NSG 550 DIAGNOSTIC REASONING -
EXAMS 1-3 COMPREHENSIVE
QUESTIONS AND ANSWERS
1. In the hypothetico-deductive model of diagnostic reasoning, what is the primary purpose
of the ‘initial hypothesis’ stage?
A. To perform a complete head-to-toe physical examination
B. To narrow down possibilities based on the patient’s age and gender
C. To form early mental representations based on the chief complaint
D. To order definitive diagnostic imaging
Answer: C
Conceptual Explanation: The initial hypothesis stage involves forming early mental
representations or ‘hunches’ immediately upon hearing the patient’s chief complaint to
guide further inquiry.
2. Which component of the SOAP note includes the patient’s Review of Systems (ROS)?
A. Objective
B. Subjective
,C. Assessment
D. Plan
Answer: B
Conceptual Explanation: Subjective data includes the history of present illness, past
medical history, and the Review of Systems as reported by the patient.
3. A diagnostic test with high sensitivity is most useful for which of the following?
A. Ruling out a disease when the test is negative
B. Confirming a diagnosis
C. Establishing a definitive prognosis
D. Minimizing false positives
Answer: A
Conceptual Explanation: Sensitivity refers to the ability of a test to correctly identify
those with the disease (SnNout: Sensitivity, Negative result, Rules out).
4. Which cranial nerve is being tested when asking a patient to shrug their shoulders against
resistance?
A. CN X (Vagus)
B. CN XI (Spinal Accessory)
C. CN XII (Hypoglossal)
, D. CN IX (Glossopharyngeal)
Answer: B
Conceptual Explanation: CN XI (Spinal Accessory) innervates the trapezius and
sternocleidomastoid muscles, which are responsible for shoulder shrugging and head
turning.
5. In the ABCDE mnemonic for melanoma, what does the ‘D’ stand for?
A. Diameter greater than 6mm
B. Depth
C. Duration of lesion
D. Density
Answer: A
Conceptual Explanation: The ABCDEs are Asymmetry, Border irregularity, Color
variation, Diameter (>6mm), and Evolving.
6. Which physical exam finding is most suggestive of acute cholecystitis?
A. McBurney’s Point tenderness
B. Psoas Sign
C. Positive Rovsing’s Sign
D. Positive Murphy’s Sign
EXAMS 1-3 COMPREHENSIVE
QUESTIONS AND ANSWERS
1. In the hypothetico-deductive model of diagnostic reasoning, what is the primary purpose
of the ‘initial hypothesis’ stage?
A. To perform a complete head-to-toe physical examination
B. To narrow down possibilities based on the patient’s age and gender
C. To form early mental representations based on the chief complaint
D. To order definitive diagnostic imaging
Answer: C
Conceptual Explanation: The initial hypothesis stage involves forming early mental
representations or ‘hunches’ immediately upon hearing the patient’s chief complaint to
guide further inquiry.
2. Which component of the SOAP note includes the patient’s Review of Systems (ROS)?
A. Objective
B. Subjective
,C. Assessment
D. Plan
Answer: B
Conceptual Explanation: Subjective data includes the history of present illness, past
medical history, and the Review of Systems as reported by the patient.
3. A diagnostic test with high sensitivity is most useful for which of the following?
A. Ruling out a disease when the test is negative
B. Confirming a diagnosis
C. Establishing a definitive prognosis
D. Minimizing false positives
Answer: A
Conceptual Explanation: Sensitivity refers to the ability of a test to correctly identify
those with the disease (SnNout: Sensitivity, Negative result, Rules out).
4. Which cranial nerve is being tested when asking a patient to shrug their shoulders against
resistance?
A. CN X (Vagus)
B. CN XI (Spinal Accessory)
C. CN XII (Hypoglossal)
, D. CN IX (Glossopharyngeal)
Answer: B
Conceptual Explanation: CN XI (Spinal Accessory) innervates the trapezius and
sternocleidomastoid muscles, which are responsible for shoulder shrugging and head
turning.
5. In the ABCDE mnemonic for melanoma, what does the ‘D’ stand for?
A. Diameter greater than 6mm
B. Depth
C. Duration of lesion
D. Density
Answer: A
Conceptual Explanation: The ABCDEs are Asymmetry, Border irregularity, Color
variation, Diameter (>6mm), and Evolving.
6. Which physical exam finding is most suggestive of acute cholecystitis?
A. McBurney’s Point tenderness
B. Psoas Sign
C. Positive Rovsing’s Sign
D. Positive Murphy’s Sign
