@
, @
Test Bank for Advanced Health Assessment & Clinical Diagnosis in Primary Care 7t
@ @ @ @ @ @ @ @ @ @ @ @
h 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@langua
ge
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@componen
ts
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@sympto
ms
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@experienc
e
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@re
sult
B. Low@percentage@of@persons@with@the@given@condition@will@have@an@abnormal@res
ult
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@re
sult
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@disea
se
C. Positive@result@is@weakly@associated@with@the@disease
D. Negative@result@is@weakly@associated@with@absence@of@the@diseas
e
, @
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?
, @
A. Clinical@practice@guideline
B. Clinical@decision@rule
C. Clinical@algorithm
Chapter 1: Clinical reasoning, differential diagnosis, evidence-based practice, and symptom ana
@ @ @ @ @ @ @ @ @ @
Answer Section
@
MULTIPLE@CHOICE
1. ANS: B
Croskerry@(2009)@describes@two@major@types@of@clinical@diagnostic@decision-
making:@intuitive@and@analytical.@Intuitive@decision-@making@(similar@to@Augenblink@decision-
making)@is@based@on@the@experience@and@intuition@of@the@clinician@and@is@less@reliable@and@paired@with@fairly@common@error
s.@In@contrast,@analytical@decision-making@is@based@on@careful@consideration@and@has@greater@reliability@with@rare@errors.
PTS: 1
2. ANS: D
To@obtain@adequate@history,@providers@must@be@well@organized,@attentive@to@the@patient‘s@verbal@and@nonverbal@language,@an
d@able@to@accurately@interpret@the@patient‘s@responses@to@questions.@Rather@than@reading@into@the@patient‘s@statements,@they@c
larify@any@areas@of@uncertainty.
PTS: 1
3. ANS: C
Vital@signs@are@part@of@the@physical@examination@portion@of@patient@assessment,@not@part@of@the@health@history.
PTS: 1
4. ANS: D
While@performing@the@physical@examination,@the@examiner@must@be@able@to@differentiate@between@normal@and@abnormal@findi
ngs,@recall@knowledge@of@a@range@of@conditions,@including@their@associated@signs@and@symptoms,@recognize@how@certain@condi
tions@affect@the@response@to@other@conditions,@and@distinguish@the@relevance@of@varied@abnormal@findings.
PTS: 1
5. ANS: C
Sources@for@diagnostic@statistics@include@textbooks,@primary@reports@of@research,@and@published@meta-
analyses.@Another@source@of@statistics,@the@one@that@has@been@most@widely@used@and@available@for@application@to@the@reasonin
g@process,@is@the@estimation@based@on@a@provider‘s@experience,@although@these@are@rarely@accurate.@Over@the@past@decade,@th
e@availability@of@evidence@on@which@to@base@clinical@reasoning@is@improving,@ and@there@is@an@increasing@expectation@that@cli
nical@reasoning@be@based@on@scientific@evidence.
Evidence-based@statistics@are@ also@increasingly@being@used@to@develop@ resources@to@facilitate@ clinical@ decision-making.
PTS: 1
6. ANS: D
To@assist@in@clinical@decision-making,@a@number@of@evidence-
based@resources@have@been@developed@to@assist@the@clinician.@Resources,@such@as@algorithms@and@clinical@practice@guidelines
,@assist@in@clinical@reasoning@when@properly@applied.
PTS: 1
7. ANS: A
The@sensitivity@of@a@diagnostic@study@is@the@percentage@of@individuals@with@the@target@condition@who@show@an@abnormal,@or@ p
ositive,@result.@A@high@sensitivity@indicates@that@a@greater@percentage@of@persons@with@the@given@condition@will@have@an@abnor
mal@result.
PTS: 1
8. ANS: B
The@specificity@of@a@diagnostic@study@is@the@percentage@of@normal,@healthy@individuals@who@have@a@normal@result.@The@great
er@the@specificity,@the@greater@the@percentage@of@individuals@who@will@have@negative,@or@normal,@results@if@they@do@not@have
@the@target@condition.
PTS: 1
9. ANS: A
The@likelihood@ratio@is@the@probability@that@a@positive@test@result@will@be@associated@with@a@person@who@has@the@target@conditi
on@and@a@negative@result@will@be@associated@with@a@healthy@person.@A@likelihood@ratio@above@1@indicates@that@a@positive@resul
t@is@associated@with@the@disease;@a@likelihood@ratio@less@than@1@indicates@that@a@negative@result@is@associated@with@an@absence@
of@the@disease.
, @
Test Bank for Advanced Health Assessment & Clinical Diagnosis in Primary Care 7t
@ @ @ @ @ @ @ @ @ @ @ @
h 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@langua
ge
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@componen
ts
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@sympto
ms
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@experienc
e
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@re
sult
B. Low@percentage@of@persons@with@the@given@condition@will@have@an@abnormal@res
ult
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@re
sult
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@disea
se
C. Positive@result@is@weakly@associated@with@the@disease
D. Negative@result@is@weakly@associated@with@absence@of@the@diseas
e
, @
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?
, @
A. Clinical@practice@guideline
B. Clinical@decision@rule
C. Clinical@algorithm
Chapter 1: Clinical reasoning, differential diagnosis, evidence-based practice, and symptom ana
@ @ @ @ @ @ @ @ @ @
Answer Section
@
MULTIPLE@CHOICE
1. ANS: B
Croskerry@(2009)@describes@two@major@types@of@clinical@diagnostic@decision-
making:@intuitive@and@analytical.@Intuitive@decision-@making@(similar@to@Augenblink@decision-
making)@is@based@on@the@experience@and@intuition@of@the@clinician@and@is@less@reliable@and@paired@with@fairly@common@error
s.@In@contrast,@analytical@decision-making@is@based@on@careful@consideration@and@has@greater@reliability@with@rare@errors.
PTS: 1
2. ANS: D
To@obtain@adequate@history,@providers@must@be@well@organized,@attentive@to@the@patient‘s@verbal@and@nonverbal@language,@an
d@able@to@accurately@interpret@the@patient‘s@responses@to@questions.@Rather@than@reading@into@the@patient‘s@statements,@they@c
larify@any@areas@of@uncertainty.
PTS: 1
3. ANS: C
Vital@signs@are@part@of@the@physical@examination@portion@of@patient@assessment,@not@part@of@the@health@history.
PTS: 1
4. ANS: D
While@performing@the@physical@examination,@the@examiner@must@be@able@to@differentiate@between@normal@and@abnormal@findi
ngs,@recall@knowledge@of@a@range@of@conditions,@including@their@associated@signs@and@symptoms,@recognize@how@certain@condi
tions@affect@the@response@to@other@conditions,@and@distinguish@the@relevance@of@varied@abnormal@findings.
PTS: 1
5. ANS: C
Sources@for@diagnostic@statistics@include@textbooks,@primary@reports@of@research,@and@published@meta-
analyses.@Another@source@of@statistics,@the@one@that@has@been@most@widely@used@and@available@for@application@to@the@reasonin
g@process,@is@the@estimation@based@on@a@provider‘s@experience,@although@these@are@rarely@accurate.@Over@the@past@decade,@th
e@availability@of@evidence@on@which@to@base@clinical@reasoning@is@improving,@ and@there@is@an@increasing@expectation@that@cli
nical@reasoning@be@based@on@scientific@evidence.
Evidence-based@statistics@are@ also@increasingly@being@used@to@develop@ resources@to@facilitate@ clinical@ decision-making.
PTS: 1
6. ANS: D
To@assist@in@clinical@decision-making,@a@number@of@evidence-
based@resources@have@been@developed@to@assist@the@clinician.@Resources,@such@as@algorithms@and@clinical@practice@guidelines
,@assist@in@clinical@reasoning@when@properly@applied.
PTS: 1
7. ANS: A
The@sensitivity@of@a@diagnostic@study@is@the@percentage@of@individuals@with@the@target@condition@who@show@an@abnormal,@or@ p
ositive,@result.@A@high@sensitivity@indicates@that@a@greater@percentage@of@persons@with@the@given@condition@will@have@an@abnor
mal@result.
PTS: 1
8. ANS: B
The@specificity@of@a@diagnostic@study@is@the@percentage@of@normal,@healthy@individuals@who@have@a@normal@result.@The@great
er@the@specificity,@the@greater@the@percentage@of@individuals@who@will@have@negative,@or@normal,@results@if@they@do@not@have
@the@target@condition.
PTS: 1
9. ANS: A
The@likelihood@ratio@is@the@probability@that@a@positive@test@result@will@be@associated@with@a@person@who@has@the@target@conditi
on@and@a@negative@result@will@be@associated@with@a@healthy@person.@A@likelihood@ratio@above@1@indicates@that@a@positive@resul
t@is@associated@with@the@disease;@a@likelihood@ratio@less@than@1@indicates@that@a@negative@result@is@associated@with@an@absence@
of@the@disease.
