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WGU D115 Advanced Pathophysiology
Pre-Assessment Exam & Study guide
Complete Guide with Questions and Verified Answers
1. An advanced practice registered nurse (APRN) is consulting with a teen
patient who has recently learned that she is pregnant. The APRN knows that a certain medication taken by the patient can contribute to the development of congenital malformations in the fetus. The APRN reviews the patient's current medication list and finds one medication that is a concern. Which medication is the APRN concerned about? Retinoic acid Clindamycin Benzoyl peroxide Bisphenol A Answer Retinoic acid
2. A newborn's screening for cystic fibrosis is positive. An advanced practice registered
nurse (APRN) is reviewing
screening results and taking a comprehensive genetic screening of the par- ents. The APRN asks the parents questions to help determine the transmission of this disease. Which question should the APRN ask? "Do any of your siblings have cystic fibrosis?" "Do you wish to have maternal genetic testing done?" "Are either of you showing symptoms of cystic fibrosis?" "Are you both the genetic donor parents?" Answer "Are you both the genetic donor parents?"
3. A 30-day-old infant presents to the emergency room with decreased oral intake,
decreased urine output, and a fever of 101.8. The infant is admitted for further evaluation with a workup to include a blood culture, a urine culture, a spinal tap, and a chest X-ray. Which issue of innate immunity, as it relates to neonates, is of concern? High levels of mannose-binding lectin Relative deficiency of factor B Excess collectin and collectin-like protein Dysfunctional chemotactic factor response Answer Relative deficiency of factor B
6. A 36-year-old patient is being seen by an advanced practice registered nurse (APRN) in
a primary care clinic for the first time. The patient reports feeling depressed due to a major life change. Additional symptoms include weight gain, sedentary activity, and insomnia. The APRN plans on providing the patient with several exercises to reduce the physiological effect of stress. Why is the APRN concerned about relieving this emotional response? It increases protein synthesis. It increases smooth muscle contraction. It decreases glucose uptake. Answer It decreases glucose uptake.
7. An 80-year-old patient brings her grandchildren with her to a routine medical
appointment. The patient has moderate chronic obstructive pulmonary disease (COPD) and is concerned about developing pneumonia because of its increased incidence at the senior center. What should the nurse practitioner recommend for this patient? Avoiding her grandchildren this winter Increasing inhaler use to four times daily Undergoing prophylactic anticoagulation Getting an annual influenza vaccine
Answer Getting an annual influenza vaccine
8. An advanced practice nurse (APRN) is working with a patient who is choos- ing to
undergo breast removal due to family history of breast cancer. The patient's genetic testing revealed an abnormal BRCA1. The patient shares with the APRN that she is relieved that she will not need to worry about cancer once the breast tissue is removed. The APRN proceeds to educate the patient about additional risks. Which other type of cancer is the patient at risk for developing? Liver Bladder Ovarian Brain Answer Ovarian
9. A patient presents to the hospital complaining of blurred vision, muscle
weaknesses, impaired gait, and fatigue lasting more than 24 hours. The patient has a history of smoking and vitamin D deficiency. Extensive diagnostic testing and a comprehensive neurological assessment reveals a diagnosis of multiple sclerosis. Which pathological mechanism will support this diagnosis?
Which diagnosis should the APRN suspect? Autonomic hyperreflexia Diffuse axonal injury Spinal cord injury Demyelinating polyneuropathy Answer Demyelinating polyneuropathy
12. A patient is seen in the clinic after being a restrained passenger in a car accident
the previous week. The patient continues to have intermittent headaches and has noticed periods of forgetfulness. Assessment findings include a BP of 130/82 mm Hg and an apical pulse rate of 72 bpm. An advanced practice registered nurse (APRN) is concerned that the symptoms might stem from a specific process. Which process should the APRN be concerned about? Decreased cerebral perfusion Subarachnoid hemorrhage Cerebral concussion Skull fracture Answer Cerebral concussion
13. An advanced practice registered nurse (APRN) is examining an adolescent patient
who describes hearing voices telling her to gather weapons because the government is trying to control her.
The patient also describes feelings of happiness related to a tragic personal event. What is the probable diagnosis? Bipolar disorder Obsessive compulsive disorder Panic attack Schizophrenia Answer Schizophrenia
14. A patient is seeing an advanced practice registered nurse (APRN) in an
occupational health setting. The patient has been referred by employee assistance for reckless and self-destructive behav- iors and a violent incident at work regarding a fellow employee. The APRN suspects post-traumatic stress disor- der (PTSD). Which diagnostic cluster of PTSD is the patient exhibiting? Negative cognitions Avoidance Reexperiencing Arousal Answer Arousal
15. A 45-year-old male patient with altered testosterone levels needs treat-
ment. An advanced practice registered nurse (APRN) is aware that three factors affect hormone target cell responses when
hypertension cardiac hypertrophy increased facial hair hypercortisolism Which pathological mechanism of the disease process is associated with these symptoms? Excessive autonomous secretion of aldosterone due to lack of its principal regulator, angiotensin II Insufficient ADH activity, excretion of large volumes of dilute urine, and increased plasma osmolality Hypomagnesemia inhibits PTH secretion, impairment of resorption of calcium from bone, and regulation of calcium reabsorption from the renal tubules
Secretion of both cortisol and adrenal androgens is increased and inhibition of corticotropin-releasing hormone (CRH) secretion Answer Secretion of both cortisol and adrenal androgens is increased and inhibition of corticotropin- releasing hormone (CRH) secretion
18. A patient presents to the emergency department complaining of difficulty
swallowing, drooling, and pain radiating to the left ear. During the assessment, an advanced practice registered nurse (APRN) notes unilateral redness, left swollen tonsil, and a displaced uvula. Which diagnosis should the APRN make for this patient? Bartholin's abscess Pharyngitis Retropharyngeal abscess Periodontitis Answer Retropharyngeal abscess
19. An advanced practice registered nurse (APRN) is performing an assess- ment on a
newborn in a nursery. The infant's head is atraumatic with an open, flat, and soft anterior fontanel. The pupils are equal, round, and reactive to light with normal light reflex. Upon occlusion of the left nare, the infant startles, becomes irritable, and is unable to
Bartholinitis Vaginitis Answer Pelvic inflammatory disease
21. An adolescent male is suffering from severe, sudden pain in his genital region
during football practice. He is embarrassed to seek emergency treatment. However, he is finding the pain unbearable. His coach appropriately recommends he seek emergency treatment. What is a plausible cause of the pain? Testicular torsion Prostate hyperplasia Cryptorchidism Hydrocele Answer Testicular torsion
22. An advanced practice registered nurse (APRN) is designing a treatment plan for a
patient diagnosed with pelvic inflammatory disease (PID). The APRN plans the sexually transmitted disease (STD) testing based on the most common pathogen in PID. Which STD testing should be considered? Herpes Chlamydia Syphilis HPV
Answer Chlamydia
23. An older adult patient presents to a clinic with complaints of penile pain and
discomfort when attempting to urinate and states the problem began the morning after a home health aide assisted him with cleansing the genital area. An advanced practice registered nurse (APRN) assesses an uncircumcised glans penis, which is reddened and edematous with the foreskin behind the corona. Which condition should the APRN suspect from these findings? Paraphimosis Phimosis Peyronie Priapism Answer Paraphimosis
24. A 29-year-old female patient presents with concerns about fertility. The patient
states she has had amenorrhea every other month and weight gain, and her labs show decreased FSH, de- creased estrogen, and altered TSH. Which female reproductive disorders should be considered for this patient?
sputum production. They also report frequent greasy-looking, bulky stools and constipation. The APRN finds that the child has been to the clinic with chronic bacterial infections every month since birth. Which abnormal pathological finding of the pulmonary system should be of concern to the APRN? Surfactant deficiency and decreased alveolar surface tension Defective chloride secretion and excess sodium absorption Lung immaturity and inflammation Airway narrowing and increased upper airway collapsibility Answer Defective chloride secretion and excess sodium absorption
27. A patient presents to an emergency department complaining of coughing, salty-
tasting skin, bulky stools, and frequent respiratory infections. On examination, an advanced practice regis- tered nurse (APRN) notes nasal polyps and a barrel chest. A diagnosis of cystic fibrosis is confirmed.
What is the pathological mechanism of this disorder? Chronic inflamed airways and mucus production Malfunction of bronchial muscle tone and loss of elasticity Thick mucus causing progressive clogging of the bronchi and bronchioles Interstitial inflammation causing necrosis of the bronchiolar and alveolar tissue Answer Thick mucus causing progressive clogging of the bronchi and bronchioles
28. An older adult patient presents with an exacerbation of chronic obstructive
pulmonary disease (COPD). An advanced practice registered nurse (APRN) notes that despite using medications as prescribed, the patient feels much worse during these exacerbations than in the past. Which response should the APRN provide to this patient? The effects of aging contribute to decreased lung function. An annual pneumococcal vaccine decreases upper respiratory illnesses. Bronchodilator medications lose their effectiveness over time. Dry powder inhalers are the treatment of choice. Answer The effects of aging contribute to decreased lung function.
29. A patient with severe chronic obstructive pulmonary disease (COPD) is admitted
to a hospital with pneumonia and acute respiratory failure. The patient has a history of CO2 retention. An ad- vanced practice registered nurse (APRN) needs to assess for rising CO2 levels. Which form of monitoring should the APRN use for this purpose? Daily chest
Antimicrobials and chest tube Early ambulation and deep breathing exercises Chest physiotherapy and bronchodilators Answer Antimicrobials and chest tube
31. An advanced practice registered nurse (APRN) assesses a patient with a long
history of infections, mood swings, and gastrointestinal complaints. The patient complains of increasing fatigue, dif- ficulty walking, and a sore tongue. Lab results indicate a hemoglobin of 7.8 g/dL. Which type of anemia should the APRN consider? Pernicious anemia Sideroblastic anemia Iron-deficiency anemia Hemolytic anemia Answer Pernicious anemia
32. An advanced practice registered nurse (APRN) is evaluating a male patient.
Findings include a painless supraclavicular adenopathy, a nonproductive cough, fatigue, anorexia, weight loss, fever, night sweats, pruritus, and the findings of Reed-Sternberg cells on a lab microscopic exam. Which disease should be suspected by the APRN? Hodgkin lymphoma Acute myeloid leukemia Non-
Hodgkin lymphoma B-precursor ALL Answer Hodgkin lymphoma
33. An advanced practice registered nurse (APRN) is evaluating an anemic patient
with stage 4 renal disease. Which pathological mechanism should the APRN note? Suppressed production of erythropoietin Hematopoietic stem cells Iron deficiency Hypocellular bone marrow Answer Suppressed production of erythropoietin
34. A patient presents to a clinic with complaints of frequent nosebleeds. An advanced
practice registered nurse (APRN) does an assessment and notes areas of ecchymosis and petechiae.The APRN questions the patient about current activities and medications and orders lab studies. Which lab exam should the APRN order for this patient? Lactic acid Platelet count
