NSG 550 DIAGNOSTIC REASONING
COMPREHENSIVE EXAM (1-3)
QUESTIONS AND ANSWERS
1. When calculating the probability of a disease after a diagnostic test is performed, which of
the following provides the most clinically useful information?
A. Likelihood Ratio
B. Sensitivity
C. Prevalence
D. Specificity
Answer: A
Conceptual Explanation: Likelihood ratios (LR) combine sensitivity and specificity into a
single ratio that indicates how much a test result changes the pre-test probability of a
disease.
2. In the SOAP note format, where should the differential diagnosis list be primarily discussed
or synthesized?
A. Assessment
,B. Objective
C. Subjective
D. Plan
Answer: A
Conceptual Explanation: The Assessment section involves the clinician’s synthesis of the
data, the final diagnosis, and the differential diagnoses considered.
3. Which physical exam finding is most indicative of a consolidated pneumonia during a
respiratory assessment?
A. Hyperresonance on percussion
B. Increased tactile fremitus
C. Decreased tactile fremitus
D. Wheezing
Answer: B
Conceptual Explanation: Tactile fremitus increases through consolidated tissue (like fluid
or solid mass) compared to air-filled lungs.
4. A 65-year-old male presents with a new onset of a ‘blowing’ holosystolic murmur heard
best at the apex. This is most consistent with:
A. Aortic Stenosis
B. Aortic Regurgitation
, C. Mitral Stenosis
D. Mitral Regurgitation
Answer: D
Conceptual Explanation: Mitral regurgitation is characterized by a holosystolic murmur
at the apex that may radiate to the axilla.
5. The Snellen chart is used to measure visual acuity. If a patient is recorded as having 20/40
vision, what does this mean?
A. The patient can see at 40 feet what a normal eye sees at 20 feet.
B. The patient can see at 20 feet what a normal eye sees at 40 feet.
C. The patient has 20% vision in the right eye and 40% in the left.
D. The patient’s vision is twice as good as normal.
Answer: B
Conceptual Explanation: The first number is the distance from the chart (20 feet), and the
second number is the distance at which a normal eye can read that line.
6. When evaluating for appendicitis, the clinician performs deep palpation in the LLQ, which
results in pain in the RLQ. This is known as:
A. Murphy’s Sign
B. Psoas Sign
C. McBurney’s Point tenderness
COMPREHENSIVE EXAM (1-3)
QUESTIONS AND ANSWERS
1. When calculating the probability of a disease after a diagnostic test is performed, which of
the following provides the most clinically useful information?
A. Likelihood Ratio
B. Sensitivity
C. Prevalence
D. Specificity
Answer: A
Conceptual Explanation: Likelihood ratios (LR) combine sensitivity and specificity into a
single ratio that indicates how much a test result changes the pre-test probability of a
disease.
2. In the SOAP note format, where should the differential diagnosis list be primarily discussed
or synthesized?
A. Assessment
,B. Objective
C. Subjective
D. Plan
Answer: A
Conceptual Explanation: The Assessment section involves the clinician’s synthesis of the
data, the final diagnosis, and the differential diagnoses considered.
3. Which physical exam finding is most indicative of a consolidated pneumonia during a
respiratory assessment?
A. Hyperresonance on percussion
B. Increased tactile fremitus
C. Decreased tactile fremitus
D. Wheezing
Answer: B
Conceptual Explanation: Tactile fremitus increases through consolidated tissue (like fluid
or solid mass) compared to air-filled lungs.
4. A 65-year-old male presents with a new onset of a ‘blowing’ holosystolic murmur heard
best at the apex. This is most consistent with:
A. Aortic Stenosis
B. Aortic Regurgitation
, C. Mitral Stenosis
D. Mitral Regurgitation
Answer: D
Conceptual Explanation: Mitral regurgitation is characterized by a holosystolic murmur
at the apex that may radiate to the axilla.
5. The Snellen chart is used to measure visual acuity. If a patient is recorded as having 20/40
vision, what does this mean?
A. The patient can see at 40 feet what a normal eye sees at 20 feet.
B. The patient can see at 20 feet what a normal eye sees at 40 feet.
C. The patient has 20% vision in the right eye and 40% in the left.
D. The patient’s vision is twice as good as normal.
Answer: B
Conceptual Explanation: The first number is the distance from the chart (20 feet), and the
second number is the distance at which a normal eye can read that line.
6. When evaluating for appendicitis, the clinician performs deep palpation in the LLQ, which
results in pain in the RLQ. This is known as:
A. Murphy’s Sign
B. Psoas Sign
C. McBurney’s Point tenderness
