WGU D118 Adult Primary Care Review Exam Latest Update 2024-2025 500 Questions and Verified Correct Answers Guaranteed A+ 74 y/o with a 4 month history of severe stiffness and aching in her neck and both shoulders and hips that is worsened by movement. She reports having difficulty getting OOB and dressing. She also has a low grade fever, fatigue, loss of appetite and weight loss. Yesterday the vision in her right eye has progressively worsened. Which of the
following is the most likely? - CORRECT ANSWER: Polymyalgia rheumatica
A 19 year old female comes to your clinic for a routine visit to obtain birth control pills.You notice a red sunburn over her body. She states that she stayed a little too long in the sunbed. She denies pain and appears happy. What is your most appropriate course of action for skin health promotion and disease prevention? - CORRECT ANSWER: Ask how often she uses the sun bed and explore why it is important to her
A 21 year old female patient comes to your clinic with complaints of headache. The headache is described as unilateral; throbbing or pulsatile. There was no preceding aura but she states mild dizziness with the headache. She denies acute visual changes, nausea, vomiting & photophobia. She states noises bothered her most.On a scale of 1 - 10 she states the headache was 7 but it disrupted her daily activities enough to make an appointment with you. The headache lasted several hours. When asked about her current medications, she states that she recently began taking birth control pills. You forget to ask about a family history so you do not have this information at the current time. You are developing your differential diagnoses. Of the differential diagnoses
below, which one do you most suspect? - CORRECT ANSWER: Classic migraine
headache
A 21 year old woman is seen in the clinic with a 3 month history of watery diarrhea. She had similar episodes on three prior occasions with negative stool cultures. Past medical history is notable for knee surgery 2 years ago. Her medications include oral contraceptives. She has not traveled out of the state in the recent past and is a nonsmoker. Examination reveals a slender woman in no distress. Rectal exam shows black mucosa and a negative Heme test. Which of the following statements is correct? -
CORRECT ANSWER: Suspect surrepitious laxative abuse
A 22 year old presents with significant effusion of the knee resulting from a football injury. You perform a knee aspiration and collect 50 ml of bloody synovial fluid. Choose all components applicable to your plan of care: - CORRECT ANSWER: Plan to immobilize, MRI and refer due to chance of ACL rupture.
A 25 year old female comes to your clinic with the chief complaint of new onset headache. What will you include in your history of present illness? - CORRECT
ANSWER: Location of pain, duration of pain, description of pain, triggers, past
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A 25 year old male presents with complaints of daily back pain localized to his lower back after lifting a heavy box at work 3 days ago. The symptoms interfere with his ability to participate in his bowling league. He denies incontinence, gait instability or radicular symptoms. On examination, you note normal musculature, FROM of the spine with moderate paravertibral tenderness throughout the lubrosacaral spine without spasm.The client complains of posterior thigh pain when his right leg is elevated 75 degrees.His remaining examination is unremarkable. Your diagnosis is: - CORRECT ANSWER: Lumbar Strain
A 28 year old female presents with complaints of chronic aching pain and stiffness, frequently involving the entire body but with prominence of pain around the neck, shoulders, low back, and hips. She reports frequent headaches and trouble sleeping at least three nights per week and reports that even minor exertion aggravates pain and increases fatigue. Physical examination is normal except for "trigger points" of pain produced by palpation of various areas such as the trapezius, the medial fat pad of the knee, and the lateral epicondyle of the elbow. Your most likely diagnosis would be: -
CORRECT ANSWER: Fibromyalgia
A 30 y/o comes to the office because he has a loss of taste, painful ulcerations on the lips and tongues, and soreness in his mouth that hinders chewing. He started chemo and radiation 2 weeks go for laryngeal cancer. On exam, his oral mucosa is red, raw, and tender with sloughing tissues. Which of the following is the most appropriate
management? - CORRECT ANSWER: initiate supportive treatment for oral mucositis
A 32 y/o woman comes to the office c/o a bad taste in her mouth. She takes Metformin and Valsartan. Three weeks ago she took Nitrofuratonin for a UTI. On exam, there are white plaques on the surface of her cheeks, hard palate, and tongue. Wiping off some of the plaques reveals an erythematous mucosal surface. Which of the following is the
most likely diagnosis? - CORRECT ANSWER: Acute psuedomembranous candidiasis
A 32-year-old patient with the right half of her face is paralyzed. She is unable to wrinkle her forehead or close the eye completely. The corner of her mouth droops. She cannot whistle or show her teeth. She has no pain. These findings are consistent with
which of the following? - CORRECT ANSWER: Bell's Palsy
A 35 year old female is seen in your clinic with the following findings on right ear exam: erythematous tympanic membrane with altered bony landmarks and diminished cone of light. A small amount of fluid is noted directly behind the membrane. She gives a history of feeling fatigued and she had sinusitis two weeks ago that has resolved. What is your
diagnosis today? - CORRECT ANSWER: Otitis media
A 36 year old male presents with acute onset of unilateral inflammation, pain, and erythema of the first metatarsophanlangeal (MTP) joint. Differential diagnoses that should be considered include: - CORRECT ANSWER: cellulitis, arthritis and gout
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A 36 year old male presents with complaints of pain and swelling in his left knee with associated knee instability and occasional "locking" when walking. He reports playing tennis last week and felt a tearing, popping sensation that caused him to fall to the ground. He denies any bruising. He has self treated with Ibuprofen and wearing a knee brace with partial resolution. Based on this history your differentials should include all of the following except: - CORRECT ANSWER: Could not be trochanteric bursitis due to locking.
A 40 y/o man comes to the office with a rash of 4-5 months duration. He had bumps on his shoulders, back and arms. He reports that the bumps are larger, he has nighttime pruritis and oral and topical corticosteroids have not helped. He has no pets, lives alone, and recalls no insect bites or contacts with anyone with a rash. On eaxm there is a symetric eruption with erythematous papules and excorations on his back, shoulders, axillae, wrists, scrotum, and upper legs. There are a few pustles in the axillae. Which of the following is the most appropriate next step? - CORRECT ANSWER: Examine a skin scraping in mineral oil under a light microscope
A 45 year old female complains of a several week history of pain, burning, and tingling in palmar surfaces of the thumb, the index and long fingers, and the radial half of the ring finger. The pain radiates into the forearm and is exacerbated by her work as a transcriptionist. It is most bothersome at night. On examination she has a positive
Tinel's sign and Phalen's maneuver. Your most likely diagnosis is: - CORRECT
ANSWER: Carpal Tunnel Syndrome
A 50 year old male is seen in your clinic for a history of hoarseness lasting greater than
- weeks. His voice has a harsh quality with a low pitch. He denies a recent history of
upper respiratory infection. To assist you in defining the differential diagnoses, the pertinent review of systems would include all of the following except : - CORRECT
ANSWER: Current use of ACE inhibitor
A 52 y/o woman comes to the office c/o severe burning in her feet which is worse at night. She recently tried Gabapentin but dc'ed it because it caused a gait disturbance.She takes Glargine 20 units qhs and Metformin 1000 mg q12 hours. Her fingersticks have been between 180-200 in the morning and mid 200s in the evening. Which of the
following is the next step for her symptoms? - CORRECT ANSWER: Start pregbalin
(Lyrica)
A 55 year old female presents as a new patient with complaints of a several year history of worsening joint pain that is worse in the morning. On examination, the NP
notices Heberden's nodes and understands that this is a sign of: - CORRECT
ANSWER: Osteoarthritis
A 56 y/o complains of episodes of lacinating pain that shoots up to his right cheek when he eats or drinks, He has stopped drinking cold drinks because of the pain. Most likely
this is - CORRECT ANSWER: trigeminal neuralgia
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A 56 year old patient is seen in your office for follow-up of results of routine lab work.You decide, based on his lipid profile that a statin medication is indicated and believe that atorvastatin is the best option for this patient. You note that the patient's estimated glomerular filtration rate is 56ml/min/1.732 . According to the 2012 KDOQI Clinical Practice Guideline, which of the following would be the appropriate rationale in deciding the appropriate dosage of atorvastatin based on his current kidney function? -
CORRECT ANSWER: The patient has Stage III CKD, no dosage adjustment is
indicated for atorvastatin
A 58 y/o woman comes to the office c/o considerable frustration understanding clients in her law office. She has worn hearing aids since age 40 when severe to profound sensorineural hearing impairment developed in both ears. She recently had a hearing test that showed no changes and reaffirmed the diagnosis. She has read about bone- anchored heading aids and cochlear implants and wonders if these may be appropriate in her case. Which of the following is the best recommendation? - CORRECT
ANSWER: Cochlear implant in one ear and a new hearing aid in the other
A 60 y/o woman is evaluated because she has erythematous lesions. Initially, the lesions were on her arms and legs. By the end of week 1, the lesions spread to her trunk and several large blisters appeared. The lesions are pruritic and cause her to scratch. On exam, there are areas of erythema with tense blisters and serous exudate.Some blisters have opened into oval erosions with serous exudate. Some blisters are
covered in scabs. What is the most likely diagnosis? - CORRECT ANSWER: Bullous
pemphigoid
A 60 year old female patient in your clinic reports the recent onset of lancinating, cutting pain (pain scale: 8) on the right side of her face that lasts for approximately 5-10 seconds. The pain commenced after brushing her teeth and there has been no pain between the two recent episodes. You suspect trigeminal neuralgia (tic douloureux).Which of the following best describes your plan of care today? - CORRECT ANSWER: Schedule MRI and start Carbamazepine (Tegretol) at 100 mg. BID. Plan to monitor Tegretol blood levels and liver function.
A 60 year old male comes to your office with a history of urticaria. He is staying at home more due to his "rash". The lesions are papular and scabbed on extremities and
trunk. What will you include in your treatment plan? - CORRECT ANSWER: Assess
medication list for ACE inhibitors and NSAIDs
A 66 year old White male is seen in your clinic for continued tinnitus. His past occupational exposure history is positive for excessive loud noises. His history is negative for head trauma, allergies, hypertension and thyroid disease. His cholesterol is borderline high and he has chronic knee pain from years of jogging. You review his medication list and want to discontinue any medications that may contribute to tinnitus.Which medication below are you most likely to discontinue today? - CORRECT
ANSWER: NSAIDs
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