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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 56-year-old man was admitted to the hospital for new-onset
atrial fibrillation. After failed attempts of pharmacologic therapy to
return his heart to normal sinus rhythm, the decision was made to
perform a transesophageal echocardiogram (TEE) and
cardioversion. When performing the TEE, he was found to have a
left atrial appendage thrombus, so the cardioversion was aborted.
He was then started on rivaroxaban. When should cardioversion
be considered again? - ANSWER-After he has been taking
rivaroxaban for 3 to 4 weeks
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
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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 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
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A 65-year-old man presents to the emergency department with
palpitations, lightheadedness, and chest discomfort. He has a
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 65-year-old man presents with an enlarging, painless thyroid
nodule. Laboratory testing shows an elevated thyroid stimulating
hormone level and a positive anti-thyroid peroxidase and anti-
thyroglobulin antibodies. Histological exam shows dense
lymphoplasmacytic infiltrate with the formation of lymphoid
follicles. What is this patient at risk for developing? - ANSWER-
Lymphoma
A 67-year-old woman is newly diagnosed with type 2 diabetes
mellitus. Her blood pressure is above 140/90 mmHg on 3
separate occasions, 2 weeks apart. Laboratory tests show a BUN
of 15 mg/dL, creatinine of 1.1 mg/dL, and spot urine microalbumin
of 100 mcg/mg creatinine. Which of the following medications
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would be most appropriate? - ANSWER-Angiotensin-converting
enzyme (ACE) inhibitor
A patient is admitted with acute appendicitis. He is to receive
nothing by mouth (NPO). The patient says, "I am supposed to
take glyburide 5 mg by mouth daily." His glucose level on
admission is 362 mg/dlL He is to receive 10 units of regular
human insulin subcutaneously without delay. Which of the
following explanations should be given to the patient? - ANSWER-
Subcutaneous insulin is only temporary while the patient is NPO.
A 55-year-old woman presents to the clinic for a follow-up. Her
past medical history is significant for hypertension and type 2
diabetes mellitus. She is currently taking lisinopril and metformin.
She reports feeling well and exercising 3-4 times per week. She
has changed her diet plan and reports a 5-pound (2.2 kg) weight
loss in the last 2 months. Her last hemoglobin A1c was obtained 2
weeks ago at the time of her diagnosis. It was 8.6% at the time.
Her home glucose readings show adequate control. Her vital
signs and physical examination, including the foot exam, are
unremarkable. What is the next step in the management? -
ANSWER-Refer to an ophthalmologist
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 56-year-old man was admitted to the hospital for new-onset
atrial fibrillation. After failed attempts of pharmacologic therapy to
return his heart to normal sinus rhythm, the decision was made to
perform a transesophageal echocardiogram (TEE) and
cardioversion. When performing the TEE, he was found to have a
left atrial appendage thrombus, so the cardioversion was aborted.
He was then started on rivaroxaban. When should cardioversion
be considered again? - ANSWER-After he has been taking
rivaroxaban for 3 to 4 weeks
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
,2|Page
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 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
,3|Page
A 65-year-old man presents to the emergency department with
palpitations, lightheadedness, and chest discomfort. He has a
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 65-year-old man presents with an enlarging, painless thyroid
nodule. Laboratory testing shows an elevated thyroid stimulating
hormone level and a positive anti-thyroid peroxidase and anti-
thyroglobulin antibodies. Histological exam shows dense
lymphoplasmacytic infiltrate with the formation of lymphoid
follicles. What is this patient at risk for developing? - ANSWER-
Lymphoma
A 67-year-old woman is newly diagnosed with type 2 diabetes
mellitus. Her blood pressure is above 140/90 mmHg on 3
separate occasions, 2 weeks apart. Laboratory tests show a BUN
of 15 mg/dL, creatinine of 1.1 mg/dL, and spot urine microalbumin
of 100 mcg/mg creatinine. Which of the following medications
, 4|Page
would be most appropriate? - ANSWER-Angiotensin-converting
enzyme (ACE) inhibitor
A patient is admitted with acute appendicitis. He is to receive
nothing by mouth (NPO). The patient says, "I am supposed to
take glyburide 5 mg by mouth daily." His glucose level on
admission is 362 mg/dlL He is to receive 10 units of regular
human insulin subcutaneously without delay. Which of the
following explanations should be given to the patient? - ANSWER-
Subcutaneous insulin is only temporary while the patient is NPO.
A 55-year-old woman presents to the clinic for a follow-up. Her
past medical history is significant for hypertension and type 2
diabetes mellitus. She is currently taking lisinopril and metformin.
She reports feeling well and exercising 3-4 times per week. She
has changed her diet plan and reports a 5-pound (2.2 kg) weight
loss in the last 2 months. Her last hemoglobin A1c was obtained 2
weeks ago at the time of her diagnosis. It was 8.6% at the time.
Her home glucose readings show adequate control. Her vital
signs and physical examination, including the foot exam, are
unremarkable. What is the next step in the management? -
ANSWER-Refer to an ophthalmologist
