2/9/25, 12:02 AM D118: OA
WGU D118: PA and OA| Explore New 276 Questions and Answers|2025 Update|
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WGU D118
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Term
A heavy smoker is in the ER complaining of generalized fatigue. He claims that he is always out of breath and has no more energy. His only medications are bronchodilators, which he rarely uses. Auscultation reveals enhanced resonance of voice sounds in his left chest. What is the most likely cause of this physical finding?
- Asthma
- Pneumonia
- Emphysema
- Pneumothorax
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ANS: B
Egophony is an increased resonance of voice sounds when a medical professional auscultates the lungs. It is most pronounced in patients with
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pneumonia and fibrosis. There is enhanced transmission of high-frequency noise across the fluid. Similarly, bronchophony and whispered pectoriloquy can be used to assess the lungs.
ANS: C
Children with T-cell disorders should not receive live-virus vaccines, but children with humoral deficiency may be given the vaccine. Vaccines are important to help prevent disease and children with immunodeficiency should receive any vaccines that are safe for them. Not all vaccines are recommended, since live-virus vaccines can cause disease in certain children
ANS: B
An immunocompromised patient, when exposed to someone with chickenpox, is given immunoglobulins unless he develops the disease. • An immunocompromised patient, when exposed to someone with chickenpox, is given antivirals when he develops the disease. • When a pregnant patient is exposed to someone with chickenpox, and she has not developed the disease. Her varicella-zoster antibodies are checked. If she has antibodies, no further treatment is required. • If a pregnant patient is exposed to someone with chickenpox and she has developed skin lesions, then antivirals are given.
ANS: A
The heterophile antibody test is the confirming test in IM. It is present in 40-60% patients in the first week and 78-90% of cases by weeks 3-4.
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Term
The parent of a 4-month-old infant who has had an episode of bronchiolitis asks the provider if the infant may have an influenza vaccine. What will the provider tell this parent?
- The infant should be given prophylactic antiviral medications.
- The infant should have an influenza vaccine now with a booster in 1
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- The infant should have the live attenuated influenza vaccine (LAIV).
- The infant should not but family and all close contacts should be
vaccinated.
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ANS: D
Corticosteroids are begun when pulmonary symptoms develop. Beta-adrenergics are not used. Antimalarial agents are used to treat chronic skin lesions.Immunosuppressants are used when corticosteroids are no longer effective or when the disease progresses.
ANS: D
These are short-lived symptoms at this point, lasting less than 2 months. Auditory and sensory hallucinations only in relation to the deceased are normal during intense grief. Hypermania is an acute, short-lived manic episode. Mania involves abnormal elevation of a person's mood. Depression is present when symptoms of grief are more severe and more prolonged.
ANS: D
This patient has symptoms consistent with an aortic aneurysm. The initial step is to determine the size of the aneurysm; this can be done by US. Immediate referral is not necessary. MRI and CT diagnostic tests are ordered before surgery to evaluate the characteristics of the aneurysm.
ANS: D
Infants are not given influenza vaccine until age 6 months. To protect infants younger than 6 months, it is important for other family members and close contacts to be vaccinated. LAIV is approved for use in children over age 2 years. Antiviral prophylaxis is not recommended.
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Term
A patient reports chronic nasal obstruction and recurrent epistaxis.Which type of nasal mass is likely?
- Inverted papilloma
- Nasal polyp
- Paranasal lymphoma
- Squamous cell carcinoma
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ANS: D
Coffee ground emesis is usually old blood from an upper GI source and melena is black, shiny, foul-smelling as a result of blood degradation and is usually upper GI in origin. Lower GI and rectal bleeding will cause bright red blood in stools. Hepatic bleeding usually does not affect the GI tract.
ANS: A
This patient has signs of milder iron-deficiency anemia and will also have a low hematocrit level. The RBC indexes are the last to change as the anemia becomes more severe. When the ferritin level drops, the TIBC will become elevated.Paresthesias, koilonychia, and pica occur with more severe anemia.
ANS: A
Inverted papillomas are benign tumors of the nasal mucosa and are highly vascular with frequent bleeding. Nasal polyps typically do not bleed and are associated with allergies. Paranasal lymphoma and squamous cell carcinoma are not initially associated with bleeding.
ANS: D
Viral pharyngitis will cause sore throat, fever, and malaise and is often accompanied by URI symptoms of cough and runny nose. Allergic pharyngitis usually also causes dryness. GAS causes high fever, cervical adenopathy, and marked erythema with exudate. Infectious mononucleosis will cause an exudate along with cervical adenopathy.
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