WGU D027 Course Material Questions and Answers Latest Update, Graded A

WGU D027 Course Material Questions and Answers Latest Update, Graded A A 23-year-old woman comes in for prenatal counseling. While completing her family history, she reports her brother has cystic fibrosis. She does n ...

WGU D027 Course Material Questions and Answers Latest Update, Graded A A 23-year-old woman comes in for prenatal counseling. While completing her family history, she reports her brother has cystic fibrosis. She does not know if she is a carrier. She asks if her children will be affected by the disease. What is an accurate way to determine the likelihood of this patient's children being affected? Correct Answer- A genetic or a carrier test - Cystic fibrosis is a hereditary disease that impacts the lungs and digestive system. It is the result of the cystic fibrosis transmembrane conductance regulator gene mutation. The disease occurs when an individual inherits the mutated gene from each parent. When only one mutated gene is inherited, the individual is labeled a carrier. A 31-year-old man comes into the office for an exam. He is 6' 5 " with a high-pitched voice, and he has a moderate degree of mental impairment. It is discovered upon exam that his body hair is sparse, his testes are small, and he has gynecomastia. Which genetic disorder should this patient be tested for? Correct Answer- Klinefelter syndrome - Klinefelter syndrome is a hereditary disease also known as 47,XXY or XXY that manifests as the series of symptoms described. The symptoms are expressed as a result of the presence of two or more X chromosomes in males. It is often not diagnosed until adulthood. A 40-year-old man presents to a clinic with an onset of a frequent cough. The patient states the cough started when he started his new blood pressure medication two weeks ago. The patient does not remember the name of the drug that was started. After a thorough assessment, it is determined the cough is not being caused by an infection. It is determined the likely cause of the frequent cough is the new blood pressure medication. Which medication is the likely cause of this patient's symptoms? Correct Answer- Lisinopril (Zestril) - ACE inhibitors such as lisinopril (Zestril) are associated with dry, persistent coughing in many patients. They prevent the breakdown of protussive mediators such as bradykinin and substance P leading to an increase of these mediators in the respiratory tract. The cough is actually a compensatory response of the body to force kinins out of the lungs.A 45-year-old female patient presents to a clinic complaining of chronic generalized pain and wishes to be evaluated for fibromyalgia and chronic pain syndrome. A thorough history and physical is conducted, and the findings are negative. The patient is not taking any medications, has no allergies to medicines, and has a negative past medical history. What is an appropriate first intervention for this patient? Correct Answer- Assess the patient's sleep hygiene and make recommendations - The most noninvasive approach to assessing generalized pain that seems to have no etiologic physical findings of chronic fatigue, chronic pain syndrome, or fibromyalgia is to further assess the patient's sleep history. Lack of adequate sleep has been linked to myalgias and chronic pain. Often a vicious cycle occurs in which the pain induced by lack of sleep then causes inability to sleep and so on. A 45-year-old Jewish man is visiting a clinic for an adjustment of his diabetes medications. Though the patient is taking oral medications, his blood sugar levels continue to increase, and a decision is made to start him on insulin. Although the patient is comfortable with the concept of starting insulin, he is concerned with the formulation of the insulin saying, "I heard insulin was made from pigs. If that is the case, I cannot take it due to my faith." Which response should be given to this patient? Correct Answer- While insulin did have porcine sources in the past, it is now synthetically made - All forms of insulin manufactured in the U.S. use recombinant DNA technology. Some are identical to human pancreatic insulin, and others are synthetic analogs of natural human insulin. It is appropriate to provide the patient with information that will decrease his concerns about breaching his religious beliefs. A 45-year-old man reports his preference for natural methods of treating illness. He states he takes natural supplements that he orders from China to boost his health and well-being. One of the supplements he takes daily is red yeast rice. Which medication should be avoided with this patient's supplement? Correct AnswerLovastatin (Mevacor) - Red yeast rice naturally contains lovastatin and other statin-related compounds that significantly impact LDL cholesterol; therefore, there is a risk for an increased effect and side effects if taken with a statin.A 45-year-old Muslim woman presents to a clinic for an intervention for her type 2 diabetes. She is prescribed metformin (Glucophage) 500 mg BID. During a follow-up phone call a week later, it is discovered she has not been taking the metformin. A second visit is scheduled. During this visit, she states that she cannot take the medication as prescribed because it is Ramadan, a month-long period of religious observances. Due to her religious beliefs, she fasts from dawn to sunset. When the pharmacist told her to take metformin with breakfast and dinner, she decided not to start the medication due to her fasting. Which nursing intervention should be made for this patient? Correct Answer- Start metformin XR (Glucophage XR) 250 mg once a day and reevaluate after Ramadan - Metformin XR (Glucophage XR) is an extended release biguanide that can be given once daily at a time when it will not impact the patient's cultural or religious practice. It has a half-life elimination time of up to nine hours. A 54-year-old Caucasian man comes in for a lab review. His lipids reveal an LDL of 180, an HDL of 52, and triglycerides of 326. He has no history of atherosclerotic cardiovascular disease (ASCVD) or diabetes. His blood pressure is 118/64. He has a pulse rate of 64, and he weighs 320 lb. He smokes one pack of cigarettes per day, and his ASCVD risk score is 12.8. Which medication should this patient be started on? Correct Answer- Atorvastatin (Lipitor) 20mg - Atorvastatin is more effective in reducing total cholesterol having a greater impact on lowering LDL cholesterol. The American College of Cardiology guidelines on blood cholesterol management emphasize that the greater the reduction in the LDL-C on statin therapy, the greater the subsequent risk reduction. A 54-year-old man comes into a clinic for a routine visit. His initial BP is 148/92. After a recheck 15 minutes later, his BP is 140/90. He states he suffers from "white coat hypertension." He states he has no history of high blood pressure and no family history of high blood pressure. Which nursing intervention would assist this patient in receiving a clinical diagnosis of hypertension? Correct Answer- Completing an ambulatory blood pressure assessment - For someone with "white coat hypertension," the best option is to eliminate the situation in which the trigger is present. Assessing blood pressure in a location of comfort like the home environment when no professional is present will enable the ability to determine his blood pressure under routine circumstances.A 55-year-old female patient presents to a clinic for exacerbation of her chronic low back pain. She is taking morphine extended-release tablets (MS Contin), hydrocodone (Vicodin) PRN, and duloxetine (Cymbalta). The patient denies any drug allergies. She rates her pain at a ten out of ten and is requesting something stronger for pain. When considering adding a medication for this patient's pain, which medication could have a significant interaction with her current medications? Correct Answer- Tramadol (Ultram) - Tramadol (Ultram) is a non-opioid analgesic that acts primarily by blocking serotonin and norepinephrine uptake. The effective increase in serotonin levels in the brain in combination with an antidepressant such as duloxetine (Cymbalta), which also raises serotonin levels, may result in serotonin syndrome or serotonin toxicity. A 55-year-old male patient is on a medical floor for respite care. He is currently in hospice for end-stage pancreatic cancer. During assessment, a nurse notices that he is diaphoretic, moaning, and clutching his abdomen. He rates his pain at a nine out of ten. The nurse notes that his abdomen is distended, and he has rebound tenderness in all four quadrants. What is an appropriate nursing intervention for this patient? Correct Answer- Giving a dose of intravenous morphine (Duramorph) - The key information in this scenario is that the patient is in hospice for end-stage pancreatic cancer. He is in significant pain, and none of the options other than the administration of morphine (Duramorph) are likely to provide the level of pain reduction necessary. Hospice care is guided by the approach to providing maximum comfort for individuals at the end of life through a peaceful, symptom-free, and dignified transition to death when disease has advanced beyond cure. A 58-year-old woman comes in complaining of retrosternal chest pain, worsening with recumbent position. She states she has had a low-grade fever for two days. Upon exam, the patient has a friction rub. An EKG reveals sinus tachycardia with inflammatory changes. An ultrasound is performed, and she is diagnosed with an acute pericarditis. Which condition would make pericarditis more likely in this patient? Correct Answer- Lupus - Lupus is an autoimmune disorder that is often responsible for causing an inflammatory response in the pericardial sac. Autoimmune disorders are known to cause chronic pericarditis.