1
NSG 550 / NSG550 Exam 3 Actual Exam
2026/2027 | Diagnostic Reasoning for
Nurse Practitioners | Wilkes | Questions
with Verified Answers | 100% Correct |
Pass Guaranteed
Q001: A 34-year-old teacher presents with 3 weeks of non-productive cough worse
at night, no wheeze, normal CXR, and a 15-pack-year history. Spirometry shows
FEV₁ 85 % predicted with a 12 % increase post-bronchodilator. Methacholine
challenge is borderline positive; FeNO is 55 ppb. Which diagnosis best integrates
these findings?
Options:
A. GERD-related cough
B. Allergic asthma with early reversible airway changes - CORRECT
C. Vocal-cord dysfunction
D. Post-infectious bronchial hyper-responsiveness
ANSWER: B
Q002: A 28-year-old woman has cyclic fevers, night sweats, and a 1 cm left
supraclavicular node with rubbery texture. CBC shows eosinophilia 18 %, LDH
2.8× ULN, and negative Quantiferon. Excisional biopsy reveals CD15+ and
CD30+ large cells. Which diagnostic test best determines stage?
Options:
A. PET-CT scan - CORRECT
B. Bone marrow aspirate only
, 2
C. Chest CT without contrast
D. Serum protein electrophoresis
ANSWER: A
Q003: A 56-year-old man with HTN on amlodipine notes 2 weeks of bilateral hand
arthralgias worse in the morning, lasting 45 min. RF is 28 IU/mL (nl <14), anti-
CCP 45 U/mL (nl <20), ESR 42 mm/h, and hand X-rays show no erosions. Which
diagnosis is most appropriate?
Options:
A. Early rheumatoid arthritis - CORRECT
B. Osteoarthritis
C. Polymyalgia rheumatica
D. Parvovirus B19 arthropathy
ANSWER: A
Q004: A 42-year-old man with DM2 has 3 days of right-foot burning pain and mild
erythema between toes; no ulceration. Temperature 37.2 °C, glucose 210 mg/dL,
WBC 9.5 k/µL. Probe-to-bone test is negative. Which diagnostic approach is best?
Options:
A. Empiric oral cephalexin and revisit in 48 h
B. X-ray and MRI if no improvement in 24 h
C. Swab culture and start doxycline-clindamycin
D. Blood cultures and IV antibiotics - CORRECT
ANSWER: B
Q005: A 30-year-old woman presents with 4 weeks of watery diarrhea (3–4/day),
nocturnal abdominal pain, and 3 kg weight loss. Stool calprotectin is 850 µg/g (nl
<50), CRP 28 mg/L, and negative O&P. Colonoscopy shows continuous
inflammation to the splenic flexure. Which diagnosis is most likely?
Options:
, 3
A. Crohn disease
B. Ulcerative colitis - CORRECT
C. Microscopic colitis
D. Post-infectious IBS
ANSWER: B
Q006: A 38-year-old woman develops acute dyspnea 3 days postpartum; HR 105
bpm, BP 98/60, RR 24, O₂ sat 91 % RA, and clear lungs. D-dimer is 1800 ng/mL,
chest CT shows bilateral peripheral ground-glass opacities, and echo reveals RV
strain. Which diagnosis best unifies these findings?
Options:
A. Acute PE with infarction
B. Post-partum cardiomyopathy
C. AFE (amniotic fluid embolism) - CORRECT
D. Peripartum pneumonia
ANSWER: C
Q007: A 48-year-old man with chronic HCV has sudden onset of confusion,
asterixis, and INR 3.2. Ammonia is 180 µmol/L, bilirubin 4 mg/dL, and ALT 85
U/L. Ultrasound shows ascites and patent portal vein. Which additional test best
grades encephalopathy severity?
Options:
A. West-Haven criteria - CORRECT
B. Child-Pugh score
C. MELD score
D. Glasgow Coma Scale
ANSWER: A
NSG 550 / NSG550 Exam 3 Actual Exam
2026/2027 | Diagnostic Reasoning for
Nurse Practitioners | Wilkes | Questions
with Verified Answers | 100% Correct |
Pass Guaranteed
Q001: A 34-year-old teacher presents with 3 weeks of non-productive cough worse
at night, no wheeze, normal CXR, and a 15-pack-year history. Spirometry shows
FEV₁ 85 % predicted with a 12 % increase post-bronchodilator. Methacholine
challenge is borderline positive; FeNO is 55 ppb. Which diagnosis best integrates
these findings?
Options:
A. GERD-related cough
B. Allergic asthma with early reversible airway changes - CORRECT
C. Vocal-cord dysfunction
D. Post-infectious bronchial hyper-responsiveness
ANSWER: B
Q002: A 28-year-old woman has cyclic fevers, night sweats, and a 1 cm left
supraclavicular node with rubbery texture. CBC shows eosinophilia 18 %, LDH
2.8× ULN, and negative Quantiferon. Excisional biopsy reveals CD15+ and
CD30+ large cells. Which diagnostic test best determines stage?
Options:
A. PET-CT scan - CORRECT
B. Bone marrow aspirate only
, 2
C. Chest CT without contrast
D. Serum protein electrophoresis
ANSWER: A
Q003: A 56-year-old man with HTN on amlodipine notes 2 weeks of bilateral hand
arthralgias worse in the morning, lasting 45 min. RF is 28 IU/mL (nl <14), anti-
CCP 45 U/mL (nl <20), ESR 42 mm/h, and hand X-rays show no erosions. Which
diagnosis is most appropriate?
Options:
A. Early rheumatoid arthritis - CORRECT
B. Osteoarthritis
C. Polymyalgia rheumatica
D. Parvovirus B19 arthropathy
ANSWER: A
Q004: A 42-year-old man with DM2 has 3 days of right-foot burning pain and mild
erythema between toes; no ulceration. Temperature 37.2 °C, glucose 210 mg/dL,
WBC 9.5 k/µL. Probe-to-bone test is negative. Which diagnostic approach is best?
Options:
A. Empiric oral cephalexin and revisit in 48 h
B. X-ray and MRI if no improvement in 24 h
C. Swab culture and start doxycline-clindamycin
D. Blood cultures and IV antibiotics - CORRECT
ANSWER: B
Q005: A 30-year-old woman presents with 4 weeks of watery diarrhea (3–4/day),
nocturnal abdominal pain, and 3 kg weight loss. Stool calprotectin is 850 µg/g (nl
<50), CRP 28 mg/L, and negative O&P. Colonoscopy shows continuous
inflammation to the splenic flexure. Which diagnosis is most likely?
Options:
, 3
A. Crohn disease
B. Ulcerative colitis - CORRECT
C. Microscopic colitis
D. Post-infectious IBS
ANSWER: B
Q006: A 38-year-old woman develops acute dyspnea 3 days postpartum; HR 105
bpm, BP 98/60, RR 24, O₂ sat 91 % RA, and clear lungs. D-dimer is 1800 ng/mL,
chest CT shows bilateral peripheral ground-glass opacities, and echo reveals RV
strain. Which diagnosis best unifies these findings?
Options:
A. Acute PE with infarction
B. Post-partum cardiomyopathy
C. AFE (amniotic fluid embolism) - CORRECT
D. Peripartum pneumonia
ANSWER: C
Q007: A 48-year-old man with chronic HCV has sudden onset of confusion,
asterixis, and INR 3.2. Ammonia is 180 µmol/L, bilirubin 4 mg/dL, and ALT 85
U/L. Ultrasound shows ascites and patent portal vein. Which additional test best
grades encephalopathy severity?
Options:
A. West-Haven criteria - CORRECT
B. Child-Pugh score
C. MELD score
D. Glasgow Coma Scale
ANSWER: A
