NSG 550 Exam 2 – Wilkes Diagnostic Reasoning 2026
UPDATE
1. A 45-year-old patient presents with a cough. Which of the following components of the HPI
describes the ‘Quality’ of the symptom?
A. The cough started three days ago.
B. The cough is productive of yellow sputum.
C. The cough is worse when lying down.
D. The patient rates the cough as a 5 out of 10 in severity.
Answer: B
Rationale: Quality describes the character of the symptom, such as productive vs. non-
productive or the color of sputum. Timing (A), aggravating factors (C), and severity (D) are
separate components of the HPI.
2. Which term describes the probability that a person with a negative test result actually does
not have the disease?
A. Negative Predictive Value
B. Specificity
C. Positive Predictive Value
D. Sensitivity
,Answer: A
Rationale: Negative Predictive Value (NPV) is the probability that subjects with a negative
screening test truly don’t have the disease.
3. In the SOAP note format, where should the provider document the patient’s reported
allergies?
A. Assessment
B. Objective
C. Subjective
D. Plan
Answer: C
Rationale: Allergies, as part of the patient’s history provided by the patient, belong in the
Subjective section.
4. When performing a physical exam on a patient with abdominal pain, which sequence of
techniques is correct?
A. Inspection, Auscultation, Percussion, Palpation
B. Inspection, Palpation, Percussion, Auscultation
C. Auscultation, Inspection, Palpation, Percussion
D. Palpation, Percussion, Auscultation, Inspection
Answer: A
, Rationale: For the abdomen, auscultation is performed before percussion and palpation to
avoid altering bowel sounds.
5. A diagnostic test with high sensitivity is most useful for which of the following?
A. Confirming a diagnosis
B. Predicting the prognosis
C. Determining the severity of a disease
D. Ruling out a disease
Answer: D
Rationale: High sensitivity tests (SnNout) are best used to rule out a disease because a
negative result strongly suggests the absence of the disease.
6. Which of the following is considered ‘Objective’ data in a clinical assessment?
A. The patient’s chief complaint of chest pain
B. A blood pressure reading of 140/90 mmHg
C. A family history of heart disease
D. The patient’s description of pain as ‘sharp’
Answer: B
Rationale: Objective data are measurable and observable signs, such as vital signs, physical
exam findings, and lab results.
UPDATE
1. A 45-year-old patient presents with a cough. Which of the following components of the HPI
describes the ‘Quality’ of the symptom?
A. The cough started three days ago.
B. The cough is productive of yellow sputum.
C. The cough is worse when lying down.
D. The patient rates the cough as a 5 out of 10 in severity.
Answer: B
Rationale: Quality describes the character of the symptom, such as productive vs. non-
productive or the color of sputum. Timing (A), aggravating factors (C), and severity (D) are
separate components of the HPI.
2. Which term describes the probability that a person with a negative test result actually does
not have the disease?
A. Negative Predictive Value
B. Specificity
C. Positive Predictive Value
D. Sensitivity
,Answer: A
Rationale: Negative Predictive Value (NPV) is the probability that subjects with a negative
screening test truly don’t have the disease.
3. In the SOAP note format, where should the provider document the patient’s reported
allergies?
A. Assessment
B. Objective
C. Subjective
D. Plan
Answer: C
Rationale: Allergies, as part of the patient’s history provided by the patient, belong in the
Subjective section.
4. When performing a physical exam on a patient with abdominal pain, which sequence of
techniques is correct?
A. Inspection, Auscultation, Percussion, Palpation
B. Inspection, Palpation, Percussion, Auscultation
C. Auscultation, Inspection, Palpation, Percussion
D. Palpation, Percussion, Auscultation, Inspection
Answer: A
, Rationale: For the abdomen, auscultation is performed before percussion and palpation to
avoid altering bowel sounds.
5. A diagnostic test with high sensitivity is most useful for which of the following?
A. Confirming a diagnosis
B. Predicting the prognosis
C. Determining the severity of a disease
D. Ruling out a disease
Answer: D
Rationale: High sensitivity tests (SnNout) are best used to rule out a disease because a
negative result strongly suggests the absence of the disease.
6. Which of the following is considered ‘Objective’ data in a clinical assessment?
A. The patient’s chief complaint of chest pain
B. A blood pressure reading of 140/90 mmHg
C. A family history of heart disease
D. The patient’s description of pain as ‘sharp’
Answer: B
Rationale: Objective data are measurable and observable signs, such as vital signs, physical
exam findings, and lab results.
