Test Bank For Advanced Assessment: Interpreting Findings And Formulating Differential Diagnoses 5Th Edition By Goolsby

Test Bank for Advanced Assessment: Interpreting Findings
and Formulating Differential Diagnoses, 5th Edition, Mary Jo
Goolsby, Laurie Grubbs Chapter 1 - 22 | Complete

,Chapter 1. Assessment and Clinical Decision-Making: Overview
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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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mj 1. Which type of clinical decision-making is most reliable?
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A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
mj 2. Which of the following is false? To obtain adequate history, health-care providers must be:
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A. Methodical and systematic mj mj




B. Attentive to the patient’s verbal and nonverbal language mj mj mj mj mj mj mj




C. Able to accurately interpret the patient’s responses
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D. Adept at reading into the patient’s statementsmj mj mj mj mj mj




mj 3. Essential parts of a health history include all of the following except:
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A. Chief complaint mj




B. History of the present illness mj mj mj mj




C. Current vital signs mj mj




D. All of the above are essential history components
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mj 4. Which of the following is false? While performing the physical examination, the examiner must beab
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le to: mj




A. Differentiate between normal and abnormal findings mj mj mj mj mj




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 mj mj mj mj mj mj mj mj mj




D. Foresee unpredictable findings mj mj




mj 5. The following is the least reliable source of information for diagnostic statistics:
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A. Evidence-based investigations mj




B. Primary reports of research mj mj mj




C. Estimation based on a provider’s experience mj mj mj mj mj




D. Published meta-analyses mj




mj 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 mj mj mj mj mj mj




B. Clinical practice guidelines mj mj




C. Evidence-based research mj




D. All of the above mj mj mj




mj 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 mj mj mj

,mj 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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mj 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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mj 10. Which of the following clinical reasoning tools is defined as evidence-
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based resource based on mathematical modeling to express the likelihood of a condition in select situ
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ations, settings, and/orpatients?
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A. Clinical practice guideline mj mj




B. Clinical decision rule mj mj




C. Clinical algorithm mj




D. Clinical recommendation mj

, Chapter 1. Assessment and Clinical Decision-Making: Overview
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Answer Section
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MULTIPLE CHOICE mj




1. ANS: B m j




Croskerry (2009) describes two major types of clinical diagnostic decision- mj mj mj mj mj mj mj mj mj




making: intuitive and analytical. Intuitive decision-making (similar to Augenblink decision-
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making) is based on the experience and intuition of the clinician and is less reliable and paired with f
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airly common errors. In contrast, analytical decision-
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making is based on careful consideration and has greater reliabilitywith rare errors.
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PTS: 1
2. ANS: D m j




To obtain adequate history, providers must be well organized, attentive to the patient’s verbal andnonv
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erbal language, and able to accurately interpret the patient’s responses to questions. Rather than readi
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ng into the patient’s statements, they clarify any areas of uncertainty.
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PTS: 1
3. ANS: C m j




Vital signs are part of the physical examination portion of patient assessment, not part of the healthhisto
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ry.

PTS: 1
4. ANS: D m j




While performing the physical examination, the examiner must be able to differentiate betweennorm
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al and abnormal findings, recall knowledge of a range of conditions, including their associated signs
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and symptoms, recognize how certain conditions affect the response to other conditions, and distingu
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ish the relevance of varied abnormal findings.
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PTS: 1
5. ANS: C m j




Sources for diagnostic statistics include textbooks, primary reports of research, and published meta-
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analyses. Another source of statistics, the one that has been most widely used and available for appli
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cation to the reasoning process, is the estimation based on a provider’s experience, although these ar
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e rarely accurate. Over the past decade, the availability of evidence on which to base clinical reasoni
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ng is improving, and there is an increasing expectation that clinical reasoningbe based on scientific
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evidence. Evidence- mj




based statistics are also increasingly being used to develop resources to facilitate clinical decision-
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making.

PTS: 1
6. ANS: D m j




To assist in clinical decision-making, a number of evidence-
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based resources have been developedto assist the clinician. Resources, such as algorithms and clinica
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l practice guidelines, assist in clinical reasoning when properly applied.
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