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WGU D027 Nursing Care & Pharmacology in
Older Adults Objective Assessment – Latest
Exam with Complete 400 Questions and
Verified Answers
Official Exam Overview:
The WGU D027 OA evaluates learners’ knowledge and practical application of nursing care for
older adults, including pharmacologic interventions for hematologic, oncologic, and hormone-
sensitive conditions. The exam emphasizes drug mechanisms, therapeutic effects, and nursing
considerations for medications used to treat cancers, leukemia, and age-related comorbidities.
Candidates are expected to identify medications based on their mechanism of action, target tissues,
and clinical use, as well as understand adverse effects and combination therapy strategies.
Exam Coverage Areas:
• Pharmacology for older adults
• Hematologic malignancies (leukemia and lymphoma)
• Oncologic drug therapy, including combination regimens
• Mechanism of action of drugs targeting lymphoid tissue
• Hormone receptor-positive cancers and SERMs (e.g., Tamoxifen)
• Glucocorticoids: indications, effects, and nursing considerations
• Monitoring for therapeutic outcomes and adverse effects
QUESTION 1:
Which drug is directly toxic to lymphoid tissues and used in combination therapy to treat leukemia?
A) Tamoxifen
B) Glucocorticoids ✅
C) Selective serotonin reuptake inhibitors (SSRIs)
D) NSAIDs
Rationale:
Glucocorticoids are cytotoxic to lymphoid tissue and are often combined with other agents in
leukemia treatment regimens, helping reduce lymphocyte proliferation and manage disease
progression.
QUESTION 2:
Tamoxifen, a selective estrogen receptor modulator (SERM), is primarily used for which condition?
A) Lymphoid leukemia
B) Hormone receptor-positive and advanced breast cancer ✅
,C) Osteoporosis
D) Hypertension
Rationale:
Tamoxifen binds to estrogen receptors in breast tissue, reducing recurrence risk and treating
hormone-sensitive breast cancers.
QUESTION 3:
Why are glucocorticoids often combined with other chemotherapy agents in leukemia treatment?
A) To increase estrogen receptor activation
B) To provide a synergistic cytotoxic effect on lymphoid cells ✅
C) To prevent hair loss
D) To enhance kidney function
Rationale:
Glucocorticoids enhance lymphoid tissue destruction when used with other agents, improving
treatment efficacy in leukemia.
QUESTION 4:
Which of the following is an important nursing consideration when administering glucocorticoids for
leukemia?
A) Monitor for hyperglycemia ✅
B) Monitor estrogen levels
C) Monitor only blood pressure
D) Avoid monitoring lab values
Rationale:
Glucocorticoids can cause hyperglycemia, immunosuppression, and fluid retention, requiring
careful monitoring in older adults.
QUESTION 5:
What is the primary therapeutic goal of using SERMs like Tamoxifen in breast cancer?
A) Enhance lymphocyte proliferation
B) Reduce hormone receptor-positive tumor growth and recurrence ✅
C) Increase estrogen production
D) Replace chemotherapy
Rationale:
SERMs block estrogen receptors in breast tissue, slowing or preventing tumor growth and
reducing recurrence risk in hormone receptor-positive breast cancer.
,What drug is used in combination with other agent to treat lymphoid tissue (leukemia). Directly
toxic to lymphoid tissues Selective estrogen receptor modulators (SERM) - for hormone
receptor positive and advanced breast cancer. (Tomaxafin - reduces risk and recurrence risk) -
ANSWER-Glucocorticoids
What is the normal ejection fraction? - ANSWER-55-60%. Less than 50% is BAD
Is an ejection fraction of 50% reduced or preserved? - ANSWER-Preserved
What are symptoms of left sided heart failure? - ANSWER-Think PULMONARY. JVD, FVO, rails,
S3 murmurs. Number one cause of right sided heart failure!
What are symptoms of right sided heart failure? - ANSWER-Think peripheral vascular. Lower
extremity edema, abdominal distension.
What is the gold standard lab test for heart failure? - ANSWER-BNP. Heart failure is a result
greater than 100
What heart disease is worse with exertion? - ANSWER-Ischemic heart disease because the
demand requirements are higher.
What should you assess before giving Digoxin? - ANSWER-Apical pulse
1
, Page 2 of 120
How should Warfarin be started? - ANSWER-Start initial dose at half to monitor the effects
What causes the destruction of alveolar walls? Air goes in but can't get out which leads to
hyperinflation - ANSWER-Emphysema
What causes excess mucus production and smooth muscle hypertrophy? - ANSWER-Bronchitis
What is a chronic inflammatory obstruction of bronchi? - ANSWER-Asthma, Triggers cause
mucus to clog bronchial tubes.
What organ does cystic fibrosis affect? - ANSWER-Affects the pancreas causing secretions into
the lungs
What is Klinefelter syndrome? - ANSWER-An extra X chromosome for males so example XXY
causing female-like qualities
What is Turner Syndrome? - ANSWER-females. missing or deformed x chromosome. right
hemisphere dysfunction, hearing loss, ear infection, language and articulation disorders, visual
spatial and attentional problems
What is beta thalassemia? - ANSWER-a condition in which the synthesis of the beta-globin
chains is decreased or absent. Causes low hemoglobin.
Which medication is contraindicated in a patient with Beta Thalassemia? - ANSWER-Ferrous
Sulfate
2
WGU D027 Nursing Care & Pharmacology in
Older Adults Objective Assessment – Latest
Exam with Complete 400 Questions and
Verified Answers
Official Exam Overview:
The WGU D027 OA evaluates learners’ knowledge and practical application of nursing care for
older adults, including pharmacologic interventions for hematologic, oncologic, and hormone-
sensitive conditions. The exam emphasizes drug mechanisms, therapeutic effects, and nursing
considerations for medications used to treat cancers, leukemia, and age-related comorbidities.
Candidates are expected to identify medications based on their mechanism of action, target tissues,
and clinical use, as well as understand adverse effects and combination therapy strategies.
Exam Coverage Areas:
• Pharmacology for older adults
• Hematologic malignancies (leukemia and lymphoma)
• Oncologic drug therapy, including combination regimens
• Mechanism of action of drugs targeting lymphoid tissue
• Hormone receptor-positive cancers and SERMs (e.g., Tamoxifen)
• Glucocorticoids: indications, effects, and nursing considerations
• Monitoring for therapeutic outcomes and adverse effects
QUESTION 1:
Which drug is directly toxic to lymphoid tissues and used in combination therapy to treat leukemia?
A) Tamoxifen
B) Glucocorticoids ✅
C) Selective serotonin reuptake inhibitors (SSRIs)
D) NSAIDs
Rationale:
Glucocorticoids are cytotoxic to lymphoid tissue and are often combined with other agents in
leukemia treatment regimens, helping reduce lymphocyte proliferation and manage disease
progression.
QUESTION 2:
Tamoxifen, a selective estrogen receptor modulator (SERM), is primarily used for which condition?
A) Lymphoid leukemia
B) Hormone receptor-positive and advanced breast cancer ✅
,C) Osteoporosis
D) Hypertension
Rationale:
Tamoxifen binds to estrogen receptors in breast tissue, reducing recurrence risk and treating
hormone-sensitive breast cancers.
QUESTION 3:
Why are glucocorticoids often combined with other chemotherapy agents in leukemia treatment?
A) To increase estrogen receptor activation
B) To provide a synergistic cytotoxic effect on lymphoid cells ✅
C) To prevent hair loss
D) To enhance kidney function
Rationale:
Glucocorticoids enhance lymphoid tissue destruction when used with other agents, improving
treatment efficacy in leukemia.
QUESTION 4:
Which of the following is an important nursing consideration when administering glucocorticoids for
leukemia?
A) Monitor for hyperglycemia ✅
B) Monitor estrogen levels
C) Monitor only blood pressure
D) Avoid monitoring lab values
Rationale:
Glucocorticoids can cause hyperglycemia, immunosuppression, and fluid retention, requiring
careful monitoring in older adults.
QUESTION 5:
What is the primary therapeutic goal of using SERMs like Tamoxifen in breast cancer?
A) Enhance lymphocyte proliferation
B) Reduce hormone receptor-positive tumor growth and recurrence ✅
C) Increase estrogen production
D) Replace chemotherapy
Rationale:
SERMs block estrogen receptors in breast tissue, slowing or preventing tumor growth and
reducing recurrence risk in hormone receptor-positive breast cancer.
,What drug is used in combination with other agent to treat lymphoid tissue (leukemia). Directly
toxic to lymphoid tissues Selective estrogen receptor modulators (SERM) - for hormone
receptor positive and advanced breast cancer. (Tomaxafin - reduces risk and recurrence risk) -
ANSWER-Glucocorticoids
What is the normal ejection fraction? - ANSWER-55-60%. Less than 50% is BAD
Is an ejection fraction of 50% reduced or preserved? - ANSWER-Preserved
What are symptoms of left sided heart failure? - ANSWER-Think PULMONARY. JVD, FVO, rails,
S3 murmurs. Number one cause of right sided heart failure!
What are symptoms of right sided heart failure? - ANSWER-Think peripheral vascular. Lower
extremity edema, abdominal distension.
What is the gold standard lab test for heart failure? - ANSWER-BNP. Heart failure is a result
greater than 100
What heart disease is worse with exertion? - ANSWER-Ischemic heart disease because the
demand requirements are higher.
What should you assess before giving Digoxin? - ANSWER-Apical pulse
1
, Page 2 of 120
How should Warfarin be started? - ANSWER-Start initial dose at half to monitor the effects
What causes the destruction of alveolar walls? Air goes in but can't get out which leads to
hyperinflation - ANSWER-Emphysema
What causes excess mucus production and smooth muscle hypertrophy? - ANSWER-Bronchitis
What is a chronic inflammatory obstruction of bronchi? - ANSWER-Asthma, Triggers cause
mucus to clog bronchial tubes.
What organ does cystic fibrosis affect? - ANSWER-Affects the pancreas causing secretions into
the lungs
What is Klinefelter syndrome? - ANSWER-An extra X chromosome for males so example XXY
causing female-like qualities
What is Turner Syndrome? - ANSWER-females. missing or deformed x chromosome. right
hemisphere dysfunction, hearing loss, ear infection, language and articulation disorders, visual
spatial and attentional problems
What is beta thalassemia? - ANSWER-a condition in which the synthesis of the beta-globin
chains is decreased or absent. Causes low hemoglobin.
Which medication is contraindicated in a patient with Beta Thalassemia? - ANSWER-Ferrous
Sulfate
2
