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 ISBN-10;
1719645930 / ISBN-13; 978-1719645935

,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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1. Which type of clinical decision-making is most reliable?
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A. Intuitive
B. Analytical
C. Experiential
D. Augenblick

2. Which of the following is false? To obtain adequate history, health-care providers must be:
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A. Methodical and systematic J J




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




C. Able to accuratelyinterpret the patient’s responses
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D. Adept at reading into the patient’s statementsJ J J J J J




3. Essential parts of a health historyinclude all of the following except:
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A. Chief complaint J




B. Historyof the present illness J J J J




C. Current vital signs J J




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




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




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 J J J J J J J J J




D. Foresee unpredictable findings J J




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




B. Primary reports of research J J J




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




D. Published meta-analyses J




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 J J J J J J




B. Clinical practice guidelines J J




C. Evidence-based research J




D. All of the above J J J




7. If a diagnostic studyhas 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 J J J

, 8. If a diagnostic studyhas 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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9. Alikelihood 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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J 10. Which of the following clinical reasoning tools is defined as evidence-based resource based on
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mathematical modeling to express the likelihood of a condition in select situations, settings, and/or
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patients?
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A. Clinical practice guideline J J




B. Clinical decision rule J J




C. Clinical algorithm J




D. Clinical recommendation J

, Answer Section
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MULTIPLE CHOICE J




1. ANS: B J J




Croskerry (2009) describes two major types of clinical diagnostic decision-making: intuitive and
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analytical. Intuitive decision-making (similar to Augenblink decision-making) is based on the
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experience and intuition of the clinician and is less reliable and paired with fairly common errors. In
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contrast, analytical decision-making is based on careful consideration and has greater reliability with
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rare errors.
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PTS: 1
2. ANS: D J J




Toobtain adequatehistory, providers must bewell organized, attentive to thepatient’s verbal and
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nonverbal language, and able to accurately interpret the patient’s responses to questions. Rather than
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reading into the patient’s statements, they clarify any areas of uncertainty.
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PTS: 1
3. ANS: C J J




Vital signs arepart of the physical examination portion of patient assessment, not part of the health history.
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PTS: 1
4. ANS: D J J




While performing the physical examination, the examiner must be able to differentiate between normal
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and abnormal findings, recall knowledge of a range of conditions, including their associated signs and
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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 J 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
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application to the reasoning process, is the estimation based on a provider’s experience, although
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these are rarely accurate. Over the past decade, the availability of evidence on which to base clinical
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reasoning is improving, and there is an increasing expectation that clinical reasoning be based on
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scientific evidence. Evidence-based statistics are also increasingly being used to develop resources to
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facilitate clinical decision-making.
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PTS: 1
6. ANS: D J J




To assist in clinical decision-making, a numberof evidence-based resources havebeen developed to
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assist the clinician. Resources, such as algorithms and clinical practice guidelines, assist in clinical
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reasoning when properly applied.
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