NSG 550
EXAM 2
Diagnostic Reasoning
Actual Questions with Verified Answers
Wilkes University
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➢Exam 2 Comprehensive Study Guide
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,Table of Contents
NSG 550 Exam 2 ................................................................. 2
NSG 550 Exam 2 Study Guide ............................................. 58
NSG 550 Exam 2
Question 1
A 52-year-old male presents to the emergency department with sudden onset of
severe epigastric pain that radiates to his back. He reports nausea and vomiting.
The pain is steady and worsens when he walks or lies supine. He admits to
drinking approximately 12 beers daily and consumed a large fatty meal 4 hours
prior to symptom onset. His vital signs reveal a temperature of 101.2°F, heart rate
of 112 bpm, and blood pressure of 148/92 mmHg. Laboratory studies show lipase
980 U/L (normal: 10–140), amylase 420 U/L (normal: 30–110), ALT 85 U/L, CRP 18
mg/L, WBC 16,500/μL, and glucose 198 mg/dL.
Which diagnostic imaging study is the first choice to confirm the diagnosis?
A. Abdominal ultrasound
B. CT abdomen with contrast — CORRECT ✓
C. MRI abdomen
D. ERCP
Rationale: The patient presents with classic signs of acute pancreatitis: epigastric
pain radiating to the back, worsened by supine position and walking,
nausea/vomiting, history of alcohol abuse and heavy meal, and laboratory
findings of elevated lipase (>3× upper limit of normal), elevated amylase,
elevated ALT, CRP, WBC, and hyperglycemia. While abdominal ultrasound can
, visualize the pancreas, CT abdomen is the first-choice diagnostic imaging for
pancreatitis as it provides detailed visualization of pancreatic inflammation,
necrosis, and complications. ERCP is used to evaluate bile duct patency, not as
initial imaging. MRI is not first-line.
Question 2 (SATA)
A 45-year-old female presents with RUQ pain, nausea, vomiting, and a low-grade
fever. She reports the pain began approximately 6 hours after eating fried
chicken. On physical examination, the nurse practitioner elicits a positive
Murphy's sign. Her WBC is 14,200/μL.
Which of the following diagnostic tests would be appropriate to order? Select all
that apply.
A. RUQ ultrasound — CORRECT ✓
B. HIDA scan — CORRECT ✓
C. CT abdomen
D. ERCP
E. Abdominal x-ray
Rationale: This patient has acute cholecystitis (RUQ pain after fatty meal, positive
Murphy's sign, fever, elevated WBC). The gold standard diagnostic imaging is
RUQ ultrasound (A). If the ultrasound is inconclusive, a HIDA scan (B) would be
the next appropriate test. A CT abdomen (C) is not the preferred initial test for
cholecystitis. ERCP (D) evaluates bile duct patency and is used for bile duct
stones, not gallbladder inflammation. Abdominal x-ray (E) has limited utility for
cholecystitis diagnosis.
Question 3
A 68-year-old male with a history of alcohol abuse presents with epigastric pain,
nausea, and vomiting. Laboratory studies reveal a lipase of 1,250 U/L (3× upper
EXAM 2
Diagnostic Reasoning
Actual Questions with Verified Answers
Wilkes University
Pass the Exam with Confidence
What You Will Get:
➢100 Exam Questions w/ Answers
➢Expert Rationales included.
➢Exam 2 Comprehensive Study Guide
,PREVIEW ACCESS
Preview Pages
Below
Get the Complete PDF
After Purchase
NEED HELP OR MORE STUDY RESOURCES?
"If you require further clarification or in need of any study
resources, feel free to Message me."
,Table of Contents
NSG 550 Exam 2 ................................................................. 2
NSG 550 Exam 2 Study Guide ............................................. 58
NSG 550 Exam 2
Question 1
A 52-year-old male presents to the emergency department with sudden onset of
severe epigastric pain that radiates to his back. He reports nausea and vomiting.
The pain is steady and worsens when he walks or lies supine. He admits to
drinking approximately 12 beers daily and consumed a large fatty meal 4 hours
prior to symptom onset. His vital signs reveal a temperature of 101.2°F, heart rate
of 112 bpm, and blood pressure of 148/92 mmHg. Laboratory studies show lipase
980 U/L (normal: 10–140), amylase 420 U/L (normal: 30–110), ALT 85 U/L, CRP 18
mg/L, WBC 16,500/μL, and glucose 198 mg/dL.
Which diagnostic imaging study is the first choice to confirm the diagnosis?
A. Abdominal ultrasound
B. CT abdomen with contrast — CORRECT ✓
C. MRI abdomen
D. ERCP
Rationale: The patient presents with classic signs of acute pancreatitis: epigastric
pain radiating to the back, worsened by supine position and walking,
nausea/vomiting, history of alcohol abuse and heavy meal, and laboratory
findings of elevated lipase (>3× upper limit of normal), elevated amylase,
elevated ALT, CRP, WBC, and hyperglycemia. While abdominal ultrasound can
, visualize the pancreas, CT abdomen is the first-choice diagnostic imaging for
pancreatitis as it provides detailed visualization of pancreatic inflammation,
necrosis, and complications. ERCP is used to evaluate bile duct patency, not as
initial imaging. MRI is not first-line.
Question 2 (SATA)
A 45-year-old female presents with RUQ pain, nausea, vomiting, and a low-grade
fever. She reports the pain began approximately 6 hours after eating fried
chicken. On physical examination, the nurse practitioner elicits a positive
Murphy's sign. Her WBC is 14,200/μL.
Which of the following diagnostic tests would be appropriate to order? Select all
that apply.
A. RUQ ultrasound — CORRECT ✓
B. HIDA scan — CORRECT ✓
C. CT abdomen
D. ERCP
E. Abdominal x-ray
Rationale: This patient has acute cholecystitis (RUQ pain after fatty meal, positive
Murphy's sign, fever, elevated WBC). The gold standard diagnostic imaging is
RUQ ultrasound (A). If the ultrasound is inconclusive, a HIDA scan (B) would be
the next appropriate test. A CT abdomen (C) is not the preferred initial test for
cholecystitis. ERCP (D) evaluates bile duct patency and is used for bile duct
stones, not gallbladder inflammation. Abdominal x-ray (E) has limited utility for
cholecystitis diagnosis.
Question 3
A 68-year-old male with a history of alcohol abuse presents with epigastric pain,
nausea, and vomiting. Laboratory studies reveal a lipase of 1,250 U/L (3× upper
