WGU D118 ADULT PRIMARY CARE
COMPREHENSIVE EXAM PREP QUESTIONS
AND SOLUTIONS VERIFIED RESOURCE
●● Next step for ACE inhibitor-induced angioedema
Answer: Discontinue ACE inhibitor immediately - Angioedema is life-
threatening and ACE-Is are permanently contraindicated
●● Labs to check before starting an ACE inhibitor
Answer: Serum creatinine and potassium - Risk of renal dysfunction and
hyperkalemia
●● Low back pain red flag requiring imaging
Answer: New urinary retention - Suggests cauda equina syndrome
●● Next step for acute monoarticular arthritis with fever
Answer: Joint aspiration - Must rule out septic arthritis before treating
gout
●● First-line treatment for acute gout flare
Answer: NSAIDs - First-line unless contraindicated
,●● Diagnostic confirmation of gout
Answer: Monosodium urate crystals on synovial fluid - Serum uric acid
is not diagnostic
●● Initial test for suspected PE in low-risk patient
Answer: D-dimer - Negative result rules out PE
●● Next step after positive D-dimer
Answer: CT pulmonary angiography - Required to confirm PE
●● First-line treatment for mild persistent asthma
Answer: Low-dose inhaled corticosteroid - Cornerstone therapy
●● Asthma hospitalization red flag
Answer: Peak flow <50% predicted - Indicates severe exacerbation
●● Preferred colon cancer screening at age 45
Answer: Colonoscopy - Gold standard and diagnostic
●● COPD patient with frequent exacerbations next step
Answer: Add inhaled corticosteroid - Reduces exacerbation frequency
, ●● Diagnostic test confirming COPD
Answer: Spirometry showing FEV1/FVC <0.70 - Confirms airflow
obstruction
●● First-line medication for type 2 diabetes
Answer: Metformin - Improves insulin sensitivity with CV benefit
●● Metformin contraindication
Answer: eGFR <30 - Risk of lactic acidosis
●● Lab monitoring long-term glucose control
Answer: Hemoglobin A1c - Reflects 3-month average
●● First-line hypothyroidism treatment
Answer: Levothyroxine - Synthetic T4 replacement
●● Labs confirming primary hypothyroidism
Answer: Elevated TSH and low free T4 - Pituitary compensation
●● Headache red flag requiring imaging
Answer: New headache with focal neurologic deficits - Possible
intracranial pathology
COMPREHENSIVE EXAM PREP QUESTIONS
AND SOLUTIONS VERIFIED RESOURCE
●● Next step for ACE inhibitor-induced angioedema
Answer: Discontinue ACE inhibitor immediately - Angioedema is life-
threatening and ACE-Is are permanently contraindicated
●● Labs to check before starting an ACE inhibitor
Answer: Serum creatinine and potassium - Risk of renal dysfunction and
hyperkalemia
●● Low back pain red flag requiring imaging
Answer: New urinary retention - Suggests cauda equina syndrome
●● Next step for acute monoarticular arthritis with fever
Answer: Joint aspiration - Must rule out septic arthritis before treating
gout
●● First-line treatment for acute gout flare
Answer: NSAIDs - First-line unless contraindicated
,●● Diagnostic confirmation of gout
Answer: Monosodium urate crystals on synovial fluid - Serum uric acid
is not diagnostic
●● Initial test for suspected PE in low-risk patient
Answer: D-dimer - Negative result rules out PE
●● Next step after positive D-dimer
Answer: CT pulmonary angiography - Required to confirm PE
●● First-line treatment for mild persistent asthma
Answer: Low-dose inhaled corticosteroid - Cornerstone therapy
●● Asthma hospitalization red flag
Answer: Peak flow <50% predicted - Indicates severe exacerbation
●● Preferred colon cancer screening at age 45
Answer: Colonoscopy - Gold standard and diagnostic
●● COPD patient with frequent exacerbations next step
Answer: Add inhaled corticosteroid - Reduces exacerbation frequency
, ●● Diagnostic test confirming COPD
Answer: Spirometry showing FEV1/FVC <0.70 - Confirms airflow
obstruction
●● First-line medication for type 2 diabetes
Answer: Metformin - Improves insulin sensitivity with CV benefit
●● Metformin contraindication
Answer: eGFR <30 - Risk of lactic acidosis
●● Lab monitoring long-term glucose control
Answer: Hemoglobin A1c - Reflects 3-month average
●● First-line hypothyroidism treatment
Answer: Levothyroxine - Synthetic T4 replacement
●● Labs confirming primary hypothyroidism
Answer: Elevated TSH and low free T4 - Pituitary compensation
●● Headache red flag requiring imaging
Answer: New headache with focal neurologic deficits - Possible
intracranial pathology
