MSN 620 Primary care Comprehensive Questions and
Answers 100% Correct and Guaranteed Pass
A 16-year-old male presents with a 2 day history of sore throat, fever, and cough. He has been
experiencing difficulty swallowing food for the last two days. He has otherwise been in good
health and is up to date with his immunizations. On examinations, he has a temperature of 100.6
F, pulse rate of 100 bpm, blood pressure of 110/80 mmHg. Oral exam reveals bilateral tonsillar
exudates and diffuse pharyngeal erythema. Which of the following would be the next best step in
the management of this patient?
1. Start the patient on amoxicillin empirically
2. Order a culture and sensitivity of a throat swab
3. Order a rapid strep test
4. Order a heterophile antibody test - CORRECT ANSWER ✔✔ -3. Order a rapid strep test
A 16-year-old presents with a long history of abdominal pain, intermittent diarrhea, constipation,
rectal bleeding, and loss of weight. She has been to many providers without a diagnosis. She
undergoes a colonoscopy which reveals that the rectum is inflamed with mucus in the lumen.
Biopsy of the specimen reveals an inflammatory reaction that is limited to the mucosa and
submucosa. Numerous neutrophils and cryptic abscesses are visible. Her carcinoembryonic
antigen levels (CEA) is elevated. What is the most likely diagnosis?
1. Hepatitis A
2. Ulcerative colitis
,3. Acute cholecystitis
4. Diverticulitis - CORRECT ANSWER ✔✔ -2. Ulcerative colitis
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 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 female is seen in the clinic with complaints of poor sleep, lack of interest in daily
living activities, low libido, and feeling depressed. She was diagnosed with depression two years
ago but has been reluctant to take her antidepressants. She has been feeling 'down' for a number
of months and has tried several types of natural treatments but without much success. She would
like to know what factors are making her depression worse. Based on recent data, what factor
may actually help decrease the risk of a major depressive disorder?
1. Religious beliefs
2. Low socioeconomic status
,3. Being single
4. Living in the city - CORRECT ANSWER ✔✔ -1. Religious beliefs
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?
1. Topical neomycin
2. Topical bacitracin
3. Topical ciprofloxacin
4. Oral azithromycin - CORRECT ANSWER ✔✔ -3. Topical ciprofloxacin
A 17-year-old female presents to the office with a severe sore throat. The symptoms, which
began four days ago, have become unilateral and much worse over the last day. She has had
fevers of 101-103 F at home and was taking over-the-counter medications but now cannot
tolerate swallowing even liquid ibuprofen. She has no trouble breathing, but reports that it is very
difficult to open her mouth because of pain in her jaw and the clinician struggles to visualize her
throat but notes unilateral tonsillar swelling. The clinician also notes tender cervical
, lymphadenopathy and some right-sided facial swelling but only minimal tenderness to palpation
over the right jaw. What is the most appropriate next step in care?
1. Referral to the emergency department for imaging and aspiration
2. In-office aspiration of likely peritonsillar abscess
3. Topical benzocaine spray and amoxicillin-clavulanic acid twice daily for seven day -
CORRECT ANSWER ✔✔ -1. Referral to the emergency department for imaging and aspiration
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 immunocompetent male presents with a pruritic rash on his left leg (see image).
He reports that it recently developed after starting a weightlifting program at a local gymnasium.
What is the most appropriate initial treatment for this patient's condition?
1. Topical nystatin
2. Oral griseofulvin
Answers 100% Correct and Guaranteed Pass
A 16-year-old male presents with a 2 day history of sore throat, fever, and cough. He has been
experiencing difficulty swallowing food for the last two days. He has otherwise been in good
health and is up to date with his immunizations. On examinations, he has a temperature of 100.6
F, pulse rate of 100 bpm, blood pressure of 110/80 mmHg. Oral exam reveals bilateral tonsillar
exudates and diffuse pharyngeal erythema. Which of the following would be the next best step in
the management of this patient?
1. Start the patient on amoxicillin empirically
2. Order a culture and sensitivity of a throat swab
3. Order a rapid strep test
4. Order a heterophile antibody test - CORRECT ANSWER ✔✔ -3. Order a rapid strep test
A 16-year-old presents with a long history of abdominal pain, intermittent diarrhea, constipation,
rectal bleeding, and loss of weight. She has been to many providers without a diagnosis. She
undergoes a colonoscopy which reveals that the rectum is inflamed with mucus in the lumen.
Biopsy of the specimen reveals an inflammatory reaction that is limited to the mucosa and
submucosa. Numerous neutrophils and cryptic abscesses are visible. Her carcinoembryonic
antigen levels (CEA) is elevated. What is the most likely diagnosis?
1. Hepatitis A
2. Ulcerative colitis
,3. Acute cholecystitis
4. Diverticulitis - CORRECT ANSWER ✔✔ -2. Ulcerative colitis
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 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 female is seen in the clinic with complaints of poor sleep, lack of interest in daily
living activities, low libido, and feeling depressed. She was diagnosed with depression two years
ago but has been reluctant to take her antidepressants. She has been feeling 'down' for a number
of months and has tried several types of natural treatments but without much success. She would
like to know what factors are making her depression worse. Based on recent data, what factor
may actually help decrease the risk of a major depressive disorder?
1. Religious beliefs
2. Low socioeconomic status
,3. Being single
4. Living in the city - CORRECT ANSWER ✔✔ -1. Religious beliefs
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?
1. Topical neomycin
2. Topical bacitracin
3. Topical ciprofloxacin
4. Oral azithromycin - CORRECT ANSWER ✔✔ -3. Topical ciprofloxacin
A 17-year-old female presents to the office with a severe sore throat. The symptoms, which
began four days ago, have become unilateral and much worse over the last day. She has had
fevers of 101-103 F at home and was taking over-the-counter medications but now cannot
tolerate swallowing even liquid ibuprofen. She has no trouble breathing, but reports that it is very
difficult to open her mouth because of pain in her jaw and the clinician struggles to visualize her
throat but notes unilateral tonsillar swelling. The clinician also notes tender cervical
, lymphadenopathy and some right-sided facial swelling but only minimal tenderness to palpation
over the right jaw. What is the most appropriate next step in care?
1. Referral to the emergency department for imaging and aspiration
2. In-office aspiration of likely peritonsillar abscess
3. Topical benzocaine spray and amoxicillin-clavulanic acid twice daily for seven day -
CORRECT ANSWER ✔✔ -1. Referral to the emergency department for imaging and aspiration
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 immunocompetent male presents with a pruritic rash on his left leg (see image).
He reports that it recently developed after starting a weightlifting program at a local gymnasium.
What is the most appropriate initial treatment for this patient's condition?
1. Topical nystatin
2. Oral griseofulvin
