MSN 622 final All Possible Questions Latest
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A 14-year-old girl is brought to the emergency department by her parents. Her parents
state that she was playing outside during a softball game when she developed nausea
and started complaining of fatigue and mild headache. Further evaluation reveals that
she has a heart rate of 120 beats/min and a temperature of 103 degrees Fahrenheit.
However, she has no mental status changes or muscle fasciculations but is sweating
profusely. What is the most likely diagnosis? - CORRECT ANSWER: Heat exhaustion
A 16-year-old girl is brought to the hospital for a facial wound. She says a friend hit her
in the face at a party. Upon further evaluation, she revealed that she was assaulted by
her boyfriend, who forced himself on her. He did not use protection. Emergency
contraception, ceftriaxone, doxycycline, and metronidazole are given. Prophylaxis
against which of the following possible infections is the primary objective of giving this
patient metronidazole? - CORRECT ANSWER: Trichomoniasis
A 16-year-old girl presents to the emergency department after being raped by two men.
After initial stabilization, the patient consents to the forensic exam by the sexual assault
nurse examiner (SANE). The patient is counseled by the SANE on receiving sexually
transmitted infection prophylaxis. The patient is uncertain about her immunization
history. On discharge which of the following vaccines should be administered to this
patient? - CORRECT ANSWER: Hepatitis B vaccine
A 16-year-old girl presents to the emergency department to be evaluated after being
sexually assaulted the night prior. Once in the exam room with the sexual assault nurse
examiner (SANE), the patient tearfully exclaims that she does not want anyone to know,
but she wants to make sure she's not pregnant. Which of the following is the next most
appropriate course of action? - CORRECT ANSWER: Report the incident to the relevant
authorities
,A 16-year-old girl presents to the office for a follow-up exam two weeks following sexual
assault. The patient was administered emergency contraception only, as she denied
prophylaxis against sexually transmitted infections. The patient's last immunization was
at the age of 5. Laboratory analysis reveals the presence of anti-Hbs antibodies only.
Which of the following vaccines should be administered to the patient, given her recent
history of sexual assault? - CORRECT ANSWER: Human papillomavirus vaccine
A 16-year-old man presents to the emergency department due to a 3-day history of
polyuria, vomiting, and extreme thirst. He had an upper respiratory infection starting 2
days prior and now presents with a temperature of 101.2 °F (38.4 °C). Physical exam
shows decreased skin turgor and dry mucous membranes, and urine analysis is positive
for ketones. He has a blood glucose level of 935 mg/dL. What structures are commonly
affected by microvascular damage from this disease? - CORRECT ANSWER: Eyes,
gums, feet, and kidneys
A 17-year-old female presents to the emergency department after having an episode of
syncope. She was out watching fireworks during the day and drinking alcohol. She
reports that she took ibuprofen earlier in the day for a mild headache. Her vital signs are
normal, and she has no symptoms at this time. Which of the following is a risk factor for
what happened to the patient? - CORRECT ANSWER: Alcohol consumption
A 17-year-old, previously healthy girl presents with an acute flu-like illness, fever,
myalgias, shortness of breath, and chest pain. Her ECG shows sinus tachycardia. Her
labs show elevated white blood cells and an abnormally elevated troponin. Her chest x-
ray shows mild pulmonary edema, with findings consistent with congestive heart failure.
What is her likely diagnosis? - CORRECT ANSWER: Acute myocarditis
A 19-year-old woman is brought to the hospital by the police after being sexually
assaulted four hours ago. She reports that the assailant performed vaginal penetration
without a condom. She believes that the assailant ejaculated. The patient did not know
her assailant and is concerned about sexually transmitted infections. She received the
HPV vaccine as a teenager and the hepatitis B vaccination when she started nursing
school last fall. She has no past medical history or medication allergies. Which of the
following combinations of medications is most appropriate for this patient? - CORRECT
ANSWER: Emergency contraception, ceftriaxone, doxycycline, raltegravir, tenofovir,
emtricitabine, and metronidazole
, A 2-month-old male is brought to the emergency department in distress. He had a
normal birth history. He had a history of viral illness 4 weeks ago, which resolved with
time. His vital signs are a heart rate of 180 beats per minute, a blood pressure of 85/52
mmHg, a respiratory rate of 50 breaths per minute, and a temperature of 37 C (98.6 F).
Physical examination reveals a pale-looking infant. The heart sounds are distant, and
there is a gallop. A chest x-ray shows an enlarged cardiac shadow. The
electrocardiogram has low voltage. Which of the following explains his presentation? -
CORRECT ANSWER: Dilated cardiomyopathy secondary to myocarditis
A 21-year-old female presents to the office five days after being sexually assaulted. The
patient was raped by a student at her college. Before discharge, the patient was given
emergency contraception and prophylaxis against sexually transmitted infections. She
states since starting the medications, she has developed a metallic taste. Which of the
following drugs is most likely responsible for the patient's complaint? - CORRECT
ANSWER: Metronidazole
A 23-year-old male presents with penile discharge for three days. He also reports
urinary urgency and cloudy urine. When asked about his sexual history, the patient
reports that he was recently sexually assaulted but did not report the assault. He
worried that his girlfriend would not understand and think he had cheated on her. He
has no past medical history. His vitals indicate a temperature of 100.1 F (37.8 C), a
pulse of 75 beats per minute, blood pressure of 115/77 mmHg, and 16 respirations per
minute. On physical examination, there is discharge at the urethral meatus that is
collected for analysis. The specimen is viewed under wet prep microscopy, and an
organism with a single flagellum is seen. What precautions should this patient take
about the medication used in his treatment? - CORRECT ANSWER: He should avoid
taking it with alcohol
A 24-year-old woman presents with diffuse aching and stiffness, worsened by cold
weather and stress. Her history is significant for Lyme disease 2 years ago treated with
doxycycline 100 mg twice a day for 4 weeks. Her joints show no tenderness or
synovitis, but she is tender over points bilaterally at the occiput, trapezius, lateral
epicondyle, gluteals, and knee. What is the most probable diagnosis? - CORRECT
ANSWER: Fibromyalgia
A 25-year-old woman presents with complaints of a facial rash that started a few months
ago and has worsened. She states that the rash is often itchy and worsens when she
goes out in the sun. In the last few days, she has noticed generalized aches all over her
body. She denies any trauma, allergies, or recent travel. She did try several over-the-
