NURS 550 EXAM 2 ACTUAL TEST PAPER 2026
QUESTIONS WITH SOLUTIONS GRADED A+
◉ Develop a Complete, Framed Differential Diagnosis (Hypothesis)
Answer: • Not all diagnoses in a given differential are: - equally likely
- equally important
• You must select: - a leading (working) hypothesis - a must not miss
hypothesis - An active alternative hypothesis
◉ SOAP stands for: Answer: • Subjective • Objective • Assessment •
Plan
◉ Subjective Answer: The subjective section is what the patient tells
you about their current condition and past conditions.
◉ Chief Complaint Answer: • What brought the patient to the office
• Example: Sore throat for 2 days
◉ History of Present Illness/Injury Answer: - Onset - When did the
symptoms and/or signs begin, what was the mechanism of injury
- Chronology - episodic, variable, constant, etc
- Quality - sharp, dull, ache, sudden, insidious
,- Severity - pain rating, 0-10 pain scale, interferes with daily
activities
- Modifying factors - aggravating and alleviating factors
- Additional symptoms - unrelated or significant symptoms
- Treatment - medications, herbs, "home remedies", rest, activity,
splint, etc
- Use "OLDCART" to assist you (Onset, Location, Duration, Character
, Aggravating factors, Relieving factors, Treatments"
◉ History Answer: Allergies - list of allergies to food, medication,
and products with type of reaction
- Medical - past and present medical conditions (i.e. asthma,
hypertension, malaria, etc.)
- Surgical - past surgeries (i.e. appendectomy, CABG, craniotomy,
etc.)
- Family - mother, father, siblings, etc. - Social - occupation, alcohol,
drug, tobacco use, risky behavior
- Immunizations - current and past received with dates
- Screenings/Health Promotion - mammography, testicular exams,
dental, vision
- Review of Systems - systemic symptoms related to the current
problem(s) including pertinent positives and negatives
,◉ Review of Systems Answer: General - fever (subjective) with chills
and sweats, denies fatigue, weakness, weight loss, or malaise
- Skin - denies rashes, lesions, discolorations
- HEENT - positive for generalized headache, sore throat, pain with
swallowing and rhinorrhea. Denies difficulty swallowing saliva,
earache, sinus congestion, sinus pain, visual or auditory aura
- Neck - denies lump, pain, stiffness, or decreased range of motion
- Cardiac - denies chest pain, pressure, tightness, palpitations
- Pulmonary - denies cough, wheeze, hemoptysis
- GI - denies nausea, vomiting, abdominal pain
- GU - denies missed menses, urinary frequency, urgency or
hematuria
- MS - denies cramping, pain,
- Neuro - denies unilateral weakness, numbness, tingling
◉ Review of Systems Answer: • Should elaborate on the chief
complaint and HPI • Don't ask questions that the patient may not
know
Review of Systems
Do you have a problem with your prostate? Do have anemia, heart
failure, cancer? Do you frequently urinate during the night? Have
you noticed a change in the stream of your urine? Do you avoid
drinking fluids during work? Do you feel tired often? Are you short
of breath? Have you had any weight loss recently?
, ◉ Objective Answer: In this section you document what you observe
during the examination and visit.
◉ Physical Examination Answer: - Vital signs - Physical examination
findings - the use of "normal", "within normal limits",
"unremarkable" and other phrases are NOT acceptable. - Diagnostic
results - Measurements including height, weight, screening tools, etc.
- Mental Status
-Weight 50 Kg previously documented height 5'3" -Vital signs - BP
118/76, HR 104, RR 16, T 38.2C, pulse Ox 99% RA -Diagnostic
results •Rapid strep test positive
◉ -Physical examination findings Answer: • General -Well nourished
and hydrated 28 yo female. Awake, alert and orient; appropriately
dressed for season. Pleasant and cooperative.
*Skin - hot, dry and pink. No rashes or lesions including petechiae
noted
• HEENT - normocephalic, symmetric face features. No tenderness in
scalp, face, ethmoid/maxillary/frontal sinuses. Negative
transillumination. External ears without deviations, ear canal clear
bilaterally, tympanic membranes pearly grey with cone of light, bony
landmarks visualized bilaterally. Nasal mucosa pink and moist
turbinates with no edema or erythema. Oral mucosa pink and moist,
dentition without obvious caries; no lesions oral cavity. Pharynx
with moderate erythema tonsillar pillars ¼ bilaterally. No exudate.
Uvula midline gag reflex present.
QUESTIONS WITH SOLUTIONS GRADED A+
◉ Develop a Complete, Framed Differential Diagnosis (Hypothesis)
Answer: • Not all diagnoses in a given differential are: - equally likely
- equally important
• You must select: - a leading (working) hypothesis - a must not miss
hypothesis - An active alternative hypothesis
◉ SOAP stands for: Answer: • Subjective • Objective • Assessment •
Plan
◉ Subjective Answer: The subjective section is what the patient tells
you about their current condition and past conditions.
◉ Chief Complaint Answer: • What brought the patient to the office
• Example: Sore throat for 2 days
◉ History of Present Illness/Injury Answer: - Onset - When did the
symptoms and/or signs begin, what was the mechanism of injury
- Chronology - episodic, variable, constant, etc
- Quality - sharp, dull, ache, sudden, insidious
,- Severity - pain rating, 0-10 pain scale, interferes with daily
activities
- Modifying factors - aggravating and alleviating factors
- Additional symptoms - unrelated or significant symptoms
- Treatment - medications, herbs, "home remedies", rest, activity,
splint, etc
- Use "OLDCART" to assist you (Onset, Location, Duration, Character
, Aggravating factors, Relieving factors, Treatments"
◉ History Answer: Allergies - list of allergies to food, medication,
and products with type of reaction
- Medical - past and present medical conditions (i.e. asthma,
hypertension, malaria, etc.)
- Surgical - past surgeries (i.e. appendectomy, CABG, craniotomy,
etc.)
- Family - mother, father, siblings, etc. - Social - occupation, alcohol,
drug, tobacco use, risky behavior
- Immunizations - current and past received with dates
- Screenings/Health Promotion - mammography, testicular exams,
dental, vision
- Review of Systems - systemic symptoms related to the current
problem(s) including pertinent positives and negatives
,◉ Review of Systems Answer: General - fever (subjective) with chills
and sweats, denies fatigue, weakness, weight loss, or malaise
- Skin - denies rashes, lesions, discolorations
- HEENT - positive for generalized headache, sore throat, pain with
swallowing and rhinorrhea. Denies difficulty swallowing saliva,
earache, sinus congestion, sinus pain, visual or auditory aura
- Neck - denies lump, pain, stiffness, or decreased range of motion
- Cardiac - denies chest pain, pressure, tightness, palpitations
- Pulmonary - denies cough, wheeze, hemoptysis
- GI - denies nausea, vomiting, abdominal pain
- GU - denies missed menses, urinary frequency, urgency or
hematuria
- MS - denies cramping, pain,
- Neuro - denies unilateral weakness, numbness, tingling
◉ Review of Systems Answer: • Should elaborate on the chief
complaint and HPI • Don't ask questions that the patient may not
know
Review of Systems
Do you have a problem with your prostate? Do have anemia, heart
failure, cancer? Do you frequently urinate during the night? Have
you noticed a change in the stream of your urine? Do you avoid
drinking fluids during work? Do you feel tired often? Are you short
of breath? Have you had any weight loss recently?
, ◉ Objective Answer: In this section you document what you observe
during the examination and visit.
◉ Physical Examination Answer: - Vital signs - Physical examination
findings - the use of "normal", "within normal limits",
"unremarkable" and other phrases are NOT acceptable. - Diagnostic
results - Measurements including height, weight, screening tools, etc.
- Mental Status
-Weight 50 Kg previously documented height 5'3" -Vital signs - BP
118/76, HR 104, RR 16, T 38.2C, pulse Ox 99% RA -Diagnostic
results •Rapid strep test positive
◉ -Physical examination findings Answer: • General -Well nourished
and hydrated 28 yo female. Awake, alert and orient; appropriately
dressed for season. Pleasant and cooperative.
*Skin - hot, dry and pink. No rashes or lesions including petechiae
noted
• HEENT - normocephalic, symmetric face features. No tenderness in
scalp, face, ethmoid/maxillary/frontal sinuses. Negative
transillumination. External ears without deviations, ear canal clear
bilaterally, tympanic membranes pearly grey with cone of light, bony
landmarks visualized bilaterally. Nasal mucosa pink and moist
turbinates with no edema or erythema. Oral mucosa pink and moist,
dentition without obvious caries; no lesions oral cavity. Pharynx
with moderate erythema tonsillar pillars ¼ bilaterally. No exudate.
Uvula midline gag reflex present.
