WGU D027 – 2 QUESTIONS WITH COMPLETE
SOLUTIONS
A 17-year-old male patient presents to a clinic for a physical,
and he has a diagnosis of moderate glucose-6-phosphate
dehydrogenase (G6PD) deficiency. During the exam, he states
he is going to study abroad in Egypt during his sophomore year,
and he has concerns about his nutrition while being away from
home. Which counseling about the patient's deficiency should
the advanced professional nurse (APN) give to this patient while
he studies abroad? Correct Answers Acetaminophen (Tylenol)
is safe to consume.
A 20-year-old male meets with an advanced professional nurse
(APN) to discuss symptoms that have been slowly progressing
over the past several years. He is mainly concerned because he
has been falling frequently. Since childhood, his gait has
consisted of walking on his toes. During middle school, he was
able to participate in sports but was unable to participate in high
school sports due to difficulty with running and jumping. Lately,
he has noticed it takes longer and is more difficult to change
positions from sitting to standing than it used to in the past. He
has also been waking up with muscle and joint stiffness. The
APRN notes that his family history is not significant for any
chronic or genetic diseases. Which condition is likely to be the
cause of these symptoms? Correct Answers Becker muscular
dystrophy. Mutation of gene dystrophin. X-linked. Affects
muscles of hips, pelvic area, thighs, and shoulders, as well as the
heart.
Diagnostic CK levels 5x normal.
,A 25-year-old female is 35 weeks pregnant and presents for
lower back pain. She has a history of moderate lower back pain
that she normally controls with stretching, yoga, and ice. The
patient reports not being able to engage in stretching and yoga
because of the state of her pregnancy. Ice use has been
ineffective. After a benign exam and a negative urinalysis, the
provider is convinced that the pain is musculoskeletal. The
patient inquires if there are any medications she can take for the
pain. Which medication does the provider tell the patient she can
safely take? Correct Answers Acetaminophen (Tylenol)
A 26-year-old female presents to urgent care with complaints of
extreme fatigue, muscle aches, abdominal pain, numbness and
tingling in her extremities, and bloating. She explains that she
has been experiencing gastrointestinal upset after meals and has
not had a bowel movement for the past four days. She reports
using over-the-counter, anti-diarrheal products last week to
combat diarrhea. She denies having any chronic diseases. The
assessment findings include a blood pressure of 108/71 mm Hg,
pulse of 82 beats per minute, and respirations of 20 breaths per
minute. The abdomen is distended and firm. Bowel sounds are
present in all four quadrants. The patient has a steady gait,
though verbally complains of feeling weak and off balance upon
ambulation. Following antibody testing, Celiac disease is
suspected. Which follow-up tissue test, the gold standard for this
suspected diagnosis, should be ordered? Correct Answers
Endoscopy with small intestine biopsy
A 32-year-old female presents to the emergency room (ER) with
headache, fatigue, and shortness of breath on exertion. A
complete blood count reveals a hemoglobin of 4.4g/dl. During
,the gynecological review of systems, she reports a change of a
fully saturated pad every two hours for the first three out of six
days of a 28-day menstrual cycle. She states she thought this
was normal and has never sought gynecological care. She does
not follow with a primary care physician. Which factor in the
"health and healthcare" domain of the social determinants of
health contributed to this patient's hemoglobin of 4.4g/dl?
Correct Answers Health literacy
A 42-year-old asthmatic who has been using beta-adrenergic
agonists for several years began to experience premature atrial
contractions (PACs). To treat the PACs, metoprolol (Toprol XL)
therapy was started. What is a likely consequence of this patient
taking metoprolol (Toprol XL)? Correct Answers Metoprolol
(Toprol XL) worsened asthma symptoms, but improved the
PACs.
A 44-year-old woman has recently been diagnosed with
advanced metastatic non-small-cell lung cancer. Genetic testing
is ordered to determine if the patient's tumor has any genomic
alterations and to guide treatment decisions. A few weeks later,
the patient's test results come back positive for a genetic
mutation. The APN starts osimertinib (Tagrisso).Based on this
information, what type of genetic mutation does this patient
have? Correct Answers EGFR mutation
A 45-year-old female patient presents to a clinic complaining of
chronic generalized pain and wishes to be evaluated for
fibromyalgia and chronic pain syndrome. A thorough history
and physical is conducted, and the findings are negative. The
, patient is not taking any medications, has no allergies to
medicines, and has a negative past medical history.
What is an appropriate first intervention for this patient?
Correct Answers Assess the patient's sleep hygiene and make
recommendations.
A 51-year-old female was voluntarily admitted to the inpatient
adult unit at the psychiatric hospital with complaints of
excessive worry, panic, anhedonia, difficulty concentrating, and
endorsed hopelessness and helplessness. Following a focused
assessment, depression has been ruled out. Which as-needed
(PRN) medication should be started to support the management
of this patient's symptoms? Correct Answers Hydroxyzine
(Vistaril)
A 54-year-old man comes into a clinic for a routine visit. His
initial BP is 148/92. After a recheck 15 minutes later, his BP is
140/90. He states he suffers from "white coat hypertension." He
states he has no history of high blood pressure and no family
history of high blood pressure.
Which nursing intervention would assist this patient in receiving
a clinical diagnosis of hypertension? Correct Answers
Completing an ambulatory blood pressure assessment
A 55-year-old female patient presents to a clinic for
exacerbation of her chronic low back pain. She is taking
morphine extended-release tablets (MS Contin), hydrocodone
(Vicodin) PRN, and duloxetine (Cymbalta). The patient denies
any drug allergies. She rates her pain at a ten out of ten and is
requesting something stronger for pain.
SOLUTIONS
A 17-year-old male patient presents to a clinic for a physical,
and he has a diagnosis of moderate glucose-6-phosphate
dehydrogenase (G6PD) deficiency. During the exam, he states
he is going to study abroad in Egypt during his sophomore year,
and he has concerns about his nutrition while being away from
home. Which counseling about the patient's deficiency should
the advanced professional nurse (APN) give to this patient while
he studies abroad? Correct Answers Acetaminophen (Tylenol)
is safe to consume.
A 20-year-old male meets with an advanced professional nurse
(APN) to discuss symptoms that have been slowly progressing
over the past several years. He is mainly concerned because he
has been falling frequently. Since childhood, his gait has
consisted of walking on his toes. During middle school, he was
able to participate in sports but was unable to participate in high
school sports due to difficulty with running and jumping. Lately,
he has noticed it takes longer and is more difficult to change
positions from sitting to standing than it used to in the past. He
has also been waking up with muscle and joint stiffness. The
APRN notes that his family history is not significant for any
chronic or genetic diseases. Which condition is likely to be the
cause of these symptoms? Correct Answers Becker muscular
dystrophy. Mutation of gene dystrophin. X-linked. Affects
muscles of hips, pelvic area, thighs, and shoulders, as well as the
heart.
Diagnostic CK levels 5x normal.
,A 25-year-old female is 35 weeks pregnant and presents for
lower back pain. She has a history of moderate lower back pain
that she normally controls with stretching, yoga, and ice. The
patient reports not being able to engage in stretching and yoga
because of the state of her pregnancy. Ice use has been
ineffective. After a benign exam and a negative urinalysis, the
provider is convinced that the pain is musculoskeletal. The
patient inquires if there are any medications she can take for the
pain. Which medication does the provider tell the patient she can
safely take? Correct Answers Acetaminophen (Tylenol)
A 26-year-old female presents to urgent care with complaints of
extreme fatigue, muscle aches, abdominal pain, numbness and
tingling in her extremities, and bloating. She explains that she
has been experiencing gastrointestinal upset after meals and has
not had a bowel movement for the past four days. She reports
using over-the-counter, anti-diarrheal products last week to
combat diarrhea. She denies having any chronic diseases. The
assessment findings include a blood pressure of 108/71 mm Hg,
pulse of 82 beats per minute, and respirations of 20 breaths per
minute. The abdomen is distended and firm. Bowel sounds are
present in all four quadrants. The patient has a steady gait,
though verbally complains of feeling weak and off balance upon
ambulation. Following antibody testing, Celiac disease is
suspected. Which follow-up tissue test, the gold standard for this
suspected diagnosis, should be ordered? Correct Answers
Endoscopy with small intestine biopsy
A 32-year-old female presents to the emergency room (ER) with
headache, fatigue, and shortness of breath on exertion. A
complete blood count reveals a hemoglobin of 4.4g/dl. During
,the gynecological review of systems, she reports a change of a
fully saturated pad every two hours for the first three out of six
days of a 28-day menstrual cycle. She states she thought this
was normal and has never sought gynecological care. She does
not follow with a primary care physician. Which factor in the
"health and healthcare" domain of the social determinants of
health contributed to this patient's hemoglobin of 4.4g/dl?
Correct Answers Health literacy
A 42-year-old asthmatic who has been using beta-adrenergic
agonists for several years began to experience premature atrial
contractions (PACs). To treat the PACs, metoprolol (Toprol XL)
therapy was started. What is a likely consequence of this patient
taking metoprolol (Toprol XL)? Correct Answers Metoprolol
(Toprol XL) worsened asthma symptoms, but improved the
PACs.
A 44-year-old woman has recently been diagnosed with
advanced metastatic non-small-cell lung cancer. Genetic testing
is ordered to determine if the patient's tumor has any genomic
alterations and to guide treatment decisions. A few weeks later,
the patient's test results come back positive for a genetic
mutation. The APN starts osimertinib (Tagrisso).Based on this
information, what type of genetic mutation does this patient
have? Correct Answers EGFR mutation
A 45-year-old female patient presents to a clinic complaining of
chronic generalized pain and wishes to be evaluated for
fibromyalgia and chronic pain syndrome. A thorough history
and physical is conducted, and the findings are negative. The
, patient is not taking any medications, has no allergies to
medicines, and has a negative past medical history.
What is an appropriate first intervention for this patient?
Correct Answers Assess the patient's sleep hygiene and make
recommendations.
A 51-year-old female was voluntarily admitted to the inpatient
adult unit at the psychiatric hospital with complaints of
excessive worry, panic, anhedonia, difficulty concentrating, and
endorsed hopelessness and helplessness. Following a focused
assessment, depression has been ruled out. Which as-needed
(PRN) medication should be started to support the management
of this patient's symptoms? Correct Answers Hydroxyzine
(Vistaril)
A 54-year-old man comes into a clinic for a routine visit. His
initial BP is 148/92. After a recheck 15 minutes later, his BP is
140/90. He states he suffers from "white coat hypertension." He
states he has no history of high blood pressure and no family
history of high blood pressure.
Which nursing intervention would assist this patient in receiving
a clinical diagnosis of hypertension? Correct Answers
Completing an ambulatory blood pressure assessment
A 55-year-old female patient presents to a clinic for
exacerbation of her chronic low back pain. She is taking
morphine extended-release tablets (MS Contin), hydrocodone
(Vicodin) PRN, and duloxetine (Cymbalta). The patient denies
any drug allergies. She rates her pain at a ten out of ten and is
requesting something stronger for pain.
