lO M o A R c P S D | 1 2 6 5 6 7 1 3
TEST BANK FOR ADVANCED HEALTH ASSESSMENT &
CLINICAL DIAGNOSIS IN PRIMARY CARE 7TH EDITION
DAINS ISBN: 9780323594554
, lO M o A R c P S D | 1 2 6 5 6 7 1 3
Test Bank for Advanced Health Assessment & Clinical Diagnosis in Primary Care
7th Edition Dains
Chapter 1: Clinical Reasoning, Differential Diagnosis, Evidence-Based Practice, and Symptom Analysis
Multiple
̦̣ Choice
Identify the choice that best completes the statement or answers the question.
̦̣
1. Which type of clinical decision-making is most reliable?
A. Intuitive
̦̣
B. Analytical
C. Experiential
D. Augenblick
̦̣
2. Which of the following is false? To obtain adequate ̦̣ history, health-care providers must
̦̣ be:
A. A. Methodical and systematic
B. Attentive to the patient’s verbal and nonverbal language̦̣
C. C. Able to accurately
̦̣ interpret the patient’s responses
D. D. Adept at reading into the patient’s statements
3. Essential parts of a health history include
̦̣ all of the following except:
A. A. Chief complaint
B. B. History of the present illness
C. C. Current
̦̣ vital signs
D. All of the above are essential history components
4. Which of the following is false? While performing the physical examination, the examiner must
̦̣ be able to:
A. A. Differentiate between normal and abnormal findings
B. Recall knowledge of a range of conditions and their associated signs and symptoms
C. C. Recognize how certain conditions affect the response to other conditions
D. D. Foresee unpredictable
̦̣ findings
5. The following is the least reliable source
̦̣ of information for diagnostic statistics:
A. A. Evidence-based investigations
B. B. Primary reports of research
C. Estimation based on a provider’s experience
D. D. Published
̦̣ meta-analyses
6. The following can be used̦̣ to assist in sound
̦̣ clinical decision-making:
A. Algorithm published
̦̣ in a peer-reviewed journal
̦̣ article
B. B. Clinical practice guidelines
̦̣
C. C. Evidence-based research
D. D. All of the above
7. If a diagnostic study
̦̣ has high sensitivity, this indicates a:
A. High percentage of persons with the given condition will have an abnormal resulț̣
B. Low percentage of persons with the given condition will have an abnormal resulț̣
C. C. Low likelihood of normal resulț̣ in persons withouț̣ a given condition
D. D. None of the above
8. If a diagnostic study
̦̣ has high specificity, this indicates a:
A. A. Low percentage of healthy individuals
̦̣ will show a normal resulț̣
B. B. High percentage of healthy individualș̣ will show a normal resulț̣
C. C. High percentage of individuals
̦̣ with a disorder will show a normal resulț̣
D. Low percentage of individualș̣ with a disorder will show an abnormal resulț̣
9. A likelihood ratio above 1 indicates that a diagnostic test showing a:
A. A. Positive resulț̣ is strongly associated with the disease
B. Negative resulț̣ is strongly associated with absence of the disease
C. C. Positive resulț̣ is weakly associated with the disease
D. Negative resulț̣ is weakly associated with absence of the disease
10. Which of the following clinical reasoning tools is defined as evidence-based resource
̦̣ based on mathematical modeling
to express the likelihood of a condition in select situations,
̦̣ settings, and/or patients?
, lO M o A R c P S D | 1 2 6 5 6 7 1 3
A. Clinical practice guideline
̦̣
B. B. Clinical decision rule
̦̣
C. C. Clinical algorithm
Chapter 1: Clinical reasoning, differential diagnosis, evidence-based practice, and symptom ana
Answer Section
MULTIPLE CHOICE
1. ANS: B
Croskerry (2009) describes two major types of clinical diagnostic decision-making: intuitive
̦̣ and analytical. Intuitive
̦̣ decision-
making (similar to Augenblink
̦̣ decision-making) is based on the experience and intuition
̦̣ of the clinician and is less reliable and
paired with fairly common errors. In contrast, analytical decision-making is based on careful̦̣ consideration and has greater
reliability with rare errors.
PTS: 1
2. ANS: D
To obtain adequate
̦̣ history, providers must ̦̣ be well organized, attentive to the patient’s verbal and nonverbal language,
̦̣ and able
to accurately
̦̣ interpret the patient’s responses to questions.
̦̣ Rather than reading into the patient’s statements, they clarify any
areas of uncertainty.
̦̣
PTS: 1
3. ANS: C
Vital signs are part of the physical examination portion of patient assessment, not part of the health history.
PTS: 1
4. ANS: D
While performing the physical examination, the examiner must ̦̣ be able to differentiate between normal and abnormal findings,
recall knowledge of a range of conditions, including
̦̣ their associated signs and symptoms, recognize how certain conditions
affect
the response to other conditions, and distinguish
̦̣ the relevance of varied abnormal findings.
PTS: 1
5. ANS: C
Sources
̦̣ for diagnostic statistics include
̦̣ textbooks, primary reports of research, and published
̦̣ meta-analyses. Another source
̦̣ of
statistics, the one that has been most widely used ̦̣ and available for application to the reasoning process, is the estimation based
on
a provider’s experience, although ̦̣ these are rarely accurate.
̦̣ Over the past decade, the availability of evidence on which to base
clinical reasoning is improving, and there is an increasing expectation that clinical reasoning be based on scientific evidence.
Evidence-based statistics are also increasingly being used ̦̣ to develop resources
̦̣ to facilitate clinical decision-making.
PTS: 1
6. ANS: D
To assist in clinical decision-making, a number
̦̣ of evidence-based resourceș̣ have been developed to assist the clinician.
Resources,
̦̣ such
̦̣ as algorithms and clinical practice guidelines,
̦̣ assist in clinical reasoning when properly applied.
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 positive,
result.
̦̣ A high sensitivity indicates that a greater percentage of persons with the given condition will have an abnormal result.
̦̣
PTS: 1
8. ANS: B
The specificity of a diagnostic study
̦̣ is the percentage of normal, healthy individuals
̦̣ who have a normal result.̦̣ The greater the
specificity, the greater the percentage of individuals
̦̣ who will have negative, or normal, results
̦̣ if they do not have the target
condition.
PTS: 1
9. ANS: A
The likelihood ratio is the probability that a positive test resulț̣ will be associated with a person who has the target condition and
a
negative resulț̣ will be associated with a healthy person. A likelihood ratio above 1 indicates that a positive resulț̣ is associated
with the disease; a likelihood ratio less than 1 indicates that a negative resulț̣ is associated with an absence of the disease.
, lO M o A R c P S D | 1 2 6 5 6 7 1 3
PTS: 1
10. ANS: B
Clinical decision (or prediction) rules
̦̣ provide another support
̦̣ for clinical reasoning. Clinical decision rules
̦̣ are evidence-
based
resources
̦̣ that provide probabilistic statements regarding the likelihood that a condition exists if certain variables are met with
regard to the prognosis of patients with specific findings. Decision ruleș̣ use
̦̣ mathematical models and are specific to certain
situations,
̦̣ settings, and/or patient characteristics.
PTS: 1
TEST BANK FOR ADVANCED HEALTH ASSESSMENT &
CLINICAL DIAGNOSIS IN PRIMARY CARE 7TH EDITION
DAINS ISBN: 9780323594554
, lO M o A R c P S D | 1 2 6 5 6 7 1 3
Test Bank for Advanced Health Assessment & Clinical Diagnosis in Primary Care
7th Edition Dains
Chapter 1: Clinical Reasoning, Differential Diagnosis, Evidence-Based Practice, and Symptom Analysis
Multiple
̦̣ Choice
Identify the choice that best completes the statement or answers the question.
̦̣
1. Which type of clinical decision-making is most reliable?
A. Intuitive
̦̣
B. Analytical
C. Experiential
D. Augenblick
̦̣
2. Which of the following is false? To obtain adequate ̦̣ history, health-care providers must
̦̣ be:
A. A. Methodical and systematic
B. Attentive to the patient’s verbal and nonverbal language̦̣
C. C. Able to accurately
̦̣ interpret the patient’s responses
D. D. Adept at reading into the patient’s statements
3. Essential parts of a health history include
̦̣ all of the following except:
A. A. Chief complaint
B. B. History of the present illness
C. C. Current
̦̣ vital signs
D. All of the above are essential history components
4. Which of the following is false? While performing the physical examination, the examiner must
̦̣ be able to:
A. A. Differentiate between normal and abnormal findings
B. Recall knowledge of a range of conditions and their associated signs and symptoms
C. C. Recognize how certain conditions affect the response to other conditions
D. D. Foresee unpredictable
̦̣ findings
5. The following is the least reliable source
̦̣ of information for diagnostic statistics:
A. A. Evidence-based investigations
B. B. Primary reports of research
C. Estimation based on a provider’s experience
D. D. Published
̦̣ meta-analyses
6. The following can be used̦̣ to assist in sound
̦̣ clinical decision-making:
A. Algorithm published
̦̣ in a peer-reviewed journal
̦̣ article
B. B. Clinical practice guidelines
̦̣
C. C. Evidence-based research
D. D. All of the above
7. If a diagnostic study
̦̣ has high sensitivity, this indicates a:
A. High percentage of persons with the given condition will have an abnormal resulț̣
B. Low percentage of persons with the given condition will have an abnormal resulț̣
C. C. Low likelihood of normal resulț̣ in persons withouț̣ a given condition
D. D. None of the above
8. If a diagnostic study
̦̣ has high specificity, this indicates a:
A. A. Low percentage of healthy individuals
̦̣ will show a normal resulț̣
B. B. High percentage of healthy individualș̣ will show a normal resulț̣
C. C. High percentage of individuals
̦̣ with a disorder will show a normal resulț̣
D. Low percentage of individualș̣ with a disorder will show an abnormal resulț̣
9. A likelihood ratio above 1 indicates that a diagnostic test showing a:
A. A. Positive resulț̣ is strongly associated with the disease
B. Negative resulț̣ is strongly associated with absence of the disease
C. C. Positive resulț̣ is weakly associated with the disease
D. Negative resulț̣ is weakly associated with absence of the disease
10. Which of the following clinical reasoning tools is defined as evidence-based resource
̦̣ based on mathematical modeling
to express the likelihood of a condition in select situations,
̦̣ settings, and/or patients?
, lO M o A R c P S D | 1 2 6 5 6 7 1 3
A. Clinical practice guideline
̦̣
B. B. Clinical decision rule
̦̣
C. C. Clinical algorithm
Chapter 1: Clinical reasoning, differential diagnosis, evidence-based practice, and symptom ana
Answer Section
MULTIPLE CHOICE
1. ANS: B
Croskerry (2009) describes two major types of clinical diagnostic decision-making: intuitive
̦̣ and analytical. Intuitive
̦̣ decision-
making (similar to Augenblink
̦̣ decision-making) is based on the experience and intuition
̦̣ of the clinician and is less reliable and
paired with fairly common errors. In contrast, analytical decision-making is based on careful̦̣ consideration and has greater
reliability with rare errors.
PTS: 1
2. ANS: D
To obtain adequate
̦̣ history, providers must ̦̣ be well organized, attentive to the patient’s verbal and nonverbal language,
̦̣ and able
to accurately
̦̣ interpret the patient’s responses to questions.
̦̣ Rather than reading into the patient’s statements, they clarify any
areas of uncertainty.
̦̣
PTS: 1
3. ANS: C
Vital signs are part of the physical examination portion of patient assessment, not part of the health history.
PTS: 1
4. ANS: D
While performing the physical examination, the examiner must ̦̣ be able to differentiate between normal and abnormal findings,
recall knowledge of a range of conditions, including
̦̣ their associated signs and symptoms, recognize how certain conditions
affect
the response to other conditions, and distinguish
̦̣ the relevance of varied abnormal findings.
PTS: 1
5. ANS: C
Sources
̦̣ for diagnostic statistics include
̦̣ textbooks, primary reports of research, and published
̦̣ meta-analyses. Another source
̦̣ of
statistics, the one that has been most widely used ̦̣ and available for application to the reasoning process, is the estimation based
on
a provider’s experience, although ̦̣ these are rarely accurate.
̦̣ Over the past decade, the availability of evidence on which to base
clinical reasoning is improving, and there is an increasing expectation that clinical reasoning be based on scientific evidence.
Evidence-based statistics are also increasingly being used ̦̣ to develop resources
̦̣ to facilitate clinical decision-making.
PTS: 1
6. ANS: D
To assist in clinical decision-making, a number
̦̣ of evidence-based resourceș̣ have been developed to assist the clinician.
Resources,
̦̣ such
̦̣ as algorithms and clinical practice guidelines,
̦̣ assist in clinical reasoning when properly applied.
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 positive,
result.
̦̣ A high sensitivity indicates that a greater percentage of persons with the given condition will have an abnormal result.
̦̣
PTS: 1
8. ANS: B
The specificity of a diagnostic study
̦̣ is the percentage of normal, healthy individuals
̦̣ who have a normal result.̦̣ The greater the
specificity, the greater the percentage of individuals
̦̣ who will have negative, or normal, results
̦̣ if they do not have the target
condition.
PTS: 1
9. ANS: A
The likelihood ratio is the probability that a positive test resulț̣ will be associated with a person who has the target condition and
a
negative resulț̣ will be associated with a healthy person. A likelihood ratio above 1 indicates that a positive resulț̣ is associated
with the disease; a likelihood ratio less than 1 indicates that a negative resulț̣ is associated with an absence of the disease.
, lO M o A R c P S D | 1 2 6 5 6 7 1 3
PTS: 1
10. ANS: B
Clinical decision (or prediction) rules
̦̣ provide another support
̦̣ for clinical reasoning. Clinical decision rules
̦̣ are evidence-
based
resources
̦̣ that provide probabilistic statements regarding the likelihood that a condition exists if certain variables are met with
regard to the prognosis of patients with specific findings. Decision ruleș̣ use
̦̣ mathematical models and are specific to certain
situations,
̦̣ settings, and/or patient characteristics.
PTS: 1
