WGU D027 OA 2026 REAL EXAM 150 QUESTIONS AND CORRECT
ANSWERS WITH RATIONALES COVERING THE MOST TESTED
QUESTIONS BUILDING CONFIDENCE TO PASS D027 EXAM
1. Which of the following is a primary mechanism of action for beta-blockers?
A) Increase heart rate
B) Block beta-adrenergic receptors
C) Stimulate renin release
D) Promote vasoconstriction
Rationale: Beta-blockers inhibit beta-adrenergic receptors, reducing heart rate and myocardial oxygen
demand.
2. A patient taking ACE inhibitors should be monitored for which common side effect?
A) Hypokalemia
B) Cough
C) Hyperglycemia
D) Tachycardia
Rationale: ACE inhibitors increase bradykinin, which can trigger a persistent dry cough.
3. Which medication is considered first-line therapy for type 2 diabetes?
A) Insulin
B) Glipizide
C) Metformin
D) Sitagliptin
Rationale: Metformin reduces hepatic glucose production and improves insulin sensitivity.
4. A patient receiving warfarin should be monitored for which laboratory value?
A) Hemoglobin A1c
B) INR
C) BUN
D) Serum potassium
Rationale: The INR (International Normalized Ratio) is used to monitor anticoagulation effect.
5. Which class of drugs is most commonly used to treat acute asthma attacks?
A) Leukotriene inhibitors
B) Short-acting beta-agonists
,C) Corticosteroids
D) Anticholinergics
Rationale: Short-acting beta-agonists (SABA) rapidly relax bronchial smooth muscle.
6. Digoxin toxicity is most likely associated with which electrolyte imbalance?
A) Hypernatremia
B) Hypermagnesemia
C) Hypokalemia
D) Hypercalcemia
Rationale: Low potassium increases digoxin binding to cardiac tissue, heightening toxicity risk.
7. Which type of insulin has the fastest onset of action?
A) NPH
B) Regular
C) Rapid-acting analogs (e.g., lispro)
D) Long-acting (e.g., glargine)
Rationale: Rapid-acting insulins start working within 15–30 minutes, ideal for postprandial glucose
control.
8. Which opioid side effect is most likely to occur with initial therapy?
A) Hypertension
B) Constipation
C) Diarrhea
D) Tachycardia
Rationale: Opioids reduce gut motility, leading to constipation.
9. The therapeutic effect of loop diuretics is primarily due to:
A) Sodium reabsorption in distal tubules
B) Inhibition of Na+/K+/2Cl− cotransporter in the loop of Henle
C) Water retention
D) Aldosterone antagonism
Rationale: Loop diuretics block sodium, potassium, and chloride reabsorption in the thick ascending
loop, increasing urine output.
10. A patient on long-term corticosteroids should be monitored for:
A) Bradycardia
B) Hypoglycemia
C) Hyperglycemia and osteoporosis
,D) Hypotension
Rationale: Corticosteroids increase blood sugar and reduce bone density over time.
11. Which of the following drugs is used to treat hyperthyroidism?
A) Levothyroxine
B) Methimazole
C) Insulin
D) Propylpentamine
Rationale: Methimazole inhibits thyroid hormone synthesis.
12. NSAIDs exert their analgesic effect primarily by:
A) Increasing prostaglandin synthesis
B) Inhibiting COX enzymes
C) Blocking opioid receptors
D) Stimulating the hypothalamus
Rationale: NSAIDs inhibit cyclooxygenase, reducing prostaglandin-mediated pain and inflammation.
13. Which electrolyte abnormality is most concerning in a patient on spironolactone?
A) Hypokalemia
B) Hyperkalemia
C) Hyponatremia
D) Hypocalcemia
Rationale: Spironolactone is a potassium-sparing diuretic, which can raise serum potassium.
14. The primary mechanism of action of ACE inhibitors in heart failure is:
A) Increasing preload
B) Stimulating sympathetic nervous system
C) Vasodilation and reduced afterload
D) Increasing heart rate
Rationale: ACE inhibitors reduce angiotensin II, leading to vasodilation and lower cardiac workload.
15. Which drug class is first-line for dyslipidemia?
A) Bile acid sequestrants
B) Statins
C) Fibrates
D) Niacin
Rationale: Statins inhibit HMG-CoA reductase, reducing LDL cholesterol and cardiovascular risk.
, 16. Which medication is most commonly used for rapid termination of severe hypoglycemia?
A) Insulin
B) Metformin
C) Glucose (oral or IV)
D) Glipizide
Rationale: Rapid administration of glucose restores blood sugar levels immediately.
17. Which of the following is a key side effect of aminoglycosides?
A) Hepatotoxicity
B) Nephrotoxicity and ototoxicity
C) Pulmonary fibrosis
D) Thrombocytopenia
Rationale: Aminoglycosides can damage kidneys and the inner ear; monitoring is essential.
18. Which anticoagulant works by directly inhibiting thrombin?
A) Warfarin
B) Heparin (indirect)
C) Dabigatran
D) Enoxaparin
Rationale: Dabigatran is a direct thrombin inhibitor.
19. Which antihypertensive class should be avoided in pregnancy?
A) Beta-blockers
B) ACE inhibitors
C) Calcium channel blockers
D) Alpha-2 agonists
Rationale: ACE inhibitors are teratogenic and contraindicated during pregnancy.
20. Which of the following drugs is indicated for heart failure with reduced ejection fraction?
A) Digoxin only
B) ACE inhibitors or ARBs
C) NSAIDs
D) Calcium channel blockers only
Rationale: ACE inhibitors reduce morbidity and mortality in HFrEF patients.
21. Which neurotransmitter is primarily targeted by SSRIs?
A) Dopamine
B) Norepinephrine
ANSWERS WITH RATIONALES COVERING THE MOST TESTED
QUESTIONS BUILDING CONFIDENCE TO PASS D027 EXAM
1. Which of the following is a primary mechanism of action for beta-blockers?
A) Increase heart rate
B) Block beta-adrenergic receptors
C) Stimulate renin release
D) Promote vasoconstriction
Rationale: Beta-blockers inhibit beta-adrenergic receptors, reducing heart rate and myocardial oxygen
demand.
2. A patient taking ACE inhibitors should be monitored for which common side effect?
A) Hypokalemia
B) Cough
C) Hyperglycemia
D) Tachycardia
Rationale: ACE inhibitors increase bradykinin, which can trigger a persistent dry cough.
3. Which medication is considered first-line therapy for type 2 diabetes?
A) Insulin
B) Glipizide
C) Metformin
D) Sitagliptin
Rationale: Metformin reduces hepatic glucose production and improves insulin sensitivity.
4. A patient receiving warfarin should be monitored for which laboratory value?
A) Hemoglobin A1c
B) INR
C) BUN
D) Serum potassium
Rationale: The INR (International Normalized Ratio) is used to monitor anticoagulation effect.
5. Which class of drugs is most commonly used to treat acute asthma attacks?
A) Leukotriene inhibitors
B) Short-acting beta-agonists
,C) Corticosteroids
D) Anticholinergics
Rationale: Short-acting beta-agonists (SABA) rapidly relax bronchial smooth muscle.
6. Digoxin toxicity is most likely associated with which electrolyte imbalance?
A) Hypernatremia
B) Hypermagnesemia
C) Hypokalemia
D) Hypercalcemia
Rationale: Low potassium increases digoxin binding to cardiac tissue, heightening toxicity risk.
7. Which type of insulin has the fastest onset of action?
A) NPH
B) Regular
C) Rapid-acting analogs (e.g., lispro)
D) Long-acting (e.g., glargine)
Rationale: Rapid-acting insulins start working within 15–30 minutes, ideal for postprandial glucose
control.
8. Which opioid side effect is most likely to occur with initial therapy?
A) Hypertension
B) Constipation
C) Diarrhea
D) Tachycardia
Rationale: Opioids reduce gut motility, leading to constipation.
9. The therapeutic effect of loop diuretics is primarily due to:
A) Sodium reabsorption in distal tubules
B) Inhibition of Na+/K+/2Cl− cotransporter in the loop of Henle
C) Water retention
D) Aldosterone antagonism
Rationale: Loop diuretics block sodium, potassium, and chloride reabsorption in the thick ascending
loop, increasing urine output.
10. A patient on long-term corticosteroids should be monitored for:
A) Bradycardia
B) Hypoglycemia
C) Hyperglycemia and osteoporosis
,D) Hypotension
Rationale: Corticosteroids increase blood sugar and reduce bone density over time.
11. Which of the following drugs is used to treat hyperthyroidism?
A) Levothyroxine
B) Methimazole
C) Insulin
D) Propylpentamine
Rationale: Methimazole inhibits thyroid hormone synthesis.
12. NSAIDs exert their analgesic effect primarily by:
A) Increasing prostaglandin synthesis
B) Inhibiting COX enzymes
C) Blocking opioid receptors
D) Stimulating the hypothalamus
Rationale: NSAIDs inhibit cyclooxygenase, reducing prostaglandin-mediated pain and inflammation.
13. Which electrolyte abnormality is most concerning in a patient on spironolactone?
A) Hypokalemia
B) Hyperkalemia
C) Hyponatremia
D) Hypocalcemia
Rationale: Spironolactone is a potassium-sparing diuretic, which can raise serum potassium.
14. The primary mechanism of action of ACE inhibitors in heart failure is:
A) Increasing preload
B) Stimulating sympathetic nervous system
C) Vasodilation and reduced afterload
D) Increasing heart rate
Rationale: ACE inhibitors reduce angiotensin II, leading to vasodilation and lower cardiac workload.
15. Which drug class is first-line for dyslipidemia?
A) Bile acid sequestrants
B) Statins
C) Fibrates
D) Niacin
Rationale: Statins inhibit HMG-CoA reductase, reducing LDL cholesterol and cardiovascular risk.
, 16. Which medication is most commonly used for rapid termination of severe hypoglycemia?
A) Insulin
B) Metformin
C) Glucose (oral or IV)
D) Glipizide
Rationale: Rapid administration of glucose restores blood sugar levels immediately.
17. Which of the following is a key side effect of aminoglycosides?
A) Hepatotoxicity
B) Nephrotoxicity and ototoxicity
C) Pulmonary fibrosis
D) Thrombocytopenia
Rationale: Aminoglycosides can damage kidneys and the inner ear; monitoring is essential.
18. Which anticoagulant works by directly inhibiting thrombin?
A) Warfarin
B) Heparin (indirect)
C) Dabigatran
D) Enoxaparin
Rationale: Dabigatran is a direct thrombin inhibitor.
19. Which antihypertensive class should be avoided in pregnancy?
A) Beta-blockers
B) ACE inhibitors
C) Calcium channel blockers
D) Alpha-2 agonists
Rationale: ACE inhibitors are teratogenic and contraindicated during pregnancy.
20. Which of the following drugs is indicated for heart failure with reduced ejection fraction?
A) Digoxin only
B) ACE inhibitors or ARBs
C) NSAIDs
D) Calcium channel blockers only
Rationale: ACE inhibitors reduce morbidity and mortality in HFrEF patients.
21. Which neurotransmitter is primarily targeted by SSRIs?
A) Dopamine
B) Norepinephrine
