WGU D027 OBJECTIVE ASSESSMENT EXAM<\/p>\n\n\n\n
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.
— Beta blockers are widely used in the management of cardiac
conditions and thyrotoxicosis, and to reduce perioperative
complications. Asthma and chronic obstructive pulmonary disease
(COPD) have been classic contraindications to the use of beta blockers
because of their potential for causing bronchospasm.
Which inhaler prescription would support long-acting treatment for
twice-daily use in controlled asthma management? – ANSWER\u0002Fluticasone 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
has been dealing with diabetes for the last 15 years. He has a history of<\/p>\n\n\n\n
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 medication would be the first line
treatment for this patient? – ANSWER- 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 history 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? – ANSWER- By
antagonizing dopamine
A 25-year-old female 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 of 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? – ANSWER- 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 pharmacodynamics. Which pharmacokinetic
phase is affected in this patient? – ANSWER- Metabolism<\/p>\n\n\n\n
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 is 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 studies abroad? – ANSWER- Acetaminophen
(Tylenol) is safe to consume.
A patient presents with new onset of atrial fibrillation that has proved
resistant to cardioversion and ablation. The patient is prescribed
Warfarin (Coumadin). Which strategy should be employed when dosing
the medication prescribed for this patient? – ANSWER- Titrate dosage to
an INR of 2.1 seconds
Which medication would be contraindicated for a 46-year-old male
patient diagnosed with beta thalassemia? – ANSWER- 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 pediatric 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? –
ANSWER- Swab the infected area<\/p>\n\n\n\n
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 the hepatitis B vaccine.What is the recommended schedule for
this patient receiving the hepatitis B vaccination? – ANSWER- 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 appointment, 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? – ANSWER- Children usually outgrow the condition at about
three months of age.
— infantile colic: Predictable 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 marketplace 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<\/p>\n\n\n\n