WILKES NSG 550 DIAGNOSTIC
REASONING COMPREHENSIVE EXAM
PREP QUESTIONS AND ANSWERS
1. A test with high sensitivity is most useful for which clinical purpose?
A. Ruling in a diagnosis when the test is positive
B. Predicting the survival rate of a patient
C. Determining the exact severity of a disease
D. Ruling out a diagnosis when the test is negative
Answer: D
Conceptual Explanation: High sensitivity (SnNOut) means that a negative result is very
reliable for ruling out a disease because there are very few false negatives.
2. Which cognitive bias involves the tendency to rely too heavily on the first piece of
information encountered during the diagnostic process?
A. Availability bias
B. Anchoring bias
C. Confirmation bias
,D. Premature closure
Answer: B
Conceptual Explanation: Anchoring bias is the tendency to fixate on initial information
and fail to adequately adjust subsequent assessments based on new data.
3. When the prevalence of a disease in a population increases, how does it affect the Positive
Predictive Value (PPV) of a diagnostic test?
A. PPV becomes zero
B. PPV decreases
C. PPV remains constant
D. PPV increases
Answer: D
Conceptual Explanation: PPV is highly dependent on prevalence; as the disease becomes
more common, a positive test result is more likely to represent a true positive.
4. In a SOAP note, where should the clinician document a patient’s report of ‘throbbing chest
pain’?
A. Objective
B. Assessment
C. Plan
D. Subjective
, Answer: D
Conceptual Explanation: Subjective data includes information provided by the patient,
such as symptoms, feelings, and perceptions.
5. Which of the following describes ‘Specificity’ in diagnostic testing?
A. The ability of a test to correctly identify those with the disease
B. The proportion of negative tests that are true negatives
C. The proportion of positive tests that are true positives
D. The ability of a test to correctly identify those without the disease
Answer: D
Conceptual Explanation: Specificity represents the True Negative rate, or the ability of the
test to identify individuals who do not have the condition.
6. Dual Process Theory in clinical reasoning suggests that ‘System 1’ thinking is:
A. Analytical, slow, and effortful
B. Logical and hypothesis-driven
C. Evidence-based and mathematically derived
D. Intuitive, fast, and pattern-based
Answer: D
REASONING COMPREHENSIVE EXAM
PREP QUESTIONS AND ANSWERS
1. A test with high sensitivity is most useful for which clinical purpose?
A. Ruling in a diagnosis when the test is positive
B. Predicting the survival rate of a patient
C. Determining the exact severity of a disease
D. Ruling out a diagnosis when the test is negative
Answer: D
Conceptual Explanation: High sensitivity (SnNOut) means that a negative result is very
reliable for ruling out a disease because there are very few false negatives.
2. Which cognitive bias involves the tendency to rely too heavily on the first piece of
information encountered during the diagnostic process?
A. Availability bias
B. Anchoring bias
C. Confirmation bias
,D. Premature closure
Answer: B
Conceptual Explanation: Anchoring bias is the tendency to fixate on initial information
and fail to adequately adjust subsequent assessments based on new data.
3. When the prevalence of a disease in a population increases, how does it affect the Positive
Predictive Value (PPV) of a diagnostic test?
A. PPV becomes zero
B. PPV decreases
C. PPV remains constant
D. PPV increases
Answer: D
Conceptual Explanation: PPV is highly dependent on prevalence; as the disease becomes
more common, a positive test result is more likely to represent a true positive.
4. In a SOAP note, where should the clinician document a patient’s report of ‘throbbing chest
pain’?
A. Objective
B. Assessment
C. Plan
D. Subjective
, Answer: D
Conceptual Explanation: Subjective data includes information provided by the patient,
such as symptoms, feelings, and perceptions.
5. Which of the following describes ‘Specificity’ in diagnostic testing?
A. The ability of a test to correctly identify those with the disease
B. The proportion of negative tests that are true negatives
C. The proportion of positive tests that are true positives
D. The ability of a test to correctly identify those without the disease
Answer: D
Conceptual Explanation: Specificity represents the True Negative rate, or the ability of the
test to identify individuals who do not have the condition.
6. Dual Process Theory in clinical reasoning suggests that ‘System 1’ thinking is:
A. Analytical, slow, and effortful
B. Logical and hypothesis-driven
C. Evidence-based and mathematically derived
D. Intuitive, fast, and pattern-based
Answer: D
