WILKES NSG 550 EXAM 3 –
DIAGNOSTIC REASONING STUDY
GUIDE QUESTIONS AND ANSWERS
1. Which phase of the dual-process theory involves fast, intuitive, and unconscious pattern
recognition?
A. System 1 Thinking
B. System 2 Thinking
C. Hypothetico-deductive reasoning
D. Evidence-based synthesis
Answer: A
Conceptual Explanation: System 1 is fast, automatic, and relies on heuristics or pattern
recognition, whereas System 2 is analytical, slow, and effortful.
2. A test with high specificity is most useful for which clinical purpose?
A. Screening for a rare disease
B. Ruling out a diagnosis (SnNOut)
C. Ruling in a diagnosis (SpPIn)
D. Identifying all possible cases in a population
,Answer: C
Conceptual Explanation: Specificity refers to the ability of a test to correctly identify those
without the disease. A highly specific test, when positive, helps rule in the diagnosis
(SpPIn).
3. In the Centor Criteria for Group A Beta-hemolytic Streptococcus, which of the following
earns one point?
A. Anterior cervical lymphadenopathy
B. Abdominal pain
C. Presence of a cough
D. Age over 45 years
Answer: A
Conceptual Explanation: Centor criteria include tonsillar exudates, tender anterior
cervical lymphadenopathy, fever history, and absence of cough.
4. Which cognitive bias occurs when a clinician focuses on the first piece of information
obtained and fails to adjust their diagnosis in light of subsequent information?
A. Availability heuristic
B. Anchoring bias
C. Confirmation bias
D. Premature closure
, Answer: B
Conceptual Explanation: Anchoring bias is the tendency to rely too heavily on the first
piece of information offered (‘the anchor’) when making decisions.
5. A 45-year-old male presents with sudden onset of severe ‘thunderclap’ headache. Which
diagnostic study is the most immediate priority?
A. Lumbar puncture
B. MRI brain with contrast
C. Non-contrast CT head
D. MRA of the Circle of Willis
Answer: C
Conceptual Explanation: Sudden ‘thunderclap’ headache is a red flag for subarachnoid
hemorrhage; a non-contrast CT is the first-line emergency diagnostic tool.
6. What does a Positive Likelihood Ratio (LR+) of 10 or greater indicate?
A. A small, rarely important change in post-test probability
B. A large and often conclusive increase in the likelihood of disease
C. A moderate increase in the likelihood of disease
D. The test has no diagnostic value
Answer: B
DIAGNOSTIC REASONING STUDY
GUIDE QUESTIONS AND ANSWERS
1. Which phase of the dual-process theory involves fast, intuitive, and unconscious pattern
recognition?
A. System 1 Thinking
B. System 2 Thinking
C. Hypothetico-deductive reasoning
D. Evidence-based synthesis
Answer: A
Conceptual Explanation: System 1 is fast, automatic, and relies on heuristics or pattern
recognition, whereas System 2 is analytical, slow, and effortful.
2. A test with high specificity is most useful for which clinical purpose?
A. Screening for a rare disease
B. Ruling out a diagnosis (SnNOut)
C. Ruling in a diagnosis (SpPIn)
D. Identifying all possible cases in a population
,Answer: C
Conceptual Explanation: Specificity refers to the ability of a test to correctly identify those
without the disease. A highly specific test, when positive, helps rule in the diagnosis
(SpPIn).
3. In the Centor Criteria for Group A Beta-hemolytic Streptococcus, which of the following
earns one point?
A. Anterior cervical lymphadenopathy
B. Abdominal pain
C. Presence of a cough
D. Age over 45 years
Answer: A
Conceptual Explanation: Centor criteria include tonsillar exudates, tender anterior
cervical lymphadenopathy, fever history, and absence of cough.
4. Which cognitive bias occurs when a clinician focuses on the first piece of information
obtained and fails to adjust their diagnosis in light of subsequent information?
A. Availability heuristic
B. Anchoring bias
C. Confirmation bias
D. Premature closure
, Answer: B
Conceptual Explanation: Anchoring bias is the tendency to rely too heavily on the first
piece of information offered (‘the anchor’) when making decisions.
5. A 45-year-old male presents with sudden onset of severe ‘thunderclap’ headache. Which
diagnostic study is the most immediate priority?
A. Lumbar puncture
B. MRI brain with contrast
C. Non-contrast CT head
D. MRA of the Circle of Willis
Answer: C
Conceptual Explanation: Sudden ‘thunderclap’ headache is a red flag for subarachnoid
hemorrhage; a non-contrast CT is the first-line emergency diagnostic tool.
6. What does a Positive Likelihood Ratio (LR+) of 10 or greater indicate?
A. A small, rarely important change in post-test probability
B. A large and often conclusive increase in the likelihood of disease
C. A moderate increase in the likelihood of disease
D. The test has no diagnostic value
Answer: B
