TESTBANK i
ADVANCED HEALTH ASSESSMENT & CLINICAL DIAGNOSIS
i i i i i
INPRIMARY CARE, 6TH EDITION
i i i i i
Joyce E. Dains, Linda Ciofu Baumann & Pamela Scheibel
i i i i i i i i
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i i i
5 67 13
Test Bank for Advanced Health Assessment & Clinical Diagnosis in Primary Care
i i i i i i i i i i i
6th Edition Dains i i i
Chapter i1: iClinical iReasoning, iDifferential iDiagnosis, iEvidence-Based iPractice, iand iSymptom iAnalysis
Multiple iChoice
i
Identify ithe ichoice ithat ibest icompletes ithe istatement ior ianswers ithe iquestion.
i 1. Which itype iof iclinical idecision-making iis imost ireliable?
A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
i 2. Which iof ithe ifollowing iis ifalse? iTo iobtain iadequate ihistory, i health-care iproviders imust ibe:
A. Methodical iand isystematic
B. Attentive ito ithe ipatient’s iverbal iand inonverbal
ilanguage
C. Able ito iaccurately iinterpret ithe ipatient’s iresponses
D. Adept iat ireading iinto ithe ipatient’s istatements
i 3. Essential iparts iof ia ihealth ihistory iinclude iall i of ithe ifollowing iexcept:
A. Chief icomplaint
B. History iof ithe ipresent iillness
C. Current ivital isigns
D. All i of ithe iabove iare iessential ihistory
icomponents
i 4. Which iof ithe ifollowing iis ifalse? iWhile iperforming ithe iphysical i examination, ithe iexaminer i must ibe iable ito:
A. Differentiate ibetween inormal iand iabnormal ifindings
B. Recall iknowledge iof ia irange iof iconditions iand itheir iassociated isigns iand
isymptoms
C. Recognize ihow icertain iconditions iaffect ithe iresponse ito iother iconditions
D. Foresee iunpredictable ifindings
i 5. The ifollowing iis ithe ileast ireliable isource iof iinformation ifor idiagnostic istatistics:
A. Evidence-based iinvestigations
B. Primary ireports iof iresearch
C. Estimation ibased ion ia iprovider’s
iexperience
D. Published imeta-analyses
i 6. The ifollowing ican ibe iused ito iassist iin isound iclinical idecision-making:
A. Algorithm ipublished iin i a ipeer-reviewed ijournal
iarticle
B. Clinical ipractice iguidelines
C. Evidence-based iresearch
D. All iof ithe iabove
i 7. If ia idiagnostic istudy ihas ihigh isensitivity, i this iindicates ia:
A. High ipercentage iof ipersons iwith ithe igiven icondition iwill ihave ian iabnormal
iresult
B. Low ipercentage iof ipersons iwith ithe igiven icondition iwill ihave ian iabnormal
iresult
C. Low ilikelihood iof inormal iresult iin ipersons iwithout ia igiven icondition
D. None iof ithe iabove
i 8. If ia idiagnostic istudy ihas ihigh ispecificity, i this iindicates ia:
A. Low ipercentage iof ihealthy iindividuals i will ishow ia inormal iresult
B. High ipercentage i of ihealthy iindividuals iwill ishow ia inormal iresult
C. High ipercentage iof iindividuals iwith ia idisorder iwill ishow ia inormal iresult
D. Low ipercentage iof iindividuals iwith ia idisorder iwill ishow ian iabnormal
iresult
i 9. A ilikelihood i ratio iabove i1 iindicates ithat ia idiagnostic itest ishowing ia:
A. Positive iresult iis istrongly iassociated iwith ithe idisease
B. Negative iresult iis istrongly iassociated iwith iabsence iof ithe
idisease
C. Positive iresult iis iweakly iassociated iwith ithe idisease
D. Negative iresult iis i weakly iassociated i with iabsence iof ithe
idisease
i 10. Which iof ithe ifollowing iclinical ireasoning itools iis idefined ias ievidence-based iresource ibased ion imathematical i modeling
to iexpress ithe ilikelihood i of ia icondition iin iselect isituations, isettings, iand/or ipatients?
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A. Clinical ipractice iguideline
B. Clinical idecision irule
C. Clinical ialgorithm
Chapter i1: iClinical ireasoning, idifferential idiagnosis, ievidence-based ipractice, iand isymptom iana
Answer iSection
MULTIPLE iCHOICE
1. ANS: B
Croskerry i(2009) idescribes itwo imajor itypes iof iclinical idiagnostic idecision-making: iintuitive iand ianalytical. iIntuitive
idecision- imaking i(similar ito iAugenblink idecision-making) iis ibased ion ithe iexperience iand iintuition iof ithe iclinician iand
iis iless ireliable iandipaired iwith ifairly icommon ierrors. iIn icontrast, ianalytical idecision-making iis ibased ion icareful
iconsideration iand ihas igreater ireliability iwith irare ierrors.
PTS: 1
2. ANS: D
To iobtain iadequate ihistory, iproviders imust ibe iwell iorganized, iattentive ito ithe ipatient’s iverbal iand inonverbal ilanguage, iand
iableito iaccurately iinterpret ithe ipatient’s iresponses ito iquestions. iRather ithan ireading iinto ithe ipatient’s istatements, ithey
iclarify iany iareas iof iuncertainty.
PTS: 1
3. ANS: C
Vital isigns iare ipart iof ithe iphysical iexamination iportion iof ipatient iassessment, inot ipart iof ithe ihealth ihistory.
PTS: 1
4. ANS: D
While iperforming ithe iphysical iexamination, ithe iexaminer imust ibe iable ito idifferentiate ibetween inormal iand iabnormal
ifindings, irecall iknowledge iof ia irange iof iconditions, iincluding itheir iassociated isigns iand isymptoms, irecognize ihow icertain
iconditions iaffectithe iresponse ito iother i conditions, iand idistinguish ithe irelevance i of ivaried iabnormal ifindings.
PTS: 1
5. ANS: C
Sources ifor idiagnostic istatistics iinclude itextbooks, iprimary ireports iof iresearch, iand ipublished imeta-analyses. iAnother
isource iofistatistics, ithe ione ithat ihas ibeen imost iwidely iused iand iavailable i for iapplication i to ithe ireasoning iprocess, iis ithe
iestimation ibased ion ia iprovider’s iexperience, ialthough ithese iare irarely iaccurate. iOver ithe ipast idecade, ithe iavailability iof
ievidence ion iwhich ito ibase iclinical ireasoning iis iimproving, i and ithere iis ian iincreasing iexpectation i that iclinical ireasoning ibe
ibased ion iscientific ievidence.
Evidence-based istatistics iare ialso iincreasingly ibeing iused ito idevelop iresources ito ifacilitate iclinical i decision-making.
PTS: 1
6. ANS: D
To iassist iin iclinical idecision-making, ia inumber iof ievidence-based iresources ihave ibeen ideveloped ito iassist ithe iclinician.
iResources, isuch ias ialgorithms iand iclinical ipractice iguidelines, iassist iin iclinical ireasoning iwhen iproperly iapplied.
PTS: 1
7. ANS: A
The isensitivity iof ia idiagnostic istudy iis ithe ipercentage iof iindividuals iwith ithe itarget icondition iwho ishow ian iabnormal, ior
ipositive,iresult. iA ihigh isensitivity iindicates ithat ia igreater ipercentage iof ipersons i with ithe igiven i condition i will ihave ian
iabnormal iresult.
PTS: 1
8. ANS: B
The ispecificity iof ia idiagnostic istudy iis ithe ipercentage iof inormal, ihealthy iindividuals iwho ihave ia inormal iresult. iThe
igreater itheispecificity, ithe igreater ithe ipercentage iof iindividuals iwho iwill ihave inegative, ior inormal, iresults iif ithey ido
inot ihave ithe itarget icondition.
PTS: 1
9. ANS: A
The ilikelihood iratio iis ithe iprobability ithat ia ipositive itest iresult iwill ibe iassociated iwith ia iperson iwho ihas ithe itarget
icondition iand iainegative iresult iwill ibe iassociated iwith ia ihealthy iperson. iA ilikelihood iratio iabove i1 iindicates ithat ia
ipositive iresult iis iassociated iwith ithe idisease; ia ilikelihood i ratio iless ithan i1 iindicates ithat ia inegative i result iis iassociated iwith
ian iabsence iof ithe idisease.
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PTS: 1
10. ANS: B
Clinical idecision i(or iprediction) irules iprovide ianother isupport ifor iclinical ireasoning. iClinical idecision irules iare
ievidence-basediresources ithat iprovide iprobabilistic istatements iregarding ithe ilikelihood ithat ia icondition iexists iif icertain
ivariables iare imet iwith iregard ito ithe iprognosis iof ipatients iwith ispecific ifindings. iDecision irules iuse imathematical
imodels iand iare ispecific ito icertain isituations, isettings, iand/or i patient icharacteristics.
PTS: 1
ADVANCED HEALTH ASSESSMENT & CLINICAL DIAGNOSIS
i i i i i
INPRIMARY CARE, 6TH EDITION
i i i i i
Joyce E. Dains, Linda Ciofu Baumann & Pamela Scheibel
i i i i i i i i
, l O M oA R cP S D | 1 2 6
i i i
5 67 13
Test Bank for Advanced Health Assessment & Clinical Diagnosis in Primary Care
i i i i i i i i i i i
6th Edition Dains i i i
Chapter i1: iClinical iReasoning, iDifferential iDiagnosis, iEvidence-Based iPractice, iand iSymptom iAnalysis
Multiple iChoice
i
Identify ithe ichoice ithat ibest icompletes ithe istatement ior ianswers ithe iquestion.
i 1. Which itype iof iclinical idecision-making iis imost ireliable?
A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
i 2. Which iof ithe ifollowing iis ifalse? iTo iobtain iadequate ihistory, i health-care iproviders imust ibe:
A. Methodical iand isystematic
B. Attentive ito ithe ipatient’s iverbal iand inonverbal
ilanguage
C. Able ito iaccurately iinterpret ithe ipatient’s iresponses
D. Adept iat ireading iinto ithe ipatient’s istatements
i 3. Essential iparts iof ia ihealth ihistory iinclude iall i of ithe ifollowing iexcept:
A. Chief icomplaint
B. History iof ithe ipresent iillness
C. Current ivital isigns
D. All i of ithe iabove iare iessential ihistory
icomponents
i 4. Which iof ithe ifollowing iis ifalse? iWhile iperforming ithe iphysical i examination, ithe iexaminer i must ibe iable ito:
A. Differentiate ibetween inormal iand iabnormal ifindings
B. Recall iknowledge iof ia irange iof iconditions iand itheir iassociated isigns iand
isymptoms
C. Recognize ihow icertain iconditions iaffect ithe iresponse ito iother iconditions
D. Foresee iunpredictable ifindings
i 5. The ifollowing iis ithe ileast ireliable isource iof iinformation ifor idiagnostic istatistics:
A. Evidence-based iinvestigations
B. Primary ireports iof iresearch
C. Estimation ibased ion ia iprovider’s
iexperience
D. Published imeta-analyses
i 6. The ifollowing ican ibe iused ito iassist iin isound iclinical idecision-making:
A. Algorithm ipublished iin i a ipeer-reviewed ijournal
iarticle
B. Clinical ipractice iguidelines
C. Evidence-based iresearch
D. All iof ithe iabove
i 7. If ia idiagnostic istudy ihas ihigh isensitivity, i this iindicates ia:
A. High ipercentage iof ipersons iwith ithe igiven icondition iwill ihave ian iabnormal
iresult
B. Low ipercentage iof ipersons iwith ithe igiven icondition iwill ihave ian iabnormal
iresult
C. Low ilikelihood iof inormal iresult iin ipersons iwithout ia igiven icondition
D. None iof ithe iabove
i 8. If ia idiagnostic istudy ihas ihigh ispecificity, i this iindicates ia:
A. Low ipercentage iof ihealthy iindividuals i will ishow ia inormal iresult
B. High ipercentage i of ihealthy iindividuals iwill ishow ia inormal iresult
C. High ipercentage iof iindividuals iwith ia idisorder iwill ishow ia inormal iresult
D. Low ipercentage iof iindividuals iwith ia idisorder iwill ishow ian iabnormal
iresult
i 9. A ilikelihood i ratio iabove i1 iindicates ithat ia idiagnostic itest ishowing ia:
A. Positive iresult iis istrongly iassociated iwith ithe idisease
B. Negative iresult iis istrongly iassociated iwith iabsence iof ithe
idisease
C. Positive iresult iis iweakly iassociated iwith ithe idisease
D. Negative iresult iis i weakly iassociated i with iabsence iof ithe
idisease
i 10. Which iof ithe ifollowing iclinical ireasoning itools iis idefined ias ievidence-based iresource ibased ion imathematical i modeling
to iexpress ithe ilikelihood i of ia icondition iin iselect isituations, isettings, iand/or ipatients?
, l O M oA R cP S D | 1 2 6
i i i
5 67 13
A. Clinical ipractice iguideline
B. Clinical idecision irule
C. Clinical ialgorithm
Chapter i1: iClinical ireasoning, idifferential idiagnosis, ievidence-based ipractice, iand isymptom iana
Answer iSection
MULTIPLE iCHOICE
1. ANS: B
Croskerry i(2009) idescribes itwo imajor itypes iof iclinical idiagnostic idecision-making: iintuitive iand ianalytical. iIntuitive
idecision- imaking i(similar ito iAugenblink idecision-making) iis ibased ion ithe iexperience iand iintuition iof ithe iclinician iand
iis iless ireliable iandipaired iwith ifairly icommon ierrors. iIn icontrast, ianalytical idecision-making iis ibased ion icareful
iconsideration iand ihas igreater ireliability iwith irare ierrors.
PTS: 1
2. ANS: D
To iobtain iadequate ihistory, iproviders imust ibe iwell iorganized, iattentive ito ithe ipatient’s iverbal iand inonverbal ilanguage, iand
iableito iaccurately iinterpret ithe ipatient’s iresponses ito iquestions. iRather ithan ireading iinto ithe ipatient’s istatements, ithey
iclarify iany iareas iof iuncertainty.
PTS: 1
3. ANS: C
Vital isigns iare ipart iof ithe iphysical iexamination iportion iof ipatient iassessment, inot ipart iof ithe ihealth ihistory.
PTS: 1
4. ANS: D
While iperforming ithe iphysical iexamination, ithe iexaminer imust ibe iable ito idifferentiate ibetween inormal iand iabnormal
ifindings, irecall iknowledge iof ia irange iof iconditions, iincluding itheir iassociated isigns iand isymptoms, irecognize ihow icertain
iconditions iaffectithe iresponse ito iother i conditions, iand idistinguish ithe irelevance i of ivaried iabnormal ifindings.
PTS: 1
5. ANS: C
Sources ifor idiagnostic istatistics iinclude itextbooks, iprimary ireports iof iresearch, iand ipublished imeta-analyses. iAnother
isource iofistatistics, ithe ione ithat ihas ibeen imost iwidely iused iand iavailable i for iapplication i to ithe ireasoning iprocess, iis ithe
iestimation ibased ion ia iprovider’s iexperience, ialthough ithese iare irarely iaccurate. iOver ithe ipast idecade, ithe iavailability iof
ievidence ion iwhich ito ibase iclinical ireasoning iis iimproving, i and ithere iis ian iincreasing iexpectation i that iclinical ireasoning ibe
ibased ion iscientific ievidence.
Evidence-based istatistics iare ialso iincreasingly ibeing iused ito idevelop iresources ito ifacilitate iclinical i decision-making.
PTS: 1
6. ANS: D
To iassist iin iclinical idecision-making, ia inumber iof ievidence-based iresources ihave ibeen ideveloped ito iassist ithe iclinician.
iResources, isuch ias ialgorithms iand iclinical ipractice iguidelines, iassist iin iclinical ireasoning iwhen iproperly iapplied.
PTS: 1
7. ANS: A
The isensitivity iof ia idiagnostic istudy iis ithe ipercentage iof iindividuals iwith ithe itarget icondition iwho ishow ian iabnormal, ior
ipositive,iresult. iA ihigh isensitivity iindicates ithat ia igreater ipercentage iof ipersons i with ithe igiven i condition i will ihave ian
iabnormal iresult.
PTS: 1
8. ANS: B
The ispecificity iof ia idiagnostic istudy iis ithe ipercentage iof inormal, ihealthy iindividuals iwho ihave ia inormal iresult. iThe
igreater itheispecificity, ithe igreater ithe ipercentage iof iindividuals iwho iwill ihave inegative, ior inormal, iresults iif ithey ido
inot ihave ithe itarget icondition.
PTS: 1
9. ANS: A
The ilikelihood iratio iis ithe iprobability ithat ia ipositive itest iresult iwill ibe iassociated iwith ia iperson iwho ihas ithe itarget
icondition iand iainegative iresult iwill ibe iassociated iwith ia ihealthy iperson. iA ilikelihood iratio iabove i1 iindicates ithat ia
ipositive iresult iis iassociated iwith ithe idisease; ia ilikelihood i ratio iless ithan i1 iindicates ithat ia inegative i result iis iassociated iwith
ian iabsence iof ithe idisease.
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PTS: 1
10. ANS: B
Clinical idecision i(or iprediction) irules iprovide ianother isupport ifor iclinical ireasoning. iClinical idecision irules iare
ievidence-basediresources ithat iprovide iprobabilistic istatements iregarding ithe ilikelihood ithat ia icondition iexists iif icertain
ivariables iare imet iwith iregard ito ithe iprognosis iof ipatients iwith ispecific ifindings. iDecision irules iuse imathematical
imodels iand iare ispecific ito icertain isituations, isettings, iand/or i patient icharacteristics.
PTS: 1
