f1
, f1
Test Bank for Advanced Health Assessment & Clinical Diagnosis in Primary Care 7th
f1 f1 f1 f1 f1 f1 f1 f1 f1 f1 f1 f1 f
Edition Dains 1 f1
Chapter 1: Clinical Reasoning, Differential Diagnosis, Evidence-Based Practice, and Symptom Analysis
f1 f1 f1 f1 f1 f1 f1 f1 f1 f1
Multiple Choice f1
Identify the choice that best completes the statement or answers the question.
f1 f1 f1 f1 f1 f1 f1 f1 f1 f1 f1
1. Whichf1typef1off1clinicalf1decision-makingf1isf1mostf1reliable?
A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
2. Whichf1off1thef1followingf1isf1false?f1Tof1obtainf1adequatef1history,f1health-caref1providersf1mustf1be:
A. Methodicalf1andf1systematic
B. Attentivef1tof1thef1patient‘sf1verbalf1andf1nonverbalf1language
C. Ablef1tof1accuratelyf1interpretf1thef1patient‘sf1responses
D. Adeptf1atf1readingf1intof1thef1patient‘sf1statements
3. Essentialf1partsf1off1af1healthf1historyf1includef1allf1off1thef1followingf1except:
A. Chieff1complaint
B. Historyf1off1thef1presentf1illness
C. Currentf1vitalf1signs
D. Allf1off1thef1abovef1aref1essentialf1historyf1components
4. Whichf1off1thef1followingf1isf1false?f1Whilef1performingf1thef1physicalf1examination,f1thef1examinerf1mustf1bef1ablef1to:
A. Differentiatef1betweenf1normalf1andf1abnormalf1findings
B. Recallf1knowledgef1off1af1rangef1off1conditionsf1andf1theirf1associatedf1signsf1andf1symptom
s
C. Recognizef1howf1certainf1conditionsf1affectf1thef1responsef1tof1otherf1conditions
D. Foreseef1unpredictablef 1 findings
5. Thef1followingf1isf1thef1leastf1reliablef1sourcef1off1informationf1forf1diagnosticf1statistics:
A. Evidence-basedf1 investigations
B. Primaryf1reportsf1off1research
C. Estimationf1basedf1onf1af1provider‘sf1experience
D. Publishedf 1 meta-analyses
6. Thef1followingf1canf1bef1usedf1tof1assistf1inf1soundf1clinicalf1decision-making:
A. Algorithmf1publishedf1inf1af1peer-reviewedf1journalf1article
B. Clinicalf1practicef1guidelines
C. Evidence-basedf1 research
D. Allf1off1thef1above
7. Iff1af1diagnosticf1studyf1hasf1highf1sensitivity,f1 thisf1indicatesf1a:
A. Highf1percentagef1off1personsf1withf1thef1givenf1conditionf1willf1havef1anf1abnormalf1resul
t
B. Lowf1percentagef1off1personsf1withf1thef1givenf1conditionf1willf1havef1anf1abnormalf1resul
t
C. Lowf1likelihoodf1off1normalf1resultf1inf1personsf1withoutf1af1givenf1condition
D. Nonef1off1thef1above
8. Iff1af1diagnosticf1studyf1hasf1highf1specificity,f1 thisf1indicatesf1a:
A. Lowf1percentagef1off1healthyf1individualsf1willf1showf1af1normalf1result
B. Highf1percentagef1off1healthyf1individualsf1willf1showf1af1normalf1result
C. Highf1percentagef1off1individualsf1withf1af1disorderf1willf1showf1af1normalf1result
D. Lowf1percentagef1off1individualsf1withf1af1disorderf1willf1showf1anf1abnormalf1resu
lt
9. Af1likelihoodf1ratiof1abovef11f1indicatesf1thatf1af1diagnosticf1testf1showingf1a:
A. Positivef1resultf1isf1stronglyf1associatedf1withf1thef1disease
B. Negativef1resultf1isf1stronglyf1associatedf1withf1absencef1off1thef1diseas
e
C. Positivef1resultf1isf1weaklyf1associatedf1withf1thef1disease
D. Negativef1resultf1isf1weaklyf1associatedf1withf1absencef1off1thef1disease
10. Whichf1off1thef1followingf1clinicalf1reasoningf1toolsf1isf1definedf1asf1evidence-
basedf1resourcef1basedf1onf1mathematicalf1modelingf1tof1expressf1thef1likelihoodf1off1af1conditionf1inf1selectf1situations,f1settings,f1and/or
f1patients?
, f1
A. Clinicalf1practicef1guideline
B. Clinicalf1decisionf1rule
C. Clinicalf1algorithm
Chapter 1: Clinical reasoning, differential diagnosis, evidence-based practice, and symptom ana
f1 f1 f1 f1 f1 f1 f1 f1 f1 f1
Answer Section
f1
MULTIPLEf1CHOICE
1. ANS: B
Croskerryf1(2009)f1describesf1twof1majorf1typesf1off1clinicalf1diagnosticf1decision-
making:f1intuitivef1andf1analytical.f1Intuitivef1decision-f1makingf1(similarf1tof1Augenblinkf1decision-
making)f1isf1basedf1onf1thef1experiencef1andf1intuitionf1off1thef1clinicianf1andf1isf1lessf1reliablef1andf1pairedf1withf1fairlyf1commonf1errors.f1I
nf1contrast,f1analyticalf1decision-makingf1isf1basedf1onf1carefulf1considerationf1andf1hasf1greaterf1reliabilityf1withf1raref1errors.
PTS: 1
2. ANS: D
Tof1obtainf1adequatef1history,f1providersf1mustf1bef1wellf1organized,f1attentivef1tof1thef1patient‘sf1verbalf1andf1nonverbalf1language,f1andf1a
blef1tof1accuratelyf1interpretf1thef1patient‘sf1responsesf1tof1questions.f1Ratherf1thanf1readingf1intof1thef1patient‘sf1statements,f1theyf1clarif
yf1anyf1areasf1off1uncertainty.
PTS: 1
3. ANS: C
Vitalf1signsf1aref1partf1off1thef1physicalf1examinationf1portionf1off1patientf1assessment,f1notf1partf1off1thef1healthf1history.
PTS: 1
4. ANS: D
Whilef1performingf1thef1physicalf1examination,f1thef1examinerf1mustf1bef1ablef1tof1differentiatef1betweenf1normalf1andf1abnormalf1findin
gs,f1recallf1knowledgef1off1af1rangef1off1conditions,f1includingf1theirf1associatedf1signsf1andf1symptoms,f1recognizef1howf1certainf1conditio
nsf1affectf1thef1responsef1tof1otherf1conditions,f1andf1distinguishf1thef1relevancef1off1variedf1abnormalf1findings.
PTS: 1
5. ANS: C
Sourcesf1forf1diagnosticf1statisticsf1includef1textbooks,f1primaryf1reportsf1off1research,f1andf1publishedf1meta-
analyses.f1Anotherf1sourcef1off1statistics,f1thef1onef1thatf1hasf1beenf1mostf1widelyf1usedf1andf1availablef1forf1applicationf1tof1thef1reasoningf1p
rocess,f1isf1thef1estimationf1basedf1onf1af1provider‘sf1experience,f1althoughf1thesef1aref1rarelyf1accurate.f1Overf1thef1pastf1decade,f1thef1avai
labilityf1off1evidencef1onf1whichf1tof1basef1clinicalf1reasoningf1isf1improving,f 1 andf1theref1isf1anf1increasingf1expectationf1thatf1clinicalf1re
asoningf1bef1basedf1onf1scientificf1evidence.
Evidence-basedf1statisticsf1 aref1 alsof1increasinglyf1beingf1usedf1tof1developf 1 resourcesf1tof1facilitatef1 clinicalf 1 decision-making.
PTS: 1
6. ANS: D
Tof1assistf1inf1clinicalf1decision-making,f1af1numberf1off1evidence-
basedf1resourcesf1havef1beenf1developedf1tof1assistf1thef1clinician.f1Resources,f1suchf1asf1algorithmsf1andf1clinicalf1practicef1guidelines,f1
assistf1inf1clinicalf1reasoningf1whenf1properlyf1applied.
PTS: 1
7. ANS: A
Thef1sensitivityf1off1af1diagnosticf1studyf1isf1thef1percentagef1off1individualsf1withf1thef1targetf1conditionf1whof1showf1anf1abnormal,f1orf 1 pos
itive,f1result.f1Af1highf1sensitivityf1indicatesf1thatf1af1greaterf1percentagef1off1personsf1withf1thef1givenf1conditionf1willf1havef1anf1abnormalf1
result.
PTS: 1
8. ANS: B
Thef1specificityf1off1af1diagnosticf1studyf1isf1thef1percentagef1off1normal,f1healthyf1individualsf1whof1havef1af1normalf1result.f1Thef1greaterf1
thef1specificity,f1thef1greaterf1thef1percentagef1off1individualsf1whof1willf1havef1negative,f1orf1normal,f1resultsf1iff1theyf1dof1notf1havef1thef1
targetf1condition.
PTS: 1
9. ANS: A
Thef1likelihoodf1ratiof1isf1thef1probabilityf1thatf1af1positivef1testf1resultf1willf1bef1associatedf1withf1af1personf1whof1hasf1thef1targetf1conditionf1
andf1af1negativef1resultf1willf1bef1associatedf1withf1af1healthyf1person.f1Af1likelihoodf1ratiof1abovef11f1indicatesf1thatf1af1positivef1resultf1isf1a
ssociatedf1withf1thef1disease;f1af1likelihoodf1ratiof1lessf1thanf11f1indicatesf1thatf1af1negativef1resultf1isf1associatedf1withf1anf1absencef1off1thef1
disease.
, f1
PTS: 1
10. ANS: B
Clinicalf1decisionf1(orf1prediction)f1rulesf1providef1anotherf1supportf1forf1clinicalf1reasoning.f1Clinicalf1decisionf1rulesf1aref1evidence-
basedf1resourcesf1thatf1providef1probabilisticf1statementsf1regardingf1thef1likelihoodf1thatf1af1conditionf1existsf1iff1certainf1variablesf1aref1
metf1withf1regardf1tof1thef1prognosisf1off1patientsf1withf1specificf1findings.f1Decisionf1rulesf1usef1mathematicalf1modelsf1andf1aref1specifi
cf1tof1certainf1situations,f1settings,f1and/orf1patientf1characteristics.
PTS: 1
, f1
Test Bank for Advanced Health Assessment & Clinical Diagnosis in Primary Care 7th
f1 f1 f1 f1 f1 f1 f1 f1 f1 f1 f1 f1 f
Edition Dains 1 f1
Chapter 1: Clinical Reasoning, Differential Diagnosis, Evidence-Based Practice, and Symptom Analysis
f1 f1 f1 f1 f1 f1 f1 f1 f1 f1
Multiple Choice f1
Identify the choice that best completes the statement or answers the question.
f1 f1 f1 f1 f1 f1 f1 f1 f1 f1 f1
1. Whichf1typef1off1clinicalf1decision-makingf1isf1mostf1reliable?
A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
2. Whichf1off1thef1followingf1isf1false?f1Tof1obtainf1adequatef1history,f1health-caref1providersf1mustf1be:
A. Methodicalf1andf1systematic
B. Attentivef1tof1thef1patient‘sf1verbalf1andf1nonverbalf1language
C. Ablef1tof1accuratelyf1interpretf1thef1patient‘sf1responses
D. Adeptf1atf1readingf1intof1thef1patient‘sf1statements
3. Essentialf1partsf1off1af1healthf1historyf1includef1allf1off1thef1followingf1except:
A. Chieff1complaint
B. Historyf1off1thef1presentf1illness
C. Currentf1vitalf1signs
D. Allf1off1thef1abovef1aref1essentialf1historyf1components
4. Whichf1off1thef1followingf1isf1false?f1Whilef1performingf1thef1physicalf1examination,f1thef1examinerf1mustf1bef1ablef1to:
A. Differentiatef1betweenf1normalf1andf1abnormalf1findings
B. Recallf1knowledgef1off1af1rangef1off1conditionsf1andf1theirf1associatedf1signsf1andf1symptom
s
C. Recognizef1howf1certainf1conditionsf1affectf1thef1responsef1tof1otherf1conditions
D. Foreseef1unpredictablef 1 findings
5. Thef1followingf1isf1thef1leastf1reliablef1sourcef1off1informationf1forf1diagnosticf1statistics:
A. Evidence-basedf1 investigations
B. Primaryf1reportsf1off1research
C. Estimationf1basedf1onf1af1provider‘sf1experience
D. Publishedf 1 meta-analyses
6. Thef1followingf1canf1bef1usedf1tof1assistf1inf1soundf1clinicalf1decision-making:
A. Algorithmf1publishedf1inf1af1peer-reviewedf1journalf1article
B. Clinicalf1practicef1guidelines
C. Evidence-basedf1 research
D. Allf1off1thef1above
7. Iff1af1diagnosticf1studyf1hasf1highf1sensitivity,f1 thisf1indicatesf1a:
A. Highf1percentagef1off1personsf1withf1thef1givenf1conditionf1willf1havef1anf1abnormalf1resul
t
B. Lowf1percentagef1off1personsf1withf1thef1givenf1conditionf1willf1havef1anf1abnormalf1resul
t
C. Lowf1likelihoodf1off1normalf1resultf1inf1personsf1withoutf1af1givenf1condition
D. Nonef1off1thef1above
8. Iff1af1diagnosticf1studyf1hasf1highf1specificity,f1 thisf1indicatesf1a:
A. Lowf1percentagef1off1healthyf1individualsf1willf1showf1af1normalf1result
B. Highf1percentagef1off1healthyf1individualsf1willf1showf1af1normalf1result
C. Highf1percentagef1off1individualsf1withf1af1disorderf1willf1showf1af1normalf1result
D. Lowf1percentagef1off1individualsf1withf1af1disorderf1willf1showf1anf1abnormalf1resu
lt
9. Af1likelihoodf1ratiof1abovef11f1indicatesf1thatf1af1diagnosticf1testf1showingf1a:
A. Positivef1resultf1isf1stronglyf1associatedf1withf1thef1disease
B. Negativef1resultf1isf1stronglyf1associatedf1withf1absencef1off1thef1diseas
e
C. Positivef1resultf1isf1weaklyf1associatedf1withf1thef1disease
D. Negativef1resultf1isf1weaklyf1associatedf1withf1absencef1off1thef1disease
10. Whichf1off1thef1followingf1clinicalf1reasoningf1toolsf1isf1definedf1asf1evidence-
basedf1resourcef1basedf1onf1mathematicalf1modelingf1tof1expressf1thef1likelihoodf1off1af1conditionf1inf1selectf1situations,f1settings,f1and/or
f1patients?
, f1
A. Clinicalf1practicef1guideline
B. Clinicalf1decisionf1rule
C. Clinicalf1algorithm
Chapter 1: Clinical reasoning, differential diagnosis, evidence-based practice, and symptom ana
f1 f1 f1 f1 f1 f1 f1 f1 f1 f1
Answer Section
f1
MULTIPLEf1CHOICE
1. ANS: B
Croskerryf1(2009)f1describesf1twof1majorf1typesf1off1clinicalf1diagnosticf1decision-
making:f1intuitivef1andf1analytical.f1Intuitivef1decision-f1makingf1(similarf1tof1Augenblinkf1decision-
making)f1isf1basedf1onf1thef1experiencef1andf1intuitionf1off1thef1clinicianf1andf1isf1lessf1reliablef1andf1pairedf1withf1fairlyf1commonf1errors.f1I
nf1contrast,f1analyticalf1decision-makingf1isf1basedf1onf1carefulf1considerationf1andf1hasf1greaterf1reliabilityf1withf1raref1errors.
PTS: 1
2. ANS: D
Tof1obtainf1adequatef1history,f1providersf1mustf1bef1wellf1organized,f1attentivef1tof1thef1patient‘sf1verbalf1andf1nonverbalf1language,f1andf1a
blef1tof1accuratelyf1interpretf1thef1patient‘sf1responsesf1tof1questions.f1Ratherf1thanf1readingf1intof1thef1patient‘sf1statements,f1theyf1clarif
yf1anyf1areasf1off1uncertainty.
PTS: 1
3. ANS: C
Vitalf1signsf1aref1partf1off1thef1physicalf1examinationf1portionf1off1patientf1assessment,f1notf1partf1off1thef1healthf1history.
PTS: 1
4. ANS: D
Whilef1performingf1thef1physicalf1examination,f1thef1examinerf1mustf1bef1ablef1tof1differentiatef1betweenf1normalf1andf1abnormalf1findin
gs,f1recallf1knowledgef1off1af1rangef1off1conditions,f1includingf1theirf1associatedf1signsf1andf1symptoms,f1recognizef1howf1certainf1conditio
nsf1affectf1thef1responsef1tof1otherf1conditions,f1andf1distinguishf1thef1relevancef1off1variedf1abnormalf1findings.
PTS: 1
5. ANS: C
Sourcesf1forf1diagnosticf1statisticsf1includef1textbooks,f1primaryf1reportsf1off1research,f1andf1publishedf1meta-
analyses.f1Anotherf1sourcef1off1statistics,f1thef1onef1thatf1hasf1beenf1mostf1widelyf1usedf1andf1availablef1forf1applicationf1tof1thef1reasoningf1p
rocess,f1isf1thef1estimationf1basedf1onf1af1provider‘sf1experience,f1althoughf1thesef1aref1rarelyf1accurate.f1Overf1thef1pastf1decade,f1thef1avai
labilityf1off1evidencef1onf1whichf1tof1basef1clinicalf1reasoningf1isf1improving,f 1 andf1theref1isf1anf1increasingf1expectationf1thatf1clinicalf1re
asoningf1bef1basedf1onf1scientificf1evidence.
Evidence-basedf1statisticsf1 aref1 alsof1increasinglyf1beingf1usedf1tof1developf 1 resourcesf1tof1facilitatef1 clinicalf 1 decision-making.
PTS: 1
6. ANS: D
Tof1assistf1inf1clinicalf1decision-making,f1af1numberf1off1evidence-
basedf1resourcesf1havef1beenf1developedf1tof1assistf1thef1clinician.f1Resources,f1suchf1asf1algorithmsf1andf1clinicalf1practicef1guidelines,f1
assistf1inf1clinicalf1reasoningf1whenf1properlyf1applied.
PTS: 1
7. ANS: A
Thef1sensitivityf1off1af1diagnosticf1studyf1isf1thef1percentagef1off1individualsf1withf1thef1targetf1conditionf1whof1showf1anf1abnormal,f1orf 1 pos
itive,f1result.f1Af1highf1sensitivityf1indicatesf1thatf1af1greaterf1percentagef1off1personsf1withf1thef1givenf1conditionf1willf1havef1anf1abnormalf1
result.
PTS: 1
8. ANS: B
Thef1specificityf1off1af1diagnosticf1studyf1isf1thef1percentagef1off1normal,f1healthyf1individualsf1whof1havef1af1normalf1result.f1Thef1greaterf1
thef1specificity,f1thef1greaterf1thef1percentagef1off1individualsf1whof1willf1havef1negative,f1orf1normal,f1resultsf1iff1theyf1dof1notf1havef1thef1
targetf1condition.
PTS: 1
9. ANS: A
Thef1likelihoodf1ratiof1isf1thef1probabilityf1thatf1af1positivef1testf1resultf1willf1bef1associatedf1withf1af1personf1whof1hasf1thef1targetf1conditionf1
andf1af1negativef1resultf1willf1bef1associatedf1withf1af1healthyf1person.f1Af1likelihoodf1ratiof1abovef11f1indicatesf1thatf1af1positivef1resultf1isf1a
ssociatedf1withf1thef1disease;f1af1likelihoodf1ratiof1lessf1thanf11f1indicatesf1thatf1af1negativef1resultf1isf1associatedf1withf1anf1absencef1off1thef1
disease.
, f1
PTS: 1
10. ANS: B
Clinicalf1decisionf1(orf1prediction)f1rulesf1providef1anotherf1supportf1forf1clinicalf1reasoning.f1Clinicalf1decisionf1rulesf1aref1evidence-
basedf1resourcesf1thatf1providef1probabilisticf1statementsf1regardingf1thef1likelihoodf1thatf1af1conditionf1existsf1iff1certainf1variablesf1aref1
metf1withf1regardf1tof1thef1prognosisf1off1patientsf1withf1specificf1findings.f1Decisionf1rulesf1usef1mathematicalf1modelsf1andf1aref1specifi
cf1tof1certainf1situations,f1settings,f1and/orf1patientf1characteristics.
PTS: 1
