MSN 620 Final Exam Questions and Answers | 100% Pass

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 Answer️️ -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 TITLE: EMILLYCHARLOTTE 2024/2025 ACADEMIC PERIOD OWNER: EMILLYCHARLOTTE COPYRIGHT STATEMENT: ©2024 EMILLYCHARLOTTE. ALL RIGHTS RESERVED FIRST PUBLISHED: SEPTEMBER 2024 2/45 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 Answer️️ -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 Answer️️ -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, TITLE: EMILLYCHARLOTTE 2024/2025 ACADEMIC PERIOD OWNER: EMILLYCHARLOTTE COPYRIGHT STATEMENT: ©2024 EMILLYCHARLOTTE. ALL RIGHTS RESERVED FIRST PUBLISHED: SEPTEMBER 2024 3/45 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 Answer️️ -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 Answer️️ -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 TITLE: EMILLYCHARLOTTE 2024/2025 ACADEMIC PERIOD OWNER: EMILLYCHARLOTTE COPYRIGHT STATEMENT: ©2024 EMILLYCHARLOTTE. ALL RIGHTS RESERVED FIRST PUBLISHED: SEPTEMBER 2024 4/45 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 Answer️️ -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 TITLE: EMILLYCHARLOTTE 2024/2025 ACADEMIC PERIOD OWNER: EMILLYCHARLOTTE COPYRIGHT STATEMENT: ©2024 EMILLYCHARLOTTE. ALL RIGHTS RESERVED FIRST PUBLISHED: SEPTEMBER 2024 5/45 4. Bacterial cultur - Correct Answer️️ -1. Reassurance 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? 1. ASO titer 2. CRP 3. Rapid antigen detection test (RADT) 4. Throat culture - Correct Answer️️ -3. Rapid antigen detection test (RADT) A 17-year-old female patient presents with a complaint