DIAGNOSTIC REASONING AND
CLINICAL DECISION MAKING (NSG
550) EXAMQUESTIONS AND ANSWERS
1. When a diagnostic test has high sensitivity, a negative result is most useful for which of the
following?
A. Ruling in the condition (SpPIn)
B. Confirming a diagnosis
C. Ruling out the condition (SnNout)
D. Calculating the post-test probability
Answer: C
Conceptual Explanation: Sensitivity refers to the proportion of people with a disease who
test positive. A highly sensitive test has very few false negatives, so a negative result
effectively rules out the disease.
2. Which statistical value represents the probability that a person without the disease will
have a negative test result?
A. Positive Predictive Value
,B. Specificity
C. Sensitivity
D. Negative Predictive Value
Answer: B
Conceptual Explanation: Specificity is the ability of a test to correctly identify those
without the disease (True Negative Rate).
3. As the prevalence of a disease in a population increases, what happens to the Positive
Predictive Value (PPV) of a diagnostic test?
A. PPV increases
B. PPV remains constant
C. PPV decreases
D. PPV becomes equal to sensitivity
Answer: A
Conceptual Explanation: PPV is dependent on disease prevalence. As prevalence
increases, the number of true positives increases relative to false positives, raising the PPV.
4. The Positive Likelihood Ratio (LR+) is calculated using which formula?
A. (1 - Specificity) / Sensitivity
B. Specificity / (1 - Sensitivity)
, C. (1 - Sensitivity) / Specificity
D. Sensitivity / (1 - Specificity)
Answer: D
Conceptual Explanation: The LR+ is the ratio of the probability of a positive test in those
with the disease to the probability of a positive test in those without the disease.
5. In the Dual Process Theory of clinical reasoning, ‘System 1’ thinking is characterized as:
A. Slow, analytical, and deliberate
B. Rule-based and logical
C. Fast, intuitive, and heuristic-based
D. Evidence-based and systematic
Answer: C
Conceptual Explanation: System 1 is the intuitive, rapid, and automatic mode of thinking
often used by experienced clinicians for pattern recognition.
6. 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. Confirmation bias
B. Availability heuristic
C. Framing effect
CLINICAL DECISION MAKING (NSG
550) EXAMQUESTIONS AND ANSWERS
1. When a diagnostic test has high sensitivity, a negative result is most useful for which of the
following?
A. Ruling in the condition (SpPIn)
B. Confirming a diagnosis
C. Ruling out the condition (SnNout)
D. Calculating the post-test probability
Answer: C
Conceptual Explanation: Sensitivity refers to the proportion of people with a disease who
test positive. A highly sensitive test has very few false negatives, so a negative result
effectively rules out the disease.
2. Which statistical value represents the probability that a person without the disease will
have a negative test result?
A. Positive Predictive Value
,B. Specificity
C. Sensitivity
D. Negative Predictive Value
Answer: B
Conceptual Explanation: Specificity is the ability of a test to correctly identify those
without the disease (True Negative Rate).
3. As the prevalence of a disease in a population increases, what happens to the Positive
Predictive Value (PPV) of a diagnostic test?
A. PPV increases
B. PPV remains constant
C. PPV decreases
D. PPV becomes equal to sensitivity
Answer: A
Conceptual Explanation: PPV is dependent on disease prevalence. As prevalence
increases, the number of true positives increases relative to false positives, raising the PPV.
4. The Positive Likelihood Ratio (LR+) is calculated using which formula?
A. (1 - Specificity) / Sensitivity
B. Specificity / (1 - Sensitivity)
, C. (1 - Sensitivity) / Specificity
D. Sensitivity / (1 - Specificity)
Answer: D
Conceptual Explanation: The LR+ is the ratio of the probability of a positive test in those
with the disease to the probability of a positive test in those without the disease.
5. In the Dual Process Theory of clinical reasoning, ‘System 1’ thinking is characterized as:
A. Slow, analytical, and deliberate
B. Rule-based and logical
C. Fast, intuitive, and heuristic-based
D. Evidence-based and systematic
Answer: C
Conceptual Explanation: System 1 is the intuitive, rapid, and automatic mode of thinking
often used by experienced clinicians for pattern recognition.
6. 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. Confirmation bias
B. Availability heuristic
C. Framing effect
