NSG 550 DIAGNOSTIC REASONING
COMPREHENSIVE (EXAMS 1-3)
QUESTIONS AND ANSWERS
1. When evaluating the diagnostic power of a clinical test, which term refers to the
probability that a person with a negative test result is truly free of the disease?
A. Sensitivity
B. Specificity
C. Positive Predictive Value
D. Negative Predictive Value
Answer: D
Conceptual Explanation: Negative Predictive Value (NPV) is the proportion of patients
with a negative test result who are actually disease-free. It is highly dependent on the
prevalence of the condition in the population.
2. A 65-year-old patient presents with sudden, painless loss of vision in one eye described as
a ‘curtain being pulled down.’ This is most characteristic of:
A. Acute Angle-Closure Glaucoma
B. Cataracts
,C. Macular Degeneration
D. Retinal Detachment
Answer: D
Conceptual Explanation: Retinal detachment typically presents as a sudden, painless loss
of vision or the appearance of floaters and flashes, often described as a shadow or curtain
moving across the field of vision.
3. During a fundoscopic exam, you observe AV nicking and copper wiring of the arterioles.
Which condition is the most likely underlying cause?
A. Diabetes Mellitus
B. Increased Intracranial Pressure
C. Chronic Hypertension
D. Hyperlipidemia
Answer: C
Conceptual Explanation: AV nicking (arteriovenous nicking) and copper/silver wiring are
classic fundoscopic findings associated with chronic hypertensive retinopathy.
4. In a patient with conductive hearing loss in the right ear, what would you expect to find
during the Weber and Rinne tests?
A. Weber lateralizes to the left; Rinne AC > BC
B. Weber lateralizes to the right; Rinne BC > AC in the right ear
, C. Weber lateralizes to the right; Rinne AC > BC in the right ear
D. Weber stays midline; Rinne BC > AC
Answer: B
Conceptual Explanation: In conductive hearing loss, the Weber test lateralizes to the
affected (impaired) ear, and the Rinne test shows Bone Conduction (BC) is greater than or
equal to Air Conduction (AC) in that same ear.
5. Which of the following physical exam findings is most specific for an acute anterior cruciate
ligament (ACL) tear?
A. Positive McMurray test
B. Positive Valgus stress test
C. Positive Lachman test
D. Positive Bulge sign
Answer: C
Conceptual Explanation: The Lachman test is considered the most sensitive and specific
clinical test for detecting an ACL tear, superior to the Anterior Drawer test.
6. A 45-year-old male presents with acute right upper quadrant pain that radiates to the right
scapula. Palpation of the RUQ during deep inspiration causes the patient to catch his breath.
What is this sign called?
A. Rovsing sign
COMPREHENSIVE (EXAMS 1-3)
QUESTIONS AND ANSWERS
1. When evaluating the diagnostic power of a clinical test, which term refers to the
probability that a person with a negative test result is truly free of the disease?
A. Sensitivity
B. Specificity
C. Positive Predictive Value
D. Negative Predictive Value
Answer: D
Conceptual Explanation: Negative Predictive Value (NPV) is the proportion of patients
with a negative test result who are actually disease-free. It is highly dependent on the
prevalence of the condition in the population.
2. A 65-year-old patient presents with sudden, painless loss of vision in one eye described as
a ‘curtain being pulled down.’ This is most characteristic of:
A. Acute Angle-Closure Glaucoma
B. Cataracts
,C. Macular Degeneration
D. Retinal Detachment
Answer: D
Conceptual Explanation: Retinal detachment typically presents as a sudden, painless loss
of vision or the appearance of floaters and flashes, often described as a shadow or curtain
moving across the field of vision.
3. During a fundoscopic exam, you observe AV nicking and copper wiring of the arterioles.
Which condition is the most likely underlying cause?
A. Diabetes Mellitus
B. Increased Intracranial Pressure
C. Chronic Hypertension
D. Hyperlipidemia
Answer: C
Conceptual Explanation: AV nicking (arteriovenous nicking) and copper/silver wiring are
classic fundoscopic findings associated with chronic hypertensive retinopathy.
4. In a patient with conductive hearing loss in the right ear, what would you expect to find
during the Weber and Rinne tests?
A. Weber lateralizes to the left; Rinne AC > BC
B. Weber lateralizes to the right; Rinne BC > AC in the right ear
, C. Weber lateralizes to the right; Rinne AC > BC in the right ear
D. Weber stays midline; Rinne BC > AC
Answer: B
Conceptual Explanation: In conductive hearing loss, the Weber test lateralizes to the
affected (impaired) ear, and the Rinne test shows Bone Conduction (BC) is greater than or
equal to Air Conduction (AC) in that same ear.
5. Which of the following physical exam findings is most specific for an acute anterior cruciate
ligament (ACL) tear?
A. Positive McMurray test
B. Positive Valgus stress test
C. Positive Lachman test
D. Positive Bulge sign
Answer: C
Conceptual Explanation: The Lachman test is considered the most sensitive and specific
clinical test for detecting an ACL tear, superior to the Anterior Drawer test.
6. A 45-year-old male presents with acute right upper quadrant pain that radiates to the right
scapula. Palpation of the RUQ during deep inspiration causes the patient to catch his breath.
What is this sign called?
A. Rovsing sign
