TEST BANK FOR WGU D115 OA / D115 OA
PREP 2026/2027 WITH 450 REAL EXAM
QUESTIONS AND VERIFIED ANSWERS
WITH RATIONALES/ WGU D115 ADVANCED
PATHOPHYSIOLOGY OA
Q1: Which cellular adaptation is most likely to occur in the left ventricle due to chronic
hypertension?
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
Answer: B. Hypertrophy
Rationale: Hypertrophy is an increase in cell size seen in cardiac muscle as it works harder
against high afterload from hypertension. Unlike hyperplasia, cardiac muscle cells cannot divide,
so they increase in size to meet increased workload demands .
Q2: A patient has been diagnosed with a condition characterized by a decrease in cell size.
What is this process called?
A) Hypertrophy
B) Hyperplasia
C) Atrophy
D) Metaplasia
Answer: C. Atrophy
Rationale: Atrophy is a decrease in cell size. It can occur due to disuse, denervation, ischemia,
malnutrition, or aging.
Q3: An APRN observes cellular changes caused by chronic irritation where one adult cell type
is replaced by another. Which term describes this process?
A) Hypertrophy
B) Hyperplasia
,C) Atrophy
D) Metaplasia
Answer: D. Metaplasia
Rationale: Metaplasia is the replacement of one differentiated cell type with another in response
to chronic irritation or injury. An example is the change from columnar to squamous epithelium
in the respiratory tract of smokers .
Q4: Which statement best describes apoptosis?
A) Uncontrolled cell division
B) Programmed cell death without inflammation
C) Cellular swelling due to injury
D) Replacement of one cell type with another
Answer: B. Programmed cell death without inflammation
Rationale: Apoptosis is programmed cell death that occurs without inflammation, essential for
normal cellular turnover. Unlike necrosis, apoptosis does not trigger an inflammatory response.
Q5: A nurse notes increased intracranial pressure in a client after traumatic brain injury.
Which change explains the pathophysiology?
A) Decrease in cerebrospinal fluid production
B) Vasodilation leading to increased cerebral blood volume
C) Increased lymphatic drainage from the brain
D) Reduced capillary permeability
Answer: B. Vasodilation leading to increased cerebral blood volume
Rationale: Cerebral vasodilation increases intracranial volume and pressure. This can lead to
herniation if not managed promptly .
Q6: A patient was rewarmed after suffering from hypothermia. What possible long-term
complication should the NP continue to assess for?
A) Acidosis
B) Dysrhythmias
C) Shock
D) Renal failure
,Answer: B. Dysrhythmias
Rationale: After rewarming from hypothermia, patients are at risk for dysrhythmias due to
electrolyte imbalances and myocardial irritability .
Q7: Which type of genetic disease affects males more frequently than females?
A) Autosomal dominant
B) Autosomal recessive
C) X-linked recessive
D) Mitochondrial
Answer: C. X-linked recessive
Rationale: Males have only one X chromosome, so a single recessive mutation on that X will be
expressed, whereas females have a second X that can mask it .
Q8: Which cellular adaptation is characterized by an increase in the number of cells?
A) Hypertrophy
B) Hyperplasia
C) Atrophy
D) Metaplasia
Answer: B. Hyperplasia
Rationale: Hyperplasia is an increase in cell number, occurring in tissues capable of mitotic
division. It can be physiologic (e.g., breast tissue during pregnancy) or pathologic (e.g., benign
prostatic hyperplasia).
Q9: A patient with chronic kidney disease has a GFR of 42. This indicates:
A) Stage 1 CKD
B) Stage 2 CKD
C) Stage 3 CKD
D) Stage 4 CKD
Answer: C. Stage 3 CKD
Rationale: A GFR of 42 indicates Stage 3 chronic kidney disease (GFR 30-59). At this stage,
kidney function is moderately decreased, and management focuses on slowing progression.
, Q10: Which lab finding indicates metabolic acidosis?
A) pH 7.48, HCO₃⁻ 30 mEq/L
B) pH 7.32, HCO₃⁻ 18 mEq/L
C) pH 7.45, PaCO₂ 30 mm Hg
D) pH 7.36, PaCO₂ 50 mm Hg
Answer: B. pH 7.32, HCO₃⁻ 18 mEq/L
Rationale: Metabolic acidosis is characterized by low pH (< 7.35) and low bicarbonate (< 22
mEq/L). Option A suggests metabolic alkalosis, C suggests respiratory alkalosis, and D suggests
respiratory acidosis .
SECTION II: GENETICS & CONGENITAL DISORDERS
Q11: A patient is choosing to undergo breast removal due to family history of breast cancer.
Genetic testing revealed an abnormal BRCA1 gene. The APRN educates the patient about
additional cancer risks. Which other type of cancer is the patient at risk for developing?
A) Pancreatic
B) Ovarian
C) Colon
D) Lung
Answer: B. Ovarian
Rationale: BRCA1 and BRCA2 mutations significantly increase the risk of both breast and ovarian
cancers. Patients with these mutations should be counseled about risk-reduction strategies for
both cancers.
Q12: A child presents with a white pupillary reflex noted in the right eye. Diagnosis of
retinoblastoma is confirmed. What is the pathological mechanism of this disorder?
A) Mutations of a gene on chromosome 13q14 leading to neoplastic proliferation of cells
B) Deletion of chromosome 5p causing abnormal eye development
C) Trisomy 21 resulting in increased cancer risk
D) Mutation of the RB1 gene on chromosome 17
Answer: A. Mutations of a gene on chromosome 13q14 lead to neoplastic proliferation of cells
PREP 2026/2027 WITH 450 REAL EXAM
QUESTIONS AND VERIFIED ANSWERS
WITH RATIONALES/ WGU D115 ADVANCED
PATHOPHYSIOLOGY OA
Q1: Which cellular adaptation is most likely to occur in the left ventricle due to chronic
hypertension?
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
Answer: B. Hypertrophy
Rationale: Hypertrophy is an increase in cell size seen in cardiac muscle as it works harder
against high afterload from hypertension. Unlike hyperplasia, cardiac muscle cells cannot divide,
so they increase in size to meet increased workload demands .
Q2: A patient has been diagnosed with a condition characterized by a decrease in cell size.
What is this process called?
A) Hypertrophy
B) Hyperplasia
C) Atrophy
D) Metaplasia
Answer: C. Atrophy
Rationale: Atrophy is a decrease in cell size. It can occur due to disuse, denervation, ischemia,
malnutrition, or aging.
Q3: An APRN observes cellular changes caused by chronic irritation where one adult cell type
is replaced by another. Which term describes this process?
A) Hypertrophy
B) Hyperplasia
,C) Atrophy
D) Metaplasia
Answer: D. Metaplasia
Rationale: Metaplasia is the replacement of one differentiated cell type with another in response
to chronic irritation or injury. An example is the change from columnar to squamous epithelium
in the respiratory tract of smokers .
Q4: Which statement best describes apoptosis?
A) Uncontrolled cell division
B) Programmed cell death without inflammation
C) Cellular swelling due to injury
D) Replacement of one cell type with another
Answer: B. Programmed cell death without inflammation
Rationale: Apoptosis is programmed cell death that occurs without inflammation, essential for
normal cellular turnover. Unlike necrosis, apoptosis does not trigger an inflammatory response.
Q5: A nurse notes increased intracranial pressure in a client after traumatic brain injury.
Which change explains the pathophysiology?
A) Decrease in cerebrospinal fluid production
B) Vasodilation leading to increased cerebral blood volume
C) Increased lymphatic drainage from the brain
D) Reduced capillary permeability
Answer: B. Vasodilation leading to increased cerebral blood volume
Rationale: Cerebral vasodilation increases intracranial volume and pressure. This can lead to
herniation if not managed promptly .
Q6: A patient was rewarmed after suffering from hypothermia. What possible long-term
complication should the NP continue to assess for?
A) Acidosis
B) Dysrhythmias
C) Shock
D) Renal failure
,Answer: B. Dysrhythmias
Rationale: After rewarming from hypothermia, patients are at risk for dysrhythmias due to
electrolyte imbalances and myocardial irritability .
Q7: Which type of genetic disease affects males more frequently than females?
A) Autosomal dominant
B) Autosomal recessive
C) X-linked recessive
D) Mitochondrial
Answer: C. X-linked recessive
Rationale: Males have only one X chromosome, so a single recessive mutation on that X will be
expressed, whereas females have a second X that can mask it .
Q8: Which cellular adaptation is characterized by an increase in the number of cells?
A) Hypertrophy
B) Hyperplasia
C) Atrophy
D) Metaplasia
Answer: B. Hyperplasia
Rationale: Hyperplasia is an increase in cell number, occurring in tissues capable of mitotic
division. It can be physiologic (e.g., breast tissue during pregnancy) or pathologic (e.g., benign
prostatic hyperplasia).
Q9: A patient with chronic kidney disease has a GFR of 42. This indicates:
A) Stage 1 CKD
B) Stage 2 CKD
C) Stage 3 CKD
D) Stage 4 CKD
Answer: C. Stage 3 CKD
Rationale: A GFR of 42 indicates Stage 3 chronic kidney disease (GFR 30-59). At this stage,
kidney function is moderately decreased, and management focuses on slowing progression.
, Q10: Which lab finding indicates metabolic acidosis?
A) pH 7.48, HCO₃⁻ 30 mEq/L
B) pH 7.32, HCO₃⁻ 18 mEq/L
C) pH 7.45, PaCO₂ 30 mm Hg
D) pH 7.36, PaCO₂ 50 mm Hg
Answer: B. pH 7.32, HCO₃⁻ 18 mEq/L
Rationale: Metabolic acidosis is characterized by low pH (< 7.35) and low bicarbonate (< 22
mEq/L). Option A suggests metabolic alkalosis, C suggests respiratory alkalosis, and D suggests
respiratory acidosis .
SECTION II: GENETICS & CONGENITAL DISORDERS
Q11: A patient is choosing to undergo breast removal due to family history of breast cancer.
Genetic testing revealed an abnormal BRCA1 gene. The APRN educates the patient about
additional cancer risks. Which other type of cancer is the patient at risk for developing?
A) Pancreatic
B) Ovarian
C) Colon
D) Lung
Answer: B. Ovarian
Rationale: BRCA1 and BRCA2 mutations significantly increase the risk of both breast and ovarian
cancers. Patients with these mutations should be counseled about risk-reduction strategies for
both cancers.
Q12: A child presents with a white pupillary reflex noted in the right eye. Diagnosis of
retinoblastoma is confirmed. What is the pathological mechanism of this disorder?
A) Mutations of a gene on chromosome 13q14 leading to neoplastic proliferation of cells
B) Deletion of chromosome 5p causing abnormal eye development
C) Trisomy 21 resulting in increased cancer risk
D) Mutation of the RB1 gene on chromosome 17
Answer: A. Mutations of a gene on chromosome 13q14 lead to neoplastic proliferation of cells
