D117 Oa / Wgu D117 Oa Prep Test Bank 2026/2027 Study Guide With Real Exam Questions And Correct /Verified Answers With Rationales/ Wgu D117 Advanced Most Recent Version A++

D117 OA / WGU D117 OA PREP TEST BANK 2026/2027 STUDY GUIDE WITH REAL EXAM QUESTIONS AND CORRECT /VERIFIED ANSWERS WITH RATIONALES/ WGU D117 ADVANCED MOST RECENT VERSION A++ A patient is admitted to a neurointensive care unit from an emergency department after a motor vehicle accident. For the first hour, the patient receives neuro checks every 15 minutes, without noted changes in condition. During the second hour, motor functions change from decorticate to decerebrate posturing. Which injury should an APRN expect given these changes? - ANSWER Mid-brain An APRN is completing an annual exam of a patient with type 1 diabetes. As the APRN questions the patient about the level of activity, the patient talks about frequently walking, however within the last month, the patient has experienced severe leg pain during walks. Which condition should the APRN suspect? - ANSWER Peripheral artery disease An APRN in an emergency department assesses several university students from the same dorm, each presenting with similar symptoms. The assessment findings are throbbing headache, photophobia, positive Brudzinski sign, CSF cloudy with neutrophils on initial culture slide. Which disease process should the APRN suspect? - ANSWER Bacterial meningitis A 22-year-old adult patient comes to a clinic with complaints of anxiety. An APRN interviews the patient and determines that the patient has ... and persistent ... such as relationships and job performance. The patient is easily fatigued, has difficulty sleeping, and also complaints of irritability and difficulty concentrating. Which disorder should be diagnosed by the APRN based on these symptoms? - ANSWER Generalized anxiety Which disorder has shown progress with deep brain stimulation as a treatment option? - ANSWER Obsessive compulsive disorder When prescribing steroid hormones for a patient, an APRN considers the impact of metabolism and excretion of the medication. Which organs are included for this class or medications? - ANSWER Renal and biliary A young adolescent female patient is being seen by an APRN for concerns regarding appearance. All of her friends are developing breasts, and she is not. She has not started her period and is concerned about an increase in facial hair. Which diagnosis should the APRN explain based on these symptoms? - ANSWER Hypersecretion of adrenal androgens Which target organ secretes melanin? - ANSWER Anterior pituitary gland An APRN assesses an older adult patient with a history of abnormal knee alignment, bilateral hip and knee joint pain, and stiffness. The pain is aggravated with activity and relieved with rest. What is the probable diagnosis for this patient? - ANSWER Osteoarthritis A child presents with a lower grade fever, cough, and a rash for the past two days. Upon closer examination, an APRN notes clusters of elevated lesions that are less than 1cm in diameter. The lesions are superficial and filled with serous fluid. The APRN suspects varicella. What type of skin lesion is suspected with this condition? - ANSWER vesicle Which psychiatric condition is characterized by lightheadedness, dyspnea, and tachycardia? - ANSWER Panic disorder An APRN examines a patient with severe pruritus. The skin on the neck, antecubital, and popliteal fossa, has redness, edema scaling and is dry and cracking. Which condition should the APRN suspect? - ANSWER Atopic dermatitis An APRN evaluates a coccyx pressure injury and notes a blister filled with clear fluid and skin that is painful to touch. Which stage should the APRN assign to this injury? - ANSWER Stage 2 A school aged child is hospitalized for shock. The parents ask when the child's breathing tube will be removed. An APRN explains treatment goals for shock to the parents. Which goals apply to this situation? - ANSWER Maximization of oxygen delivery and minimization of oxygen demand A patient is admitted with a diagnosis of acute pancreatitis. An APRN notes the patient's condition has deteriorated over the 48 hours since the patient's arrival. The following assessment information is obtained: BUN increase of 6 mg/l from admission levels, blood pressure 92/48, apical pulse 120, respirations 32, pulse oximeter 91%. Which rationale explains the change in the patient's condition? - ANSWER Increase of vascular permeability due to inflammatory mediators An APRN reviews the medical record of a patient complaining of chest pain, dyspnea, and feelings of impending doom. Assessment findings include tachycardia, hypotension, JVD, and dysrhythmia. The medical team is concerned about inadequate perfusion to the heart and organs. Which disease process should the APRN suspect? - ANSWER Cardiogenic shock An APRN assesses a patient who was diagnosed with DIC. The patient has now developed a low grade fever, tachycardia, tachypnea, dyspnea, altered mental status, and a general hyper dynamic and hypermetabolic state. Which diagnosis should the APRN consider? - ANSWER Multiple organ dysfunction What are the signs of renal involvement in SLE? - ANSWER Proteinuria, hematuria, edema, increased blood pressure, and decreased kidney function. What should patients with gout do to manage their condition? - ANSWER Maintain adequate hydration, achieve a healthy weight, and make appropriate dietary modifications. What is the ATI priority clue for SLE? - ANSWER SLE + decreased urine output indicates renal involvement. What is the priority for a client receiving blood transfusion with fever and chills? - ANSWER STOP THE TRANSFUSION. A 31-year-old woman has malar rash, joint pain, photosensitivity, oral ulcers, and proteinuria. Most likely diagnosis? A. Dermatomyositis B. Systemic lupus erythematosus C. Psoriatic arthritis D. Rosacea - ANSWERB. Systemic lupus erythematosus — classic multisystem autoimmune picture. A pregnant patient with lupus has a history of recurrent spontaneous abortions. Which therapy is commonly used to help prevent future pregnancy loss when antiphospholipid syndrome is suspected? A. Methotrexate B. Aspirin plus heparin C. Isotretinoin D. Warfarin in first trimester - ANSWERB. Aspirin plus heparin — standard prevention strategy in lupus with suspected APS pregnancy loss. A 64-year-old smoker has persistent cough, weight loss, and hemoptysis. Next best test? A. Spirometry B. Chest CT C. Repeat chest X-ray in 3 months D. Trial of azithromycin - ANSWERB. Chest CT — concerning for lung malignancy. A 58-year-old with smoking history presents for preventive screening. Which screening is specifically recommended for a man age 65-75 who has ever smoked? A. Annual chest X-ray B. Abdominal ultrasound for AAA C. PSA every year D. Echocardiogram - ANSWERB. Abdominal ultrasound for AAA — recommended one-time screening in men 65-75 who ever smoked. A 66-year-old man with irregularly irregular rhythm is found to have atrial fibrillation. He is hemodynamically stable. What is the immediate outpatient management priority besides rate control? A. Start aspirin for all patients B. Assess stroke risk for anticoagulation decision C. Send home with no treatment D. Immediate cardioversion in clinic for all patients - ANSWERB. Assess stroke risk for anticoagulation decision — use CHA2DS2-VASc. A patient with atrial fibrillation has a CHA2DS2-VASc score of 4. Best management? A. No antithrombotic therapy B. Aspirin only C. Oral anticoagulation D. Clopidogrel only - ANSWERC. Oral anticoagulation — elevated stroke risk. A patient reports palpitations. ECG shows narrow-complex tachycardia at 180 bpm, regular rhythm, no visible P waves. Stable vitals. Best initial treatment? A. Adenosine after vagal maneuvers B. Amiodarone infusion C. Immediate defibrillation D. Digoxin - ANSWERA. Adenosine after vagal maneuvers — stable SVT treatment. A patient has crushing chest pain and ECG shows ST-segment elevation in contiguous leads. Best next step? A. Send for outpatient stress test B. Treat as GERD C. Emergency reperfusion evaluation D. Repeat ECG in 1 week - ANSWERC. Emergency reperfusion evaluation — STEMI. A 74-year-old presents with sudden right facial droop, arm weakness, and aphasia starting 45 minutes ago. Best next test? A. MRI in 1 week B. CT head without contrast C. EEG D. Carotid ultrasound first - ANSWERB. CT head without contrast — first step in suspected acute stroke. A patient has unilateral facial paralysis involving inability to close the eye and inability to wrinkle the forehead. Most likely diagnosis? A. Stroke B. Bell palsy C. Trigeminal neuralgia D. TIA - ANSWERB. Bell palsy — complete unilateral facial weakness including forehead. A 43-year-old with obesity and daytime somnolence snores loudly and has witnessed apneic episodes. Best next diagnostic test? A. Chest X-ray B. Sleep study C. Pulmonary function tests D. BNP - ANSWERB. Sleep study — diagnostic test for obstructive sleep apnea. A 27-year-old presents with fever, neck stiffness, photophobia, and altered mental status. Which action is most important first? A. Start empiric antibiotics promptly B. Wait for LP before treating C. Order outpatient MRI D. Observe for 24 hours - ANSWERA. Start empiric antibiotics promptly — suspected meningitis is a medical emergency. A patient reports "worst headache of my life" with sudden onset. Best first test? A. CT head without contrast B. MRI cervical spine C. EEG D. Sinus CT - ANSWERA. CT head without contrast — first test for suspected subarachnoid hemorrhage. A 68-year-old has resting tremor, bradykinesia, cogwheel rigidity, and shuffling gait. Most likely diagnosis? A. Essential tremor B. Parkinson disease C. Huntington disease D. Cerebellar lesion - ANSWERB. Parkinson disease — classic motor findings. A 34-year-old has bilateral action tremor that improves with a small amount of alcohol and worsens when reaching for objects. Most likely diagnosis? A. Parkinson disease B. Essential tremor C. Seizure disorder D. Tardive dyskinesia - ANSWERB. Essential tremor — action tremor improved by alcohol. A patient has transient monocular vision loss lasting 5 minutes and then complete resolution. Best interpretation? A. Migraine aura only B. Bell palsy C. TIA equivalent requiring urgent evaluation D. Benign vertigo - ANSWERC. TIA equivalent requiring urgent evaluation — amaurosis fugax. A 25-year-old woman has episodes of vision loss, numbness, and weakness separated in time and location. Most likely diagnosis? A. ALS B. Multiple sclerosis C. Myasthenia gravis D. Parkinson disease - ANSWERB. Multiple sclerosis — lesions disseminated in time and space. A patient presents with acute red swollen exquisitely painful monoarticular knee with fever. What must be ruled out urgently? A. Osteoarthritis B. Septic arthritis C. Rheumatoid arthritis D. Bursitis - ANSWERB. Septic arthritis — emergency. A 60-year-old with diabetes has severe foot pain, erythema, warmth, and an ulcer probing to bone. Concern is highest for: A. Cellulitis only B. Osteomyelitis C. Contact dermatitis D. Gout - ANSWERB. Osteomyelitis — ulcer probing to bone is highly concerning. A 42-year-old has diffuse chronic musculoskeletal pain, fatigue, poor sleep, and normal ESR/CRP. Most likely diagnosis? A. Rheumatoid arthritis B. Fibromyalgia C. Polymyalgia rheumatica D. Septic arthritis - ANSWERB. Fibromyalgia — chronic widespread pain with normal inflammatory markers. A patient presents with LLQ pain, fever, and leukocytosis. Best imaging study for suspected diverticulitis? A. Colonoscopy B. CT abdomen/pelvis C. Barium enema D. Abdominal X-ray only - ANSWERB. CT abdomen/pelvis — best test for diverticulitis What are the major clues for an acute hemolytic reaction? - ANSWER Fever, chills, flank/back pain, and hypotension. What is the priority action when a client receiving packed RBCs develops chills, fever, and low back pain? - ANSWER Stop the transfusion. What is anaphylaxis? - ANSWER A severe, potentially fatal systemic allergic reaction that can cause airway swelling, bronchospasm, hypotension, and respiratory distress. What is the first-line medication for treating anaphylaxis? - ANSWER Epinephrine, typically administered IM into the lateral thigh. What are common opportunistic infections associated with HIV? - ANSWER Pneumocystis jirovecii pneumonia, candidiasis, tuberculosis, toxoplasmosis, and Kaposi sarcoma. What is the significance of Methotrexate in nursing exams? - ANSWER It is associated with immunosuppression and requires toxicity monitoring. What should be avoided while taking Methotrexate? - ANSWER Pregnancy and live vaccines unless approved by a provider. Which cellular protein molecule, when altered, causes glomerular disease? - ANSWER Podocin A 6-year-old male patient presents to a clinic with complaints of sneezing, rhinorrhea, eye irritation, ore throat, and cough. Upon examination of the patient, an APRN notes ... conjunctives, cobble-stoning, erythema of posterior pharynx, and hypertrophic turbinates that are boggy and pale. What is the probably diagnosis? - ANSWER Allergic rhinitis A 50-year-old average-risk adult asks about colon cancer screening. Best response? A. Screening is recommended beginning at guideline age for average-risk adults B. No screening unless symptoms develop C. Colonoscopy every year for everyone D. Screening starts at age 70 only - ANSWERA. Screening is recommended beginning at guideline age for average-risk adults.