WGU D116 NETWORK AND SECURITY FOUNDATIONS (PDF)
| 2026 EXAM QUESTIONS AND ANSWERS + RATIONALES |
STUDY GUIDE | 100% CORRECT
1. A 14-year-old male patient who plays football is admitted to the hospital. The nurse
practitioner notes that the patient has short stature for his age according to a standard
growth chart. The patient is muscular, has a deep voice, and needs to shave. The NP
should order:
A) Liver function tests and serum electrolytes
B) Bone age and testosterone levels
C) Growth hormone stimulation test
D) Thyroid function tests
Correct Answer: B) Bone age and testosterone levels
Rationale: The patient's presentation—short stature with advanced secondary sexual
characteristics (deep voice, muscular build, need to shave)—suggests possible precocious
puberty or an androgen-secreting tumor . Bone age and testosterone levels would help evaluate
this. Precocious puberty causes early epiphyseal closure, leading to short adult stature .
2. A patient asks his provider to explain what drug tolerance means. The provider responds
by telling the patient that when tolerance occurs, it means the patient __________.
A) has developed a psychological dependence on the drug
B) may need increased amounts of the drug over time
C) will cause an abstinence syndrome if the drug is discontinued abruptly
D) will have increased sensitivity to drug side effects
Correct Answer: B) may need increased amounts of the drug over time
Rationale: When tolerance develops, a dose increase may be needed because a decreased
response may occur with prolonged use . Psychological dependence involves cravings, physical
dependence involves withdrawal symptoms, and sensitivity to side effects typically decreases
with adaptation .
3. A group of nursing students asks a nurse to explain the blood-brain barrier. The nurse
would be correct to say that the blood-brain barrier __________.
A) prevents some potentially toxic substances from crossing into the central nervous
system
B) causes infants to be less sensitive to CNS drugs and thus require larger doses
C) allows only ionized or protein-bound drugs to cross into the central nervous system
D) prevents lipid-soluble drugs from entering the central nervous system
Correct Answer: A) prevents some potentially toxic substances from crossing into the central
nervous system
,Rationale: The blood-brain barrier prevents some potentially toxic substances from crossing into
the central nervous system . It is not fully developed at birth, making infants more sensitive to
CNS drugs . The BBB allows lipid-soluble drugs to cross; it prevents highly ionized or protein-
bound drugs from crossing .
4. Which vitamin B deficiency is associated with cheilosis, glossitis, vascularization of the
cornea, and itchy dermatitis of the scrotum and vulva?
A) Thiamine (Vitamin B1)
B) Riboflavin (Vitamin B2)
C) Niacin (Vitamin B3)
D) Pyridoxine (Vitamin B6)
Correct Answer: B) Riboflavin (Vitamin B2)
Rationale: Riboflavin (Vitamin B2) deficiency is associated with cheilosis (cracked lips),
glossitis (swollen tongue), vascularization of the cornea, and itchy dermatitis of the scrotum and
vulva . Thiamine deficiency causes beriberi and Wernicke-Korsakoff syndrome, niacin
deficiency causes pellagra, and pyridoxine deficiency causes peripheral neuropathy .
5. A patient who is known to be a heavy drinker is brought to the emergency department
with ataxia and confusion. The patient cannot remember the events of the previous day.
The examination reveals nystagmus, and the patient reports having double vision. Which
vitamin should the provider order for this patient?
A) Riboflavin (Vitamin B2)
B) Niacin (Vitamin B3)
C) Thiamine (Vitamin B1)
D) Vitamin B12
Correct Answer: C) Thiamine (Vitamin B1)
Rationale: This patient is presenting with Wernicke-Korsakoff syndrome, characterized by the
classic triad of ataxia, confusion, and ophthalmoplegia/nystagmus . It is caused by thiamine
(Vitamin B1) deficiency, commonly seen in chronic alcohol use disorder .
6. A patient is taking a medication that undergoes significant first-pass metabolism. The
provider is considering changing the route of administration. Which route would
completely bypass the first-pass effect?
A) Oral
B) Sublingual
C) Rectal
D) Intramuscular
Correct Answer: B) Sublingual
Rationale: Sublingual administration bypasses the first-pass effect because the drug is absorbed
directly into the systemic circulation via the rich venous plexus under the tongue, avoiding the
, hepatic portal system . Oral and rectal routes are subject to first-pass metabolism, and
intramuscular administration partially bypasses it but not completely.
7. A drug has a half-life of 8 hours. Approximately how long will it take to reach steady
state?
A) 8 hours
B) 16 hours
C) 32 hours
D) 40 hours
Correct Answer: D) 40 hours
Rationale: Steady state is typically achieved after approximately 4-5 half-lives . With an 8-hour
half-life: 8 hours x 5 = 40 hours. One half-life (8 hours) is insufficient for accumulation, two
half-lives (16 hours) is approximately 75% of steady state, and four half-lives (32 hours) is close
but slightly less than the standard 4-5 half-life rule.
8. A patient on warfarin is prescribed amiodarone. The NP should anticipate:
A) Decreased INR, increase warfarin dose
B) Increased INR, decrease warfarin dose
C) No interaction
D) Switch to heparin
Correct Answer: B) Increased INR, decrease warfarin dose
Rationale: Amiodarone inhibits CYP2C9 and CYP3A4, which metabolize warfarin, leading to
decreased warfarin metabolism and increased INR . The warfarin dose should be reduced by 30-
50% to prevent bleeding complications. Regular INR monitoring is essential when these drugs
are used together.
9. A patient is prescribed lisinopril and develops a dry cough. What is the mechanism for
this side effect?
A) Angiotensin II blockade
B) Bradykinin accumulation
C) Histamine release
D) Direct airway irritation
Correct Answer: B) Bradykinin accumulation
Rationale: ACE inhibitors prevent the breakdown of bradykinin, leading to its accumulation,
which causes a dry cough and angioedema . ARBs do not affect bradykinin and are less likely to
cause this side effect. Angiotensin II blockade is the therapeutic mechanism, not the cause of
cough.
10. A patient with type 2 diabetes and heart failure is prescribed an SGLT-2 inhibitor. The
nurse understands that this drug class:
A) Increases the risk of hypoglycemia
B) Reduces cardiovascular mortality
| 2026 EXAM QUESTIONS AND ANSWERS + RATIONALES |
STUDY GUIDE | 100% CORRECT
1. A 14-year-old male patient who plays football is admitted to the hospital. The nurse
practitioner notes that the patient has short stature for his age according to a standard
growth chart. The patient is muscular, has a deep voice, and needs to shave. The NP
should order:
A) Liver function tests and serum electrolytes
B) Bone age and testosterone levels
C) Growth hormone stimulation test
D) Thyroid function tests
Correct Answer: B) Bone age and testosterone levels
Rationale: The patient's presentation—short stature with advanced secondary sexual
characteristics (deep voice, muscular build, need to shave)—suggests possible precocious
puberty or an androgen-secreting tumor . Bone age and testosterone levels would help evaluate
this. Precocious puberty causes early epiphyseal closure, leading to short adult stature .
2. A patient asks his provider to explain what drug tolerance means. The provider responds
by telling the patient that when tolerance occurs, it means the patient __________.
A) has developed a psychological dependence on the drug
B) may need increased amounts of the drug over time
C) will cause an abstinence syndrome if the drug is discontinued abruptly
D) will have increased sensitivity to drug side effects
Correct Answer: B) may need increased amounts of the drug over time
Rationale: When tolerance develops, a dose increase may be needed because a decreased
response may occur with prolonged use . Psychological dependence involves cravings, physical
dependence involves withdrawal symptoms, and sensitivity to side effects typically decreases
with adaptation .
3. A group of nursing students asks a nurse to explain the blood-brain barrier. The nurse
would be correct to say that the blood-brain barrier __________.
A) prevents some potentially toxic substances from crossing into the central nervous
system
B) causes infants to be less sensitive to CNS drugs and thus require larger doses
C) allows only ionized or protein-bound drugs to cross into the central nervous system
D) prevents lipid-soluble drugs from entering the central nervous system
Correct Answer: A) prevents some potentially toxic substances from crossing into the central
nervous system
,Rationale: The blood-brain barrier prevents some potentially toxic substances from crossing into
the central nervous system . It is not fully developed at birth, making infants more sensitive to
CNS drugs . The BBB allows lipid-soluble drugs to cross; it prevents highly ionized or protein-
bound drugs from crossing .
4. Which vitamin B deficiency is associated with cheilosis, glossitis, vascularization of the
cornea, and itchy dermatitis of the scrotum and vulva?
A) Thiamine (Vitamin B1)
B) Riboflavin (Vitamin B2)
C) Niacin (Vitamin B3)
D) Pyridoxine (Vitamin B6)
Correct Answer: B) Riboflavin (Vitamin B2)
Rationale: Riboflavin (Vitamin B2) deficiency is associated with cheilosis (cracked lips),
glossitis (swollen tongue), vascularization of the cornea, and itchy dermatitis of the scrotum and
vulva . Thiamine deficiency causes beriberi and Wernicke-Korsakoff syndrome, niacin
deficiency causes pellagra, and pyridoxine deficiency causes peripheral neuropathy .
5. A patient who is known to be a heavy drinker is brought to the emergency department
with ataxia and confusion. The patient cannot remember the events of the previous day.
The examination reveals nystagmus, and the patient reports having double vision. Which
vitamin should the provider order for this patient?
A) Riboflavin (Vitamin B2)
B) Niacin (Vitamin B3)
C) Thiamine (Vitamin B1)
D) Vitamin B12
Correct Answer: C) Thiamine (Vitamin B1)
Rationale: This patient is presenting with Wernicke-Korsakoff syndrome, characterized by the
classic triad of ataxia, confusion, and ophthalmoplegia/nystagmus . It is caused by thiamine
(Vitamin B1) deficiency, commonly seen in chronic alcohol use disorder .
6. A patient is taking a medication that undergoes significant first-pass metabolism. The
provider is considering changing the route of administration. Which route would
completely bypass the first-pass effect?
A) Oral
B) Sublingual
C) Rectal
D) Intramuscular
Correct Answer: B) Sublingual
Rationale: Sublingual administration bypasses the first-pass effect because the drug is absorbed
directly into the systemic circulation via the rich venous plexus under the tongue, avoiding the
, hepatic portal system . Oral and rectal routes are subject to first-pass metabolism, and
intramuscular administration partially bypasses it but not completely.
7. A drug has a half-life of 8 hours. Approximately how long will it take to reach steady
state?
A) 8 hours
B) 16 hours
C) 32 hours
D) 40 hours
Correct Answer: D) 40 hours
Rationale: Steady state is typically achieved after approximately 4-5 half-lives . With an 8-hour
half-life: 8 hours x 5 = 40 hours. One half-life (8 hours) is insufficient for accumulation, two
half-lives (16 hours) is approximately 75% of steady state, and four half-lives (32 hours) is close
but slightly less than the standard 4-5 half-life rule.
8. A patient on warfarin is prescribed amiodarone. The NP should anticipate:
A) Decreased INR, increase warfarin dose
B) Increased INR, decrease warfarin dose
C) No interaction
D) Switch to heparin
Correct Answer: B) Increased INR, decrease warfarin dose
Rationale: Amiodarone inhibits CYP2C9 and CYP3A4, which metabolize warfarin, leading to
decreased warfarin metabolism and increased INR . The warfarin dose should be reduced by 30-
50% to prevent bleeding complications. Regular INR monitoring is essential when these drugs
are used together.
9. A patient is prescribed lisinopril and develops a dry cough. What is the mechanism for
this side effect?
A) Angiotensin II blockade
B) Bradykinin accumulation
C) Histamine release
D) Direct airway irritation
Correct Answer: B) Bradykinin accumulation
Rationale: ACE inhibitors prevent the breakdown of bradykinin, leading to its accumulation,
which causes a dry cough and angioedema . ARBs do not affect bradykinin and are less likely to
cause this side effect. Angiotensin II blockade is the therapeutic mechanism, not the cause of
cough.
10. A patient with type 2 diabetes and heart failure is prescribed an SGLT-2 inhibitor. The
nurse understands that this drug class:
A) Increases the risk of hypoglycemia
B) Reduces cardiovascular mortality
