Advanced Health Assessment and Clinical
Diagnosis in Primary Care 6th Ed Test Bank | Dains
Q&A
Chapter 1: Clinical Reasoning, Differential Diagnosis, Evidence-Based Practice,
and Symptom Analysis
1. Which type of clinical decision-making is most reliable?
A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
Answer: B
Rationale: Analytical decision-making is based on careful consideration and has
greater reliability with rare errors. In contrast, intuitive decision-making (similar to
Augenblink) is based on experience and is less reliable.
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
Answer: D
Rationale: Providers must be organized, attentive, and accurate in interpretation.
Rather than "reading into" statements, they should clarify any areas of
uncertainty.
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
,Answer: C
Rationale: Vital signs are part of the physical examination, not part of the health
history.
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
Answer: D
Rationale: The examiner must differentiate normal from abnormal, recall
knowledge of conditions, and recognize how conditions affect each other.
Foreseeing unpredictable findings is not possible.
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
Answer: C
Rationale: Estimations based on provider experience are rarely accurate.
Evidence-based sources like research and meta-analyses are more reliable.
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
Answer: D
Rationale: Algorithms, clinical practice guidelines, and evidence-based research
are all resources to assist in clinical decision-making.
,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
Answer: A
Rationale: Sensitivity is the percentage of individuals with the target condition
who show an abnormal (positive) result. High sensitivity means more people with
the disease will test positive.
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
Answer: B
Rationale: Specificity is the percentage of healthy individuals who have a normal
(negative) result. High specificity means healthy people are correctly identified as
negative.
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
Answer: A
Rationale: A likelihood ratio above 1 indicates a positive test result is associated
with the disease. A ratio less than 1 indicates a negative result is associated with
absence of 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?
A. Clinical practice guideline
B. Clinical decision rule
C. Clinical algorithm
D. Clinical pathway
Answer: B
Rationale: Clinical decision (or prediction) rules are evidence-based resources that
provide probabilistic statements regarding the likelihood of a condition based on
mathematical models.
Chapter 2: Evidence-Based Health Screening
11. The first step in the genomic assessment of a patient is obtaining
information regarding:
A. Family history
B. Environmental exposures
C. Lifestyle and behaviors
D. Current medications
Answer: A
Rationale: The genomic assessment begins with obtaining a family history.
12. An affected individual who manifests symptoms of a particular condition
through whom a family with a genetic disorder is ascertained is called a(n):
A. Consultand
B. Consulband
C. Index patient
D. Proband
Answer: D
Rationale: The proband is the affected individual through whom a family with a
genetic disorder is identified.
13. An autosomal dominant disorder involves the:
A. X chromosome
Diagnosis in Primary Care 6th Ed Test Bank | Dains
Q&A
Chapter 1: Clinical Reasoning, Differential Diagnosis, Evidence-Based Practice,
and Symptom Analysis
1. Which type of clinical decision-making is most reliable?
A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
Answer: B
Rationale: Analytical decision-making is based on careful consideration and has
greater reliability with rare errors. In contrast, intuitive decision-making (similar to
Augenblink) is based on experience and is less reliable.
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
Answer: D
Rationale: Providers must be organized, attentive, and accurate in interpretation.
Rather than "reading into" statements, they should clarify any areas of
uncertainty.
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
,Answer: C
Rationale: Vital signs are part of the physical examination, not part of the health
history.
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
Answer: D
Rationale: The examiner must differentiate normal from abnormal, recall
knowledge of conditions, and recognize how conditions affect each other.
Foreseeing unpredictable findings is not possible.
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
Answer: C
Rationale: Estimations based on provider experience are rarely accurate.
Evidence-based sources like research and meta-analyses are more reliable.
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
Answer: D
Rationale: Algorithms, clinical practice guidelines, and evidence-based research
are all resources to assist in clinical decision-making.
,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
Answer: A
Rationale: Sensitivity is the percentage of individuals with the target condition
who show an abnormal (positive) result. High sensitivity means more people with
the disease will test positive.
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
Answer: B
Rationale: Specificity is the percentage of healthy individuals who have a normal
(negative) result. High specificity means healthy people are correctly identified as
negative.
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
Answer: A
Rationale: A likelihood ratio above 1 indicates a positive test result is associated
with the disease. A ratio less than 1 indicates a negative result is associated with
absence of 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?
A. Clinical practice guideline
B. Clinical decision rule
C. Clinical algorithm
D. Clinical pathway
Answer: B
Rationale: Clinical decision (or prediction) rules are evidence-based resources that
provide probabilistic statements regarding the likelihood of a condition based on
mathematical models.
Chapter 2: Evidence-Based Health Screening
11. The first step in the genomic assessment of a patient is obtaining
information regarding:
A. Family history
B. Environmental exposures
C. Lifestyle and behaviors
D. Current medications
Answer: A
Rationale: The genomic assessment begins with obtaining a family history.
12. An affected individual who manifests symptoms of a particular condition
through whom a family with a genetic disorder is ascertained is called a(n):
A. Consultand
B. Consulband
C. Index patient
D. Proband
Answer: D
Rationale: The proband is the affected individual through whom a family with a
genetic disorder is identified.
13. An autosomal dominant disorder involves the:
A. X chromosome
