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NURSING MSN 620 FINAL EXAM| GRADED A+
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NURSING MSN 620 FINAL EXAM| GRADED A+
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NURSING MSN 620 FINAL EXAM| GRADED A+A 32-year-old female who is 9 weeks pregnant presents with nasal congestion
bilaterally. She has been using an over-the-counter intranasal decongestant for a
prolonged period, but her symptoms have not improved. Physical examination shows a
midline septum and 4+ turbinates. The nasal mucosa is hyperemic and erythematous
without cobblestoning. On further inquiry, she denies illicit drug use. Which of the
following medications is most appropriate to help ease her symptoms as she weans off
the topical decongestant? - ANSWERIntranasal fluticasone
A 17-year-old boy presents with a sore throat that started yesterday afternoon. He
denies any congestion or cough but reports a temperature of 102° F (38.8° C) and
generalized fatigue. He has pain with swallowing but can speak normally and manage
his saliva. On physical examination, the clinician sees yellow-white plaques on his
tonsils and anterior cervical lymphadenopathy that is tender to palpation. What is the
most appropriate next step in care? - ANSWERPoint-of-care streptococcal antigen
testing
A 17-year-old boy presents with purulent discharge from his right ear for 3 days. He is
recovering from a recent upper respiratory illness, with no fever over the past 3 days.
His ear was painful initially but is not currently. The tympanic membrane appears to
have a small perforation with copious purulent discharge. The external auditory canal
shows very faint erythema. There is no tragus tenderness and no nasopharyngeal
mass. What is the most appropriate management for this patient? - ANSWEROral
antibiotics
A 17-year-old male patient presents with a complaint of watery discharge from his eyes
for the past three days. He also complains of itching and redness associated with it.
Upon further questioning, he reveals a history of upper respiratory tract infections. His
vital signs show blood pressure of 120/80 mmHg, heart rate of 80 beats per minute,
respiratory rate of 14 breaths per minute, and temperature of 98.6 F (37 C). Ocular
examination findings are shown in the image. A polymerase chain reaction (PCR)
performed confirms the diagnosis. What is the most common causative organism? -
ANSWERAdenovirus
A 17-year-old female with asthma presents with a three-hour history of burning and
itching in both eyes and mild eyelid swelling that started after she went on a hike with
her friends. She is afebrile, and ocular examination shows bilateral watery discharge
and erythema of both the bulbar and tarsal conjunctiva. What is the most appropriate
next step in treatment? - ANSWERAntihistamine eye drops
A 17-year-old boy presents to the hospital with a severe sore throat and fatigue that has
been ongoing for 3 days. He has a high-grade fever for which he has been taking
ibuprofen at home. The pain in his throat has been making it difficult for him to swallow,
, though he can take cold drinks with care, which helps with the pain. He does not feel
throat congestion and does not have a cough. On physical examination, the clinician
notes exudates and tender cervical lymphadenopathy. The clinician treats him
empirically for strep throat with amoxicillin 500 mg twice daily for 10 days. The patient
returns two 2 days later, reporting a full-body, blotchy, bumpy rash and no change in his
symptoms. He stopped taking the antibiotics after the rash began. What is the most
appropriate next step in care? - ANSWERSend a throat swab for culture and order a
complete blood count and heterophile antibodies.
A 67-year-old female presents with a sore throat and cough that started three days ago
and has not resolved despite regular use of a combination of cold and cough medicines.
She reports feeling mildly uncomfortable but is not having a fever at home. She takes
medication for high blood pressure and high cholesterol but reports that they are well
controlled. Her vital signs, including oxygen saturation, are all within normal limits. On
examination, she has injected conjunctiva, nasal congestion, a red pharynx with no
exudates, and shotty cervical lymphadenopathy that is not tender. She is fully
vaccinated against COVID-19, and her polymerase chain reaction (PCR) is negative for
COVID-19. What is the most appropriate next step in care? - ANSWERReassurance
and prescription for symptom-directed medications
A 17-year-old male patient presents to the hospital with a sore throat. His condition is
associated with fever and chills, difficulty in swallowing, referred ear pain, headache,
and muscle aches. The vital sign shows a temperature of 39 C (102.2 F), pulse rate
105/min, and respiratory rate of 22 breaths/min. The physical exam reveals a dry
tongue, erythematous enlarged tonsils, pharyngeal exudate, and tender cervical
lymphadenopathy. What would be most beneficial investigation in establishing a
diagnosis in this case? - ANSWERRapid antigen detection test (RADT)
A 17-year-old female patient presents with a complaint of thick discharge from her eyes
that started five days ago. She also complains of redness and a feeling of dirt in her
eyes. On further questioning, she reveals that her eyes are usually matted in the
morning. A detailed medical history reveals that she has had multiple similar episodes
previously. She has been using contact lenses for the past two years. Her vital signs
show blood pressure 120/80 mmHg, heart rate 88/min, respiratory rate 14 breaths/min,
and temperature 37 C (98.6 F). An ocular examination reveals hyperemia and elevated
yellow-white lesions at the lower cul-de-sac. What is the most appropriate next step in
the management of her condition? - ANSWERTopical ciprofloxacin
A 9-year-old male is brought by his mother, who states that he has had a stuffy and
runny nose for around eight months. The patient admits to occasional sneezing and
congestion to the point that he has to breathe through his mouth. He denies fever,
wheezing, or ear discomfort. On physical examination, he is noted to have mild
darkening under both eyes, a small crease above the tip of his nose, clear rhinorrhea
bilaterally, mild turbinate swelling with pale blue mucosa, and some cobblestoning in the
posterior pharynx. His lungs are clear on auscultation. Which of the following physical
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