WGU D027 – 2 QUESTIONS AND
ANSWERS WITH VERIFIED SOLUTIONS
2024
Loop Diuretics - ANSWER Prefix "emide" Furosemide.
Mechanism of action: Block water reabsorption in the loop of Henle of the nephron. Increases urine
output.
AE: decreased K+, decreased BP, Ototoxicity, nephrotoxicity.
Contradictions: auditory, renal impartments
During diastole, which part of the heart is filling with blood? - ANSWER Both ventricles. Systole reflects
the perfusing pressure of the cardiovascular system where the ventricles eject blood from the heart.
Once complete, a resting period—diastole—follows, where blood must refill the ventricles directly from
the collection that occurred in the atria.
Oxygenated blood flows through which vessel? - ANSWER Pulmonary vein. The superior vena cava
carries all the deoxygenated blood from peripheral circulation back to the heart where it enters the right
atrium to be pumped into the right ventricle. The right ventricle pumps to the lungs for oxygenation via
the pulmonary artery. After pulmonary circulation, the oxygenated blood is carried back to the heart via
the pulmonary vein.
What effect does atherosclerosis have on the development of an aneurysm? - ANSWER Erodes the vessel
wall .Atherosclerosis, also known as the process of "hardening of the arteries" and secondary to plaque
formation, weakens the flexibility of a blood vessel wall. Without vascular compliance, the vessel wall
becomes more rigid and susceptible to rupture (i.e., an aneurysm).
Which complex (wave) represents the sum of all ventricular muscle cell depolarizations? - ANSWER The
QRS wave of an electrocardiogram (ECG or EKG) represents the largest spike in electrical activity of the
heart, as ventricular muscle cells perform the highest burden of work to pump blood volume out of the
heart in that instance.
Which factor is responsible for the hypertrophy of the myocardium associated with hypertension? -
ANSWER Angiotensin II leads to myocardial hypertrophy, poor myocardial compliance, and ventricular
dilation through stimulating increased cardiac preload and afterload and direct toxicity to myocardial
cells. It causes sarcomere death, abnormal collagen matrices, and interstitial fibrosis
,Most cardiovascular developments occur between which weeks of gestation? - ANSWER During weeks
four to seven, the primitive heart tube progresses through numerous stages of development leading to a
developed heart with distinct atria, ventricles, and cardiac vessels.
Which compensatory mechanism is spontaneously used by children diagnosed with tetralogy of Fallot
(TOF) to relieve hypoxic spells? - ANSWER Spontaneous squatting helps relieve hypercyanotic events in
older children through increasing systemic vascular resistance, decreasing venous blood return. This
provides a larger amount of oxygenated blood for the body and leads to the temporary reversal of blood
through the ventricular septal defect (VSD), which results in increased pulmonary flow. Squatting is
rarely seen clinically because most TOF defects are diagnosed and surgically repaired in infancy
Which condition is consistent with the cardiac defect of transposition of the great vessels? - ANSWER
The aorta arises from the right ventricle. In transposition of the great vessels, opposite of a normal
heart, the aorta arises from the right ventricle, and the pulmonary artery arises from the left ventricle.
A 26-year-old female presents to urgent care with complaints of extreme fatigue, muscle aches,
abdominal pain, numbness and tingling in her extremities, and bloating. She explains that she has been
experiencing gastrointestinal upset after meals and has not had a bowel movement for the past four
days. She reports using over-the-counter, anti-diarrheal products last week to combat diarrhea. She
denies having any chronic diseases. The assessment findings include a blood pressure of 108/71 mm Hg,
pulse of 82 beats per minute, and respirations of 20 breaths per minute. The abdomen is distended and
firm. Bowel sounds are present in all four quadrants. The patient has a steady gait, though verbally
complains of feeling weak and off balance upon ambulation. Following antibody testing, Celiac disease is
suspected. Which follow-up tissue test, the gold standard for this suspected diagnosis, should be
ordered? - ANSWER Endoscopy with small intestine biopsy
A 44-year-old woman has recently been diagnosed with advanced metastatic non-small-cell lung cancer.
Genetic testing is ordered to determine if the patient's tumor has any genomic alterations and to guide
treatment decisions. A few weeks later, the patient's test results come back positive for a genetic
mutation. The APN starts osimertinib (Tagrisso).Based on this information, what type of genetic mutation
does this patient have? - ANSWER EGFR mutation
A 20-year-old male meets with an advanced professional nurse (APN) to discuss symptoms that have
been slowly progressing over the past several years. He is mainly concerned because he has been falling
frequently. Since childhood, his gait has consisted of walking on his toes. During middle school, he was
able to participate in sports but was unable to participate in high school sports due to difficulty with
running and jumping. Lately, he has noticed it takes longer and is more difficult to change positions from
, sitting to standing than it used to in the past. He has also been waking up with muscle and joint stiffness.
The APRN notes that his family history is not significant for any chronic or genetic diseases. Which
condition is likely to be the cause of these symptoms? - ANSWER Becker muscular dystrophy. Mutation
of gene dystrophin. X-linked. Affects muscles of hips, pelvic area, thighs, and shoulders, as well as the
heart.
Diagnostic CK levels 5x normal.
Which statement should the provider give the patient regarding the pathophysiology of SLE and its
relation to thrombocytopenia? - ANSWER SLE disrupts immune homeostasis and promotes development
of self-reactive antibodies.
A female patient presents to an office to establish care. Her previous primary care provider told her to
follow up regarding an elevated ferritin level. She has no previous medical history and is currently
asymptomatic. She is concerned about the elevated ferritin and would like to know if she should be
worried. What should the provider do next for this patient? - ANSWER Order a liver function test
A 75-year-old female presents to the emergency department with an irregular heart rate of 130.What
can be ascertained about this patient's findings given the limited information? - ANSWER She is
diagnosed with atrial fibrillation and needs her heart rate controlled with metoprolol (Lopressor).
Nephrotic syndrome treatment - ANSWER Furosemide 40 mg po BID, or Bumetanide 1 mg daily, with
doubling dose every 3 days if there is inadequate improvement in edema or evidence of fluid overload.
Limit of Furosemide 240 mg per dose and 600 mg per day.
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? -
ANSWER 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 metoprolol (Toprol XL)? - ANSWER Metoprolol
(Toprol XL) worsened asthma symptoms, but improved the PACs.
Which inhaler prescription would support long-acting treatment for twice-daily use in controlled asthma
management? - ANSWER Fluticasone propionate/salmeterol (Advair Diskus)