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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?
- Continue the nasal decongestant and introduce additional
- Discontinue the nasal decongestant straight away
- Gradually discontinue the nasal decongestant and consider the
- Consent the patient for nasal surgery - ANSWER-3.
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intranasal corticosteroids
use of short-course oral corticosteroids during this withdrawal period
Gradually discontinue the nasal decongestant and consider the use of short-course oral corticosteroids during this withdrawal period
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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?
- Neisseria gonorrhea
- Staphylococcal aureus
- Herpes simplex virus
- 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? 2 / 4
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- Referral to the emergency department for imaging and
- In-office aspiration of likely peritonsillar abscess
- Topical benzocaine spray and amoxicillin-clavulanic acid
aspiration
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?
- Intranasal corticosteroids
- Send carpet fiber for analysis
- Immunotherapy for cat dander
- Wash and keep carpets and drapes - ANSWER-1. Intranasal
corticosteroids 3 / 4
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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?
- Start carbamazepine therapy
- Obtain magnetic resonance imaging (MRI) of the brain and
- Obtain X-ray of the right hand
- Start as needed ibuprofen therapy - ANSWER-2. Obtain
spine
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
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