,Chapter 1. Clinical Decision Making
Multiple Choice
____ 1. What is the MOST appropriate classification of patient impairments that are the result of inactivity
and expanding multisystem dysfunction following a stroke?
a. Direct impairments
b. Indirect impairments
c. Composite impairments
d. Comprehensive impairments
____ 2. Which one of the following statements BEST describes the difference between measurement and
diagnosis?
a. Measurement describes phenomena in terms that can be analyzed numerically,
whereas diagnosis is the process that labels patients and classifies their illnesses,
leading to the determination of prognoses.
b. Diagnosis describes phenomena in terms that can be analyzed numerically,
whereas measurement is the process that labels patients and classifies their
illnesses, leading to the determination of prognoses.
c. Diagnosis and measurement are part of the same process, and the terms can be
used interchangeably.
d. Measurement requires the use of SOAP notes, whereas diagnosis is facilitated
exclusively through the physical therapy guide.
____ 3. Which one of the following BEST describes the FIRST step that a physical therapist should take when
integrating best evidence into clinical practice?
a. Identify current best evidence on the most successful interventions for the patient’s
diagnosis.
b. Mine the available data and critically appraise the evidence for its validity, level of
evidence, and applicability.
c. Integrate the best evidence into clinical decision making after discussing it with the
patient.
d. Identify a clinically relevant question that is important for the patient.
____ 4. Which of the following questions is designed to assess capacity for functional activities and
participation when interviewing a patient who suffered a stroke?
a. How much of a problem do you have in walking long distances?
b. Is the problem of walking made worse or better by use of an assistive device?
c. How much difficulty do you have walking a quarter of a mile?
d. How much of a problem do you have going up and down stairs?
____ 5. Which one of the following disability standardized instruments is MOST specific for a patient
recovering from a stroke?
a. Functional Independence Measure
b. Fugl-Meyer Assessment of Physical Performance
c. Short Form-36
d. Berg Balance Scale
,____ 6. If a clinical diagnostic test for patients with cervical radiculopathy is positive in 95% of patients who
truly have the disease, but it is also positive in a large number of healthy individuals, what is this test
most useful for?
a. Ruling out cervical radiculopathy
b. Ruling in cervical radiculopathy
c. Neither ruling in nor ruling out cervical radiculopathy
d. Both ruling in and ruling out cervical radiculopathy
, Chapter 1. Clinical Decision Making
Answer Section
MULTIPLE CHOICE
1. ANS: B
Explanation: These impairments are best classified as indirect impairments because they result from
inactivity and expanding multisystem dysfunction.
PTS: 1 REF: From: Chapter 1 TOP: Content: Examination
2. ANS: A
Explanation: Measurement describes phenomena in terms that can be analyzed numerically, whereas
diagnosis is the process that labels patients and classifies their illnesses, leading to the determination
of prognoses. The test-taker will need to know and understand the differences between the two
concepts.
PTS: 1 REF: From: Chapter 1 TOP: Content: Examination
3. ANS: D
Explanation: The importance of starting with a clinically relevant question that integrates patient
values is commonly overlooked, even though it is necessary for integrating best evidence into
clinical practice.
PTS: 1 REF: From: Chapter 1 TOP: Content: Examination
4. ANS: C
Explanation: Asking whether the individual has difficulty walking a quarter of a mile is both specific
to capacity and quantifiable.
PTS: 1 REF: From: Chapter 1 TOP: Content: Examination
5. ANS: B
Explanation: The test-taker needs to know that the Fugl-Meyer scale is specific to stroke, whereas
the other instruments are used in a variety of diagnoses.
PTS: 1 REF: From: Chapter 1 TOP: Content: Examination
6. ANS: A
Explanation: The test-taker will need to understand the concepts of sensitivity and specificity and
understand their clinical utility in this example. This test is highly sensitive but has low specificity;
thus, it is more useful for ruling out the disease.
PTS: 1 REF: From: Chapter 1 TOP: Content: Examination
Chapter 2. Examination of Vital Signs
Multiple Choice
Identify the choice that best completes the statement or answers the question.
____ 1. In which location of the cardiovascular system is the highest concentration of baroreceptors?
a. The aorta and carotid veins
b. The aorta and supraclavicular arteries
Multiple Choice
____ 1. What is the MOST appropriate classification of patient impairments that are the result of inactivity
and expanding multisystem dysfunction following a stroke?
a. Direct impairments
b. Indirect impairments
c. Composite impairments
d. Comprehensive impairments
____ 2. Which one of the following statements BEST describes the difference between measurement and
diagnosis?
a. Measurement describes phenomena in terms that can be analyzed numerically,
whereas diagnosis is the process that labels patients and classifies their illnesses,
leading to the determination of prognoses.
b. Diagnosis describes phenomena in terms that can be analyzed numerically,
whereas measurement is the process that labels patients and classifies their
illnesses, leading to the determination of prognoses.
c. Diagnosis and measurement are part of the same process, and the terms can be
used interchangeably.
d. Measurement requires the use of SOAP notes, whereas diagnosis is facilitated
exclusively through the physical therapy guide.
____ 3. Which one of the following BEST describes the FIRST step that a physical therapist should take when
integrating best evidence into clinical practice?
a. Identify current best evidence on the most successful interventions for the patient’s
diagnosis.
b. Mine the available data and critically appraise the evidence for its validity, level of
evidence, and applicability.
c. Integrate the best evidence into clinical decision making after discussing it with the
patient.
d. Identify a clinically relevant question that is important for the patient.
____ 4. Which of the following questions is designed to assess capacity for functional activities and
participation when interviewing a patient who suffered a stroke?
a. How much of a problem do you have in walking long distances?
b. Is the problem of walking made worse or better by use of an assistive device?
c. How much difficulty do you have walking a quarter of a mile?
d. How much of a problem do you have going up and down stairs?
____ 5. Which one of the following disability standardized instruments is MOST specific for a patient
recovering from a stroke?
a. Functional Independence Measure
b. Fugl-Meyer Assessment of Physical Performance
c. Short Form-36
d. Berg Balance Scale
,____ 6. If a clinical diagnostic test for patients with cervical radiculopathy is positive in 95% of patients who
truly have the disease, but it is also positive in a large number of healthy individuals, what is this test
most useful for?
a. Ruling out cervical radiculopathy
b. Ruling in cervical radiculopathy
c. Neither ruling in nor ruling out cervical radiculopathy
d. Both ruling in and ruling out cervical radiculopathy
, Chapter 1. Clinical Decision Making
Answer Section
MULTIPLE CHOICE
1. ANS: B
Explanation: These impairments are best classified as indirect impairments because they result from
inactivity and expanding multisystem dysfunction.
PTS: 1 REF: From: Chapter 1 TOP: Content: Examination
2. ANS: A
Explanation: Measurement describes phenomena in terms that can be analyzed numerically, whereas
diagnosis is the process that labels patients and classifies their illnesses, leading to the determination
of prognoses. The test-taker will need to know and understand the differences between the two
concepts.
PTS: 1 REF: From: Chapter 1 TOP: Content: Examination
3. ANS: D
Explanation: The importance of starting with a clinically relevant question that integrates patient
values is commonly overlooked, even though it is necessary for integrating best evidence into
clinical practice.
PTS: 1 REF: From: Chapter 1 TOP: Content: Examination
4. ANS: C
Explanation: Asking whether the individual has difficulty walking a quarter of a mile is both specific
to capacity and quantifiable.
PTS: 1 REF: From: Chapter 1 TOP: Content: Examination
5. ANS: B
Explanation: The test-taker needs to know that the Fugl-Meyer scale is specific to stroke, whereas
the other instruments are used in a variety of diagnoses.
PTS: 1 REF: From: Chapter 1 TOP: Content: Examination
6. ANS: A
Explanation: The test-taker will need to understand the concepts of sensitivity and specificity and
understand their clinical utility in this example. This test is highly sensitive but has low specificity;
thus, it is more useful for ruling out the disease.
PTS: 1 REF: From: Chapter 1 TOP: Content: Examination
Chapter 2. Examination of Vital Signs
Multiple Choice
Identify the choice that best completes the statement or answers the question.
____ 1. In which location of the cardiovascular system is the highest concentration of baroreceptors?
a. The aorta and carotid veins
b. The aorta and supraclavicular arteries
