1|Page
MSN 620 final exam 2026, nursing theory questions,
evidence-based practice nursing exam, advanced
practice MSN study guide, graded A+ MSN exam PDF,
final exam questions and answers||Verified Exam!!!
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
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,
,2|Page
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|Page
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?
1. Intranasal corticosteroids
2. Send carpet fiber for analysis
3. Immunotherapy for cat dander
4. Wash and keep carpets and drapes - ANSWER-1.
Intranasal corticosteroids
A 25-year-old female, who is a smoker, presents to the
outpatient department with recurrent episodes of pain over
, 4|Page
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,
MSN 620 final exam 2026, nursing theory questions,
evidence-based practice nursing exam, advanced
practice MSN study guide, graded A+ MSN exam PDF,
final exam questions and answers||Verified Exam!!!
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
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,
,2|Page
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|Page
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?
1. Intranasal corticosteroids
2. Send carpet fiber for analysis
3. Immunotherapy for cat dander
4. Wash and keep carpets and drapes - ANSWER-1.
Intranasal corticosteroids
A 25-year-old female, who is a smoker, presents to the
outpatient department with recurrent episodes of pain over
, 4|Page
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,
