Page 1 of 54
MSN 620 final exam 2025, nursing theory questions,
evidence-based practice nursing exam, advanced
practice MSN study guide, graded A+ MSN exam
PDF, final exam questions and answers
A 35-year-old man with nasal congestion continues to use an
over-the-counter intranasal decongestant for four weeks. He
complains that he is dependant on the intranasal decongestant
spray and that he needs to use it more frequently to obtain relief.
Which of the following is the best approach to the management
of this patient?
1. Continue the nasal decongestant and introduce additional
intranasal corticosteroids
2. Discontinue the nasal decongestant straight away
3. Gradually discontinue the nasal decongestant and consider the
use of short-course oral corticosteroids during this withdrawal
period
4. Consent the patient for nasal surgery - ANSWER-3.
Gradually discontinue the nasal decongestant and consider the
use of short-course oral corticosteroids during this withdrawal
period
,Page 2 of 54
A 28-year-old male patient with a history of asthma presents
complaining of eye discharge, morning matting, and redness. He
denies eye itching, burning, or recent upper respiratory
symptoms. On examination, there is a bilateral diffuse
conjunctival injection, purulent discharge, and conjunctival
papillae. What is the most likely etiological agent for this
patient's presentation?
1. Neisseria gonorrhea
2. Staphylococcal aureus
3. Herpes simplex virus
4. House dust mite - ANSWER-2. Staphylococcal aureus
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?
,Page 3 of 54
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 - ANSWER-1. Referral to the
emergency department for imaging and aspiration
A 38-year-old male patient complains of chronic nasal allergies.
He has used over-the-counter antihistamines without much
success. He believes he is allergic to ragweed but has had no
testing. His past medical history is remarkable for hypertension
that is controlled on hydrochlorothiazide. He does not drink,
smoke, or use illicit drugs. He works in a relatively new office,
but he lives in a 60-year-old house with his family. They have
carpets, drapes, and a cat. Exam shows pale and boggy nasal
mucosa and cobblestoning of the posterior pharynx. Lungs are
clear on auscultation. Skin prick testing shows allergies to cat
dander, dust mites, ragweed, and tree pollen. Which of the
following would be an appropriate step to take?
1. Intranasal corticosteroids
2. Send carpet fiber for analysis
3. Immunotherapy for cat dander
4. Wash and keep carpets and drapes - ANSWER-1. Intranasal
corticosteroids
, Page 4 of 54
A 25-year-old female, who is a smoker, presents to the
outpatient department with recurrent episodes of pain over both
sides of the face over the past three months. The pain occurs as a
sudden shooting pain which is severe in intensity and affects one
side of the face at a time. She describes it as electric shocks that
last for about 10 seconds and resolves by itself. She experiences
this symptom several times during the day and is sometimes
triggered by touching some particular spots on the face. She also
complains of intermittent numbness in the bilateral upper
extremities. Neurological examination shows sensory loss to
gross touch in the dorsal aspect of the right upper extremity.
What is the next step in the management of this patient?
1. Start carbamazepine therapy
2. Obtain magnetic resonance imaging (MRI) of the brain and
spine
3. Obtain X-ray of the right hand
4. Start as needed ibuprofen therapy - ANSWER-2. Obtain
magnetic resonance imaging (MRI) of the brain and spine
A 65-year-old man presents with postauricular pain, facial
weakness, and excessive tearing that started 24 hours ago. He
denies a history of these symptoms before this episode. Past
medical history is significant for cold sores and asthma. He is
MSN 620 final exam 2025, nursing theory questions,
evidence-based practice nursing exam, advanced
practice MSN study guide, graded A+ MSN exam
PDF, final exam questions and answers
A 35-year-old man with nasal congestion continues to use an
over-the-counter intranasal decongestant for four weeks. He
complains that he is dependant on the intranasal decongestant
spray and that he needs to use it more frequently to obtain relief.
Which of the following is the best approach to the management
of this patient?
1. Continue the nasal decongestant and introduce additional
intranasal corticosteroids
2. Discontinue the nasal decongestant straight away
3. Gradually discontinue the nasal decongestant and consider the
use of short-course oral corticosteroids during this withdrawal
period
4. Consent the patient for nasal surgery - ANSWER-3.
Gradually discontinue the nasal decongestant and consider the
use of short-course oral corticosteroids during this withdrawal
period
,Page 2 of 54
A 28-year-old male patient with a history of asthma presents
complaining of eye discharge, morning matting, and redness. He
denies eye itching, burning, or recent upper respiratory
symptoms. On examination, there is a bilateral diffuse
conjunctival injection, purulent discharge, and conjunctival
papillae. What is the most likely etiological agent for this
patient's presentation?
1. Neisseria gonorrhea
2. Staphylococcal aureus
3. Herpes simplex virus
4. House dust mite - ANSWER-2. Staphylococcal aureus
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?
,Page 3 of 54
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 - ANSWER-1. Referral to the
emergency department for imaging and aspiration
A 38-year-old male patient complains of chronic nasal allergies.
He has used over-the-counter antihistamines without much
success. He believes he is allergic to ragweed but has had no
testing. His past medical history is remarkable for hypertension
that is controlled on hydrochlorothiazide. He does not drink,
smoke, or use illicit drugs. He works in a relatively new office,
but he lives in a 60-year-old house with his family. They have
carpets, drapes, and a cat. Exam shows pale and boggy nasal
mucosa and cobblestoning of the posterior pharynx. Lungs are
clear on auscultation. Skin prick testing shows allergies to cat
dander, dust mites, ragweed, and tree pollen. Which of the
following would be an appropriate step to take?
1. Intranasal corticosteroids
2. Send carpet fiber for analysis
3. Immunotherapy for cat dander
4. Wash and keep carpets and drapes - ANSWER-1. Intranasal
corticosteroids
, Page 4 of 54
A 25-year-old female, who is a smoker, presents to the
outpatient department with recurrent episodes of pain over both
sides of the face over the past three months. The pain occurs as a
sudden shooting pain which is severe in intensity and affects one
side of the face at a time. She describes it as electric shocks that
last for about 10 seconds and resolves by itself. She experiences
this symptom several times during the day and is sometimes
triggered by touching some particular spots on the face. She also
complains of intermittent numbness in the bilateral upper
extremities. Neurological examination shows sensory loss to
gross touch in the dorsal aspect of the right upper extremity.
What is the next step in the management of this patient?
1. Start carbamazepine therapy
2. Obtain magnetic resonance imaging (MRI) of the brain and
spine
3. Obtain X-ray of the right hand
4. Start as needed ibuprofen therapy - ANSWER-2. Obtain
magnetic resonance imaging (MRI) of the brain and spine
A 65-year-old man presents with postauricular pain, facial
weakness, and excessive tearing that started 24 hours ago. He
denies a history of these symptoms before this episode. Past
medical history is significant for cold sores and asthma. He is
