MSN 621 UPDATED CORE EXAMS TEST QUESTIONS AND
SOLUTIONS RATED A+
✔✔A healthy patient was given a purified protein derivative on the inside of the forearm
48 hours ago. A 15-mm induration has developed. What is the diagnosis?
Well done!You answered successfully
A. Active tuberculosis
B. Immunity to tuberculosis
C. Advanced tuberculosis
D. Exposure to tuberculosis - ✔✔D. Exposure to tuberculosis
✔✔A 38-year-old man presents with numbness and tingling in his extremities for the
past week. He says his hands have been feeling unusual, and that this interferes with
his sleep. He has no muscle weakness or memory impairment. His past medical history
includes pulmonary tuberculosis, for which he takes isoniazid, rifampin, pyrazinamide,
and ethambutol. All his vital signs are within normal limits. Examination reveals
diminished breath sounds in the left upper lobe. A chest x-ray shows a cavitating lesion
in the left lung. What is the most appropriate next step in the management of this
patient?
A. Add pyridoxine
B. Stop isoniazid
C. Stop rifampin
D. Add streptomycin - ✔✔A. Add pyridoxine
✔✔A 33-year-old inmate is brought to the clinic for a routine annual checkup. The
patient says that he has been in good health and does not have any medical problems.
He, however, does complain of disturbed sleep, constipation, and weight loss. A review
of systems is negative for cough, shortness of breath, burning urination, abdominal
discomfort, or weakness. Examination shows normal vitals, a soft, nontender abdomen
with no organomegaly, normal S1 and S2 with no added sounds, and normal bronchial
breathing bilaterally. A purified protein derivative test shows an induration of 11 mm.
What is the next best step in the management of this patient?
Well done!You answered successfully
A. Isoniazid for 6 to 9 months
B. Isoniazid and rifampin for 4 months
C. Chest x-ray
D. Reassurance and follow-up in 6 months - ✔✔C. Chest x-ray
✔✔A 34-year-old Asian woman reported a history of losing weight and cough over a
period of 5 months. On examination, she was anemic and on auscultation left apical
crackles were noted. Her chest x-ray revealed left apical shadowing with cavitation.
What is the next stage in her management?
Well done!You answered successfully
A. A chest CT scan and infectious disease serological panel
,B. Tuberculin skin test and sputum culture
C. Bronchoscopy and histology of bronchial secretions
D. HIV ELISA test - ✔✔B. Tuberculin skin test and sputum culture
✔✔A 3-year-old boy is brought in by parents for a 5 cm round pruritic rash that has
been rapidly progressing for the past 3 hours. It is the middle of summer, and he has
been playing outside. What is the best initial therapy for this patient?
Well done!You answered successfully
A. Calamine lotion
B. Sulfamethoxazole/ trimethoprim
C. Cetirizine
D. Cephalexin - ✔✔C. Cetirizine
✔✔A patient presents to the clinic who is recovering from malaria. On physical and
examination, there is no significant finding. The patient is planning on going on a
vacation and is worried about the recurrence of the disease. He is interested in effective
ways of preventing mosquito bites while on vacation. Which of the following is true
regarding techniques to prevent mosquito bites?
Well done!You answered successfully
A. Showering with permethrin is a recommended repellant technique.
B. Picaridin has been found to be superior to diethyltoluamide (DEET) in all studies.
C. Citronella's repellant has been found to protect for just as long as high doses of
DEET.
D. DEET is the most well studied and most commonly recommended repellant. - ✔✔D.
DEET is the most well studied and most commonly recommended repellant.
✔✔A 13-year-old female presents because she has not had a menstrual cycle for the
past three months. She reached menarche 14 months ago and previously menstruated
every 30 to 40 days with 5 to 7 days of bleeding. She has never been sexually active.
She enjoys running and swimming in her spare time. Height and weight are within
normal limits for her age. Her mother recently had a total abdominal hysterectomy
because of excessive bleeding. The urine pregnancy test is negative. Which of the
following is the most appropriate next step in managing this patient?
Well done!You answered successfully
A. Draw blood
B. Reassurance and follow-up
C. Ultrasound
D. Genetic testing - ✔✔B. Reassurance and follow-up
✔✔A 30-year-old female presents to her provider complaining of a swelling on the left
side of her vulva. She reports that this is the third time she develops a recurrence of this
problem. She asks what is her diagnosis and she wonders what should be the best
treatment to be done for her to prevent this swelling from recurring again and again?
Well done!You answered successfully
A. Skene's gland cyst, laser
, B. Bartholin's gland abscess, cryotherapy
C. Bartholin's gland abscess, marsupialization
D. Skene's gland cyst, incision, and drainage - ✔✔C. Bartholin's gland abscess,
marsupialization
✔✔A 48-year-old woman presents with a swelling on the left side of her vulva. The
patient says she noticed this swelling one week ago. She denies any pain, or history of
weight loss. She reports having regular menstrual cycles and being sexually active with
her husband. She has no past medical history and takes no medications. On
examination, there is no erythema, or purulent discharge. Which of the following is the
most appropriate treatment option?
A. Marsupialization
B. Incision and drainage
C. Antibiotic prescription
D. Observation, no further treatment is required - ✔✔D. Observation, no further
treatment is required
✔✔A 45-year-old woman presents complaining of a swelling on her left labia that she
discovered it accidentally while bathing. She reports having a regular menstrual cycle
that lasts for about 5 days every month. She is sexually active with her husband for the
last twenty years. She is concerned as her mother died from metastatic breast cancer,
two years ago. What is the most common vulvar mass in a young woman?
Well done!You answered successfully
A. Lipoma
B. Dermatofibroma
C. Bartholin gland cyst
D. Sebaceous cyst - ✔✔C. Bartholin gland cyst
✔✔A 39-year-old woman attends a clinic seeking contraception. She is a smoker and
smokes 20 cigarettes a day while her body mass index is 26. She has no personal or
family history of venous thromboembolism. However, she had a left-sided
salpingectomy for an ectopic pregnancy seven years ago. Which of the following
methods of contraception would be contraindicated in this patient?
Well done!You answered successfully
A. Copper intrauterine device
B. Levonogesterol intrauterine system
C. Combined oral contraceptive
D. Progesterone only pill - ✔✔C. Combined oral contraceptive
✔✔A 26-year-old female presents to the office for a health maintenance visit. The
patient has no active complaints but states that she experienced dysuria a couple of
weeks ago, which resolved by drinking plenty of water. The patient is sexually active
with two partners and wants to know about female contraceptive methods. She says
she does not want to take oral contraceptive pills and wants to try a female barrier
SOLUTIONS RATED A+
✔✔A healthy patient was given a purified protein derivative on the inside of the forearm
48 hours ago. A 15-mm induration has developed. What is the diagnosis?
Well done!You answered successfully
A. Active tuberculosis
B. Immunity to tuberculosis
C. Advanced tuberculosis
D. Exposure to tuberculosis - ✔✔D. Exposure to tuberculosis
✔✔A 38-year-old man presents with numbness and tingling in his extremities for the
past week. He says his hands have been feeling unusual, and that this interferes with
his sleep. He has no muscle weakness or memory impairment. His past medical history
includes pulmonary tuberculosis, for which he takes isoniazid, rifampin, pyrazinamide,
and ethambutol. All his vital signs are within normal limits. Examination reveals
diminished breath sounds in the left upper lobe. A chest x-ray shows a cavitating lesion
in the left lung. What is the most appropriate next step in the management of this
patient?
A. Add pyridoxine
B. Stop isoniazid
C. Stop rifampin
D. Add streptomycin - ✔✔A. Add pyridoxine
✔✔A 33-year-old inmate is brought to the clinic for a routine annual checkup. The
patient says that he has been in good health and does not have any medical problems.
He, however, does complain of disturbed sleep, constipation, and weight loss. A review
of systems is negative for cough, shortness of breath, burning urination, abdominal
discomfort, or weakness. Examination shows normal vitals, a soft, nontender abdomen
with no organomegaly, normal S1 and S2 with no added sounds, and normal bronchial
breathing bilaterally. A purified protein derivative test shows an induration of 11 mm.
What is the next best step in the management of this patient?
Well done!You answered successfully
A. Isoniazid for 6 to 9 months
B. Isoniazid and rifampin for 4 months
C. Chest x-ray
D. Reassurance and follow-up in 6 months - ✔✔C. Chest x-ray
✔✔A 34-year-old Asian woman reported a history of losing weight and cough over a
period of 5 months. On examination, she was anemic and on auscultation left apical
crackles were noted. Her chest x-ray revealed left apical shadowing with cavitation.
What is the next stage in her management?
Well done!You answered successfully
A. A chest CT scan and infectious disease serological panel
,B. Tuberculin skin test and sputum culture
C. Bronchoscopy and histology of bronchial secretions
D. HIV ELISA test - ✔✔B. Tuberculin skin test and sputum culture
✔✔A 3-year-old boy is brought in by parents for a 5 cm round pruritic rash that has
been rapidly progressing for the past 3 hours. It is the middle of summer, and he has
been playing outside. What is the best initial therapy for this patient?
Well done!You answered successfully
A. Calamine lotion
B. Sulfamethoxazole/ trimethoprim
C. Cetirizine
D. Cephalexin - ✔✔C. Cetirizine
✔✔A patient presents to the clinic who is recovering from malaria. On physical and
examination, there is no significant finding. The patient is planning on going on a
vacation and is worried about the recurrence of the disease. He is interested in effective
ways of preventing mosquito bites while on vacation. Which of the following is true
regarding techniques to prevent mosquito bites?
Well done!You answered successfully
A. Showering with permethrin is a recommended repellant technique.
B. Picaridin has been found to be superior to diethyltoluamide (DEET) in all studies.
C. Citronella's repellant has been found to protect for just as long as high doses of
DEET.
D. DEET is the most well studied and most commonly recommended repellant. - ✔✔D.
DEET is the most well studied and most commonly recommended repellant.
✔✔A 13-year-old female presents because she has not had a menstrual cycle for the
past three months. She reached menarche 14 months ago and previously menstruated
every 30 to 40 days with 5 to 7 days of bleeding. She has never been sexually active.
She enjoys running and swimming in her spare time. Height and weight are within
normal limits for her age. Her mother recently had a total abdominal hysterectomy
because of excessive bleeding. The urine pregnancy test is negative. Which of the
following is the most appropriate next step in managing this patient?
Well done!You answered successfully
A. Draw blood
B. Reassurance and follow-up
C. Ultrasound
D. Genetic testing - ✔✔B. Reassurance and follow-up
✔✔A 30-year-old female presents to her provider complaining of a swelling on the left
side of her vulva. She reports that this is the third time she develops a recurrence of this
problem. She asks what is her diagnosis and she wonders what should be the best
treatment to be done for her to prevent this swelling from recurring again and again?
Well done!You answered successfully
A. Skene's gland cyst, laser
, B. Bartholin's gland abscess, cryotherapy
C. Bartholin's gland abscess, marsupialization
D. Skene's gland cyst, incision, and drainage - ✔✔C. Bartholin's gland abscess,
marsupialization
✔✔A 48-year-old woman presents with a swelling on the left side of her vulva. The
patient says she noticed this swelling one week ago. She denies any pain, or history of
weight loss. She reports having regular menstrual cycles and being sexually active with
her husband. She has no past medical history and takes no medications. On
examination, there is no erythema, or purulent discharge. Which of the following is the
most appropriate treatment option?
A. Marsupialization
B. Incision and drainage
C. Antibiotic prescription
D. Observation, no further treatment is required - ✔✔D. Observation, no further
treatment is required
✔✔A 45-year-old woman presents complaining of a swelling on her left labia that she
discovered it accidentally while bathing. She reports having a regular menstrual cycle
that lasts for about 5 days every month. She is sexually active with her husband for the
last twenty years. She is concerned as her mother died from metastatic breast cancer,
two years ago. What is the most common vulvar mass in a young woman?
Well done!You answered successfully
A. Lipoma
B. Dermatofibroma
C. Bartholin gland cyst
D. Sebaceous cyst - ✔✔C. Bartholin gland cyst
✔✔A 39-year-old woman attends a clinic seeking contraception. She is a smoker and
smokes 20 cigarettes a day while her body mass index is 26. She has no personal or
family history of venous thromboembolism. However, she had a left-sided
salpingectomy for an ectopic pregnancy seven years ago. Which of the following
methods of contraception would be contraindicated in this patient?
Well done!You answered successfully
A. Copper intrauterine device
B. Levonogesterol intrauterine system
C. Combined oral contraceptive
D. Progesterone only pill - ✔✔C. Combined oral contraceptive
✔✔A 26-year-old female presents to the office for a health maintenance visit. The
patient has no active complaints but states that she experienced dysuria a couple of
weeks ago, which resolved by drinking plenty of water. The patient is sexually active
with two partners and wants to know about female contraceptive methods. She says
she does not want to take oral contraceptive pills and wants to try a female barrier
