ADVANCED HEALTH ASSESSMENT & CLINICAL DIAGNOSIS INPRI
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MARY 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 Care6th
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Edition Dains u
Chapteru1:uClinicaluReasoning,uDifferentialuDiagnosis,uEvidence-
BaseduPractice,uanduSymptomuAnalysisuMultipleuChoice
Identifyutheuchoiceuthatubestucompletesutheustatementuoruanswersutheuquestion.
u 1. Whichutypeuofuclinicaludecision-makinguisumostureliable?
A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
u 2. Whichuofutheufollowinguisufalse?uTouobtainuadequateuhistory,uhealth-careuprovidersumustube:
A. Methodicaluandusystematic
B. Attentiveutoutheupatient’suverbaluandunonverbalulanguage
C. Ableutouaccuratelyuinterpretutheupatient’suresponses
D. Adeptuatureadinguintoutheupatient’sustatements
u 3. Essentialupartsuofuauhealthuhistoryuincludeualluofutheufollowinguexcept:
A. Chiefucomplaint
B. Historyuofutheupresentuillness
C. Currentuvitalusigns
D. Alluofutheuaboveuareuessentialuhistoryucomponents
u 4. Whichuofutheufollowinguisufalse?uWhileuperformingutheuphysicalu examination,utheuexamineru mustubeuableuto:
A. Differentiateubetweenunormaluanduabnormalufindings
B. Recalluknowledgeuofuaurangeuofuconditionsuandutheiruassociatedusignsuandusymptoms
C. Recognizeuhowucertainuconditionsuaffectutheuresponseutouotheruconditions
D. Foreseeuunpredictableu findings
u 5. Theufollowinguisutheuleastureliableusourceuofuinformationuforudiagnosticustatistics:
A. Evidence-baseduinvestigations
B. Primaryureportsuofuresearch
C. Estimationubaseduonuauprovider’suexperience
D. Publishedumeta-analyses
u 6. Theufollowingucanubeuusedutouassistuinusounduclinicaludecision-making:
A. Algorithmupublisheduinuaupeer-reviewedujournaluarticle
B. Clinicalupracticeuguidelines
C. Evidence-baseduresearch
D. Alluofutheuabove
u 7. Ifuaudiagnosticustudyuhasuhighusensitivity,u thisuindicatesua:
A. Highupercentageuofupersonsuwithutheugivenuconditionuwilluhaveuanuabnormaluresult
B. Lowupercentageuofupersonsuwithutheugivenuconditionuwilluhaveuanuabnormaluresult
C. Lowulikelihooduofunormaluresultuinupersonsuwithoutuaugivenucondition
D. Noneuofutheuabove
u 8. Ifuaudiagnosticustudyuhasuhighuspecificity,u thisuindicatesua:
A. Lowupercentageuofuhealthyuindividualsuwillushowuaunormaluresult
B. Highupercentageuofuhealthyuindividualsuwillushowuaunormaluresult
C. Highupercentageuofuindividualsuwithuaudisorderuwillushowuaunormaluresult
D. Lowupercentageuofuindividualsuwithuaudisorderuwillushowuanuabnormaluresult
u 9. Aulikelihooduratiouaboveu1uindicatesuthatuaudiagnosticutestushowingua:
A. Positiveuresultuisustronglyuassociateduwithutheudisease
B. Negativeuresultuisustronglyuassociateduwithuabsenceuofutheudisease
C. Positiveuresultuisuweaklyuassociateduwithutheudisease
D. Negativeuresultuisuweaklyuassociateduwithuabsenceuofutheudisease
u 10. Whichuofutheufollowinguclinicalureasoningutoolsuisudefineduasuevidence-baseduresourceubaseduonumathematicalu modeling
touexpressutheulikelihooduofuauconditionuinuselectusituations,usettings,uand/orupatients?
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A. Clinicalupracticeuguideline
B. Clinicaludecisionurule
C. Clinicalualgorithm
Chapteru1:uClinicalureasoning,udifferentialudiagnosis,uevidence-basedupractice,uandusymptomuana
Answeru Section
MULTIPLEuCHOICE
1. ANS: B
Croskerryu(2009)udescribesutwoumajorutypesuofuclinicaludiagnosticudecision-making:uintuitiveuanduanalytical.uIntuitiveudecision-
umakingu(similarutouAugenblinkudecision-
making)uisubaseduonutheuexperienceuanduintuitionuofutheuclinicianuanduisulessureliableuandupaireduwithufairlyucommonuerrors.uInuc
ontrast,uanalyticaludecision-makinguisubaseduonucarefuluconsiderationuanduhasugreaterureliabilityuwithurareuerrors.
PTS: 1
2. ANS: D
Touobtainuadequateuhistory,uprovidersumustubeuwelluorganized,uattentiveutoutheupatient’suverbaluandunonverbalulanguage,uanduable
utouaccuratelyuinterpretutheupatient’suresponsesutouquestions.uRatheruthanureadinguintoutheupatient’sustatements,utheyuclarifyuanyu
areasuofuuncertainty.
PTS: 1
3. ANS: C
Vitalusignsuareupartuofutheuphysicaluexaminationuportionuofupatientuassessment,unotupartuofutheuhealthuhistory.
PTS: 1
4. ANS: D
Whileuperformingutheuphysicaluexamination,utheuexaminerumustubeuableutoudifferentiateubetweenunormaluanduabnormalufindings,ur
ecalluknowledgeuofuaurangeuofuconditions,uincludingutheiruassociatedusignsuandusymptoms,urecognizeuhowucertainuconditionsuaffectu
theuresponseutouotheruconditions,uandudistinguishutheurelevanceuofuvarieduabnormalufindings.
PTS: 1
5. ANS: C
Sourcesuforudiagnosticustatisticsuincludeutextbooks,uprimaryureportsuofuresearch,uandupublishedumeta-
analyses.uAnotherusourceuofustatistics,utheuoneuthatuhasubeenumostuwidelyuuseduanduavailableuforuapplicationutoutheureasoninguproce
ss,uisutheuestimationubaseduonuauprovider’suexperience,ualthoughutheseuareurarelyuaccurate.uOverutheupastudecade,utheuavailabilityu
ofuevidenceuonuwhichutoubaseuclinicalureasoninguisuimproving,u anduthereuisuanuincreasinguexpectationuthatuclinicalureasoningubeub
aseduonuscientificuevidence.
Evidence-basedustatisticsuareualsouincreasinglyubeinguusedutoudevelopu resourcesutoufacilitateu clinicalu decision-making.
PTS: 1
6. ANS: D
Touassistuinuclinicaludecision-making,uaunumberuofuevidence-
baseduresourcesuhaveubeenudevelopedutouassistutheuclinician.uResources,usuchuasualgorithmsuanduclinicalupracticeuguidelines,uassis
tuinuclinicalureasoninguwhenuproperlyuapplied.
PTS: 1
7. ANS: A
Theusensitivityuofuaudiagnosticustudyuisutheupercentageuofuindividualsuwithutheutargetuconditionuwhoushowuanuabnormal,uorupositive
,uresult.uAuhighusensitivityuindicatesuthatuaugreaterupercentageuofupersonsuwithutheugivenuconditionuwilluhaveuanuabnormaluresult.
PTS: 1
8. ANS: B
Theuspecificityuofuaudiagnosticustudyuisutheupercentageuofunormal,uhealthyuindividualsuwhouhaveuaunormaluresult.uTheugreaterutheu
specificity,utheugreaterutheupercentageuofuindividualsuwhouwilluhaveunegative,uorunormal,uresultsuifutheyudounotuhaveutheutargetuc
ondition.
PTS: 1
9. ANS: A
Theulikelihooduratiouisutheuprobabilityuthatuaupositiveutesturesultuwillubeuassociateduwithuaupersonuwhouhasutheutargetuconditionuandu
aunegativeuresultuwillubeuassociateduwithuauhealthyuperson.uAulikelihooduratiouaboveu1uindicatesuthatuaupositiveuresultuisuassociatedu
withutheudisease;uaulikelihooduratioulessuthanu1uindicatesuthatuaunegativeuresultuisuassociateduwithuanuabsenceuofutheudisease.
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PTS: 1
10. ANS: B
Clinicaludecisionu(oruprediction)urulesuprovideuanotherusupportuforuclinicalureasoning.uClinicaludecisionurulesuareuevidence-
baseduresourcesuthatuprovideuprobabilisticustatementsuregardingutheulikelihooduthatuauconditionuexistsuifucertainuvariablesuareumet
uwithuregardutoutheuprognosisuofupatientsuwithuspecificufindings.uDecisionurulesuuseumathematicalumodelsuanduareuspecificutoucer
tainusituations,usettings,uand/orupatientucharacteristics.
PTS: 1