TEST BANK
ADVANCED HEALTH ASSESSMENT & CLINICAL DIAGNOSIS IN
PRIMARY CARE, 6TH EDITION
Joyce E. Dains, Linda Ciofu Baumann & Pamela Scheibel
, lOMoARcPSD|126 567 13
Test Bank for Advanced Health Assessment & Clinical Diagnosis in Primary Care
6th Edition Dains
Chapter 1: Clinical Reasoning, Differential Diagnosis, Evidence-Based Practice, and Symptom Analysis
Multiple Choice
Identify the choice that best completes the statement or answers the question.
1. Which type of clinical decision-making is most reliable?
A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
2. Which of the following is false? To obtain adequate history, health-care providers must be:
A. Methodical and systematic
B. Attentive to the patient’s verbal and nonverbal language
C. Able to accurately interpret the patient’s responses
D. Adept at reading into the patient’s statements
3. Essential parts of a health history include all of the following except:
A. Chief complaint
B. History of the present illness
C. Current vital signs
D. All of the above are essential history components
4. Which of the following is false? While performing the physical examination, the examiner must be able to:
A. Differentiate between normal and abnormal findings
B. Recall knowledge of a range of conditions and their associated signs and symptoms
C. Recognize how certain conditions affect the response to other conditions
D. Foresee unpredictable findings
5. The following is the least reliable source of information for diagnostic statistics:
A. Evidence-based investigations
B. Primary reports of research
C. Estimation based on a provider’s experience
D. Published meta-analyses
6. The following can be used to assist in sound clinical decision-making:
A. Algorithm published in a peer-reviewed journal article
B. Clinical practice guidelines
C. Evidence-based research
D. All of the above
7. If a diagnostic study has high sensitivity, this indicates a:
A. High percentage of persons with the given condition will have an abnormal result
B. Low percentage of persons with the given condition will have an abnormal result
C. Low likelihood of normal result in persons without a given condition
D. None of the above
8. If a diagnostic study has high specificity, this indicates a:
A. Low percentage of healthy individuals will show a normal result
B. High percentage of healthy individuals will show a normal result
C. High percentage of individuals with a disorder will show a normal result
D. Low percentage of individuals with a disorder will show an abnormal result
9. A likelihood ratio above 1 indicates that a diagnostic test showing a:
A. Positive result is strongly associated with the disease
B. Negative result is strongly associated with absence of the disease
C. Positive result is weakly associated with the disease
D. Negative result is weakly associated with absence of the disease
10. Which of the following clinical reasoning tools is defined as evidence-based resource based on mathematical modeling
to express the likelihood of a condition in select situations, settings, and/or patients?
, lOMoARcPSD|126 567 13
A. Clinical gpractice gguideline
B. Clinical gdecision grule
C. Clinical galgorithm
Chapter 1: Clinical reasoning, differential diagnosis, evidence-based practice, and symptom ana
g g g g g g g g g g
Answer Section
g
MULTIPLE gCHOICE
1. ANS: B
Croskerry g(2009) gdescribes gtwo gmajor gtypes gof gclinical gdiagnostic gdecision-making: gintuitive gand ganalytical. gIntuitive
gdecision- gmaking g(similar gto gAugenblink gdecision-making) gis gbased gon gthe gexperience gand gintuition gof gthe gclinician gand gis
gless greliable gand gpaired gwith gfairly gcommon gerrors. gIn gcontrast, ganalytical gdecision-making gis gbased gon gcareful gconsideration
gand ghas ggreater greliability gwith grare gerrors.
PTS: 1
2. ANS: D
To gobtain gadequate ghistory, gproviders gmust gbe gwell gorganized, gattentive gto gthe gpatient’s gverbal gand gnonverbal glanguage, gand
gable gto gaccurately ginterpret gthe gpatient’s gresponses gto gquestions. gRather gthan greading ginto gthe gpatient’s gstatements, gthey
gclarify gany gareas gof guncertainty.
PTS: 1
3. ANS: C
Vital gsigns gare gpart gof gthe gphysical gexamination gportion gof gpatient gassessment, gnot gpart gof gthe ghealth ghistory.
PTS: 1
4. ANS: D
While gperforming gthe gphysical gexamination, gthe gexaminer gmust gbe gable gto gdifferentiate gbetween gnormal gand gabnormal
gfindings, grecall gknowledge gof ga grange gof gconditions, gincluding gtheir gassociated gsigns gand gsymptoms, grecognize ghow gcertain
gconditions gaffect gthe gresponse gto gother gconditions, gand gdistinguish gthe grelevance gof gvaried gabnormal gfindings.
PTS: 1
5. ANS: C
Sources gfor gdiagnostic gstatistics ginclude gtextbooks, gprimary greports gof gresearch, gand gpublished gmeta-analyses. gAnother gsource
gof gstatistics, gthe gone gthat ghas gbeen gmost gwidelygused gand gavailable gfor gapplication gto gthe greasoning gprocess, gis gthe gestimation
gbased gon ga gprovider’s gexperience, galthough gthese gare grarely gaccurate. gOver gthe gpast gdecade, gthe gavailability gof gevidence gon
gwhich gto gbase gclinical greasoning gis gimproving, g and gthere gis gan gincreasing gexpectation gthat gclinical greasoning gbe gbased gon
gscientific gevidence.
Evidence-based gstatistics gare g also gincreasingly gbeing gused gto gdevelop g resources gto gfacilitate g clinical g decision-making.
PTS: 1
6. ANS: D
To gassist gin gclinical gdecision-making, ga gnumber gof gevidence-based gresources ghave gbeen gdeveloped gto gassist gthe gclinician.
gResources, gsuch gas galgorithms gand gclinical gpractice gguidelines, gassist gin gclinical greasoning gwhen gproperly gapplied.
PTS: 1
7. ANS: A
The gsensitivity gof ga gdiagnostic gstudy gis gthe gpercentage gof gindividuals gwith gthe gtarget gcondition gwho gshow gan gabnormal, gor
gpositive, gresult. gA ghigh gsensitivity gindicates gthat ga ggreater gpercentage gof gpersons gwith gthe ggiven gcondition gwill ghave gan
gabnormal gresult.
PTS: 1
8. ANS: B
The gspecificity gof ga gdiagnostic gstudy gis gthe gpercentage gof gnormal, ghealthy gindividuals gwho ghave ga gnormal gresult. gThe ggreater
gthe gspecificity, gthe ggreater gthe gpercentage gof gindividuals gwho gwill ghave gnegative, gor gnormal, gresults gif gthey gdo gnot ghave gthe
gtarget gcondition.
PTS: 1
9. ANS: A
The glikelihood gratio gis gthe gprobability gthat ga gpositive gtest gresult gwill gbe gassociated gwith ga gperson gwho ghas gthe gtarget gcondition
gand ga gnegative gresult gwill gbe gassociated gwith ga ghealthy gperson. gA glikelihood gratio gabove g1 gindicates gthat ga gpositive gresult gis
gassociated gwith gthe gdisease; ga glikelihood gratio gless gthan g1 gindicates gthat ga gnegative gresult gis gassociated gwith gan gabsence gof gthe
gdisease.
, lOMoARcPSD|126 567 13
PTS: 1
10. ANS: B
Clinical gdecision g(or gprediction) grules gprovide ganother gsupport gfor gclinical greasoning. gClinical gdecision grules gare gevidence-
based gresources gthat gprovide gprobabilistic gstatements gregarding gthe glikelihood gthat ga gcondition gexists gif gcertain gvariables gare
gmet gwith gregard gto gthe gprognosis gof gpatients gwith gspecific gfindings. gDecision grules guse gmathematical gmodels gand gare gspecific
gto gcertain gsituations, gsettings, gand/or gpatient gcharacteristics.
PTS: 1
ADVANCED HEALTH ASSESSMENT & CLINICAL DIAGNOSIS IN
PRIMARY CARE, 6TH EDITION
Joyce E. Dains, Linda Ciofu Baumann & Pamela Scheibel
, lOMoARcPSD|126 567 13
Test Bank for Advanced Health Assessment & Clinical Diagnosis in Primary Care
6th Edition Dains
Chapter 1: Clinical Reasoning, Differential Diagnosis, Evidence-Based Practice, and Symptom Analysis
Multiple Choice
Identify the choice that best completes the statement or answers the question.
1. Which type of clinical decision-making is most reliable?
A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
2. Which of the following is false? To obtain adequate history, health-care providers must be:
A. Methodical and systematic
B. Attentive to the patient’s verbal and nonverbal language
C. Able to accurately interpret the patient’s responses
D. Adept at reading into the patient’s statements
3. Essential parts of a health history include all of the following except:
A. Chief complaint
B. History of the present illness
C. Current vital signs
D. All of the above are essential history components
4. Which of the following is false? While performing the physical examination, the examiner must be able to:
A. Differentiate between normal and abnormal findings
B. Recall knowledge of a range of conditions and their associated signs and symptoms
C. Recognize how certain conditions affect the response to other conditions
D. Foresee unpredictable findings
5. The following is the least reliable source of information for diagnostic statistics:
A. Evidence-based investigations
B. Primary reports of research
C. Estimation based on a provider’s experience
D. Published meta-analyses
6. The following can be used to assist in sound clinical decision-making:
A. Algorithm published in a peer-reviewed journal article
B. Clinical practice guidelines
C. Evidence-based research
D. All of the above
7. If a diagnostic study has high sensitivity, this indicates a:
A. High percentage of persons with the given condition will have an abnormal result
B. Low percentage of persons with the given condition will have an abnormal result
C. Low likelihood of normal result in persons without a given condition
D. None of the above
8. If a diagnostic study has high specificity, this indicates a:
A. Low percentage of healthy individuals will show a normal result
B. High percentage of healthy individuals will show a normal result
C. High percentage of individuals with a disorder will show a normal result
D. Low percentage of individuals with a disorder will show an abnormal result
9. A likelihood ratio above 1 indicates that a diagnostic test showing a:
A. Positive result is strongly associated with the disease
B. Negative result is strongly associated with absence of the disease
C. Positive result is weakly associated with the disease
D. Negative result is weakly associated with absence of the disease
10. Which of the following clinical reasoning tools is defined as evidence-based resource based on mathematical modeling
to express the likelihood of a condition in select situations, settings, and/or patients?
, lOMoARcPSD|126 567 13
A. Clinical gpractice gguideline
B. Clinical gdecision grule
C. Clinical galgorithm
Chapter 1: Clinical reasoning, differential diagnosis, evidence-based practice, and symptom ana
g g g g g g g g g g
Answer Section
g
MULTIPLE gCHOICE
1. ANS: B
Croskerry g(2009) gdescribes gtwo gmajor gtypes gof gclinical gdiagnostic gdecision-making: gintuitive gand ganalytical. gIntuitive
gdecision- gmaking g(similar gto gAugenblink gdecision-making) gis gbased gon gthe gexperience gand gintuition gof gthe gclinician gand gis
gless greliable gand gpaired gwith gfairly gcommon gerrors. gIn gcontrast, ganalytical gdecision-making gis gbased gon gcareful gconsideration
gand ghas ggreater greliability gwith grare gerrors.
PTS: 1
2. ANS: D
To gobtain gadequate ghistory, gproviders gmust gbe gwell gorganized, gattentive gto gthe gpatient’s gverbal gand gnonverbal glanguage, gand
gable gto gaccurately ginterpret gthe gpatient’s gresponses gto gquestions. gRather gthan greading ginto gthe gpatient’s gstatements, gthey
gclarify gany gareas gof guncertainty.
PTS: 1
3. ANS: C
Vital gsigns gare gpart gof gthe gphysical gexamination gportion gof gpatient gassessment, gnot gpart gof gthe ghealth ghistory.
PTS: 1
4. ANS: D
While gperforming gthe gphysical gexamination, gthe gexaminer gmust gbe gable gto gdifferentiate gbetween gnormal gand gabnormal
gfindings, grecall gknowledge gof ga grange gof gconditions, gincluding gtheir gassociated gsigns gand gsymptoms, grecognize ghow gcertain
gconditions gaffect gthe gresponse gto gother gconditions, gand gdistinguish gthe grelevance gof gvaried gabnormal gfindings.
PTS: 1
5. ANS: C
Sources gfor gdiagnostic gstatistics ginclude gtextbooks, gprimary greports gof gresearch, gand gpublished gmeta-analyses. gAnother gsource
gof gstatistics, gthe gone gthat ghas gbeen gmost gwidelygused gand gavailable gfor gapplication gto gthe greasoning gprocess, gis gthe gestimation
gbased gon ga gprovider’s gexperience, galthough gthese gare grarely gaccurate. gOver gthe gpast gdecade, gthe gavailability gof gevidence gon
gwhich gto gbase gclinical greasoning gis gimproving, g and gthere gis gan gincreasing gexpectation gthat gclinical greasoning gbe gbased gon
gscientific gevidence.
Evidence-based gstatistics gare g also gincreasingly gbeing gused gto gdevelop g resources gto gfacilitate g clinical g decision-making.
PTS: 1
6. ANS: D
To gassist gin gclinical gdecision-making, ga gnumber gof gevidence-based gresources ghave gbeen gdeveloped gto gassist gthe gclinician.
gResources, gsuch gas galgorithms gand gclinical gpractice gguidelines, gassist gin gclinical greasoning gwhen gproperly gapplied.
PTS: 1
7. ANS: A
The gsensitivity gof ga gdiagnostic gstudy gis gthe gpercentage gof gindividuals gwith gthe gtarget gcondition gwho gshow gan gabnormal, gor
gpositive, gresult. gA ghigh gsensitivity gindicates gthat ga ggreater gpercentage gof gpersons gwith gthe ggiven gcondition gwill ghave gan
gabnormal gresult.
PTS: 1
8. ANS: B
The gspecificity gof ga gdiagnostic gstudy gis gthe gpercentage gof gnormal, ghealthy gindividuals gwho ghave ga gnormal gresult. gThe ggreater
gthe gspecificity, gthe ggreater gthe gpercentage gof gindividuals gwho gwill ghave gnegative, gor gnormal, gresults gif gthey gdo gnot ghave gthe
gtarget gcondition.
PTS: 1
9. ANS: A
The glikelihood gratio gis gthe gprobability gthat ga gpositive gtest gresult gwill gbe gassociated gwith ga gperson gwho ghas gthe gtarget gcondition
gand ga gnegative gresult gwill gbe gassociated gwith ga ghealthy gperson. gA glikelihood gratio gabove g1 gindicates gthat ga gpositive gresult gis
gassociated gwith gthe gdisease; ga glikelihood gratio gless gthan g1 gindicates gthat ga gnegative gresult gis gassociated gwith gan gabsence gof gthe
gdisease.
, lOMoARcPSD|126 567 13
PTS: 1
10. ANS: B
Clinical gdecision g(or gprediction) grules gprovide ganother gsupport gfor gclinical greasoning. gClinical gdecision grules gare gevidence-
based gresources gthat gprovide gprobabilistic gstatements gregarding gthe glikelihood gthat ga gcondition gexists gif gcertain gvariables gare
gmet gwith gregard gto gthe gprognosis gof gpatients gwith gspecific gfindings. gDecision grules guse gmathematical gmodels gand gare gspecific
gto gcertain gsituations, gsettings, gand/or gpatient gcharacteristics.
PTS: 1
