answer: B
Rationale: Nitrofurantoin has minimal impact on the colonic microbiome and is associated with low CDI
risk. Fluoroquinolones, beta-lactams, and cephalosporins are high-risk agents that disrupt gut flora and
promote C. difficile overgrowth .
