MSN 620 final exam
MSN 620 FINAL EXAM 2025, NURSING THEORY QUESTIONS,
EVIDENCE-BASED PRACTICE NURSING EXAM, ADVANCED
PRACTICE MSN STUDY GUIDE, GRADED A+ MSN EXAM PDF,
FINAL EXAM QUESTIONS AND ANSWERS
A 28-year-old male patient with a history of asthma presents complaining of eye discharge,
morning matting, and redness. He denies eye itching, burning, or recent upper respiratory
symptoms. On examination, there is a bilateral diffuse conjunctival injection, purulent
discharge, and conjunctival papillae. What is the most likely etiological agent for this patient's
presentation? - ANSWER-Staphylococcal aureus
A 6-day-old girl presents with significant redness and copious discharge from her eyes. She was
born via spontaneous vaginal delivery to a gravida three, para two mother. Thick, purulent
discharge is noted from both eyes on examination. Which of the following is the most
appropriate treatment? - ANSWER-Hospital admission, intravenous administration of
ceftriaxone, and saline solution irrigation
A 10-year-old boy presents to the provider with complaints of left eye tearing. He states that
when he woke up this morning, his left eye was crusted with his eyelids glued together. He adds
that he has noticed some redness and mild discomfort over the previous 2 days. The patient
also reports left ear pain and fullness. On further examination, his visual acuity is 20/25 on the
right and 20/90 in the left eye. There is left-sided conjunctival erythema and clear discharge, but
there does not appear to be any corneal involvement. On otoscopic examination, the left
tympanic membrane is bulging and red. Which of the following factors best indicates the need
for an ophthalmologic referral? - ANSWER-Decreased visual acuity
A 17-year-old female presents to the office with a severe sore throat. The symptoms, which
began four days ago, have become unilateral and much worse over the last day. She has had
fevers of 101-103 F at home and was taking over-the-counter medications but now cannot
tolerate swallowing even liquid ibuprofen. She has no trouble breathing, but reports that it is
very difficult to open her mouth because of pain in her jaw and the clinician struggles to
visualize her throat but notes unilateral tonsillar swelling. The clinician also notes tender
1|Page
, MSN 620 final exam
cervical lymphadenopathy and some right-sided facial swelling but only minimal tenderness to
palpation over the right jaw. What is the most appropriate next step in care? - ANSWER-Referral
to the emergency department for imaging and aspiration
An 11-year-old girl presents with a 1-day history of sore throat, fatigue, and nausea but no
congestion and no cough. Her temperature is 103 °F (39.4 °C), and the clinician palpates tender
anterior cervical lymph nodes and observes exudates on her swollen tonsils, but a rapid strep
test is negative. What is the most appropriate nex - ANSWER-Obtain a throat sample for
bacterial culture
A 27-year-old man presents to the healthcare provider for regular follow-up but mentions that
he has had a severe sore throat with fever, pain with swallowing, and painful lymph nodes on
the front of his neck but no cough or congestion. He also asks for a refill of the emtricitabine-
tenofovir pill he takes for pre-exposure prophylaxis to prevent HIV. He is reluctant to answer
questions about sexual activity. What is the most likely pathogen causing his symptoms? -
ANSWER-Group A Streptococcus
A 38-year-old man complains of chronic nasal allergies. He has used over-the-counter
antihistamines without much success. He believes he is allergic to ragweed but has had no
testing. His past medical history is remarkable for hypertension, which is controlled by
hydrochlorothiazide. He does not drink, smoke, or use illicit drugs. He works in a relatively new
office but lives in a 60-year-old house with his family. They have carpets, drapes, and a cat. The
exam shows pale and boggy nasal mucosa and cobblestoning of the posterior pharynx. Lungs
are clear on auscultation. Skin prick testing shows cat dander, dust mites, ragweed, and tree
pollen allergies. Which of the following would be an appropriate step to take? - ANSWER-
Intranasal corticosteroids
A 65-year-old man presents with postauricular pain, facial weakness, and excessive tearing that
started 24 hours ago. He denies a history of these symptoms before this episode. His history is
significant for cold sores and asthma. He is not currently taking any medication and has no
allergies. Physical examination demonstrates severe but incomplete paralysis of the left side of
his face, with normal sensation on both sides of his face. There are no other symptoms or
findings. What is the most appropriate next step in management? - ANSWER-Prescribe
prednisone and acyclovir.
2|Page
, MSN 620 final exam
An 88-year-old man presents with progressive dementia and increasing difficulty in
remembering things. He can ambulate with a walker and can swallow without any difficulty. He
is unable to express his needs from time to time resulting in decreased oral intake which is
associated with progressive weakness. He currently lives by himself. Which of the following is
the best option? - ANSWER-Assisted living facility with meal and medication administration
services.
A 56-year-old woman presents with intermittent, severe, brief episodes of lancinating pain in
the right cheek and lips for the past 4 months. She has no relief from over-the-counter pain
medications. The pain usually occurs when brushing the teeth or when touching some specific
points in the lower side of the right cheek. The pain sometimes increases with chewing. On
physical examination, she does not have any neurological deficits. What is the most likely cause
of the pain? - ANSWER-Trigeminal nerve compression
A 40-year-old man presents with left-sided facial weakness, which started 2 days ago. He has a
past medical history of bipolar disorder. Vital signs are heart rate 76 bpm, blood pressure
125/79 mm Hg, temperature 99° F (37.2° C), respiratory rate 16 breaths/min, and oxygen
saturation 99% on room air. Physical examination shows paralysis of the left side of his face. No
sensory deficits are noted. What motor task will the patient have difficulty completing? -
ANSWER-Closing the left eye completely
A daughter brings her 72-year-old mother to the provider because of a constellation of
symptoms that appear to be getting slowly worse over the past year. She tells the clinician that
her mother is forgetting any new information she is given, is frequently disoriented, and
demonstrates faulty judgment. Her house is no longer kept as clean as it used to be and she is
having trouble staying on top of organizing her bills and finances. What is the most likely cause
of the patient's condition? - ANSWER-Major neurocognitive disorder
A 17-year-old boy presents with a sore throat that started yesterday afternoon. He denies any
congestion or cough but reports a temperature of 102° F (38.8° C) and generalized fatigue. He
has pain with swallowing but can speak normally and manage his saliva. On physical
3|Page
, MSN 620 final exam
examination, the clinician sees yellow-white plaques on his tonsils and anterior cervical
lymphadenopathy that is tender to palpation. What is the most appropriate next step in care? -
ANSWER-Point-of-care streptococcal antigen testing
A 17-year-old boy presents to the hospital with a severe sore throat and fatigue that has been
ongoing for 3 days. He has a high-grade fever for which he has been taking ibuprofen at home.
The pain in his throat has been making it difficult for him to swallow, though he can take cold
drinks with care, which helps with the pain. He does not feel throat congestion and does not
have a cough. On physical examination, the clinician notes exudates and tender cervical
lymphadenopathy. The clinician treats him empirically for strep throat with amoxicillin 500 mg
twice daily for 10 days. The patient returns two 2 days later, reporting a full-body, blotchy,
bumpy rash and no change in his symptoms. He stopped taking the antibiotics after the rash
began. What is the most appropriate next step in care? - ANSWER-Send a throat swab for
culture and order a complete blood count and heterophile antibodies.
An 8-year-old girl presents with a 4-day history of fever and sore throat. A review of systems is
negative for cough. Her past medical and family history is insignificant. She is allergic to
penicillin. Vital signs are temperature 101 °F (38.3 °C), heart rate 88 bpm, and blood pressure
110/70 mm Hg. On physical examination, some exudates are seen on the posterior pharyngeal
wall, and tender anterior cervical nodes are palpated. Findings on heart and lung examination
are normal. Which of the following is the recommended treatment? - ANSWER-Clindamycin
A 17-year-old boy presents with a sore throat. Associated symptoms include fever and chills,
difficulty in swallowing, referred ear pain, headache, and muscle aches. The vital signs are
temperature 39 °C (102.2 °F), heart rate 105 bpm, and respiratory rate 22 breaths/min. The
physical examination reveals a dry tongue, erythematous enlarged tonsils, pharyngeal exudate,
and tender cervical lymphadenopathy. Which of the following is the diagnostic test of choice? -
ANSWER-Rapid antigen detection test
A 17-year-old girl presents with a thick discharge from her eyes that started 5 days ago.
Associated symptoms include redness and a feeling of dirt in her eyes. Her eyes are usually
matted in the morning. Her medical history is significant for multiple similar episodes. She has
been using contact lenses for the past 2 years. Her vital signs are blood pressure 120/80 mm Hg,
heart rate 88 bpm, respiratory rate 14 breaths/min, and temperature 37 °C (98.6 °F). An ocular
4|Page
MSN 620 FINAL EXAM 2025, NURSING THEORY QUESTIONS,
EVIDENCE-BASED PRACTICE NURSING EXAM, ADVANCED
PRACTICE MSN STUDY GUIDE, GRADED A+ MSN EXAM PDF,
FINAL EXAM QUESTIONS AND ANSWERS
A 28-year-old male patient with a history of asthma presents complaining of eye discharge,
morning matting, and redness. He denies eye itching, burning, or recent upper respiratory
symptoms. On examination, there is a bilateral diffuse conjunctival injection, purulent
discharge, and conjunctival papillae. What is the most likely etiological agent for this patient's
presentation? - ANSWER-Staphylococcal aureus
A 6-day-old girl presents with significant redness and copious discharge from her eyes. She was
born via spontaneous vaginal delivery to a gravida three, para two mother. Thick, purulent
discharge is noted from both eyes on examination. Which of the following is the most
appropriate treatment? - ANSWER-Hospital admission, intravenous administration of
ceftriaxone, and saline solution irrigation
A 10-year-old boy presents to the provider with complaints of left eye tearing. He states that
when he woke up this morning, his left eye was crusted with his eyelids glued together. He adds
that he has noticed some redness and mild discomfort over the previous 2 days. The patient
also reports left ear pain and fullness. On further examination, his visual acuity is 20/25 on the
right and 20/90 in the left eye. There is left-sided conjunctival erythema and clear discharge, but
there does not appear to be any corneal involvement. On otoscopic examination, the left
tympanic membrane is bulging and red. Which of the following factors best indicates the need
for an ophthalmologic referral? - ANSWER-Decreased visual acuity
A 17-year-old female presents to the office with a severe sore throat. The symptoms, which
began four days ago, have become unilateral and much worse over the last day. She has had
fevers of 101-103 F at home and was taking over-the-counter medications but now cannot
tolerate swallowing even liquid ibuprofen. She has no trouble breathing, but reports that it is
very difficult to open her mouth because of pain in her jaw and the clinician struggles to
visualize her throat but notes unilateral tonsillar swelling. The clinician also notes tender
1|Page
, MSN 620 final exam
cervical lymphadenopathy and some right-sided facial swelling but only minimal tenderness to
palpation over the right jaw. What is the most appropriate next step in care? - ANSWER-Referral
to the emergency department for imaging and aspiration
An 11-year-old girl presents with a 1-day history of sore throat, fatigue, and nausea but no
congestion and no cough. Her temperature is 103 °F (39.4 °C), and the clinician palpates tender
anterior cervical lymph nodes and observes exudates on her swollen tonsils, but a rapid strep
test is negative. What is the most appropriate nex - ANSWER-Obtain a throat sample for
bacterial culture
A 27-year-old man presents to the healthcare provider for regular follow-up but mentions that
he has had a severe sore throat with fever, pain with swallowing, and painful lymph nodes on
the front of his neck but no cough or congestion. He also asks for a refill of the emtricitabine-
tenofovir pill he takes for pre-exposure prophylaxis to prevent HIV. He is reluctant to answer
questions about sexual activity. What is the most likely pathogen causing his symptoms? -
ANSWER-Group A Streptococcus
A 38-year-old man complains of chronic nasal allergies. He has used over-the-counter
antihistamines without much success. He believes he is allergic to ragweed but has had no
testing. His past medical history is remarkable for hypertension, which is controlled by
hydrochlorothiazide. He does not drink, smoke, or use illicit drugs. He works in a relatively new
office but lives in a 60-year-old house with his family. They have carpets, drapes, and a cat. The
exam shows pale and boggy nasal mucosa and cobblestoning of the posterior pharynx. Lungs
are clear on auscultation. Skin prick testing shows cat dander, dust mites, ragweed, and tree
pollen allergies. Which of the following would be an appropriate step to take? - ANSWER-
Intranasal corticosteroids
A 65-year-old man presents with postauricular pain, facial weakness, and excessive tearing that
started 24 hours ago. He denies a history of these symptoms before this episode. His history is
significant for cold sores and asthma. He is not currently taking any medication and has no
allergies. Physical examination demonstrates severe but incomplete paralysis of the left side of
his face, with normal sensation on both sides of his face. There are no other symptoms or
findings. What is the most appropriate next step in management? - ANSWER-Prescribe
prednisone and acyclovir.
2|Page
, MSN 620 final exam
An 88-year-old man presents with progressive dementia and increasing difficulty in
remembering things. He can ambulate with a walker and can swallow without any difficulty. He
is unable to express his needs from time to time resulting in decreased oral intake which is
associated with progressive weakness. He currently lives by himself. Which of the following is
the best option? - ANSWER-Assisted living facility with meal and medication administration
services.
A 56-year-old woman presents with intermittent, severe, brief episodes of lancinating pain in
the right cheek and lips for the past 4 months. She has no relief from over-the-counter pain
medications. The pain usually occurs when brushing the teeth or when touching some specific
points in the lower side of the right cheek. The pain sometimes increases with chewing. On
physical examination, she does not have any neurological deficits. What is the most likely cause
of the pain? - ANSWER-Trigeminal nerve compression
A 40-year-old man presents with left-sided facial weakness, which started 2 days ago. He has a
past medical history of bipolar disorder. Vital signs are heart rate 76 bpm, blood pressure
125/79 mm Hg, temperature 99° F (37.2° C), respiratory rate 16 breaths/min, and oxygen
saturation 99% on room air. Physical examination shows paralysis of the left side of his face. No
sensory deficits are noted. What motor task will the patient have difficulty completing? -
ANSWER-Closing the left eye completely
A daughter brings her 72-year-old mother to the provider because of a constellation of
symptoms that appear to be getting slowly worse over the past year. She tells the clinician that
her mother is forgetting any new information she is given, is frequently disoriented, and
demonstrates faulty judgment. Her house is no longer kept as clean as it used to be and she is
having trouble staying on top of organizing her bills and finances. What is the most likely cause
of the patient's condition? - ANSWER-Major neurocognitive disorder
A 17-year-old boy presents with a sore throat that started yesterday afternoon. He denies any
congestion or cough but reports a temperature of 102° F (38.8° C) and generalized fatigue. He
has pain with swallowing but can speak normally and manage his saliva. On physical
3|Page
, MSN 620 final exam
examination, the clinician sees yellow-white plaques on his tonsils and anterior cervical
lymphadenopathy that is tender to palpation. What is the most appropriate next step in care? -
ANSWER-Point-of-care streptococcal antigen testing
A 17-year-old boy presents to the hospital with a severe sore throat and fatigue that has been
ongoing for 3 days. He has a high-grade fever for which he has been taking ibuprofen at home.
The pain in his throat has been making it difficult for him to swallow, though he can take cold
drinks with care, which helps with the pain. He does not feel throat congestion and does not
have a cough. On physical examination, the clinician notes exudates and tender cervical
lymphadenopathy. The clinician treats him empirically for strep throat with amoxicillin 500 mg
twice daily for 10 days. The patient returns two 2 days later, reporting a full-body, blotchy,
bumpy rash and no change in his symptoms. He stopped taking the antibiotics after the rash
began. What is the most appropriate next step in care? - ANSWER-Send a throat swab for
culture and order a complete blood count and heterophile antibodies.
An 8-year-old girl presents with a 4-day history of fever and sore throat. A review of systems is
negative for cough. Her past medical and family history is insignificant. She is allergic to
penicillin. Vital signs are temperature 101 °F (38.3 °C), heart rate 88 bpm, and blood pressure
110/70 mm Hg. On physical examination, some exudates are seen on the posterior pharyngeal
wall, and tender anterior cervical nodes are palpated. Findings on heart and lung examination
are normal. Which of the following is the recommended treatment? - ANSWER-Clindamycin
A 17-year-old boy presents with a sore throat. Associated symptoms include fever and chills,
difficulty in swallowing, referred ear pain, headache, and muscle aches. The vital signs are
temperature 39 °C (102.2 °F), heart rate 105 bpm, and respiratory rate 22 breaths/min. The
physical examination reveals a dry tongue, erythematous enlarged tonsils, pharyngeal exudate,
and tender cervical lymphadenopathy. Which of the following is the diagnostic test of choice? -
ANSWER-Rapid antigen detection test
A 17-year-old girl presents with a thick discharge from her eyes that started 5 days ago.
Associated symptoms include redness and a feeling of dirt in her eyes. Her eyes are usually
matted in the morning. Her medical history is significant for multiple similar episodes. She has
been using contact lenses for the past 2 years. Her vital signs are blood pressure 120/80 mm Hg,
heart rate 88 bpm, respiratory rate 14 breaths/min, and temperature 37 °C (98.6 °F). An ocular
4|Page
