WGU D118 OBJECTIVE ASSESSMENT FINAL EXAM 2 LATEST VERSIONS (VERSION A & B) EXAM ACTUAL EXAM 500 QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED A+(EVERYTHING YOU NEED TO PASS OA EXAM IN ONE DOCUMENT)

WGU D118 OBJECTIVE ASSESSMENT FINAL EXAM 2 LATEST VERSIONS ( VERSION A & B) EXAM 2023 -2024 ACTUAL EXAM 500 QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED A+(EVERYTHING YOU NEED TO PASS OA EXAM IN ONE DOCUMENT) WGU D118 OBJECTIVE ASSESSMENT VERSION A A patient was initially treated as an outpatient for pneumonia and then after 2 weeks was hospitalized after no improvement was evident. The patient continues to show no improvement after several antibiotic regimens have been attempted. What is the next st ep in managing this patient? a. Administration of the pneumonia vaccine b. Increasing the dose of the antibiotics c. Open lung biopsy d. Performing diagnostic bronchoscopy ANS: D Rationale: Patients who do not respond to antibiotic therapy may have opportunistic fungal or other infections, bronchogenic carcinoma, or other diseases. Bronchoscopy can exclude or confirm these. The pneumonia vaccine is preventative for pneumococcal causes and wil l not help this patient. Increasing the dose of the antibiotics is not recommended. Open lung biopsy may be performed if a bronchoscopy is inconclusive. A pregnant woman tests positive for human immunodeficiency virus (HIV -1) infection. What will the provider recommend? a. Consideration of termination of the pregnancy b. No treatment and caesarian section for delivery c. Treatment with highly active antiretroviral therapy (HAART) d. Treatment with standard antiretroviral therapy ANS: C Rationale: An absolute indication for treatment with highly active antiretroviral therapy (HAART) is the treatment of a pregnant woman to prevent mother -to-child transmission. Recommended regimens have no known significant fetal toxicity and can reduce the risk of ve rtical transmission from approximately 25% to less than 2%, making elective caesarean section no longer indicated in treated pregnant women. A 35 -year old primigravida comes to an antenatal clinic for her first obstetric visit. Her LMP was five weeks ago. She has a known case of HIV diagnosed 6 years ago and is adherent to her triple drug ART regimen with an undetectable viral load. At 35 weeks her viral load is still undetectable and she gives birth via normal vaginal delivery at 39 weeks. At discharge ART regimens for the mother and child are finalized. Which of the following recommendations about breastfeeding in HIV positive mothers is most accurate? A. There is no significant risk of HIV transmission via breastfeeding in mothers under 30 years of age. B. In resource rich settings the benefits of breastfeeding outweigh the risk of HIV transmission C. Maternal antibodies in breastmilk will protect the infant from HIV infection D. The risk of HIV transmission from breastmilk makes breastfeeding unadvisable ANS: D Rationale: The risk of HIV Transmission from breastmilk makes breastfeeding unadvisable. Rationale: 10% -14% of breastfeeding mothers transmit HIV to the uninfected infant. The US official guidelines by the panel on treatment of pregnant women with HIV infection and p revention of perinatal infection state that HIV positive women must avoid breastfeeding as transmission of HIV through breastmilk is still possible despite ART therapy. In parts of the world that lack adequate resources the benefit of breastfeeding may out weigh these risks. A homeless patient who has human immunodeficiency virus (HIV -1) infection has been on antiretroviral therapy (ART) for 18 months and has had normal CD4 counts and viral loads for past year. What will the provider recommend? a. Allow for periods of time off from ART medications b. Begin monitoring viral load and CD4 counts every 6 to 12 months c. Consider beginning highly active antiretroviral therapy (HAART) d. Continue monitoring viral lNoUadRaSnId NCGDT4Bco.uCntOsMevery 3 to 4 months ANS: D Rationale: In patients who are clinically well and highly adherent, who have normal CD4 counts and viral loads, monitoring may begin at 6 -month intervals and sometimes annually. Those with risk factors such as homelessness, however, must continue to be monitored ever y 3 to 4 months. ART medications should never be interrupted unless there are medical reasons for doing so. HAART is given only by clinicians with significant training and experience in its use to patients who meet specific criteria. A 43 -year-old IV drug user who has been on ART treatment complains of continuous diarrhea that is watery, epigastric pain, and difficulty swallowing. His CBC shows a hemoglobin of 7.0 mg/dl, a total leukocyte count of 2900cmm, and a platelet count of 70,00 0. A CD4+ cell count was requested and it came out to be 90/cmm. Which of the following laboratory investigations would best help with the further evaluation of his diarrhea? A. Stool tests for oocysts of cryptosporidium B. Blood cultures for progressive disseminated histoplasmosis C. Microscopy for pseudohyphae of Candida albicans D. A stool for ova and parasites test for giardiasis ANS: A