ADVANCED HEALTH ASSESSMENT
AND CLINICAL DIAGNOSIS IN
PRIMARY CARE 8TH EDITION – DAINS
QUESTIONS AND ANSWERS
1. A clinician is using the hypothetico-deductive model of diagnostic reasoning. Which step
occurs immediately after the clinician performs an initial data collection?
A. Conducting a comprehensive physical exam
B. Formulating a treatment plan
C. Ordering definitive laboratory tests
D. Generating a list of differential diagnoses
Answer: D
Conceptual Explanation: In the hypothetico-deductive model, the clinician generates a list
of potential hypotheses (differential diagnoses) immediately after the initial data collection
to guide further focused assessment.
2. When assessing a patient for a potential melanoma, the clinician notes a lesion with
irregular borders and multiple colors. Which characteristic in the ‘ABCDE’ mnemonic refers to
the lesion having varied shades of brown, black, or blue?
A. Asymmetry
,B. Border irregularity
C. Diameter over 6mm
D. Color variegation
Answer: D
Conceptual Explanation: Color variegation refers to the presence of multiple colors or
shades within a single lesion, which is a warning sign for melanoma.
3. A patient presents with a ‘curtain-like’ shadow over their field of vision and flashes of light.
Which condition is most likely?
A. Acute angle-closure glaucoma
B. Macular degeneration
C. Cataracts
D. Retinal detachment
Answer: D
Conceptual Explanation: A sudden sensation of a curtain closing over the vision, often
preceded by floaters or flashes of light (photopsia), is a classic presentation of retinal
detachment.
4. During a Weber test, the sound lateralizes to the right ear. During the Rinne test, the right
ear shows Bone Conduction (BC) > Air Conduction (AC). What is the interpretation?
A. Sensorineural hearing loss in the right ear
, B. Conductive hearing loss in the right ear
C. Normal hearing
D. Sensorineural hearing loss in the left ear
Answer: B
Conceptual Explanation: In conductive hearing loss, the Weber test lateralizes to the
affected ear, and the Rinne test shows BC > AC in that same ear.
5. A 45-year-old male presents with sudden onset of severe periorbital pain, ptosis, and nasal
congestion occurring at the same time every night. What is the most likely diagnosis?
A. Migraine headache
B. Cluster headache
C. Tension headache
D. Temporal arteritis
Answer: B
Conceptual Explanation: Cluster headaches are characterized by severe unilateral
periorbital pain, autonomic symptoms (nasal congestion, ptosis), and a circadian rhythm
pattern.
6. Which physical examination finding is most indicative of pneumonia rather than simple
bronchitis?
A. Generalized wheezing
AND CLINICAL DIAGNOSIS IN
PRIMARY CARE 8TH EDITION – DAINS
QUESTIONS AND ANSWERS
1. A clinician is using the hypothetico-deductive model of diagnostic reasoning. Which step
occurs immediately after the clinician performs an initial data collection?
A. Conducting a comprehensive physical exam
B. Formulating a treatment plan
C. Ordering definitive laboratory tests
D. Generating a list of differential diagnoses
Answer: D
Conceptual Explanation: In the hypothetico-deductive model, the clinician generates a list
of potential hypotheses (differential diagnoses) immediately after the initial data collection
to guide further focused assessment.
2. When assessing a patient for a potential melanoma, the clinician notes a lesion with
irregular borders and multiple colors. Which characteristic in the ‘ABCDE’ mnemonic refers to
the lesion having varied shades of brown, black, or blue?
A. Asymmetry
,B. Border irregularity
C. Diameter over 6mm
D. Color variegation
Answer: D
Conceptual Explanation: Color variegation refers to the presence of multiple colors or
shades within a single lesion, which is a warning sign for melanoma.
3. A patient presents with a ‘curtain-like’ shadow over their field of vision and flashes of light.
Which condition is most likely?
A. Acute angle-closure glaucoma
B. Macular degeneration
C. Cataracts
D. Retinal detachment
Answer: D
Conceptual Explanation: A sudden sensation of a curtain closing over the vision, often
preceded by floaters or flashes of light (photopsia), is a classic presentation of retinal
detachment.
4. During a Weber test, the sound lateralizes to the right ear. During the Rinne test, the right
ear shows Bone Conduction (BC) > Air Conduction (AC). What is the interpretation?
A. Sensorineural hearing loss in the right ear
, B. Conductive hearing loss in the right ear
C. Normal hearing
D. Sensorineural hearing loss in the left ear
Answer: B
Conceptual Explanation: In conductive hearing loss, the Weber test lateralizes to the
affected ear, and the Rinne test shows BC > AC in that same ear.
5. A 45-year-old male presents with sudden onset of severe periorbital pain, ptosis, and nasal
congestion occurring at the same time every night. What is the most likely diagnosis?
A. Migraine headache
B. Cluster headache
C. Tension headache
D. Temporal arteritis
Answer: B
Conceptual Explanation: Cluster headaches are characterized by severe unilateral
periorbital pain, autonomic symptoms (nasal congestion, ptosis), and a circadian rhythm
pattern.
6. Which physical examination finding is most indicative of pneumonia rather than simple
bronchitis?
A. Generalized wheezing
