MSN 622 FINAL EXAM NEWEST 2024 ACTUAL EXAM COMPLETE 160 QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS) ALREADY GRADED A+.pdf

MSN 622 FINAL EXAM NEWEST 2024/2025ACTUAL EXAM COMP
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LETE 116 QUESTIONS AND CORRECT ANSWERS
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(VERIFIED ANSWERS) n




blowing - CORRECT ANSWER A 67-year- n n n n n


old man with a history of hypertension and tobacco use presents with a two
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-day history of hypogastric pain. An examination reveals a 5 cm, non-
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tender, pulsatile abdominal mass above the umbilicus. Which of the follo
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wing type of sounds might be heard upon auscultation at the midline, two i
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nches cephalad to the umbilicus?
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ultrasound every 3 years - n n n n


CORRECT ANSWER What is the recommended management for a patient
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with a 3.5 cm abdominal aortic aneurysm?
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immediate surgery - CORRECT ANSWER A 75-year- n n n n n n


old man presents to the emergency department with complaints of severe a
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bdominal pain and sweating. The pain started about an hour ago and is beco
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ming worse with time. He has been diagnosed with hypertension and diabe
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tes and is on amlodipine and metformin, respectively. On presentation, the
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vital signs show blood pressure 70/40 mmHg, pulse 140/min, respiratory r
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ate 32/min, temperature 38.5 C (101.3 F), and oxygen saturation 87% at ro
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om air. On physical examination of the abdomen, generalized tenderness a
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nd guarding are seen. There is a midline pulsatile mass.
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What is the next best step in the management of this patient?
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,abdominal CT - CORRECT ANSWER A 67-year- n n n n n n


old male with a history of hypertension and nicotine dependence presents t
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o the emergency department with sudden onset of abdominal pain radiatin
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g to the back. There is no history of alcohol use. On examination, he is thin,
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npale, and diaphoretic. His vital signs show a blood pressure of 110/70 mm
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Hg and a heart rate of 95 bpm. Which of the following is most likely to conf
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irm the diagnosis? n n




Surgery will improve 5-year survival - CORRECT ANSWER A 78-
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nyear-
old is found to have an asymptomatic pulsatile abdominal mass. The ultra
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sound shows an abdominal aortic aneurysm measuring 5.5 cm. Which of t
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he following statements concerning this patient's condition is correct?
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stress electrocardiogram - CORRECT ANSWER A 65-year-
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old man presents to the office with complaints of occasional chest pain. Th
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e patient has a past medical history significant for hypertension, diabetes
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mellitus, and hyperlipidemia. The patient states he experiences chest pain
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on exertion, which is only relieved on rest. An electrocardiogram is normal
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. Which of the following is the next step in management?
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Determining the precipitating factors for his condition - n n n n n n n


nCORRECT ANSWER A 65-year- n n n


old man presents with complaints of chest pain that started 30 mins ago but
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stopped on his way to the hospital. The patient has a past medical history si
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gnificant for hypertension and diabetes mellitus. An electrocardiogram (E
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CG) is normal. A stress ECG shows mild ST elevations after 12 minutes of
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exercise. A diagnosis of stable angina is made. Which of the following shou
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ld be the first step in counseling the patient about his condition?
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,hypertensive emergency - CORRECT ANSWER A 47-year- n n n n n n


old male presents to the office for routine health maintenance. His blood pr
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essure is 182/138, with all other vital signs within normal limits. The patie
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nt is currently complaining of a headache and blurred vision but denies che
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st pain, shortness of breath, and abdominal pain. Under which of the follo
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wing forms of hypertension would this patient be classified
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Losartan/hydrochlorothiazide and atorvastatin - n n n


CORRECT ANSWER A 65-year-
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old male with a history of type 2 diabetes comes into the provider's office c
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omplaining of blurry vision, nosebleeds, and exertional chest pain for the p
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ast six months. The blood pressure is measured to be 160/94 mmHg. A CT
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angiogram is performed, which reveals partially occlusive coronary artery
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plaques. Which of the following medication regimens would be most appr
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opriate for this patient? n n n




Reassure him that this is expected from his ACE inhibitor and continue the
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rapy with periodic monitoring. - CORRECT ANSWER A 68-year-
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nold male with a past medical history of type 2 diabetes mellitus and diabeti
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c nephropathy presented to the clinic for a follow-
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up appointment. His blood pressure on the last visit was 150/90 mmHg. He
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nwas called in for a follow-
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up appointment in 4 weeks to monitor his blood pressure. The blood pressu
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re on this visit is 168/105 mmHg, and HbA1c is 8.9%. His antihypertensive
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nregimen was adjusted, and an ACE inhibitor was added. He is on metformi
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n and sitagliptin for diabetes mellitus. One week later, his blood pressure w
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as 130/80 mmHg, the patient's potassium was 5.1 mEq/L, sodium was 133
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mEq/L, and the rest of the renal panel was within normal limits. He reports
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no symptoms.n


What is the next best step in his care?
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, Reassurance - CORRECT ANSWER A 50-year- n n n n n


old man presents to the clinic for routine evaluation. His systolic blood pres
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sure has persistently been in the 150-
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160 mmHg range. Treatment with ramipril is initiated.
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On the next visit, he complained of an itchy throat and a dry cough, which i
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s not distressing for him, but he is concerned that there might be something
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serious as he used to smoke but quit 5 years ago. A chest x-
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nray is within normal limits. What is the next best step in the management of
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this patient? n




Assess the accuracy of his digital BP readings -
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CORRECT ANSWER A 65-year-
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old man presents for a review of his medications. The patient states his bloo
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d pressure (BP) is always elevated whenever he checks it with his digital B
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P monitoring machine, despite taking all of his medications. He has a past
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medical history significant for hypertension, diabetes mellitus, and hyperli
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pidemia. Laboratory evaluation reveals a normal random blood glucose lev
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el and a normal lipid profile. Which of the following is the most appropriate
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initial step before changing the patient's antihypertensive medication?
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clopidogrel - CORRECT ANSWER A 65-year- n n n n n


old man presents with episodic substernal pain. Initially, he experienced ch
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est pain with physical activity, which remits with rest. But now it occurs at
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rest too. He has a history of hypertension and smokes 30 cigarettes/day. In
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addition, he has aspirin hypersensitivity. His blood pressure is 145/90 mm
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Hg, pulse is 78/min, and oxygen saturation is 97%. Physical examination is
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unremarkable. ECG reveals mild ST-segment depressions in V1-
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V2. Cardiac troponins are not elevated. Which of the following is the best o
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ption for the management in this patient?
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