Page 1 of 138
WGU D236 Pathophysiology - OA & PA Exam
LATEST 2026-2027 ACTUAL EXAM 300 QUESTIONS
WITH CORRECT SOLUTIONS AND RATIONALES JUST
RELEASED THIS YEAR
1. A 55-year-old male with a 30-pack-year smoking history presents with a chronic cough,
hemoptysis, and weight loss. A chest X-ray reveals a hilar mass. What is the most likely
underlying cellular change?
A) Hyperplasia
B) Metaplasia
C) Dysplasia
D) Anaplasia
Answer: D) Anaplasia refers to poorly differentiated cells with loss of normal architecture,
characteristic of malignant transformation in lung cancer.
2. A 45-year-old female with rheumatoid arthritis is on long-term corticosteroid therapy. She
presents with a sudden onset of severe back pain after sneezing. What is the most likely
diagnosis?
A) Muscle strain
B) Vertebral compression fracture
, Page 2 of 138
C) Renal calculi
D) Degenerative disc disease
Answer: B) Chronic corticosteroid use causes osteoporosis, increasing the risk of vertebral
compression fractures from minor trauma.
3. A 62-year-old male with a history of hypertension presents with a sudden, severe "tearing"
chest pain that radiates to his back. His blood pressure is 180/110 mmHg in the right arm and
110/70 in the left. What is the most likely diagnosis?
A) Myocardial infarction
B) Pulmonary embolism
C) Aortic dissection
D) Pericarditis
Answer: C) Aortic dissection presents with acute tearing chest pain and a pulse/blood pressure
differential between arms.
4. A 28-year-old female presents with fatigue, joint pain, and a malar rash that worsens with
sun exposure. She also has oral ulcers. Which autoantibody is most specific for this condition?
A) Anti-dsDNA
B) Rheumatoid factor
, Page 3 of 138
C) Antinuclear antibody
D) Anti-Sm
Answer: A) Anti-dsDNA is highly specific for systemic lupus erythematosus (SLE), though ANA is
more sensitive.
5. A 3-year-old child presents with fever, cough, and a "barking" cough that is worse at night.
The child is sitting upright and drooling. What is the most appropriate immediate action?
A) Nebulized epinephrine
B) Oral dexamethasone
C) Prepare for intubation
D) Chest X-ray
Answer: C) Drooling and tripod positioning suggest epiglottitis, a medical emergency requiring
airway support; do not manipulate the airway.
6. A 58-year-old diabetic patient presents with a non-healing ulcer on the plantar surface of
the foot. The wound is painless, well-circumscribed, and surrounded by callus. What is the
primary underlying cause?
A) Peripheral artery disease
B) Venous insufficiency
, Page 4 of 138
C) Diabetic neuropathy
D) Osteomyelitis
Answer: C) Loss of protective sensation due to diabetic neuropathy leads to painless plantar
ulcers from repeated trauma.
7. A 70-year-old female with a history of heart failure presents with worsening dyspnea,
orthopnea, and peripheral edema. She has gained 5 lbs in 3 days. Which medication is most
appropriate initially?
A) Digoxin
B) Furosemide
C) Carvedilol
D) Lisinopril
Answer: B) Loop diuretics like furosemide are first-line for acute volume overload in heart failure
exacerbation.
8. A 32-year-old G1P0 at 28 weeks gestation presents with headache, visual changes, and
epigastric pain. BP is 165/105 mmHg with 3+ proteinuria. What is the priority treatment?
A) Labetalol
B) Magnesium sulfate
WGU D236 Pathophysiology - OA & PA Exam
LATEST 2026-2027 ACTUAL EXAM 300 QUESTIONS
WITH CORRECT SOLUTIONS AND RATIONALES JUST
RELEASED THIS YEAR
1. A 55-year-old male with a 30-pack-year smoking history presents with a chronic cough,
hemoptysis, and weight loss. A chest X-ray reveals a hilar mass. What is the most likely
underlying cellular change?
A) Hyperplasia
B) Metaplasia
C) Dysplasia
D) Anaplasia
Answer: D) Anaplasia refers to poorly differentiated cells with loss of normal architecture,
characteristic of malignant transformation in lung cancer.
2. A 45-year-old female with rheumatoid arthritis is on long-term corticosteroid therapy. She
presents with a sudden onset of severe back pain after sneezing. What is the most likely
diagnosis?
A) Muscle strain
B) Vertebral compression fracture
, Page 2 of 138
C) Renal calculi
D) Degenerative disc disease
Answer: B) Chronic corticosteroid use causes osteoporosis, increasing the risk of vertebral
compression fractures from minor trauma.
3. A 62-year-old male with a history of hypertension presents with a sudden, severe "tearing"
chest pain that radiates to his back. His blood pressure is 180/110 mmHg in the right arm and
110/70 in the left. What is the most likely diagnosis?
A) Myocardial infarction
B) Pulmonary embolism
C) Aortic dissection
D) Pericarditis
Answer: C) Aortic dissection presents with acute tearing chest pain and a pulse/blood pressure
differential between arms.
4. A 28-year-old female presents with fatigue, joint pain, and a malar rash that worsens with
sun exposure. She also has oral ulcers. Which autoantibody is most specific for this condition?
A) Anti-dsDNA
B) Rheumatoid factor
, Page 3 of 138
C) Antinuclear antibody
D) Anti-Sm
Answer: A) Anti-dsDNA is highly specific for systemic lupus erythematosus (SLE), though ANA is
more sensitive.
5. A 3-year-old child presents with fever, cough, and a "barking" cough that is worse at night.
The child is sitting upright and drooling. What is the most appropriate immediate action?
A) Nebulized epinephrine
B) Oral dexamethasone
C) Prepare for intubation
D) Chest X-ray
Answer: C) Drooling and tripod positioning suggest epiglottitis, a medical emergency requiring
airway support; do not manipulate the airway.
6. A 58-year-old diabetic patient presents with a non-healing ulcer on the plantar surface of
the foot. The wound is painless, well-circumscribed, and surrounded by callus. What is the
primary underlying cause?
A) Peripheral artery disease
B) Venous insufficiency
, Page 4 of 138
C) Diabetic neuropathy
D) Osteomyelitis
Answer: C) Loss of protective sensation due to diabetic neuropathy leads to painless plantar
ulcers from repeated trauma.
7. A 70-year-old female with a history of heart failure presents with worsening dyspnea,
orthopnea, and peripheral edema. She has gained 5 lbs in 3 days. Which medication is most
appropriate initially?
A) Digoxin
B) Furosemide
C) Carvedilol
D) Lisinopril
Answer: B) Loop diuretics like furosemide are first-line for acute volume overload in heart failure
exacerbation.
8. A 32-year-old G1P0 at 28 weeks gestation presents with headache, visual changes, and
epigastric pain. BP is 165/105 mmHg with 3+ proteinuria. What is the priority treatment?
A) Labetalol
B) Magnesium sulfate
