MSN 621 TEST BANK FINAL EXAM / MSN621
ACTUAL FINAL EXAM COMPLETE EXAM
QUESTIONS AND CORRECT VERIFIED ANSWERS
(FULL REVISED EXAM) A NEW UPDATED VERSION
| ALREADY A GRADED (ACTUAL FINAL EXAM)
A 26-year-old male comes to the emergency department complaining of
fatigue, dyspnea, chest pain, and syncope, especially when playing soccer.
This has been going on for the past 2 weeks. He has no significant past medical
history. He denies smoking, caffeine intake, tinnitus, vomiting, or coughing. He
has been taking NSAIDs regularly for the past year due to
headaches that he attributes to "being stressed out from my new job." On
examination, BP: 120/81 mmHg, HR: 55 bpm, RR: 18/min, and O2: 99% on room
air. Skin examination: no rashes, abdominal examination: mild epigastric
tenderness but no organomegaly, chest examination: equal air entry bilaterally
with no abnormal sounds. ECG shows P waves and QRS
complexes that are independent of each other. Blood tests show antibodies to
the organism in the picture. Which of the following is the most
appropriate treatment for this patient's case? (see photo)
ANSWERS: Hospitalization for close monitoring with telemetry and IV ceftriaxone
, An adolescent presents to you with sore throat, fever, lymphadenopathy,
and splenomegaly. He also complains of headache but has been previously
well. Which should be done?
ANSWERS: Treat symptomatically
A 39-year-old woman is brought to the emergency department
with
complaints of fever, headache, severe body aches, dry cough,
dyspnea, and coryza for the last 2 days. She has had rheumatoid
arthritis for the last 5
years, and she is on oral prednisone therapy. History reveals that
she is a school teacher, and many of her students have been sick
with similar
symptoms. Physical examination shows scattered crackles in both
lung
fields. Laboratory findings indicate a white blood cell (WBC) count
of 12,000 cells/mm3 with 67% lymphocytes. Chest x-ray (CXR)
detects bilateral
increased interstitial markings. Which of the following treatment
is most likely to be given to this patient?
ANSWERS: Oseltamivir 75 mg orally 2 times daily
,A healthy 17-year-old male presents with three days of worsening fatigue,
rhinorrhea, nasal congestion, myalgias, and subjective fever. He is severely
allergic to eggs and therefore does not receive the annual influenza vaccine.
His blood pressure is 125/75 mmHg, pulse 100 beats per minute, temperature
100 F (37.7 C), and respiratory rate 18 breaths per minute.
Examination demonstrates conjunctivitis, oropharyngeal erythema, and
clear breath sounds. Given the likely diagnosis, what is the most appropriate
treatment?
ANSWERS: Symptomatic treatment only
A 33-year-old inmate is brought to the clinic for a routine annual checkup. The
patient says that he has been in good health and does not have any medical
problems. He, however, does complain of disturbed sleep,
constipation, and weight loss. A review of systems is negative for cough,
shortness of breath, burning urination, abdominal discomfort, or weakness.
Examination shows normal vitals, a soft, nontender abdomen with no
organomegaly, normal S1 and S2 with no added sounds, and normal
bronchial breathing bilaterally. A purified protein derivative test shows an
induration of 11 mm. What is the next best step in the management of this
patient?
ANSWERS: Chest x-ray
, A 16-year-old patient presents to the hospital with fever, fatigue,
lymphadenopathy, and sore throat. Exudative pharyngitis is noted on the throat
examination. However, rapid strep testing is negative. His blood
pressure is 135/85 mmHg, the pulse rate is 92/min regular, and his
respiratory rate is 16/min. Past medical history is positive for asthma, and his
father had leukemia. Social history is notable for being involved in multiple
school sporting activities. What is the most appropriate piece of advice for
this patient?
ANSWERS: Avoid contact sports for a minimum of 6 weeks
A 38-year-old man presents with numbness and tingling in his extremities
for the past week. He says his hands have been feeling unusual, and that this
interferes with his sleep. He has no muscle weakness or memory
impairment. His past medical history includes pulmonary tuberculosis, for which
he takes isoniazid, rifampin, pyrazinamide, and ethambutol. All his vital signs
are within normal limits. Examination reveals diminished breath
sounds in the left upper lobe. A chest x-ray shows a cavitating lesion in the left
lung. What is the most appropriate next step in the management of this
patient?
ANSWERS: Add pyridoxine
ACTUAL FINAL EXAM COMPLETE EXAM
QUESTIONS AND CORRECT VERIFIED ANSWERS
(FULL REVISED EXAM) A NEW UPDATED VERSION
| ALREADY A GRADED (ACTUAL FINAL EXAM)
A 26-year-old male comes to the emergency department complaining of
fatigue, dyspnea, chest pain, and syncope, especially when playing soccer.
This has been going on for the past 2 weeks. He has no significant past medical
history. He denies smoking, caffeine intake, tinnitus, vomiting, or coughing. He
has been taking NSAIDs regularly for the past year due to
headaches that he attributes to "being stressed out from my new job." On
examination, BP: 120/81 mmHg, HR: 55 bpm, RR: 18/min, and O2: 99% on room
air. Skin examination: no rashes, abdominal examination: mild epigastric
tenderness but no organomegaly, chest examination: equal air entry bilaterally
with no abnormal sounds. ECG shows P waves and QRS
complexes that are independent of each other. Blood tests show antibodies to
the organism in the picture. Which of the following is the most
appropriate treatment for this patient's case? (see photo)
ANSWERS: Hospitalization for close monitoring with telemetry and IV ceftriaxone
, An adolescent presents to you with sore throat, fever, lymphadenopathy,
and splenomegaly. He also complains of headache but has been previously
well. Which should be done?
ANSWERS: Treat symptomatically
A 39-year-old woman is brought to the emergency department
with
complaints of fever, headache, severe body aches, dry cough,
dyspnea, and coryza for the last 2 days. She has had rheumatoid
arthritis for the last 5
years, and she is on oral prednisone therapy. History reveals that
she is a school teacher, and many of her students have been sick
with similar
symptoms. Physical examination shows scattered crackles in both
lung
fields. Laboratory findings indicate a white blood cell (WBC) count
of 12,000 cells/mm3 with 67% lymphocytes. Chest x-ray (CXR)
detects bilateral
increased interstitial markings. Which of the following treatment
is most likely to be given to this patient?
ANSWERS: Oseltamivir 75 mg orally 2 times daily
,A healthy 17-year-old male presents with three days of worsening fatigue,
rhinorrhea, nasal congestion, myalgias, and subjective fever. He is severely
allergic to eggs and therefore does not receive the annual influenza vaccine.
His blood pressure is 125/75 mmHg, pulse 100 beats per minute, temperature
100 F (37.7 C), and respiratory rate 18 breaths per minute.
Examination demonstrates conjunctivitis, oropharyngeal erythema, and
clear breath sounds. Given the likely diagnosis, what is the most appropriate
treatment?
ANSWERS: Symptomatic treatment only
A 33-year-old inmate is brought to the clinic for a routine annual checkup. The
patient says that he has been in good health and does not have any medical
problems. He, however, does complain of disturbed sleep,
constipation, and weight loss. A review of systems is negative for cough,
shortness of breath, burning urination, abdominal discomfort, or weakness.
Examination shows normal vitals, a soft, nontender abdomen with no
organomegaly, normal S1 and S2 with no added sounds, and normal
bronchial breathing bilaterally. A purified protein derivative test shows an
induration of 11 mm. What is the next best step in the management of this
patient?
ANSWERS: Chest x-ray
, A 16-year-old patient presents to the hospital with fever, fatigue,
lymphadenopathy, and sore throat. Exudative pharyngitis is noted on the throat
examination. However, rapid strep testing is negative. His blood
pressure is 135/85 mmHg, the pulse rate is 92/min regular, and his
respiratory rate is 16/min. Past medical history is positive for asthma, and his
father had leukemia. Social history is notable for being involved in multiple
school sporting activities. What is the most appropriate piece of advice for
this patient?
ANSWERS: Avoid contact sports for a minimum of 6 weeks
A 38-year-old man presents with numbness and tingling in his extremities
for the past week. He says his hands have been feeling unusual, and that this
interferes with his sleep. He has no muscle weakness or memory
impairment. His past medical history includes pulmonary tuberculosis, for which
he takes isoniazid, rifampin, pyrazinamide, and ethambutol. All his vital signs
are within normal limits. Examination reveals diminished breath
sounds in the left upper lobe. A chest x-ray shows a cavitating lesion in the left
lung. What is the most appropriate next step in the management of this
patient?
ANSWERS: Add pyridoxine
