FNP MSN 560 Complete Test Bank
|ANSWERS AND RATIONALES FNP
MSN 560 | latest update 2025
A 17-year-old boy presents with a sore throat that started yesterday afternoon. He
denies any congestion or cough but reports a temperature of 102° F (38.8° C) and
generalized fatigue. He has pain with swallowing but can speak normally and manage
his saliva. On physical examination, the clinician sees yellow-white plaques on his
tonsils and anterior cervical lymphadenopathy that is tender to palpation. What is the
most appropriate next step in care? - ANSWERS--Point-of-care streptococcal antigen
testing
A 17-year-old boy presents to the hospital with a severe sore throat and fatigue that has
been ongoing for 3 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 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 10 days. The patient
returns two 2 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? - ANSWERS--Send a throat swab for culture and order a
complete blood count and heterophile antibodies.
,An 8-year-old girl presents with a 4-day history of fever and sore throat. A review of
systems is negative for cough. Her past medical and family history is insignificant. She
is allergic to penicillin. Vital signs are temperature 101 °F (38.3 °C), heart rate 88 bpm,
and blood pressure 110/70 mm Hg. On physical examination, some exudates are seen
on the posterior pharyngeal wall, and tender anterior cervical nodes are palpated.
Findings on heart and lung examination are normal. Which of the following is the
recommended treatment? - ANSWERS--Clindamycin
A 17-year-old boy presents with a sore throat. Associated symptoms include fever and
chills, difficulty in swallowing, referred ear pain, headache, and muscle aches. The vital
signs are temperature 39 °C (102.2 °F), heart rate 105 bpm, and respiratory rate 22
breaths/min. The physical examination reveals a dry tongue, erythematous enlarged
tonsils, pharyngeal exudate, and tender cervical lymphadenopathy. Which of the
following is the diagnostic test of choice? - ANSWERS--Rapid antigen detection test
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? -
ANSWERS--Gradually discontinue the nasal decongestant and consider the use of
short-course oral corticosteroids during this withdrawal period
A 17-year-old girl presents with a thick discharge from her eyes that started 5 days ago.
Associated symptoms include redness and a feeling of dirt in her eyes. Her eyes are
usually matted in the morning. Her medical history is significant for multiple similar
episodes. She has been using contact lenses for the past 2 years. Her vital signs are
blood pressure 120/80 mm Hg, heart rate 88 bpm, respiratory rate 14 breaths/min, and
temperature 37 °C (98.6 °F). An ocular examination reveals hyperemia and elevated
yellow-white lesions at the lower cul-de-sac. What is the most appropriate next step in
management? - ANSWERS--Topical ciprofloxacin
A 46-year-old man presents with symptoms consistent with allergic rhinitis. He has a
history of depression and is treated with a selective serotonin reuptake inhibitor. He
works as a school bus driver. Which of the following should be used to treat his
symptoms? - ANSWERS--Fexofenadine
A 5-year-old boy is brought for evaluation of a sore throat for the past 5 days. His
parents report no cough during this period. His medical and family history is
insignificant. Vitals show blood pressure 120/80 mm Hg, temperature of 100.4 °F (38
°C), and heart rate 78 bpm. On physical examination, anterior cervical nodes are
palpable and tender. Exudates are seen on the posterior pharyngeal wall. A rapid
, antigen test was performed, which came back negative. Which of the following is the
next best step in management? - ANSWERS--Perform a throat culture
A 16-year-old boy presents with a 2-day history of sore throat, fever, and cough. He has
been experiencing difficulty swallowing food for the last 2 days. He has no significant
medical history and is up to date with his immunizations. His vital signs are temperature
100.6 °F (38.1 °C), heart rate 100 bpm, and blood pressure 110/80 mm Hg. His physical
examination reveals bilateral tonsillar exudates and diffuse pharyngeal erythema. What
is the next best step in management? - ANSWERS--Order a rapid strep test.
A 27-year-old man presents with fever, sore throat, and a generalized maculopapular
erythematous rash. He reports having sexual relations with other men. His rapid antigen
test for Group A beta-hemolytic streptococcus is negative. What is the next best step in
the management of this patient? - ANSWERS--Obtain testing for human
immunodeficiency virus (HIV), syphilis, chlamydia, and gonorrhea
A 6-year-old girl is brought in with a 5-day history of sore throat and fever. Other
children at school have had similar symptoms. She has not had any cough during this
time. Her medical and family history is insignificant. Her vitals are currently within
normal limits. On physical examination, her anterior cervical nodes are palpable and
tender. There are no exudates seen on the posterior pharyngeal wall. What is the next
best step in the management of this patient? - ANSWERS--Rapid antigen testing
A 2-year-old boy presents with a fever of 102 °F (38.9 °C). His physical examination
reveals bilateral otitis media with effusion with noted erythema on the right side. His
parents state that this is his sixth diagnosis of otitis media in the past 12 months. His
parents also note that he only has 2 words that are intelligible to them. Following the
treatment of this patient for his acute otitis media, which of the following is an
appropriate management strategy? - ANSWERS--Tympanostomy tube placement
Despite trying to manage a child diagnosed with otitis media with effusion
conservatively, it is decided an intervention is necessary. Following consultation with an
otolaryngologist, it is decided to proceed with the placement of bilateral ventilation
tubes. Informed consent is obtained from the parents. Which of the following is the most
likely complication of tympanostomy tube placement? - ANSWERS--The development
of otorrhea
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? - ANSWERS--Staphylococcal aureus
A 6-day-old girl presents with significant redness and copious discharge from her eyes.
She was born via spontaneous vaginal delivery to a gravida three, para two mother.
Thick, purulent discharge is noted from both eyes on examination. Which of the
|ANSWERS AND RATIONALES FNP
MSN 560 | latest update 2025
A 17-year-old boy presents with a sore throat that started yesterday afternoon. He
denies any congestion or cough but reports a temperature of 102° F (38.8° C) and
generalized fatigue. He has pain with swallowing but can speak normally and manage
his saliva. On physical examination, the clinician sees yellow-white plaques on his
tonsils and anterior cervical lymphadenopathy that is tender to palpation. What is the
most appropriate next step in care? - ANSWERS--Point-of-care streptococcal antigen
testing
A 17-year-old boy presents to the hospital with a severe sore throat and fatigue that has
been ongoing for 3 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 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 10 days. The patient
returns two 2 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? - ANSWERS--Send a throat swab for culture and order a
complete blood count and heterophile antibodies.
,An 8-year-old girl presents with a 4-day history of fever and sore throat. A review of
systems is negative for cough. Her past medical and family history is insignificant. She
is allergic to penicillin. Vital signs are temperature 101 °F (38.3 °C), heart rate 88 bpm,
and blood pressure 110/70 mm Hg. On physical examination, some exudates are seen
on the posterior pharyngeal wall, and tender anterior cervical nodes are palpated.
Findings on heart and lung examination are normal. Which of the following is the
recommended treatment? - ANSWERS--Clindamycin
A 17-year-old boy presents with a sore throat. Associated symptoms include fever and
chills, difficulty in swallowing, referred ear pain, headache, and muscle aches. The vital
signs are temperature 39 °C (102.2 °F), heart rate 105 bpm, and respiratory rate 22
breaths/min. The physical examination reveals a dry tongue, erythematous enlarged
tonsils, pharyngeal exudate, and tender cervical lymphadenopathy. Which of the
following is the diagnostic test of choice? - ANSWERS--Rapid antigen detection test
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? -
ANSWERS--Gradually discontinue the nasal decongestant and consider the use of
short-course oral corticosteroids during this withdrawal period
A 17-year-old girl presents with a thick discharge from her eyes that started 5 days ago.
Associated symptoms include redness and a feeling of dirt in her eyes. Her eyes are
usually matted in the morning. Her medical history is significant for multiple similar
episodes. She has been using contact lenses for the past 2 years. Her vital signs are
blood pressure 120/80 mm Hg, heart rate 88 bpm, respiratory rate 14 breaths/min, and
temperature 37 °C (98.6 °F). An ocular examination reveals hyperemia and elevated
yellow-white lesions at the lower cul-de-sac. What is the most appropriate next step in
management? - ANSWERS--Topical ciprofloxacin
A 46-year-old man presents with symptoms consistent with allergic rhinitis. He has a
history of depression and is treated with a selective serotonin reuptake inhibitor. He
works as a school bus driver. Which of the following should be used to treat his
symptoms? - ANSWERS--Fexofenadine
A 5-year-old boy is brought for evaluation of a sore throat for the past 5 days. His
parents report no cough during this period. His medical and family history is
insignificant. Vitals show blood pressure 120/80 mm Hg, temperature of 100.4 °F (38
°C), and heart rate 78 bpm. On physical examination, anterior cervical nodes are
palpable and tender. Exudates are seen on the posterior pharyngeal wall. A rapid
, antigen test was performed, which came back negative. Which of the following is the
next best step in management? - ANSWERS--Perform a throat culture
A 16-year-old boy presents with a 2-day history of sore throat, fever, and cough. He has
been experiencing difficulty swallowing food for the last 2 days. He has no significant
medical history and is up to date with his immunizations. His vital signs are temperature
100.6 °F (38.1 °C), heart rate 100 bpm, and blood pressure 110/80 mm Hg. His physical
examination reveals bilateral tonsillar exudates and diffuse pharyngeal erythema. What
is the next best step in management? - ANSWERS--Order a rapid strep test.
A 27-year-old man presents with fever, sore throat, and a generalized maculopapular
erythematous rash. He reports having sexual relations with other men. His rapid antigen
test for Group A beta-hemolytic streptococcus is negative. What is the next best step in
the management of this patient? - ANSWERS--Obtain testing for human
immunodeficiency virus (HIV), syphilis, chlamydia, and gonorrhea
A 6-year-old girl is brought in with a 5-day history of sore throat and fever. Other
children at school have had similar symptoms. She has not had any cough during this
time. Her medical and family history is insignificant. Her vitals are currently within
normal limits. On physical examination, her anterior cervical nodes are palpable and
tender. There are no exudates seen on the posterior pharyngeal wall. What is the next
best step in the management of this patient? - ANSWERS--Rapid antigen testing
A 2-year-old boy presents with a fever of 102 °F (38.9 °C). His physical examination
reveals bilateral otitis media with effusion with noted erythema on the right side. His
parents state that this is his sixth diagnosis of otitis media in the past 12 months. His
parents also note that he only has 2 words that are intelligible to them. Following the
treatment of this patient for his acute otitis media, which of the following is an
appropriate management strategy? - ANSWERS--Tympanostomy tube placement
Despite trying to manage a child diagnosed with otitis media with effusion
conservatively, it is decided an intervention is necessary. Following consultation with an
otolaryngologist, it is decided to proceed with the placement of bilateral ventilation
tubes. Informed consent is obtained from the parents. Which of the following is the most
likely complication of tympanostomy tube placement? - ANSWERS--The development
of otorrhea
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? - ANSWERS--Staphylococcal aureus
A 6-day-old girl presents with significant redness and copious discharge from her eyes.
She was born via spontaneous vaginal delivery to a gravida three, para two mother.
Thick, purulent discharge is noted from both eyes on examination. Which of the
