WILKES UNIVERSITY NUR 508 – DIAGNOSTIC
REASONING EXAM 3 QUESTION AND CORRECT
ANSWER 2026 UPDATE COMPLETE SOLUTION
1. A patient presents with acute chest pain and diaphoresis. What is the priority
diagnostic test?
A. Chest X-ray
B. ECG
C. MRI
D. CT scan
ECG is the fastest and most critical test to detect myocardial ischemia or infarction.
2. Which lab value is most specific for myocardial infarction?
A. CK-MB
B. Troponin I
C. Myoglobin
D. BNP
Troponin I is highly sensitive and specific for cardiac muscle injury.
3. A patient presents with fever, hypotension, and tachycardia. What is the likely
diagnosis?
A. Cardiogenic shock
B. Septic shock
C. Neurogenic shock
D. Hypovolemic shock
These findings are classic for sepsis progressing to shock.
4. Which test confirms pulmonary embolism?
A. Chest X-ray
B. CT pulmonary angiography
C. ECG
,D. MRI
This imaging directly visualizes emboli in pulmonary arteries.
5. Fruity breath and confusion indicate:
A. Hypoglycemia
B. DKA
C. Stroke
D. Renal failure
Fruity breath is due to ketones in diabetic ketoacidosis.
6. Which lab confirms DKA?
A. Low glucose
B. High glucose + ketones + low bicarbonate
C. High sodium
D. Low potassium
DKA involves hyperglycemia, ketosis, and metabolic acidosis.
7. Sudden unilateral weakness requires:
A. MRI
B. CT head (non-contrast)
C. EEG
D. X-ray
CT scan differentiates ischemic vs hemorrhagic stroke.
8. Which indicates increased ICP?
A. Bradycardia + hypertension
B. Tachycardia
C. Hypotension
D. Fever
Cushing’s triad signals increased intracranial pressure.
9. Abdominal pain radiating to the back suggests:
, A. Appendicitis
B. Pancreatitis
C. Gastritis
D. IBS
Classic presentation of pancreatitis.
10. Best lab for pancreatitis?
A. AST
B. Lipase
C. Sodium
D. Hemoglobin
Lipase is more specific than amylase.
11. Dyspnea and crackles indicate:
A. Asthma
B. Heart failure
C. COPD
D. PE
Fluid accumulation in lungs causes crackles.
12. Which test measures ejection fraction?
A. ECG
B. Echocardiogram
C. CT
D. X-ray
Echocardiography evaluates cardiac function.
13. Flank pain + hematuria suggests:
A. UTI
B. Kidney stones
C. Cancer
D. Prostatitis
Classic presentation of renal calculi.
REASONING EXAM 3 QUESTION AND CORRECT
ANSWER 2026 UPDATE COMPLETE SOLUTION
1. A patient presents with acute chest pain and diaphoresis. What is the priority
diagnostic test?
A. Chest X-ray
B. ECG
C. MRI
D. CT scan
ECG is the fastest and most critical test to detect myocardial ischemia or infarction.
2. Which lab value is most specific for myocardial infarction?
A. CK-MB
B. Troponin I
C. Myoglobin
D. BNP
Troponin I is highly sensitive and specific for cardiac muscle injury.
3. A patient presents with fever, hypotension, and tachycardia. What is the likely
diagnosis?
A. Cardiogenic shock
B. Septic shock
C. Neurogenic shock
D. Hypovolemic shock
These findings are classic for sepsis progressing to shock.
4. Which test confirms pulmonary embolism?
A. Chest X-ray
B. CT pulmonary angiography
C. ECG
,D. MRI
This imaging directly visualizes emboli in pulmonary arteries.
5. Fruity breath and confusion indicate:
A. Hypoglycemia
B. DKA
C. Stroke
D. Renal failure
Fruity breath is due to ketones in diabetic ketoacidosis.
6. Which lab confirms DKA?
A. Low glucose
B. High glucose + ketones + low bicarbonate
C. High sodium
D. Low potassium
DKA involves hyperglycemia, ketosis, and metabolic acidosis.
7. Sudden unilateral weakness requires:
A. MRI
B. CT head (non-contrast)
C. EEG
D. X-ray
CT scan differentiates ischemic vs hemorrhagic stroke.
8. Which indicates increased ICP?
A. Bradycardia + hypertension
B. Tachycardia
C. Hypotension
D. Fever
Cushing’s triad signals increased intracranial pressure.
9. Abdominal pain radiating to the back suggests:
, A. Appendicitis
B. Pancreatitis
C. Gastritis
D. IBS
Classic presentation of pancreatitis.
10. Best lab for pancreatitis?
A. AST
B. Lipase
C. Sodium
D. Hemoglobin
Lipase is more specific than amylase.
11. Dyspnea and crackles indicate:
A. Asthma
B. Heart failure
C. COPD
D. PE
Fluid accumulation in lungs causes crackles.
12. Which test measures ejection fraction?
A. ECG
B. Echocardiogram
C. CT
D. X-ray
Echocardiography evaluates cardiac function.
13. Flank pain + hematuria suggests:
A. UTI
B. Kidney stones
C. Cancer
D. Prostatitis
Classic presentation of renal calculi.
