NSG 527 ADVANCED HEALTH
ASSESSMENT AND DIFFERENTIAL
DIAGNOSIS EXAM STUDY GUIDE
1. When evaluating the sensitivity of a diagnostic test, the clinician knows that this value
represents:
A. The proportion of people without the disease who test negative.
B. The probability that a negative test result represents a true negative.
C. The probability that a positive test result represents a true positive.
D. The proportion of people with the disease who test positive.
Answer: D
Conceptual Explanation: Sensitivity refers to the ability of a test to correctly identify
those with the disease (true positive rate). Specificity refers to the ability to identify those
without the disease (true negative rate).
2. A 45-year-old patient presents with a ‘tearing’ chest pain radiating to the back. What is the
most critical differential diagnosis to rule out?
A. Aortic Dissection
,B. Acute Myocardial Infarction
C. Pulmonary Embolism
D. Tension Pneumothorax
Answer: A
Conceptual Explanation: The description of ‘tearing’ or ‘ripping’ pain radiating to the back
is pathognomonic for an aortic dissection, which is a life-threatening emergency.
3. Which physical exam maneuver is most specific for diagnosing acute cholecystitis?
A. Rovsing’s sign
B. Psoas sign
C. Cullen’s sign
D. Murphy’s sign
Answer: D
Conceptual Explanation: Murphy’s sign is performed by palpating the right upper
quadrant while the patient inspires; a positive sign is the cessation of inspiration due to
pain, suggesting gallbladder inflammation.
4. In the SOAP note format, where should a clinician document a patient’s reported
symptoms and history of present illness?
A. Objective
B. Subjective
, C. Assessment
D. Plan
Answer: B
Conceptual Explanation: The Subjective section contains information provided by the
patient, including the HPI, ROS, and medical history.
5. Which cranial nerve is primarily responsible for the motor function of the tongue?
A. CN IX (Glossopharyngeal)
B. CN X (Vagus)
C. CN XII (Hypoglossal)
D. CN XI (Accessory)
Answer: C
Conceptual Explanation: Cranial Nerve XII, the Hypoglossal nerve, provides motor
innervation to the muscles of the tongue.
6. A patient exhibits a high-pitched, blowing holosystolic murmur heard best at the apex and
radiating to the axilla. This is consistent with:
A. Mitral Regurgitation
B. Aortic Stenosis
C. Mitral Stenosis
ASSESSMENT AND DIFFERENTIAL
DIAGNOSIS EXAM STUDY GUIDE
1. When evaluating the sensitivity of a diagnostic test, the clinician knows that this value
represents:
A. The proportion of people without the disease who test negative.
B. The probability that a negative test result represents a true negative.
C. The probability that a positive test result represents a true positive.
D. The proportion of people with the disease who test positive.
Answer: D
Conceptual Explanation: Sensitivity refers to the ability of a test to correctly identify
those with the disease (true positive rate). Specificity refers to the ability to identify those
without the disease (true negative rate).
2. A 45-year-old patient presents with a ‘tearing’ chest pain radiating to the back. What is the
most critical differential diagnosis to rule out?
A. Aortic Dissection
,B. Acute Myocardial Infarction
C. Pulmonary Embolism
D. Tension Pneumothorax
Answer: A
Conceptual Explanation: The description of ‘tearing’ or ‘ripping’ pain radiating to the back
is pathognomonic for an aortic dissection, which is a life-threatening emergency.
3. Which physical exam maneuver is most specific for diagnosing acute cholecystitis?
A. Rovsing’s sign
B. Psoas sign
C. Cullen’s sign
D. Murphy’s sign
Answer: D
Conceptual Explanation: Murphy’s sign is performed by palpating the right upper
quadrant while the patient inspires; a positive sign is the cessation of inspiration due to
pain, suggesting gallbladder inflammation.
4. In the SOAP note format, where should a clinician document a patient’s reported
symptoms and history of present illness?
A. Objective
B. Subjective
, C. Assessment
D. Plan
Answer: B
Conceptual Explanation: The Subjective section contains information provided by the
patient, including the HPI, ROS, and medical history.
5. Which cranial nerve is primarily responsible for the motor function of the tongue?
A. CN IX (Glossopharyngeal)
B. CN X (Vagus)
C. CN XII (Hypoglossal)
D. CN XI (Accessory)
Answer: C
Conceptual Explanation: Cranial Nerve XII, the Hypoglossal nerve, provides motor
innervation to the muscles of the tongue.
6. A patient exhibits a high-pitched, blowing holosystolic murmur heard best at the apex and
radiating to the axilla. This is consistent with:
A. Mitral Regurgitation
B. Aortic Stenosis
C. Mitral Stenosis
