MSN 620 Quiz Questions For Final Verified Answers
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 m...
MSN 620 Quiz Questions For Final Verified Answers
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 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?
1.
Weight-based dosing of ibuprofen
2.
Weight-based dosing of azithromycin for a 5-day treatment
3.
Point-of-care streptococcal antigen testing
4.
Bacterial culture of the throat
3
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....
1.
Send a throat swab for culture and record the patient's allergy to ampicillin.
2.
Send a throat swab for culture and order a complete blood count and heterophile antibodies.
3.
Send a throat swab for culture and take a punch biopsy of the patient's rash.
4.
Provide supportive care, and no additional testing is required.
2
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?
1.
Amoxicillin
2.
Clindamycin
,3.
Linezolid
4.
Vancomycin
2
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?
1.
ASO titer
2.
C-reactive protein
3.
Rapid antigen detection test
4.
Throat culture
3
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 examination reveals hyperemia and elevated
yellow-white lesions at the lower cul-de-sac. What is the most appropriate next step in management?
1.
Topical neomycin
2.
Topical bacitracin
3.
Topical ciprofloxacin
4.
Oral azithromycin
3
A 6-year-old girl is brought in with a 5-day history of sore throat and fever. Other children at school have
had similar symptoms. She has not had any cough during this time. Her medical and family history is
insignificant. Her vitals are currently within normal limits. On physical examination, her anterior cervical
nodes are palpable and tender. There are no exudates seen on the posterior pharyngeal wall. What is
the next best step in the management of this patient?
1.
Rapid antigen testing
A 46-year-old man presents with symptoms consistent with allergic rhinitis. He has a history of
depression and is treated with a selective serotonin reuptake inhibitor. He works as a school bus driver.
Which of the following should be used to treat his symptoms?
1.
Fexofenadine
2.
Hydroxyzine
3.
Diphenhydramine
4.
Chlorpheniramine
1
A 5-year-old boy is brought for evaluation of a sore throat for the past 5 days. His parents report no
cough during this period. His medical and family history is insignificant. Vitals show blood pressure
120/80 mm Hg, temperature of 100.4 °F (38 °C), and heart rate 78 bpm. On physical examination,
anterior cervical nodes are palpable and tender. Exudates are seen on the posterior pharyngeal wall. A
rapid antigen test was performed, which came back negative. Which of the following is the next best
step in management?
1.
No treatment required
2.
Start broad-spectrum antibiotics
3.
Start antiviral drugs
4.
Perform a throat culture
4
A 16-year-old boy presents with a 2-day history of sore throat, fever, and cough. He has been
experiencing difficulty swallowing food for the last 2 days. He has no significant medical history and is up
to date with his immunizations. His vital signs are temperature 100.6 °F (38.1 °C), heart rate 100 bpm,
and blood pressure 110/80 mm Hg. His physical examination reveals bilateral tonsillar exudates and
diffuse pharyngeal erythema. What is the next best step in management?
1.
Start the patient on amoxicillin empirically.
, 2.
Order a culture and sensitivity of a throat swab.
3.
Order a rapid strep test.
4.
Order a heterophile antibody test.
3
A 27-year-old man presents with fever, sore throat, and a generalized maculopapular erythematous
rash. He reports having sexual relations with other men. His rapid antigen test for Group A beta-
hemolytic streptococcus is negative. What is the next best step in the management of this patient?
1.
Obtain testing for human immunodeficiency virus (HIV), syphilis, chlamydia, and gonorrhea
2.
Urgently give penicillin V and follow up after 4 weeks
3.
Give a stat dose of azithromycin and perform urine dipstick
4.
Obtain a complete blood count and blood culture
1
A 2-year-old boy presents with a fever of 102 °F (38.9 °C). His physical examination reveals bilateral otitis
media with effusion with noted erythema on the right side. His parents state that this is his sixth
diagnosis of otitis media in the past 12 months. His parents also note that he only has 2 words that are
intelligible to them. Following the treatment of this patient for his acute otitis media, which of the
following is an appropriate management strategy?
1.
Tympanostomy tube placement
2.
Antibiotics administered for prophylaxis
3.
Nasal decongestants to aid in drainage
4.
Oral prednisone
1
Despite trying to manage a child diagnosed with otitis media with effusion conservatively, it is decided
an intervention is necessary. Following consultation with an otolaryngologist, it is decided to proceed
with the placement of bilateral ventilation tubes. Informed consent is obtained from the parents. Which
of the following is the most likely complication of tympanostomy tube placement?
1.
The development of granulation tissue
2.
The development of otorrhea
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