Page 1 of 664
WGU D118 OBJECTIVE ASSESSMENT FINAL EXAM 3
LATEST VERSIONS (VERSION A, B&C) EXAM 2024
ACTUAL EXAM 700 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 A
A patient reports chronic nasal obstruction and recurrent epistaxis. Which type of nasal mass
is likely?
a. Inverted papilloma
b. Nasal polyp
c. Paranasal lymphoma
d. Squamous cell carcinoma
ANS: A
Inverted papillomas are benign tumors of the nasal mucosa and are highly vascular with
frequent bleeding. Nasal polyps typically do not bleed and are associated with allergies.
Paranasal lymphoma and squamous cell carcinoma are not initially associated with bleeding.
A patient reports chronic nasal obstruction and difficulty distinguishing smells. The provider
examines the nares with a nasal speculum and observes several grape-like lesions in both
nostrils. What is the likely cause of this patient's symptoms?
a. Chronic sinusitis
b. Nasal polyps
1
,Page 2 of 664
c. Squamous cell carcinoma
d. Vascular benign tumor
ANS: B
Polyps cause obstruction and olfactory dysfunction and appear as grape-like lesions on the
nasal mucosa. Most malignant neoplasms are asymptomatic until late in the course. Chronic
sinusitis characteristically produces inflammation and purulent discharge.
A provider examines a patient who has chronic nasal obstruction, respiratory tract symptoms,
and generalized malaise. An examination of the nasal mucosa reveals ulceration of the nasal
septum. What is the most important action when caring for this patient?
a. Administering prednisone
b. Obtaining a chest radiograph
c. Performing laboratory tests
d. Referring to a specialist
ANS: D
This patient has symptoms of granulomatosis with polyangiitis (GPA) and should be referred as
soon as the disease is suspected. The other actions will be taken, but referral is the most
important.
A 58-year-old man presented to the hospital with right-sided decreased hearing for two
years. His wife mentions he has started snoring recently. He has been a smoker for the last 25
years and smokes up to 20 cigarettes/day. The provider decides to perform a nasendoscopy.
Which key anatomical area is the pathology most likely to be situated in?
A. Right Middle Meatus
2
,Page 3 of 664
B. The roof of the nasal cavity
C. Right vallecula
D. Postnasal space
ANS: D
In a patient with recent-onset unilateral hearing loss and nasal obstruction with a social history
of smoking one must rule out a nasopharyngeal pathology most likely a malignancy. • Any mass
in the nasopharynx can obstruct the medial ends of the eustachian tube leading to problems
with the ears. • Nasopharyngeal cancer can arise from the fossa of Rosenmüller, which lies
behind the eustachian tubes on either side. So a clear look at this area with a nasendoscopy in
high-risk patients with unilateral middle ear effusion is mandatory. • Malignancies in the other
anatomical areas mentioned are obviously possible, but will not cause unilateral middle ear
effusion with conductive hearing loss.
A patient with systemic lupus erythematosus (SLE) develops end-stage renal disease. Because
of the underlying SLE, what treatment is recommended for this patient?
a. Dialysis only
b. Immunosuppressant therapy
c. Kidney transplantation
d. Palliative care
ANS: C
Patients with SLE who develop renal failure may require dialysis and then kidney
transplantation; most who undergo transplant do relatively well because of the
immunosuppression given to prevent graft rejection. Immunosuppressant therapy is given for
3
, Page 4 of 664
graft rejection and does not treat end-stage renal failure. Palliative care is not the only option
for this patient.
A 49-year-old woman admitted to the hospital complaining of severe kidney injury after
being stabbed by a thief. She was diagnosed with acute kidney failure and was referred to the
hemodialysis center. Later on, she decided to undergo a kidney transplantation procedure.
After the procedure was done, the doctor prescribed cyclosporine for her as prophylaxis to
avoid organ rejection. Still, after a month, she came to the hospital complaining of some flu-
like symptoms and fever. The doctor noticed that the previously prescribed drug is not
efficient in reducing immunity. What is the next preferred step to avoid rejection?
A. Prescribe tacrolimus
B. Increase the dose of cyclosporine
C. Prescribe amoxicillin
D. Prescribe paracetamol
ANS: A
Tacrolimus is efficient more than ten folds when compared to cyclosporine. • Calcineurin
inhibitors' dosages should be monitored cautiously as an increase in its blood concentration
could cause many complications like kidney failure. • Cyclosporine, tacrolimus, and
pimecrolimus are called calcineurin inhibitors because they inhibit the enzyme "calcineurin"
that is responsible for T-cell activation. • Tacrolimus is used as an adjuvant to other
immunosuppressive drugs to avoid organ rejection.
A 28-year-old primigravida presented to the antenatal clinic for a routine check-up. She has
been exposed to someone with chickenpox but has not developed any skin lesions. She has
no varicella-zoster antibodies. What would be the best possible treatment for her?
4
WGU D118 OBJECTIVE ASSESSMENT FINAL EXAM 3
LATEST VERSIONS (VERSION A, B&C) EXAM 2024
ACTUAL EXAM 700 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 A
A patient reports chronic nasal obstruction and recurrent epistaxis. Which type of nasal mass
is likely?
a. Inverted papilloma
b. Nasal polyp
c. Paranasal lymphoma
d. Squamous cell carcinoma
ANS: A
Inverted papillomas are benign tumors of the nasal mucosa and are highly vascular with
frequent bleeding. Nasal polyps typically do not bleed and are associated with allergies.
Paranasal lymphoma and squamous cell carcinoma are not initially associated with bleeding.
A patient reports chronic nasal obstruction and difficulty distinguishing smells. The provider
examines the nares with a nasal speculum and observes several grape-like lesions in both
nostrils. What is the likely cause of this patient's symptoms?
a. Chronic sinusitis
b. Nasal polyps
1
,Page 2 of 664
c. Squamous cell carcinoma
d. Vascular benign tumor
ANS: B
Polyps cause obstruction and olfactory dysfunction and appear as grape-like lesions on the
nasal mucosa. Most malignant neoplasms are asymptomatic until late in the course. Chronic
sinusitis characteristically produces inflammation and purulent discharge.
A provider examines a patient who has chronic nasal obstruction, respiratory tract symptoms,
and generalized malaise. An examination of the nasal mucosa reveals ulceration of the nasal
septum. What is the most important action when caring for this patient?
a. Administering prednisone
b. Obtaining a chest radiograph
c. Performing laboratory tests
d. Referring to a specialist
ANS: D
This patient has symptoms of granulomatosis with polyangiitis (GPA) and should be referred as
soon as the disease is suspected. The other actions will be taken, but referral is the most
important.
A 58-year-old man presented to the hospital with right-sided decreased hearing for two
years. His wife mentions he has started snoring recently. He has been a smoker for the last 25
years and smokes up to 20 cigarettes/day. The provider decides to perform a nasendoscopy.
Which key anatomical area is the pathology most likely to be situated in?
A. Right Middle Meatus
2
,Page 3 of 664
B. The roof of the nasal cavity
C. Right vallecula
D. Postnasal space
ANS: D
In a patient with recent-onset unilateral hearing loss and nasal obstruction with a social history
of smoking one must rule out a nasopharyngeal pathology most likely a malignancy. • Any mass
in the nasopharynx can obstruct the medial ends of the eustachian tube leading to problems
with the ears. • Nasopharyngeal cancer can arise from the fossa of Rosenmüller, which lies
behind the eustachian tubes on either side. So a clear look at this area with a nasendoscopy in
high-risk patients with unilateral middle ear effusion is mandatory. • Malignancies in the other
anatomical areas mentioned are obviously possible, but will not cause unilateral middle ear
effusion with conductive hearing loss.
A patient with systemic lupus erythematosus (SLE) develops end-stage renal disease. Because
of the underlying SLE, what treatment is recommended for this patient?
a. Dialysis only
b. Immunosuppressant therapy
c. Kidney transplantation
d. Palliative care
ANS: C
Patients with SLE who develop renal failure may require dialysis and then kidney
transplantation; most who undergo transplant do relatively well because of the
immunosuppression given to prevent graft rejection. Immunosuppressant therapy is given for
3
, Page 4 of 664
graft rejection and does not treat end-stage renal failure. Palliative care is not the only option
for this patient.
A 49-year-old woman admitted to the hospital complaining of severe kidney injury after
being stabbed by a thief. She was diagnosed with acute kidney failure and was referred to the
hemodialysis center. Later on, she decided to undergo a kidney transplantation procedure.
After the procedure was done, the doctor prescribed cyclosporine for her as prophylaxis to
avoid organ rejection. Still, after a month, she came to the hospital complaining of some flu-
like symptoms and fever. The doctor noticed that the previously prescribed drug is not
efficient in reducing immunity. What is the next preferred step to avoid rejection?
A. Prescribe tacrolimus
B. Increase the dose of cyclosporine
C. Prescribe amoxicillin
D. Prescribe paracetamol
ANS: A
Tacrolimus is efficient more than ten folds when compared to cyclosporine. • Calcineurin
inhibitors' dosages should be monitored cautiously as an increase in its blood concentration
could cause many complications like kidney failure. • Cyclosporine, tacrolimus, and
pimecrolimus are called calcineurin inhibitors because they inhibit the enzyme "calcineurin"
that is responsible for T-cell activation. • Tacrolimus is used as an adjuvant to other
immunosuppressive drugs to avoid organ rejection.
A 28-year-old primigravida presented to the antenatal clinic for a routine check-up. She has
been exposed to someone with chickenpox but has not developed any skin lesions. She has
no varicella-zoster antibodies. What would be the best possible treatment for her?
4
