z!
lOMoARcPSD| 126 567
z! 13
, z!
lOMoARcPSD| 126 567
z! 13
Test Bank for Advanced Health Assessment & Clinical Diagnosis in Primary Care 7th
z! z! z! z! z! z! z! z! z! z! z! z! z!
Edition Dains z!
Chapter 1: Clinical Reasoning, Differential Diagnosis, Evidence-Based Practice, and Symptom Analysis
z! z! z! z! z! z! z! z! z! z!
Multiple Choice z!
Identify the choice that best completes the statement or answers the question.
z! z! z! z! z! z! z! z! z! z! z!
1. Whichz!typez!ofz!clinicalz!decision-makingz!isz!mostz!reliable?
A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
2. Whichz!ofz!thez!followingz!isz!false?z!Toz!obtainz!adequatez!history,z!health-carez!providersz!mustz!be:
A. Methodicalz!andz!systematic
B. Attentivez!toz!thez!patient’sz!verbalz!andz!nonverbalz!language
C. Ablez!toz!accuratelyz!interpretz!thez!patient’sz!responses
D. Adeptz!atz!readingz!intoz!thez!patient’sz!statements
3. Essentialz!partsz!ofz!az!healthz!historyz!includez!allz!ofz!thez!followingz!except:
A. Chiefz!complaint
B. Historyz!ofz!thez!presentz!illness
C. Currentz!vitalz!signs
D. Allz!ofz!thez!abovez!arez!essentialz!historyz!components
4. Whichz!ofz!thez!followingz!isz!false?z!Whilez!performingz!thez!physicalz!examination,z!thez!examinerz!mustz!bez!ablez!to:
A. Differentiatez!betweenz!normalz!andz!abnormalz!findings
B. Recallz!knowledgez!ofz!az!rangez!ofz!conditionsz!andz!theirz!associatedz!signsz!andz!symptoms
C. Recognizez!howz!certainz!conditionsz!affectz!thez!responsez!toz!otherz!conditions
D. Foreseez!unpredictablez ! findings
5. Thez!followingz!isz!thez!leastz!reliablez!sourcez!ofz!informationz!forz!diagnosticz!statistics:
A. Evidence-basedz ! investigations
B. Primaryz!reportsz!ofz!research
C. Estimationz!basedz!onz!az!provider’sz!experience
D. Publishedz ! meta-analyses
6. Thez!followingz!canz!bez!usedz!toz!assistz!inz!soundz!clinicalz!decision-making:
A. Algorithmz!publishedz!inz!az!peer-reviewedz!journalz!article
B. Clinicalz!practicez!guidelines
C. Evidence-basedz ! research
D. Allz!ofz!thez!above
7. Ifz!az!diagnosticz!studyz!hasz!highz!sensitivity,z! thisz!indicatesz!a:
A. Highz!percentagez!ofz!personsz!withz!thez!givenz!conditionz!willz!havez!anz!abnormalz!result
B. Lowz!percentagez!ofz!personsz!withz!thez!givenz!conditionz!willz!havez!anz!abnormalz!result
C. Lowz!likelihoodz!ofz!normalz!resultz!inz!personsz!withoutz!az!givenz!condition
D. Nonez!ofz!thez!above
8. Ifz!az!diagnosticz!studyz!hasz!highz!specificity,z!thisz!indicatesz!a:
A. Lowz!percentagez!ofz!healthyz!individualsz!willz!showz!az!normalz!result
B. Highz!percentagez!ofz!healthyz!individualsz!willz!showz!az!normalz!result
C. Highz!percentagez!ofz!individualsz!withz!az!disorderz!willz!showz!az!normalz!result
D. Lowz!percentagez!ofz!individualsz!withz!az!disorderz!willz!showz!anz!abnormalz!result
9. Az!likelihoodz!ratioz!abovez!1z!indicatesz!thatz!az!diagnosticz!testz!showingz!a:
A. Positivez!resultz!isz!stronglyz!associatedz!withz!thez!disease
B. Negativez!resultz!isz!stronglyz!associatedz!withz!absencez!ofz!thez!disease
C. Positivez!resultz!isz!weaklyz!associatedz!withz!thez!disease
D. Negativez!resultz!isz!weaklyz!associatedz!withz!absencez!ofz!thez!disease
10. Whichz!ofz!thez!followingz!clinicalz!reasoningz!toolsz!isz!definedz!asz!evidence-
basedz!resourcez!basedz!onz!mathematicalz!modelingz!toz!expressz!thez!likelihoodz!ofz!az!conditionz!inz!selectz!situations,z!settings,z!and/orz!
patients?
, z!
lOMoARcPSD| 126 567
z! 13
A. Clinicalz!practicez!guideline
B. Clinicalz!decisionz!rule
C. Clinicalz!algorithm
Chapter 1: Clinical reasoning, differential diagnosis, evidence-based practice, and symptom ana
z! z! z! z! z! z! z! z! z! z!
Answer Section
z!
MULTIPLEz!CHOICE
1. ANS: B
Croskerryz!(2009)z!describesz!twoz!majorz!typesz!ofz!clinicalz!diagnosticz!decision-
making:z!intuitivez!andz!analytical.z!Intuitivez!decision-z!makingz!(similarz!toz!Augenblinkz!decision-
making)z!isz!basedz!onz!thez!experiencez!andz!intuitionz!ofz!thez!clinicianz!andz!isz!lessz!reliablez!andz!pairedz!withz!fairlyz!commonz!errors.z!In
z!contrast,z!analyticalz!decision-makingz!isz!basedz!onz!carefulz!consideration z!andz!hasz!greaterz!reliabilityz! withz!rarez!errors.
PTS: 1
2. ANS: D
Toz!obtainz!adequatez!history,z!providersz!mustz!bez!wellz!organized,z!attentivez!toz!thez!patient’sz!verbalz!andz!nonverbalz!language,z!andz!ab
lez!toz!accuratelyz!interpretz!thez!patient’sz!responsesz!toz!questions.z!Ratherz!thanz!readingz!intoz!thez!patient’sz!statements,z!theyz!clarifyz!
anyz!areasz!ofz!uncertainty.
PTS: 1
3. ANS: C
Vitalz!signsz!arez!partz!ofz!thez!physicalz!examinationz!portionz!ofz!patientz!assessment,z!notz!partz!ofz!thez!healthz!history.
PTS: 1
4. ANS: D
Whilez!performingz!thez!physicalz!examination,z!thez!examinerz!mustz!bez!ablez!toz!differentiatez!betweenz!normalz!andz!abnormalz!finding
s,z!recallz!knowledgez!ofz!az!rangez!ofz!conditions,z!includingz!theirz!associatedz!signsz!andz!symptoms,z!recognizez!howz!certainz!conditionsz!
affectz!thez!responsez!toz!otherz!conditions,z!andz!distinguishz!thez!relevancez!ofz!variedz!abnormalz!findings.
PTS: 1
5. ANS: C
Sourcesz!forz!diagnosticz!statisticsz!includez!textbooks,z!primaryz!reportsz!ofz!research,z!andz!publishedz!meta-
analyses.z!Anotherz!sourcez!ofz!statistics,z!thez!onez!thatz!hasz!beenz!mostz!widelyz!usedz!andz!availablez!forz!applicationz!toz!thez!reasoningz!pr
ocess,z!isz!thez!estimationz!basedz!onz!az!provider’sz!experience,z!althoughz!thesez!arez!rarelyz!accurate.z!Overz!thez!pastz!decade,z!thez!availa
bilityz!ofz!evidencez!onz!whichz!toz!basez!clinicalz!reasoningz!isz!improving,z ! andz!therez!isz!anz!increasingz!expectationz!thatz!clinicalz!reaso
ningz!bez!basedz!onz!scientificz!evidence.
Evidence-basedz!statisticsz! arez! alsoz!increasinglyz!beingz!usedz!toz!developz ! resourcesz!toz!facilitatez ! clinicalz ! decision-making.
PTS: 1
6. ANS: D
Toz!assistz!inz!clinicalz!decision-making,z!az!numberz!ofz!evidence-
basedz!resourcesz!havez!beenz!developedz!toz!assistz!thez!clinician.z!Resources,z!suchz!asz!algorithmsz!andz!clinicalz!practicez!guidelines,z!a
ssistz!inz!clinicalz!reasoningz!whenz!properlyz!applied.
PTS: 1
7. ANS: A
Thez!sensitivityz!ofz!az!diagnosticz!studyz!isz!thez!percentagez!ofz!individualsz!withz!thez!targetz!conditionz!whoz!showz!anz!abnormal,z!orz ! posit
ive,z!result.z!Az!highz!sensitivityz!indicatesz!thatz!az!greaterz!percentagez!ofz!personsz!withz!thez!givenz!conditionz!willz!havez!anz!abnormalz!re
sult.
PTS: 1
8. ANS: B
Thez!specificityz!ofz!az!diagnosticz!studyz!isz!thez!percentagez!ofz!normal,z!healthyz!individualsz!whoz!havez!az!normalz!result.z!Thez!greaterz!t
hez!specificity,z!thez!greaterz!thez!percentagez!ofz!individualsz!whoz!willz!havez!negative,z!orz!normal,z!resultsz!ifz!theyz!doz!notz!havez!thez!ta
rgetz!condition.
PTS: 1
9. ANS: A
Thez!likelihoodz!ratioz!isz!thez!probabilityz!thatz!az!positivez!testz!resultz!willz!bez!associatedz!withz!az!personz!whoz!hasz!thez!targetz!conditionz!a
ndz!az!negativez!resultz!willz!bez!associatedz!withz!az!healthyz!person.z!Az!likelihoodz!ratioz!abovez!1z!indicatesz!thatz!az!positivez!resultz!isz!ass
ociatedz!withz!thez!disease;z!az!likelihoodz!ratioz!lessz!thanz!1z!indicatesz!thatz!az!negativez!resultz!isz!associatedz!withz!anz!absencez!ofz!thez!dise
ase.
, z!
lOMoARcPSD| 126 567
z! 13
PTS: 1
10. ANS: B
Clinicalz!decisionz!(orz!prediction)z!rulesz!providez!anotherz!supportz!forz!clinicalz!reasoning.z!Clinicalz!decisionz!rulesz!arez!evidence-
basedz!resourcesz!thatz!providez!probabilisticz!statementsz!regardingz!thez!likelihoodz!thatz!az!conditionz!existsz!ifz!certainz!variablesz!arez!
metz!withz!regardz!toz!thez!prognosisz!ofz!patientsz!withz!specificz!findings.z!Decisionz!rulesz!usez!mathematicalz!modelsz!andz!arez!specificz
!toz!certainz!situations,z!settings,z! and/orz!patientz!characteristics.
PTS: 1
lOMoARcPSD| 126 567
z! 13
, z!
lOMoARcPSD| 126 567
z! 13
Test Bank for Advanced Health Assessment & Clinical Diagnosis in Primary Care 7th
z! z! z! z! z! z! z! z! z! z! z! z! z!
Edition Dains z!
Chapter 1: Clinical Reasoning, Differential Diagnosis, Evidence-Based Practice, and Symptom Analysis
z! z! z! z! z! z! z! z! z! z!
Multiple Choice z!
Identify the choice that best completes the statement or answers the question.
z! z! z! z! z! z! z! z! z! z! z!
1. Whichz!typez!ofz!clinicalz!decision-makingz!isz!mostz!reliable?
A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
2. Whichz!ofz!thez!followingz!isz!false?z!Toz!obtainz!adequatez!history,z!health-carez!providersz!mustz!be:
A. Methodicalz!andz!systematic
B. Attentivez!toz!thez!patient’sz!verbalz!andz!nonverbalz!language
C. Ablez!toz!accuratelyz!interpretz!thez!patient’sz!responses
D. Adeptz!atz!readingz!intoz!thez!patient’sz!statements
3. Essentialz!partsz!ofz!az!healthz!historyz!includez!allz!ofz!thez!followingz!except:
A. Chiefz!complaint
B. Historyz!ofz!thez!presentz!illness
C. Currentz!vitalz!signs
D. Allz!ofz!thez!abovez!arez!essentialz!historyz!components
4. Whichz!ofz!thez!followingz!isz!false?z!Whilez!performingz!thez!physicalz!examination,z!thez!examinerz!mustz!bez!ablez!to:
A. Differentiatez!betweenz!normalz!andz!abnormalz!findings
B. Recallz!knowledgez!ofz!az!rangez!ofz!conditionsz!andz!theirz!associatedz!signsz!andz!symptoms
C. Recognizez!howz!certainz!conditionsz!affectz!thez!responsez!toz!otherz!conditions
D. Foreseez!unpredictablez ! findings
5. Thez!followingz!isz!thez!leastz!reliablez!sourcez!ofz!informationz!forz!diagnosticz!statistics:
A. Evidence-basedz ! investigations
B. Primaryz!reportsz!ofz!research
C. Estimationz!basedz!onz!az!provider’sz!experience
D. Publishedz ! meta-analyses
6. Thez!followingz!canz!bez!usedz!toz!assistz!inz!soundz!clinicalz!decision-making:
A. Algorithmz!publishedz!inz!az!peer-reviewedz!journalz!article
B. Clinicalz!practicez!guidelines
C. Evidence-basedz ! research
D. Allz!ofz!thez!above
7. Ifz!az!diagnosticz!studyz!hasz!highz!sensitivity,z! thisz!indicatesz!a:
A. Highz!percentagez!ofz!personsz!withz!thez!givenz!conditionz!willz!havez!anz!abnormalz!result
B. Lowz!percentagez!ofz!personsz!withz!thez!givenz!conditionz!willz!havez!anz!abnormalz!result
C. Lowz!likelihoodz!ofz!normalz!resultz!inz!personsz!withoutz!az!givenz!condition
D. Nonez!ofz!thez!above
8. Ifz!az!diagnosticz!studyz!hasz!highz!specificity,z!thisz!indicatesz!a:
A. Lowz!percentagez!ofz!healthyz!individualsz!willz!showz!az!normalz!result
B. Highz!percentagez!ofz!healthyz!individualsz!willz!showz!az!normalz!result
C. Highz!percentagez!ofz!individualsz!withz!az!disorderz!willz!showz!az!normalz!result
D. Lowz!percentagez!ofz!individualsz!withz!az!disorderz!willz!showz!anz!abnormalz!result
9. Az!likelihoodz!ratioz!abovez!1z!indicatesz!thatz!az!diagnosticz!testz!showingz!a:
A. Positivez!resultz!isz!stronglyz!associatedz!withz!thez!disease
B. Negativez!resultz!isz!stronglyz!associatedz!withz!absencez!ofz!thez!disease
C. Positivez!resultz!isz!weaklyz!associatedz!withz!thez!disease
D. Negativez!resultz!isz!weaklyz!associatedz!withz!absencez!ofz!thez!disease
10. Whichz!ofz!thez!followingz!clinicalz!reasoningz!toolsz!isz!definedz!asz!evidence-
basedz!resourcez!basedz!onz!mathematicalz!modelingz!toz!expressz!thez!likelihoodz!ofz!az!conditionz!inz!selectz!situations,z!settings,z!and/orz!
patients?
, z!
lOMoARcPSD| 126 567
z! 13
A. Clinicalz!practicez!guideline
B. Clinicalz!decisionz!rule
C. Clinicalz!algorithm
Chapter 1: Clinical reasoning, differential diagnosis, evidence-based practice, and symptom ana
z! z! z! z! z! z! z! z! z! z!
Answer Section
z!
MULTIPLEz!CHOICE
1. ANS: B
Croskerryz!(2009)z!describesz!twoz!majorz!typesz!ofz!clinicalz!diagnosticz!decision-
making:z!intuitivez!andz!analytical.z!Intuitivez!decision-z!makingz!(similarz!toz!Augenblinkz!decision-
making)z!isz!basedz!onz!thez!experiencez!andz!intuitionz!ofz!thez!clinicianz!andz!isz!lessz!reliablez!andz!pairedz!withz!fairlyz!commonz!errors.z!In
z!contrast,z!analyticalz!decision-makingz!isz!basedz!onz!carefulz!consideration z!andz!hasz!greaterz!reliabilityz! withz!rarez!errors.
PTS: 1
2. ANS: D
Toz!obtainz!adequatez!history,z!providersz!mustz!bez!wellz!organized,z!attentivez!toz!thez!patient’sz!verbalz!andz!nonverbalz!language,z!andz!ab
lez!toz!accuratelyz!interpretz!thez!patient’sz!responsesz!toz!questions.z!Ratherz!thanz!readingz!intoz!thez!patient’sz!statements,z!theyz!clarifyz!
anyz!areasz!ofz!uncertainty.
PTS: 1
3. ANS: C
Vitalz!signsz!arez!partz!ofz!thez!physicalz!examinationz!portionz!ofz!patientz!assessment,z!notz!partz!ofz!thez!healthz!history.
PTS: 1
4. ANS: D
Whilez!performingz!thez!physicalz!examination,z!thez!examinerz!mustz!bez!ablez!toz!differentiatez!betweenz!normalz!andz!abnormalz!finding
s,z!recallz!knowledgez!ofz!az!rangez!ofz!conditions,z!includingz!theirz!associatedz!signsz!andz!symptoms,z!recognizez!howz!certainz!conditionsz!
affectz!thez!responsez!toz!otherz!conditions,z!andz!distinguishz!thez!relevancez!ofz!variedz!abnormalz!findings.
PTS: 1
5. ANS: C
Sourcesz!forz!diagnosticz!statisticsz!includez!textbooks,z!primaryz!reportsz!ofz!research,z!andz!publishedz!meta-
analyses.z!Anotherz!sourcez!ofz!statistics,z!thez!onez!thatz!hasz!beenz!mostz!widelyz!usedz!andz!availablez!forz!applicationz!toz!thez!reasoningz!pr
ocess,z!isz!thez!estimationz!basedz!onz!az!provider’sz!experience,z!althoughz!thesez!arez!rarelyz!accurate.z!Overz!thez!pastz!decade,z!thez!availa
bilityz!ofz!evidencez!onz!whichz!toz!basez!clinicalz!reasoningz!isz!improving,z ! andz!therez!isz!anz!increasingz!expectationz!thatz!clinicalz!reaso
ningz!bez!basedz!onz!scientificz!evidence.
Evidence-basedz!statisticsz! arez! alsoz!increasinglyz!beingz!usedz!toz!developz ! resourcesz!toz!facilitatez ! clinicalz ! decision-making.
PTS: 1
6. ANS: D
Toz!assistz!inz!clinicalz!decision-making,z!az!numberz!ofz!evidence-
basedz!resourcesz!havez!beenz!developedz!toz!assistz!thez!clinician.z!Resources,z!suchz!asz!algorithmsz!andz!clinicalz!practicez!guidelines,z!a
ssistz!inz!clinicalz!reasoningz!whenz!properlyz!applied.
PTS: 1
7. ANS: A
Thez!sensitivityz!ofz!az!diagnosticz!studyz!isz!thez!percentagez!ofz!individualsz!withz!thez!targetz!conditionz!whoz!showz!anz!abnormal,z!orz ! posit
ive,z!result.z!Az!highz!sensitivityz!indicatesz!thatz!az!greaterz!percentagez!ofz!personsz!withz!thez!givenz!conditionz!willz!havez!anz!abnormalz!re
sult.
PTS: 1
8. ANS: B
Thez!specificityz!ofz!az!diagnosticz!studyz!isz!thez!percentagez!ofz!normal,z!healthyz!individualsz!whoz!havez!az!normalz!result.z!Thez!greaterz!t
hez!specificity,z!thez!greaterz!thez!percentagez!ofz!individualsz!whoz!willz!havez!negative,z!orz!normal,z!resultsz!ifz!theyz!doz!notz!havez!thez!ta
rgetz!condition.
PTS: 1
9. ANS: A
Thez!likelihoodz!ratioz!isz!thez!probabilityz!thatz!az!positivez!testz!resultz!willz!bez!associatedz!withz!az!personz!whoz!hasz!thez!targetz!conditionz!a
ndz!az!negativez!resultz!willz!bez!associatedz!withz!az!healthyz!person.z!Az!likelihoodz!ratioz!abovez!1z!indicatesz!thatz!az!positivez!resultz!isz!ass
ociatedz!withz!thez!disease;z!az!likelihoodz!ratioz!lessz!thanz!1z!indicatesz!thatz!az!negativez!resultz!isz!associatedz!withz!anz!absencez!ofz!thez!dise
ase.
, z!
lOMoARcPSD| 126 567
z! 13
PTS: 1
10. ANS: B
Clinicalz!decisionz!(orz!prediction)z!rulesz!providez!anotherz!supportz!forz!clinicalz!reasoning.z!Clinicalz!decisionz!rulesz!arez!evidence-
basedz!resourcesz!thatz!providez!probabilisticz!statementsz!regardingz!thez!likelihoodz!thatz!az!conditionz!existsz!ifz!certainz!variablesz!arez!
metz!withz!regardz!toz!thez!prognosisz!ofz!patientsz!withz!specificz!findings.z!Decisionz!rulesz!usez!mathematicalz!modelsz!andz!arez!specificz
!toz!certainz!situations,z!settings,z! and/orz!patientz!characteristics.
PTS: 1
