WGU D118 Adult Primary Care for the Advanced Practice Nurse
WGU D118 Adult Primary Care for the
Advanced Practice Nurse OA Practice
Exam Questions and Answers 2026.
Advanced NCLEX-Style 100 MCQs with
Rationales
Questions 1–25 (Advanced FNP/APRN Level)
D118 focuses on health promotion, disease prevention, differential diagnosis, management of
acute and chronic adult conditions, evidence-based primary care guidelines, pharmacology, and
clinical decision-making for adult and older adult patients.
Q1
A 56-year-old patient presents with blood pressure readings averaging 148/92 mmHg over three
separate visits. Which medication is considered an appropriate first-line treatment for
uncomplicated primary hypertension?
A. Clonidine
B. Hydrochlorothiazide
C. Hydralazine
D. Propranolol
Answer: B
Rationale: Thiazide diuretics remain a recommended first-line option for uncomplicated
hypertension in many adults. Lifestyle modification should accompany pharmacologic therapy.
Q2
A 62-year-old patient with type 2 diabetes has an A1c of 8.4% despite lifestyle modification.
Which medication is generally recommended as first-line pharmacologic therapy?
A. Insulin glargine
B. Metformin
, WGU D118 Adult Primary Care for the Advanced Practice Nurse
C. Pioglitazone
D. Glyburide
Answer: B
Q3
A patient presents with fatigue, weight gain, constipation, and cold intolerance. Which laboratory
finding is most consistent with primary hypothyroidism?
A. Low TSH, High T4
B. High TSH, Low Free T4
C. High TSH, High T4
D. Low TSH, Low T4
Answer: B
Q4
Which screening is recommended for adults with significant smoking history to detect lung
cancer?
A. Chest X-ray annually
B. Sputum cytology annually
C. Low-dose CT scan
D. MRI annually
Answer: C
Q5
A patient reports sudden unilateral facial droop, inability to close one eye, and altered taste
sensation. The most likely diagnosis is:
A. Bell's palsy
B. Trigeminal neuralgia
C. Temporal arteritis
D. Migraine
, WGU D118 Adult Primary Care for the Advanced Practice Nurse
Answer: A
Q6
A patient presents with productive cough, fever, crackles, and tachypnea. Which diagnostic test
is most appropriate initially?
A. MRI chest
B. Pulmonary function testing
C. Chest radiograph
D. Bronchoscopy
Answer: C
Q7
Which lipid-lowering medication is considered first-line therapy for hyperlipidemia?
A. Niacin
B. Fibrate
C. Statin
D. Bile Acid Sequestrant
Answer: C
Q8
An older adult reports increasing confusion over several days following a urinary tract infection.
Which condition should be suspected first?
A. Dementia
B. Delirium
C. Depression
D. Parkinson disease
Answer: B
Rationale: Acute onset confusion with fluctuating mental status suggests delirium rather than
dementia.
, WGU D118 Adult Primary Care for the Advanced Practice Nurse
Q9
A patient has fasting glucose of 132 mg/dL on two separate occasions. Which diagnosis is
supported?
A. Prediabetes
B. Metabolic syndrome
C. Type 2 diabetes mellitus
D. Reactive hypoglycemia
Answer: C
Q10
A patient with COPD asks which inhaler should be used during acute shortness of breath.
A. Tiotropium
B. Fluticasone
C. Albuterol
D. Budesonide
Answer: C
Q11
Which finding is most concerning for acute coronary syndrome?
A. Sharp chest pain worse with inspiration
B. Reproducible chest wall tenderness
C. Pressure-like chest discomfort radiating to jaw
D. Burning epigastric pain after meals
Answer: C
Q12
WGU D118 Adult Primary Care for the
Advanced Practice Nurse OA Practice
Exam Questions and Answers 2026.
Advanced NCLEX-Style 100 MCQs with
Rationales
Questions 1–25 (Advanced FNP/APRN Level)
D118 focuses on health promotion, disease prevention, differential diagnosis, management of
acute and chronic adult conditions, evidence-based primary care guidelines, pharmacology, and
clinical decision-making for adult and older adult patients.
Q1
A 56-year-old patient presents with blood pressure readings averaging 148/92 mmHg over three
separate visits. Which medication is considered an appropriate first-line treatment for
uncomplicated primary hypertension?
A. Clonidine
B. Hydrochlorothiazide
C. Hydralazine
D. Propranolol
Answer: B
Rationale: Thiazide diuretics remain a recommended first-line option for uncomplicated
hypertension in many adults. Lifestyle modification should accompany pharmacologic therapy.
Q2
A 62-year-old patient with type 2 diabetes has an A1c of 8.4% despite lifestyle modification.
Which medication is generally recommended as first-line pharmacologic therapy?
A. Insulin glargine
B. Metformin
, WGU D118 Adult Primary Care for the Advanced Practice Nurse
C. Pioglitazone
D. Glyburide
Answer: B
Q3
A patient presents with fatigue, weight gain, constipation, and cold intolerance. Which laboratory
finding is most consistent with primary hypothyroidism?
A. Low TSH, High T4
B. High TSH, Low Free T4
C. High TSH, High T4
D. Low TSH, Low T4
Answer: B
Q4
Which screening is recommended for adults with significant smoking history to detect lung
cancer?
A. Chest X-ray annually
B. Sputum cytology annually
C. Low-dose CT scan
D. MRI annually
Answer: C
Q5
A patient reports sudden unilateral facial droop, inability to close one eye, and altered taste
sensation. The most likely diagnosis is:
A. Bell's palsy
B. Trigeminal neuralgia
C. Temporal arteritis
D. Migraine
, WGU D118 Adult Primary Care for the Advanced Practice Nurse
Answer: A
Q6
A patient presents with productive cough, fever, crackles, and tachypnea. Which diagnostic test
is most appropriate initially?
A. MRI chest
B. Pulmonary function testing
C. Chest radiograph
D. Bronchoscopy
Answer: C
Q7
Which lipid-lowering medication is considered first-line therapy for hyperlipidemia?
A. Niacin
B. Fibrate
C. Statin
D. Bile Acid Sequestrant
Answer: C
Q8
An older adult reports increasing confusion over several days following a urinary tract infection.
Which condition should be suspected first?
A. Dementia
B. Delirium
C. Depression
D. Parkinson disease
Answer: B
Rationale: Acute onset confusion with fluctuating mental status suggests delirium rather than
dementia.
, WGU D118 Adult Primary Care for the Advanced Practice Nurse
Q9
A patient has fasting glucose of 132 mg/dL on two separate occasions. Which diagnosis is
supported?
A. Prediabetes
B. Metabolic syndrome
C. Type 2 diabetes mellitus
D. Reactive hypoglycemia
Answer: C
Q10
A patient with COPD asks which inhaler should be used during acute shortness of breath.
A. Tiotropium
B. Fluticasone
C. Albuterol
D. Budesonide
Answer: C
Q11
Which finding is most concerning for acute coronary syndrome?
A. Sharp chest pain worse with inspiration
B. Reproducible chest wall tenderness
C. Pressure-like chest discomfort radiating to jaw
D. Burning epigastric pain after meals
Answer: C
Q12
