Test Bank for Advanced Health Assessment & Clinical Diagnosis in Primary Care, 6th Edition by dains

TESTBANK y




ADVANCED HEALTH ASSESSMENT & CLINICAL DIAGNOSIS IN
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PRIMARY CARE, 6TH EDITION
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Joyce E. Dains, Linda Ciofu Baumann & Pamela Scheibel
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Test Bank for Advanced Health Assessment & Clinical Diagnosis in Primary Care 6t
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h Edition Dains y y




Chaptery1:yClinicalyReasoning,yDifferentialyDiagnosis,yEvidence-BasedyPractice,yandySymptomyAnalysis

MultipleyChoice
Identifyytheychoiceythatybestycompletesytheystatementyoryanswersytheyquestion.
1. Whichytypeyofyclinicalydecision-makingyisymostyreliable?
A. Intuitive
B. Analytical
C. Experiential
D. Augenblick

2. Whichyofytheyfollowingyisyfalse?yToyobtainyadequateyhistory,yhealth-careyprovidersymustybe:
A. Methodicalyandysystematic
B. Attentiveytoytheypatient’syverbalyandynonverbalylanguage
C. Ableytoyaccuratelyyinterpretytheypatient’syresponses
D. Adeptyatyreadingyintoytheypatient’systatements

3. Essentialypartsyofyayhealthyhistoryyincludeyallyofytheyfollowingyexcept:
A. Chiefycomplaint
B. Historyyofytheypresentyillness
C. Currentyvitalysigns
D. Allyofytheyaboveyareyessentialyhistoryycomponents

4. Whichyofytheyfollowingyisyfalse?yWhileyperformingytheyphysicalyexamination,ytheyexaminerymustybeyableyto:
A. Differentiateybetweenynormal yandyabnormalyfindings
B. Recallyknowledgeyofyayrangeyofyconditionsyandytheiryassociatedysignsyandysymptoms
C. Recognizeyhowycertainyconditionsyaffectytheyresponseytoyotheryconditions
D. Foreseeyunpredictableyfindings

5. Theyfollowingyisytheyleastyreliableysourceyofyinformationyforydiagnosticystatistics:
A. Evidence-basedyinvestigations
B. Primaryyreportsyofyresearch
C. Estimationybasedyonyayprovider’syexperience
D. Publishedymeta-analyses

6. Theyfollowingycanybeyusedytoyassistyinysoundyclinicalydecision-making:
A. Algorithmypublishedyinyaypeer-reviewedyjournalyarticle
B. Clinicalypracticeyguidelines
C. Evidence-basedyresearch
D. Allyofytheyabove

7. Ifyaydiagnosticystudyyhasyhighysensitivity,ythisyindicatesya:
A. Highypercentageyofypersonsywithytheygivenyconditionywillyhaveyanyabnormalyresult
B. Lowypercentageyofypersonsywithytheygivenyconditionywillyhaveyanyabnormalyresult
C. Lowylikelihoodyofynormalyresultyinypersonsywithoutyaygivenycondition
D. Noneyofytheyabove

8. Ifyaydiagnosticystudyyhasyhighyspecificity,ythisyindicatesya:
A. Lowypercentageyofyhealthyyindividualsywillyshowyaynormalyresult
B. Highypercentageyofyhealthyyindividualsywillyshowyaynormalyresult
C. Highypercentageyofyindividualsywithyaydisorderywillyshowyaynormalyresult
D. Lowypercentageyofyindividualsywithyaydisorderywillyshowyanyabnormalyresult

9. Aylikelihoodyratioyabovey1yindicatesythatyaydiagnosticytestyshowingya:
A. Positiveyresultyisystronglyyassociatedywithytheydisease
B. Negativeyresultyisystronglyyassociatedywithyabsenceyofytheydisease
C. Positiveyresultyisyweaklyyassociatedywithytheydisease
D. Negativeyresultyisyweaklyyassociatedywithyabsenceyofytheydisease

10. Whichyofytheyfollowingyclinicalyreasoningytoolsyisydefinedyasyevidence-
basedyresourceybasedyonymathematicalymodelingytoyexpressytheylikelihoodyofyayconditionyinyselectysituations,ysettings,yand/orypa
tients?

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A. Clinicalypracticeyguideline
B. Clinicalydecisionyrule
C. Clinicalyalgorithm
Chaptery1:yClinicalyreasoning,ydifferentialydiagnosis,yevidence-basedypractice,yandysymptomyana
AnswerySection

MULTIPLEyCHOICE

1. ANS: B
Croskerryy(2009)ydescribesytwoymajorytypesyofyclinicalydiagnosticydecision-making:yintuitiveyandyanalytical.yIntuitiveydecision-
ymakingy(similaryto yAugenblinkydecision-

making)yisybasedyonytheyexperienceyandyintuitionyofytheyclinicianyandyisylessyreliableyandypairedywithyfairlyycommonyerrors.yInyc
ontrast,yanalyticalydecision-makingyisybasedyonycarefulyconsiderationyandyhasygreateryreliabilityywithyrareyerrors.

PTS: 1
2. ANS: D
Toyobtainyadequateyhistory,yprovidersymustybeywellyorganized,yattentiveytoytheypatient’syverbalyandynonverbalylanguage,yandyable
yto yaccuratelyyinterpret ytheypatient’s yresponsesyto yquestions. yRatherythanyreadingyintoytheypatient’s ystatements, ytheyyclarifyyanyy

areasyofyuncertainty.

PTS: 1
3. ANS: C
Vitalysignsyareypartyofytheyphysicalyexaminationyportionyofypatientyassessment,ynotypartyofytheyhealthyhistory.

PTS: 1
4. ANS: D
Whileyperformingytheyphysicalyexamination,ytheyexaminerymustybeyableytoydifferentiateybetweenynormalyandyabnormalyfindings,yr
ecallyknowledgeyofyayrangeyofyconditions,yincludingytheiryassociatedysignsyandysymptoms,yrecognizeyhowycertainyconditionsyaffect
ytheyresponseyto yotheryconditions,yandydistinguishytheyrelevanceyofyvaried yabnormal yfindings.



PTS: 1
5. ANS: C
Sourcesyforydiagnosticystatisticsyincludeytextbooks,yprimaryyreportsyofyresearch,yandypublishedymeta-
analyses.yAnotherysourceyofystatistics,ytheyoneythatyhasybeenymostywidelyyusedyandyavailableyforyapplicationytoytheyreasoningyproc
ess,yisytheyestimationybasedyonyayprovider’syexperience,yalthoughytheseyareyrarelyyaccurate.yOverytheypastydecade,ytheyavailabilit
yyofyevidenceyonywhichytoybaseyclinicalyreasoningyisyimproving,y andythereyisyanyincreasingyexpectationythatyclinicalyreasoningyb
eybasedyonyscientificyevidence.
Evidence-basedystatisticsyareyalsoyincreasinglyybeingyusedytoydevelopyresourcesytoyfacilitateyclinicaly decision-making.

PTS: 1
6. ANS: D
Toyassistyinyclinicalydecision-making,yaynumberyofyevidence-
basedyresourcesyhaveybeenydevelopedytoyassistytheyclinician.yResources,ysuchyasyalgorithmsyandyclinicalypracticeyguidelines,yassi
styinyclinicalyreasoningywhenyproperlyyapplied.

PTS: 1
7. ANS: A
Theysensitivityyofyaydiagnosticystudyyisytheypercentageyofyindividualsywithytheytargetyconditionywhoyshowyanyabnormal,yorypositive
,yresult.yAyhighysensitivityyindicatesythatyaygreaterypercentageyofypersonsywithytheygivenyconditionywillyhaveyanyabnormalyresult.

PTS: 1
8. ANS: B
Theyspecificityyofyaydiagnosticystudyyisytheypercentageyofynormal,yhealthyyindividualsywhoyhaveyaynormalyresult.yTheygreaterythe
yspecificity, ytheygreaterytheypercentageyofyindividualsywho ywill yhaveynegative, yorynormal, yresults yifytheyydo ynotyhaveytheytargety

condition.

PTS: 1
9. ANS: A
Theylikelihoodyratioyisytheyprobabilityythatyaypositiveytestyresultywillybeyassociatedywithyaypersonywhoyhasytheytargetyconditionyandy
aynegativeyresultywillybeyassociatedywithyayhealthyyperson.yAylikelihoodyratioyabovey1yindicatesythatyaypositiveyresultyisyassociated
ywith ytheydisease;yaylikelihoodyratio ylessythan y1 yindicatesythatyaynegativeyresult yisyassociated ywith yan yabsenceyofytheydisease.

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PTS: 1
10. ANS: B
Clinicalydecisiony(oryprediction)yrulesyprovideyanotherysupportyforyclinicalyreasoning.yClinicalydecisionyrulesyareyevidence-
basedyresourcesythatyprovideyprobabilisticystatementsyregardingytheylikelihoodythatyayconditionyexistsyifycertainyvariablesyareyme
tywithyregardytoytheyprognosisyofypatientsywithyspecificyfindings.yDecisionyrulesyuseymathematicalymodelsyandyareyspecificytoyce
rtainysituations,ysettings,yand/orypatientycharacteristics.

PTS: 1