TEST BANK for Advanced Assessment Interpreting Findings and Formulating Differential Diagnoses 5th Edition by Goolsby Chapters 1-22, Complete

Test Bank for Advanced Assessment: Interpreting Findings
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and Formulating Differential Diagnoses, 5th Edition, Mary JoG
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oolsby, Laurie GrubbsChapter 1 - 22 | Complete
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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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x 1. Which type of clinical decision-making is most reliable?
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A. Intuitive
B. Analytical
C. Experiential
D. Augenblick

x 2. Which of the following is false? To obtain adequate history, health-care providers must be:
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A. Methodical and systematic x x


B. Attentive to the patient’s verbal and nonverbal language x x x x x x x


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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Essential parts of a health history include all of the following except:
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x 3. A. Chief complaint x


B. History of the present illness x x x x


C. Current vital signs x x


D. All of the above are essential history components
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Which of the following is false? While performing the physical examination, the examiner must beab
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x 4. le to: x


A. Differentiate between normal and abnormal findings x x x x x


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 x x




The following is the least reliable source of information for diagnostic statistics:
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x 5. A. Evidence-based investigations x


B. Primary reports of research x x x


C. Estimation based on a provider’s experience x x x x x


D. Published meta-analyses x




The following can be used to assist in sound clinical decision-making:
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x 6. A. Algorithm published in a peer-reviewed journal article x x x x x x


B. Clinical practice guidelines x x


C. Evidence-based research x


D. All of the above x x x




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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x 7. 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 x x x

,x 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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x 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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x xxx 10. Which of the following clinical reasoning tools is defined as evidence-
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based resource based on mathematical modeling to express the likelihood of a condition in select sit
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uations, settings, and/orpatients?
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A. Clinical practice guideline x x x


B. Clinical decision rule Clin x x x


C. ical algorithm Clinical rec
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D. ommendation

, Chapter 1. Assessment and Clinical Decision-Making: Overview
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Answer Section
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MULTIPLE CHOICEx




1. ANS: B x


Croskerry (2009) describes two major types of clinical diagnostic decision-
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making: intuitive and analytical. Intuitive decision-making (similar to Augenblink decision-
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making) is based on the experience and intuition of the clinician and is less reliable and paired with f
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airly common errors. In contrast, analytical decision-
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making is based on careful consideration and has greater reliabilitywith rare errors.
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PTS: 1
2. ANS: D x


To obtain adequate history, providers must be well organized, attentive to the patient’s verbal andn
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onverbal language, and able to accurately interpret the patient’s responses to questions. Rather th
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an reading into the patient’s statements, they clarify any areas of uncertainty.
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PTS: 1
3. ANS: C x


Vital signs are part of the physical examination portion of patient assessment, not part of the healthhistor
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y.

PTS: 1
4. ANS: D x


While performing the physical examination, the examiner must be able to differentiate betweennor
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mal and abnormal findings, recall knowledge of a range of conditions, including their associated sig
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ns and symptoms, recognize how certain conditions affect the response to other conditions, and dis
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tinguish the relevance of varied abnormal findings.
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PTS: 1
5. ANS: C x


Sources for diagnostic statistics include textbooks, primary reports of research, and published met
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a-
analyses. Another source of statistics, the one that has been most widely used and available for ap
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plication to the reasoning process, is the estimation based on a provider’s experience, although th
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ese are rarely accurate. Over the past decade, the availability of evidence on which to base clinical r
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easoning is improving, and there is an increasing expectation that clinical reasoningbe based on sci
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entific evidence. Evidence-
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based statistics are also increasingly being used to develop resources to facilitate clinical decision-
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making.

PTS: 1
6. ANS: D x


To assist in clinical decision-making, a number of evidence-
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based resources have been developedto assist the clinician. Resources, such as algorithms and clini
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cal practice guidelines, assist in clinical reasoning when properly applied.
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