1 | P a g e WGU D027 OBJECTIVE ASSESSMENT EXAMS AND STUDY GUIDE EXAMS WITH ACTUAL CORRECT QUESTIONS AND VERIFIED DETAILED RATIONALES 2024 (NEWEST) ALREADY GRADED A+ WGU D027 OBJECTIVE ASSESSMENT EXAMS A 74 - year -old male with Cushing syndrome presents to the emergency department (ED) with pain in his left leg, and is diagnosed with a deep vein thrombosis (DVT). What is this patient's symptoms related to? Elevated Von Willebrand factor A 42 -year-old asthmatic who has been using beta -adrenergic agonists for several years began to experience premature atrial contractions (PACs). To treat the PACs, metoprolol (Toprol XL) therapy was started.What is a likely consequence of this patient taking meto prolol (Toprol XL)? Metoprolol (Toprol XL) is a cardio -selective beta blocker that failed to affect the patient's asthma symptoms. Which inhaler prescription would support long -acting treatment for twice -daily use in controlled asthma management? Fluticaso ne propionate/salmeterol (Advair Diskus) --Fluticasone and salmeterol is a combination of two medicines that are used to help control the symptoms of asthma and improve breathing. A 65 -year -old male presents for a visit regarding his type 2 diabetes. He ha s been dealing with diabetes for the last 15 years. He has a history of diabetic neuropathy in his feet. Six months ago his symptoms were mild to almost nonexistent. He currently describes the neuropathy as painful, and it wakes him up at night. Which medi cation would be the first line treatment for this patient? Pregabalin (Lyrica) A 55 -year -old male presents for a new diagnosis of Parkinson's Disease. He has experienced gait disorders and a pill rolling tremor. The patient was a former boxer with a histor y of multiple concussions. He was started on carbidopa -levodopa (Sinemet), which has decreased his symptoms. How would an antipsychotic medication such as haloperidol (Haldol) cause an interaction with this patient? 2 | P a g e By antagonizing dopamine A 25 -year -old f emale is 35 weeks pregnant and presents for lower back pain. She has a history of moderate lower back pain that she normally controls with stretching, yoga, and ice. The patient reports not being able to engage in stretching and yoga because of the state o f her pregnancy. Ice use has been ineffective. After a benign exam and a negative urinalysis, the provider is convinced that the pain is musculoskeletal. The patient inquires if there are any medications she can take for the pain. Which medication does the provider tell the patient she can safely take? Acetaminophen (Tylenol) A nurse is administering medication to a 67 -year -old patient in liver failure, secondary to end -stage cirrhosis. Liver dysfunction can influence drug pharmacokinetics and pharmacodynam ics. Which pharmacokinetic phase is affected in this patient? Metabolism A 17 -year -old male patient presents to a clinic for a physical, and he has a diagnosis of moderate glucose -6-phosphate dehydrogenase (G6PD) deficiency. During the exam, he states he i s going to study abroad in Egypt during his sophomore year, and he has concerns about his nutrition while being away from home. Which counseling about the patient's deficiency should the advanced professional nurse (APN) give to this patient while he studi es abroad? Acetaminophen (Tylenol) is safe to consume. A 55 -year -old Asian American male presents for new onset atrial fibrillation that has proved resistant to cardioversion and ablation. To decrease risk of stroke, the patient will be started on an antic oagulant. Due to cost considerations, warfarin (Coumadin) is selected.Which strategy should be employed when dosing the Coumadin for this patient? Start at half the standard dosing for Coumadin. Which medication would be contraindicated for a 46 -year -old m ale patient diagnosed with beta thalassemia? Ferrous sulfate (Feosol) --People with thalassaemia may be advised to avoid iron supplements because they are at risk of iron overload . An advanced professional nurse (APN) is administering medications on the pe diatric floor and treating an infant with thrush who is currently taking Nystatin oral suspension (Mycostatin). The APN knows the infant is unable to follow the directions of swishing the medication and swallowing. How should the APN administer this infant 's suspension? Swab the infected area A two -week -old newborn presents to the pediatric clinic with her mother for a check -up. The nurse discusses the recommended vaccination guidelines from the Centers for Disease Control and Prevention (CDC), including th e hepatitis B vaccine.What is the recommended schedule for this patient receiving the hepatitis B vaccination? 3 | P a g e Three immunizations with one injection now (if not given at birth), one injection at two months, and one injection at six months On a follow -up a ppointment, a mother of a newborn reports the infant draws up the legs, clenches fists, and cries as if in pain. The mother reports the symptoms usually occur during the evening but the baby tolerates formula well. The nurse tells the mother that the baby has infantile colic. The mother inquires about the child's prognosis. How should the nurse describe the prognosis of infantile colic to the patient's mother? Children usually outgrow the condition at about three months of age. -- infantile colic: Predictab le periods of significant distress in an otherwise well -fed, healthy baby. A 40 -year -old Trinidadian male comes into a clinic complaining of burning chest pain, indigestion, nausea, and belching after eating certain foods. He is a single father living and working in New York City. He recently obtained his green card after living in the United States for more than 10 years. He has a GED and works as an IT help desk technician earning $42,000 a year. He has health insurance through the New York health marketp lace because it is cheaper than his employer's plan. Because of the high cost of living in New York, the patient is unable to afford an apartment on his own; therefore, he and his child share a home with his mother and older sister. As the nurse begins to explore his social history regarding his alcohol use, the patient states, "I have two to three beers every night to help me sleep. I have been doing this for the past year." The patient also states he has trouble falling asleep and stayi The patient's life style structure A 40 -year -old Trinidadian male comes into a clinic complaining of burning chest pain, indigestion, nausea, and belching after eating certain foods. He is a single father living and working in New York City. He recently obtained his green ca rd after living in the United States for more than 10 years. He has a GED and works as an IT help desk technician earning $42,000 a year. He has health insurance through the New York health marketplace because it is cheaper than his employer's plan. Becaus e of the high cost of living in New York, the patient is unable to afford an apartment on his own; therefore, he and his son share a home with his mother and older sister. As the nurse begins to explore his social history regarding his alcohol use, the pat ient states, "I have two to three beers every night to help me sleep. I have been doing this for the past year." The patient also states he has trouble falling asleep and staying Seeking higher or advanced education in his field A 72 -year -old male patient comes into the clinic complaining of shortness of breath, wheezing, chills, and hot flashes at night for over three weeks. He is currently only prescribed a blood pressure medication but is unsure of the name and has not had any refills in the last several months. He reports being unsure if he has been exposed to any respiratory illnesses. He continues to report he is homeless and lives in different shelters or outside. He is unemployed but does receive assistance money from an unknown donor which averages $300 per month. He states he does not have any family or social support. The patient states he only has an eighth -grade education and is unable to read very well. He is unable to write his name, although he has always learned easily by watching and interac ting with live instructions. He denies illegal drug use and uses public transportation.The assessment findings include a blood pressure Lack of income and poverty level 4 | P a g e A 32 -year -old female presents to the emergency room (ER) with headache, fatigue, and sh ortness of breath on exertion. A complete blood count reveals a hemoglobin of 4.4g/dl. During the gynecological review of systems, she reports a change of a fully saturated pad every two hours for the first three out of six days of a 28 -day menstrual cycle . She states she thought this was normal and has never sought gynecological care. She does not follow with a primary care physician.Which factor in the "health and healthcare" domain of the social determinants of health contributed to this patient's hemogl obin of 4.4g/dl? Health literacy An emergency room (ER) nurse is in a room caring for a patient when the ER suddenly becomes very busy and fills all available rooms. When the nurse completes the care of the current patient, he finds an emergency medical te chnician (EMT) ready to report on each of the new patients. Which patient from the report should be seen first? The 40 -year -old male with crushing chest pain who denies any injury or prior history of heart disease An advanced professional nurse (APN) on th e float team was assigned to provide care of four postoperative patients on the medical -surgical unit. Which patient should the APN see first? The patient who is four days post right lobectomy with a heart rate of 120, cold sweats, and lightheadedness Four patients are sitting in an emergency room (ER) waiting to be seen. Each patient checked into the ER using an electronic kiosk that required the reason for the visit. The nurse reviews the data entered by each patient. Which patient should the nurse assist first? A 19 -year -old male with a temperature of 101°F and a stiff neck. A cardiac advanced professional nurse (APN) receives and assesses a report of her patients at the beginning of her shift. Her report includes the following patients: a patient who rec eived furosemide (Lasix) two hours ago and is complaining of excessive urination a post -op cardiac catheterization patient who received hydrocodone bitartrate and acetaminophen (Norco) and is now complaining of drowsiness a patient who received metoprolol (Toprol XL) with a heart rate of 42 and who is complaining of extreme weakness and dizziness a patient who is day two post -myocardial infarction and is requesting medication for constipation Which patient should the APN see first? The patient who received metoprolol (Toprol XL) A 72 -year -old male patient with chronic atrial fibrillation is currently taking digoxin (Lanoxin). The nurse knows this medication helps with irregular heartbeat but that it can have side effects. What should the nurse do before admi nistering this patient's next dose of digoxin? Obtain the patient's apical pulse -- Apical pulse should be taken for a full minute before administration of this medication. If the apical pulse is less than 60, the dose should be withheld and the prescribin g provider notified. Serum digoxin levels should be monitored, with a normal therapeutic range from 0.8 to 2 ng/mL .
