NSG 550 DIAGNOSTIC REASONING
COMPREHENSIVE EXAM (EXAMS 1-3)
QUESTIONS AND ANSWERS
1. When a clinical test has a very high sensitivity, which of the following is the most accurate
interpretation of a negative result?
A. The disease is likely present
B. The test result effectively rules out the disease
C. The test result effectively rules in the disease
D. The test has a high rate of false positives
Answer: B
Conceptual Explanation: Sensitivity refers to the ability of a test to correctly identify
those with the disease (True Positive Rate). A high sensitivity means that a negative result
is very reliable for ruling out the disease (SnNout).
2. A patient presents with a history of sharp chest pain that increases with inspiration and is
relieved by leaning forward. Which physical finding is most likely?
A. Pericardial friction rub
B. Pleural friction rub
,C. S3 gallop
D. Tactile fremitus
Answer: A
Conceptual Explanation: Chest pain relieved by leaning forward is characteristic of
pericarditis, where a pericardial friction rub is the classic auscultatory finding.
3. In performing the Weber test, a patient with conductive hearing loss in the right ear will
experience which of the following?
A. Sound lateralizes to the left ear
B. Sound lateralizes to the right ear
C. Sound is heard equally in both ears
D. Sound is not heard at all
Answer: B
Conceptual Explanation: In conductive hearing loss, the sound lateralizes to the ‘bad’ ear
because the affected ear is not distracted by ambient room noise.
4. During a physical exam, you note ‘AV nicking’ during a funduscopic examination. This
finding is most commonly associated with which condition?
A. Chronic Hypertension
B. Diabetes Mellitus
C. Increased Intracranial Pressure
, D. Macular Degeneration
Answer: A
Conceptual Explanation: AV nicking occurs when a retinal artery crosses a vein and
compresses it, which is a classic sign of hypertensive retinopathy.
5. Which of the following physical exam findings is most suggestive of a large pleural
effusion?
A. Increased tactile fremitus and dullness to percussion
B. Decreased tactile fremitus and hyperresonance to percussion
C. Increased tactile fremitus and tympany to percussion
D. Decreased tactile fremitus and dullness to percussion
Answer: D
Conceptual Explanation: Pleural effusion acts as a barrier to sound vibration (decreasing
fremitus) and replaces air with fluid (causing dullness to percussion).
6. While assessing a patient for appendicitis, you apply pressure to the left lower quadrant
and the patient feels pain in the right lower quadrant. This is known as:
A. Rovsing’s sign
B. Psoas sign
C. Murphy’s sign
D. Obturator sign
COMPREHENSIVE EXAM (EXAMS 1-3)
QUESTIONS AND ANSWERS
1. When a clinical test has a very high sensitivity, which of the following is the most accurate
interpretation of a negative result?
A. The disease is likely present
B. The test result effectively rules out the disease
C. The test result effectively rules in the disease
D. The test has a high rate of false positives
Answer: B
Conceptual Explanation: Sensitivity refers to the ability of a test to correctly identify
those with the disease (True Positive Rate). A high sensitivity means that a negative result
is very reliable for ruling out the disease (SnNout).
2. A patient presents with a history of sharp chest pain that increases with inspiration and is
relieved by leaning forward. Which physical finding is most likely?
A. Pericardial friction rub
B. Pleural friction rub
,C. S3 gallop
D. Tactile fremitus
Answer: A
Conceptual Explanation: Chest pain relieved by leaning forward is characteristic of
pericarditis, where a pericardial friction rub is the classic auscultatory finding.
3. In performing the Weber test, a patient with conductive hearing loss in the right ear will
experience which of the following?
A. Sound lateralizes to the left ear
B. Sound lateralizes to the right ear
C. Sound is heard equally in both ears
D. Sound is not heard at all
Answer: B
Conceptual Explanation: In conductive hearing loss, the sound lateralizes to the ‘bad’ ear
because the affected ear is not distracted by ambient room noise.
4. During a physical exam, you note ‘AV nicking’ during a funduscopic examination. This
finding is most commonly associated with which condition?
A. Chronic Hypertension
B. Diabetes Mellitus
C. Increased Intracranial Pressure
, D. Macular Degeneration
Answer: A
Conceptual Explanation: AV nicking occurs when a retinal artery crosses a vein and
compresses it, which is a classic sign of hypertensive retinopathy.
5. Which of the following physical exam findings is most suggestive of a large pleural
effusion?
A. Increased tactile fremitus and dullness to percussion
B. Decreased tactile fremitus and hyperresonance to percussion
C. Increased tactile fremitus and tympany to percussion
D. Decreased tactile fremitus and dullness to percussion
Answer: D
Conceptual Explanation: Pleural effusion acts as a barrier to sound vibration (decreasing
fremitus) and replaces air with fluid (causing dullness to percussion).
6. While assessing a patient for appendicitis, you apply pressure to the left lower quadrant
and the patient feels pain in the right lower quadrant. This is known as:
A. Rovsing’s sign
B. Psoas sign
C. Murphy’s sign
D. Obturator sign
