,NSG 550 Exam 3 | Advanced Pathophysiology
Wilkes University | Q & A | 2026/2027 Edition (PDF)
**1. Which of the following best describes the fundamental difference between MRI and MRA?**
A) MRI evaluates bone density, while MRA evaluates soft tissue structures
B) MRI provides information on structures and ventricles but cannot give information on blood vessels,
while MRA visualizes blood vessels and blood flow
C) MRI uses ionizing radiation, while MRA uses magnetic fields only
D) MRI is used for cancer screening, while MRA is used for fracture detection
Correct Answer: MRI provides information on structures and ventricles but cannot give information on
blood vessels, while MRA visualizes blood vessels and blood flow
Rationale: MRI (Magnetic Resonance Imaging) provides detailed images of soft tissues, structures, and
ventricles but does not visualize blood vessels directly. MRA (Magnetic Resonance Angiography) is a
specialized MRI sequence that visualizes blood vessels and blood flow without the need for contrast in
some cases. Understanding when to order each is essential for appropriate diagnostic imaging selection.
**2. A 58-year-old female with dense breast tissue undergoes screening mammography. The radiologist
reports a BI-RADS category 3 finding. Which of the following is the most appropriate management?**
A) Immediate biopsy
B) Routine annual screening
C) Short-interval follow-up (6-month) mammography
D) MRI for further evaluation
Correct Answer: Short-interval follow-up (6-month) mammography
Rationale: BI-RADS category 3 indicates a probably benign finding with a less than 2% chance of
malignancy. The standard recommendation is short-interval follow-up mammography at 6 months to
assess for stability. Category 0 requires additional imaging, Category 4 requires biopsy, and Category 5 is
highly suggestive of malignancy.
,**3. According to the Bethesda System for reporting cervical cytology, which of the following findings
would require immediate colposcopy referral?**
A) Atypical squamous cells of undetermined significance (ASC-US)
B) Low-grade squamous intraepithelial lesion (LSIL)
C) High-grade squamous intraepithelial lesion (HSIL)
D) Normal cytology with positive high-risk HPV
Correct Answer: High-grade squamous intraepithelial lesion (HSIL)
Rationale: The Bethesda System categorizes cervical cytology findings. HSIL is a high-grade lesion that
requires immediate colposcopy referral for further evaluation and potential biopsy. ASC-US may be
managed with HPV triage or repeat cytology. LSIL often resolves spontaneously. HPV-positive with
normal cytology typically requires follow-up rather than immediate colposcopy.
**4. What is the primary clinical indication for performing a colposcopy?**
A) Routine cervical cancer screening in all women over age 21
B) Evaluation of an abnormal Pap smear or HPV-positive result
C) Diagnosis of pelvic inflammatory disease
D) Assessment of endometrial thickness
Correct Answer: Evaluation of an abnormal Pap smear or HPV-positive result
Rationale: Colposcopy is an examination of the cervix, vagina, and vulva through a magnifying device
(colposcope). It is typically performed when a patient has an abnormal Pap smear (screening result) or
concern for HPV. It allows for directed biopsy of suspicious lesions and can be performed at the bedside.
**5. Which of the following diagnostic imaging modalities is most appropriate for evaluating a patient
with suspected acute ischemic stroke within the first 6 hours of symptom onset?**
A) CT head without contrast
B) MRI brain with diffusion-weighted imaging (DWI)
C) CT angiography of the head and neck
, D) Carotid Doppler ultrasound
Correct Answer: CT head without contrast
Rationale: Non-contrast CT head is the initial imaging study of choice for suspected acute stroke because
it rapidly excludes hemorrhage, which is a contraindication to thrombolytic therapy. While MRI with
DWI is more sensitive for early ischemia, CT is faster and more widely available in the acute setting. CTA
and Doppler are used for vascular evaluation but are not the initial test.
**6. A 72-year-old male with a history of hypertension presents with sudden, severe headache and
vomiting. Non-contrast CT head shows a hyperdense lesion in the basal ganglia. Which of the following
is the most likely diagnosis?**
A) Ischemic stroke
B) Subarachnoid hemorrhage
C) Intracerebral hemorrhage
D) Brain tumor
Correct Answer: Intracerebral hemorrhage
Rationale: A hyperdense (bright) lesion on non-contrast CT in the basal ganglia is characteristic of acute
intracerebral hemorrhage. Hypertension is the most common cause of intracerebral hemorrhage in the
basal ganglia. Ischemic stroke appears as a hypodense (dark) area. Subarachnoid hemorrhage appears as
hyperdensity in the subarachnoid spaces. Tumors may appear as hypodense or isodense lesions.
**7. Which of the following is the most appropriate screening test for colorectal cancer in an average-
risk 55-year-old patient?**
A) Fecal immunochemical test (FIT) annually
B) Colonoscopy every 10 years
C) CT colonography every 5 years
D) All of the above are acceptable screening options
Correct Answer: All of the above are acceptable screening options
Wilkes University | Q & A | 2026/2027 Edition (PDF)
**1. Which of the following best describes the fundamental difference between MRI and MRA?**
A) MRI evaluates bone density, while MRA evaluates soft tissue structures
B) MRI provides information on structures and ventricles but cannot give information on blood vessels,
while MRA visualizes blood vessels and blood flow
C) MRI uses ionizing radiation, while MRA uses magnetic fields only
D) MRI is used for cancer screening, while MRA is used for fracture detection
Correct Answer: MRI provides information on structures and ventricles but cannot give information on
blood vessels, while MRA visualizes blood vessels and blood flow
Rationale: MRI (Magnetic Resonance Imaging) provides detailed images of soft tissues, structures, and
ventricles but does not visualize blood vessels directly. MRA (Magnetic Resonance Angiography) is a
specialized MRI sequence that visualizes blood vessels and blood flow without the need for contrast in
some cases. Understanding when to order each is essential for appropriate diagnostic imaging selection.
**2. A 58-year-old female with dense breast tissue undergoes screening mammography. The radiologist
reports a BI-RADS category 3 finding. Which of the following is the most appropriate management?**
A) Immediate biopsy
B) Routine annual screening
C) Short-interval follow-up (6-month) mammography
D) MRI for further evaluation
Correct Answer: Short-interval follow-up (6-month) mammography
Rationale: BI-RADS category 3 indicates a probably benign finding with a less than 2% chance of
malignancy. The standard recommendation is short-interval follow-up mammography at 6 months to
assess for stability. Category 0 requires additional imaging, Category 4 requires biopsy, and Category 5 is
highly suggestive of malignancy.
,**3. According to the Bethesda System for reporting cervical cytology, which of the following findings
would require immediate colposcopy referral?**
A) Atypical squamous cells of undetermined significance (ASC-US)
B) Low-grade squamous intraepithelial lesion (LSIL)
C) High-grade squamous intraepithelial lesion (HSIL)
D) Normal cytology with positive high-risk HPV
Correct Answer: High-grade squamous intraepithelial lesion (HSIL)
Rationale: The Bethesda System categorizes cervical cytology findings. HSIL is a high-grade lesion that
requires immediate colposcopy referral for further evaluation and potential biopsy. ASC-US may be
managed with HPV triage or repeat cytology. LSIL often resolves spontaneously. HPV-positive with
normal cytology typically requires follow-up rather than immediate colposcopy.
**4. What is the primary clinical indication for performing a colposcopy?**
A) Routine cervical cancer screening in all women over age 21
B) Evaluation of an abnormal Pap smear or HPV-positive result
C) Diagnosis of pelvic inflammatory disease
D) Assessment of endometrial thickness
Correct Answer: Evaluation of an abnormal Pap smear or HPV-positive result
Rationale: Colposcopy is an examination of the cervix, vagina, and vulva through a magnifying device
(colposcope). It is typically performed when a patient has an abnormal Pap smear (screening result) or
concern for HPV. It allows for directed biopsy of suspicious lesions and can be performed at the bedside.
**5. Which of the following diagnostic imaging modalities is most appropriate for evaluating a patient
with suspected acute ischemic stroke within the first 6 hours of symptom onset?**
A) CT head without contrast
B) MRI brain with diffusion-weighted imaging (DWI)
C) CT angiography of the head and neck
, D) Carotid Doppler ultrasound
Correct Answer: CT head without contrast
Rationale: Non-contrast CT head is the initial imaging study of choice for suspected acute stroke because
it rapidly excludes hemorrhage, which is a contraindication to thrombolytic therapy. While MRI with
DWI is more sensitive for early ischemia, CT is faster and more widely available in the acute setting. CTA
and Doppler are used for vascular evaluation but are not the initial test.
**6. A 72-year-old male with a history of hypertension presents with sudden, severe headache and
vomiting. Non-contrast CT head shows a hyperdense lesion in the basal ganglia. Which of the following
is the most likely diagnosis?**
A) Ischemic stroke
B) Subarachnoid hemorrhage
C) Intracerebral hemorrhage
D) Brain tumor
Correct Answer: Intracerebral hemorrhage
Rationale: A hyperdense (bright) lesion on non-contrast CT in the basal ganglia is characteristic of acute
intracerebral hemorrhage. Hypertension is the most common cause of intracerebral hemorrhage in the
basal ganglia. Ischemic stroke appears as a hypodense (dark) area. Subarachnoid hemorrhage appears as
hyperdensity in the subarachnoid spaces. Tumors may appear as hypodense or isodense lesions.
**7. Which of the following is the most appropriate screening test for colorectal cancer in an average-
risk 55-year-old patient?**
A) Fecal immunochemical test (FIT) annually
B) Colonoscopy every 10 years
C) CT colonography every 5 years
D) All of the above are acceptable screening options
Correct Answer: All of the above are acceptable screening options
