NSG 550 Exam 2 Diagnostic Reasoning: 200-Q Test Bank with NGN Case Scenarios & Rationales

,NSG 550 EXAM 2 – DIAGNOSTIC REASONING

Complete 200-Question Test Bank with NGN Case
Scenarios & Detailed Rationales

Wilkes University | 2026/2027 Edition | 100% Pass
Guarantee




EXAM 2 BLUEPRINT

Topic Area Percentage

Pulmonary Function Testing & Diagnostics 25%

Cardiac Diagnostics (ECG, Stress, Echo,
20%
Cath)

GI & Vascular Diagnostics 15%

Sleep Studies & Diagnostic Test Selection 10%

Bayesian Reasoning & Test Characteristics 15%

Cognitive Biases & Clinical Decision-
5%
Making

NGN Case Scenarios (Integrated) 10%

,SECTION 1: PULMONARY FUNCTION TESTING &
DIAGNOSTICS (Questions 1–50)




1. A 45-year-old male presents with a chronic cough and
dyspnea on exertion. He has a 30-pack-year smoking
history. Which initial diagnostic test is most appropriate?
A) Chest X-ray
B) Spirometry
C) CT chest
D) Bronchoscopy
Answer: B) Spirometry
Rationale: Spirometry is the initial test to evaluate for
obstructive or restrictive lung disease in patients with
respiratory symptoms and smoking history. It provides
objective measurement of airflow limitation. Chest X-ray
(A) and CT (C) may follow but are not the initial diagnostic
test. Bronchoscopy (D) is invasive and reserved for specific
indications.

, 2. Which of the following is a contraindication to performing
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spirometry?
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A) Age >65 years
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B) Recent myocardial infarction
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C) Mild obesity
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D) History of smoking
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Answer: B) Recent myocardial infarction K K K K




Rationale: Contraindications to spirometry include recent
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MI (any cardiovascular problem), pneumothorax, active
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hemoptysis, pulmonary embolism, recent surgery, cerebral
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aneurysm, and respiratory infections. Spirometry requires
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forceful exhalation and can increase intrathoracic pressure.
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3. A patient's spirometry shows an FEV1/FVC ratio of 65%
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with FEV1 55% of predicted. What is the most likely
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diagnosis?
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A) Restrictive lung disease
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B) Obstructive lung disease
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C) Normal lung function
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D) Mixed obstructive-restrictive
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Answer: B) Obstructive lung disease K K K K




Rationale: An FEV1/FVC ratio <70% indicates obstruction.K K K K K K




The reduced FEV1 (55% predicted) indicates moderate
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obstruction. This pattern is seen in COPD, asthma, and other
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