TEST BANK
Advanced Assessment: Interpreting Findings and Formulating Differential Diagnoses
MARY JO GOOLSBY
Fourth Edition
, TABLEOFCONTENTS
ChapterJ1. Assessment and Clinical Decision Making: An Overview
ChapterJ2. Genomic Assessment: InterpretingJFindings and Formulating Differential Diagnoses
ChapterJ3. Skin
ChapterJ4. Head, Face, and Neck
ChapterJ5. The Eye
ChapterJ6. Ear, Nose, Mouth, and Throat
ChapterJ7. Cardiac and Peripheral VascularJSystems
ChapterJ8. Respiratory System
ChapterJ9. Breasts
Chapter 10. Abdomen
ChapterJ11. Genitourinary System
ChapterJ12. Male Reproductive System
ChapterJ13. Female Reproductive System
Chapter 14. Musculoskeletal System
ChapterJ15. Neurological System
ChapterJ16. Nonspecific Complaints
ChapterJ17. Psychiatric Mental Health
Chapter 18. Pediatric Patients
ChapterJ19. Pregnant Patients
ChapterJ20. Assessment of the Transgender or Gender Diverse Adult
ChapterJ21. Older Patients
ChapterJ22. Persons With Disabilities
, Chapter 1. Assessment and Clinical Decision Making: An Overview
Multiple Choice
Identify the choice thatJbest completes the statementJor answers the question.
1. Which type of clinical decision-makingJis 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 andJnonverbal
language
C. Able to accuratelyJinterpret the patient‘s responses
D. Adept at reading intoJthe patient‘s statements
3. Essential parts of a health historyJincludeJall ofJthe followingJexcept:
A. ChiefJcomplaint
B. History of the present illness
C. Current vital signs
D. All of the aboveJare essential history
components
4. Which of the following is false? While performing theJphysical examination, theJexaminer must be able to:
A. Differentiate between normal and abnormal findings
B. Recall knowledge of aJrangeJof conditions andJtheirJassociatedJsigns and
symptoms
C. Recognize how certain conditions affect the response to otherJconditions
D. Foresee unpredictable findings
5. The followingJis the least reliable source of information for diagnostic statistics:
A. Evidence-based investigations
B. Primary reportsJof research
C. Estimation based on a provider‘s
experience
D. PublishedJmeta-analyses
6. The followingJcan 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 ofJthe above
7. If aJdiagnostic studyJhas high sensitivity, this indicates a:
A. High percentage of persons with the givenJcondition will have an abnormal
result
B. Low percentage ofJpersons with the given condition will have an abnormal
result
C. Low likelihood of normal result in persons without a given condition
D. None ofJthe above
8. If a diagnostic study has highJspecificity, this indicates a:
A. Low percentage of healthy individuals will show a normal result
B. High percentage ofJhealthyJindividuals will show a normal result
C. HighJpercentage of individuals with a disorder will show aJnormal result
D. Low percentageJof individuals with a disorderJwill show an abnormal
, result
9. A likelihood ratio above 1 indicates that aJdiagnostic test showing a:
A. Positive result is stronglyJassociated withJthe disease
B. NegativeJresult is stronglyJassociated with absence ofJthe
disease
C. Positive result is weakly associated with the disease
D. NegativeJresult is weakly associatedJwith absence of the
disease
Chapter 1: Clinical reasoning, differential diagnosis, evidence-based practice, and symptom ana
Answer Section
MULTIPLE CHOICE
1. ANS: B
Croskerry (2009) describes two majorJtypes ofJclinical diagnostic decision-making: intuitive and analytical.
IntuitiveJdecision- making (similar to Augenblink decision-
making) is based onJthe experience andJintuitionJof the clinician and is less reliable andpaired with fairly common
errors. In co ntrast, analytical decision-making is based onJcareful considerationJand has greaterJreliability 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, and abl eto accuratelyJinterpret the patient‘s responses to questions. Rather thanJreading into the patient‘s
statements, theyJclarify anyJa reas of uncertainty.
PTS: 1
3. ANS: C
Vital signs are part of the physical examinationJportion of patientJassessment, not part of theJhealth history.
PTS: 1
4. ANS: D
While performing the physical examination, the examiner mustJbe able to differentiate betweenJnormal and abnormal
findings, re call knowledge ofJa range of conditions, including theirJassociated signs and symptoms, recognize
howJcertainJconditions affectt he response to otherJconditions, 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. AnotherJsource ofstatistics, the one that has been most widelyJusedJandJavailable forJapplication to the
reasoning proce ss, is the estimation based ona provider‘s experience, although these are rarely accurate. Over the
past decade, the availability o f evidence onJwhich to base clinical reasoning is improving, and there is an increasing
expectation thatJclinical reasoning be base dJon scientific evidence.
Evidence-based statistics areJalso increasingly beingJused to develop resources to facilitate clinical decision-making.
PTS: 1
6. ANS: D
To assist in clinical decision-making, a number ofJevidence-
basedJresources have been developed to assist the clinician.Resources, such as algorithms and clinical practice
guideline s, assist inJclinical reasoningJwhen properlyJapplied.
PTS: 1
7. ANS: A
The sensitivity ofJa diagnostic studyJisJthe percentage of individuals with the target condition who showJan abnormal, or
positive,r esult. AJhigh sensitivityJindicates that aJgreater percentage of persons with the given condition will have
anJabnormalJresult.
Advanced Assessment: Interpreting Findings and Formulating Differential Diagnoses
MARY JO GOOLSBY
Fourth Edition
, TABLEOFCONTENTS
ChapterJ1. Assessment and Clinical Decision Making: An Overview
ChapterJ2. Genomic Assessment: InterpretingJFindings and Formulating Differential Diagnoses
ChapterJ3. Skin
ChapterJ4. Head, Face, and Neck
ChapterJ5. The Eye
ChapterJ6. Ear, Nose, Mouth, and Throat
ChapterJ7. Cardiac and Peripheral VascularJSystems
ChapterJ8. Respiratory System
ChapterJ9. Breasts
Chapter 10. Abdomen
ChapterJ11. Genitourinary System
ChapterJ12. Male Reproductive System
ChapterJ13. Female Reproductive System
Chapter 14. Musculoskeletal System
ChapterJ15. Neurological System
ChapterJ16. Nonspecific Complaints
ChapterJ17. Psychiatric Mental Health
Chapter 18. Pediatric Patients
ChapterJ19. Pregnant Patients
ChapterJ20. Assessment of the Transgender or Gender Diverse Adult
ChapterJ21. Older Patients
ChapterJ22. Persons With Disabilities
, Chapter 1. Assessment and Clinical Decision Making: An Overview
Multiple Choice
Identify the choice thatJbest completes the statementJor answers the question.
1. Which type of clinical decision-makingJis 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 andJnonverbal
language
C. Able to accuratelyJinterpret the patient‘s responses
D. Adept at reading intoJthe patient‘s statements
3. Essential parts of a health historyJincludeJall ofJthe followingJexcept:
A. ChiefJcomplaint
B. History of the present illness
C. Current vital signs
D. All of the aboveJare essential history
components
4. Which of the following is false? While performing theJphysical examination, theJexaminer must be able to:
A. Differentiate between normal and abnormal findings
B. Recall knowledge of aJrangeJof conditions andJtheirJassociatedJsigns and
symptoms
C. Recognize how certain conditions affect the response to otherJconditions
D. Foresee unpredictable findings
5. The followingJis the least reliable source of information for diagnostic statistics:
A. Evidence-based investigations
B. Primary reportsJof research
C. Estimation based on a provider‘s
experience
D. PublishedJmeta-analyses
6. The followingJcan 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 ofJthe above
7. If aJdiagnostic studyJhas high sensitivity, this indicates a:
A. High percentage of persons with the givenJcondition will have an abnormal
result
B. Low percentage ofJpersons with the given condition will have an abnormal
result
C. Low likelihood of normal result in persons without a given condition
D. None ofJthe above
8. If a diagnostic study has highJspecificity, this indicates a:
A. Low percentage of healthy individuals will show a normal result
B. High percentage ofJhealthyJindividuals will show a normal result
C. HighJpercentage of individuals with a disorder will show aJnormal result
D. Low percentageJof individuals with a disorderJwill show an abnormal
, result
9. A likelihood ratio above 1 indicates that aJdiagnostic test showing a:
A. Positive result is stronglyJassociated withJthe disease
B. NegativeJresult is stronglyJassociated with absence ofJthe
disease
C. Positive result is weakly associated with the disease
D. NegativeJresult is weakly associatedJwith absence of the
disease
Chapter 1: Clinical reasoning, differential diagnosis, evidence-based practice, and symptom ana
Answer Section
MULTIPLE CHOICE
1. ANS: B
Croskerry (2009) describes two majorJtypes ofJclinical diagnostic decision-making: intuitive and analytical.
IntuitiveJdecision- making (similar to Augenblink decision-
making) is based onJthe experience andJintuitionJof the clinician and is less reliable andpaired with fairly common
errors. In co ntrast, analytical decision-making is based onJcareful considerationJand has greaterJreliability 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, and abl eto accuratelyJinterpret the patient‘s responses to questions. Rather thanJreading into the patient‘s
statements, theyJclarify anyJa reas of uncertainty.
PTS: 1
3. ANS: C
Vital signs are part of the physical examinationJportion of patientJassessment, not part of theJhealth history.
PTS: 1
4. ANS: D
While performing the physical examination, the examiner mustJbe able to differentiate betweenJnormal and abnormal
findings, re call knowledge ofJa range of conditions, including theirJassociated signs and symptoms, recognize
howJcertainJconditions affectt he response to otherJconditions, 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. AnotherJsource ofstatistics, the one that has been most widelyJusedJandJavailable forJapplication to the
reasoning proce ss, is the estimation based ona provider‘s experience, although these are rarely accurate. Over the
past decade, the availability o f evidence onJwhich to base clinical reasoning is improving, and there is an increasing
expectation thatJclinical reasoning be base dJon scientific evidence.
Evidence-based statistics areJalso increasingly beingJused to develop resources to facilitate clinical decision-making.
PTS: 1
6. ANS: D
To assist in clinical decision-making, a number ofJevidence-
basedJresources have been developed to assist the clinician.Resources, such as algorithms and clinical practice
guideline s, assist inJclinical reasoningJwhen properlyJapplied.
PTS: 1
7. ANS: A
The sensitivity ofJa diagnostic studyJisJthe percentage of individuals with the target condition who showJan abnormal, or
positive,r esult. AJhigh sensitivityJindicates that aJgreater percentage of persons with the given condition will have
anJabnormalJresult.
