MSN 622 FINAL EXAM NEWEST 2024
ACTUAL EXAM COMPLETE 200
QUESTIONS AND CORRECT
DETAILED ANSWERS
(VERIFIED ANSWERS)
blowing - ANSWER-A 67-year-old man with a history of
hypertension and tobacco use presents with a two-day
history of hypogastric pain. An examination reveals a 5 cm, non-
tender, pulsatile abdominal mass above the
umbilicus. Which of the following type of sounds might be heard
upon auscultation at the midline, two inches
cephalad to the
umbilicus?
ultrasound every 3 years - ANSWER-What is the recommended
management for a patient with a 3.5 cm abdominal
aortic
aneurysm?
immediate surgery - ANSWER-A 75-year-old man presents to the
emergency department with complaints of severe
abdominal pain and sweating. The pain started about an hour ago
and is becoming worse with time. He has been
,diagnosed with hypertension and diabetes and is on amlodipine and
metformin, respectively. On presentation, the
vital signs show blood pressure 70/40 mmHg, pulse 140/min,
respiratory rate 32/min, temperature 38.5 C (101.3 F),
and oxygen saturation 87% at room air. On physical examination
of the abdomen, generalized tenderness and
guarding are seen. There is a midline pulsatile mass. What is the next
best step in the management of this patient?
abdominal CT - ANSWER-A 67-year-old male with a history of
hypertension and nicotine dependence presents to the emergency
department with sudden onset of abdominal pain radiating to the
back. There is no history of alcohol use. On examination, he is thin,
pale, and diaphoretic. His vital signs show a blood pressure of 110/70
mmHg and a heart rate of 95 bpm. Which of the following is most
likely to confirm the diagnosis?
Surgery will improve 5-year survival - ANSWER-A 78-year-old is found
to have an asymptomatic pulsatile abdominal
mass. The ultrasound shows an abdominal aortic aneurysm
measuring 5.5 cm. Which of the following statements
concerning this patient's
condition is correct?
stress electrocardiogram - ANSWER-A 65-year-old man presents to
the office with complaints of occasional chest pain. The patient has a
,past medical history significant for hypertension, diabetes mellitus,
and hyperlipidemia. The patient states he experiences chest pain on
exertion, which is only relieved on rest. An electrocardiogram is
normal. Which of the following is the next step in management?
Determining the precipitating factors for his condition - ANSWER-A
65-year-old man presents with complaints of chest pain that started
30 mins ago but stopped on his way to the hospital. The patient has a
past medical history significant for hypertension and diabetes
mellitus. An electrocardiogram (ECG) is normal. A stress ECG shows
mild ST elevations after 12 minutes of exercise. A diagnosis of stable
angina is made. Which of the following should be the first step in
counseling the patient about his condition?
hypertensive emergency - ANSWER-A 47-year-old male presents to
the office for routine health maintenance. His blood pressure is
182/138, with all other vital signs within normal limits. The patient is
currently complaining of a headache and blurred vision but denies
chest pain, shortness of breath, and abdominal pain. Under which of
the following forms of hypertension would this patient be classified
Losartan/hydrochlorothiazide and atorvastatin - ANSWER-A 65-year-
old male with a history of type 2 diabetes comes
into the provider's office complaining of blurry vision, nosebleeds,
and exertional chest pain for the past six months.
, The blood pressure is measured to be 160/94 mmHg. A CT angiogram
is performed, which reveals partially occlusive
coronary artery plaques. Which of the following medication
regimens would be most appropriate for this patient?
Reassure him that this is expected from his ACE inhibitor and
continue therapy with periodic monitoring. - ANSWERA 68-year-old
male with a past medical history of type 2 diabetes mellitus and
diabetic nephropathy presented to the clinic for a follow-up
appointment. His blood pressure on the last visit was 150/90 mmHg.
He was called in for a
follow-up appointment in 4 weeks to monitor his blood pressure. The
blood pressure on this visit is 168/105 mmHg,
and HbA1c is 8.9%. His antihypertensive regimen was adjusted, and an
ACE inhibitor was added. He is on metformin
and sitagliptin for diabetes mellitus. One week later, his blood
pressure was 130/80 mmHg, the patient's potassium
was 5.1 mEq/L, sodium was 133 mEq/L, and the rest of the renal
panel was within normal limits. He reports no
symptoms. What is the next
best step in his care?
Reassurance - ANSWER-A 50-year-old man presents to the clinic for
routine evaluation. His systolic blood pressure has persistently been
in the 150-160 mmHg range. Treatment with ramipril is initiated. On
the next visit, he complained of an itchy throat and a dry cough,
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