MSN 620 QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT
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Core Domains
Ears, Eyes, Nose, and Throat (EENT) Disorders
Neurological and Psychosocial Assessment
Dermatological Conditions in Primary Care
Musculoskeletal and Abdominal Systems
Pathophysiology and Diagnostic Reasoning
Health Promotion and Disease Prevention
Pharmacological and Therapeutic Management
Ethics and Professional Standards in Advanced Practice
Introduction
The MSN 620 examination assesses advanced practice nursing
competencies in primary care of adolescents and adults. It
evaluates clinical decision-making, diagnostic reasoning, and
evidence-based management across core systems including
EENT, neurological, psychosocial, dermatological,
musculoskeletal, and abdominal domains. The multiple-
choice and scenario-based format emphasizes real-world
application, requiring candidates to demonstrate foundational
theory, regulatory compliance, ethical judgment, and critical
thinking in patient-centered care.
,Section One: Questions 1–100
Question 1
A 35-year-old man with nasal congestion has used an over-
the-counter intranasal decongestant for four weeks. He
reports dependence on the spray and needing more
frequent use for relief. What is the most appropriate
management approach?
A. Continue the decongestant and add intranasal
corticosteroids
B. Discontinue the decongestant immediately without
further intervention
C. Gradually discontinue the decongestant and consider
short-course oral corticosteroids during withdrawal
D. Refer for nasal surgery
🟢 Correct answer C.
🔴 RATIONALE: Prolonged use of intranasal decongestants
leads to rhinitis medicamentosa. Gradual withdrawal with
short-course oral corticosteroids reduces rebound
congestion and mucosal inflammation during the transition
period.
Question 2
,A 28-year-old male with a history of asthma presents with
bilateral eye discharge, morning matting, and redness. He
denies itching or recent upper respiratory symptoms.
Examination reveals diffuse conjunctival injection, purulent
discharge, and conjunctival papillae. What is the most likely
etiological agent?
A. Neisseria gonorrhea
B. Staphylococcus aureus
C. Herpes simplex virus
D. House dust mite
🟢 Correct answer B.
🔴 RATIONALE: Purulent discharge with conjunctival
papillae in the absence of itching suggests bacterial
conjunctivitis. Staphylococcus aureus is the most common
cause in adults, particularly those with asthma.
Question 3
A 17-year-old female presents with severe unilateral sore
throat worsening over one day, fever of 101–103°F, difficulty
opening her mouth, and inability to swallow liquids.
Examination shows unilateral tonsillar swelling, tender
cervical lymphadenopathy, and right-sided facial swelling.
What is the most appropriate next step?
, A. Referral to the emergency department for imaging and
aspiration
B. In-office aspiration of likely peritonsillar abscess
C. Topical benzocaine spray and amoxicillin-clavulanic acid
for seven days
D. Prescribe oral steroids and discharge home
🟢 Correct answer A.
🔴 RATIONALE: Unilateral tonsillar swelling with trismus,
severe odynophagia, and facial swelling suggests
peritonsillar abscess. Emergency department referral for
imaging and possible aspiration or incision and drainage is
indicated.
Question 4
A 38-year-old male with chronic nasal allergies has failed
over-the-counter antihistamines. He has hypertension
controlled on hydrochlorothiazide. Skin prick testing reveals
allergies to cat dander, dust mites, ragweed, and tree pollen.
What is the most appropriate step?
A. Intranasal corticosteroids
B. Send carpet fiber for analysis
C. Immunotherapy for cat dander only
D. Wash and keep carpets and drapes
ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT
DOWNLOAD PDF
Core Domains
Ears, Eyes, Nose, and Throat (EENT) Disorders
Neurological and Psychosocial Assessment
Dermatological Conditions in Primary Care
Musculoskeletal and Abdominal Systems
Pathophysiology and Diagnostic Reasoning
Health Promotion and Disease Prevention
Pharmacological and Therapeutic Management
Ethics and Professional Standards in Advanced Practice
Introduction
The MSN 620 examination assesses advanced practice nursing
competencies in primary care of adolescents and adults. It
evaluates clinical decision-making, diagnostic reasoning, and
evidence-based management across core systems including
EENT, neurological, psychosocial, dermatological,
musculoskeletal, and abdominal domains. The multiple-
choice and scenario-based format emphasizes real-world
application, requiring candidates to demonstrate foundational
theory, regulatory compliance, ethical judgment, and critical
thinking in patient-centered care.
,Section One: Questions 1–100
Question 1
A 35-year-old man with nasal congestion has used an over-
the-counter intranasal decongestant for four weeks. He
reports dependence on the spray and needing more
frequent use for relief. What is the most appropriate
management approach?
A. Continue the decongestant and add intranasal
corticosteroids
B. Discontinue the decongestant immediately without
further intervention
C. Gradually discontinue the decongestant and consider
short-course oral corticosteroids during withdrawal
D. Refer for nasal surgery
🟢 Correct answer C.
🔴 RATIONALE: Prolonged use of intranasal decongestants
leads to rhinitis medicamentosa. Gradual withdrawal with
short-course oral corticosteroids reduces rebound
congestion and mucosal inflammation during the transition
period.
Question 2
,A 28-year-old male with a history of asthma presents with
bilateral eye discharge, morning matting, and redness. He
denies itching or recent upper respiratory symptoms.
Examination reveals diffuse conjunctival injection, purulent
discharge, and conjunctival papillae. What is the most likely
etiological agent?
A. Neisseria gonorrhea
B. Staphylococcus aureus
C. Herpes simplex virus
D. House dust mite
🟢 Correct answer B.
🔴 RATIONALE: Purulent discharge with conjunctival
papillae in the absence of itching suggests bacterial
conjunctivitis. Staphylococcus aureus is the most common
cause in adults, particularly those with asthma.
Question 3
A 17-year-old female presents with severe unilateral sore
throat worsening over one day, fever of 101–103°F, difficulty
opening her mouth, and inability to swallow liquids.
Examination shows unilateral tonsillar swelling, tender
cervical lymphadenopathy, and right-sided facial swelling.
What is the most appropriate next step?
, A. Referral to the emergency department for imaging and
aspiration
B. In-office aspiration of likely peritonsillar abscess
C. Topical benzocaine spray and amoxicillin-clavulanic acid
for seven days
D. Prescribe oral steroids and discharge home
🟢 Correct answer A.
🔴 RATIONALE: Unilateral tonsillar swelling with trismus,
severe odynophagia, and facial swelling suggests
peritonsillar abscess. Emergency department referral for
imaging and possible aspiration or incision and drainage is
indicated.
Question 4
A 38-year-old male with chronic nasal allergies has failed
over-the-counter antihistamines. He has hypertension
controlled on hydrochlorothiazide. Skin prick testing reveals
allergies to cat dander, dust mites, ragweed, and tree pollen.
What is the most appropriate step?
A. Intranasal corticosteroids
B. Send carpet fiber for analysis
C. Immunotherapy for cat dander only
D. Wash and keep carpets and drapes
