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MSN 622 FINAL EXAM NEWEST
2024-2025 ACTUAL EXAM
COMPLETE 116 QUESTIONS AND
CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) Questions with
Detailed Verified Answers
Question: A 67-year-old man with a history of hypertension and tobacco use
presents with a two-day history of hypogastric pain. An examination reveals a
5 cm, non-tender, pulsatile abdominal mass above the umbilicus. Which of the
following type of sounds might be heard upon auscultation at the midline, two
inches cephalad to the umbilicus?
Ans: blowing
Question: What is the recommended management for a patient with a 3.5 cm
abdominal aortic aneurysm?
Ans: ultrasound every 3 years
Question: A 75-year-old man presents to the emergency department with
complaints of severe abdominal pain and sweating. The pain started about an
hour ago and is becoming worse with time. He has been diagnosed with
hypertension and diabetes and is on amlodipine and metformin, respectively.
On presentation, the vital signs show blood pressure 70/40 mmHg, pulse
, Page | 2
140/min, respiratory rate 32/min, temperature 38.5 C (101.3 F), and oxygen
saturation 87% at room air. On physical examination of the abdomen,
generalized tenderness and guarding are seen. There is a midline pulsatile
mass. What is the next best step in the management of this patient?
Ans: immediate surgery
Question: A 67-year-old male with a history of hypertension and nicotine
dependence presents to the emergency department with sudden onset of
abdominal pain radiating to the back. There is no history of alcohol use. On
examination, he is thin, pale, and diaphoretic. His vital signs show a blood
pressure of 110/70 mmHg and a heart rate of 95 bpm. Which of the following is
most likely to confirm the diagnosis?
Ans: abdominal CT
Question: A 78-year-old is found to have an asymptomatic pulsatile
abdominal mass. The ultrasound shows an abdominal aortic aneurysm
measuring 5.5 cm. Which of the following statements concerning this patient's
condition is correct?
Ans: Surgery will improve 5-year survival
Question: A 65-year-old man presents to the office with complaints of
occasional chest pain. The patient has a past medical history significant for
hypertension, diabetes mellitus, and hyperlipidemia. The patient states he
experiences chest pain on exertion, which is only relieved on rest. An
, Page | 3
electrocardiogram is normal. Which of the following is the next step in
management?
Ans: stress electrocardiogram
Question: A 65-year-old man presents with complaints of chest pain that
started 30 mins ago but stopped on his way to the hospital. The patient has a
past medical history significant for hypertension and diabetes mellitus. An
electrocardiogram (ECG) is normal. A stress ECG shows mild ST elevations
after 12 minutes of exercise. A diagnosis of stable angina is made. Which of
the following should be the first step in counseling the patient about his
condition?
Ans: Determining the precipitating factors for his condition
Question: A 47-year-old male presents to the office for routine health
maintenance. His blood pressure is 182/138, with all other vital signs within
normal limits. The patient is currently complaining of a headache and blurred
vision but denies chest pain, shortness of breath, and abdominal pain. Under
which of the following forms of hypertension would this patient be classified
Ans: hypertensive emergency
Question: A 65-year-old male with a history of type 2 diabetes comes into the
provider's office complaining of blurry vision, nosebleeds, and exertional chest
pain for the past six months. The blood pressure is measured to be 160/94
mmHg. A CT angiogram is performed, which reveals partially occlusive
, Page | 4
coronary artery plaques. Which of the following medication regimens would
be most appropriate for this patient?
Ans: Losartan/hydrochlorothiazide and atorvastatin
Question: A 68-year-old male with a past medical history of type 2 diabetes
mellitus and diabetic nephropathy presented to the clinic for a follow-up
appointment. His blood pressure on the last visit was 150/90 mmHg. He was
called in for a follow-up appointment in 4 weeks to monitor his blood pressure.
The blood pressure on this visit is 168/105 mmHg, and HbA1c is 8.9%. His
antihypertensive regimen was adjusted, and an ACE inhibitor was added. He is
on metformin and sitagliptin for diabetes mellitus. One week later, his blood
pressure was 130/80 mmHg, the patient's potassium was 5.1 mEq/L, sodium
was 133 mEq/L, and the rest of the renal panel was within normal limits. He
reports no symptoms. What is the next best step in his care?
Ans: Reassure him that this is expected from his ACE inhibitor and continue
therapy with periodic monitoring.
Question: A 50-year-old man presents to the clinic for routine evaluation. His
systolic blood pressure has persistently been in the 150-160 mmHg range.
Treatment with ramipril is initiated. On the next visit, he complained of an
itchy throat and a dry cough, which is not distressing for him, but he is
concerned that there might be something serious as he used to smoke but
quit 5 years ago. A chest x-ray is within normal limits. What is the next best
step in the management of this patient?
MSN 622 FINAL EXAM NEWEST
2024-2025 ACTUAL EXAM
COMPLETE 116 QUESTIONS AND
CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) Questions with
Detailed Verified Answers
Question: A 67-year-old man with a history of hypertension and tobacco use
presents with a two-day history of hypogastric pain. An examination reveals a
5 cm, non-tender, pulsatile abdominal mass above the umbilicus. Which of the
following type of sounds might be heard upon auscultation at the midline, two
inches cephalad to the umbilicus?
Ans: blowing
Question: What is the recommended management for a patient with a 3.5 cm
abdominal aortic aneurysm?
Ans: ultrasound every 3 years
Question: A 75-year-old man presents to the emergency department with
complaints of severe abdominal pain and sweating. The pain started about an
hour ago and is becoming worse with time. He has been diagnosed with
hypertension and diabetes and is on amlodipine and metformin, respectively.
On presentation, the vital signs show blood pressure 70/40 mmHg, pulse
, Page | 2
140/min, respiratory rate 32/min, temperature 38.5 C (101.3 F), and oxygen
saturation 87% at room air. On physical examination of the abdomen,
generalized tenderness and guarding are seen. There is a midline pulsatile
mass. What is the next best step in the management of this patient?
Ans: immediate surgery
Question: A 67-year-old male with a history of hypertension and nicotine
dependence presents to the emergency department with sudden onset of
abdominal pain radiating to the back. There is no history of alcohol use. On
examination, he is thin, pale, and diaphoretic. His vital signs show a blood
pressure of 110/70 mmHg and a heart rate of 95 bpm. Which of the following is
most likely to confirm the diagnosis?
Ans: abdominal CT
Question: A 78-year-old is found to have an asymptomatic pulsatile
abdominal mass. The ultrasound shows an abdominal aortic aneurysm
measuring 5.5 cm. Which of the following statements concerning this patient's
condition is correct?
Ans: Surgery will improve 5-year survival
Question: A 65-year-old man presents to the office with complaints of
occasional chest pain. The patient has a past medical history significant for
hypertension, diabetes mellitus, and hyperlipidemia. The patient states he
experiences chest pain on exertion, which is only relieved on rest. An
, Page | 3
electrocardiogram is normal. Which of the following is the next step in
management?
Ans: stress electrocardiogram
Question: A 65-year-old man presents with complaints of chest pain that
started 30 mins ago but stopped on his way to the hospital. The patient has a
past medical history significant for hypertension and diabetes mellitus. An
electrocardiogram (ECG) is normal. A stress ECG shows mild ST elevations
after 12 minutes of exercise. A diagnosis of stable angina is made. Which of
the following should be the first step in counseling the patient about his
condition?
Ans: Determining the precipitating factors for his condition
Question: A 47-year-old male presents to the office for routine health
maintenance. His blood pressure is 182/138, with all other vital signs within
normal limits. The patient is currently complaining of a headache and blurred
vision but denies chest pain, shortness of breath, and abdominal pain. Under
which of the following forms of hypertension would this patient be classified
Ans: hypertensive emergency
Question: A 65-year-old male with a history of type 2 diabetes comes into the
provider's office complaining of blurry vision, nosebleeds, and exertional chest
pain for the past six months. The blood pressure is measured to be 160/94
mmHg. A CT angiogram is performed, which reveals partially occlusive
, Page | 4
coronary artery plaques. Which of the following medication regimens would
be most appropriate for this patient?
Ans: Losartan/hydrochlorothiazide and atorvastatin
Question: A 68-year-old male with a past medical history of type 2 diabetes
mellitus and diabetic nephropathy presented to the clinic for a follow-up
appointment. His blood pressure on the last visit was 150/90 mmHg. He was
called in for a follow-up appointment in 4 weeks to monitor his blood pressure.
The blood pressure on this visit is 168/105 mmHg, and HbA1c is 8.9%. His
antihypertensive regimen was adjusted, and an ACE inhibitor was added. He is
on metformin and sitagliptin for diabetes mellitus. One week later, his blood
pressure was 130/80 mmHg, the patient's potassium was 5.1 mEq/L, sodium
was 133 mEq/L, and the rest of the renal panel was within normal limits. He
reports no symptoms. What is the next best step in his care?
Ans: Reassure him that this is expected from his ACE inhibitor and continue
therapy with periodic monitoring.
Question: A 50-year-old man presents to the clinic for routine evaluation. His
systolic blood pressure has persistently been in the 150-160 mmHg range.
Treatment with ramipril is initiated. On the next visit, he complained of an
itchy throat and a dry cough, which is not distressing for him, but he is
concerned that there might be something serious as he used to smoke but
quit 5 years ago. A chest x-ray is within normal limits. What is the next best
step in the management of this patient?
