NR 511 Differential Diagnosis and Primary Care- Mid Term
Review Questions with Verified Answers (Correct Update)
Question 1: what is the sensitivity of the Prostate Specific Anti- # gen (PSA) for detecting
prostate cancer?
Answer: men with prostate cancer # men with positive PSA 160 # men with negative PSA 40 total 200
The correct answer is 160/200. Sensitivity is the proportion of patients with the disease that have a
positive result; it is the number of true positives divided by the total number of patients who have the
disease.
Question 2: A diagnostic test is used in a sample of 1000 patients. 500 of these patients have the
disease, while 500 do not. Of those 500 patients without the disease, 30 test positive, and 470 test
negative. What is the specificity of the test?
Answer: The correct answer is 470/500. Specificity is the proportion of patients who test negative out of
the total number of patients who do not have the disease; it is the number of true negatives overall
negatives. In this example, patients have the disease. Of those 500 patients without the disease, 30 test
positive, and 470 test negative.
Question 3: The Positive Predictive Value (PPV) of a test refers the to which of the following?
Answer: proportion of patients with a positive test who have the disease.
Question 4: Which of the following depends on the prevalence positive of the disease?
Answer: predictive value. Predictive values depend on the prevalence of disease in the population
whereas sensitivity and specificity are intrinsic properties of the test. Reliability refers to the consistency
or stability of a measure.
Question 5: A low pretest probability of disease may lead to which of the following?
Answer: low positive predictive value and more false-positive results. Positive predictive value
increases with prevalence; therefore, a low prevalence value yields a low positive predictive value and
implies a high false-positive rate. Negative predictive value decreases with prevalence, and sensitivity
and specificity do not vary with prevalence.
Question 6: If you strongly suspect that a patient is positive for a specific condition but tests
negative, the negative result may be:
Answer: false-negative test results due to a low negative predictive value. At the individual level, your
clinical suspicion is equivalent to pre-test probability and high prevalence at the population level.
Negative predictive value is inversely correlated with prevalence; therefore, your clinical suspicion
translates to a low negative predictive value, suggesting a false-negative test result.
Page 1
,Question 7: Which test(s) provide data relevant to the chief complaint: Fever
Answer: CBC Check CBC with ditterential for neutrophil shift in suspected infection
Question 8: Which test(s) provide data relevant to the chief complaint: Unexplained bruising
Answer: CBC Check platelet count
Question 9: Which test(s) provide data relevant to the chief complaint: Fatigue
Answer: Both CBC and CMP Check RBC, Hgb and Hct for anemia, CMP for potential liver or kidney
abnormalities
Question 10: Which test(s) provide data relevant to the chief complaint: Cardiac dysrhythmias
Answer: CMP Monitor electrolytes for abnormalities
Question 11: Which test(s) provide data relevant to the chief complaint: Unexplained weight loss
Answer: Both CBC and CMP Check WBC for inflammation or possible cancer, CMP for glucose, liver
or kidney abnormalities
Question 12: Which test(s) provide data relevant to the chief complaint: Edema
Answer: CMP Check for kidney function
Question 13: What is SNAPPS?
Answer: Summarize the history and findings Narrow the ditterential diagnosis to two or three
possibilities Analyze the ditterential by comparing and contrasting the possibilities Probe the preceptor
by asking questions about alternative approaches or uncertainties Plan the management of the client's
health issues Select an issue from the case for self-directed learning
Question 14: a 13 year old presents to the clinic complaining of Refer severe left side sore throat
and pain with swallowing for 1 day. upon exam, the patient appears uncomfortable and febrile.
Cervical adenopathy is present on left side, difficulty opening and closing mouth. What should
you do?
Answer: to the ER
Page 2
, Question 15: a 37 year old female presents for her annual visit. After She mentions that her 13
year old daughter has had to recent infestions of lice. She asks what she can do to prevent this?
Answer: 2 days of no head lice, her bedding is lice free
Question 16: Which of the following is the appropriate treatment for giardia
Answer: quin.hydr.
Question 17: Your client, a 72-year-old smoker of 50 years, is at the office today for a routine
physical. During your inspection of the oral mucosa, you discover a white lesion on the lateral
surface of the tongue that you suspect to be cancerous. You document your finding as:
Answer: A white, painless, firm, ulcerated lesion with indurated borders
Question 18: Maryann, age 28, presents to the clinic because of Alopecia a rapid onset of patchy
hair loss. The skin within these oval patches of hair loss is very smooth. Tapered hairs that
resemble exclamation points are seen at the margin of a patch of hair loss. Based on these
findings, you suspect Maryann has:
Answer: areata The findings are consistent with alopecia areata, ie, nonscarring hair loss of rapid onset,
the pattern of which is most commonly sharply defined round or oval patches.
Question 19: Which of the following is not a complication of
Answer: group a strep hemolytic anemia glomerular nephritis
Question 20: Which of the following is an example of conductive hearing loss?
Answer: Serous OM
Question 21: Medical coding is the process of submitting and following up on claims made to the
payer in order process
Answer: Coding is done in order to demographic, insurance, ... number as shown on insured's ID card
for the payer to whom the claim is being submitted.
Question 22: Tom, age 50, is complaining of an itchy rash that occurred about a half hour after
putting on his leather jacket. He recalls having a slightly similar rash last year when he wore his
jacket. The annular lesions are on his neck and both arms. They are erythematous, sharply
circumscribed, and both flat and elevated. His voice seems a little raspy, although he states that
his breathing is normal. What is your first action?
Answer: Determine the need for 0.5 mL 1:1000 epinephrine subcutaneously.
Page 3
Review Questions with Verified Answers (Correct Update)
Question 1: what is the sensitivity of the Prostate Specific Anti- # gen (PSA) for detecting
prostate cancer?
Answer: men with prostate cancer # men with positive PSA 160 # men with negative PSA 40 total 200
The correct answer is 160/200. Sensitivity is the proportion of patients with the disease that have a
positive result; it is the number of true positives divided by the total number of patients who have the
disease.
Question 2: A diagnostic test is used in a sample of 1000 patients. 500 of these patients have the
disease, while 500 do not. Of those 500 patients without the disease, 30 test positive, and 470 test
negative. What is the specificity of the test?
Answer: The correct answer is 470/500. Specificity is the proportion of patients who test negative out of
the total number of patients who do not have the disease; it is the number of true negatives overall
negatives. In this example, patients have the disease. Of those 500 patients without the disease, 30 test
positive, and 470 test negative.
Question 3: The Positive Predictive Value (PPV) of a test refers the to which of the following?
Answer: proportion of patients with a positive test who have the disease.
Question 4: Which of the following depends on the prevalence positive of the disease?
Answer: predictive value. Predictive values depend on the prevalence of disease in the population
whereas sensitivity and specificity are intrinsic properties of the test. Reliability refers to the consistency
or stability of a measure.
Question 5: A low pretest probability of disease may lead to which of the following?
Answer: low positive predictive value and more false-positive results. Positive predictive value
increases with prevalence; therefore, a low prevalence value yields a low positive predictive value and
implies a high false-positive rate. Negative predictive value decreases with prevalence, and sensitivity
and specificity do not vary with prevalence.
Question 6: If you strongly suspect that a patient is positive for a specific condition but tests
negative, the negative result may be:
Answer: false-negative test results due to a low negative predictive value. At the individual level, your
clinical suspicion is equivalent to pre-test probability and high prevalence at the population level.
Negative predictive value is inversely correlated with prevalence; therefore, your clinical suspicion
translates to a low negative predictive value, suggesting a false-negative test result.
Page 1
,Question 7: Which test(s) provide data relevant to the chief complaint: Fever
Answer: CBC Check CBC with ditterential for neutrophil shift in suspected infection
Question 8: Which test(s) provide data relevant to the chief complaint: Unexplained bruising
Answer: CBC Check platelet count
Question 9: Which test(s) provide data relevant to the chief complaint: Fatigue
Answer: Both CBC and CMP Check RBC, Hgb and Hct for anemia, CMP for potential liver or kidney
abnormalities
Question 10: Which test(s) provide data relevant to the chief complaint: Cardiac dysrhythmias
Answer: CMP Monitor electrolytes for abnormalities
Question 11: Which test(s) provide data relevant to the chief complaint: Unexplained weight loss
Answer: Both CBC and CMP Check WBC for inflammation or possible cancer, CMP for glucose, liver
or kidney abnormalities
Question 12: Which test(s) provide data relevant to the chief complaint: Edema
Answer: CMP Check for kidney function
Question 13: What is SNAPPS?
Answer: Summarize the history and findings Narrow the ditterential diagnosis to two or three
possibilities Analyze the ditterential by comparing and contrasting the possibilities Probe the preceptor
by asking questions about alternative approaches or uncertainties Plan the management of the client's
health issues Select an issue from the case for self-directed learning
Question 14: a 13 year old presents to the clinic complaining of Refer severe left side sore throat
and pain with swallowing for 1 day. upon exam, the patient appears uncomfortable and febrile.
Cervical adenopathy is present on left side, difficulty opening and closing mouth. What should
you do?
Answer: to the ER
Page 2
, Question 15: a 37 year old female presents for her annual visit. After She mentions that her 13
year old daughter has had to recent infestions of lice. She asks what she can do to prevent this?
Answer: 2 days of no head lice, her bedding is lice free
Question 16: Which of the following is the appropriate treatment for giardia
Answer: quin.hydr.
Question 17: Your client, a 72-year-old smoker of 50 years, is at the office today for a routine
physical. During your inspection of the oral mucosa, you discover a white lesion on the lateral
surface of the tongue that you suspect to be cancerous. You document your finding as:
Answer: A white, painless, firm, ulcerated lesion with indurated borders
Question 18: Maryann, age 28, presents to the clinic because of Alopecia a rapid onset of patchy
hair loss. The skin within these oval patches of hair loss is very smooth. Tapered hairs that
resemble exclamation points are seen at the margin of a patch of hair loss. Based on these
findings, you suspect Maryann has:
Answer: areata The findings are consistent with alopecia areata, ie, nonscarring hair loss of rapid onset,
the pattern of which is most commonly sharply defined round or oval patches.
Question 19: Which of the following is not a complication of
Answer: group a strep hemolytic anemia glomerular nephritis
Question 20: Which of the following is an example of conductive hearing loss?
Answer: Serous OM
Question 21: Medical coding is the process of submitting and following up on claims made to the
payer in order process
Answer: Coding is done in order to demographic, insurance, ... number as shown on insured's ID card
for the payer to whom the claim is being submitted.
Question 22: Tom, age 50, is complaining of an itchy rash that occurred about a half hour after
putting on his leather jacket. He recalls having a slightly similar rash last year when he wore his
jacket. The annular lesions are on his neck and both arms. They are erythematous, sharply
circumscribed, and both flat and elevated. His voice seems a little raspy, although he states that
his breathing is normal. What is your first action?
Answer: Determine the need for 0.5 mL 1:1000 epinephrine subcutaneously.
Page 3
