Wilkes University NSG 550 Diagnostic Reasoning Exam 3 (pdf) |
2026/2027 | NP Q&A | Nursing
1. A 28-year-old woman presents with fluctuating diplopia and proximal
muscle weakness that worsens throughout the day and improves with rest.
Which diagnostic test is most appropriate to confirm the autoimmune
etiology of myasthenia gravis?
A) Serum cholinesterase level
B) Acetylcholine receptor antibody panel
C) CT scan of the brain
D) EEG
Correct Answer: Acetylcholine receptor antibody panel
Rationale: The acetylcholine receptor (AChR) antibody panel detects
antibodies that block or destroy postsynaptic receptors, supporting a
diagnosis of myasthenia gravis. This test is useful for confirming the
autoimmune etiology and monitoring response to therapy. Serum
cholinesterase levels are used for organophosphate exposure, CT brain rules
out structural lesions but does not establish MG, and EEG evaluates cortical
electrical activity.
2. A nurse practitioner is evaluating a patient with suspected
organophosphate poisoning. Which diagnostic test would be most useful?
A) Acetylcholine receptor antibody panel
B) Serum cholinesterase level
C) EEG
D) CT scan of the brain
Correct Answer: Serum cholinesterase level
,Rationale: Serum cholinesterase levels are used to evaluate for
organophosphate exposure, nerve gas, and pesticide poisoning. Decreased
levels indicate exposure to cholinesterase inhibitors. The acetylcholine
receptor antibody panel is used for myasthenia gravis, EEG for seizure
evaluation, and CT brain for structural lesions.
3. A patient with suspected seizure disorder is referred for an EEG. What is
the primary purpose of an electroencephalogram?
A) To evaluate for brain tumors
B) To detect and characterize seizure activity
C) To measure intracranial pressure
D) To assess cerebral blood flow
Correct Answer: To detect and characterize seizure activity
Rationale: EEG is a graphical record of brain wave activity obtained through
electrodes placed on the scalp and forehead. It is used to identify seizure
activity, as well as tumors, infarcts, and brain death (coma).
4. A patient is undergoing a caloric study as part of a neurological workup.
This test evaluates the function of which cranial nerve?
A) Cranial nerve VII (Facial)
B) Cranial nerve VIII (Vestibulocochlear)
C) Cranial nerve V (Trigeminal)
D) Cranial nerve IX (Glossopharyngeal)
Correct Answer: Cranial nerve VIII (Vestibulocochlear)
,Rationale: A caloric study is an electrodiagnostic test used to evaluate the
function of Cranial nerve VIII (Vestibulocochlear). It is part of a complete
neurological examination and assesses vestibular function.
5. A nurse practitioner suspects multiple sclerosis in a patient presenting
with optic neuritis and paresthesias. Which diagnostic test is most useful for
confirming the diagnosis?
A) CT scan of the brain
B) MRI of the brain and spinal cord
C) Lumbar puncture for CSF analysis
D) Both B and C
Correct Answer: Both B and C
Rationale: MRI of the brain and spinal cord is the most sensitive imaging
study for detecting demyelinating plaques in multiple sclerosis. Lumbar
puncture with CSF analysis showing oligoclonal bands supports the
diagnosis. A combination of both is often used for confirmation.
6. A patient presents with acute onset of severe headache, fever, and nuchal
rigidity. Which diagnostic test is most appropriate for evaluating suspected
meningitis?
A) CT scan of the brain
B) Lumbar puncture with CSF analysis
C) EEG
D) MRI of the brain
Correct Answer: Lumbar puncture with CSF analysis
, Rationale: Lumbar puncture with cerebrospinal fluid (CSF) analysis is the
definitive diagnostic test for meningitis. CSF cell count, glucose, protein,
Gram stain, and culture help identify the causative organism and guide
treatment. CT scan may be performed before LP if increased ICP is
suspected.
7. A patient with suspected carpal tunnel syndrome is referred for
electrodiagnostic testing. Which test is most appropriate?
A) Nerve conduction study (NCS)
B) Electromyography (EMG)
C) MRI of the wrist
D) Both A and B
Correct Answer: Both A and B
Rationale: Nerve conduction studies (NCS) evaluate the conduction velocity
of the median nerve across the wrist and are the most sensitive and specific
electrodiagnostic tests for carpal tunnel syndrome. EMG is often performed
concurrently to assess for denervation in severe cases.
8. A patient with symptoms suggestive of myasthenia gravis has a negative
acetylcholine receptor antibody panel. Which additional test should the nurse
practitioner consider?
A) Repeat AChR panel
B) Muscle-specific tyrosine kinase (MuSK) antibody test
C) Serum cholinesterase
D) CT chest
Correct Answer: Muscle-specific tyrosine kinase (MuSK) antibody test
2026/2027 | NP Q&A | Nursing
1. A 28-year-old woman presents with fluctuating diplopia and proximal
muscle weakness that worsens throughout the day and improves with rest.
Which diagnostic test is most appropriate to confirm the autoimmune
etiology of myasthenia gravis?
A) Serum cholinesterase level
B) Acetylcholine receptor antibody panel
C) CT scan of the brain
D) EEG
Correct Answer: Acetylcholine receptor antibody panel
Rationale: The acetylcholine receptor (AChR) antibody panel detects
antibodies that block or destroy postsynaptic receptors, supporting a
diagnosis of myasthenia gravis. This test is useful for confirming the
autoimmune etiology and monitoring response to therapy. Serum
cholinesterase levels are used for organophosphate exposure, CT brain rules
out structural lesions but does not establish MG, and EEG evaluates cortical
electrical activity.
2. A nurse practitioner is evaluating a patient with suspected
organophosphate poisoning. Which diagnostic test would be most useful?
A) Acetylcholine receptor antibody panel
B) Serum cholinesterase level
C) EEG
D) CT scan of the brain
Correct Answer: Serum cholinesterase level
,Rationale: Serum cholinesterase levels are used to evaluate for
organophosphate exposure, nerve gas, and pesticide poisoning. Decreased
levels indicate exposure to cholinesterase inhibitors. The acetylcholine
receptor antibody panel is used for myasthenia gravis, EEG for seizure
evaluation, and CT brain for structural lesions.
3. A patient with suspected seizure disorder is referred for an EEG. What is
the primary purpose of an electroencephalogram?
A) To evaluate for brain tumors
B) To detect and characterize seizure activity
C) To measure intracranial pressure
D) To assess cerebral blood flow
Correct Answer: To detect and characterize seizure activity
Rationale: EEG is a graphical record of brain wave activity obtained through
electrodes placed on the scalp and forehead. It is used to identify seizure
activity, as well as tumors, infarcts, and brain death (coma).
4. A patient is undergoing a caloric study as part of a neurological workup.
This test evaluates the function of which cranial nerve?
A) Cranial nerve VII (Facial)
B) Cranial nerve VIII (Vestibulocochlear)
C) Cranial nerve V (Trigeminal)
D) Cranial nerve IX (Glossopharyngeal)
Correct Answer: Cranial nerve VIII (Vestibulocochlear)
,Rationale: A caloric study is an electrodiagnostic test used to evaluate the
function of Cranial nerve VIII (Vestibulocochlear). It is part of a complete
neurological examination and assesses vestibular function.
5. A nurse practitioner suspects multiple sclerosis in a patient presenting
with optic neuritis and paresthesias. Which diagnostic test is most useful for
confirming the diagnosis?
A) CT scan of the brain
B) MRI of the brain and spinal cord
C) Lumbar puncture for CSF analysis
D) Both B and C
Correct Answer: Both B and C
Rationale: MRI of the brain and spinal cord is the most sensitive imaging
study for detecting demyelinating plaques in multiple sclerosis. Lumbar
puncture with CSF analysis showing oligoclonal bands supports the
diagnosis. A combination of both is often used for confirmation.
6. A patient presents with acute onset of severe headache, fever, and nuchal
rigidity. Which diagnostic test is most appropriate for evaluating suspected
meningitis?
A) CT scan of the brain
B) Lumbar puncture with CSF analysis
C) EEG
D) MRI of the brain
Correct Answer: Lumbar puncture with CSF analysis
, Rationale: Lumbar puncture with cerebrospinal fluid (CSF) analysis is the
definitive diagnostic test for meningitis. CSF cell count, glucose, protein,
Gram stain, and culture help identify the causative organism and guide
treatment. CT scan may be performed before LP if increased ICP is
suspected.
7. A patient with suspected carpal tunnel syndrome is referred for
electrodiagnostic testing. Which test is most appropriate?
A) Nerve conduction study (NCS)
B) Electromyography (EMG)
C) MRI of the wrist
D) Both A and B
Correct Answer: Both A and B
Rationale: Nerve conduction studies (NCS) evaluate the conduction velocity
of the median nerve across the wrist and are the most sensitive and specific
electrodiagnostic tests for carpal tunnel syndrome. EMG is often performed
concurrently to assess for denervation in severe cases.
8. A patient with symptoms suggestive of myasthenia gravis has a negative
acetylcholine receptor antibody panel. Which additional test should the nurse
practitioner consider?
A) Repeat AChR panel
B) Muscle-specific tyrosine kinase (MuSK) antibody test
C) Serum cholinesterase
D) CT chest
Correct Answer: Muscle-specific tyrosine kinase (MuSK) antibody test
