Advanced Health Assessment & Clinical Diagnosis in Primary Care, 7th Edition (2024) – Comprehensive Test Bank, Practice Questions & Exam Preparation Material

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ADVANCED HEALTH ASSESSMENT & CLINICAL DIAGNOSIS IN
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PRIMARY CARE, 7TH EDITION
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Joyce E. Dains, Linda Ciofu Baumann & Pamela Scheibel
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Test Bank for Advanced Health Assessment & Clinical Diagnosis in Primary Care
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6th Edition Dains fd df df




Chapter1: Clinical Reasoning, DifferentialDiagnosis, Evidence-Based Practice, and Symptom AnalysisMultiple
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Choice
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Identify the choice that best completes the statement oranswers thequestion.
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df 1. Which type of clinical decision-making is most reliable? df df df df df df df




A. Intuitive
B. Analytical
C. Experiential
D. Augenblick

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




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




C. Able to accuratelyinterpret the patient’s responses
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D. Adept at reading intothe patient’s statements
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df 3. Essential parts of a health historyinclude all of the following except: df df df df df df df df df df df




A. Chief complaint df




B. Historyof the present illness df df df df




C. Current vital signs df df




D. All of the above are essential historycomponents
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df 4. Which of the following is false? While performing the physical examination, the examiner must beableto:
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A. Differentiatebetween normal and abnormal findings df df df df df




B. Recall knowledge of a range of conditions andtheir associated signs and symptoms
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C. Recognize how certain conditions affect the response to other conditions df df df df df df df df df




D. Foresee unpredictable findings df df




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




B. Primaryreports of research df df df




C. Estimation based on aprovider’s experience df df df df df




D. Published meta-analyses df




df 6. The following can be used to assist in sound clinical decision-making:
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A. Algorithmpublished in a peer-reviewed journal article f
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B. Clinical practice guidelines df df




C. Evidence-based research df




D. All of theabove
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df 7. If a diagnostic studyhas 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 df df df




df 8. If a diagnostic studyhas high specificity, this indicates a:
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A. Low percentage of healthyindividuals will show a normal result
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B. High percentage of healthyindividuals will show a normal result
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C. High percentage ofindividuals 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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df 9. Alikelihood ratio above 1 indicates that a diagnostic test showing a:
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A. Positive result is stronglyassociated with the disease
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B. Negative result is stronglyassociated with absence of the disease
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C. Positive result is weakly associated with the diseasedf df df df df df df




D. Negativeresult is weaklyassociated with absence of the disease
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df 10. Which of the following clinical reasoning tools is defined as evidence-based resource based on mathematical modeling
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to expressthe likelihood of a condition in select situations, settings, and/or patients?
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A. Clinical practice guideline df df




B. Clinical decision rule df df




C. Clinical algorithm df




Chapter 1: Clinical reasoning, differentialdiagnosis, evidence-basedpractice, and symptom ana
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Answer Section
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MULTIPLE CHOICE df




1. ANS: B
Croskerry (2009) describes two major types of clinical diagnostic decision-making: intuitive and analytical. Intuitive decision-
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making (similar to Augenblink decision-making) is based on the experience and intuition of the clinician and is less reliable and
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paired with fairly common errors. In contrast, analytical decision-making is based on careful consideration and has greater
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reliabilitywith rare errors.
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PTS: 1
2. ANS: D
To obtain adequate history, providers must be well organized, attentive to the patient’s verbal and nonverbal language, and ableto
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accurately interpret the patient’s responses to questions. Rather than reading into the patient’s statements, they clarify any areas
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of uncertainty.
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PTS: 1
3. ANS: C
Vital signs are part of the physical examination portion of patient assessment, not part of the health history.
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PTS: 1
4. ANS: D
While performing the physical examination, the examiner must be able to differentiate between normal and abnormal findings,
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recall knowledge of a range of conditions, including their associated signs and symptoms, recognize how certain conditions affect
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the response to other conditions, and distinguish the relevance of varied abnormal findings.
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PTS: 1
5. ANS: C
Sources for diagnostic statistics include textbooks, primary reports of research, and published meta-analyses. Another source of
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statistics, the one that has been most widelyused and available for application to the reasoning process, is the estimation based on a
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provider’s experience, although these are rarely accurate. Over the past decade, the availability of evidence on which to base
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clinical reasoningis improving, and thereis an increasing expectation that clinical reasoning be based on scientific evidence.
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Evidence-based statistics are also increasinglybeing used to develop resources to facilitate clinical decision-making.
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PTS: 1
6. ANS: D
To assist in clinical decision-making, a number of evidence-based resources have been developed to assist the clinician.Resources,
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such as algorithms and clinical practice guidelines, assist in clinical reasoning when properlyapplied.
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PTS: 1
7. ANS: A
The sensitivity of a diagnostic study is the percentage of individuals with the target condition who show an abnormal, or positive,
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result. Ahigh sensitivityindicates that a greater percentage of persons with the given condition will have an abnormal result.
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PTS: 1
8. ANS: B
The specificity of a diagnostic study is the percentage of normal, healthy individuals who have a normal result. The greater the
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specificity, the greater the percentage of individuals who will have negative, or normal, results if they do not have the target
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condition.
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PTS: 1
9. ANS: A
The likelihood ratio is the probability that a positive test result will be associated with a person who has the target condition and a
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negative result will be associated with a healthy person. A likelihood ratio above 1 indicates that a positive result is associated
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withthe disease; a likelihood ratioless than 1 indicates that a negative result is associated with an absence of the disease.
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PTS: 1
10. ANS: B
Clinical decision (or prediction) rules provide another support for clinical reasoning. Clinical decision rules are evidence-based
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resources that provide probabilistic statements regarding the likelihood that a condition exists if certain variables are met with
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regard to the prognosis of patients with specific findings. Decision rules use mathematical models and are specific to certain
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situations, settings, and/or patient characteristics.
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PTS: 1