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MSN 620 Final Exam Questions and Answers | 100% Pass

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MSN 620 Final Exam Questions and Answers | 100% Pass A 32-year-old female who is nine 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 ...

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  • September 25, 2024
  • 45
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • MSN 620
  • MSN 620
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EmillyCharlotte
TITLE: EMILLYCHARLOTTE 2024/2025 ACADEMIC PERIOD
OWNER: EMILLYCHARLOTTE
COPYRIGHT STATEMENT: ©2024 EMILLYCHARLOTTE. ALL RIGHTS
RESERVED
FIRST PUBLISHED: SEPTEMBER 2024

MSN 620 Final Exam Questions and
Answers | 100% Pass


A 32-year-old female who is nine 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?




1. Intranasal azelastine

2. Intranasal fluticasone

3. Intranasal ipratropium

4. Oral prednisone - Correct Answer✔️✔️-2. Intranasal fluticasone

A 17-year-old boy presents to the office with a sore throat that started yesterday

afternoon. He denies any congestion or cough but reports a temperature of 102 degrees

F and generalized fatigue. He has pain with swallowing but can speak normally and

manage his saliva. On exam, the clinician notes yellow-white plaques on his tonsils and


1/45

,TITLE: EMILLYCHARLOTTE 2024/2025 ACADEMIC PERIOD
OWNER: EMILLYCHARLOTTE
COPYRIGHT STATEMENT: ©2024 EMILLYCHARLOTTE. ALL RIGHTS
RESERVED
FIRST PUBLISHED: SEPTEMBER 2024
anterior cervical lymphadenopathy that is tender to palpation. Besides his fever, his vital

signs are all within normal limits. What is the most appropriate next step in care?

1. Weight-based dosing of ibuprofen

2. Weight-based dosing of azithromycin for a five-day treatment

3. Point-of-care streptococcal antigen testing

4. Bacterial culture of the throat - Correct Answer✔️✔️-3. Point-of-care streptococcal

antigen testing

A 17-year-old male presents with purulent discharge from his right ear for three days.

He is recovering from a recent upper respiratory illness, with no fever over the past

three 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?

1. Ear wick

2. Culture of the discharge

3. Oral antibiotics

4. Ototopical corticosteroids - Correct Answer✔️✔️-3. Oral 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,
2/45

,TITLE: EMILLYCHARLOTTE 2024/2025 ACADEMIC PERIOD
OWNER: EMILLYCHARLOTTE
COPYRIGHT STATEMENT: ©2024 EMILLYCHARLOTTE. ALL RIGHTS
RESERVED
FIRST PUBLISHED: SEPTEMBER 2024
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?

1. Adenovirus

2. Herpes simplex

3. Herpes zoster

4. Enterovirus - Correct Answer✔️✔️-1. Adenovirus

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?



1. Warm compresses

2. Antihistamine eye drops

3. Corticosteroid eye drops

4. Oral antihistamines - Correct Answer✔️✔️-2. Antihistamine eye drops

A 17-year-old male presents to the hospital with a severe sore throat and fatigue that

has been ongoing for three 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
3/45

, TITLE: EMILLYCHARLOTTE 2024/2025 ACADEMIC PERIOD
OWNER: EMILLYCHARLOTTE
COPYRIGHT STATEMENT: ©2024 EMILLYCHARLOTTE. ALL RIGHTS
RESERVED
FIRST PUBLISHED: SEPTEMBER 2024
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 ten days. The patient

returns two 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?

1. Send a throat swab for culture and record the patient's allergy to ampicillin. 2. Send a

throat swab for culture and orde - Correct Answer✔️✔️-2. Send a throat swab for culture

and order a complete blood count and heterophile antibodies.

A 65-year-old woman presents to the hospital 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 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, her primary provider notes 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 PCR is negative for

COVID-19. What is the most appropriate next step in care?

1. Reassurance and prescription for symptom-directed medications

2. Empiric therapy with amoxicillin twice daily for 10 days

3. Multiplex PCR for viral pathogens

4/45

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