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MSN 621 final exam 2025, advanced health assessment questions, MSN clinical decision making exam, nursing study guide PDF, graded A+ MSN 621, nurse practitioner final exam
A patient is diagnosed with Lyme disease and started on doxycycline 100 mg PO BID for 4 weeks. After the first dose, the patient is worse with dizziness, shaking, and fever. What is the cause of the change in the patient's condition?Well done!You answered successfully
- Reaction to the antibiotic
- Resistance to the doxycycline
- Jarisch-Herxheimer reaction
- Sepsis secondary to B. burgdorferi
Submit - ANSWER-C. Jarisch-Herxheimer reaction
A 34-year-old forest ranger, previously healthy, presents with dizziness, syncope, and increasing fatigue for 2 weeks. Vital signs are the temperature of 98°F (36.7°C), blood pressure of 110/80 mm Hg, and a heart rate of 38 beats per minute with a regular pulse. No murmur is noted. The neurological exam 1 / 4
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reveals a Bell palsy. An electrocardiogram (EKG) shows a complete heart block. Which joint is most likely painful?Well done!You answered successfully
- Hip
- Knee
- Elbow
- Spine - ANSWER-B. Knee
A patient presents because she believes she is bitten by a tick a few days ago while hiking in the woods. She mentions swelling in her right ear and general malaise. On exam, she has a 1 x 2 cm bluish-red nodule located on the right ear lobe. What is the next best step in management for this patient?Well done!You answered successfully
- Ehrlichiosis serology
- Arthrocentesis
- Start corticosteroids therapy
- Lyme serology - ANSWER-D. Lyme serology
A female presents with progressive confusion over weeks with memory loss. She has a slight fever at 100.4 F. Prior to cognitive changes, she had been complaining of arthralgias. History is 2 / 4
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otherwise unremarkable except for the fact she is an avid camper. Which of the following is the initial diagnostic test that should be ordered?Well done!You answered successfully
- Serology
- Culture of synovial fluid
C. PCR
- CBC - ANSWER-A. Serology
A 7-year-old boy presents with a pronounced limp secondary to pain in his leg. The pain is around his left knee, and on physical examination, the left knee is swollen. Two weeks earlier, he had a painful right ankle with limping. His mother reports he has had an elevated temperature, but she has not measured it. He lives in a rural area that has a stream running through the back of the property. Prior to aggressive-invasive therapy, what infective process should be considered that may not need surgical intervention as the primary mode of treatment?Well done!You answered successfully
- Tuberculosis
- Salmonella infection
- Lyme disease
- Polio - ANSWER-C. Lyme disease 3 / 4
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A 17-year-old presents with tonsil hypertrophy, new-onset snoring, bilateral cervical lymphadenopathy, low-grade fever, and general malaise. Two days ago, the patient developed severe abdominal pain and anorexia, unaffected by eating or drinking.He has had a recent bowel movement. Which of the following is the gold standard test in diagnosing his condition?Well done!You answered successfully
- Abdominal CT
- Heterophil antibody test
- Hepatobiliary iminodiacetic acid scan
- Blood cultures and complete blood count - ANSWER-B.
Heterophil antibody test
A 17-year-old female presents with a severe sore throat. She has been sick with a fever for four days. The patient's voice is muffled, and she prefers not to speak secondary to pain. She has not been able to eat solids for 2 days and has refused to drink for
- day. Vital signs show a temperature of 39.8 C, heart rate 140
- / 4
beats/min, respiratory rate 20, and blood pressure 110/70 mmHg. The exam shows the tonsils to be four-plus enlarged with partial airway obstruction and grey-white exudates. It is associated with cervical lymphadenopathy and splenomegaly. A