TESTBANK
ADVANCEDHEALTHASSESSMENT&CLINICALDIAGNOSISIN P
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RIMARY CARE, 6TH EDITION
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JoyceE. Dains, Linda Ciofu Baumann & Pamela Scheibel
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, gt
lOMoARcPSD|126 567
gt 13
Test Bank for Advanced Health Assessment & Clinical Diagnosis in Primary Care 6th Ed
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ition Dains gt
Chapter 1: Clinical Reasoning, Differential Diagnosis, Evidence-Based Practice, and Symptom Analysis
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Multiple Choice gt
Identify the choice that best completes the statement oranswers the question.
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1. Which type of clinical decision-making is most reliable?
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A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
2. Which of the following is false? To obtain adequate history, health-care providers must be:
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A. Methodical and systematic gt gt
B. Attentive to the patient’s verbal and nonverbal langua
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g
e
C. Able to accurately interpret the patient’s responses
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D. Adept at reading into the patient’s statements
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3. Essential parts of a health history include all of the following except:
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A. Chief complaint gt
B. History of the present illness gt gt gt g t
C. Current vital signs gt gt
D. All of the above are essential history compone
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nt
s
4. Which of the following is false? While performing the physical examination, the examiner must be able to:
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A. Differentiate between normal and abnormal findings gt gt gt gt gt
B. Recall knowledge of a range of conditions and their associated signs and sympto
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ms
C. Recognize how certain conditions affect the response to other conditions
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D. Foresee unpredictable findings gt gt
5. The following is the least reliable source of information for diagnostic statistics:
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A. Evidence-based investigations ym
B. Primary reports of research gt gt gt
C. Estimation based on a provider’s experienc gt gt gt gt gt
e
D. Published meta-analyses gt
6. The following can be used to assist in sound clinical decision-making:
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A. Algorithm published in a peer- ym gt gt ym
reviewed journal article ym gt
B. Clinical practice guidelines gt gt
C. Evidence-based research ym
D. All of the above g t gt gt
7. If a diagnostic study has high sensitivity, this indicates a:
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A. High percentage of persons with the given condition will have an abnormal r
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es
ult
B. Low percentage of persons with the given condition will have an abnormal r
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es
ult
C. Low likelihood of normal result in persons without a given condition
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D. None of the above gt gt gt
8. If a diagnostic study has high specificity, this indicates a:
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A. Low percentage of healthy individuals will show a normal result
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B. High percentage of healthy individuals will show a normal result
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C. High percentage of individuals with a disorder will show a normal resul
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D. Low percentage of individuals with a disorder will show an abnormal res
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ult gt
9. A likelihood ratio above 1 indicates that a diagnostic test showing a:
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A. Positive result is strongly associated with the disease
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B. Negative result is strongly associated with absence of the dise
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as
e
C. Positive result is weakly associated with the disease
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, gt
D. Negative result is weakly associated with absence of the disea
lOMoARcPSD|126 567
gt 13
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se
10. Which of the following clinical reasoning tools is defined as evidence-
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based resource based on mathematical modeling to express the likelihood of a condition in select situations, settings, and
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/or patients?
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, gt
lOMoARcPSD|126 567
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A. Clinical practice guidelin gt g t
e
B. Clinical decision rule gt g t
C. Clinical algorithm gt
Chapter 1: Clinical reasoning, differential diagnosis, evidence-based practice, and symptom ana
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Answer Section
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MULTIPLE CHOICE g t
1. ANS: B
Croskerry (2009) describes two major types of clinical diagnostic decision-
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making: intuitive and analytical. Intuitive decision- making (similar to Augenblink decision-
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making) is based on the experience and intuition of the clinician and is less reliable and paired with fairly common error
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s. In contrast, analytical decision-making is based on careful consideration and has greater reliability with rare errors.
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PTS: 1
2. ANS: D
To obtain adequate history, providers must be well organized, attentive to the patient’s verbal and nonverbal language, and
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able to accurately interpret the patient’s responses to questions. Rather than reading into the patient’s stateme
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nts, they clarify any areas of uncertainty.
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PTS: 1
3. ANS: C
Vital signs are part of the physical examination portion of patient assessment, not part of the health history.
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PTS: 1
4. ANS: D
While performing the physical examination, the examiner must be able to differentiate between normal and abnorm
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al find ings, recall knowledge of a range of conditions, including their associated signs and symptoms, recognize how certain c
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ond itions affect the response to other conditions, and distinguish the relevance of varied abnormal findings.
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PTS: 1
5. ANS: C
Sources for diagnostic statistics include textbooks, primary reports of research, and published meta-
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analyses. Another source of statistics, the one that has been most widely used and available for application to the reasoning pr
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ocess, is the estimation based on a provider’s experience, although these are rarely accurate. Over the past decade, the availabi
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lity of evidence on which to base clinical reasoning is improving, and there is an increasing expectation that cl
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inical reasoning be based on scientific evidence.
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Evidence-based statistics are also increasingly being used to develop resources to facilitate clinical decision-making.
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PTS: 1
6. ANS: D
To assist in clinical decision-making, a number of evidence-
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based resources have been developed to assist the clinician. Resources, such as algorithms and clinical practice guidelines
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, assist in clinical reasoning when properly applied.
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PTS: 1
7. ANS: A
The sensitivity of a diagnostic study is the percentage of individuals with the target condition who show an abnormal, or p ositiv
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e, result. A high sensitivity indicates that a greater percentage of persons with the given condition will have an abn
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o rmal result.
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PTS: 1
8. ANS: B
The specificity of a diagnostic study is the percentage of normal, healthy individuals who have a normal result. Th
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e grea ter the specificity, the greater the percentage of individuals who will have negative, or normal, results if t
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hey do not ha ve the target condition.
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PTS: 1
9. ANS: A
The likelihood ratio is the probability that a positive test result will be associated with a person who has the target
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tconditi on and a negative result will be associated with a healthy person. A likelihood ratio above 1 indicates th
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at a positive res ult is associated with the disease; a likelihood ratio less than 1 indicates that a negative result is
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associated with an absen ce of the disease. g t g t g t gt g t g t g t
ADVANCEDHEALTHASSESSMENT&CLINICALDIAGNOSISIN P
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RIMARY CARE, 6TH EDITION
gt gt gt
JoyceE. Dains, Linda Ciofu Baumann & Pamela Scheibel
gt gt gt gt gt gt gt gt
, gt
lOMoARcPSD|126 567
gt 13
Test Bank for Advanced Health Assessment & Clinical Diagnosis in Primary Care 6th Ed
gt gt gt gt gt gt gt gt gt gt gt gt gt
ition Dains gt
Chapter 1: Clinical Reasoning, Differential Diagnosis, Evidence-Based Practice, and Symptom Analysis
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Multiple Choice gt
Identify the choice that best completes the statement oranswers the question.
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1. Which type of clinical decision-making is most reliable?
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A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
2. Which of the following is false? To obtain adequate history, health-care providers must be:
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A. Methodical and systematic gt gt
B. Attentive to the patient’s verbal and nonverbal langua
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g
e
C. Able to accurately interpret the patient’s responses
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D. Adept at reading into the patient’s statements
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3. Essential parts of a health history include all of the following except:
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A. Chief complaint gt
B. History of the present illness gt gt gt g t
C. Current vital signs gt gt
D. All of the above are essential history compone
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nt
s
4. Which of the following is false? While performing the physical examination, the examiner must be able to:
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A. Differentiate between normal and abnormal findings gt gt gt gt gt
B. Recall knowledge of a range of conditions and their associated signs and sympto
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ms
C. Recognize how certain conditions affect the response to other conditions
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D. Foresee unpredictable findings gt gt
5. The following is the least reliable source of information for diagnostic statistics:
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A. Evidence-based investigations ym
B. Primary reports of research gt gt gt
C. Estimation based on a provider’s experienc gt gt gt gt gt
e
D. Published meta-analyses gt
6. The following can be used to assist in sound clinical decision-making:
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A. Algorithm published in a peer- ym gt gt ym
reviewed journal article ym gt
B. Clinical practice guidelines gt gt
C. Evidence-based research ym
D. All of the above g t gt gt
7. If a diagnostic study has high sensitivity, this indicates a:
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A. High percentage of persons with the given condition will have an abnormal r
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es
ult
B. Low percentage of persons with the given condition will have an abnormal r
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es
ult
C. Low likelihood of normal result in persons without a given condition
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D. None of the above gt gt gt
8. If a diagnostic study has high specificity, this indicates a:
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A. Low percentage of healthy individuals will show a normal result
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B. High percentage of healthy individuals will show a normal result
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C. High percentage of individuals with a disorder will show a normal resul
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t
D. Low percentage of individuals with a disorder will show an abnormal res
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ult gt
9. A likelihood ratio above 1 indicates that a diagnostic test showing a:
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A. Positive result is strongly associated with the disease
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B. Negative result is strongly associated with absence of the dise
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as
e
C. Positive result is weakly associated with the disease
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, gt
D. Negative result is weakly associated with absence of the disea
lOMoARcPSD|126 567
gt 13
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se
10. Which of the following clinical reasoning tools is defined as evidence-
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based resource based on mathematical modeling to express the likelihood of a condition in select situations, settings, and
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/or patients?
g t
, gt
lOMoARcPSD|126 567
gt 13
A. Clinical practice guidelin gt g t
e
B. Clinical decision rule gt g t
C. Clinical algorithm gt
Chapter 1: Clinical reasoning, differential diagnosis, evidence-based practice, and symptom ana
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Answer Section
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MULTIPLE CHOICE g t
1. ANS: B
Croskerry (2009) describes two major types of clinical diagnostic decision-
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making: intuitive and analytical. Intuitive decision- making (similar to Augenblink decision-
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making) is based on the experience and intuition of the clinician and is less reliable and paired with fairly common error
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s. In contrast, analytical decision-making is based on careful consideration and has greater reliability with rare errors.
g t g t g t g t g t g t g t g t g t g t g t g t g t g t g t g t
PTS: 1
2. ANS: D
To obtain adequate history, providers must be well organized, attentive to the patient’s verbal and nonverbal language, and
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able to accurately interpret the patient’s responses to questions. Rather than reading into the patient’s stateme
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nts, they clarify any areas of uncertainty.
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PTS: 1
3. ANS: C
Vital signs are part of the physical examination portion of patient assessment, not part of the health history.
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PTS: 1
4. ANS: D
While performing the physical examination, the examiner must be able to differentiate between normal and abnorm
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al find ings, recall knowledge of a range of conditions, including their associated signs and symptoms, recognize how certain c
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ond itions affect the response to other conditions, and distinguish the relevance of varied abnormal findings.
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PTS: 1
5. ANS: C
Sources for diagnostic statistics include textbooks, primary reports of research, and published meta-
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analyses. Another source of statistics, the one that has been most widely used and available for application to the reasoning pr
gt gt gt gt gt gt gt gt gt gt gt gt ym ym gt gt gt gt gt gt
ocess, is the estimation based on a provider’s experience, although these are rarely accurate. Over the past decade, the availabi
gt gt gt gt gt gt gt gt gt gt gt gt gt gt gt gt gt gt gt
lity of evidence on which to base clinical reasoning is improving, and there is an increasing expectation that cl
g t g t g t g t g t g t g t g t gt g t g t g t g t g t g t g t g t g t
inical reasoning be based on scientific evidence.
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Evidence-based statistics are also increasingly being used to develop resources to facilitate clinical decision-making.
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PTS: 1
6. ANS: D
To assist in clinical decision-making, a number of evidence-
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based resources have been developed to assist the clinician. Resources, such as algorithms and clinical practice guidelines
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, assist in clinical reasoning when properly applied.
g t g t g t g t g t g t gt
PTS: 1
7. ANS: A
The sensitivity of a diagnostic study is the percentage of individuals with the target condition who show an abnormal, or p ositiv
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e, result. A high sensitivity indicates that a greater percentage of persons with the given condition will have an abn
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o rmal result.
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PTS: 1
8. ANS: B
The specificity of a diagnostic study is the percentage of normal, healthy individuals who have a normal result. Th
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e grea ter the specificity, the greater the percentage of individuals who will have negative, or normal, results if t
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hey do not ha ve the target condition.
g t g t g t gt g t g t g t
PTS: 1
9. ANS: A
The likelihood ratio is the probability that a positive test result will be associated with a person who has the target
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tconditi on and a negative result will be associated with a healthy person. A likelihood ratio above 1 indicates th
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at a positive res ult is associated with the disease; a likelihood ratio less than 1 indicates that a negative result is
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associated with an absen ce of the disease. g t g t g t gt g t g t g t
