WGU D027 EXAM QUESTIONS AND ANSWERS
1. A 23-year-old woman comes in for prenatal counseling. While
completing her family history, she reports her brother has cystic
fibrosis. She does not know if she is a carrier. She asks if her
children will be affected by the disease. What is an accurate way
to determine the likelihood of this patient's children being affected?:
A genetic or a carrier test
2. A 31-year-old man comes into the office for an exam. He is 6' 5
" with a high-pitched voice, and he has a moderate degree of
mental impairment. It is discovered upon exam that his body hair
is sparse, his testes are small, and he has gynecomastia.
Which genetic disorder should this patient be tested for?:
kleinfelters
3. sign of becker muscle dystrophy in kids?: may
begin to waddle, walk on
their toes or push their abdomen forward when walking
4. A six-month-old female infant with failure to thrive comes in to
the office with her parents. It is noticed upon exam that the
patient has facial deformi-ties and is jaundiced. A complete blood
count (CBC) is ordered, which reveals anemia. When that
patient's blood is examined under a microscope, the red blood
,cells appear small and abnormally shaped. A mutational analysis
is ordered, and alpha thalassemia is diagnosed.
What is the likelihood of incidence of these parent's future
children having alpha thalassemia?: 100%
5. A 64-year-old male truck driver comes in complaining of pain in his
lower left calf. He states he drives eight to ten hours per day. Upon
exam, swelling and mottled coloring are noted in the patient's calf. A
D-dimer test is ordered and comes back positive.
Which additional test should be ordered to confirm a diagnosis
in this pa-tient?: Doppler U/S
6. A 54-year-old man comes into a clinic for a routine visit. His
initial BP is 148/92. After a recheck 15 minutes later, his BP is
140/90. He states he suffers from "white coat hypertension." He
states he has no history of high blood pressure and no family
history of high blood pressure.
Which nursing intervention would assist this patient in receiving
a clinical diagnosis of hypertension?: Completing an ambulatory
blood pressure assessment
,7. A 58-year-old woman comes in complaining of retrosternal chest
pain, wors-ening with recumbent position. She states she has had
a low-grade fever for two days. Upon exam, the patient has a
friction rub. An EKG reveals sinus tachycardia with inflammatory
changes. An ultrasound is performed, and she is diagnosed with
an acute pericarditis.
Which condition would make pericarditis more likely in this
patient?: Lupus
8. A 54-year-old Caucasian man comes in for a lab review. His
lipids reveal an LDL of 180, an HDL of 52, and triglycerides of
326. He has no history of ath-erosclerotic cardiovascular disease
(ASCVD) or diabetes. His blood pressure is 118/64. He has a pulse
rate of 64, and he weighs 320 lb. He smokes one pack of
cigarettes per day, and his ASCVD risk score is 12.8.
Which medication should this patient be started on?: Lipitor 20 mg
9. A 73-year-old man with Systolic congestive heart failure (CHF)
with reduced ejection fraction (HFrEF) comes to a clinic
complaining of shortness of breath. He is currently taking 6.25
mg carvedilol (Coreg) twice a day and 50 mg losartan (Cozaar)
and 20 mg furosemide (Lasix) daily. His oxygen saturation is
95%, and he has a pulse of 64. His BP is 138/82, and his BNP is
1150.
Using the 2017 heart failure guidelines, which medication change
should be recommended for this patient?: Stop angiotensin receptor
blockers (ARB) and add sacubitril/valsar-tan (Entresto), if BNP high replace
ARB w/ ACE or ARNI
, 10. A 78-year-old man comes in with stable angina. He reports he
has been having more angina recently. He is currently taking the
following medications: lisinopril (Zestril), atorvastatin (Lipitor),
aspirin, and nitrostat PRN for chest pain. He has a history of
COPD with bronchospasm. His blood pressure is 145/88, and he
has a pulse of 74.
Which class of medications should be avoided for this patient?: BBs,
BB contraindi-cated in pts w/ COPD/ asthma
11. A 45-year-old Muslim woman presents to a clinic for an
intervention for her type 2 diabetes. She is prescribed metformin
(Glucophage) 500 mg BID. During a follow-up phone call a week
later, it is discovered she has not been taking the metformin. A
second visit is scheduled. During this visit, she states
1. A 23-year-old woman comes in for prenatal counseling. While
completing her family history, she reports her brother has cystic
fibrosis. She does not know if she is a carrier. She asks if her
children will be affected by the disease. What is an accurate way
to determine the likelihood of this patient's children being affected?:
A genetic or a carrier test
2. A 31-year-old man comes into the office for an exam. He is 6' 5
" with a high-pitched voice, and he has a moderate degree of
mental impairment. It is discovered upon exam that his body hair
is sparse, his testes are small, and he has gynecomastia.
Which genetic disorder should this patient be tested for?:
kleinfelters
3. sign of becker muscle dystrophy in kids?: may
begin to waddle, walk on
their toes or push their abdomen forward when walking
4. A six-month-old female infant with failure to thrive comes in to
the office with her parents. It is noticed upon exam that the
patient has facial deformi-ties and is jaundiced. A complete blood
count (CBC) is ordered, which reveals anemia. When that
patient's blood is examined under a microscope, the red blood
,cells appear small and abnormally shaped. A mutational analysis
is ordered, and alpha thalassemia is diagnosed.
What is the likelihood of incidence of these parent's future
children having alpha thalassemia?: 100%
5. A 64-year-old male truck driver comes in complaining of pain in his
lower left calf. He states he drives eight to ten hours per day. Upon
exam, swelling and mottled coloring are noted in the patient's calf. A
D-dimer test is ordered and comes back positive.
Which additional test should be ordered to confirm a diagnosis
in this pa-tient?: Doppler U/S
6. A 54-year-old man comes into a clinic for a routine visit. His
initial BP is 148/92. After a recheck 15 minutes later, his BP is
140/90. He states he suffers from "white coat hypertension." He
states he has no history of high blood pressure and no family
history of high blood pressure.
Which nursing intervention would assist this patient in receiving
a clinical diagnosis of hypertension?: Completing an ambulatory
blood pressure assessment
,7. A 58-year-old woman comes in complaining of retrosternal chest
pain, wors-ening with recumbent position. She states she has had
a low-grade fever for two days. Upon exam, the patient has a
friction rub. An EKG reveals sinus tachycardia with inflammatory
changes. An ultrasound is performed, and she is diagnosed with
an acute pericarditis.
Which condition would make pericarditis more likely in this
patient?: Lupus
8. A 54-year-old Caucasian man comes in for a lab review. His
lipids reveal an LDL of 180, an HDL of 52, and triglycerides of
326. He has no history of ath-erosclerotic cardiovascular disease
(ASCVD) or diabetes. His blood pressure is 118/64. He has a pulse
rate of 64, and he weighs 320 lb. He smokes one pack of
cigarettes per day, and his ASCVD risk score is 12.8.
Which medication should this patient be started on?: Lipitor 20 mg
9. A 73-year-old man with Systolic congestive heart failure (CHF)
with reduced ejection fraction (HFrEF) comes to a clinic
complaining of shortness of breath. He is currently taking 6.25
mg carvedilol (Coreg) twice a day and 50 mg losartan (Cozaar)
and 20 mg furosemide (Lasix) daily. His oxygen saturation is
95%, and he has a pulse of 64. His BP is 138/82, and his BNP is
1150.
Using the 2017 heart failure guidelines, which medication change
should be recommended for this patient?: Stop angiotensin receptor
blockers (ARB) and add sacubitril/valsar-tan (Entresto), if BNP high replace
ARB w/ ACE or ARNI
, 10. A 78-year-old man comes in with stable angina. He reports he
has been having more angina recently. He is currently taking the
following medications: lisinopril (Zestril), atorvastatin (Lipitor),
aspirin, and nitrostat PRN for chest pain. He has a history of
COPD with bronchospasm. His blood pressure is 145/88, and he
has a pulse of 74.
Which class of medications should be avoided for this patient?: BBs,
BB contraindi-cated in pts w/ COPD/ asthma
11. A 45-year-old Muslim woman presents to a clinic for an
intervention for her type 2 diabetes. She is prescribed metformin
(Glucophage) 500 mg BID. During a follow-up phone call a week
later, it is discovered she has not been taking the metformin. A
second visit is scheduled. During this visit, she states
