MSN 623 Final
A 14-year-old girl is brought to the emergency
department by her parents. Her parents state that
she was playing outside during a softball game
when she developed nausea and started
complaining of fatigue and mild headache. Further
evaluation reveals that she has a heart rate of 120
beats/min and a temperature of 103 degrees
Fahrenheit. However, she has no mental status
changes or muscle fasciculations but is sweating
profusely. What is the most likely diagnosis?
1.Heat stroke
2.Heat cramps
3.Heat exhaustion
4.Heat syncope Correct Answers 3.Heat
exhaustion
A 16-year-old girl is brought to the hospital for a
facial wound. She says a friend hit her in the face
at a party. Upon further evaluation, she revealed
that she was assaulted by her boyfriend, who
forced himself on her. He did not use protection.
Emergency contraception, ceftriaxone,
doxycycline, and metronidazole are given.
Prophylaxis against which of the following possible
infections is the primary objective of giving this
patient metronidazole?
1.Gonorrhea
2.Chlamydia
,3.Syphilis
4.Trichomoniasis Correct Answers
4.Trichomoniasis
A 16-year-old girl presents to the emergency
department after being raped by two men. After
initial stabilization, the patient consents to the
forensic exam by the sexual assault nurse
examiner (SANE). The patient is counseled by the
SANE on receiving sexually transmitted infection
prophylaxis. The patient is uncertain about her
immunization history. On discharge which of the
following vaccines should be administered to this
patient?
1.Hepatitis A vaccine
2.Hepatitis B vaccine
3.Hepatitis D vaccine
4.Hepatitis E vaccine Correct Answers 2.Hepatitis
B vaccine
A 16-year-old girl presents to the emergency
department to be evaluated after being sexually
assaulted the night prior. Once in the exam room
with the sexual assault nurse examiner (SANE), the
patient tearfully exclaims that she does not want
anyone to know, but she wants to make sure she's
not pregnant. Which of the following is the next
most appropriate course of action?
1.Report the incident to the relevant authorities
2.Keep the incident a secret
,3.Inform the patient's parents
4.Ask the patient to file charges against the person
that assaulted her Correct Answers 1.Report the
incident to the relevant authorities
A 16-year-old girl presents to the office for a follow-
up exam two weeks following sexual assault. The
patient was administered emergency contraception
only, as she denied prophylaxis against sexually
transmitted infections. The patient's last
immunization was at the age of 5. Laboratory
analysis reveals the presence of anti-Hbs
antibodies only. Which of the following vaccines
should be administered to the patient, given her
recent history of sexual assault?
1.Hepatitis B vaccine
2.Hepatitis C vaccine
3.Human papillomavirus vaccine
4.Pneumococcal vaccine Correct Answers
3.Human papillomavirus vaccine
A 16-year-old man presents to the emergency
department due to a 3-day history of polyuria,
vomiting, and extreme thirst. He had an upper
respiratory infection starting 2 days prior and now
presents with a temperature of 101.2 °F (38.4 °C).
Physical exam shows decreased skin turgor and
dry mucous membranes, and urine analysis is
positive for ketones. He has a blood glucose level
of 935 mg/dL. What structures are commonly
, affected by microvascular damage from this
disease?
1.Eyes and feet
2.Gums, feet, and heart
3.Eyes and gums
4.Eyes, gums, feet, and kidneys Correct Answers
4.Eyes, gums, feet, and kidneys
A 17-year-old female presents to the emergency
department after having an episode of syncope.
She was out watching fireworks during the day and
drinking alcohol. She reports that she took
ibuprofen earlier in the day for a mild headache.
Her vital signs are normal, and she has no
symptoms at this time. Which of the following is a
risk factor for what happened to the patient?
1.Age
2.Exposure to loud noises
3.Alcohol consumption
4.NSAID use Correct Answers 3.Alcohol
consumption
A 17-year-old, previously healthy girl presents with
an acute flu-like illness, fever, myalgias, shortness
of breath, and chest pain. Her ECG shows sinus
tachycardia. Her labs show elevated white blood
cells and an abnormally elevated troponin. Her
chest x-ray shows mild pulmonary edema, with
findings consistent with congestive heart failure.
What is her likely diagnosis?
A 14-year-old girl is brought to the emergency
department by her parents. Her parents state that
she was playing outside during a softball game
when she developed nausea and started
complaining of fatigue and mild headache. Further
evaluation reveals that she has a heart rate of 120
beats/min and a temperature of 103 degrees
Fahrenheit. However, she has no mental status
changes or muscle fasciculations but is sweating
profusely. What is the most likely diagnosis?
1.Heat stroke
2.Heat cramps
3.Heat exhaustion
4.Heat syncope Correct Answers 3.Heat
exhaustion
A 16-year-old girl is brought to the hospital for a
facial wound. She says a friend hit her in the face
at a party. Upon further evaluation, she revealed
that she was assaulted by her boyfriend, who
forced himself on her. He did not use protection.
Emergency contraception, ceftriaxone,
doxycycline, and metronidazole are given.
Prophylaxis against which of the following possible
infections is the primary objective of giving this
patient metronidazole?
1.Gonorrhea
2.Chlamydia
,3.Syphilis
4.Trichomoniasis Correct Answers
4.Trichomoniasis
A 16-year-old girl presents to the emergency
department after being raped by two men. After
initial stabilization, the patient consents to the
forensic exam by the sexual assault nurse
examiner (SANE). The patient is counseled by the
SANE on receiving sexually transmitted infection
prophylaxis. The patient is uncertain about her
immunization history. On discharge which of the
following vaccines should be administered to this
patient?
1.Hepatitis A vaccine
2.Hepatitis B vaccine
3.Hepatitis D vaccine
4.Hepatitis E vaccine Correct Answers 2.Hepatitis
B vaccine
A 16-year-old girl presents to the emergency
department to be evaluated after being sexually
assaulted the night prior. Once in the exam room
with the sexual assault nurse examiner (SANE), the
patient tearfully exclaims that she does not want
anyone to know, but she wants to make sure she's
not pregnant. Which of the following is the next
most appropriate course of action?
1.Report the incident to the relevant authorities
2.Keep the incident a secret
,3.Inform the patient's parents
4.Ask the patient to file charges against the person
that assaulted her Correct Answers 1.Report the
incident to the relevant authorities
A 16-year-old girl presents to the office for a follow-
up exam two weeks following sexual assault. The
patient was administered emergency contraception
only, as she denied prophylaxis against sexually
transmitted infections. The patient's last
immunization was at the age of 5. Laboratory
analysis reveals the presence of anti-Hbs
antibodies only. Which of the following vaccines
should be administered to the patient, given her
recent history of sexual assault?
1.Hepatitis B vaccine
2.Hepatitis C vaccine
3.Human papillomavirus vaccine
4.Pneumococcal vaccine Correct Answers
3.Human papillomavirus vaccine
A 16-year-old man presents to the emergency
department due to a 3-day history of polyuria,
vomiting, and extreme thirst. He had an upper
respiratory infection starting 2 days prior and now
presents with a temperature of 101.2 °F (38.4 °C).
Physical exam shows decreased skin turgor and
dry mucous membranes, and urine analysis is
positive for ketones. He has a blood glucose level
of 935 mg/dL. What structures are commonly
, affected by microvascular damage from this
disease?
1.Eyes and feet
2.Gums, feet, and heart
3.Eyes and gums
4.Eyes, gums, feet, and kidneys Correct Answers
4.Eyes, gums, feet, and kidneys
A 17-year-old female presents to the emergency
department after having an episode of syncope.
She was out watching fireworks during the day and
drinking alcohol. She reports that she took
ibuprofen earlier in the day for a mild headache.
Her vital signs are normal, and she has no
symptoms at this time. Which of the following is a
risk factor for what happened to the patient?
1.Age
2.Exposure to loud noises
3.Alcohol consumption
4.NSAID use Correct Answers 3.Alcohol
consumption
A 17-year-old, previously healthy girl presents with
an acute flu-like illness, fever, myalgias, shortness
of breath, and chest pain. Her ECG shows sinus
tachycardia. Her labs show elevated white blood
cells and an abnormally elevated troponin. Her
chest x-ray shows mild pulmonary edema, with
findings consistent with congestive heart failure.
What is her likely diagnosis?
