PHYSICAL EXAMINATION AND HEALTH
ASSESSMENT
9TH EDITION
• AUTHOR(S)CAROLYN JARVIS; ANN L.
ECKHARDT
TEST BANK
1
Reference
Ch. 1 — Evidence-Based Assessment
Stem
A 52-year-old patient comes for a routine visit and asks whether
a newly published study showing benefit from a screening test
applies to them. The nurse notes the study was a small, single-
center cohort with no control group and the patient has
multiple chronic conditions. Which approach best follows
evidence-based assessment principles?
Page 1 of 982
,A. Recommend the test because any positive study supports
wider use.
B. Explain the study’s limitations and integrate patient values
and clinical context before deciding. (Correct)
C. Refuse to discuss the test because single studies are always
unreliable.
D. Order the test immediately to avoid missing potential
benefit.
Correct Answer
B
Rationale — Correct
Jarvis emphasizes integrating the best available evidence with
clinical expertise and patient values. Explaining study
limitations, assessing applicability to this patient’s
comorbidities, and engaging in shared decision-making aligns
with EBP. This prevents overgeneralization from low-quality
evidence and supports safe, individualized care.
Rationale — Incorrect
A: Overgeneralizes from low-quality evidence; Jarvis warns
against assuming applicability without critical appraisal.
C: Dismisses patient concerns and ignores that even single
studies can inform further discussion when critically appraised.
D: Ordering immediately ignores study limitations and patient
context, risking unnecessary testing.
Page 2 of 982
,Teaching Point
Critically appraise study quality; combine evidence, clinician
judgment, and patient preference.
Citation
Jarvis, C., & Eckhardt, A. L. (2023). Physical Examination and
Health Assessment (9th ed.). Ch. 1.
2
Reference
Ch. 1 — Evidence-Based Assessment
Stem
During pretest counseling, a 40-year-old asks what a screening
test’s sensitivity and specificity mean for them. The test has
high sensitivity but moderate specificity. Which statement best
explains the clinical implication?
A. A positive result definitely means disease is present.
B. A negative result effectively rules out disease in this patient.
(Correct)
C. The test should only be used to confirm disease.
D. Sensitivity and specificity are irrelevant to individual patients.
Correct Answer
B
Rationale — Correct
Jarvis discusses test characteristics: high sensitivity is useful to
Page 3 of 982
, rule out disease (SnNout). A negative result on a highly sensitive
test makes disease unlikely, which aids safe clinical decision-
making when pretest probability is moderate to low.
Rationale — Incorrect
A: High sensitivity does not mean a positive test is definitive—
specificity matters for ruling in.
C: Tests with high sensitivity are best for screening/ruling out,
not solely confirmation.
D: Sensitivity/specificity inform clinical interpretation and
decision-making; Jarvis stresses their relevance.
Teaching Point
High sensitivity → good for ruling out disease: “SnNout.”
Citation
Jarvis, C., & Eckhardt, A. L. (2023). Physical Examination and
Health Assessment (9th ed.). Ch. 1.
3
Reference
Ch. 1 — Evidence-Based Assessment
Stem
A nurse is appraising two randomized controlled trials (RCTs)
about an intervention: one with large sample and low attrition,
another small but clinically similar results. Which appraisal step
best follows Jarvis’ guidance to determine applicability to a
specific patient?
Page 4 of 982
ASSESSMENT
9TH EDITION
• AUTHOR(S)CAROLYN JARVIS; ANN L.
ECKHARDT
TEST BANK
1
Reference
Ch. 1 — Evidence-Based Assessment
Stem
A 52-year-old patient comes for a routine visit and asks whether
a newly published study showing benefit from a screening test
applies to them. The nurse notes the study was a small, single-
center cohort with no control group and the patient has
multiple chronic conditions. Which approach best follows
evidence-based assessment principles?
Page 1 of 982
,A. Recommend the test because any positive study supports
wider use.
B. Explain the study’s limitations and integrate patient values
and clinical context before deciding. (Correct)
C. Refuse to discuss the test because single studies are always
unreliable.
D. Order the test immediately to avoid missing potential
benefit.
Correct Answer
B
Rationale — Correct
Jarvis emphasizes integrating the best available evidence with
clinical expertise and patient values. Explaining study
limitations, assessing applicability to this patient’s
comorbidities, and engaging in shared decision-making aligns
with EBP. This prevents overgeneralization from low-quality
evidence and supports safe, individualized care.
Rationale — Incorrect
A: Overgeneralizes from low-quality evidence; Jarvis warns
against assuming applicability without critical appraisal.
C: Dismisses patient concerns and ignores that even single
studies can inform further discussion when critically appraised.
D: Ordering immediately ignores study limitations and patient
context, risking unnecessary testing.
Page 2 of 982
,Teaching Point
Critically appraise study quality; combine evidence, clinician
judgment, and patient preference.
Citation
Jarvis, C., & Eckhardt, A. L. (2023). Physical Examination and
Health Assessment (9th ed.). Ch. 1.
2
Reference
Ch. 1 — Evidence-Based Assessment
Stem
During pretest counseling, a 40-year-old asks what a screening
test’s sensitivity and specificity mean for them. The test has
high sensitivity but moderate specificity. Which statement best
explains the clinical implication?
A. A positive result definitely means disease is present.
B. A negative result effectively rules out disease in this patient.
(Correct)
C. The test should only be used to confirm disease.
D. Sensitivity and specificity are irrelevant to individual patients.
Correct Answer
B
Rationale — Correct
Jarvis discusses test characteristics: high sensitivity is useful to
Page 3 of 982
, rule out disease (SnNout). A negative result on a highly sensitive
test makes disease unlikely, which aids safe clinical decision-
making when pretest probability is moderate to low.
Rationale — Incorrect
A: High sensitivity does not mean a positive test is definitive—
specificity matters for ruling in.
C: Tests with high sensitivity are best for screening/ruling out,
not solely confirmation.
D: Sensitivity/specificity inform clinical interpretation and
decision-making; Jarvis stresses their relevance.
Teaching Point
High sensitivity → good for ruling out disease: “SnNout.”
Citation
Jarvis, C., & Eckhardt, A. L. (2023). Physical Examination and
Health Assessment (9th ed.). Ch. 1.
3
Reference
Ch. 1 — Evidence-Based Assessment
Stem
A nurse is appraising two randomized controlled trials (RCTs)
about an intervention: one with large sample and low attrition,
another small but clinically similar results. Which appraisal step
best follows Jarvis’ guidance to determine applicability to a
specific patient?
Page 4 of 982
