TEST BANK FOR ADVANCED ASSESSMENT:
L
T L
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INTERPRETING FINDINGS AND
L
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FORMULATING DIFFERENTIAL
T L T L T L
DIAGNOSES 5TH EDITION, MARY JO
T L T L T L T L T L T L
GOOLSBY, LAURIE GRUBBS ISBN-10;
T L T L T L T L
1719645930 / ISBN-13;978-1719645935
T L T L T L L
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,Chapter 1. Assessment and Clinical Decision-Making: Overview
T L L
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Multiple Choice
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Identify the choice that best completes the statement or answers 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:
L
T L
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T L
T L
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T L
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A. Methodical and systematic L
T L
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B. Attentive to the patient’s verbal and nonverbal language L
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T
C. Able to accurately interpret the patient’s responses L
T L
T L
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D. Adept at reading into the patient’s statements L
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T T L L
T L
T L
T
3. Essential parts of a health history include all of the following except:
L
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A. Chief complaint L
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B. History of the present illness L
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T
C. Current vital signs L
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D. All of the above are essential history components
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4. Which of the following is false? While performing the physical examination, the examiner must be
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able to: L
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A. Differentiate between normal and abnormal findings L
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T
B. Recall knowledge of a range of conditions and their associated signs and symptoms
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C. Recognize how certain conditions affect the response to other conditions T L T L T L L
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D. Foresee unpredictable findings T L L
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5. The following is the least reliable source of information for diagnostic statistics:
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A. Evidence-based investigations L
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B. Primary reports of research L
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C. Estimation based on a provider’s experience T L L
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D. Published meta-analyses L
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6. The following can be used to assist in sound clinical decision-making:
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A. Algorithm published in a peer-reviewed journal article L
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B. Clinical practice guidelines T L T L
C. Evidence-based research L
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D. All of the above T L T L T L
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 result
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B. Low percentage of persons with the given condition will have an abnormal result
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C. Low likelihood of normal result in persons without a given condition
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D. None of the above T L L
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, 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 result
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D. Low percentage of individuals with a disorder will show an abnormal result
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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 disease
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C. Positive result is weakly associated with the disease
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D. Negative result is weakly associated with absence of the disease
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T L 10. Which of the following clinical reasoning tools is defined as evidence-based resource based on
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mathematical modeling to express the likelihood of a condition in select situations, settings, and/or
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patients?
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A. Clinical practice guideline L
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B. Clinical decision rule L
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C. Clinical algorithm L
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D. Clinical recommendation L
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, Answer Section
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MULTIPLE CHOICEL
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1. ANS: B T L T L
Croskerry (2009) describes two major types of clinical diagnostic decision-making: intuitive and
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analytical. Intuitive decision-making (similar to Augenblink decision-making) is based on the
L
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experience and intuition of the clinician and is less reliable and paired with fairly common errors.
L
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In contrast, analytical decision-making is based on careful consideration and has greater reliability
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with rare errors.
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PTS: 1
2. ANS: D T L T L
To obtain adequate history, providers must be well organized, attentive to the patient’s verbal and
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nonverbal language, and able to accurately interpret the patient’s responses to questions. Rather
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than reading into the patient’s statements, they clarify any areas of uncertainty.
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T L
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PTS: 1
3. ANS: C T L T L
Vital signs are part of the physical examination portion of patient assessment, not part of the health
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history.
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PTS: 1
4. ANS: D T L T L
While performing the physical examination, the examiner must be able to differentiate between
L
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T L
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T L
T L
T L
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normal and abnormal findings, recall knowledge of a range of conditions, including their
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associated signs and symptoms, recognize how certain conditions affect the response to other
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conditions, and distinguish the relevance of varied abnormal findings.
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PTS: 1
5. ANS: C T L T L
Sources for diagnostic statistics include textbooks, primary reports of research, and published
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meta-analyses. Another source of statistics, the one that has been most widely used and available
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T T L T L T L
for application to the reasoning process, is the estimation based on a provider’s experience,
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although these are rarely accurate. Over the past decade, the availability of evidence on which to
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T T L T L L
T T L T L T L L
T T L L
T T L T L T L L
T
base clinical reasoning is improving, and there is an increasing expectation that clinical reasoning
L
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T T L T L L
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be based on scientific evidence. Evidence-based statistics are also increasingly being used to
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T L
T T L T L T L
develop resources to facilitate clinical decision-making.
L
T T L T L T L L
T L
T
PTS: 1
6. ANS: D T L T L
To assist in clinical decision-making, a number of evidence-based resources have been developed to
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T L
T L
T T L L
T L
T L
T L
T L
T L
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assist the clinician. Resources, such as algorithms and clinical practice guidelines, assist in
L
T T L T L T L T L T L T L T L L
T T L L
T L
T T L
clinical reasoning when properly applied.
L
T T L T L T L L
T
L
T L
T L
T L
T L
T
INTERPRETING FINDINGS AND
L
T T L T L T L
FORMULATING DIFFERENTIAL
T L T L T L
DIAGNOSES 5TH EDITION, MARY JO
T L T L T L T L T L T L
GOOLSBY, LAURIE GRUBBS ISBN-10;
T L T L T L T L
1719645930 / ISBN-13;978-1719645935
T L T L T L L
T
,Chapter 1. Assessment and Clinical Decision-Making: Overview
T L L
T T L T L T L T L
Multiple Choice
L
T
Identify the choice that best completes the statement or answers the question.
L
T L
T L
T L
T L
T T L T L L
T L
T T L L
T
1. Which type of clinical decision-making is most reliable?
L
T T L L
T T L L
T L
T L
T
A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
2. Which of the following is false? To obtain adequate history, health-care providers must be:
L
T L
T L
T L
T L
T L
T L
T T L L
T L
T L
T L
T L
T
A. Methodical and systematic L
T L
T
B. Attentive to the patient’s verbal and nonverbal language L
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T T L L
T L
T
C. Able to accurately interpret the patient’s responses L
T L
T L
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T L
T T L
D. Adept at reading into the patient’s statements L
T L
T T L L
T L
T L
T
3. Essential parts of a health history include all of the following except:
L
T T L T L L
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T L
T T L T L L
T L
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A. Chief complaint L
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B. History of the present illness L
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T
C. Current vital signs L
T L
T
D. All of the above are essential history components
T L T L L
T T L L
T L
T L
T
4. Which of the following is false? While performing the physical examination, the examiner must be
L
T L
T L
T L
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T L
T L
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T L
T L
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T L
T
able to: L
T T L
A. Differentiate between normal and abnormal findings L
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T
B. Recall knowledge of a range of conditions and their associated signs and symptoms
L
T L
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T
C. Recognize how certain conditions affect the response to other conditions T L T L T L L
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T
D. Foresee unpredictable findings T L L
T
5. The following is the least reliable source of information for diagnostic statistics:
L
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A. Evidence-based investigations L
T
B. Primary reports of research L
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C. Estimation based on a provider’s experience T L L
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T
D. Published meta-analyses L
T
6. The following can be used to assist in sound clinical decision-making:
L
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T L
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T T L L
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T L
T T L
A. Algorithm published in a peer-reviewed journal article L
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T
B. Clinical practice guidelines T L T L
C. Evidence-based research L
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D. All of the above T L T L T L
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 result
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B. Low percentage of persons with the given condition will have an abnormal result
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C. Low likelihood of normal result in persons without a given condition
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D. None of the above T L L
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, 8. If a diagnostic study has high specificity, this indicates a:
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T L
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T L
T L
T T L
A. Low percentage of healthy individuals will show a normal result
L
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B. High percentage of healthy individuals will show a normal result
T L L
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C. High percentage of individuals with a disorder will show a normal result
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D. Low percentage of individuals with a disorder will show an abnormal result
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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 disease
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C. Positive result is weakly associated with the disease
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D. Negative result is weakly associated with absence of the disease
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T L 10. Which of the following clinical reasoning tools is defined as evidence-based resource based on
L
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T L
T T L
mathematical modeling to express the likelihood of a condition in select situations, settings, and/or
L
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T L
T L
T L
T L
T L
T L
T L
T L
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patients?
L
T
A. Clinical practice guideline L
T L
T
B. Clinical decision rule L
T L
T
C. Clinical algorithm L
T
D. Clinical recommendation L
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, Answer Section
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MULTIPLE CHOICEL
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1. ANS: B T L T L
Croskerry (2009) describes two major types of clinical diagnostic decision-making: intuitive and
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T T L L
T L
T
analytical. Intuitive decision-making (similar to Augenblink decision-making) is based on the
L
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T T L L
T L
T L
T T L T L T L
experience and intuition of the clinician and is less reliable and paired with fairly common errors.
L
T T L L
T T L T L T L L
T T L T L T L T L L
T L
T L
T T L T L
In contrast, analytical decision-making is based on careful consideration and has greater reliability
L
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T L
T L
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T L
T
with rare errors.
L
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T L
T
PTS: 1
2. ANS: D T L T L
To obtain adequate history, providers must be well organized, attentive to the patient’s verbal and
L
T L
T L
T L
T L
T L
T L
T L
T L
T L
T L
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T L
T
nonverbal language, and able to accurately interpret the patient’s responses to questions. Rather
L
T L
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T L
T
than reading into the patient’s statements, they clarify any areas of uncertainty.
L
T L
T T L L
T T L L
T L
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PTS: 1
3. ANS: C T L T L
Vital signs are part of the physical examination portion of patient assessment, not part of the health
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T L
T T L T L L
T T L L
T L
T L
T L
T L
T L
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T L
T
history.
L
T
PTS: 1
4. ANS: D T L T L
While performing the physical examination, the examiner must be able to differentiate between
L
T L
T L
T T L L
T L
T T L L
T L
T L
T L
T L
T
normal and abnormal findings, recall knowledge of a range of conditions, including their
L
T T L L
T L
T T L L
T T L T L L
T T L T L L
T L
T
associated signs and symptoms, recognize how certain conditions affect the response to other
L
T L
T T L L
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conditions, and distinguish the relevance of varied abnormal findings.
L
T L
T T L L
T T L L
T T L L
T T L
PTS: 1
5. ANS: C T L T L
Sources for diagnostic statistics include textbooks, primary reports of research, and published
T L T L T L T L L
T T L L
T L
T L
T T L T L
meta-analyses. Another source of statistics, the one that has been most widely used and available
L
T T L L
T T L T L T L T L L
T T L L
T T L L
T T L T L T L
for application to the reasoning process, is the estimation based on a provider’s experience,
L
T T L T L T L L
T T L T L T L T L T L T L T L T L L
T
although these are rarely accurate. Over the past decade, the availability of evidence on which to
L
T L
T L
T T L T L L
T T L T L T L L
T T L L
T T L T L T L L
T
base clinical reasoning is improving, and there is an increasing expectation that clinical reasoning
L
T T L L
T L
T L
T L
T T L T L L
T L
T L
T T L T L T L
be based on scientific evidence. Evidence-based statistics are also increasingly being used to
L
T T L T L T L L
T T L L
T T L L
T L
T T L T L T L
develop resources to facilitate clinical decision-making.
L
T T L T L T L L
T L
T
PTS: 1
6. ANS: D T L T L
To assist in clinical decision-making, a number of evidence-based resources have been developed to
L
T L
T L
T T L L
T L
T L
T L
T L
T L
T L
T L
T T L
assist the clinician. Resources, such as algorithms and clinical practice guidelines, assist in
L
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T T L L
T L
T T L
clinical reasoning when properly applied.
L
T T L T L T L L
T
