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Test Bank for Advanced Health Assessment & Clinical Diagnosis in Primary Care
6th 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. Methodical and systematic
B. Attentive to the patient‘s verbal and nonverbal language
C. Able to accurately interpret the patient‘s responses
D. Adept at reading into the patient‘s statements
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
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 conditions
D. Foresee unpredictable 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-analyses
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
7. If a diagnostic study has high sensitivity, this indicates a:
A. High percentage of persons with the given condition will have an abnormal result
B. Low percentage of persons with the given condition will have an abnormal result
C. Low likelihood of normal result in persons without a given condition
D. None of the above
8. If a diagnostic study has high specificity, this indicates a:
A. Low percentage of healthy individuals will show a normal result
B. High percentage of healthy individuals will show a normal result
C. High percentage of individuals with a disorder will show a normal result
D. Low percentage of individuals with a disorder will show an abnormal result
9. A likelihood ratio above 1 indicates that a diagnostic test showing a:
A. Positive result is strongly associated with the disease
B. Negative result is strongly associated with absence of the disease
C. Positive result is weakly associated with the disease
D. Negative result 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?
, lOMoARcPSD| 126
n n
A. Clinical npractice nguideline
B. Clinical ndecision nrule
C. Clinical nalgorithm
Chapter n1: nClinical nreasoning, ndifferential ndiagnosis, nevidence-based npractice, nand nsymptom nana
Answer nSection
MULTIPLE nCHOICE
1. ANS: B
Croskerry n(2009) ndescribes ntwo nmajor ntypes nof nclinical ndiagnostic ndecision-making: nintuitive nand nanalytical. nIntuitive
ndecision- nmaking n(similar nto nAugenblink ndecision-making) nis nbased non nthe nexperience nand nintuition nof nthe nclinician nand nis
nless nreliable nand npaired nwith nfairly ncommon nerrors. nIn ncontrast, nanalytical ndecision-making nis nbased non ncareful
nconsideration nand nhas ngreater nreliability nwith nrare nerrors.
PTS: 1
2. ANS: D
To nobtain nadequate nhistory, nproviders nmust nbe nwell norganized, nattentive nto nthe npatient‘s nverbal nand nnonverbal nlanguage, nand
nable nto naccurately ninterpret nthe npatient‘s nresponses nto nquestions. nRather nthan nreading ninto nthe npatient‘s nstatements, nthey
nclarify nany nareas nof nuncertainty.
PTS: 1
3. ANS: C
Vital nsigns nare npart nof nthe nphysical nexamination nportion nof npatient nassessment, nnot npart nof nthe nhealth nhistory.
PTS: 1
4. ANS: D
While nperforming nthe nphysical nexamination, nthe nexaminer nmust nbe nable nto ndifferentiate nbetween nnormal nand nabnormal
nfindings, nrecall nknowledge nof na nrange nof nconditions, nincluding ntheir nassociated nsigns nand nsymptoms, nrecognize nhow ncertain
nconditions naffect nthe nresponse nto nother nconditions, nand ndistinguish nthe nrelevance nof nvaried nabnormal nfindings.
PTS: 1
5. ANS: C
Sources nfor ndiagnostic nstatistics ninclude ntextbooks, nprimary nreports nof nresearch, nand npublished nmeta-analyses. nAnother
nsource nof nstatistics, nthe none nthat nhas nbeen nmost nwidely nused nand navailable nfor napplication nto nthe nreasoning nprocess, nis nthe
nestimation nbased non na nprovider‘s nexperience, nalthough nthese nare nrarely naccurate. nOver nthe npast ndecade, nthe navailability nof
nevidence non nwhich nto nbase nclinical nreasoning nis nimproving, n and nthere nis nan nincreasing nexpectation nthat nclinical nreasoning
nbe nbased non nscientific nevidence.
Evidence-based nstatistics n are n also nincreasingly nbeing nused nto ndevelop n resources nto nfacilitate n clinical n decision-making.
PTS: 1
6. ANS: D
To nassist nin nclinical ndecision-making, na nnumber nof nevidence-based nresources nhave nbeen ndeveloped nto nassist nthe nclinician.
nResources, nsuch nas nalgorithms nand nclinical npractice nguidelines, nassist nin nclinical nreasoning nwhen nproperly napplied.
PTS: 1
7. ANS: A
The nsensitivity nof na ndiagnostic nstudy nis nthe npercentage nof nindividuals nwith nthe ntarget ncondition nwho nshow nan nabnormal, nor
n positive, nresult. nA nhigh nsensitivity nindicates nthat na ngreater npercentage nof npersons nwith nthe ngiven ncondition nwill nhave nan
nabnormal nresult.
PTS: 1
8. ANS: B
The nspecificity nof na ndiagnostic nstudy nis nthe npercentage nof nnormal, nhealthy nindividuals nwho nhave na nnormal nresult. nThe
ngreater nthe nspecificity, nthe ngreater nthe npercentage nof nindividuals nwho nwill nhave nnegative, nor nnormal, nresults nif nthey ndo nnot
nhave nthe ntarget ncondition.
PTS: 1
9. ANS: A
The nlikelihood nratio nis nthe nprobability nthat na npositive ntest nresult nwill nbe nassociated nwith na nperson nwho nhas nthe ntarget
ncondition nand na nnegative nresult nwill nbe nassociated nwith na nhealthy nperson. nA nlikelihood nratio nabove n1 nindicates nthat na
npositive nresult nis nassociated nwith nthe ndisease; na nlikelihood nratio nless nthan n1 nindicates nthat na nnegative nresult nis nassociated
nwith nan nabsence nof nthe ndisease.
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n n
PTS: 1
10. ANS: B
Clinical ndecision n(or nprediction) nrules nprovide nanother nsupport nfor nclinical nreasoning. nClinical ndecision nrules nare nevidence-
based nresources nthat nprovide nprobabilistic nstatements nregarding nthe nlikelihood nthat na ncondition nexists nif ncertain nvariables
nare nmet nwith nregard nto nthe nprognosis nof npatients nwith nspecific nfindings. nDecision nrules nuse nmathematical nmodels nand nare
nspecific nto ncertain nsituations, nsettings, nand/or npatient ncharacteristics.
PTS: 1
n n
, lOMoARcPSD| 126
n n
Test Bank for Advanced Health Assessment & Clinical Diagnosis in Primary Care
6th 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. Methodical and systematic
B. Attentive to the patient‘s verbal and nonverbal language
C. Able to accurately interpret the patient‘s responses
D. Adept at reading into the patient‘s statements
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
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 conditions
D. Foresee unpredictable 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-analyses
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
7. If a diagnostic study has high sensitivity, this indicates a:
A. High percentage of persons with the given condition will have an abnormal result
B. Low percentage of persons with the given condition will have an abnormal result
C. Low likelihood of normal result in persons without a given condition
D. None of the above
8. If a diagnostic study has high specificity, this indicates a:
A. Low percentage of healthy individuals will show a normal result
B. High percentage of healthy individuals will show a normal result
C. High percentage of individuals with a disorder will show a normal result
D. Low percentage of individuals with a disorder will show an abnormal result
9. A likelihood ratio above 1 indicates that a diagnostic test showing a:
A. Positive result is strongly associated with the disease
B. Negative result is strongly associated with absence of the disease
C. Positive result is weakly associated with the disease
D. Negative result 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?
, lOMoARcPSD| 126
n n
A. Clinical npractice nguideline
B. Clinical ndecision nrule
C. Clinical nalgorithm
Chapter n1: nClinical nreasoning, ndifferential ndiagnosis, nevidence-based npractice, nand nsymptom nana
Answer nSection
MULTIPLE nCHOICE
1. ANS: B
Croskerry n(2009) ndescribes ntwo nmajor ntypes nof nclinical ndiagnostic ndecision-making: nintuitive nand nanalytical. nIntuitive
ndecision- nmaking n(similar nto nAugenblink ndecision-making) nis nbased non nthe nexperience nand nintuition nof nthe nclinician nand nis
nless nreliable nand npaired nwith nfairly ncommon nerrors. nIn ncontrast, nanalytical ndecision-making nis nbased non ncareful
nconsideration nand nhas ngreater nreliability nwith nrare nerrors.
PTS: 1
2. ANS: D
To nobtain nadequate nhistory, nproviders nmust nbe nwell norganized, nattentive nto nthe npatient‘s nverbal nand nnonverbal nlanguage, nand
nable nto naccurately ninterpret nthe npatient‘s nresponses nto nquestions. nRather nthan nreading ninto nthe npatient‘s nstatements, nthey
nclarify nany nareas nof nuncertainty.
PTS: 1
3. ANS: C
Vital nsigns nare npart nof nthe nphysical nexamination nportion nof npatient nassessment, nnot npart nof nthe nhealth nhistory.
PTS: 1
4. ANS: D
While nperforming nthe nphysical nexamination, nthe nexaminer nmust nbe nable nto ndifferentiate nbetween nnormal nand nabnormal
nfindings, nrecall nknowledge nof na nrange nof nconditions, nincluding ntheir nassociated nsigns nand nsymptoms, nrecognize nhow ncertain
nconditions naffect nthe nresponse nto nother nconditions, nand ndistinguish nthe nrelevance nof nvaried nabnormal nfindings.
PTS: 1
5. ANS: C
Sources nfor ndiagnostic nstatistics ninclude ntextbooks, nprimary nreports nof nresearch, nand npublished nmeta-analyses. nAnother
nsource nof nstatistics, nthe none nthat nhas nbeen nmost nwidely nused nand navailable nfor napplication nto nthe nreasoning nprocess, nis nthe
nestimation nbased non na nprovider‘s nexperience, nalthough nthese nare nrarely naccurate. nOver nthe npast ndecade, nthe navailability nof
nevidence non nwhich nto nbase nclinical nreasoning nis nimproving, n and nthere nis nan nincreasing nexpectation nthat nclinical nreasoning
nbe nbased non nscientific nevidence.
Evidence-based nstatistics n are n also nincreasingly nbeing nused nto ndevelop n resources nto nfacilitate n clinical n decision-making.
PTS: 1
6. ANS: D
To nassist nin nclinical ndecision-making, na nnumber nof nevidence-based nresources nhave nbeen ndeveloped nto nassist nthe nclinician.
nResources, nsuch nas nalgorithms nand nclinical npractice nguidelines, nassist nin nclinical nreasoning nwhen nproperly napplied.
PTS: 1
7. ANS: A
The nsensitivity nof na ndiagnostic nstudy nis nthe npercentage nof nindividuals nwith nthe ntarget ncondition nwho nshow nan nabnormal, nor
n positive, nresult. nA nhigh nsensitivity nindicates nthat na ngreater npercentage nof npersons nwith nthe ngiven ncondition nwill nhave nan
nabnormal nresult.
PTS: 1
8. ANS: B
The nspecificity nof na ndiagnostic nstudy nis nthe npercentage nof nnormal, nhealthy nindividuals nwho nhave na nnormal nresult. nThe
ngreater nthe nspecificity, nthe ngreater nthe npercentage nof nindividuals nwho nwill nhave nnegative, nor nnormal, nresults nif nthey ndo nnot
nhave nthe ntarget ncondition.
PTS: 1
9. ANS: A
The nlikelihood nratio nis nthe nprobability nthat na npositive ntest nresult nwill nbe nassociated nwith na nperson nwho nhas nthe ntarget
ncondition nand na nnegative nresult nwill nbe nassociated nwith na nhealthy nperson. nA nlikelihood nratio nabove n1 nindicates nthat na
npositive nresult nis nassociated nwith nthe ndisease; na nlikelihood nratio nless nthan n1 nindicates nthat na nnegative nresult nis nassociated
nwith nan nabsence nof nthe ndisease.
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n n
PTS: 1
10. ANS: B
Clinical ndecision n(or nprediction) nrules nprovide nanother nsupport nfor nclinical nreasoning. nClinical ndecision nrules nare nevidence-
based nresources nthat nprovide nprobabilistic nstatements nregarding nthe nlikelihood nthat na ncondition nexists nif ncertain nvariables
nare nmet nwith nregard nto nthe nprognosis nof npatients nwith nspecific nfindings. nDecision nrules nuse nmathematical nmodels nand nare
nspecific nto ncertain nsituations, nsettings, nand/or npatient ncharacteristics.
PTS: 1
