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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cv 1. Which type of clinical decision-making is most reliable?
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A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
cv 2. Which of the following is false? To obtain adequate history, health-care providers must be:
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A. Methodical and systematic cv cv
B. Attentive to the patient’s verbal and nonverbal language cv cv cv cv cv cv cv
C. Able to accurately interpret the patient’s responses
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D. Adept at reading into the patient’s statements cv cv cv cv cv cv
cv 3. Essential parts of a health history include all of the following except:
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A. Chief complaint cv
B. History of the present illness cv cv cv cv
C. Current vital signs cv cv
D. All of the above are essential history components
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cv 4. Which of the following is false? While performing the physical examination, the examiner must beabl
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e to: cv
A. Differentiate between normal and abnormal findings cv cv cv cv cv
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 cv cv cv cv cv cv cv cv cv
D. Foresee unpredictable findings cv cv
cv 5. The following is the least reliable source of information for diagnostic statistics:
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A. Evidence-based investigations cv
B. Primary reports of research cv cv cv
C. Estimation based on a provider’s experience cv cv cv cv cv
D. Published meta-analyses cv
cv 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 cv cv cv cv cv cv
B. Clinical practice guidelines cv cv
C. Evidence-based research cv
D. All of the above cv cv cv
cv 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 cv cv cv
,cv 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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cv 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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cv 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 situa
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tions, settings, and/orpatients?
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A. Clinical practice guideline cv cv
B. Clinical decision rule cv cv
C. Clinical algorithm cv
D. Clinical recommendation cv
, Chapter 1.Assessment and Clinical Decision-Making: Overview
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Answer Section
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MULTIPLE CHOICE cv
1. ANS: B c v
Croskerry (2009) describes two major types of clinical diagnostic decision- cv cv cv cv cv cv cv cv cv
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 fai
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rly 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 c v
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 c v
Vital signs are part of the physical examination portion of patient assessment, not part of the healthhistor
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y.
PTS: 1
4. ANS: D c v
While performing the physical examination, the examiner must be able to differentiate betweennorma
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l and abnormal findings, recall knowledge of a range of conditions, including their associated signs an
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d symptoms, recognize how certain conditions affect the response to other conditions, and distinguish
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the relevance of varied abnormal findings.
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PTS: 1
5. ANS: C c v
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 e
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vidence. Evidence- cv
based statistics are also increasingly being used to develop resources to facilitate clinical decision-
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making.
PTS: 1
6. ANS: D c v
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 clinical
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practice guidelines, assist in clinical reasoning when properly applied.
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