EXAM 3
Diagnostic Reasoning
Actual Questions with Verified Answers
Wilkes University
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What You Will Get:
➢100 Exam Questions w/ Answers
➢Expert Rationales included.
➢Exam 3 Comprehensive Study Guide
,Table of Contents
NSG 550 Exam 3 .................................................. 2
NSG 550 Exam 3 Study Guide ............................. 51
NSG 550 Exam 3
Question 1
A 72-year-old female is brought to the clinic by her daughter, who reports that
her mother has had progressive memory loss over the past 3 years. She
forgets recent conversations, misplaces items daily, and recently got lost
driving home from the grocery store. She denies visual hallucinations or
movement disorders. Her MRI shows cortical atrophy and hippocampal
volume loss.
What is the most likely diagnosis?
• A. Vascular dementia
• B. Alzheimer's disease ✅ CORRECT
• C. Lewy body dementia
• D. Parkinsonism
Rationale: Alzheimer's disease (B) is the most common form of dementia,
characterized by progressive memory loss, cognitive decline, and changes in
behavior. The patient's gradual onset over years, prominent memory impairment,
and cortical atrophy on imaging are classic. Vascular dementia (A) typically has a
stepwise decline with focal neurologic deficits. Lewy body dementia (C) presents
with cognitive fluctuations, visual hallucinations, and movement disorders
(Parkinsonism). Parkinsonism (D) is a syndrome of tremors, rigidity, and
bradykinesia, not primarily a dementia diagnosis.
,Question 2
A 68-year-old male with a history of hypertension and two prior strokes
presents with abrupt onset of cognitive decline. His family notes that his
memory and executive function worsened stepwise after each
cerebrovascular event. He has no visual hallucinations.
Which type of dementia is most consistent with this presentation?
• A. Alzheimer's disease
• B. Lewy body dementia
• C. Vascular dementia ✅ CORRECT
• D. Frontotemporal dementia
Rationale: Vascular dementia (C) is the second most common type of dementia,
caused by reduced blood flow to the brain from cerebrovascular disease. The
stepwise decline correlating with stroke events is pathognomonic. Alzheimer's (A)
has a gradual, continuous decline. Lewy body dementia (B) features visual
hallucinations and fluctuating cognition. Frontotemporal dementia (D) presents
with personality/behavior changes and language impairment rather than stepwise
decline.
Question 3 (SATA)
A 65-year-old male presents with cognitive fluctuations, vivid visual
hallucinations of small animals in his home, and Parkinsonian features
including rigidity and bradykinesia. His symptoms fluctuate dramatically from
hour to hour.
Which of the following are characteristic features of this patient's most likely
diagnosis? Select all that apply.
• A. Abnormal protein deposits (Lewy bodies) in the brain ✅ CORRECT
• B. Cognitive fluctuations ✅ CORRECT
• C. Visual hallucinations ✅ CORRECT
• D. Movement disorders (Parkinsonism) ✅ CORRECT
• E. Stepwise cognitive decline after strokes
Rationale: This patient has Lewy body dementia (A, B, C, D), a progressive dementia
associated with abnormal protein deposits (Lewy bodies) in the brain. Core features
include cognitive fluctuations (B), visual hallucinations (C), and movement
, disorders/Parkinsonism (D). Stepwise decline after strokes (E) describes vascular
dementia, not Lewy body dementia.
Question 4
A 70-year-old female with Lewy body dementia develops worsening tremor,
rigidity, and bradykinesia. Her neurologist explains that these motor
symptoms are part of a broader syndrome.
Which syndrome is characterized by tremors, rigidity, and bradykinesia and
can occur with various types of dementia?
• A. Cerebellar ataxia
• B. Parkinsonism ✅ CORRECT
• C. Myoclonus
• D. Chorea
Rationale: Parkinsonism (B) is a syndrome characterized by tremors, rigidity, and
bradykinesia (slowed movement). It can occur in conjunction with various types of
dementia, particularly Lewy body dementia and Parkinson's disease dementia.
Cerebellar ataxia (A) involves coordination and balance. Myoclonus (C) is sudden
muscle jerking. Chorea (D) involves dance-like involuntary movements.
Question 5 (SATA)
A 45-year-old female presents for her annual well-woman examination. She
has no breast complaints. The nurse practitioner discusses breast cancer
screening options.
Which statements about mammography are correct? Select all that apply.
• A. Mammography uses low-dose x-ray for breast cancer detection. ✅
CORRECT
• B. Mammography can monitor benign breast conditions. ✅ CORRECT
• C. Mammography is used for surveillance after breast cancer treatment. ✅
CORRECT
• D. Mammography uses high-frequency sound waves instead of x-rays.
• E. Mammography is the only imaging modality needed for all breast evaluations.