WGU D115 OA ADVANCED
PATHOPHYSIOLOGYEXAM 2024 | ACTUAL
EXAM QUESTIONS WITH DETAILED ANSWERS
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A 2 year old child presents to a clinic with acute pyelo for the third time in four months.
An APRN suspects vesicourethral reflux and orders a voiding cystourethrograph scan.
Results indicate reflux into dilated ureter or blunting of calyceal fornices. What grade
should the APRN document? - ✔✔ANSW✔✔..Grade 3*: reflux into dilated ureter or
blunting of calyceal fornices
Grade 1: reflux into a nondilated distal ureter
Grade 2: reflux into the upper collecting system without dilation
Grade 4: Reflux into a grossly dilated ureter
A 21-year-old white college female complains of fatigue, RLQ pain, and diarrhea for the
last 2 months. She has lost 10lbs and notes chills periodically. She denies rectal
bleeding. She notes she is stressed about final exam. The FNP would be most
concerned about: - ✔✔ANSW✔✔..Chron disease
Most commonly in the small intestine
Peak age of onset is 15-25 years old with females and whites most affected
A 35-year-old man presents with edema of the face, hands, and ankles, and a blood
pressure of 175/115 mmHg. He reports urine that is darkly colored and foamy. The APN
,suspects acute glomerulonephritis and would expect UA results to include all of the
following findings except: - ✔✔ANSW✔✔..abnormally elevated glucose levels
A 54 year-old female complains fo intermittent crampy abdominal pain over the last 18
hours, loss of appetite, vomiting, abdominal bloating, and inability to have a bowel
movement. She has a history of hysterectomy 20 years ago, cholecystectomy 5 years
ago, and tow laparoscopies for abdominal pain over the last 4 years. The FNP send her
to the ER because she suspects: - ✔✔ANSW✔✔..SBO
hx of having multiple abd surgeries increases adhesions which can cause a small bowel
obstruction
A 65-year-old male presents to the FNP for evaluation of years of "heartburn" and
recent weight loss of 30lbs over the last month. He has been taking antacids and an
oral histamine 2 receptor antagonist for years "off and on". He has a 60 pack per year
smoking history and drinks alcohol daily. What differential diagnoses should the FNP
consider? - ✔✔ANSW✔✔..Esophageal cancer
Long-term GERD without tx increases risk for barret esophagus and cancer
Rapid weight loss is concerning
A 74-year-old male complains of rectal bleeding for the past year. He has not change in
bowel habits and denies abdominal pain, weight loss, and rectal pain. He has seen
blood in the toilet water and when wiping approximately once every few weeks, but
lately the bleeding has increased. He had colonoscopy 5 year ago. The FNP should: -
✔✔ANSW✔✔..Schedule a colonoscopy to look for colon polyps and/or cancer
Conductive hearing loss involves what part of the ear? - ✔✔ANSW✔✔..Middle ear
A potential complication of streptococcal pharyngitis that leads to contralateral uvular
deviation, asymmetric tonsillar hypertrophy, muffled voice on exam but no stridor,
drooling, or dyspnea or dysphagia is recognized as what? - ✔✔ANSW✔✔..Peritonsillar
abscess
A 64 year old woman presents to the office with complains of vision loss. Funduscopic
examination reveals cupping of the optic nerve. Which action should you take? -
✔✔ANSW✔✔..Send the pt to the ER
A 39 year old female presents with complaints of sudden onset of blurry vision. She
states that she sees flashing lights and it sensation that she is "looking through a
curtain." Which dx finding would the NP expect to find in this patient? -
✔✔ANSW✔✔..Hemoglobin A1C of 12
,Retinal detachment is a potential outcome of retinopathy of diabetes
A 16 year old presents to the urgent care clinic after a hard hit in football practice.
During the physical exam, the NP observes "battle's sign" and immediately refers the
patient to the ED. Which dx is the NP concerned about? - ✔✔ANSW✔✔..Basal skull fx
A 4 year old male is brought into a clinic with complaints of fever and sore throat for 2
days. the NP suspects a peritonsilar abscess and refers the pt to the ED. Which finding
is most consistent with this dx? - ✔✔ANSW✔✔..Fever, sore throat, dysphagia, drooling,
"hot potato" voice
A 40 year old female presents with complaints of soreness when eating spicy foods.
The NP observes that the patient has a "geographic tongue." What would be the most
appropriate for the patient's plan of care? - ✔✔ANSW✔✔..Tell pt to rinse with salt water
and avoid spicy food until s/s resolve
A 2 year old boy presents to the clinic with a fever. During the physical exam the NP
observes Koplik's spots inside of his buccal mucosa. Which would be the most
important to assess on the pt to aid in an appropriate dx? - ✔✔ANSW✔✔..Vaccination
status
Koplik spots are seen with measles: small white spots on a reddened background that
occur on the inside of the cheeks
A 26 year old presents to a clinic with complaints of left eye pain. the NP performs
fluorescent dye staining which reveals fern-like lines in the corneal surface. Which
would be the most appropriate hx question to ask the pt? - ✔✔ANSW✔✔..have you
ever had a cold sore?
A 17 year old female was dx with angular cheilitis. She had tx failure after a course of
topical abx, topical steroids, moisture barrier creams, and antifungals were rxed. What
would be the most appropriate next step in the pt's plan of care? - ✔✔ANSW✔✔..Check
vitamin B12 levels
Most common cause is a fungal infection but can be from vitamin B12 deficiency and
bacterial infections
Which finding is most consistent with acute otitis externa? - ✔✔ANSW✔✔..Pruritis and
hx of recent swimming
Otitis externa is referred to as "swimmers ear"
A 15 year old male pt presents to the clinic with abd pain and fatigue, and is dx with
mono. Which is the most important part of this patient's plan of care? -
✔✔ANSW✔✔..Avoid contact sports for up to 4 weeks
, Splenomegaly is a complication of mono. Contact sports increase risk of spleen
rupturing
A 20 year old female reports a hx of "cold symptoms" for 12 days. Her physical exam
reveals unilateral facial pain and purulent nasal discharge. Which dx are these findings
consistent with? - ✔✔ANSW✔✔..Acute bacterial rhinosinusitis
S/S are facial pain or pressure, postnasal drip, nasal congestion, upper jaw or tooth
pain, nasal discharge, fever, cough
Inflammation and swelling of the 7th cranial nerve with resultant unilateral facial muscle
paralysis is called? - ✔✔ANSW✔✔..Bell's Palsy
Caused by virus, sudden onset of facial paralysis usually resolves within 2 weeks
The NP caring for a pt with a recent TIA understands that? - ✔✔ANSW✔✔..Long-term
antiplatelet therapy is likely indicated-aspirin or clopidrogrel (plavix)
A 22 yr old woman has a new onset of panic disorder. As part of her clinical
presentation, you expect to find all of the following except? - ✔✔ANSW✔✔..Hx of
thought disorder
thought disorders are like schizophrenia
The NP is providing care for a pt with PTSD. The NP anticipates that all of the following
will be report except - ✔✔ANSW✔✔..Poor recall of the precipitating event
s/s: flashbacks, nightmares, anxiety, avoidance, detachment, and hyperarousal
Physical examination findings in patients with bulimia nervosa often include? -
✔✔ANSW✔✔..Dental surface erosion
swollen salivary glands, dehydration, electrolyte abnormalities, weight loss, irregular
menstruation
The NP examines a 29 year old women who has sudden onset of right sided facial
asymmetry. She is unable to closer her right eyelid tightly, frown, or smile on the
affected side. Her examination is otherwise unremarkable. Which represents the most
appropriate dx test for this patient? - ✔✔ANSW✔✔..Lyme disease antibody titer
Late symptoms of lyme disease are HA, neck stiffness, facial palsy, joint pain and
swelling, dizzy, SOB, and nerve pain
