WGU D027 PRACTICE EXAM # 2
Questions and Answers
1.1.During the body's inflammatory process, what causes edema?
Vasodila- tion of blood vessels
Emigration of neutrophils
Endothelial cell expansion
Increased capillary permeability:
Answer Increased capillary permeability. The increased flow and
capillary permeability result in a leakage of plasma from the vessels
causing swelling (edema) in the surrounding tissue and is solely
responsible for inflammation induced edema
2.2.A 56-year-old diabetic patient has not taken his insulin in 4 days due to
him "feeling well without it". He is admitted to the ED with an elevated
blood sugar. What electrolyte should be assessed FIRST
Calcium
Sodium
Potassium
Chloride
Answer Potassium. Insulin facilitates the intracellular transport of
potassium, phos- phate, and magnesium. Without insulin, potassium doe
not get transported to the intracellular environment and the serum
potassium will rise.
3.3.A 46-year-old women is considering having another child. The
healthcare providers are explaining to the woman that children born to
women late in life have an increase rate in having children with which
condition
Answer Kawasaki's disease
1/
31
,Down syndrome
Down syndrome risk increases with Maternal age.
Klinefelter syndrome
Turner syndrome
4.4.A patient with several risk factors is concerned about developing
type 2 diabetes. The healthcare professional advises the patient to lose
weight,
explaining that obesity is an important risk factor for type 2 diabetes mellitus
because it causes what
Answer Reduced insulin production by the pancreas
Increased resistance to insulin in the cells
People with type 2 diabetes mellitus suffer from insulin resistance.
Obesity causes this resistance so their cells have difficulty using insulin.
Obesity does not lead
to reduced insulin production, obstructed insulin outflow, or stimulation o
glucose production.
Obstructed outflow of insulin from the pancreas
Stimulation of glucose production by the liver
5.5.When evaluating a patient for hypertensive target organ damage,
the APRN looks for evidence of
Answer Lipid abnormality
Insulin resistance
Left ventricular hypertrophy
2/
31
,Clotting disorders
6.6.On ultrasound a patient had 4-chamber dilation with an ejection fraction
of 15% and a pleural effusion on chest x-ray. Elevated liver function tests,
hypokalemia, and hypomagnesema are seen on lab results. Blood pressure
is 115/60 and heart rate is 110 bpm with regular rate and rhythm, respiratory
rate 30 bpm and O2 saturation is 88% on room air. Initial therapy should
include all of the following except
Answer Diuretic
ACE
Inhibitor
Digoxin
Beta Blocker
7.7.A patient in the emergency department is suspected of having a
myocar- dial infarction (MI). The initial cardiac troponin 1 level was negative.
What action by the healthcare professional is best
Answer Administer thrombolytic therapy.
Discharge the patient.
Schedule repeat troponin within a few hours.
Several cardiac biomarkers exist including the most specific, cardiac
troponin 1
(cTnI), cTnI begins to rise within 2 to 4 hours after cardiac injury, so if
the initial result is normal, the test should be repeated within 6 to 9
hours and again at 12 to 24 hours. It is not known yet if the patient has
had an MI so treatment with thrombolytic therapy and/or catheterization
would be premature. The patient should not be discharged since the
professional suspected an MI.
3/
31
, Prepare the patient for cardiac catheterization.
8.8.Which patient would the healthcare professional assess for elevated
lev- els of antidiuretic
hormone (ADH) secretion
Answer Being treated for small cell carcinoma of the stomach
Taking high dose acetaminophen (Tylenol) for
arthritis Had a hip replacement operation 14 days
ago
Has long-standing kidney disease from diabetes
9.9.A post-operative patient with gallbladder surgery has an epidural in-
fusion of Astramorph. The patients respiratory rate starts to decline to 9
breaths/minute. Which medication should the healthcare provider
anticipate administering to this patient?
Protamine
sulfate
Mucomyst
Naloxone
Naloxone is a narcotic antagonist that can reverse the effect of both adverse
and therapeutic use of opioid narcotic analgesics.
Solu-Medrol:
10.10.A patient is brought to the Emergency Department with a gunshot
wound to the chest. The healthcare professional assesses an abnormality
involving a pleural rupture that acts as a one-way valve, permitting air to
enter on inspiration but preventing its escape by closing during expiration.
4/
31
Questions and Answers
1.1.During the body's inflammatory process, what causes edema?
Vasodila- tion of blood vessels
Emigration of neutrophils
Endothelial cell expansion
Increased capillary permeability:
Answer Increased capillary permeability. The increased flow and
capillary permeability result in a leakage of plasma from the vessels
causing swelling (edema) in the surrounding tissue and is solely
responsible for inflammation induced edema
2.2.A 56-year-old diabetic patient has not taken his insulin in 4 days due to
him "feeling well without it". He is admitted to the ED with an elevated
blood sugar. What electrolyte should be assessed FIRST
Calcium
Sodium
Potassium
Chloride
Answer Potassium. Insulin facilitates the intracellular transport of
potassium, phos- phate, and magnesium. Without insulin, potassium doe
not get transported to the intracellular environment and the serum
potassium will rise.
3.3.A 46-year-old women is considering having another child. The
healthcare providers are explaining to the woman that children born to
women late in life have an increase rate in having children with which
condition
Answer Kawasaki's disease
1/
31
,Down syndrome
Down syndrome risk increases with Maternal age.
Klinefelter syndrome
Turner syndrome
4.4.A patient with several risk factors is concerned about developing
type 2 diabetes. The healthcare professional advises the patient to lose
weight,
explaining that obesity is an important risk factor for type 2 diabetes mellitus
because it causes what
Answer Reduced insulin production by the pancreas
Increased resistance to insulin in the cells
People with type 2 diabetes mellitus suffer from insulin resistance.
Obesity causes this resistance so their cells have difficulty using insulin.
Obesity does not lead
to reduced insulin production, obstructed insulin outflow, or stimulation o
glucose production.
Obstructed outflow of insulin from the pancreas
Stimulation of glucose production by the liver
5.5.When evaluating a patient for hypertensive target organ damage,
the APRN looks for evidence of
Answer Lipid abnormality
Insulin resistance
Left ventricular hypertrophy
2/
31
,Clotting disorders
6.6.On ultrasound a patient had 4-chamber dilation with an ejection fraction
of 15% and a pleural effusion on chest x-ray. Elevated liver function tests,
hypokalemia, and hypomagnesema are seen on lab results. Blood pressure
is 115/60 and heart rate is 110 bpm with regular rate and rhythm, respiratory
rate 30 bpm and O2 saturation is 88% on room air. Initial therapy should
include all of the following except
Answer Diuretic
ACE
Inhibitor
Digoxin
Beta Blocker
7.7.A patient in the emergency department is suspected of having a
myocar- dial infarction (MI). The initial cardiac troponin 1 level was negative.
What action by the healthcare professional is best
Answer Administer thrombolytic therapy.
Discharge the patient.
Schedule repeat troponin within a few hours.
Several cardiac biomarkers exist including the most specific, cardiac
troponin 1
(cTnI), cTnI begins to rise within 2 to 4 hours after cardiac injury, so if
the initial result is normal, the test should be repeated within 6 to 9
hours and again at 12 to 24 hours. It is not known yet if the patient has
had an MI so treatment with thrombolytic therapy and/or catheterization
would be premature. The patient should not be discharged since the
professional suspected an MI.
3/
31
, Prepare the patient for cardiac catheterization.
8.8.Which patient would the healthcare professional assess for elevated
lev- els of antidiuretic
hormone (ADH) secretion
Answer Being treated for small cell carcinoma of the stomach
Taking high dose acetaminophen (Tylenol) for
arthritis Had a hip replacement operation 14 days
ago
Has long-standing kidney disease from diabetes
9.9.A post-operative patient with gallbladder surgery has an epidural in-
fusion of Astramorph. The patients respiratory rate starts to decline to 9
breaths/minute. Which medication should the healthcare provider
anticipate administering to this patient?
Protamine
sulfate
Mucomyst
Naloxone
Naloxone is a narcotic antagonist that can reverse the effect of both adverse
and therapeutic use of opioid narcotic analgesics.
Solu-Medrol:
10.10.A patient is brought to the Emergency Department with a gunshot
wound to the chest. The healthcare professional assesses an abnormality
involving a pleural rupture that acts as a one-way valve, permitting air to
enter on inspiration but preventing its escape by closing during expiration.
4/
31
