WGU D118 FINAL TEST 2024/2025 QUESTIOS
WITH VERIFIED ANSWERS [GRADED A+]
LATEST EXAM 2024 // WGU D118
A female patient exhibits visual field defect, ataxia, and dysarthria, and complains
of a mild headache. A family member reports that the symptoms began several
hours prior and that the patient said that it was as if a shade was lowered over her
eye. An examination reveals normal range of motion of the neck.
his life. - ANSWER-Correct! Patients with ischemic stroke typically do not have
headaches; if they do, the headaches are milder than with hemorrhagic stroke.
Painless loss of vision, compared to a shade being lowered over the visual field
(amaurosis fugax) is a classic visual disturbance associated with ischemic stroke.
A male patient presents with nausea, vomiting, and a sudden, severe headache that
is described as the worst of - ANSWER-Correct! Patients with hemorrhagic stroke
typically have sudden, severe headaches, nausea, vomiting, and may briefly lose
consciousness.
A male patient was walking with his spouse when he complained of a headache,
and within five minutes, started slurring his speech, demonstrating marked
weakness in his left arm and leg, and developing worsening left-sided facial sag. -
ANSWER-Correct! Patients with hypertensive intracranial hemorrhage typically
experience headaches while awake and active, then develop neurological deficits
over a 5-30 minute period, marked by unilateral facial sag and unilateral leg and
arm weakness.
A female patient reports that she was unable to speak and had right-sided weakness
for 45 minutes, and then she regained her strength and ability to speak. -
,ANSWER-Correct! Patients with transient ischemic attack (TIA) report neurologic
deficits that are temporary and self-resolve. They typically have sudden, severe
headaches, nausea, vomiting, and may briefly lose consciousness.
DEMENTIA - ANSWER-To rule out reversible causes of dementia
a. Lab tests: CBC, vitamin B12 level, TSH and free T4, and chemistry panel;
depending on patient's history and medical condition, consider serum ammonia and
RPR or VDRL
b. Probable noncontrast CT or MRI of the brain (subdural hematoma, brain tumor,
Cryptococcus); see Table 4.2
c. If indicated, carotid Doppler studies; possibly echocardiogram
With depression, consider citalopram 10 to 20 mg qd
quetiapine
DEMENTIA TX - ANSWER-c) Cholinesterase inhibitors: donepezil (Aricept),
rivastigmine (Exelon, oral and patch), galantamine (Raza dyne, Raza dyne ER):
used with mild-to-moderate AD, vascular dementia (VaD), dementia with Lewy
bodies, or Parkinson disease
d) Memantine (Namenda): used with moderate-to-severe AD and VaD; little
benefit with mild AD
e) Vitamin E 2000 IU qd may help delay functional decline in mild-to-moderate
AD only, but does not have an effect on cognitive performance
f) The following have shown no benefit: NSAIDs, estrogen, vitamin B, Ginkgo
biloba, statins, omega-3 fatty acids
,A patient with dementia experiences agitation and visual hallucinations and is
given haloperidol with a subsequent worsening of symptoms.
What is the likely cause of this patient's symptoms, based on this response?
Pseudodementia
Alzheimer disease
Lewy body dementia
Vascular neurocognitive disorder - ANSWER-Correct! Patients with Lewy body
dementia may present with these symptoms and will have an increased sensitivity
to neuroleptics; when given haloperidol for agitation, the patient will actually get
worse.
Guillain-Barré syndrome - ANSWER-A. Signs and symptoms
1. Progressive (over approximately 2 wks.), fairly symmetric muscle weakness,
usually with ascending paralysis; may develop paraplegia or quadriplegia
2. Acute onset of hyperalgesia or myalgia
Which diagnostic test helps confirm a diagnosis of Guillain-Barré syndrome in a
patient who is developing muscle weakness and paresthesia’s?
Lumbar puncture
Screening for systemic infection
Nerve conduction studies
Magnetic resonance imaging (MRI)
Correct! A lumbar puncture is the most important confirmatory test showing
albumin cytologic disassociation.
What is an effective abortive therapy for a majority of patients with cluster
headaches?
Oxygen
, Verapamil
NSAIDs
Lithium - ANSWER-Correct! Oxygen works as abortive therapy for cluster
headaches in 75% of patients and should be inhaled at the start of an attack.
What is evidenced-based practice and why is it important in healthcare? -
ANSWER-Evidence-based practice (EBP) is defined by Duke University Medical
Center as "the integration of clinical expertise, patient values and the best research
evidence into the decision-making process for patient care.
DESCRIBE the standard methods for appraising evidence including evidence
grading scales. - ANSWER-Randomized control trials (RCTs) and systematic
reviews (SRs) are considered the goal standards in the types of evidence
hierarchical structure.
the Iowa Model of Evidence-Based Practice to Promote Quality Care - ANSWER-
IOWA Model was developed at the University of Iowa Hospitals and Clinics in
1990s to serve as a guide for nurses to use research findings to help improve
patient care. The model was developed as a pathway or method to EBP - a method
to guide the steps to help identify issues, research solutions and implement changes
ACE Star Model of Knowledge Transformation - ANSWER-The ACE Star Model
emphasizes crucial steps to convert one form of knowledge to the next and
incorporate best research evidence with clinical expertise and patient preferences
thereby achieving EBP
the Johns Hopkins Nursing Evidence-Based Practice Model - ANSWER-The Johns
Hopkins Nursing EBP Model is a powerful problem-solving approach to clinical
decision-making, and is accompanied by user-friendly tools to guide individual or
group use. It is designed specifically to meet the needs of the practicing nurse.
WITH VERIFIED ANSWERS [GRADED A+]
LATEST EXAM 2024 // WGU D118
A female patient exhibits visual field defect, ataxia, and dysarthria, and complains
of a mild headache. A family member reports that the symptoms began several
hours prior and that the patient said that it was as if a shade was lowered over her
eye. An examination reveals normal range of motion of the neck.
his life. - ANSWER-Correct! Patients with ischemic stroke typically do not have
headaches; if they do, the headaches are milder than with hemorrhagic stroke.
Painless loss of vision, compared to a shade being lowered over the visual field
(amaurosis fugax) is a classic visual disturbance associated with ischemic stroke.
A male patient presents with nausea, vomiting, and a sudden, severe headache that
is described as the worst of - ANSWER-Correct! Patients with hemorrhagic stroke
typically have sudden, severe headaches, nausea, vomiting, and may briefly lose
consciousness.
A male patient was walking with his spouse when he complained of a headache,
and within five minutes, started slurring his speech, demonstrating marked
weakness in his left arm and leg, and developing worsening left-sided facial sag. -
ANSWER-Correct! Patients with hypertensive intracranial hemorrhage typically
experience headaches while awake and active, then develop neurological deficits
over a 5-30 minute period, marked by unilateral facial sag and unilateral leg and
arm weakness.
A female patient reports that she was unable to speak and had right-sided weakness
for 45 minutes, and then she regained her strength and ability to speak. -
,ANSWER-Correct! Patients with transient ischemic attack (TIA) report neurologic
deficits that are temporary and self-resolve. They typically have sudden, severe
headaches, nausea, vomiting, and may briefly lose consciousness.
DEMENTIA - ANSWER-To rule out reversible causes of dementia
a. Lab tests: CBC, vitamin B12 level, TSH and free T4, and chemistry panel;
depending on patient's history and medical condition, consider serum ammonia and
RPR or VDRL
b. Probable noncontrast CT or MRI of the brain (subdural hematoma, brain tumor,
Cryptococcus); see Table 4.2
c. If indicated, carotid Doppler studies; possibly echocardiogram
With depression, consider citalopram 10 to 20 mg qd
quetiapine
DEMENTIA TX - ANSWER-c) Cholinesterase inhibitors: donepezil (Aricept),
rivastigmine (Exelon, oral and patch), galantamine (Raza dyne, Raza dyne ER):
used with mild-to-moderate AD, vascular dementia (VaD), dementia with Lewy
bodies, or Parkinson disease
d) Memantine (Namenda): used with moderate-to-severe AD and VaD; little
benefit with mild AD
e) Vitamin E 2000 IU qd may help delay functional decline in mild-to-moderate
AD only, but does not have an effect on cognitive performance
f) The following have shown no benefit: NSAIDs, estrogen, vitamin B, Ginkgo
biloba, statins, omega-3 fatty acids
,A patient with dementia experiences agitation and visual hallucinations and is
given haloperidol with a subsequent worsening of symptoms.
What is the likely cause of this patient's symptoms, based on this response?
Pseudodementia
Alzheimer disease
Lewy body dementia
Vascular neurocognitive disorder - ANSWER-Correct! Patients with Lewy body
dementia may present with these symptoms and will have an increased sensitivity
to neuroleptics; when given haloperidol for agitation, the patient will actually get
worse.
Guillain-Barré syndrome - ANSWER-A. Signs and symptoms
1. Progressive (over approximately 2 wks.), fairly symmetric muscle weakness,
usually with ascending paralysis; may develop paraplegia or quadriplegia
2. Acute onset of hyperalgesia or myalgia
Which diagnostic test helps confirm a diagnosis of Guillain-Barré syndrome in a
patient who is developing muscle weakness and paresthesia’s?
Lumbar puncture
Screening for systemic infection
Nerve conduction studies
Magnetic resonance imaging (MRI)
Correct! A lumbar puncture is the most important confirmatory test showing
albumin cytologic disassociation.
What is an effective abortive therapy for a majority of patients with cluster
headaches?
Oxygen
, Verapamil
NSAIDs
Lithium - ANSWER-Correct! Oxygen works as abortive therapy for cluster
headaches in 75% of patients and should be inhaled at the start of an attack.
What is evidenced-based practice and why is it important in healthcare? -
ANSWER-Evidence-based practice (EBP) is defined by Duke University Medical
Center as "the integration of clinical expertise, patient values and the best research
evidence into the decision-making process for patient care.
DESCRIBE the standard methods for appraising evidence including evidence
grading scales. - ANSWER-Randomized control trials (RCTs) and systematic
reviews (SRs) are considered the goal standards in the types of evidence
hierarchical structure.
the Iowa Model of Evidence-Based Practice to Promote Quality Care - ANSWER-
IOWA Model was developed at the University of Iowa Hospitals and Clinics in
1990s to serve as a guide for nurses to use research findings to help improve
patient care. The model was developed as a pathway or method to EBP - a method
to guide the steps to help identify issues, research solutions and implement changes
ACE Star Model of Knowledge Transformation - ANSWER-The ACE Star Model
emphasizes crucial steps to convert one form of knowledge to the next and
incorporate best research evidence with clinical expertise and patient preferences
thereby achieving EBP
the Johns Hopkins Nursing Evidence-Based Practice Model - ANSWER-The Johns
Hopkins Nursing EBP Model is a powerful problem-solving approach to clinical
decision-making, and is accompanied by user-friendly tools to guide individual or
group use. It is designed specifically to meet the needs of the practicing nurse.
