MSN 622 FINAL EXAM QUESTIONS AND VERIFIED ANSWERS (100% CORRECT) LATEST UPDATE 2026/2027 | GUARANTEED PASS | GRADED A+.

MSN 622 FINAL EXAM QUESTIONS AND VERIFIED ANSWERS (100% CORRECT) LATEST UPDATE 2026/2027 | GUARANTEED PASS | GRADED A+. A 65-year-old man presents with an episode of gross hematuria. He has no significant history. An abdominal CT incidentally demonstrates a 6 cm abdominal aortic aneurysm (AAA). What is the next step in the management of the AAA? A. Observation with annual follow-up. B. Elective abdominal aortic aneurysm surgery. C. Emergency surgery to replace the aneurysm. D. Angiogram to determine the size of the abdominal aortic aneurysm. - CORRECT ANSWER B. Elective abdominal aortic aneurysm surgery. A 65-year-old female is admitted to the hospital with palpitations and shortness of breath. Her past medical history includes congestive heart failure with an ejection fraction of 28%, hypertension, and asthma. She reports smoking 4 to 5 cigarettes a day but no illicit drug use. She takes amlodipine 10 mg once a day, lisinopril 10 mg a day and uses an albuterol inhaler about once a month in the spring and fall). Physical exam reveals blood pressure 140/80 mmHg, heart rate 164 bpm, irregular, respiratory rate 20. EKG results are shown. What is an appropriate rate control medication for her that would also be useful for her congestive heart failure?(Click Image to Enlarge) 1. Metoprolol 2. Digoxin 3. Ivabradine 4. Atropine - CORRECT ANSWER 1. Metoprolol A 65-year-old female patient presents with complaints of periodic, intermittent, sudden-onset chest pain and shortness of breath, which radiates to her left jaw and arm. She reports that she tires easily with mild physical activity. Initially, she experienced chest pain with activity, but now it occurs throughout the day. Medical history is significant for hypertension and type 2 diabetes mellitus. An electrocardiogram (ECG) and cardiac enzyme markers are ordered. Which of the following tests will be most helpful in differentiating unstable angina from a non-ST segment elevation myocardial infarction (NSTEMI)? A. Troponin I B. Echocardiogram C. Electrocardiogram D. Creatine kinase (CK) - CORRECT ANSWER A. Troponin I A 65-year-old female patient presents with complaints of progressive dyspnea on exertion for the past two weeks. The patient has a past medical history of hypertension. She has a 25-year smoking history but quit smoking 4 years ago. The patient reveals further that she initially had dyspnea only on moderate exertion, but now it occurs with activities like showering. The patient denies chest pain, cough, or wheezing. Her medications include metformin, amlodipine, and simvastatin. The patient appears comfortable at rest. Currently, she is afebrile and hemodynamically stable. Physical examination reveals bibasilar crackles. The patient's troponin-T level is normal. What changes are more likely to be seen on an electrocardiogram (ECG) if this patient is a suspected case of unstable angina? A. Diffuse ST-segment elevation in all the leads B. Deep, symmetric T-wave inversions in V2 and V3 accompanied by flat ST-segment C. - CORRECT ANSWER B. Deep, symmetric T-wave inversions in V2 and V3 accompanied by flat ST-segment A 73-year-old patient presents with a 6-month history of progressive fatigue, with difficulty climbing stairs and brushing her hair. These symptoms are different than her usual symptoms. Her medical history is significant for rheumatoid arthritis diagnosed 15 years ago. During this time, the patient has tried multiple biological agents with most of these medications discontinued because of adverse effects or loss of efficacy. The patient declined to try rituximab and requested to continue steroids. She has been on 10 mg of prednisone daily for about 10 years. Her dose is increased to 15 mg daily when the patient experiences an increase in joint pain, which happens about twice a month. What is the most likely etiology of the patient's symptoms? Well done!You answered successfully A. The patient has overextended herself and pulled a muscle. B. The patient most likely has an infection secondary to steroid use. C. The pa - CORRECT ANSWER C. The patient probably has proximal muscle weakness secondary to corticosteroids. A 76-year-old male comes into the emergency department with a complaint of chest pain. The patient was placed on telemetry monitoring that showed an abnormal rhythm at a rate of 160 beats per minute. A 12 lead EKG was performed showing an irregularly irregular rhythm. He has a history of atrial fibrillation and has been taking rivaroxaban for the past four months. The patient soon becomes diaphoretic, unresponsive, and hypotensive. What is the next best step? 1. Give 10 mg IV push of diltiazem bolus for rate control 2. Give 150 mg IV push of amiodarone for rhythm control 3. Immediate cardioversion 4. Begin transcutaneous pacing - CORRECT ANSWER 3. Immediate cardioversion What heart sound would one hear in a patient with systolic congestive heart failure (CHF)? 1. A systolic murmur 2. A diastolic murmur 3. S3 heart sound 4. A snap in early diastole - CORRECT ANSWER 3. S3 heart sound A 65-year-old man presents with a 4-hour history of progressively worsening left chest pain that radiates to his left neck. A history of present illness reveals minor episodes of transient chest pain over the last 6 months after climbing 2 flights of stairs or running. His past medical history includes hypertension, type 2 diabetes mellitus, and hyperlipidemia. His vital signs are oxygen saturation 98% on room air, respiratory rate 18 breaths/min, heart rate 91 bpm, blood pressure 131/91 mm Hg, and temperature 98.6 °F (37 °C). A 12-lead electrocardiogram (ECG) demonstrates ST depressions in leads V5, V6, and aVL. The patient is administered oxygen, morphine, nitroglycerin, and aspirin. According to the Society for Vascular Surgery (SVS) 2018 guidelines, what is the recommended management for a patient with a 3.5 cm abdominal aortic aneurysm? A. Open repair B. Duplex ultrasound every 3 years C. Endovascular stenting D. CT scan every 12 months - CORRECT ANSWER B. Duplex ultrasound every 3 years 1. A middle-aged patient with diabetes mellitus is referred to the clinic by his primary care provider to diagnose heart failure. The patient states that he does not have any documentation or labs from his previous medical encounters. Which of the following is the most significant and earliest sign of heart failure? 1. Peripheral edema 2. Pulmonary rales 3. An S3 gallop 4. Kussmaul sign - CORRECT ANSWER 3. An S3 gallop A 60-year-old obese female with congestive heart failure (CHF) presents to her primary care provider with a complaint of increased abdominal girth. She has noticed this take place over the last week and is making her feel self-conscious of her appearance. She reports shortness of breath, constipation, and abdominal discomfort, but denies nausea and vomiting, or any changes in appetite. She also reports a history of cholecystectomy and frequently experiences constipation. Physical examination reveals jugular venous distension, pulmonary crackles, a distended abdomen that is non-tender, and bulging flanks. The liver is non-palpable. Which of the following is the best assessment of this patient? 1. The patient has a buildup of gas and stool in her abdomen. Give the patient polyethylene glycol and encourage increased fiber consumption 2. There is a pathologic buildup of fluid in her peritoneum due to abnormal changes in - CORRECT ANSWER 3. There is a pathologic buildup of fluid in her peritoneum due to abnormal changes in her hydrostatic pressure due to a CHF exacerbation. Her serum albumin is 4 g/dL, and ascitic fluid albumin is 2 g/dL A patient presents with the complaint of polyphagia and polydipsia. After the relevant tests, he is diagnosed with diabetes mellitus. Which is the most appropriate nursing diagnosis? A. Ineffective airway clearance B. Impaired gas exchange C. Knowledge deficit D. Self-care deficit - CORRECT ANSWER C. Knowledge deficit