NSG 550/ NSG550 Exam 3 V2 – Diagnostic Reasoning for Nurse Practitioners Guide| Wilkes (Latest 2026/ 2027 Update) 100% Verified Questions & Answers | Grade A

NSG 550/ NSG550 Exam 3 V2 – Diagnostic Reasoning for Nurse Practitioners Guide| Wilkes (Latest 2026/ 2027 Update) 100% Verified Questions & Answers | Grade A T/F: An magnetic resonance imaging (MRI) & magnetic resonance angiography (MRA) are often ordered together T: An MRI & MRA are often ordered together Which tends to be ordered first, an MRI or an MRA? An MRI Why is an MRI typically ordered before an MRI? Because it can determine which areas of the brain have been damaged An MRA is often ordered after an MRI, why? To evaluate blood flow In patients presenting with CVA symptoms, which test is usually performed first? A non-contrast CT Why is a non-contrast CT typically usually performed first when a patient presents with CVA symptoms? Because it helps to determine whether the patient is having an ischemic or hemorrhagic stroke An MRA looks for _____ _____ in the blood vessels of the head & neck Blood flow Because an MRA looks for blood flow in the blood vessels of the head & neck, it can help identify _____, _____, or _____ - Aneurysms - Stenosis - Blockages What does an MRI evaluate? - Soft tissues - Muscles - Ligaments - Organs Because an MRI evaluates soft tissues, muscles, ligaments, & organs, it can help identify _____, _____, _____, & _____ _____ _____ - Headache - Seizure - Weakness - Loss of consciousness The spinal column consists of how many vertebrae? 33 What is the purpose of the spinal column? To protect the spinal cord & support the body The spinal column is divided into _____, _____, _____, _____, & _____ regions - Cervical - Thoracic - Lumbar - Sacral - Coccyx Key structures of the spinal column include: - Vertebral foramen - Intervertebral foramina - Annulus fibrosus - Nucleus Pulposus - Intervertebral Disc - Cauda Equina - Facet Joints What is the vertebral foramen? The large central opening where the spinal cord passes What is the intervertebral foramina? The smaller openings on each side where spinal nerves exit to the body What is the annulus fibrosus? The tough, outer ring of the intervertebral disc that surrounds the nucleus pulposus & stabilizes the spine What is the nucleus pulposus? The gelatinous inner core of an intervertebral disc that functions as a shock absorber for the spine What is the intervertebral disc? A tough, elastic cushion located between the vertebrae What is the cauda equina? A collection of nerve roots at the end of the spinal cord which controls sensation & motor function in the legs, bladder, & bowels at the end of the spinal cord What are facet joints? Small joints located on the posterior spine that connect each vertebra to the next providing stability to allow for bending & twisting motions _____ pain is one of the most common diagnoses seen in primary care Back What are the most common reasons for back pain? - Muscle strain - Ligament strain When a patient has back pain & red flag diagnoses are ruled out, then _____ treatment is recommended Conservative What are examples of conservative spine treatment? - Heat - Ice - Analgesics - Physical therapy X-rays are/are not recommended when a patient initially presents with back pain Are not T/F: Insurance will cover CT &/or MRI scans prior to trying & failing conservative treatment F: Insurance will not cover CT &/or MRI scans prior to trying & failing conservative treatmet When a patient presents with back pain, what are some differential diagnoses? - Spinal fracture - Cauda equina syndrome -- Saddle anesthesia - AAA - Kidney stones - Infection -- Pyelonephritis -- Herpes Zoster - Cancer What is a dual-energy x-ray absorptiometry (DEXA scan)? A flow-radiation x-ray test that assesses mineral at the hip & spine to diagnose osteoporosis or osteopenia A DEXA scan is recommended for females greater than age _____ 65 A DEXA scan is recommended for males greater than age _____ 70 What is a mammogram? A low-dose x-ray for breast cancer detection, monitoring of benign breast conditions & monitoring of breast cancer Which tool is used to report mammography, ultrasound, & MRI findings? BI-RADS tool BIRADS: Category 1 - Negative MRI - The breasts are symmetrical with no masses, architectural distortion, or suspicious calcifications BIRADS: Category 2 - Benign findings - Cyst - 0% probability of malignancy - Patient does not need to follow-up except for routine, yearly mammograms BIRADS: Category 3 - Findings are probably benign - 2% probability of malignancy - Short-interval follow-up is suggested BIRADS: Category 4 - Findings are suspicious for malignancy - Further evaluation with biopsy should be considered due to high probability of malignancy BIRADS: Category 5 - Cancer is highly suspected - Findings are highly suggestive of malignancy - 95% chance of malignancy - Immediate referral required BIRADS: Category 6 Known biopsy-proven malignancy BIRADS: Category 0 - Abnormality noted - Need for additional imaging evaluation with additional mammographic views, ultrasound, &/or for mammography for diagnosis What is a breast ultrasound? A non-invasive, radiation-free medical imaging technique that uses high- frequency sound waves A breast ultrasound is used to determine if a palpable lump or lesion found on a mammogram is _____ or _____ Cystic; Solid Most cysts are malignant/benign Benign Breast ultrasounds are also used for breast cancer screening in women with _____ breasts found on mammogram Dense Benign breast lesions are _____ & _____-_____ - Hypoechoic (light) - Well-circumscribed Cancer, hematoma, &/or abscesses are _____ & NOT _____-_____ - Hyperechoic (dark/posterior acoustic shadowing) - NOT well-circumscribed The Bethesda System for Reporting Cervical Cytology provides a standardized terminology for _____ _____ to ensure clear communication between laboratory pathologists and clinicians Pap tests If the pap test is positive/negative for intraepithelial lesions or malignancy, then we must document the organism causing the infection, IUD changes, or radiation changes Negative Which organisms may cause infection if the pap test is negative? - Trich - Candida - Etc.