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WGU D115 COMPREHENSIVE FINAL EXAM V4 - LATEST
2026/2027 | WESTERN GOVERNORS UNIVERSITY |
EXPERT VERIFIED | 200 VERIFIED Q&A | COMPLETE
RATIONALES | PASS GUARANTEED - A+ GRADED
EXAM OVERVIEW
Course: WGU D115 Advanced Pathophysiology Comprehensive Final V4
Institution: Western Governors University
Exam Type: Comprehensive Final Exam
Question Count: 200 Questions
Format: Multiple Choice with Verified Answers and Complete Rationales
Focus Areas: Comprehensive advanced pathophysiology including cellular biology, genetics, immunology,
inflammation, fluid/electrolyte balance, and all body systems
QUESTION 1
A client presents with fatigue, pallor, and shortness of breath on exertion. Laboratory results reveal
hemoglobin 8.5 g/dL, mean corpuscular volume (MCV) 65 fL, and ferritin 10 ng/mL. Which type of anemia
does the nurse practitioner suspect?
A) Pernicious anemia
B) Iron deficiency anemia
C) Aplastic anemia
D) Sickle cell anemia
Correct Answer: B
Rationale: Iron deficiency anemia is characterized by low hemoglobin, microcytic (low MCV) red blood cells,
and low ferritin. Pernicious anemia (A) is macrocytic (high MCV) with low B12. Aplastic anemia (C) presents
with pancytopenia. Sickle cell anemia (D) presents with sickle-shaped cells and hemolytic crises.
QUESTION 2
A 65-year-old client with a history of hypertension and type 2 diabetes presents with a 2-hour history of left-
sided weakness, facial droop, and slurred speech. The client's blood pressure is 168/92 mmHg. A non-contrast
CT scan shows no hemorrhage. The client's symptoms started 1.5 hours ago. Which intervention should the
nurse practitioner implement FIRST?
A) Administer alteplase (tPA) immediately
B) Treat hypertension to lower BP to < 185/110 mmHg before tPA
,2
C) Administer aspirin 325 mg
D) Administer heparin
Correct Answer: B
Rationale: Blood pressure must be lowered to < 185/110 mmHg before administering tPA to reduce the risk of
hemorrhagic conversion. tPA (A) should not be given until BP is controlled. Aspirin (C) and heparin (D) are
not first-line in acute ischemic stroke.
QUESTION 3
A 70-year-old client with a history of heart failure presents with progressive shortness of breath, orthopnea,
and peripheral edema. Vital signs: BP 158/92 mmHg, HR 104 bpm, RR 26/min, SpO2 89% on room air.
Physical examination reveals crackles at the lung bases, jugular venous distention, and 2+ pitting edema to the
knees. The nurse practitioner understands that the client's symptoms are most likely due to:
A) Left-sided heart failure
B) Right-sided heart failure
C) Biventricular heart failure
D) Cardiogenic shock
Correct Answer: C
Rationale: The client has signs of both left-sided heart failure (crackles, orthopnea, dyspnea) and right-sided
heart failure (peripheral edema, JVD), indicating biventricular failure. Left-sided failure (A) presents with
pulmonary symptoms only. Right-sided failure (B) presents with systemic symptoms only. Cardiogenic shock
(D) presents with hypotension and end-organ dysfunction.
QUESTION 4
A 55-year-old client with a history of chronic obstructive pulmonary disease (COPD) presents with worsening
dyspnea, increased sputum production, and fever. Arterial blood gas: pH 7.28, PaCO2 65 mmHg, PaO2 48
mmHg, HCO3 28 mEq/L. The nurse practitioner interprets these results as:
A) Respiratory alkalosis with metabolic compensation
B) Respiratory acidosis with metabolic compensation
C) Metabolic acidosis with respiratory compensation
D) Metabolic alkalosis with respiratory compensation
Correct Answer: B
Rationale: The pH is low (7.28) indicating acidosis. PaCO2 is elevated (65 mmHg) indicating respiratory
,3
acidosis. HCO3 is elevated (28 mEq/L) indicating metabolic compensation. This is respiratory acidosis with
metabolic compensation.
QUESTION 5
A 45-year-old client with a history of systemic lupus erythematosus (SLE) presents with proteinuria,
hematuria, and edema. Laboratory results: ANA positive, anti-dsDNA positive, complement C3 and C4 low,
serum creatinine 2.0 mg/dL, urine protein 3.0 g/24 hours. The nurse practitioner suspects:
A) Lupus nephritis
B) Acute kidney injury
C) Nephrotic syndrome
D) Glomerulonephritis
Correct Answer: A
Rationale: The client has SLE with proteinuria, hematuria, elevated creatinine, positive anti-dsDNA, and low
complement, consistent with lupus nephritis. Acute kidney injury (B) would not have positive anti-dsDNA.
Nephrotic syndrome (C) presents with proteinuria > 3.5 g/24 hours and edema but is not specific to SLE.
Glomerulonephritis (D) is a broad term.
QUESTION 6
A 60-year-old client with a history of diabetes presents with a non-healing foot ulcer. Physical examination
reveals a 3 cm x 4 cm ulcer with purulent drainage, surrounding erythema, and warmth. The client has
decreased sensation in both feet. The nurse practitioner understands that the most common cause of diabetic
foot ulcers is:
A) Peripheral neuropathy
B) Peripheral artery disease
C) Venous insufficiency
D) Infection
Correct Answer: A
Rationale: Peripheral neuropathy is the most common cause of diabetic foot ulcers, leading to decreased
sensation and unrecognized trauma. Peripheral artery disease (B) contributes but is not the most common.
Venous insufficiency (C) is more common in venous stasis ulcers. Infection (D) is a complication, not a cause.
QUESTION 7
, 4
A 50-year-old client with a history of hypertension presents with a blood pressure of 180/110 mmHg. The
nurse practitioner prescribes lisinopril. The nurse practitioner understands that lisinopril works by:
A) Blocking angiotensin II receptors
B) Blocking the conversion of angiotensin I to angiotensin II
C) Blocking beta-1 receptors
D) Blocking calcium channels
Correct Answer: B
Rationale: Lisinopril is an ACE inhibitor that works by blocking the conversion of angiotensin I to
angiotensin II. ARBs (A) block angiotensin II receptors. Beta-blockers (C) block beta-1 receptors. Calcium
channel blockers (D) block calcium channels.
QUESTION 8
A 65-year-old client with a history of osteoporosis presents with acute back pain after lifting a heavy object. X-
ray shows a compression fracture of the L1 vertebral body. The nurse practitioner prescribes alendronate.
Which teaching is essential?
A) "Take this medication with food to prevent stomach upset."
B) "Take this medication on an empty stomach with a full glass of water and remain upright for 30 minutes."
C) "Take this medication with milk to enhance absorption."
D) "Take this medication at bedtime."
Correct Answer: B
Rationale: Alendronate should be taken on an empty stomach with a full glass of water, and the client should
remain upright for 30 minutes to prevent esophagitis. Taking with food (A) or milk (C) reduces absorption.
Bedtime (D) increases the risk of esophagitis.
QUESTION 9
A 55-year-old client with a history of atrial fibrillation presents with a sudden onset of severe headache,
nausea, and vomiting. CT scan shows subarachnoid hemorrhage. The nurse practitioner understands that the
most common cause of subarachnoid hemorrhage is:
A) Hypertension
B) Ruptured cerebral aneurysm
C) Trauma
D) Arteriovenous malformation
WGU D115 COMPREHENSIVE FINAL EXAM V4 - LATEST
2026/2027 | WESTERN GOVERNORS UNIVERSITY |
EXPERT VERIFIED | 200 VERIFIED Q&A | COMPLETE
RATIONALES | PASS GUARANTEED - A+ GRADED
EXAM OVERVIEW
Course: WGU D115 Advanced Pathophysiology Comprehensive Final V4
Institution: Western Governors University
Exam Type: Comprehensive Final Exam
Question Count: 200 Questions
Format: Multiple Choice with Verified Answers and Complete Rationales
Focus Areas: Comprehensive advanced pathophysiology including cellular biology, genetics, immunology,
inflammation, fluid/electrolyte balance, and all body systems
QUESTION 1
A client presents with fatigue, pallor, and shortness of breath on exertion. Laboratory results reveal
hemoglobin 8.5 g/dL, mean corpuscular volume (MCV) 65 fL, and ferritin 10 ng/mL. Which type of anemia
does the nurse practitioner suspect?
A) Pernicious anemia
B) Iron deficiency anemia
C) Aplastic anemia
D) Sickle cell anemia
Correct Answer: B
Rationale: Iron deficiency anemia is characterized by low hemoglobin, microcytic (low MCV) red blood cells,
and low ferritin. Pernicious anemia (A) is macrocytic (high MCV) with low B12. Aplastic anemia (C) presents
with pancytopenia. Sickle cell anemia (D) presents with sickle-shaped cells and hemolytic crises.
QUESTION 2
A 65-year-old client with a history of hypertension and type 2 diabetes presents with a 2-hour history of left-
sided weakness, facial droop, and slurred speech. The client's blood pressure is 168/92 mmHg. A non-contrast
CT scan shows no hemorrhage. The client's symptoms started 1.5 hours ago. Which intervention should the
nurse practitioner implement FIRST?
A) Administer alteplase (tPA) immediately
B) Treat hypertension to lower BP to < 185/110 mmHg before tPA
,2
C) Administer aspirin 325 mg
D) Administer heparin
Correct Answer: B
Rationale: Blood pressure must be lowered to < 185/110 mmHg before administering tPA to reduce the risk of
hemorrhagic conversion. tPA (A) should not be given until BP is controlled. Aspirin (C) and heparin (D) are
not first-line in acute ischemic stroke.
QUESTION 3
A 70-year-old client with a history of heart failure presents with progressive shortness of breath, orthopnea,
and peripheral edema. Vital signs: BP 158/92 mmHg, HR 104 bpm, RR 26/min, SpO2 89% on room air.
Physical examination reveals crackles at the lung bases, jugular venous distention, and 2+ pitting edema to the
knees. The nurse practitioner understands that the client's symptoms are most likely due to:
A) Left-sided heart failure
B) Right-sided heart failure
C) Biventricular heart failure
D) Cardiogenic shock
Correct Answer: C
Rationale: The client has signs of both left-sided heart failure (crackles, orthopnea, dyspnea) and right-sided
heart failure (peripheral edema, JVD), indicating biventricular failure. Left-sided failure (A) presents with
pulmonary symptoms only. Right-sided failure (B) presents with systemic symptoms only. Cardiogenic shock
(D) presents with hypotension and end-organ dysfunction.
QUESTION 4
A 55-year-old client with a history of chronic obstructive pulmonary disease (COPD) presents with worsening
dyspnea, increased sputum production, and fever. Arterial blood gas: pH 7.28, PaCO2 65 mmHg, PaO2 48
mmHg, HCO3 28 mEq/L. The nurse practitioner interprets these results as:
A) Respiratory alkalosis with metabolic compensation
B) Respiratory acidosis with metabolic compensation
C) Metabolic acidosis with respiratory compensation
D) Metabolic alkalosis with respiratory compensation
Correct Answer: B
Rationale: The pH is low (7.28) indicating acidosis. PaCO2 is elevated (65 mmHg) indicating respiratory
,3
acidosis. HCO3 is elevated (28 mEq/L) indicating metabolic compensation. This is respiratory acidosis with
metabolic compensation.
QUESTION 5
A 45-year-old client with a history of systemic lupus erythematosus (SLE) presents with proteinuria,
hematuria, and edema. Laboratory results: ANA positive, anti-dsDNA positive, complement C3 and C4 low,
serum creatinine 2.0 mg/dL, urine protein 3.0 g/24 hours. The nurse practitioner suspects:
A) Lupus nephritis
B) Acute kidney injury
C) Nephrotic syndrome
D) Glomerulonephritis
Correct Answer: A
Rationale: The client has SLE with proteinuria, hematuria, elevated creatinine, positive anti-dsDNA, and low
complement, consistent with lupus nephritis. Acute kidney injury (B) would not have positive anti-dsDNA.
Nephrotic syndrome (C) presents with proteinuria > 3.5 g/24 hours and edema but is not specific to SLE.
Glomerulonephritis (D) is a broad term.
QUESTION 6
A 60-year-old client with a history of diabetes presents with a non-healing foot ulcer. Physical examination
reveals a 3 cm x 4 cm ulcer with purulent drainage, surrounding erythema, and warmth. The client has
decreased sensation in both feet. The nurse practitioner understands that the most common cause of diabetic
foot ulcers is:
A) Peripheral neuropathy
B) Peripheral artery disease
C) Venous insufficiency
D) Infection
Correct Answer: A
Rationale: Peripheral neuropathy is the most common cause of diabetic foot ulcers, leading to decreased
sensation and unrecognized trauma. Peripheral artery disease (B) contributes but is not the most common.
Venous insufficiency (C) is more common in venous stasis ulcers. Infection (D) is a complication, not a cause.
QUESTION 7
, 4
A 50-year-old client with a history of hypertension presents with a blood pressure of 180/110 mmHg. The
nurse practitioner prescribes lisinopril. The nurse practitioner understands that lisinopril works by:
A) Blocking angiotensin II receptors
B) Blocking the conversion of angiotensin I to angiotensin II
C) Blocking beta-1 receptors
D) Blocking calcium channels
Correct Answer: B
Rationale: Lisinopril is an ACE inhibitor that works by blocking the conversion of angiotensin I to
angiotensin II. ARBs (A) block angiotensin II receptors. Beta-blockers (C) block beta-1 receptors. Calcium
channel blockers (D) block calcium channels.
QUESTION 8
A 65-year-old client with a history of osteoporosis presents with acute back pain after lifting a heavy object. X-
ray shows a compression fracture of the L1 vertebral body. The nurse practitioner prescribes alendronate.
Which teaching is essential?
A) "Take this medication with food to prevent stomach upset."
B) "Take this medication on an empty stomach with a full glass of water and remain upright for 30 minutes."
C) "Take this medication with milk to enhance absorption."
D) "Take this medication at bedtime."
Correct Answer: B
Rationale: Alendronate should be taken on an empty stomach with a full glass of water, and the client should
remain upright for 30 minutes to prevent esophagitis. Taking with food (A) or milk (C) reduces absorption.
Bedtime (D) increases the risk of esophagitis.
QUESTION 9
A 55-year-old client with a history of atrial fibrillation presents with a sudden onset of severe headache,
nausea, and vomiting. CT scan shows subarachnoid hemorrhage. The nurse practitioner understands that the
most common cause of subarachnoid hemorrhage is:
A) Hypertension
B) Ruptured cerebral aneurysm
C) Trauma
D) Arteriovenous malformation
