Chapter 04: Clinical Reasoning
Ball: Seidel’s Guide to Physical Examination, 9th Edition
MULTIPLE CHOICE
1. After the subjective and objective data have been prioritized, the next step is to:
a. order laboratory tests.
b. formulate a problem list.
c. initiate appropriate referrals.
d. initiate therapy.
ANS: B
After the data have been prioritized and a presumed diagnosis is made, the next step is to
consider the appropriate laboratory tests,
imaging studies, or specialty consultations.
DIF: Cognitive Level: Understanding (Comprehension) OBJ: Nursing process—evaluating
MSC: Safe and Effective Care: Management of Care
2. New findings of unknown causes are:
a. problems to be noted on the problem list.
b. deferred for subsequent visits.
c. diagnosed before physical examination.
d. reserved for specialists.
ANS: A
New findings of unknown causes are added to the problem list, but do not let them become a red
herring that distracts your
attention from the central issues.
DIF: Cognitive Level: Understanding (Comprehension) OBJ: Nursing process—diagnosis
MSC: Safe and Effective Care: Management of Care
3. Which is an accepted method of making a diagnosis?
a. Relying on intuition
b. Making maximal use of laboratory tests
c. Using first assumptions
d. Using algorithms
ANS: D
Methods to make a diagnosis include recognizing patterns, sampling the universe, and using
algorithms. Do not rely on intuition,
extensive use of laboratory findings, or always going with your first assumptions.
DIF: Cognitive Level: Remembering (Knowledge) OBJ: Nursing process—diagnosis
MSC: Safe and Effective Care: Management of Care
4. The adage that “common problems occur commonly” advises the practitioner to:
a. always diagnose the patient’s problem in terms of what their practice usually sees.
, b. refer any uncommon complaints to specialists as soon as possible.
c. not consider more than one diagnosis unless necessary.
d. examine uncommon problems critically before assuming that the issue is an
unusual presentation of a common problem.
ANS: C
This adage is to guide the practitioner to pay attention to unexpected or unusual findings but not
to consider more than one diagnosis unless necessary and to favor the simplest hypothesis when
competing hypotheses exist.
DIF: Cognitive Level: Analyzing (Analysis) OBJ: Nursing process—diagnosis
MSC: Safe and Effective Care: Management of Care
5. The most important guide to sequencing actions should be:
a. probability and utility.
b. assumption and intuition.
c. costs and risks of procedures.
d. reimbursement potential and patient acceptance.
ANS: A
Although all choices are relevant, the prioritized guide is to select actions based on an estimate
of the probability of successfully
achieving the patient’s goals and on the utility of implementation.
DIF: Cognitive Level: Remembering (Knowledge) OBJ: Nursing process—diagnosis
MSC: Safe and Effective Care: Management of Care
6. Utilitarianism can be described as:
a. balancing interests.
b. preventing harm.
c. choosing wisely.
d. doing good.
ANS: C
Utilitarianism occurs when one considers appropriate use of resources with concern for the
greater good of the larger community. It
also means to “choose wisely.”
DIF: Cognitive Level: Remembering (Knowledge) OBJ: Nursing process—diagnosis
MSC: Safe and Effective Care: Management of Care
7. Positive outcomes depend on the:
a. number of laboratory tests ordered.
b. quality of decisions made.
c. use of pharmacologic modalities.
d. time saved by the use of ancillary personnel.
ANS: B
Positive patient outcomes are dependent on your ability to arrive at accurate hypotheses that then
direct quality patient care
decisions.
DIF: Cognitive Level: Understanding (Comprehension) OBJ: Nursing process—diagnosis
MSC: Safe and Effective Care: Management of Care
Ball: Seidel’s Guide to Physical Examination, 9th Edition
MULTIPLE CHOICE
1. After the subjective and objective data have been prioritized, the next step is to:
a. order laboratory tests.
b. formulate a problem list.
c. initiate appropriate referrals.
d. initiate therapy.
ANS: B
After the data have been prioritized and a presumed diagnosis is made, the next step is to
consider the appropriate laboratory tests,
imaging studies, or specialty consultations.
DIF: Cognitive Level: Understanding (Comprehension) OBJ: Nursing process—evaluating
MSC: Safe and Effective Care: Management of Care
2. New findings of unknown causes are:
a. problems to be noted on the problem list.
b. deferred for subsequent visits.
c. diagnosed before physical examination.
d. reserved for specialists.
ANS: A
New findings of unknown causes are added to the problem list, but do not let them become a red
herring that distracts your
attention from the central issues.
DIF: Cognitive Level: Understanding (Comprehension) OBJ: Nursing process—diagnosis
MSC: Safe and Effective Care: Management of Care
3. Which is an accepted method of making a diagnosis?
a. Relying on intuition
b. Making maximal use of laboratory tests
c. Using first assumptions
d. Using algorithms
ANS: D
Methods to make a diagnosis include recognizing patterns, sampling the universe, and using
algorithms. Do not rely on intuition,
extensive use of laboratory findings, or always going with your first assumptions.
DIF: Cognitive Level: Remembering (Knowledge) OBJ: Nursing process—diagnosis
MSC: Safe and Effective Care: Management of Care
4. The adage that “common problems occur commonly” advises the practitioner to:
a. always diagnose the patient’s problem in terms of what their practice usually sees.
, b. refer any uncommon complaints to specialists as soon as possible.
c. not consider more than one diagnosis unless necessary.
d. examine uncommon problems critically before assuming that the issue is an
unusual presentation of a common problem.
ANS: C
This adage is to guide the practitioner to pay attention to unexpected or unusual findings but not
to consider more than one diagnosis unless necessary and to favor the simplest hypothesis when
competing hypotheses exist.
DIF: Cognitive Level: Analyzing (Analysis) OBJ: Nursing process—diagnosis
MSC: Safe and Effective Care: Management of Care
5. The most important guide to sequencing actions should be:
a. probability and utility.
b. assumption and intuition.
c. costs and risks of procedures.
d. reimbursement potential and patient acceptance.
ANS: A
Although all choices are relevant, the prioritized guide is to select actions based on an estimate
of the probability of successfully
achieving the patient’s goals and on the utility of implementation.
DIF: Cognitive Level: Remembering (Knowledge) OBJ: Nursing process—diagnosis
MSC: Safe and Effective Care: Management of Care
6. Utilitarianism can be described as:
a. balancing interests.
b. preventing harm.
c. choosing wisely.
d. doing good.
ANS: C
Utilitarianism occurs when one considers appropriate use of resources with concern for the
greater good of the larger community. It
also means to “choose wisely.”
DIF: Cognitive Level: Remembering (Knowledge) OBJ: Nursing process—diagnosis
MSC: Safe and Effective Care: Management of Care
7. Positive outcomes depend on the:
a. number of laboratory tests ordered.
b. quality of decisions made.
c. use of pharmacologic modalities.
d. time saved by the use of ancillary personnel.
ANS: B
Positive patient outcomes are dependent on your ability to arrive at accurate hypotheses that then
direct quality patient care
decisions.
DIF: Cognitive Level: Understanding (Comprehension) OBJ: Nursing process—diagnosis
MSC: Safe and Effective Care: Management of Care
