NR569 EXAMINATION 2026 VERIFIED
SOLUTION COMPENDIUM
◉How to build a DDx. Answer: 1. list your top dx first followed by
other potential dx for a specific problem, but keep it problem
oriented until you have the actual dx.
2. Aggressively prioritize workup of the most likely and most
harmful dx under consideration.
3. prioritize the workup of acute and reversible diseases followed by
chronic and irreversible.
4. As info or data the effectively rules out a particular dx, remove
that dx from the list and focus your attention towards the remaining
possibilities.
5. once the dx has been confirmed, the problem list should be
diagnosis oriented rather than problem oriented.
●if the pt were to not respond to the tx, the pt should be re-evaluate
the pt, review diagnostic data and finally provide a summary of key
data to ensure that the diagnosis is indeed correct.
◉Likelihood Ratios. Answer: Likelihood ratios are more helpful to
make clinical decisions than sensitivty and specificity. For a given dx
test, positive likelihood ratio apply to positive results; negative
likelihood ratios apply to negative results
,◉Positive likelihood ratio. Answer: is the likelihood that a pt with
the disease test positive compared to the likelihood that a patient
without the disease test positive.
●if a test result is positive and the positive likelihood is >1, then it is
more likely than chance that the pt has the disease. However, if the
likelihood ratio for that test is <1, then it is less likely that the pt has
the disease.
◉Negative Likelihood Ratio. Answer: is the likelihood that a pt with
the disease test negative compared to the likelihood that a pt
without the disease test negative.
◉Acute nausea & vomiting. Answer: are associated with acute
infections (especially in the GI tract), ingestion of toxins, GI
obstruction or ischemia, new meds, pregnancy, or head trauma/
increase ICP.
◉Chronic nausea & vomiting. Answer: usually defined as persistence
of symptoms for more than 1 month, suggest partial mechanical
obstruction, intracranial pathology, dysmotility such as
gastroparesis, metabolic or endocrine etiology, or a psychologic
disturbance.
◉PE of the Skin (order). Answer: 1. gown pt
2. hand hygiene
, *patient starts seated*
3. inspect the hair & scalp (distribution, texture, & quantity)
4. inspect the head and neck, including the forehead, eyebrows,
eyelids, eyelashes, conjunctivae, sclerae, nose, ears, cheeks, lips, oral
cavity, chin and beard.
5. inspect the upper back
6. inspect the shoulders, arms, and hands including palpation of
fingernails
7. inspect the chest and abd
8. inspect the anterior thighs and legs
9. inspect the feet and toes, including soles, interdigital areas and
toenails.
*patient position is standing*
10. inspect lower back
11. inspect posterior aspect of thighs and legs.
12. inspect breast, axillae, and genitalia, including axillary and pubic
hair.
◉principles of good documentation (8). Answer: 1.Is the
organization clear?
2.Does the included information contribute directly to the
assessment?
3.Are pertinent negatives specifically described?
SOLUTION COMPENDIUM
◉How to build a DDx. Answer: 1. list your top dx first followed by
other potential dx for a specific problem, but keep it problem
oriented until you have the actual dx.
2. Aggressively prioritize workup of the most likely and most
harmful dx under consideration.
3. prioritize the workup of acute and reversible diseases followed by
chronic and irreversible.
4. As info or data the effectively rules out a particular dx, remove
that dx from the list and focus your attention towards the remaining
possibilities.
5. once the dx has been confirmed, the problem list should be
diagnosis oriented rather than problem oriented.
●if the pt were to not respond to the tx, the pt should be re-evaluate
the pt, review diagnostic data and finally provide a summary of key
data to ensure that the diagnosis is indeed correct.
◉Likelihood Ratios. Answer: Likelihood ratios are more helpful to
make clinical decisions than sensitivty and specificity. For a given dx
test, positive likelihood ratio apply to positive results; negative
likelihood ratios apply to negative results
,◉Positive likelihood ratio. Answer: is the likelihood that a pt with
the disease test positive compared to the likelihood that a patient
without the disease test positive.
●if a test result is positive and the positive likelihood is >1, then it is
more likely than chance that the pt has the disease. However, if the
likelihood ratio for that test is <1, then it is less likely that the pt has
the disease.
◉Negative Likelihood Ratio. Answer: is the likelihood that a pt with
the disease test negative compared to the likelihood that a pt
without the disease test negative.
◉Acute nausea & vomiting. Answer: are associated with acute
infections (especially in the GI tract), ingestion of toxins, GI
obstruction or ischemia, new meds, pregnancy, or head trauma/
increase ICP.
◉Chronic nausea & vomiting. Answer: usually defined as persistence
of symptoms for more than 1 month, suggest partial mechanical
obstruction, intracranial pathology, dysmotility such as
gastroparesis, metabolic or endocrine etiology, or a psychologic
disturbance.
◉PE of the Skin (order). Answer: 1. gown pt
2. hand hygiene
, *patient starts seated*
3. inspect the hair & scalp (distribution, texture, & quantity)
4. inspect the head and neck, including the forehead, eyebrows,
eyelids, eyelashes, conjunctivae, sclerae, nose, ears, cheeks, lips, oral
cavity, chin and beard.
5. inspect the upper back
6. inspect the shoulders, arms, and hands including palpation of
fingernails
7. inspect the chest and abd
8. inspect the anterior thighs and legs
9. inspect the feet and toes, including soles, interdigital areas and
toenails.
*patient position is standing*
10. inspect lower back
11. inspect posterior aspect of thighs and legs.
12. inspect breast, axillae, and genitalia, including axillary and pubic
hair.
◉principles of good documentation (8). Answer: 1.Is the
organization clear?
2.Does the included information contribute directly to the
assessment?
3.Are pertinent negatives specifically described?
