WGU D118 ASSESSMENT PRACTICE
SOLUTION QUESTIONS AND SOLUTIONS
2026 GRADED A+.
◍ A 35-year old primigravida comes to an antenatal clinic for her first
obstetric visit. Her LMP was five weeks ago. She has a known case of
HIV diagnosed 6 years ago and is adherent to her triple drug ART
regimen with an undetectable viral load. At 35 weeks her viral load is
still undetectable and she gives birth via normal vaginal delivery at 39
weeks. At discharge ART regimens for the mother and child are
finalized. Which of the following recommendations about
breastfeeding in HIV positive mothers is most accurate?
A. There is no significant risk of HIV transmission via breastfeeding
in mothers under 30 years of age.
B. In resource rich settings the benefits of breastfeeding outweigh the
risk of HIV transmission
C. Maternal antibodies in breastmilk will protect the infant from HIV
infection
D. The risk of HIV transmission from breastmilk makes breastfeeding
unadvisable. Answer: D. The risk of HIV Transmission from
breastmilk makes breastfeeding unadvisable. Rationale: 10%-14% of
breastfeeding mothers transmit HIV to the uninfected infant. The US
official guidelines by the panel on treatment of pregnant women with
HIV infection and prevention of perinatal infection state that HIV
positive women must avoid breastfeeding as transmission of HIV
through breastmilk is still possible despite ART therapy. In parts of
,the world that lack adequate resources the benefit of breastfeeding
may outweigh these risks.
◍ A 43 year old IV drug user who has been on ART treatment
complains of continuous diarrhea that is watery, epigastric pain and
difficulty swallowing. His CBC shows a hemoglobin of 7.0 mg/dl,
total leukocyte count of 2900cmm and a platelet count of 70,000. A
CD4+ cell count was requested and it came out to be 90/cmm. Which
of the following laboratory investigations would best help with the
further evaluation of his diarrhea?
A. Stool tests for oocysts of cryptosporidium
B. Blood cultures for progressive disseminated histoplasmosis
C. Microscopy for pseudohyphae of Candida albicans
D. A stool for ova and parasites test for giardiasis. Answer: A. Stool
tests for oocysts of cryptosporidium. Rationale: The scenario is
indicative of diarrhea due to cryptosporidium which is a protozoan
and responsible for causing severe diarrhea in AIDS. This is seen
when CD4+ cell counts lower than 100 per cubic mm. The diarrhea is
of chronic nature and watery. The diagnosis is based on finding acid
fast oocysts in stool and also by antigen detection. With declining
CD4+ counts opportunistic infections become common.
Histoplasmosis usually presents with CD4+ counts usually between
100-200 cubic mm and fever, cough, dyspnea are the predominant
symptoms. Giardiasis has no specific association with AIDs and
presents usually with fatty diarrhea, not watery. Candida Albicans
causes esophagitis at cell counts lower than 100 per cubic mm which
explains the features of epigastric pain and dysphagia but has no
associations with diarrhea.
,◍ A 45 year old patient with a history of alcohol use disorder has
developed weakness, fatigue, loss of appetite, weight loss and
physical exam reveals ascites, hepatosplenomegaly, spider nevi,
clubbing, and dupuytren contracture. His ALT/AST ratio is 2.7 and
hemoglobin is 8.8 mg/dL. His MCV is 104 and ultrasonography
detects nodularity and increased echogenicity of the liver. Which of
the following would confirm a diagnosis of the suspected condition in
this patient?
A. Scleral icterus
B. Hyperbilirubinemia
C. Biopsy of the liver tissue
D. Elevated prothrombin time. Answer: C. Biopsy of the liver tissue.
Rationale: a liver biopsy is required to confirm cirrhosis . elevated
LFTs, bilirubin and decreased albumin are indicative of cirrhosis but
not confirmatory. predictors of cirrhosis are ascites, platelet count less
than 160,000 mm3, spider angiomata, and bonacini cirrhosis
discriminant score greater than 7.
◍ A 38-year-old woman presents to the clinic with a painful, tender
keratinized lesion on the sole of her right foot. She says that the lesion
developed two months ago and is slowly enlarging. She now has
difficulty bearing weight on her affected foot. Her past medical
history is significant for type II diabetes mellitus managed on
rosiglitazone. Her last menstrual period was three weeks ago. She is
sexually active with three partners, and inconsistently uses condoms.
Vital signs are within normal limits. The examination of the foot
shows a hyperkeratotic lesion with a dark center. The palpation of the
, lesion causes immense pain. What cancer is linked with the etiology
of this lesion?
A. Basal Cell Carcinoma
B. Melanoma
C. Cervical Cancer
D. Burkitt's lymphoma. Answer: C. Cervical Cancer. Rationale: This
lesion is most likely a plantar wart. However, with skin contact, the
HPV can be transferred to any part of the body. HPV tends to cause
genital warts, flat warts, and palmoplantar warts. Warts are easily
transmitted by direct or indirect contact, especially if there is a
disruption of the normal epithelial barrier. • Plantar warts are caused
by human papillomaviruses (HPV). • HPV serotypes 16 and 18 are
associated with carcinogenesis. Malignant transformation usually is
seen in patients with genital warts and immunocompromised patients.
• Cervical cancers are most commonly attributed to genital infections
with HPV serotypes 16 and 18.
◍ A 58-year-old man presented to the hospital with right-sided
decreased hearing for two years. His wife mentions he has started
snoring recently. He has been a smoker for the last 25 years and
smokes up to 20 cigarettes/day. The provider decides to perform a
nasendoscopy. Which key anatomical area is the pathology most
likely to be situated in?
A. Right Middle Meatus
B. The roof of the nasal cavity
C. Right vallecula
SOLUTION QUESTIONS AND SOLUTIONS
2026 GRADED A+.
◍ A 35-year old primigravida comes to an antenatal clinic for her first
obstetric visit. Her LMP was five weeks ago. She has a known case of
HIV diagnosed 6 years ago and is adherent to her triple drug ART
regimen with an undetectable viral load. At 35 weeks her viral load is
still undetectable and she gives birth via normal vaginal delivery at 39
weeks. At discharge ART regimens for the mother and child are
finalized. Which of the following recommendations about
breastfeeding in HIV positive mothers is most accurate?
A. There is no significant risk of HIV transmission via breastfeeding
in mothers under 30 years of age.
B. In resource rich settings the benefits of breastfeeding outweigh the
risk of HIV transmission
C. Maternal antibodies in breastmilk will protect the infant from HIV
infection
D. The risk of HIV transmission from breastmilk makes breastfeeding
unadvisable. Answer: D. The risk of HIV Transmission from
breastmilk makes breastfeeding unadvisable. Rationale: 10%-14% of
breastfeeding mothers transmit HIV to the uninfected infant. The US
official guidelines by the panel on treatment of pregnant women with
HIV infection and prevention of perinatal infection state that HIV
positive women must avoid breastfeeding as transmission of HIV
through breastmilk is still possible despite ART therapy. In parts of
,the world that lack adequate resources the benefit of breastfeeding
may outweigh these risks.
◍ A 43 year old IV drug user who has been on ART treatment
complains of continuous diarrhea that is watery, epigastric pain and
difficulty swallowing. His CBC shows a hemoglobin of 7.0 mg/dl,
total leukocyte count of 2900cmm and a platelet count of 70,000. A
CD4+ cell count was requested and it came out to be 90/cmm. Which
of the following laboratory investigations would best help with the
further evaluation of his diarrhea?
A. Stool tests for oocysts of cryptosporidium
B. Blood cultures for progressive disseminated histoplasmosis
C. Microscopy for pseudohyphae of Candida albicans
D. A stool for ova and parasites test for giardiasis. Answer: A. Stool
tests for oocysts of cryptosporidium. Rationale: The scenario is
indicative of diarrhea due to cryptosporidium which is a protozoan
and responsible for causing severe diarrhea in AIDS. This is seen
when CD4+ cell counts lower than 100 per cubic mm. The diarrhea is
of chronic nature and watery. The diagnosis is based on finding acid
fast oocysts in stool and also by antigen detection. With declining
CD4+ counts opportunistic infections become common.
Histoplasmosis usually presents with CD4+ counts usually between
100-200 cubic mm and fever, cough, dyspnea are the predominant
symptoms. Giardiasis has no specific association with AIDs and
presents usually with fatty diarrhea, not watery. Candida Albicans
causes esophagitis at cell counts lower than 100 per cubic mm which
explains the features of epigastric pain and dysphagia but has no
associations with diarrhea.
,◍ A 45 year old patient with a history of alcohol use disorder has
developed weakness, fatigue, loss of appetite, weight loss and
physical exam reveals ascites, hepatosplenomegaly, spider nevi,
clubbing, and dupuytren contracture. His ALT/AST ratio is 2.7 and
hemoglobin is 8.8 mg/dL. His MCV is 104 and ultrasonography
detects nodularity and increased echogenicity of the liver. Which of
the following would confirm a diagnosis of the suspected condition in
this patient?
A. Scleral icterus
B. Hyperbilirubinemia
C. Biopsy of the liver tissue
D. Elevated prothrombin time. Answer: C. Biopsy of the liver tissue.
Rationale: a liver biopsy is required to confirm cirrhosis . elevated
LFTs, bilirubin and decreased albumin are indicative of cirrhosis but
not confirmatory. predictors of cirrhosis are ascites, platelet count less
than 160,000 mm3, spider angiomata, and bonacini cirrhosis
discriminant score greater than 7.
◍ A 38-year-old woman presents to the clinic with a painful, tender
keratinized lesion on the sole of her right foot. She says that the lesion
developed two months ago and is slowly enlarging. She now has
difficulty bearing weight on her affected foot. Her past medical
history is significant for type II diabetes mellitus managed on
rosiglitazone. Her last menstrual period was three weeks ago. She is
sexually active with three partners, and inconsistently uses condoms.
Vital signs are within normal limits. The examination of the foot
shows a hyperkeratotic lesion with a dark center. The palpation of the
, lesion causes immense pain. What cancer is linked with the etiology
of this lesion?
A. Basal Cell Carcinoma
B. Melanoma
C. Cervical Cancer
D. Burkitt's lymphoma. Answer: C. Cervical Cancer. Rationale: This
lesion is most likely a plantar wart. However, with skin contact, the
HPV can be transferred to any part of the body. HPV tends to cause
genital warts, flat warts, and palmoplantar warts. Warts are easily
transmitted by direct or indirect contact, especially if there is a
disruption of the normal epithelial barrier. • Plantar warts are caused
by human papillomaviruses (HPV). • HPV serotypes 16 and 18 are
associated with carcinogenesis. Malignant transformation usually is
seen in patients with genital warts and immunocompromised patients.
• Cervical cancers are most commonly attributed to genital infections
with HPV serotypes 16 and 18.
◍ A 58-year-old man presented to the hospital with right-sided
decreased hearing for two years. His wife mentions he has started
snoring recently. He has been a smoker for the last 25 years and
smokes up to 20 cigarettes/day. The provider decides to perform a
nasendoscopy. Which key anatomical area is the pathology most
likely to be situated in?
A. Right Middle Meatus
B. The roof of the nasal cavity
C. Right vallecula
