NSG 550 DIAGNOSTIC REASONING
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS
1. When calculating the likelihood ratio (LR) for a diagnostic test, what does a positive LR of
10 or greater typically indicate?
A. A small, often clinically insignificant increase in the probability of disease.
B. A large and often conclusive increase in the probability of disease.
C. The test is better at ruling out the disease than ruling it in.
D. A decrease in the post-test probability of disease.
Answer: B
Conceptual Explanation: In diagnostic reasoning, a Positive Likelihood Ratio (LR+) > 10 is
considered a strong indicator that the test result significantly increases the probability of
the disease, often providing conclusive evidence for a diagnosis.
2. A 45-year-old patient presents with a ‘tearing’ chest pain radiating to the back. Which
component of the SOAP note should contain the patient’s report of radiation?
A. Subjective
B. Objective
,C. Assessment
D. Plan
Answer: A
Conceptual Explanation: The ‘Subjective’ portion of the SOAP note includes the history of
present illness (HPI), which encompasses the location, quality, and radiation of pain as
reported by the patient.
3. During a physical exam, you note a ‘strawberry tongue’ and a sandpaper-like rash in a
pediatric patient. This most likely suggests:
A. Scarlet Fever
B. Measles (Rubeola)
C. Hand-Foot-and-Mouth Disease
D. Roseola
Answer: A
Conceptual Explanation: Scarlet fever, caused by Group A Streptococcus, is classically
characterized by a strawberry tongue and a fine, erythematous, sandpaper-like rash
(scarlatiniform).
4. Sensitivity is defined as the ability of a test to:
A. Correctly identify those without the disease.
B. Determine the prevalence of the disease in a population.
, C. Predict the outcome of a treatment plan.
D. Correctly identify those with the disease.
Answer: D
Conceptual Explanation: Sensitivity refers to the true positive rate; it measures the
proportion of people who actually have the disease who are correctly identified by the test.
5. In the assessment of the cardiovascular system, which heart sound is associated with rapid
ventricular filling and is often a sign of heart failure in older adults?
A. S1
B. S2
C. S3
D. S4
Answer: C
Conceptual Explanation: S3, or the ventricular gallop, occurs during the early diastolic
filling phase and is often associated with fluid overload or ventricular dysfunction in older
adults.
6. While performing a musculoskeletal exam, you perform the McMurray test. A click or pop
during this maneuver indicates an injury to the:
A. Anterior cruciate ligament (ACL)
B. Medial collateral ligament (MCL)
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS
1. When calculating the likelihood ratio (LR) for a diagnostic test, what does a positive LR of
10 or greater typically indicate?
A. A small, often clinically insignificant increase in the probability of disease.
B. A large and often conclusive increase in the probability of disease.
C. The test is better at ruling out the disease than ruling it in.
D. A decrease in the post-test probability of disease.
Answer: B
Conceptual Explanation: In diagnostic reasoning, a Positive Likelihood Ratio (LR+) > 10 is
considered a strong indicator that the test result significantly increases the probability of
the disease, often providing conclusive evidence for a diagnosis.
2. A 45-year-old patient presents with a ‘tearing’ chest pain radiating to the back. Which
component of the SOAP note should contain the patient’s report of radiation?
A. Subjective
B. Objective
,C. Assessment
D. Plan
Answer: A
Conceptual Explanation: The ‘Subjective’ portion of the SOAP note includes the history of
present illness (HPI), which encompasses the location, quality, and radiation of pain as
reported by the patient.
3. During a physical exam, you note a ‘strawberry tongue’ and a sandpaper-like rash in a
pediatric patient. This most likely suggests:
A. Scarlet Fever
B. Measles (Rubeola)
C. Hand-Foot-and-Mouth Disease
D. Roseola
Answer: A
Conceptual Explanation: Scarlet fever, caused by Group A Streptococcus, is classically
characterized by a strawberry tongue and a fine, erythematous, sandpaper-like rash
(scarlatiniform).
4. Sensitivity is defined as the ability of a test to:
A. Correctly identify those without the disease.
B. Determine the prevalence of the disease in a population.
, C. Predict the outcome of a treatment plan.
D. Correctly identify those with the disease.
Answer: D
Conceptual Explanation: Sensitivity refers to the true positive rate; it measures the
proportion of people who actually have the disease who are correctly identified by the test.
5. In the assessment of the cardiovascular system, which heart sound is associated with rapid
ventricular filling and is often a sign of heart failure in older adults?
A. S1
B. S2
C. S3
D. S4
Answer: C
Conceptual Explanation: S3, or the ventricular gallop, occurs during the early diastolic
filling phase and is often associated with fluid overload or ventricular dysfunction in older
adults.
6. While performing a musculoskeletal exam, you perform the McMurray test. A click or pop
during this maneuver indicates an injury to the:
A. Anterior cruciate ligament (ACL)
B. Medial collateral ligament (MCL)
