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MSN 620 Final Exam 2025 – Advanced Nursing
Leadership, Practice Questions & Study Guide
Prepare for the MSN 620 Final Exam 2025 with a complete study guide and practice test
covering advanced nursing leadership, healthcare systems, evidence-based practice, and
management strategies to help you pass confidently and excel in your MSN program.
• MSN 620 final exam
• MSN 620 study guide
• MSN 620 practice questions
A 25-year-old female, who is a smoker, presents to the outpatient department with recurrent episodes of
pain over both sides of the face over the past three months. The pain occurs as a sudden shooting pain
which is severe in intensity and affects one side of the face at a time. She describes it as electric shocks
that last for about 10 seconds and resolves by itself. She experiences this symptom several times during
the day and is sometimes triggered by touching some particular spots on the face. She also complains of
intermittent numbness in the bilateral upper extremities. Neurological examination shows sensory loss
to gross touch in the dorsal aspect of the right upper extremity. What is the next step in the
management of this patient?
1. Start carbamazepine therapy
2. Obtain magnetic resonance imaging (MRI) of the brain and spine
3. Obtain X-ray of the right hand
4. Start as needed ibuprofen therapy - ANSWER-2. Obtain magnetic resonance imaging (MRI) of the brain
and spine
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. Past medical 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
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normal sensation on both sides of his face. There are no other symptoms or findings. What is the most
appropriate next step in management for this patient?
1. Order electroneuronography and electromyography testing
2. Perform a lumbar puncture for viral culture
3. Prescribe prednisone and acyclovir
4. Order magnetic resonance imaging of the brain - ANSWER-3. Prescribe prednisone and acyclovir
An 88-year-old white male who lives by himself has been developing progressive dementia and
increasing difficulty in remembering things. He can ambulate with a walker and able to swallow without
any problem. Also, he is unable to express his needs from time to time resulting in decreased PO intake
which is associated with progressive weakness. Which of the following would be the best option given
his current condition?
1. Independent senior living
2. Acute rehabilitation facility for intensive physical therapy
3. Skilled nursing facility with 24-hour nursing care
4. Assisted living facility - ANSWER-4. Assisted living facility
A 56-year-old female, who is a smoker, presents to the outpatient department with the complaint of
intermittent, severe, brief episodes of lancinating pain of the right cheek and lips for the past four
months, which is not subsiding with over the counter pain medications. Usually, the pain occurs when
brushing the teeth or when touching some specific points in the lower side of the right cheek. The pain
sometimes increases in chewing. On examination, she does not have any neurological deficits. What is
the most likely cause of pain in this patient?
1. Facial nerve compression
2. Trigeminal nerve compression
3. Facial nerve avulsion
4. Trigeminal nerve avulsion - ANSWER-2. Trigeminal nerve compression
A 35-year-old man with nasal congestion continues to use an over-the-counter intranasal decongestant
for four weeks. He complains that he is dependant on the intranasal decongestant spray and that he
needs to use it more frequently to obtain relief. Which of the following is the best approach to the
management of this patient?
1. Continue the nasal decongestant and introduce additional intranasal corticosteroids
, 3|Page
2. Discontinue the nasal decongestant straight away
3. Gradually discontinue the nasal decongestant and consider the use of short-course oral corticosteroids
during this withdrawal period
4. Consent the patient for nasal surgery - ANSWER-3. Gradually discontinue the nasal decongestant and
consider the use of short-course oral corticosteroids during this withdrawal period
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?
1. Neisseria gonorrhea
2. Staphylococcal aureus
3. Herpes simplex virus
4. House dust mite - ANSWER-2. Staphylococcal aureus
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 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?
1. Referral to the emergency department for imaging and aspiration
2. In-office aspiration of likely peritonsillar abscess
3. Topical benzocaine spray and amoxicillin-clavulanic acid twice daily for seven day - ANSWER-1. Referral
to the emergency department for imaging and aspiration
A 38-year-old male patient 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 that is controlled on hydrochlorothiazide. He does
not drink, smoke, or use illicit drugs. He works in a relatively new office, but he lives in a 60-year-old
house with his family. They have carpets, drapes, and a cat. Exam shows pale and boggy nasal mucosa
and cobblestoning of the posterior pharynx. Lungs are clear on auscultation. Skin prick testing shows
allergies to cat dander, dust mites, ragweed, and tree pollen. Which of the following would be an
appropriate step to take?
MSN 620 Final Exam 2025 – Advanced Nursing
Leadership, Practice Questions & Study Guide
Prepare for the MSN 620 Final Exam 2025 with a complete study guide and practice test
covering advanced nursing leadership, healthcare systems, evidence-based practice, and
management strategies to help you pass confidently and excel in your MSN program.
• MSN 620 final exam
• MSN 620 study guide
• MSN 620 practice questions
A 25-year-old female, who is a smoker, presents to the outpatient department with recurrent episodes of
pain over both sides of the face over the past three months. The pain occurs as a sudden shooting pain
which is severe in intensity and affects one side of the face at a time. She describes it as electric shocks
that last for about 10 seconds and resolves by itself. She experiences this symptom several times during
the day and is sometimes triggered by touching some particular spots on the face. She also complains of
intermittent numbness in the bilateral upper extremities. Neurological examination shows sensory loss
to gross touch in the dorsal aspect of the right upper extremity. What is the next step in the
management of this patient?
1. Start carbamazepine therapy
2. Obtain magnetic resonance imaging (MRI) of the brain and spine
3. Obtain X-ray of the right hand
4. Start as needed ibuprofen therapy - ANSWER-2. Obtain magnetic resonance imaging (MRI) of the brain
and spine
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. Past medical 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
,2|Page
normal sensation on both sides of his face. There are no other symptoms or findings. What is the most
appropriate next step in management for this patient?
1. Order electroneuronography and electromyography testing
2. Perform a lumbar puncture for viral culture
3. Prescribe prednisone and acyclovir
4. Order magnetic resonance imaging of the brain - ANSWER-3. Prescribe prednisone and acyclovir
An 88-year-old white male who lives by himself has been developing progressive dementia and
increasing difficulty in remembering things. He can ambulate with a walker and able to swallow without
any problem. Also, he is unable to express his needs from time to time resulting in decreased PO intake
which is associated with progressive weakness. Which of the following would be the best option given
his current condition?
1. Independent senior living
2. Acute rehabilitation facility for intensive physical therapy
3. Skilled nursing facility with 24-hour nursing care
4. Assisted living facility - ANSWER-4. Assisted living facility
A 56-year-old female, who is a smoker, presents to the outpatient department with the complaint of
intermittent, severe, brief episodes of lancinating pain of the right cheek and lips for the past four
months, which is not subsiding with over the counter pain medications. Usually, the pain occurs when
brushing the teeth or when touching some specific points in the lower side of the right cheek. The pain
sometimes increases in chewing. On examination, she does not have any neurological deficits. What is
the most likely cause of pain in this patient?
1. Facial nerve compression
2. Trigeminal nerve compression
3. Facial nerve avulsion
4. Trigeminal nerve avulsion - ANSWER-2. Trigeminal nerve compression
A 35-year-old man with nasal congestion continues to use an over-the-counter intranasal decongestant
for four weeks. He complains that he is dependant on the intranasal decongestant spray and that he
needs to use it more frequently to obtain relief. Which of the following is the best approach to the
management of this patient?
1. Continue the nasal decongestant and introduce additional intranasal corticosteroids
, 3|Page
2. Discontinue the nasal decongestant straight away
3. Gradually discontinue the nasal decongestant and consider the use of short-course oral corticosteroids
during this withdrawal period
4. Consent the patient for nasal surgery - ANSWER-3. Gradually discontinue the nasal decongestant and
consider the use of short-course oral corticosteroids during this withdrawal period
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?
1. Neisseria gonorrhea
2. Staphylococcal aureus
3. Herpes simplex virus
4. House dust mite - ANSWER-2. Staphylococcal aureus
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 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?
1. Referral to the emergency department for imaging and aspiration
2. In-office aspiration of likely peritonsillar abscess
3. Topical benzocaine spray and amoxicillin-clavulanic acid twice daily for seven day - ANSWER-1. Referral
to the emergency department for imaging and aspiration
A 38-year-old male patient 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 that is controlled on hydrochlorothiazide. He does
not drink, smoke, or use illicit drugs. He works in a relatively new office, but he lives in a 60-year-old
house with his family. They have carpets, drapes, and a cat. Exam shows pale and boggy nasal mucosa
and cobblestoning of the posterior pharynx. Lungs are clear on auscultation. Skin prick testing shows
allergies to cat dander, dust mites, ragweed, and tree pollen. Which of the following would be an
appropriate step to take?
