1|Page
MSN 621 final exam 2026, advanced health
assessment questions, MSN clinical decision making
exam, nursing study guide PDF, graded A+ MSN 621,
nurse practitioner final exam||Verified Exam!!!
A 17-year-old female presents to your office with a 2-year
history of irregular menstrual cycles. She reports that her
cycles last 7-8 days on average, but some months she
may spot in between or miss her cycle completely. She
reports some cramping with her cycles and denies vaginal
discharge, fever or chills, weight loss, fatigue. She reports
she is not sexually active. What would be the most
appropriate management for her abnormal uterine
bleeding?
A. Perform pelvic ultrasound
B. Prescribe oral contraceptive pills and schedule follow
up
C. Perform endometrial sampling
D. Prescribe clomiphene and schedule follow up -
ANSWER-B. Prescribe oral contraceptive pills and
schedule follow up
A 51-year-old female presents with a chief complaint of
irregular, heavy menstrual bleeding for the past six
months. She reports previously regular cycles every 30
days, lasting 4 to 6 days, with medium flow. She reports
,2|Page
her cycles are now occurring every 30 to 45 days, lasting
anywhere from 5 to 12 days, with heavy flow and
occasional passing of clots. On exam, her BMI is 30.2 and
vitals are within normal limits. Along with a pelvic
examination, what is the next most appropriate step in the
evaluation of this patient?
Well done!You answered successfully
A. Luteinizing and follicle stimulating hormones
B. Sonohysterography
C. Endometrial sampling
D. Gonorrhea and chlamydia testing - ANSWER-C.
Endometrial sampling
An 18-year-old white female presents for a wellness
examination. After some questioning, she admits to heavy
menstrual cycles that are 28 days apart and last 7-8 days.
She reports the passage of clots and on her heaviest
days, having to change her pads every 1-2 hours. She is
not sexually active and denies any significant past medical
history. She does admit to an episode of heavy bleeding
after tooth extraction for braces when she was 13 years
old. The physical examination is unremarkable except for
scattered ecchymoses on her bilateral shins. Which of the
following is the most appropriate step in the diagnosis of
this patient?
,3|Page
A. Endometrial biopsy
B. Thyroid function studies
C. Pelvic ultrasound
D. Coagulopathy studies - ANSWER-D. Coagulopathy
studies
A 65-year-old woman with a BMI of 32 kg/m2 comes to the
clinician with a complaint of two episodes of vaginal
bleeding in the past 40 days. She has a past medical
history of hypertension and diabetes mellitus type 2. On
both occasions, light spotting lasted for three days. She
experienced menopause at the age of 56 years. Currently,
she is afebrile and hemodynamically stable with an
unremarkable physical examination. She takes metformin
and lisinopril. What is the first-line imaging study to
evaluate a patient with this complaint?
A. MRI
B. Transvaginal ultrasound
C. Sonohysterography
D. Hysteroscopy - ANSWER-B. Transvaginal ultrasound
A 16-year-old girl presents to the clinic with moderately
severe vaginal bleeding with lower abdominal cramping
, 4|Page
going for the past two months. She is not sexually active
and her last menstrual period was 3 weeks ago. Per FIGO
terminology, which of the following best identifies the
patient's presentation?
Well done!You answered successfully
A. Menorrhagia
B. Menometorrhagia
C. Dysfunctional uterine bleeding
D. Abnormal uterine bleeding - ANSWER-D. Abnormal
uterine bleeding
A 25-year-old G0P0 female presents with intermittent
abdominal pain. She states that the pain starts before her
period, is "crampy" in nature, and lasts for a few days
after, and has been occurring intermittently since
menarche. Her periods have been regular, with no spotting
or pain in between periods. Her last period was a week
ago. She has no other health issues and takes no
medications. She has had no previous surgeries in the
past. She is currently sexually active with her husband and
is interested in starting a family shortly. What is the first
line of treatment for this patient?
Well done!You answered successfully
A. Morphine
B. Selective serotonin reuptake inhibitor
MSN 621 final exam 2026, advanced health
assessment questions, MSN clinical decision making
exam, nursing study guide PDF, graded A+ MSN 621,
nurse practitioner final exam||Verified Exam!!!
A 17-year-old female presents to your office with a 2-year
history of irregular menstrual cycles. She reports that her
cycles last 7-8 days on average, but some months she
may spot in between or miss her cycle completely. She
reports some cramping with her cycles and denies vaginal
discharge, fever or chills, weight loss, fatigue. She reports
she is not sexually active. What would be the most
appropriate management for her abnormal uterine
bleeding?
A. Perform pelvic ultrasound
B. Prescribe oral contraceptive pills and schedule follow
up
C. Perform endometrial sampling
D. Prescribe clomiphene and schedule follow up -
ANSWER-B. Prescribe oral contraceptive pills and
schedule follow up
A 51-year-old female presents with a chief complaint of
irregular, heavy menstrual bleeding for the past six
months. She reports previously regular cycles every 30
days, lasting 4 to 6 days, with medium flow. She reports
,2|Page
her cycles are now occurring every 30 to 45 days, lasting
anywhere from 5 to 12 days, with heavy flow and
occasional passing of clots. On exam, her BMI is 30.2 and
vitals are within normal limits. Along with a pelvic
examination, what is the next most appropriate step in the
evaluation of this patient?
Well done!You answered successfully
A. Luteinizing and follicle stimulating hormones
B. Sonohysterography
C. Endometrial sampling
D. Gonorrhea and chlamydia testing - ANSWER-C.
Endometrial sampling
An 18-year-old white female presents for a wellness
examination. After some questioning, she admits to heavy
menstrual cycles that are 28 days apart and last 7-8 days.
She reports the passage of clots and on her heaviest
days, having to change her pads every 1-2 hours. She is
not sexually active and denies any significant past medical
history. She does admit to an episode of heavy bleeding
after tooth extraction for braces when she was 13 years
old. The physical examination is unremarkable except for
scattered ecchymoses on her bilateral shins. Which of the
following is the most appropriate step in the diagnosis of
this patient?
,3|Page
A. Endometrial biopsy
B. Thyroid function studies
C. Pelvic ultrasound
D. Coagulopathy studies - ANSWER-D. Coagulopathy
studies
A 65-year-old woman with a BMI of 32 kg/m2 comes to the
clinician with a complaint of two episodes of vaginal
bleeding in the past 40 days. She has a past medical
history of hypertension and diabetes mellitus type 2. On
both occasions, light spotting lasted for three days. She
experienced menopause at the age of 56 years. Currently,
she is afebrile and hemodynamically stable with an
unremarkable physical examination. She takes metformin
and lisinopril. What is the first-line imaging study to
evaluate a patient with this complaint?
A. MRI
B. Transvaginal ultrasound
C. Sonohysterography
D. Hysteroscopy - ANSWER-B. Transvaginal ultrasound
A 16-year-old girl presents to the clinic with moderately
severe vaginal bleeding with lower abdominal cramping
, 4|Page
going for the past two months. She is not sexually active
and her last menstrual period was 3 weeks ago. Per FIGO
terminology, which of the following best identifies the
patient's presentation?
Well done!You answered successfully
A. Menorrhagia
B. Menometorrhagia
C. Dysfunctional uterine bleeding
D. Abnormal uterine bleeding - ANSWER-D. Abnormal
uterine bleeding
A 25-year-old G0P0 female presents with intermittent
abdominal pain. She states that the pain starts before her
period, is "crampy" in nature, and lasts for a few days
after, and has been occurring intermittently since
menarche. Her periods have been regular, with no spotting
or pain in between periods. Her last period was a week
ago. She has no other health issues and takes no
medications. She has had no previous surgeries in the
past. She is currently sexually active with her husband and
is interested in starting a family shortly. What is the first
line of treatment for this patient?
Well done!You answered successfully
A. Morphine
B. Selective serotonin reuptake inhibitor
