NSG 550 – Diagnostic Reasoning for Nurse
Practitioners Exam 1 (2025-2026) Fall-Spring
Practice Questions And Answers Graded A+ Wilkes
An 8-year-old patient presents with their mother to the clinic. The client's chief
complaint is a "very sore throat". The vital signs for the patient are: temperature
101.6F, pulse 102 bpm, blood pressure 92/54 mmHg, respirations 12/min. Which
diagnostic test should the provider order first?
Rapid streptococcal testing
Rapid screening tests (rapid antigen detection testing [RADT]) for streptococcal
antigens are useful in patients with signs and symptoms of acute pharyngitis.
Because of improvements with RADT, a throat culture is not necessary unless the
RADT is negative, symptoms do not improve or the patient shows no response to
appropriate antibiotics. Streptococcal pharyngitis is most common among those
under 25 years of age, especially 5 - 15 years.
A 36-year-old female presents to the office complaining of headache since she
started a new position at work. When completing the HPI, the clinician notes that
the client's previous position involved walking through the industrial plant,
however the new job has her sitting at a desk, looking at a computer most of the
day. The client describes the headaches as dull, non-throbbing and rates the pain
4/10. The provider would make which likely diagnosis?
Tension Headache
,Tension headaches are often the result of emotional or physical stress and can also
occur as a result of abnormal neck positions (especially neck tension) and
prolonged mental concentration. Tension HA is the most common cause of
headache at any age and occurs more commonly in females.
Your client is complaining of fatigue, weight loss, loss of body hair and has palmar
erythema. They have been taking a multivitamin with iron to see if this would help
with symptoms for the last month, but they have increased. Lab values show
microcytic anemia and normal ferritin levels. This is indicative of
Thalassemia
See anemia slide 36 symptoms along with microcytic anemia and normal ferritin
levels indicative of thalassemia
The most sensitive and specific test for iron deficiency is:
Ferritin level
See anemia slide 24 Iron level not indicative of iron stores or true deficiency TIBC
nonspecific and Reticulocyte count compensatory
You are evaluating a 24-year-old female in her 3rd trimester of pregnancy. You
order a hemoglobin and hematocrit due to complaints of fatigue. She denies
spotting or bleeding and her hemoglobin is 13mg/dl and her hematocrit is 30%.
Her current hemoglobin and hematocrit most likely represents
,Hemodilution
Hgb⁄Hct ratio is usually 1:3 when greater usually hemodilution
You are evaluating a client with a history of fever. The Complete Blood Count
reveals the following: WBC 16,000mm3, Neutrophils 40% Lymphocytes 55%
Monocytes 3% Eosinophils: 1%, Basophils 1%. Based on these findings you
suspect:
Viral Infection
WBC and differential slides slide 13 Lymphocytes 20-40% total WBC -increase
with viral infection
Using glomerular filtration rate testing to estimate to monitor the severity of
chronic kidney disease is an example of:
Tertiary Prevention
Screening tests are utilized to:
Assess the likelihood of the presence of a disease or condition in asymptomatic
individuals
, predictive values are dependent on the prevalence of disease among the population
of interest. The same diagnostic test will have varying predictive values in different
population
A 35-year-old male presents with a complaint of sore throat for 3 days. You order
a rapid strep test. This is an example of:
Diagnostic test
Screening assess the likelihood of the presence of a disease or condition in
apparently healthy or asymptomatic individuals who are at sufficient risk for a
condition to benefit from further investigation or preventive action. Laboratory
tests used for diagnosis are performed to determine the presence or absence of a
specific disease or condition in symptomatic individuals. Health promotion is
associated with prevention of conditions is asymptomatic individuals A test with
high clinical utility yields results, whether positive or negative, that provide
information of value to the patient, clinician, or others involved in making
decisions about management of a patient with a given condition
Your client is complaining of "blurriness" in the center of their visual field. They
deny pain, drainage or itching; you know these symptoms are consistent with:
Macular Degeneration
Age-related macular degeneration (AMD) is a disease that blurs the sharp, central
vision you need for "straight-ahead" activities such as reading, sewing, and driving
Practitioners Exam 1 (2025-2026) Fall-Spring
Practice Questions And Answers Graded A+ Wilkes
An 8-year-old patient presents with their mother to the clinic. The client's chief
complaint is a "very sore throat". The vital signs for the patient are: temperature
101.6F, pulse 102 bpm, blood pressure 92/54 mmHg, respirations 12/min. Which
diagnostic test should the provider order first?
Rapid streptococcal testing
Rapid screening tests (rapid antigen detection testing [RADT]) for streptococcal
antigens are useful in patients with signs and symptoms of acute pharyngitis.
Because of improvements with RADT, a throat culture is not necessary unless the
RADT is negative, symptoms do not improve or the patient shows no response to
appropriate antibiotics. Streptococcal pharyngitis is most common among those
under 25 years of age, especially 5 - 15 years.
A 36-year-old female presents to the office complaining of headache since she
started a new position at work. When completing the HPI, the clinician notes that
the client's previous position involved walking through the industrial plant,
however the new job has her sitting at a desk, looking at a computer most of the
day. The client describes the headaches as dull, non-throbbing and rates the pain
4/10. The provider would make which likely diagnosis?
Tension Headache
,Tension headaches are often the result of emotional or physical stress and can also
occur as a result of abnormal neck positions (especially neck tension) and
prolonged mental concentration. Tension HA is the most common cause of
headache at any age and occurs more commonly in females.
Your client is complaining of fatigue, weight loss, loss of body hair and has palmar
erythema. They have been taking a multivitamin with iron to see if this would help
with symptoms for the last month, but they have increased. Lab values show
microcytic anemia and normal ferritin levels. This is indicative of
Thalassemia
See anemia slide 36 symptoms along with microcytic anemia and normal ferritin
levels indicative of thalassemia
The most sensitive and specific test for iron deficiency is:
Ferritin level
See anemia slide 24 Iron level not indicative of iron stores or true deficiency TIBC
nonspecific and Reticulocyte count compensatory
You are evaluating a 24-year-old female in her 3rd trimester of pregnancy. You
order a hemoglobin and hematocrit due to complaints of fatigue. She denies
spotting or bleeding and her hemoglobin is 13mg/dl and her hematocrit is 30%.
Her current hemoglobin and hematocrit most likely represents
,Hemodilution
Hgb⁄Hct ratio is usually 1:3 when greater usually hemodilution
You are evaluating a client with a history of fever. The Complete Blood Count
reveals the following: WBC 16,000mm3, Neutrophils 40% Lymphocytes 55%
Monocytes 3% Eosinophils: 1%, Basophils 1%. Based on these findings you
suspect:
Viral Infection
WBC and differential slides slide 13 Lymphocytes 20-40% total WBC -increase
with viral infection
Using glomerular filtration rate testing to estimate to monitor the severity of
chronic kidney disease is an example of:
Tertiary Prevention
Screening tests are utilized to:
Assess the likelihood of the presence of a disease or condition in asymptomatic
individuals
, predictive values are dependent on the prevalence of disease among the population
of interest. The same diagnostic test will have varying predictive values in different
population
A 35-year-old male presents with a complaint of sore throat for 3 days. You order
a rapid strep test. This is an example of:
Diagnostic test
Screening assess the likelihood of the presence of a disease or condition in
apparently healthy or asymptomatic individuals who are at sufficient risk for a
condition to benefit from further investigation or preventive action. Laboratory
tests used for diagnosis are performed to determine the presence or absence of a
specific disease or condition in symptomatic individuals. Health promotion is
associated with prevention of conditions is asymptomatic individuals A test with
high clinical utility yields results, whether positive or negative, that provide
information of value to the patient, clinician, or others involved in making
decisions about management of a patient with a given condition
Your client is complaining of "blurriness" in the center of their visual field. They
deny pain, drainage or itching; you know these symptoms are consistent with:
Macular Degeneration
Age-related macular degeneration (AMD) is a disease that blurs the sharp, central
vision you need for "straight-ahead" activities such as reading, sewing, and driving
