TEST BANK m
ADVANCED HEALTH ASSESSMENT & CLINICAL DIAGNOSIS I
m m m m m m
N PRIMARY CARE, 6TH EDITION
m m m m
Joyce E. Dains, Linda Ciofu Baumann & Pamela Scheibel
m m m m m m m m
, lOMoARcPSD|126 567 13
Test Bank for Advanced Health Assessment & Clinical Diagnosis in Primary Care 6t
m m m m m m m m m m m m
h Edition Dains m m
Chapterm1:mClinicalmReasoning,mDifferentialmDiagnosis,mEvidence-BasedmPractice,mandmSymptommAnalysis
MultiplemChoice
Identifymthemchoicemthatmbestmcompletesmthemstatementmormanswersmthemquestion.
1. Whichmtypemofmclinicalmdecision-makingmismmostmreliable?
A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
2. Whichmofmthemfollowingmismfalse?mTomobtainmadequatemhistory,mhealth-caremprovidersmmustmbe:
A. Methodicalmandmsystematic
B. Attentivemtomthempatient’smverbalmandmnonverbalmlangua
ge
C. Ablemtomaccuratelyminterpretmthempatient’smresponses
D. Adeptmatmreadingmintomthempatient’smstatements
3. Essentialmpartsmofmamhealthmhistorymincludemallm ofmthemfollowingmexcept:
A. Chiefmcomplaint
B. Historymofmthempresentmillness
C. Currentmvitalmsigns
D. Allmofmthemabovemaremessentialmhistorymcompone
nts
4. Whichmofmthemfollowingmismfalse?mWhilemperformingmthemphysicalm examination,mthemexaminermmustmbemablemto:
A. Differentiatembetweenmnormalmandmabnormalmfindings
B. Recallmknowledgemofmamrangemofmconditionsmandmtheirmassociatedmsignsmandmsympt
oms
C. Recognizemhowmcertainmconditionsmaffectmthemresponsemtomothermconditions
D. Foreseemunpredictablem findings
5. Themfollowingmismthemleastmreliablemsourcemofminformationmformdiagnosticmstatistics:
A. Evidence-basedminvestigations
B. Primarymreportsmofmresearch
C. Estimationmbasedmonmamprovider’smexperienc
e
D. Publishedmmeta-analyses
6. Themfollowingmcanmbemusedmtomassistminmsoundmclinicalmdecision-making:
A. Algorithmmpublishedminmampeer-
reviewedmjournalmarticle
B. Clinicalmpracticemguidelines
C. Evidence-basedm research
D. Allmofmthemabove
7. Ifmamdiagnosticmstudymhasmhighmsensitivity,m thismindicatesma:
A. Highmpercentagemofmpersonsmwithmthemgivenmconditionmwillmhavemanmabnormalmr
esult
B. Lowmpercentagemofmpersonsmwithmthemgivenmconditionmwillmhavemanmabnormalmre
sult
C. Lowmlikelihoodmofmnormalmresultminmpersonsmwithoutmamgivenmcondition
D. Nonemofmthemabove
8. Ifmamdiagnosticmstudymhasmhighmspecificity,m thismindicatesma:
A. Lowmpercentagemofmhealthymindividualsmwillmshowmamnormalmresult
B. Highmpercentagemofmhealthymindividualsmwillmshowmamnormalmresult
C. Highmpercentagemofmindividualsmwithmamdisordermwillmshowmamnormalmresul
t
D. Lowmpercentagemofmindividualsmwithmamdisordermwillmshowmanmabnormalmre
sult
9. Amlikelihoodmratiomabovem1mindicatesmthatmamdiagnosticmtestmshowingma:
A. Positivemresultmismstronglymassociatedmwithmthemdisease
B. Negativemresultmismstronglymassociatedmwithmabsencemofmthemdise
ase
C. Positivemresultmismweaklymassociatedmwithmthemdisease
D. Negativemresultmismweaklymassociatedmwithmabsencemofmthemdisea
se
10. Whichmofmthemfollowingmclinicalmreasoningmtoolsmismdefinedmasmevidence-
, lOMoARcPSD|126 567 13
basedmresourcembasedmonmmathematicalmmodelingmtomexpressmthemlikelihoodmofmamconditionminmselectmsituations,msettings,man
d/ormpatients?
, lOMoARcPSD|126 567 13
A. Clinicalmpracticemguideline
B. Clinicalmdecisionmrule
C. Clinicalmalgorithm
Chapterm1:mClinicalmreasoning,mdifferentialmdiagnosis,mevidence-basedmpractice,mandmsymptommana
AnswermSection
MULTIPLEmCHOICE
1. ANS: B
Croskerrym(2009)mdescribesmtwommajormtypesmofmclinicalmdiagnosticmdecision-
making:mintuitivemandmanalytical.mIntuitivemdecision-mmakingm(similarmtomAugenblinkmdecision-
making)mismbasedmonmthemexperiencemandmintuitionmofmthemclinicianmandmismlessmreliablemandmpairedmwithmfairlymcommonmerro
rs.mInmcontrast,manalyticalmdecision-makingmismbasedmonmcarefulmconsiderationmandmhasmgreatermreliabilitymwithmraremerrors.
PTS: 1
2. ANS: D
Tomobtainmadequatemhistory,mprovidersmmustmbemwellmorganized,mattentivemtomthempatient’smverbalmandmnonverbalmlanguage,ma
ndmablemtomaccuratelyminterpretmthempatient’smresponsesmtomquestions.mRathermthanmreadingmintomthempatient’smstatements,mthe
ymclarifymanymareasmofmuncertainty.
PTS: 1
3. ANS: C
Vitalmsignsmarempartmofmthemphysicalmexaminationmportionmofmpatientmassessment,mnotmpartmofmthemhealthmhistory.
PTS: 1
4. ANS: D
Whilemperformingmthemphysicalmexamination,mthemexaminermmustmbemablemtomdifferentiatembetweenmnormalmandmabnormalmfind
ings,mrecallmknowledgemofmamrangemofmconditions,mincludingmtheirmassociatedmsignsmandmsymptoms,mrecognizemhowmcertainmcon
ditionsmaffectmthemresponsemtomothermconditions,mandmdistinguishmthemrelevancemofmvariedmabnormalmfindings.
PTS: 1
5. ANS: C
Sourcesmformdiagnosticmstatisticsmincludemtextbooks,mprimarymreportsmofmresearch,mandmpublishedmmeta-
analyses.mAnothermsourcemofmstatistics,mthemonemthatmhasmbeenmmostmwidelymusedmandmavailablemformapplicationmtomthemreasoni
ngmprocess,mismthemestimationmbasedmonmamprovider’smexperience,malthoughmthesemaremrarelymaccurate.mOvermthempastmdecade,m
themavailabilitymofmevidencemonmwhichmtombasemclinicalmreasoningmismimproving,m andmtheremismanmincreasingmexpectationmthat
mclinicalmreasoningmbembasedmonmscientificmevidence.
Evidence-basedmstatisticsmarem alsomincreasinglymbeingmusedmtomdevelopm resourcesmtomfacilitatem clinicalm decision-making.
PTS: 1
6. ANS: D
Tomassistminmclinicalmdecision-making,mamnumbermofmevidence-
basedmresourcesmhavembeenmdevelopedmtomassistmthemclinician.mResources,msuchmasmalgorithmsmandmclinicalmpracticemguideline
s,massistminmclinicalmreasoningmwhenmproperlymapplied.
PTS: 1
7. ANS: A
Themsensitivitymofmamdiagnosticmstudymismthempercentagemofmindividualsmwithmthemtargetmconditionmwhomshowmanmabnormal,morm
positive,mresult.mAmhighmsensitivitymindicatesmthatmamgreatermpercentagemofmpersonsmwithmthemgivenmconditionmwillmhavemanmabn
ormalmresult.
PTS: 1
8. ANS: B
Themspecificitymofmamdiagnosticmstudymismthempercentagemofmnormal,mhealthymindividualsmwhomhavemamnormalmresult.mThemgre
atermthemspecificity,mthemgreatermthempercentagemofmindividualsmwhomwillmhavemnegative,mormnormal,mresultsmifmtheymdomnotmh
avemthemtargetmcondition.
PTS: 1
9. ANS: A
Themlikelihoodmratiomismthemprobabilitymthatmampositivemtestmresultmwillmbemassociatedmwithmampersonmwhomhasmthemtargetmcondit
ionmandmamnegativemresultmwillmbemassociatedmwithmamhealthymperson.mAmlikelihoodmratiomabovem1mindicatesmthatmampositivemres
ultmismassociatedmwithmthemdisease;mamlikelihoodmratiomlessmthanm1mindicatesmthatmamnegativemresultmismassociatedmwithmanmabsen
cemofmthemdisease.
ADVANCED HEALTH ASSESSMENT & CLINICAL DIAGNOSIS I
m m m m m m
N PRIMARY CARE, 6TH EDITION
m m m m
Joyce E. Dains, Linda Ciofu Baumann & Pamela Scheibel
m m m m m m m m
, lOMoARcPSD|126 567 13
Test Bank for Advanced Health Assessment & Clinical Diagnosis in Primary Care 6t
m m m m m m m m m m m m
h Edition Dains m m
Chapterm1:mClinicalmReasoning,mDifferentialmDiagnosis,mEvidence-BasedmPractice,mandmSymptommAnalysis
MultiplemChoice
Identifymthemchoicemthatmbestmcompletesmthemstatementmormanswersmthemquestion.
1. Whichmtypemofmclinicalmdecision-makingmismmostmreliable?
A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
2. Whichmofmthemfollowingmismfalse?mTomobtainmadequatemhistory,mhealth-caremprovidersmmustmbe:
A. Methodicalmandmsystematic
B. Attentivemtomthempatient’smverbalmandmnonverbalmlangua
ge
C. Ablemtomaccuratelyminterpretmthempatient’smresponses
D. Adeptmatmreadingmintomthempatient’smstatements
3. Essentialmpartsmofmamhealthmhistorymincludemallm ofmthemfollowingmexcept:
A. Chiefmcomplaint
B. Historymofmthempresentmillness
C. Currentmvitalmsigns
D. Allmofmthemabovemaremessentialmhistorymcompone
nts
4. Whichmofmthemfollowingmismfalse?mWhilemperformingmthemphysicalm examination,mthemexaminermmustmbemablemto:
A. Differentiatembetweenmnormalmandmabnormalmfindings
B. Recallmknowledgemofmamrangemofmconditionsmandmtheirmassociatedmsignsmandmsympt
oms
C. Recognizemhowmcertainmconditionsmaffectmthemresponsemtomothermconditions
D. Foreseemunpredictablem findings
5. Themfollowingmismthemleastmreliablemsourcemofminformationmformdiagnosticmstatistics:
A. Evidence-basedminvestigations
B. Primarymreportsmofmresearch
C. Estimationmbasedmonmamprovider’smexperienc
e
D. Publishedmmeta-analyses
6. Themfollowingmcanmbemusedmtomassistminmsoundmclinicalmdecision-making:
A. Algorithmmpublishedminmampeer-
reviewedmjournalmarticle
B. Clinicalmpracticemguidelines
C. Evidence-basedm research
D. Allmofmthemabove
7. Ifmamdiagnosticmstudymhasmhighmsensitivity,m thismindicatesma:
A. Highmpercentagemofmpersonsmwithmthemgivenmconditionmwillmhavemanmabnormalmr
esult
B. Lowmpercentagemofmpersonsmwithmthemgivenmconditionmwillmhavemanmabnormalmre
sult
C. Lowmlikelihoodmofmnormalmresultminmpersonsmwithoutmamgivenmcondition
D. Nonemofmthemabove
8. Ifmamdiagnosticmstudymhasmhighmspecificity,m thismindicatesma:
A. Lowmpercentagemofmhealthymindividualsmwillmshowmamnormalmresult
B. Highmpercentagemofmhealthymindividualsmwillmshowmamnormalmresult
C. Highmpercentagemofmindividualsmwithmamdisordermwillmshowmamnormalmresul
t
D. Lowmpercentagemofmindividualsmwithmamdisordermwillmshowmanmabnormalmre
sult
9. Amlikelihoodmratiomabovem1mindicatesmthatmamdiagnosticmtestmshowingma:
A. Positivemresultmismstronglymassociatedmwithmthemdisease
B. Negativemresultmismstronglymassociatedmwithmabsencemofmthemdise
ase
C. Positivemresultmismweaklymassociatedmwithmthemdisease
D. Negativemresultmismweaklymassociatedmwithmabsencemofmthemdisea
se
10. Whichmofmthemfollowingmclinicalmreasoningmtoolsmismdefinedmasmevidence-
, lOMoARcPSD|126 567 13
basedmresourcembasedmonmmathematicalmmodelingmtomexpressmthemlikelihoodmofmamconditionminmselectmsituations,msettings,man
d/ormpatients?
, lOMoARcPSD|126 567 13
A. Clinicalmpracticemguideline
B. Clinicalmdecisionmrule
C. Clinicalmalgorithm
Chapterm1:mClinicalmreasoning,mdifferentialmdiagnosis,mevidence-basedmpractice,mandmsymptommana
AnswermSection
MULTIPLEmCHOICE
1. ANS: B
Croskerrym(2009)mdescribesmtwommajormtypesmofmclinicalmdiagnosticmdecision-
making:mintuitivemandmanalytical.mIntuitivemdecision-mmakingm(similarmtomAugenblinkmdecision-
making)mismbasedmonmthemexperiencemandmintuitionmofmthemclinicianmandmismlessmreliablemandmpairedmwithmfairlymcommonmerro
rs.mInmcontrast,manalyticalmdecision-makingmismbasedmonmcarefulmconsiderationmandmhasmgreatermreliabilitymwithmraremerrors.
PTS: 1
2. ANS: D
Tomobtainmadequatemhistory,mprovidersmmustmbemwellmorganized,mattentivemtomthempatient’smverbalmandmnonverbalmlanguage,ma
ndmablemtomaccuratelyminterpretmthempatient’smresponsesmtomquestions.mRathermthanmreadingmintomthempatient’smstatements,mthe
ymclarifymanymareasmofmuncertainty.
PTS: 1
3. ANS: C
Vitalmsignsmarempartmofmthemphysicalmexaminationmportionmofmpatientmassessment,mnotmpartmofmthemhealthmhistory.
PTS: 1
4. ANS: D
Whilemperformingmthemphysicalmexamination,mthemexaminermmustmbemablemtomdifferentiatembetweenmnormalmandmabnormalmfind
ings,mrecallmknowledgemofmamrangemofmconditions,mincludingmtheirmassociatedmsignsmandmsymptoms,mrecognizemhowmcertainmcon
ditionsmaffectmthemresponsemtomothermconditions,mandmdistinguishmthemrelevancemofmvariedmabnormalmfindings.
PTS: 1
5. ANS: C
Sourcesmformdiagnosticmstatisticsmincludemtextbooks,mprimarymreportsmofmresearch,mandmpublishedmmeta-
analyses.mAnothermsourcemofmstatistics,mthemonemthatmhasmbeenmmostmwidelymusedmandmavailablemformapplicationmtomthemreasoni
ngmprocess,mismthemestimationmbasedmonmamprovider’smexperience,malthoughmthesemaremrarelymaccurate.mOvermthempastmdecade,m
themavailabilitymofmevidencemonmwhichmtombasemclinicalmreasoningmismimproving,m andmtheremismanmincreasingmexpectationmthat
mclinicalmreasoningmbembasedmonmscientificmevidence.
Evidence-basedmstatisticsmarem alsomincreasinglymbeingmusedmtomdevelopm resourcesmtomfacilitatem clinicalm decision-making.
PTS: 1
6. ANS: D
Tomassistminmclinicalmdecision-making,mamnumbermofmevidence-
basedmresourcesmhavembeenmdevelopedmtomassistmthemclinician.mResources,msuchmasmalgorithmsmandmclinicalmpracticemguideline
s,massistminmclinicalmreasoningmwhenmproperlymapplied.
PTS: 1
7. ANS: A
Themsensitivitymofmamdiagnosticmstudymismthempercentagemofmindividualsmwithmthemtargetmconditionmwhomshowmanmabnormal,morm
positive,mresult.mAmhighmsensitivitymindicatesmthatmamgreatermpercentagemofmpersonsmwithmthemgivenmconditionmwillmhavemanmabn
ormalmresult.
PTS: 1
8. ANS: B
Themspecificitymofmamdiagnosticmstudymismthempercentagemofmnormal,mhealthymindividualsmwhomhavemamnormalmresult.mThemgre
atermthemspecificity,mthemgreatermthempercentagemofmindividualsmwhomwillmhavemnegative,mormnormal,mresultsmifmtheymdomnotmh
avemthemtargetmcondition.
PTS: 1
9. ANS: A
Themlikelihoodmratiomismthemprobabilitymthatmampositivemtestmresultmwillmbemassociatedmwithmampersonmwhomhasmthemtargetmcondit
ionmandmamnegativemresultmwillmbemassociatedmwithmamhealthymperson.mAmlikelihoodmratiomabovem1mindicatesmthatmampositivemres
ultmismassociatedmwithmthemdisease;mamlikelihoodmratiomlessmthanm1mindicatesmthatmamnegativemresultmismassociatedmwithmanmabsen
cemofmthemdisease.
