WGU D027 COMPREHENSIVE MEDICAL
EXAM WITH 200+ QUESTIONS AND
CORRECT ANSWERS| GRADED A+ FOR
QUICK REVIEW
A patient who has traveler's diarrhea asks the nurse about using loperamide to stop
the symptoms. What will the nurse tell the patient about this drug? - Answer "Use
of this drug may prolong symptoms by slowing peristalsis and should not be used
for infectious diarrhea." -
Loperamide is recommended to treat mild diarrheal illness. It should not be used
for infectious diarrhea due to its slowing the body's mechanisms of expelling the
infectious agent.
A patient with type 2 diabetes mellitus takes glipizide. The patient develops a
urinary tract infection, and the prescriber orders trimethoprim/sulfamethoxazole
(TMP/SMZ). What will the nurse tell the patient? - Answer "The patient should
check the blood glucose level more often while taking TMP/SMZ." -
The SMZ in TMP/SMZ increases the effect of glipizide, which puts the patient at
risk of hypoglycemia. (Blood glucose should be tested more frequently while
taking TMP/SMZ.)
A young, nonpregnant female patient with a history of a previous urinary tract
infection (UTI) is experiencing dysuria, urinary urgency and frequency, and
suprapubic pain of three days' duration. She is afebrile. A urine culture is positive
for more than 100,000/mL of CFU urine. Which treatment should the nurse caring
,for this patient recommend? - Answer A three-day course of
trimethoprim/sulfamethoxazole [Bactrim] -
A female UTI is treated with either a single-dose, short course, or long course of
antibiotics, depending on the etiology. Eighty percent of female recurrent UTIs are
due to reinfection versus relapse and should be treated as a new infection with a
short course of antibiotics. Short-course therapy is more efficacious than single-
dose therapy in treating uncomplicated UTIs in nonpregnant women with
symptoms that last less than seven days.
A patient complains of painful urination. A physical examination reveals vesicles
on her labia, vagina, and the foreskin of her clitoris. The nurse will expect to teach
this patient about which medication? - Answer Acyclovir [Zovirax] -
Vesicular infections caused by herpes simplex genitalis are treated with antiviral
agents like acyclovir and valacyclovir [Valtrex].
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 atherosclerotic
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? - Answer Atorvastatin
(Lipitor) 20mg -
Atorvastatin is more effective in reducing total cholesterol having a greater impact
on lowering LDL cholesterol. The American College of Cardiology guidelines on
blood cholesterol management emphasize that the greater the reduction in the
LDL-C on statin therapy, the greater the subsequent risk reduction.
A 73-year-old man with congestive heart failure (CHF) 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 1500.
Using the 2017 heart failure guidelines, which medication change should be
recommended for this patient? - Answer Stop angiotensin receptor blockers (ARB)
and add sacubitril/valsartan (Entresto) -
In this case, the elevated BNP indicates significant heart failure. Guidelines
recommend replacing an ARB or ACE inhibitor with an ARNI such as Entresto.
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? - Answer Beta
blockers -
The use of nonselective beta blockers is contraindicated in the management of
patients with a history of COPD or asthma because they impact both beta 1 and
beta 2 receptors and precipitate bronchospasms. Cardioselective beta blockers,
while less likely to cause bronchospasms, may still add to the risk of respiratory
compromise.
Which statement regarding hypertension (HTN) is true? - Answer One of the most
important factors affecting blood pressure is sodium intake -
A family history of HTN accounts for upwards of 40% of variation in blood
pressure. Stress, obesity, lifestyle, and dietary intake of sodium especially are
significant causes of HTN.
What statement regarding type 2 diabetes is true? - Answer It accounts for 90-95%
of all cases of diabetes -
, Only 5% of all individuals with diabetes are diagnosed with type 1 diabetes, while
90-95% of individuals with diabetes are diagnosed with type 2 (Rosenthal, L., &
Burchum, J. (2018), p. 485).
A nurse is teaching a group of women about medications. The women want to
know why so many drugs have unpredictable effects in women. The nurse should
tell them which of the following? - Answer Most known drug effects are based on
drug trials in men -
Most drug studies have been conducted on subjects who are white and male. This
creates an opportunity for unexpected side effects in females that would otherwise
have been known had enough women been enrolled in drug trials.
A nurse administers the same medication in the same preparation in the same dose
to several patients and notes that some patients have a better response to the drug
than others. What is the most likely explanation for this phenomenon? - Answer
Pharmacogenomic differences among individuals -
Varying individual responses to drugs are driven by genetic differences between
persons. The study of genes and drug responses is pharmacogenomics.
A patient has been taking narcotic analgesics for chronic pain for several months.
The nurse caring for this patient notes that the prescribed dose is higher than the
recommended dose. The patient has normal vital signs, is awake and alert, and
reports mild pain. What should the nurse recognize about this patient? - Answer
This patient has developed pharmacodynamic tolerance, which has increased the
minimal effective concentration (MEC) needed for an analgesic effect -
After taking narcotic analgesics for several months, the patient has developed
pharmacodynamic tolerance due to chronic binding to G protein-coupled receptors.
This leads to an increased MEC needed to reduce pain.
EXAM WITH 200+ QUESTIONS AND
CORRECT ANSWERS| GRADED A+ FOR
QUICK REVIEW
A patient who has traveler's diarrhea asks the nurse about using loperamide to stop
the symptoms. What will the nurse tell the patient about this drug? - Answer "Use
of this drug may prolong symptoms by slowing peristalsis and should not be used
for infectious diarrhea." -
Loperamide is recommended to treat mild diarrheal illness. It should not be used
for infectious diarrhea due to its slowing the body's mechanisms of expelling the
infectious agent.
A patient with type 2 diabetes mellitus takes glipizide. The patient develops a
urinary tract infection, and the prescriber orders trimethoprim/sulfamethoxazole
(TMP/SMZ). What will the nurse tell the patient? - Answer "The patient should
check the blood glucose level more often while taking TMP/SMZ." -
The SMZ in TMP/SMZ increases the effect of glipizide, which puts the patient at
risk of hypoglycemia. (Blood glucose should be tested more frequently while
taking TMP/SMZ.)
A young, nonpregnant female patient with a history of a previous urinary tract
infection (UTI) is experiencing dysuria, urinary urgency and frequency, and
suprapubic pain of three days' duration. She is afebrile. A urine culture is positive
for more than 100,000/mL of CFU urine. Which treatment should the nurse caring
,for this patient recommend? - Answer A three-day course of
trimethoprim/sulfamethoxazole [Bactrim] -
A female UTI is treated with either a single-dose, short course, or long course of
antibiotics, depending on the etiology. Eighty percent of female recurrent UTIs are
due to reinfection versus relapse and should be treated as a new infection with a
short course of antibiotics. Short-course therapy is more efficacious than single-
dose therapy in treating uncomplicated UTIs in nonpregnant women with
symptoms that last less than seven days.
A patient complains of painful urination. A physical examination reveals vesicles
on her labia, vagina, and the foreskin of her clitoris. The nurse will expect to teach
this patient about which medication? - Answer Acyclovir [Zovirax] -
Vesicular infections caused by herpes simplex genitalis are treated with antiviral
agents like acyclovir and valacyclovir [Valtrex].
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 atherosclerotic
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? - Answer Atorvastatin
(Lipitor) 20mg -
Atorvastatin is more effective in reducing total cholesterol having a greater impact
on lowering LDL cholesterol. The American College of Cardiology guidelines on
blood cholesterol management emphasize that the greater the reduction in the
LDL-C on statin therapy, the greater the subsequent risk reduction.
A 73-year-old man with congestive heart failure (CHF) 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 1500.
Using the 2017 heart failure guidelines, which medication change should be
recommended for this patient? - Answer Stop angiotensin receptor blockers (ARB)
and add sacubitril/valsartan (Entresto) -
In this case, the elevated BNP indicates significant heart failure. Guidelines
recommend replacing an ARB or ACE inhibitor with an ARNI such as Entresto.
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? - Answer Beta
blockers -
The use of nonselective beta blockers is contraindicated in the management of
patients with a history of COPD or asthma because they impact both beta 1 and
beta 2 receptors and precipitate bronchospasms. Cardioselective beta blockers,
while less likely to cause bronchospasms, may still add to the risk of respiratory
compromise.
Which statement regarding hypertension (HTN) is true? - Answer One of the most
important factors affecting blood pressure is sodium intake -
A family history of HTN accounts for upwards of 40% of variation in blood
pressure. Stress, obesity, lifestyle, and dietary intake of sodium especially are
significant causes of HTN.
What statement regarding type 2 diabetes is true? - Answer It accounts for 90-95%
of all cases of diabetes -
, Only 5% of all individuals with diabetes are diagnosed with type 1 diabetes, while
90-95% of individuals with diabetes are diagnosed with type 2 (Rosenthal, L., &
Burchum, J. (2018), p. 485).
A nurse is teaching a group of women about medications. The women want to
know why so many drugs have unpredictable effects in women. The nurse should
tell them which of the following? - Answer Most known drug effects are based on
drug trials in men -
Most drug studies have been conducted on subjects who are white and male. This
creates an opportunity for unexpected side effects in females that would otherwise
have been known had enough women been enrolled in drug trials.
A nurse administers the same medication in the same preparation in the same dose
to several patients and notes that some patients have a better response to the drug
than others. What is the most likely explanation for this phenomenon? - Answer
Pharmacogenomic differences among individuals -
Varying individual responses to drugs are driven by genetic differences between
persons. The study of genes and drug responses is pharmacogenomics.
A patient has been taking narcotic analgesics for chronic pain for several months.
The nurse caring for this patient notes that the prescribed dose is higher than the
recommended dose. The patient has normal vital signs, is awake and alert, and
reports mild pain. What should the nurse recognize about this patient? - Answer
This patient has developed pharmacodynamic tolerance, which has increased the
minimal effective concentration (MEC) needed for an analgesic effect -
After taking narcotic analgesics for several months, the patient has developed
pharmacodynamic tolerance due to chronic binding to G protein-coupled receptors.
This leads to an increased MEC needed to reduce pain.
