diagnosis in primary care 6th Edition
Dains Test Bank
Chapter 1: clinical reasoning, differential diagnosis, evidence-based practice, and
symptoms ana
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. Experimental
d. Augenblick
ANS:B
Croskerry (2009) describes two major types of clinical diagnostic
decision-making: intuitive and analytical. Intuitive decision-making
(similar to Augenblink-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 in careful consideration
and has greater reliability with rare errors
2. Which of the following is false? To obtain adequate history, health-care
providers must be:
a. Methodical and systematic
b. Attentive to the patient’s verbal and nonverbal language
c. Able to accurately interpret the patient’s response
d. Adept at reading into the patient’s statement
, 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
3. Essential parts of a health history include all of the following except:
a. Chief complaint
b. History of the present illness
c. Current vital signs
d. All of the above are essential history components
ANS: C
Vital signs are part of the physical examination portion of patient
assessment, not part of the health history.
4. Which of the following is false? While performing the physical examination,
the examiner must be able to
a. Differentiate between normal and abnormal findings
b. Recall knowledge of a range of conditions and their associated signs and
symptoms
c. Recognize how certain conditions affect the response to other conditons
d. Foresee unpredictable findings
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.
, 5. The following is the least reliable source of information for diagnostic
statistics
a. Evidence-based investigations
b. Primary reports of research
c. Estimation based on a provider’s experience
d. Published meta-analysis
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.
6. The following can be used to assist in sound clinical decision-making:
a. Algorithm published in a peer-reviewed journal article
b. Clinical practice guidelines
c. Evidence-based research
d. All of the above
ANS: D
To assist in clinical decision-making, a number of evidence-based
resources have been developed to assist the clinician. Resources such as
algorithms and clinical guidelines, assist in clinical reasoning when
properly applied.
7. If a diagnostic study has high sensitivity, this indicates a: