TEST BANK FOR ADVANCED ASSESSMENT:
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INTERPRETING FINDINGS AND
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FORMULATING DIFFERENTIAL
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DIAGNOSES 5TH EDITION, MARY JO
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GOOLSBY, LAURIE GRUBBS ISBN-10;
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1719645930 / ISBN-13;978-1719645935
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,Chapter 1. Assessment and Clinical Decision-Making: Overview
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Multiple Choice
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Identify the choice that best completes the statement or answers the question.
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1. Which type of clinical decision-making is most reliable?
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A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
2. Which of the following is false? To obtain adequate history, health-care providers must be:
vv vv vv vv vv vv vv vv vv vv vv vv vv
A. Methodical and systematic vv vv
B. Attentive to the patient’s verbal and nonverbal languagevv vv vv vv vv vv vv
C. Able to accurately interpret the patient’s responses
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D. Adept at reading into the patient’s statements
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3. Essential parts of a health history include all of the following except:
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A. Chief complaint vv
B. History of the present illness vv vv vv vv
C. Current vital signs vv vv
D. All of the above are essential history components
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4. Which of the following is false? While performing the physical examination, the examiner
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must be able to:
vv vv vv vv
A. Differentiate between normal and abnormal findings vv vv vv vv vv
B. Recall knowledge of a range of conditions and their associated signs and symptoms
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C. Recognize how certain conditions affect the response to other conditions
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D. Foresee unpredictable findings vv vv
5. The following is the least reliable source of information for diagnostic statistics:
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A. Evidence-based investigations vv
B. Primary reports of research vv vv vv
C. Estimation based on a provider’s experience vv vv vv vv vv
D. Published meta-analyses vv
6. The following can be used to assist in sound clinical decision-making:
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A. Algorithm published in a peer-reviewed journal article vv vv vv vv vv vv
B. Clinical practice guidelines vv vv
C. Evidence-based research vv
D. All of the above vv vv vv
7. If a diagnostic study has high sensitivity, this indicates a:
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A. High percentage of persons with the given condition will have an abnormal result
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B. Low percentage of persons with the given condition will have an abnormal result
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C. Low likelihood of normal result in persons without a given condition
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D. None of the above vv vv vv
, 8. If a diagnostic study has high specificity, this indicates a:
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A. Low percentage of healthy individuals will show a normal result
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B. High percentage of healthy individuals will show a normal result
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C. High percentage of individuals with a disorder will show a normal result
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D. Low percentage of individuals with a disorder will show an abnormal result
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9. A likelihood ratio above 1 indicates that a diagnostic test showing a:
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A. Positive result is strongly associated with the disease
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B. Negative result is strongly associated with absence of the disease
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C. Positive result is weakly associated with the disease
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D. Negative result is weakly associated with absence of the disease
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v v 10. Which of the following clinical reasoning tools is defined as evidence-based resource based
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on mathematical modeling to express the likelihood of a condition in select situations,
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settings, and/or patients?
vv vv vv
A. Clinical practice guideline
vv vv
B. Clinical decision rule vv vv
C. Clinical algorithm vv
D. Clinical recommendation vv
, Answer Section
vv
MULTIPLE CHOICE
vv
1. ANS: B vv vv
Croskerry (2009) describes two major types of clinical diagnostic decision-making: intuitive
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and analytical. Intuitive decision-making (similar to Augenblink decision-making) is based
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on the experience and intuition of the clinician and is less reliable and paired with fairly
vv vv vv vv vv vv vv vv vv vv vv vv vv vv vv vv
common errors. In contrast, analytical decision-making is based on careful consideration and
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has greater reliability with rare errors.
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PTS: 1
2. ANS: D vv vv
To obtain adequate history, providers must be well organized, attentive to the patient’s verbal
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and nonverbal language, and able to accurately interpret the patient’s responses to questions.
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Rather than reading into the patient’s statements, they clarify any areas of uncertainty.
vv vv vv vv vv vv vv vv vv vv vv vv vv
PTS: 1
3. ANS: C vv vv
Vital signs are part of the physical examination portion of patient assessment, not part of the
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health history.
vv vv
PTS: 1
4. ANS: D vv vv
While performing the physical examination, the examiner must be able to differentiate between
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normal and abnormal findings, recall knowledge of a range of conditions, including their
vv vv vv vv vv vv vv vv vv vv vv vv vv
associated signs and symptoms, recognize how certain conditions affect the response to
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other conditions, and distinguish the relevance of varied abnormal findings.
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PTS: 1
5. ANS: C vv vv
Sources for diagnostic statistics include textbooks, primary reports of research, and
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published meta-analyses. Another source of statistics, the one that has been most widely
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used and available for application to the reasoning process, is the estimation based on a
vv vv vv vv vv vv vv vv vv vv vv vv vv vv vv
provider’s experience, although these are rarely accurate. Over the past decade, the
vv vv vv vv vv vv vv vv vv vv vv vv
availability of evidence on which to base clinical reasoning is improving, and there is an
vv vv vv vv vv vv vv vv vv vv vv vv vv vv vv
increasing expectation that clinical reasoning be based on scientific evidence. Evidence-
vv vv vv vv vv vv vv vv vv vv vv
based statistics are also increasingly being used to develop resources to facilitate clinical
vv vv vv vv vv vv vv vv vv vv vv vv
decision-making.
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PTS: 1
6. ANS: D vv vv
To assist in clinical decision-making, a number of evidence-based resources have been
vv vv vv vv vv vv vv vv vv vv vv
developed to assist the clinician. Resources, such as algorithms and clinical practice
vv vv vv vv vv vv vv vv vv vv vv vv
guidelines, assist in clinical reasoning when properly applied.
vv vv vv vv vv vv vv vv
vv vv vv vv vv
INTERPRETING FINDINGS AND
vv vv vv vv
FORMULATING DIFFERENTIAL
vv vv vv
DIAGNOSES 5TH EDITION, MARY JO
vv vv vv vv vv vv
GOOLSBY, LAURIE GRUBBS ISBN-10;
vv vv vv vv
1719645930 / ISBN-13;978-1719645935
vv vv vv v
,Chapter 1. Assessment and Clinical Decision-Making: Overview
vv vv vv vv vv vv
Multiple Choice
vv
Identify the choice that best completes the statement or answers the question.
vv vv vv vv vv vv vv vv vv vv vv
1. Which type of clinical decision-making is most reliable?
vv vv vv vv vv vv vv
A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
2. Which of the following is false? To obtain adequate history, health-care providers must be:
vv vv vv vv vv vv vv vv vv vv vv vv vv
A. Methodical and systematic vv vv
B. Attentive to the patient’s verbal and nonverbal languagevv vv vv vv vv vv vv
C. Able to accurately interpret the patient’s responses
vv vv vv vv vv vv
D. Adept at reading into the patient’s statements
vv vv vv vv vv vv
3. Essential parts of a health history include all of the following except:
vv vv vv vv vv vv vv vv vv vv vv
A. Chief complaint vv
B. History of the present illness vv vv vv vv
C. Current vital signs vv vv
D. All of the above are essential history components
vv vv vv vv vv vv vv
4. Which of the following is false? While performing the physical examination, the examiner
vv vv vv vv vv vv vv vv vv vv vv vv
must be able to:
vv vv vv vv
A. Differentiate between normal and abnormal findings vv vv vv vv vv
B. Recall knowledge of a range of conditions and their associated signs and symptoms
vv vv vv vv vv vv vv vv vv vv vv vv
C. Recognize how certain conditions affect the response to other conditions
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D. Foresee unpredictable findings vv vv
5. The following is the least reliable source of information for diagnostic statistics:
vv vv vv vv vv vv vv vv vv vv vv
A. Evidence-based investigations vv
B. Primary reports of research vv vv vv
C. Estimation based on a provider’s experience vv vv vv vv vv
D. Published meta-analyses vv
6. The following can be used to assist in sound clinical decision-making:
vv vv vv vv vv vv vv vv vv vv
A. Algorithm published in a peer-reviewed journal article vv vv vv vv vv vv
B. Clinical practice guidelines vv vv
C. Evidence-based research vv
D. All of the above vv vv vv
7. If a diagnostic study has high sensitivity, this indicates a:
vv vv vv vv vv vv vv vv vv
A. High percentage of persons with the given condition will have an abnormal result
vv vv vv vv vv vv vv vv vv vv vv vv
B. Low percentage of persons with the given condition will have an abnormal result
vv vv vv vv vv vv vv vv vv vv vv vv
C. Low likelihood of normal result in persons without a given condition
vv vv vv vv vv vv vv vv vv vv
D. None of the above vv vv vv
, 8. If a diagnostic study has high specificity, this indicates a:
vv vv vv vv vv vv vv vv vv
A. Low percentage of healthy individuals will show a normal result
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B. High percentage of healthy individuals will show a normal result
vv vv vv vv vv vv vv vv vv
C. High percentage of individuals with a disorder will show a normal result
vv vv vv vv vv vv vv vv vv vv vv
D. Low percentage of individuals with a disorder will show an abnormal result
vv vv vv vv vv vv vv vv vv vv vv
9. A likelihood ratio above 1 indicates that a diagnostic test showing a:
vv vv vv vv vv vv vv vv vv vv vv
A. Positive result is strongly associated with the disease
vv vv vv vv vv vv vv
B. Negative result is strongly associated with absence of the disease
vv vv vv vv vv vv vv vv vv
C. Positive result is weakly associated with the disease
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D. Negative result is weakly associated with absence of the disease
vv vv vv vv vv vv vv vv vv
v v 10. Which of the following clinical reasoning tools is defined as evidence-based resource based
vv vv vv vv vv vv vv vv vv vv vv vv vv
on mathematical modeling to express the likelihood of a condition in select situations,
vv vv vv vv vv vv vv vv vv vv vv vv vv
settings, and/or patients?
vv vv vv
A. Clinical practice guideline
vv vv
B. Clinical decision rule vv vv
C. Clinical algorithm vv
D. Clinical recommendation vv
, Answer Section
vv
MULTIPLE CHOICE
vv
1. ANS: B vv vv
Croskerry (2009) describes two major types of clinical diagnostic decision-making: intuitive
vv vv vv vv vv vv vv vv vv vv
and analytical. Intuitive decision-making (similar to Augenblink decision-making) is based
vv vv vv vv vv vv vv vv vv vv
on the experience and intuition of the clinician and is less reliable and paired with fairly
vv vv vv vv vv vv vv vv vv vv vv vv vv vv vv vv
common errors. In contrast, analytical decision-making is based on careful consideration and
vv vv vv vv vv vv vv vv vv vv vv vv
has greater reliability with rare errors.
vv vv vv vv vv vv
PTS: 1
2. ANS: D vv vv
To obtain adequate history, providers must be well organized, attentive to the patient’s verbal
vv vv vv vv vv vv vv vv vv vv vv vv vv
and nonverbal language, and able to accurately interpret the patient’s responses to questions.
vv vv vv vv vv vv vv vv vv vv vv vv vv
Rather than reading into the patient’s statements, they clarify any areas of uncertainty.
vv vv vv vv vv vv vv vv vv vv vv vv vv
PTS: 1
3. ANS: C vv vv
Vital signs are part of the physical examination portion of patient assessment, not part of the
vv vv vv vv vv vv vv vv vv vv vv vv vv vv vv
health history.
vv vv
PTS: 1
4. ANS: D vv vv
While performing the physical examination, the examiner must be able to differentiate between
vv vv vv vv vv vv vv vv vv vv vv vv
normal and abnormal findings, recall knowledge of a range of conditions, including their
vv vv vv vv vv vv vv vv vv vv vv vv vv
associated signs and symptoms, recognize how certain conditions affect the response to
vv vv vv vv vv vv vv vv vv vv vv vv
other conditions, and distinguish the relevance of varied abnormal findings.
vv vv vv vv vv vv vv vv vv vv
PTS: 1
5. ANS: C vv vv
Sources for diagnostic statistics include textbooks, primary reports of research, and
vv vv vv vv vv vv vv vv vv vv
published meta-analyses. Another source of statistics, the one that has been most widely
vv vv vv vv vv vv vv vv vv vv vv vv vv
used and available for application to the reasoning process, is the estimation based on a
vv vv vv vv vv vv vv vv vv vv vv vv vv vv vv
provider’s experience, although these are rarely accurate. Over the past decade, the
vv vv vv vv vv vv vv vv vv vv vv vv
availability of evidence on which to base clinical reasoning is improving, and there is an
vv vv vv vv vv vv vv vv vv vv vv vv vv vv vv
increasing expectation that clinical reasoning be based on scientific evidence. Evidence-
vv vv vv vv vv vv vv vv vv vv vv
based statistics are also increasingly being used to develop resources to facilitate clinical
vv vv vv vv vv vv vv vv vv vv vv vv
decision-making.
vv
PTS: 1
6. ANS: D vv vv
To assist in clinical decision-making, a number of evidence-based resources have been
vv vv vv vv vv vv vv vv vv vv vv
developed to assist the clinician. Resources, such as algorithms and clinical practice
vv vv vv vv vv vv vv vv vv vv vv vv
guidelines, assist in clinical reasoning when properly applied.
vv vv vv vv vv vv vv vv
