1|Page
MSN 622 FINAL EXAM LATEST 2026 ACTUAL EXAM WITH COMPLETE
QUESTIONS AND CORRECT DETAILED ANSWERS (100% VERIFIED
ANSWERS) |ALREADY GRADED A+| ||PROFESSOR VERIFIED||
||BRANDNEW!!!||
A 59-year-old female with a past medical history of coronary
artery disease, hypertension, hyperlipidemia, obesity,
gastroesophageal reflux disease, and alcohol dependence
presents to the emergency department with acute onset
shortness of breath for one day. She has dry cough and nausea.
Vitals shows heart rate of 138/min, respiratory rate 32/min,
temperature 99 F, and blood pressure is 142/92 mmHg. Oral
mucosa is dry, and her breath smells of alcohol. Lungs exam
reveals fine bibasilar crackles and the neck exam is
unremarkable. Also, the EKG shows an irregularly irregular
rhythm. Labs indicate a raised blood alcohol level and TSH is
0.36 mU/L. Diltiazem infusion is initiated along with fluids. Which
of the following is the best management plan for this patient? -
ANSWER-Continue diltiazem drip, IV fluids, and consult
cardiology
A 65-year-old woman with claudication symptoms for the last six
months presents to the clinic for evaluation. The patient has a
history of diabetes and hypertension. She denies smoking.
,2|Page
Physical exam shows palpable pulses on the bilateral lower
extremities. Ankle-brachial index done at bedside shows a 1.1 on
the right and 1.0 on the left lower extremity. What is the next best
step in the management of this patient? - ANSWER-Repeat
ankle-brachial index after exercise
A 65-year-old man presents with palpitations and dyspnea without
chest pain or lightheadedness. His medical history is significant
for hypertension and hyperthyroidism. A 12-lead ECG is shown
below. What is the mechanism of this patient's arrhythmia? -
ANSWER-Micro-reentry
A 65-year-old man presents to the emergency department with
chest pain, palpitations, and dyspnea. The client has a past
medical history significant for hypertension and hyperthyroidism.
An electrocardiogram (EKG) is performed, as shown in the figure.
Initial medical management is initiated. Which of the following is
the most appropriate initial objective of this patient's treatment? -
ANSWER-Decrease the ventricular rate below 100/min
A 65-year-old man presents to the emergency department with
palpitations, lightheadedness, and chest discomfort. He has a
,3|Page
history of hypertension and mitral stenosis. His vital signs include
a heart rate of 141/minute, blood pressure of 110/78 mm Hg, and
oxygen saturation of 97% on room air. A 12-lead
electrocardiogram is shown. Which of the following best describes
the rate of atrial activity associated with this patient's condition? -
ANSWER-More than 350/minute
A 45-year-old man presents for a two-month history of worsening
dyspnea. He denies a history of fever and sore throat with joint
pain during childhood. On examination, he is found to have
displaced, thrusting apex beats and a systolic murmur. His
echocardiographic images are shown below. What is the definitive
management for this patient's condition? - ANSWER-Mitral valve
repair or replacement
A 65-year-old man presents with complaints of palpitation,
dizziness, and dyspnea for the past 2 hours. The patient has a
past medical history significant for hypertension, diabetes
mellitus, and hyperthyroidism. An electrocardiogram (ECG) is
shown. After initial stabilization, the patient is discharged with a
Holter monitor and asked to return after 7 days. At his next visit,
ECG tracings show similar findings as seen on his first visit. The
, 4|Page
patient's condition can be classified as which of the following? -
ANSWER-Persistent atrial fibrillation
A 65-year-old man presents with complaints of palpitations,
dyspnea, and chest discomfort. The patient has hypertension and
diabetes mellitus. His blood pressure is 140/90 mmHg, heart rate
120/min, and respiratory rate 23/min. An electrocardiogram is
performed, which is shown in the image. Which of the following
valvular diseases is associated with this patient's condition? -
ANSWER-Mitral stenosis
A 75-year-old man with a history of hypertension presents to the
emergency department with dizziness, lightheadedness, and
palpitations that started this morning. He reports occasional
palpitations at home while climbing stairs or doing heavy work,
but these episodes do not last more than a few minutes. His blood
pressure is 95/70 mm Hg, heart rate 125 bpm, respiratory rate 22
breaths/min, and oxygen saturation 95% on room air. The
physical examination findings are unremarkable. An
electrocardiogram is negative for ST-segment changes or T-wave
abnormalities. A rhythm strip is shown below. What is the best
MSN 622 FINAL EXAM LATEST 2026 ACTUAL EXAM WITH COMPLETE
QUESTIONS AND CORRECT DETAILED ANSWERS (100% VERIFIED
ANSWERS) |ALREADY GRADED A+| ||PROFESSOR VERIFIED||
||BRANDNEW!!!||
A 59-year-old female with a past medical history of coronary
artery disease, hypertension, hyperlipidemia, obesity,
gastroesophageal reflux disease, and alcohol dependence
presents to the emergency department with acute onset
shortness of breath for one day. She has dry cough and nausea.
Vitals shows heart rate of 138/min, respiratory rate 32/min,
temperature 99 F, and blood pressure is 142/92 mmHg. Oral
mucosa is dry, and her breath smells of alcohol. Lungs exam
reveals fine bibasilar crackles and the neck exam is
unremarkable. Also, the EKG shows an irregularly irregular
rhythm. Labs indicate a raised blood alcohol level and TSH is
0.36 mU/L. Diltiazem infusion is initiated along with fluids. Which
of the following is the best management plan for this patient? -
ANSWER-Continue diltiazem drip, IV fluids, and consult
cardiology
A 65-year-old woman with claudication symptoms for the last six
months presents to the clinic for evaluation. The patient has a
history of diabetes and hypertension. She denies smoking.
,2|Page
Physical exam shows palpable pulses on the bilateral lower
extremities. Ankle-brachial index done at bedside shows a 1.1 on
the right and 1.0 on the left lower extremity. What is the next best
step in the management of this patient? - ANSWER-Repeat
ankle-brachial index after exercise
A 65-year-old man presents with palpitations and dyspnea without
chest pain or lightheadedness. His medical history is significant
for hypertension and hyperthyroidism. A 12-lead ECG is shown
below. What is the mechanism of this patient's arrhythmia? -
ANSWER-Micro-reentry
A 65-year-old man presents to the emergency department with
chest pain, palpitations, and dyspnea. The client has a past
medical history significant for hypertension and hyperthyroidism.
An electrocardiogram (EKG) is performed, as shown in the figure.
Initial medical management is initiated. Which of the following is
the most appropriate initial objective of this patient's treatment? -
ANSWER-Decrease the ventricular rate below 100/min
A 65-year-old man presents to the emergency department with
palpitations, lightheadedness, and chest discomfort. He has a
,3|Page
history of hypertension and mitral stenosis. His vital signs include
a heart rate of 141/minute, blood pressure of 110/78 mm Hg, and
oxygen saturation of 97% on room air. A 12-lead
electrocardiogram is shown. Which of the following best describes
the rate of atrial activity associated with this patient's condition? -
ANSWER-More than 350/minute
A 45-year-old man presents for a two-month history of worsening
dyspnea. He denies a history of fever and sore throat with joint
pain during childhood. On examination, he is found to have
displaced, thrusting apex beats and a systolic murmur. His
echocardiographic images are shown below. What is the definitive
management for this patient's condition? - ANSWER-Mitral valve
repair or replacement
A 65-year-old man presents with complaints of palpitation,
dizziness, and dyspnea for the past 2 hours. The patient has a
past medical history significant for hypertension, diabetes
mellitus, and hyperthyroidism. An electrocardiogram (ECG) is
shown. After initial stabilization, the patient is discharged with a
Holter monitor and asked to return after 7 days. At his next visit,
ECG tracings show similar findings as seen on his first visit. The
, 4|Page
patient's condition can be classified as which of the following? -
ANSWER-Persistent atrial fibrillation
A 65-year-old man presents with complaints of palpitations,
dyspnea, and chest discomfort. The patient has hypertension and
diabetes mellitus. His blood pressure is 140/90 mmHg, heart rate
120/min, and respiratory rate 23/min. An electrocardiogram is
performed, which is shown in the image. Which of the following
valvular diseases is associated with this patient's condition? -
ANSWER-Mitral stenosis
A 75-year-old man with a history of hypertension presents to the
emergency department with dizziness, lightheadedness, and
palpitations that started this morning. He reports occasional
palpitations at home while climbing stairs or doing heavy work,
but these episodes do not last more than a few minutes. His blood
pressure is 95/70 mm Hg, heart rate 125 bpm, respiratory rate 22
breaths/min, and oxygen saturation 95% on room air. The
physical examination findings are unremarkable. An
electrocardiogram is negative for ST-segment changes or T-wave
abnormalities. A rhythm strip is shown below. What is the best
