WGU D115 OA ADVANCED
PATHOPHYSIOLOGY EXAM BANK: (LATEST
2026/2027 UPDATE), WITH
CORRECT/ACCURATE ANSWERS
WGU D115 |OA| OBJECTIVE ASSESSMENT
ADVANCED PATHOPHYSIOLOGY
WGU D115 OA ADVANCED PATHOPHYSIOLOGY EXAM 2026/2027 –
QUESTIONS & ANSWERS WITH RATIONALES
1. Age and the admission of the Glasgow Coma Scale (GCS) are important
diagnostic factors in TBI. Which GCS score describes a severe TBI?
A) 13-15
B) 12-13
C) 9-12
D) 3-8
Rationale: The Glasgow Coma Scale scores range from 3 to 15, with 3 indicating
deep coma and 15 fully alert. Severe TBI is classified as a GCS of 3–8. Scores of 9–
12 indicate moderate TBI, and 13–15 indicate mild TBI. This classification helps
guide acute management and prognosis.
2. Which term describes recurrent, intrusive thoughts or impulses?
A) Hallucinations
B) Compulsions
C) Obsessions
D) Delusions
Rationale: Obsessions are recurrent and persistent thoughts, impulses, or images
that cause significant anxiety or distress. Compulsions are repetitive behaviors
performed in response to obsessions. Hallucinations involve sensory perception
without a stimulus, and delusions are fixed false beliefs.
,3. During an intake interview with a 26-year-old man diagnosed with
generalized anxiety disorder, the FNP might observe what type of
behavior?
A) An inflated sense of self
B) Constant relation to future events
C) Inability to concentrate and irritability when questioned
D) Nervousness and fear of the FNP during the interview
Rationale: Impaired concentration and irritability are hallmark features of
generalized anxiety disorder (GAD). Patients may also show restlessness, fatigue,
and sleep disturbances. Inflated self-esteem is characteristic of mania, and
nervousness toward the provider is situational, not diagnostic.
4. The FNP would expect which symptoms in a patient with a diagnosis of
schizophrenia?
A) High energy with varying sleep patterns and nonstop conversation
B) Extreme and frequent mood swings with hyperactivity and difficulty
concentrating
C) Paranoia, delusions, hallucinations, and diminished self-care
D) Anti-social behavior, manipulative behavior, charisma, and ability to lie
convincingly
Rationale: Schizophrenia is characterized by positive symptoms (hallucinations,
delusions, disorganized thinking) and negative symptoms (diminished self-care,
flat affect). High energy and mood swings are more indicative of bipolar disorder.
5. The FNP is seeing a 10-year-old child with complaints of otalgia and
muffled hearing. The mother states the child recently recovered from an
upper respiratory infection. The FNP suspects that this child has:
A) Acute otitis media
B) Acute otitis externa
C) Cholesteatoma
D) Chronic otitis media
Rationale: Acute otitis media typically presents with ear pain, muffled hearing,
and recent upper respiratory infection. Otitis externa usually involves ear canal
pain and discharge, while chronic otitis media involves longer-term complications
like tympanic membrane perforation.
6. The FNP understands that a potential complication of tonsillar
infections, which is characterized by severe sore throat, difficulty
swallowing, odynophagia, trismus, and a "hot potato" voice; accompanied
by fever, chills, and malaise is indicative of:
A) Retropharyngeal abscess
B) Epiglottitis
,C) Peritonsillar cellulitis
D) Peritonsillar abscess
Rationale: A peritonsillar abscess is a collection of pus beside the tonsil, causing
severe unilateral throat pain, difficulty swallowing, and a muffled "hot potato"
voice. It is a common complication of untreated or severe tonsillitis.
7. A young adult female patient presents with nervousness,
tremulousness, palpitations, heat intolerance, fatigue, weight loss, and
polyphagia. After thyroid function tests, the FNP diagnoses
hyperthyroidism. The most common cause is:
A) Thyroid cancer
B) Graves' disease
C) Pituitary adenoma
D) Postpartum thyroiditis
Rationale: Graves' disease is the most common cause of hyperthyroidism in
adults and is an autoimmune disorder causing diffuse thyroid enlargement and
overproduction of thyroid hormones. Thyroid cancer and pituitary adenomas are
much less common causes.
8. During an evaluation of a patient with prediabetes, the FNP identifies
which finding in the patient's objective data that is associated with
increasing insulin resistance?
A) Triglycerides > 150 mg/dL
B) HDL > 40 mg/dL in men and >50 mg/dL in women
C) BP < 130/85 mm Hg
D) FBS < 110 mg/dL
Rationale: Insulin resistance is often associated with elevated triglycerides due to
improper utilization of glucose, which increases free fatty acid release. HDL
typically decreases, and blood pressure may rise with metabolic syndrome.
9. When prescribing a meal plan for a patient with type 2 diabetes, the
FNP emphasizes which macronutrient has the most influence on
postprandial glucose levels?
A) Fiber
B) Fat
C) Protein
D) Carbohydrate
Rationale: Carbohydrates have the greatest impact on postprandial glucose levels
because they are directly converted into glucose. Proteins and fats influence
glucose more slowly, while fiber can help modulate glucose absorption.
, 10. Which characteristic applies to type 1 diabetes mellitus?
A) Significant hyperglycemia and ketoacidosis result from a lack of insulin
B) Commonly diagnosed on routine examination
C) Initial response to oral sulfonylureas is favorable
D) Insulin resistance is significant
Rationale: Type 1 diabetes involves autoimmune destruction of beta cells,
causing absolute insulin deficiency. This can lead to hyperglycemia and diabetic
ketoacidosis (DKA). Type 2 diabetes often responds to oral medications and
involves insulin resistance rather than absolute deficiency.
11. Which characteristic applies to type 2 diabetes mellitus?
A) Major risk factors are heredity and obesity
B) Pear-shaped body type is commonly found
C) Exogenous insulin is always required
D) Physical activity increases insulin resistance
Rationale: Type 2 diabetes risk factors include genetic predisposition, obesity,
age, and sedentary lifestyle. Insulin resistance is the hallmark, and physical
activity actually improves glucose uptake. Pear-shaped body type is less strongly
associated than central obesity.
12. Which of the following is NOT a risk factor for endometrial cancer?
A) Obesity
B) Oral contraceptive use
C) Unopposed estrogen use
D) Advancing age (>50 years)
Rationale: Oral contraceptives are protective against endometrial cancer by
providing progestin, which counteracts estrogen-induced endometrial proliferation.
Obesity, unopposed estrogen therapy, and older age increase the risk.
13. The most accurate explanation for mixed precocious puberty is:
A) When a child develops some secondary sex characteristics of the
opposite sex
B) No identifiable external sex organs
C) Early puberty due to multiple causative effects
D) Early puberty with physical and hormonal abnormalities
Rationale: Mixed precocious puberty involves features of both sexes, such as
gynecomastia in boys or virilization in girls. It may result from complex interactions
of hormones from adrenal, gonadal, or pituitary sources.
14. In the majority of children experiencing delayed puberty, the problem
is caused by:
PATHOPHYSIOLOGY EXAM BANK: (LATEST
2026/2027 UPDATE), WITH
CORRECT/ACCURATE ANSWERS
WGU D115 |OA| OBJECTIVE ASSESSMENT
ADVANCED PATHOPHYSIOLOGY
WGU D115 OA ADVANCED PATHOPHYSIOLOGY EXAM 2026/2027 –
QUESTIONS & ANSWERS WITH RATIONALES
1. Age and the admission of the Glasgow Coma Scale (GCS) are important
diagnostic factors in TBI. Which GCS score describes a severe TBI?
A) 13-15
B) 12-13
C) 9-12
D) 3-8
Rationale: The Glasgow Coma Scale scores range from 3 to 15, with 3 indicating
deep coma and 15 fully alert. Severe TBI is classified as a GCS of 3–8. Scores of 9–
12 indicate moderate TBI, and 13–15 indicate mild TBI. This classification helps
guide acute management and prognosis.
2. Which term describes recurrent, intrusive thoughts or impulses?
A) Hallucinations
B) Compulsions
C) Obsessions
D) Delusions
Rationale: Obsessions are recurrent and persistent thoughts, impulses, or images
that cause significant anxiety or distress. Compulsions are repetitive behaviors
performed in response to obsessions. Hallucinations involve sensory perception
without a stimulus, and delusions are fixed false beliefs.
,3. During an intake interview with a 26-year-old man diagnosed with
generalized anxiety disorder, the FNP might observe what type of
behavior?
A) An inflated sense of self
B) Constant relation to future events
C) Inability to concentrate and irritability when questioned
D) Nervousness and fear of the FNP during the interview
Rationale: Impaired concentration and irritability are hallmark features of
generalized anxiety disorder (GAD). Patients may also show restlessness, fatigue,
and sleep disturbances. Inflated self-esteem is characteristic of mania, and
nervousness toward the provider is situational, not diagnostic.
4. The FNP would expect which symptoms in a patient with a diagnosis of
schizophrenia?
A) High energy with varying sleep patterns and nonstop conversation
B) Extreme and frequent mood swings with hyperactivity and difficulty
concentrating
C) Paranoia, delusions, hallucinations, and diminished self-care
D) Anti-social behavior, manipulative behavior, charisma, and ability to lie
convincingly
Rationale: Schizophrenia is characterized by positive symptoms (hallucinations,
delusions, disorganized thinking) and negative symptoms (diminished self-care,
flat affect). High energy and mood swings are more indicative of bipolar disorder.
5. The FNP is seeing a 10-year-old child with complaints of otalgia and
muffled hearing. The mother states the child recently recovered from an
upper respiratory infection. The FNP suspects that this child has:
A) Acute otitis media
B) Acute otitis externa
C) Cholesteatoma
D) Chronic otitis media
Rationale: Acute otitis media typically presents with ear pain, muffled hearing,
and recent upper respiratory infection. Otitis externa usually involves ear canal
pain and discharge, while chronic otitis media involves longer-term complications
like tympanic membrane perforation.
6. The FNP understands that a potential complication of tonsillar
infections, which is characterized by severe sore throat, difficulty
swallowing, odynophagia, trismus, and a "hot potato" voice; accompanied
by fever, chills, and malaise is indicative of:
A) Retropharyngeal abscess
B) Epiglottitis
,C) Peritonsillar cellulitis
D) Peritonsillar abscess
Rationale: A peritonsillar abscess is a collection of pus beside the tonsil, causing
severe unilateral throat pain, difficulty swallowing, and a muffled "hot potato"
voice. It is a common complication of untreated or severe tonsillitis.
7. A young adult female patient presents with nervousness,
tremulousness, palpitations, heat intolerance, fatigue, weight loss, and
polyphagia. After thyroid function tests, the FNP diagnoses
hyperthyroidism. The most common cause is:
A) Thyroid cancer
B) Graves' disease
C) Pituitary adenoma
D) Postpartum thyroiditis
Rationale: Graves' disease is the most common cause of hyperthyroidism in
adults and is an autoimmune disorder causing diffuse thyroid enlargement and
overproduction of thyroid hormones. Thyroid cancer and pituitary adenomas are
much less common causes.
8. During an evaluation of a patient with prediabetes, the FNP identifies
which finding in the patient's objective data that is associated with
increasing insulin resistance?
A) Triglycerides > 150 mg/dL
B) HDL > 40 mg/dL in men and >50 mg/dL in women
C) BP < 130/85 mm Hg
D) FBS < 110 mg/dL
Rationale: Insulin resistance is often associated with elevated triglycerides due to
improper utilization of glucose, which increases free fatty acid release. HDL
typically decreases, and blood pressure may rise with metabolic syndrome.
9. When prescribing a meal plan for a patient with type 2 diabetes, the
FNP emphasizes which macronutrient has the most influence on
postprandial glucose levels?
A) Fiber
B) Fat
C) Protein
D) Carbohydrate
Rationale: Carbohydrates have the greatest impact on postprandial glucose levels
because they are directly converted into glucose. Proteins and fats influence
glucose more slowly, while fiber can help modulate glucose absorption.
, 10. Which characteristic applies to type 1 diabetes mellitus?
A) Significant hyperglycemia and ketoacidosis result from a lack of insulin
B) Commonly diagnosed on routine examination
C) Initial response to oral sulfonylureas is favorable
D) Insulin resistance is significant
Rationale: Type 1 diabetes involves autoimmune destruction of beta cells,
causing absolute insulin deficiency. This can lead to hyperglycemia and diabetic
ketoacidosis (DKA). Type 2 diabetes often responds to oral medications and
involves insulin resistance rather than absolute deficiency.
11. Which characteristic applies to type 2 diabetes mellitus?
A) Major risk factors are heredity and obesity
B) Pear-shaped body type is commonly found
C) Exogenous insulin is always required
D) Physical activity increases insulin resistance
Rationale: Type 2 diabetes risk factors include genetic predisposition, obesity,
age, and sedentary lifestyle. Insulin resistance is the hallmark, and physical
activity actually improves glucose uptake. Pear-shaped body type is less strongly
associated than central obesity.
12. Which of the following is NOT a risk factor for endometrial cancer?
A) Obesity
B) Oral contraceptive use
C) Unopposed estrogen use
D) Advancing age (>50 years)
Rationale: Oral contraceptives are protective against endometrial cancer by
providing progestin, which counteracts estrogen-induced endometrial proliferation.
Obesity, unopposed estrogen therapy, and older age increase the risk.
13. The most accurate explanation for mixed precocious puberty is:
A) When a child develops some secondary sex characteristics of the
opposite sex
B) No identifiable external sex organs
C) Early puberty due to multiple causative effects
D) Early puberty with physical and hormonal abnormalities
Rationale: Mixed precocious puberty involves features of both sexes, such as
gynecomastia in boys or virilization in girls. It may result from complex interactions
of hormones from adrenal, gonadal, or pituitary sources.
14. In the majority of children experiencing delayed puberty, the problem
is caused by:
