WGU D115 OA ADVANCED PATHOPHYSIOLOGY
EXAM 2 2026 | ACTUAL EXAM QUESTIONS WITH
DETAILED ANSWERS WITH RATIONALES AND A
READINESS PRACTICE EXAM WITH A STUDY GUIDE
RATED A GRADE.
1. An advanced practice registered nurse (APRN) is working with patients at
an eating disorder clinic. One patient is a 64-year-old woman with a long
history of anorexia nervosa. Which health promotion intervention is
appropriate for this patient considering complications of her disease process?
A. Encouraging high-impact aerobic exercise
B. Recommending daily calcium and vitamin D supplements
C. Prescribing a cholesterol-lowering medication
D. Ordering a screening colonoscopy and antidiarrheal medication
Rationale: This patient is at high risk of osteoporosis and stress fractures due to
the extensive history of anorexia nervosa. The body changes its hormone
production in response to low body weight, which negatively affects bone growth
and strength. Calcium and vitamin D supplementation helps mitigate bone loss.
2. A young adult patient and the patient's spouse are meeting with an APRN
for a fertility consultation. The patient's spouse is of African American
descent. Which genetic condition has the highest prevalence in African
Americans?
A. Cystic fibrosis
B. Sickle cell anemia
C. Huntington disease
D. Tay-Sachs disease
Rationale: Sickle cell disease has an increased prevalence in African Americans (1
in 600). It is an autosomal recessive disorder caused by a mutation in the
hemoglobin beta chain gene on chromosome 11.
,3. A patient with a basal metabolic index (BMI) of 29 is seen by an APRN to
discuss routine health maintenance. The patient reports a strong family
history of colorectal cancer and has hypertension and normal cholesterol.
Which primary recommendation should the APRN make to decrease the risk
of colorectal cancer?
A. Multiple vitamin with iron daily
B. Exercise of one hour daily
C. Low-fat dietary intake daily
D. Two glasses of red wine daily
Rationale: A high-fat diet raises the risk of colorectal cancer. It would be
important for this patient who has a familial risk (nonmodifiable) for colorectal
cancer to decrease as many modifiable risks as possible, including dietary fat
intake.
4. A patient undergoes surgical consultation for the removal of scar tissue.
The APRN explains that keloid formation occurs during which phase of
healing?
A. Inflammation
B. Proliferation
C. Reconstruction
D. Hemostasis
Rationale: Keloid formation occurs during reconstruction and is a dysfunctional
collagen synthesis, which may involve excessive production of collagen, causing
surface over-healing and leading to a hypertrophic scar or keloid. A hypertrophic
scar is raised but remains within the original boundaries of the wound and tends to
regress over time. A keloid is a raised scar that extends beyond the original
boundaries of the wound, invades surrounding tissue, and is likely to recur after
surgical removal.
5. An APRN is consulting with a patient during a scheduled well-child visit.
The mother informs the APRN that her father-in-law has been diagnosed with
Huntington disease. The mother, husband, and her male child may also have
,the disease. The APRN explains the disease is autosomal dominant and age-
dependent and suggests testing for the mother, husband, and child. Which
additional information should the APRN provide for this type of
transmission?
A. Both parents must carry the autosomal dominant gene for the child to have the
condition
B. Men are more likely to exhibit autosomal dominant diseases than women
C. Autosomal dominant diseases usually have a 50% recurrence risk
D. Autosomal dominant diseases typically have no treatments
Rationale: Autosomal dominant is a pattern of inheritance in which an affected
individual has one copy of a mutant gene (one parent) and one normal gene on a
pair of autosomal chromosomes. Autosomal recessive diseases require that the
individual have two copies of the mutant gene. Individuals with autosomal
dominant diseases are at 50% risk for developing the disease.
6. Which electrolyte imbalance is most commonly associated with chronic
diuretic use?
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hypermagnesemia
Rationale: Loop and thiazide diuretics cause potassium wasting, leading to
hypokalemia. This can result in cardiac arrhythmias and muscle weakness.
7. A patient with chronic kidney disease has a serum potassium of 6.5 mEq/L.
Which ECG finding is expected?
A. U waves
B. Peaked T waves
C. Prolonged PR interval
D. ST-segment depression
, Rationale: Hyperkalemia causes peaked (tall, tented) T waves on ECG. U waves
are associated with hypokalemia. Hyperkalemia can progress to life-threatening
arrhythmias.
8. Which acid-base imbalance is expected in a patient with severe vomiting?
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic alkalosis
D. Metabolic acidosis
Rationale: Severe vomiting leads to loss of gastric acid (hydrochloric acid),
causing metabolic alkalosis. The bicarbonate concentration increases relative to
acid.
9. A patient with diabetic ketoacidosis (DKA) has an arterial blood gas
showing pH 7.25, HCO3 14 mEq/L, and PaCO2 30 mmHg. This indicates:
A. Metabolic acidosis with respiratory compensation
B. Metabolic acidosis without compensation
C. Respiratory acidosis with metabolic compensation
D. Metabolic alkalosis
Rationale: Low pH (7.25) and low HCO3 (14) indicate metabolic acidosis. The
low PaCO2 (30) indicates respiratory compensation (hyperventilation) to blow off
CO2.
10. Which cellular adaptation is characterized by an increase in cell size?
A. Hyperplasia
B. Hypertrophy
C. Atrophy
D. Metaplasia
Rationale: Hypertrophy is an increase in cell size, often in response to increased
workload (e.g., cardiac muscle in hypertension). Hyperplasia is an increase in cell
number.
EXAM 2 2026 | ACTUAL EXAM QUESTIONS WITH
DETAILED ANSWERS WITH RATIONALES AND A
READINESS PRACTICE EXAM WITH A STUDY GUIDE
RATED A GRADE.
1. An advanced practice registered nurse (APRN) is working with patients at
an eating disorder clinic. One patient is a 64-year-old woman with a long
history of anorexia nervosa. Which health promotion intervention is
appropriate for this patient considering complications of her disease process?
A. Encouraging high-impact aerobic exercise
B. Recommending daily calcium and vitamin D supplements
C. Prescribing a cholesterol-lowering medication
D. Ordering a screening colonoscopy and antidiarrheal medication
Rationale: This patient is at high risk of osteoporosis and stress fractures due to
the extensive history of anorexia nervosa. The body changes its hormone
production in response to low body weight, which negatively affects bone growth
and strength. Calcium and vitamin D supplementation helps mitigate bone loss.
2. A young adult patient and the patient's spouse are meeting with an APRN
for a fertility consultation. The patient's spouse is of African American
descent. Which genetic condition has the highest prevalence in African
Americans?
A. Cystic fibrosis
B. Sickle cell anemia
C. Huntington disease
D. Tay-Sachs disease
Rationale: Sickle cell disease has an increased prevalence in African Americans (1
in 600). It is an autosomal recessive disorder caused by a mutation in the
hemoglobin beta chain gene on chromosome 11.
,3. A patient with a basal metabolic index (BMI) of 29 is seen by an APRN to
discuss routine health maintenance. The patient reports a strong family
history of colorectal cancer and has hypertension and normal cholesterol.
Which primary recommendation should the APRN make to decrease the risk
of colorectal cancer?
A. Multiple vitamin with iron daily
B. Exercise of one hour daily
C. Low-fat dietary intake daily
D. Two glasses of red wine daily
Rationale: A high-fat diet raises the risk of colorectal cancer. It would be
important for this patient who has a familial risk (nonmodifiable) for colorectal
cancer to decrease as many modifiable risks as possible, including dietary fat
intake.
4. A patient undergoes surgical consultation for the removal of scar tissue.
The APRN explains that keloid formation occurs during which phase of
healing?
A. Inflammation
B. Proliferation
C. Reconstruction
D. Hemostasis
Rationale: Keloid formation occurs during reconstruction and is a dysfunctional
collagen synthesis, which may involve excessive production of collagen, causing
surface over-healing and leading to a hypertrophic scar or keloid. A hypertrophic
scar is raised but remains within the original boundaries of the wound and tends to
regress over time. A keloid is a raised scar that extends beyond the original
boundaries of the wound, invades surrounding tissue, and is likely to recur after
surgical removal.
5. An APRN is consulting with a patient during a scheduled well-child visit.
The mother informs the APRN that her father-in-law has been diagnosed with
Huntington disease. The mother, husband, and her male child may also have
,the disease. The APRN explains the disease is autosomal dominant and age-
dependent and suggests testing for the mother, husband, and child. Which
additional information should the APRN provide for this type of
transmission?
A. Both parents must carry the autosomal dominant gene for the child to have the
condition
B. Men are more likely to exhibit autosomal dominant diseases than women
C. Autosomal dominant diseases usually have a 50% recurrence risk
D. Autosomal dominant diseases typically have no treatments
Rationale: Autosomal dominant is a pattern of inheritance in which an affected
individual has one copy of a mutant gene (one parent) and one normal gene on a
pair of autosomal chromosomes. Autosomal recessive diseases require that the
individual have two copies of the mutant gene. Individuals with autosomal
dominant diseases are at 50% risk for developing the disease.
6. Which electrolyte imbalance is most commonly associated with chronic
diuretic use?
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hypermagnesemia
Rationale: Loop and thiazide diuretics cause potassium wasting, leading to
hypokalemia. This can result in cardiac arrhythmias and muscle weakness.
7. A patient with chronic kidney disease has a serum potassium of 6.5 mEq/L.
Which ECG finding is expected?
A. U waves
B. Peaked T waves
C. Prolonged PR interval
D. ST-segment depression
, Rationale: Hyperkalemia causes peaked (tall, tented) T waves on ECG. U waves
are associated with hypokalemia. Hyperkalemia can progress to life-threatening
arrhythmias.
8. Which acid-base imbalance is expected in a patient with severe vomiting?
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic alkalosis
D. Metabolic acidosis
Rationale: Severe vomiting leads to loss of gastric acid (hydrochloric acid),
causing metabolic alkalosis. The bicarbonate concentration increases relative to
acid.
9. A patient with diabetic ketoacidosis (DKA) has an arterial blood gas
showing pH 7.25, HCO3 14 mEq/L, and PaCO2 30 mmHg. This indicates:
A. Metabolic acidosis with respiratory compensation
B. Metabolic acidosis without compensation
C. Respiratory acidosis with metabolic compensation
D. Metabolic alkalosis
Rationale: Low pH (7.25) and low HCO3 (14) indicate metabolic acidosis. The
low PaCO2 (30) indicates respiratory compensation (hyperventilation) to blow off
CO2.
10. Which cellular adaptation is characterized by an increase in cell size?
A. Hyperplasia
B. Hypertrophy
C. Atrophy
D. Metaplasia
Rationale: Hypertrophy is an increase in cell size, often in response to increased
workload (e.g., cardiac muscle in hypertension). Hyperplasia is an increase in cell
number.
