NSG 550 DIAGNOSTIC REASONING
COMPREHENSIVE EXAM (1-3)
QUESTIONS AND ANSWERS
1. In the context of diagnostic reasoning, which term refers to the probability that a person
with a disease will have a positive test result?
A. Sensitivity
B. Specificity
C. Positive Predictive Value
D. Likelihood Ratio
Answer: A
Conceptual Explanation: Sensitivity (Sn) is the proportion of true positives that are
correctly identified by the test. High sensitivity is useful for ‘SnNout’ (ruling out) a disease
when the result is negative.
2. Which cognitive bias occurs when a clinician relies too heavily on the first piece of
information offered during the diagnostic process?
A. Anchoring bias
B. Availability heuristic
C. Confirmation bias
,D. Premature closure
Answer: A
Conceptual Explanation: Anchoring bias is the tendency to fixate on initial information
and fail to adequately adjust for subsequent information.
3. A patient presents with a ‘curtain dropping’ over their vision in the right eye. This symptom
is most characteristic of which condition?
A. Retinal Detachment
B. Acute Angle Closure Glaucoma
C. Macular Degeneration
D. Cataracts
Answer: A
Conceptual Explanation: Retinal detachment often presents as a sudden, painless loss of
vision described as a curtain or shadow being pulled across the eye.
4. During a Weber test, sound lateralizes to the patient’s right ear. The Rinne test on the right
ear shows Bone Conduction (BC) > Air Conduction (AC). What is the interpretation?
A. Sensorineural hearing loss in the right ear
B. Conductive hearing loss in the right ear
C. Sensorineural hearing loss in the left ear
D. Normal hearing
, Answer: B
Conceptual Explanation: In conductive hearing loss, sound lateralizes to the impaired ear
in the Weber test, and BC > AC (negative Rinne) in that same ear.
5. Which heart sound is considered a hallmark of heart failure in older adults and is caused by
rapid ventricular filling?
A. S3
B. S2
C. S1
D. S4
Answer: A
Conceptual Explanation: The S3 gallop is associated with fluid volume overload and rapid
filling of a dilated ventricle, typical in congestive heart failure.
6. A 45-year-old female presents with sharp, stabbing chest pain that worsens when she
breathes deeply or coughs. This is best described as:
A. Anginal pain
B. Gastroesophageal reflux
C. Musculoskeletal pain
D. Pleuritic pain
Answer: D
COMPREHENSIVE EXAM (1-3)
QUESTIONS AND ANSWERS
1. In the context of diagnostic reasoning, which term refers to the probability that a person
with a disease will have a positive test result?
A. Sensitivity
B. Specificity
C. Positive Predictive Value
D. Likelihood Ratio
Answer: A
Conceptual Explanation: Sensitivity (Sn) is the proportion of true positives that are
correctly identified by the test. High sensitivity is useful for ‘SnNout’ (ruling out) a disease
when the result is negative.
2. Which cognitive bias occurs when a clinician relies too heavily on the first piece of
information offered during the diagnostic process?
A. Anchoring bias
B. Availability heuristic
C. Confirmation bias
,D. Premature closure
Answer: A
Conceptual Explanation: Anchoring bias is the tendency to fixate on initial information
and fail to adequately adjust for subsequent information.
3. A patient presents with a ‘curtain dropping’ over their vision in the right eye. This symptom
is most characteristic of which condition?
A. Retinal Detachment
B. Acute Angle Closure Glaucoma
C. Macular Degeneration
D. Cataracts
Answer: A
Conceptual Explanation: Retinal detachment often presents as a sudden, painless loss of
vision described as a curtain or shadow being pulled across the eye.
4. During a Weber test, sound lateralizes to the patient’s right ear. The Rinne test on the right
ear shows Bone Conduction (BC) > Air Conduction (AC). What is the interpretation?
A. Sensorineural hearing loss in the right ear
B. Conductive hearing loss in the right ear
C. Sensorineural hearing loss in the left ear
D. Normal hearing
, Answer: B
Conceptual Explanation: In conductive hearing loss, sound lateralizes to the impaired ear
in the Weber test, and BC > AC (negative Rinne) in that same ear.
5. Which heart sound is considered a hallmark of heart failure in older adults and is caused by
rapid ventricular filling?
A. S3
B. S2
C. S1
D. S4
Answer: A
Conceptual Explanation: The S3 gallop is associated with fluid volume overload and rapid
filling of a dilated ventricle, typical in congestive heart failure.
6. A 45-year-old female presents with sharp, stabbing chest pain that worsens when she
breathes deeply or coughs. This is best described as:
A. Anginal pain
B. Gastroesophageal reflux
C. Musculoskeletal pain
D. Pleuritic pain
Answer: D
