WGU D236 EXAM/WGU D236
PATHOPHYSIOLOGY OBJECTIVE
ASSESSMENT ACTUAL EXAM 2026-2027
COMPLETE EXAM REAL QUESTIONS AND
CORRECT VERIFIED ANSWERS WITH
DETAILED RATIONALES (100% RELIABLE
SOLUTIONS) WGU D236 EXAM 2026
CURRENTLY UPDATED EXAM
|GUARANTEED PASS A+ |INSTANT
DOWNLOAD PDF
1. A patient with chronic alcoholism presents with ataxia and ophthalmoplegia.
Which vitamin deficiency is most likely responsible?
A) Vitamin B12
B) Folate
C) Thiamine (B1)
D) Vitamin E
ANSWER: C
, Wernicke-Korsakoff syndrome, characterized by ataxia, ophthalmoplegia, and
confusion, is caused by thiamine (B1) deficiency, often seen in chronic alcoholism.
A is incorrect because B12 deficiency causes subacute combined degeneration of
the spinal cord.
B is incorrect because folate deficiency causes macrocytic anemia without these
specific neurological signs.
D is incorrect because vitamin E deficiency causes peripheral neuropathy and
retinopathy.
2. A patient with liver failure has prolonged prothrombin time (PT). This is most
directly due to impaired synthesis of which clotting factors?
A) Factors II, VII, IX, X
B) Factors I, V, VIII, XIII
C) Factors III, IV, VI, XI
D) Factors VII, VIII, IX, XI
ANSWER: A
The liver synthesizes vitamin K-dependent clotting factors II, VII, IX, and X. PT
specifically measures the extrinsic pathway, which is highly dependent on Factor
VII.
B is incorrect because Factor VIII is not synthesized in the liver.
C is incorrect because Factor IV is calcium and Factor III is tissue factor.
D is incorrect because Factor VIII is not liver-synthesized.
3. In a patient with heart failure, which compensatory mechanism initially
increases cardiac output but eventually leads to increased afterload and worsening
failure?
,A) Frank-Starling mechanism
B) Sympathetic nervous system activation
C) Renin-angiotensin-aldosterone system (RAAS) activation
D) Natriuretic peptide release
ANSWER: C
RAAS activation causes vasoconstriction (increasing afterload) and sodium/water
retention (increasing preload). While initially compensatory, it exacerbates heart
failure over time.
A is incorrect because the Frank-Starling mechanism increases contractility but is
not the primary driver of increased afterload.
B is incorrect because sympathetic activation increases heart rate and contractility,
but its direct effect on afterload is less significant than RAAS.
D is incorrect because natriuretic peptides are counter-regulatory and reduce
preload.
4. A patient with a history of COPD develops worsening dyspnea and cyanosis. An
arterial blood gas shows pH 7.25, PaCO2 60 mmHg, and HCO3- 26 mEq/L. What
is the primary acid-base disturbance?
A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis
ANSWER: C
The elevated PaCO2 (hypercapnia) and low pH indicate respiratory acidosis. The
HCO3- is normal, suggesting acute uncompensated respiratory acidosis.
, A is incorrect because metabolic acidosis would have a low HCO3-.
B is incorrect because metabolic alkalosis would have a high HCO3- and high pH.
D is incorrect because respiratory alkalosis would have a low PaCO2 and high pH.
5. A patient with type 1 diabetes mellitus is found unresponsive. Which laboratory
finding is most consistent with diabetic ketoacidosis (DKA)?
A) Serum glucose 200 mg/dL, pH 7.38, HCO3- 24 mEq/L
B) Serum glucose 450 mg/dL, pH 7.20, HCO3- 14 mEq/L
C) Serum glucose 650 mg/dL, pH 7.48, HCO3- 30 mEq/L
D) Serum glucose 120 mg/dL, pH 7.35, HCO3- 22 mEq/L
ANSWER: B
DKA is characterized by hyperglycemia (>250 mg/dL), metabolic acidosis (pH
<7.30), and low bicarbonate due to ketone body accumulation.
A is incorrect because the glucose is only mildly elevated and pH is normal.
C is incorrect because the pH is alkalotic, suggesting a different condition.
D is incorrect because the glucose and pH are within normal limits.
6. A patient with septic shock develops acute respiratory distress syndrome
(ARDS). The underlying pathophysiology involves:
A) Increased pulmonary capillary hydrostatic pressure
B) Decreased plasma oncotic pressure
C) Increased alveolar-capillary membrane permeability
D) Lymphatic obstruction
PATHOPHYSIOLOGY OBJECTIVE
ASSESSMENT ACTUAL EXAM 2026-2027
COMPLETE EXAM REAL QUESTIONS AND
CORRECT VERIFIED ANSWERS WITH
DETAILED RATIONALES (100% RELIABLE
SOLUTIONS) WGU D236 EXAM 2026
CURRENTLY UPDATED EXAM
|GUARANTEED PASS A+ |INSTANT
DOWNLOAD PDF
1. A patient with chronic alcoholism presents with ataxia and ophthalmoplegia.
Which vitamin deficiency is most likely responsible?
A) Vitamin B12
B) Folate
C) Thiamine (B1)
D) Vitamin E
ANSWER: C
, Wernicke-Korsakoff syndrome, characterized by ataxia, ophthalmoplegia, and
confusion, is caused by thiamine (B1) deficiency, often seen in chronic alcoholism.
A is incorrect because B12 deficiency causes subacute combined degeneration of
the spinal cord.
B is incorrect because folate deficiency causes macrocytic anemia without these
specific neurological signs.
D is incorrect because vitamin E deficiency causes peripheral neuropathy and
retinopathy.
2. A patient with liver failure has prolonged prothrombin time (PT). This is most
directly due to impaired synthesis of which clotting factors?
A) Factors II, VII, IX, X
B) Factors I, V, VIII, XIII
C) Factors III, IV, VI, XI
D) Factors VII, VIII, IX, XI
ANSWER: A
The liver synthesizes vitamin K-dependent clotting factors II, VII, IX, and X. PT
specifically measures the extrinsic pathway, which is highly dependent on Factor
VII.
B is incorrect because Factor VIII is not synthesized in the liver.
C is incorrect because Factor IV is calcium and Factor III is tissue factor.
D is incorrect because Factor VIII is not liver-synthesized.
3. In a patient with heart failure, which compensatory mechanism initially
increases cardiac output but eventually leads to increased afterload and worsening
failure?
,A) Frank-Starling mechanism
B) Sympathetic nervous system activation
C) Renin-angiotensin-aldosterone system (RAAS) activation
D) Natriuretic peptide release
ANSWER: C
RAAS activation causes vasoconstriction (increasing afterload) and sodium/water
retention (increasing preload). While initially compensatory, it exacerbates heart
failure over time.
A is incorrect because the Frank-Starling mechanism increases contractility but is
not the primary driver of increased afterload.
B is incorrect because sympathetic activation increases heart rate and contractility,
but its direct effect on afterload is less significant than RAAS.
D is incorrect because natriuretic peptides are counter-regulatory and reduce
preload.
4. A patient with a history of COPD develops worsening dyspnea and cyanosis. An
arterial blood gas shows pH 7.25, PaCO2 60 mmHg, and HCO3- 26 mEq/L. What
is the primary acid-base disturbance?
A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis
ANSWER: C
The elevated PaCO2 (hypercapnia) and low pH indicate respiratory acidosis. The
HCO3- is normal, suggesting acute uncompensated respiratory acidosis.
, A is incorrect because metabolic acidosis would have a low HCO3-.
B is incorrect because metabolic alkalosis would have a high HCO3- and high pH.
D is incorrect because respiratory alkalosis would have a low PaCO2 and high pH.
5. A patient with type 1 diabetes mellitus is found unresponsive. Which laboratory
finding is most consistent with diabetic ketoacidosis (DKA)?
A) Serum glucose 200 mg/dL, pH 7.38, HCO3- 24 mEq/L
B) Serum glucose 450 mg/dL, pH 7.20, HCO3- 14 mEq/L
C) Serum glucose 650 mg/dL, pH 7.48, HCO3- 30 mEq/L
D) Serum glucose 120 mg/dL, pH 7.35, HCO3- 22 mEq/L
ANSWER: B
DKA is characterized by hyperglycemia (>250 mg/dL), metabolic acidosis (pH
<7.30), and low bicarbonate due to ketone body accumulation.
A is incorrect because the glucose is only mildly elevated and pH is normal.
C is incorrect because the pH is alkalotic, suggesting a different condition.
D is incorrect because the glucose and pH are within normal limits.
6. A patient with septic shock develops acute respiratory distress syndrome
(ARDS). The underlying pathophysiology involves:
A) Increased pulmonary capillary hydrostatic pressure
B) Decreased plasma oncotic pressure
C) Increased alveolar-capillary membrane permeability
D) Lymphatic obstruction
