!z
lOMoARcPSD| 126 567
!z 13
, !z
lOMoARcPSD| 126 567
!z 13
Test Bank for Advanced Health Assessment & Clinical Diagnosis in Primary Care 7th
!z !z !z !z !z !z !z !z !z !z !z !z !z
Edition Dains !z
Chapter 1: Clinical Reasoning, Differential Diagnosis, Evidence-Based Practice, and Symptom Analysis
!z !z !z !z !z !z !z !z !z !z
Multiple Choice !z
Identify the choice that best completes the statement or answers the question.
!z !z !z !z !z !z !z !z !z !z !z
1. Which!ztype!zof!zclinical!zdecision-making!zis!zmost!zreliable?
A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
2. Which!zof!zthe!zfollowing!zis!zfalse?!zTo!zobtain!zadequate!zhistory,!zhealth-care!zproviders!zmust!zbe:
A. Methodical!zand!zsystematic
B. Attentive!zto!zthe!zpatient’s!zverbal!zand!znonverbal!zlanguage
C. Able!zto!zaccurately!zinterpret!zthe!zpatient’s!zresponses
D. Adept!zat!zreading!zinto!zthe!zpatient’s!zstatements
3. Essential!zparts!zof!za!zhealth!zhistory!zinclude!zall!zof!zthe!zfollowing!zexcept:
A. Chief!zcomplaint
B. History!zof!zthe!zpresent!zillness
C. Current!zvital!zsigns
D. All!zof!zthe!zabove!zare!zessential!zhistory!zcomponents
4. Which!zof!zthe!zfollowing!zis!zfalse?!zWhile!zperforming!zthe!zphysical!zexamination,!zthe!zexaminer!zmust!zbe!zable!zto:
A. Differentiate!zbetween!znormal!zand!zabnormal!zfindings
B. Recall!zknowledge!zof!za!zrange!zof!zconditions!zand!ztheir!zassociated!zsigns!zand!zsymptoms
C. Recognize!zhow!zcertain!zconditions!zaffect!zthe!zresponse!zto!zother!zconditions
D. Foresee!zunpredictable! z findings
5. The!zfollowing!zis!zthe!zleast!zreliable!zsource!zof!zinformation!zfor!zdiagnostic!zstatistics:
A. Evidence-based! z investigations
B. Primary!zreports!zof!zresearch
C. Estimation!zbased!zon!za!zprovider’s!zexperience
D. Published! z meta-analyses
6. The!zfollowing!zcan!zbe!zused!zto!zassist!zin!zsound!zclinical!zdecision-making:
A. Algorithm!zpublished!zin!za!zpeer-reviewed!zjournal!zarticle
B. Clinical!zpractice!zguidelines
C. Evidence-based! z research
D. All!zof!zthe!zabove
7. If!za!zdiagnostic!zstudy!zhas!zhigh!zsensitivity,!z this!zindicates!za:
A. High!zpercentage!zof!zpersons!zwith!zthe!zgiven!zcondition!zwill!zhave!zan!zabnormal!zresult
B. Low!zpercentage!zof!zpersons!zwith!zthe!zgiven!zcondition!zwill!zhave!zan!zabnormal!zresult
C. Low!zlikelihood!zof!znormal!zresult!zin!zpersons!zwithout!za!zgiven!zcondition
D. None!zof!zthe!zabove
8. If!za!zdiagnostic!zstudy!zhas!zhigh!zspecificity,!zthis!zindicates!za:
A. Low!zpercentage!zof!zhealthy!zindividuals!zwill!zshow!za!znormal!zresult
B. High!zpercentage!zof!zhealthy!zindividuals!zwill!zshow!za!znormal!zresult
C. High!zpercentage!zof!zindividuals!zwith!za!zdisorder!zwill!zshow!za!znormal!zresult
D. Low!zpercentage!zof!zindividuals!zwith!za!zdisorder!zwill!zshow!zan!zabnormal!zresult
9. A!zlikelihood!zratio!zabove!z1!zindicates!zthat!za!zdiagnostic!ztest!zshowing!za:
A. Positive!zresult!zis!zstrongly!zassociated!zwith!zthe!zdisease
B. Negative!zresult!zis!zstrongly!zassociated!zwith!zabsence!zof!zthe!zdisease
C. Positive!zresult!zis!zweakly!zassociated!zwith!zthe!zdisease
D. Negative!zresult!zis!zweakly!zassociated!zwith!zabsence!zof!zthe!zdisease
10. Which!zof!zthe!zfollowing!zclinical!zreasoning!ztools!zis!zdefined!zas!zevidence-
based!zresource!zbased!zon!zmathematical!zmodeling!zto!zexpress!zthe!zlikelihood!zof!za!zcondition!zin!zselect!zsituations,!zsettings,!zand/or!z
patients?
, !z
lOMoARcPSD| 126 567
!z 13
A. Clinical!zpractice!zguideline
B. Clinical!zdecision!zrule
C. Clinical!zalgorithm
Chapter 1: Clinical reasoning, differential diagnosis, evidence-based practice, and symptom ana
!z !z !z !z !z !z !z !z !z !z
Answer Section
!z
MULTIPLE!zCHOICE
1. ANS: B
Croskerry!z(2009)!zdescribes!ztwo!zmajor!ztypes!zof!zclinical!zdiagnostic!zdecision-
making:!zintuitive!zand!zanalytical.!zIntuitive!zdecision-!zmaking!z(similar!zto!zAugenblink!zdecision-
making)!zis!zbased!zon!zthe!zexperience!zand!zintuition!zof!zthe!zclinician!zand!zis!zless!zreliable!zand!zpaired!zwith!zfairly!zcommon!zerrors.!zIn
!zcontrast,!zanalytical!zdecision-making!zis!zbased!zon!zcareful!zconsideration !zand!zhas!zgreater!zreliability!zwith!zrare!zerrors.
PTS: 1
2. ANS: D
To!zobtain!zadequate!zhistory,!zproviders!zmust!zbe!zwell!zorganized,!zattentive!zto!zthe!zpatient’s!zverbal!zand!znonverbal!zlanguage,!zand!zab
le!zto!zaccurately!zinterpret!zthe!zpatient’s!zresponses!zto!zquestions.!zRather!zthan!zreading!zinto!zthe!zpatient’s!zstatements,!zthey!zclarify!z
any!zareas!zof!zuncertainty.
PTS: 1
3. ANS: C
Vital!zsigns!zare!zpart!zof!zthe!zphysical!zexamination!zportion!zof!zpatient!zassessment,!znot!zpart!zof!zthe!zhealth!zhistory.
PTS: 1
4. ANS: D
While!zperforming!zthe!zphysical!zexamination,!zthe!zexaminer!zmust!zbe!zable!zto!zdifferentiate!zbetween!znormal!zand!zabnormal!zfinding
s,!zrecall!zknowledge!zof!za!zrange!zof!zconditions,!zincluding!ztheir!zassociated!zsigns!zand!zsymptoms,!zrecognize!zhow!zcertain!zconditions!z
affect!zthe!zresponse!zto!zother!zconditions,!zand!zdistinguish!zthe!zrelevance!zof!zvaried!zabnormal!zfindings.
PTS: 1
5. ANS: C
Sources!zfor!zdiagnostic!zstatistics!zinclude!ztextbooks,!zprimary!zreports!zof!zresearch,!zand!zpublished!zmeta-
analyses.!zAnother!zsource!zof!zstatistics,!zthe!zone!zthat!zhas!zbeen!zmost!zwidely!zused!zand!zavailable!zfor!zapplication!zto!zthe!zreasoning!zpr
ocess,!zis!zthe!zestimation!zbased!zon!za!zprovider’s!zexperience,!zalthough!zthese!zare!zrarely!zaccurate.!zOver!zthe!zpast!zdecade,!zthe!zavaila
bility!zof!zevidence!zon!zwhich!zto!zbase!zclinical!zreasoning!zis!zimproving,! z and!zthere!zis!zan!zincreasing!zexpectation!zthat!zclinical!zreaso
ning!zbe!zbased!zon!zscientific!zevidence.
Evidence-based!zstatistics!z are! z also!zincreasingly!zbeing!zused!zto!zdevelop! z resources!zto!zfacilitate! z clinical! z decision-making.
PTS: 1
6. ANS: D
To!zassist!zin!zclinical!zdecision-making,!za!znumber!zof!zevidence-
based!zresources!zhave!zbeen!zdeveloped!zto!zassist!zthe!zclinician.!zResources,!zsuch!zas!zalgorithms!zand!zclinical!zpractice!zguidelines,!za
ssist!zin!zclinical!zreasoning!zwhen!zproperly!zapplied.
PTS: 1
7. ANS: A
The!zsensitivity!zof!za!zdiagnostic!zstudy!zis!zthe!zpercentage!zof!zindividuals!zwith!zthe!ztarget!zcondition!zwho!zshow!zan!zabnormal,!zor! z posit
ive,!zresult.!zA!zhigh!zsensitivity!zindicates!zthat!za!zgreater!zpercentage!zof!zpersons!zwith!zthe!zgiven!zcondition!zwill!zhave!zan!zabnormal!zre
sult.
PTS: 1
8. ANS: B
The!zspecificity!zof!za!zdiagnostic!zstudy!zis!zthe!zpercentage!zof!znormal,!zhealthy!zindividuals!zwho!zhave!za!znormal!zresult.!zThe!zgreater!zt
he!zspecificity,!zthe!zgreater!zthe!zpercentage!zof!zindividuals!zwho!zwill!zhave!znegative,!zor!znormal,!zresults!zif!zthey!zdo!znot!zhave!zthe!zta
rget!zcondition.
PTS: 1
9. ANS: A
The!zlikelihood!zratio!zis!zthe!zprobability!zthat!za!zpositive!ztest!zresult!zwill!zbe!zassociated!zwith!za!zperson!zwho!zhas!zthe!ztarget!zcondition!za
nd!za!znegative!zresult!zwill!zbe!zassociated!zwith!za!zhealthy!zperson.!zA!zlikelihood!zratio!zabove!z1!zindicates!zthat!za!zpositive!zresult!zis!zass
ociated!zwith!zthe!zdisease;!za!zlikelihood!zratio!zless!zthan!z1!zindicates!zthat!za!znegative!zresult!zis!zassociated!zwith!zan!zabsence!zof!zthe!zdise
ase.
, !z
lOMoARcPSD| 126 567
!z 13
PTS: 1
10. ANS: B
Clinical!zdecision!z(or!zprediction)!zrules!zprovide!zanother!zsupport!zfor!zclinical!zreasoning.!zClinical!zdecision!zrules!zare!zevidence-
based!zresources!zthat!zprovide!zprobabilistic!zstatements!zregarding!zthe!zlikelihood!zthat!za!zcondition!zexists!zif!zcertain!zvariables!zare!z
met!zwith!zregard!zto!zthe!zprognosis!zof!zpatients!zwith!zspecific!zfindings.!zDecision!zrules!zuse!zmathematical!zmodels!zand!zare!zspecific!
zto!zcertain!zsituations,!zsettings,!zand/or!zpatient!zcharacteristics.
PTS: 1
lOMoARcPSD| 126 567
!z 13
, !z
lOMoARcPSD| 126 567
!z 13
Test Bank for Advanced Health Assessment & Clinical Diagnosis in Primary Care 7th
!z !z !z !z !z !z !z !z !z !z !z !z !z
Edition Dains !z
Chapter 1: Clinical Reasoning, Differential Diagnosis, Evidence-Based Practice, and Symptom Analysis
!z !z !z !z !z !z !z !z !z !z
Multiple Choice !z
Identify the choice that best completes the statement or answers the question.
!z !z !z !z !z !z !z !z !z !z !z
1. Which!ztype!zof!zclinical!zdecision-making!zis!zmost!zreliable?
A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
2. Which!zof!zthe!zfollowing!zis!zfalse?!zTo!zobtain!zadequate!zhistory,!zhealth-care!zproviders!zmust!zbe:
A. Methodical!zand!zsystematic
B. Attentive!zto!zthe!zpatient’s!zverbal!zand!znonverbal!zlanguage
C. Able!zto!zaccurately!zinterpret!zthe!zpatient’s!zresponses
D. Adept!zat!zreading!zinto!zthe!zpatient’s!zstatements
3. Essential!zparts!zof!za!zhealth!zhistory!zinclude!zall!zof!zthe!zfollowing!zexcept:
A. Chief!zcomplaint
B. History!zof!zthe!zpresent!zillness
C. Current!zvital!zsigns
D. All!zof!zthe!zabove!zare!zessential!zhistory!zcomponents
4. Which!zof!zthe!zfollowing!zis!zfalse?!zWhile!zperforming!zthe!zphysical!zexamination,!zthe!zexaminer!zmust!zbe!zable!zto:
A. Differentiate!zbetween!znormal!zand!zabnormal!zfindings
B. Recall!zknowledge!zof!za!zrange!zof!zconditions!zand!ztheir!zassociated!zsigns!zand!zsymptoms
C. Recognize!zhow!zcertain!zconditions!zaffect!zthe!zresponse!zto!zother!zconditions
D. Foresee!zunpredictable! z findings
5. The!zfollowing!zis!zthe!zleast!zreliable!zsource!zof!zinformation!zfor!zdiagnostic!zstatistics:
A. Evidence-based! z investigations
B. Primary!zreports!zof!zresearch
C. Estimation!zbased!zon!za!zprovider’s!zexperience
D. Published! z meta-analyses
6. The!zfollowing!zcan!zbe!zused!zto!zassist!zin!zsound!zclinical!zdecision-making:
A. Algorithm!zpublished!zin!za!zpeer-reviewed!zjournal!zarticle
B. Clinical!zpractice!zguidelines
C. Evidence-based! z research
D. All!zof!zthe!zabove
7. If!za!zdiagnostic!zstudy!zhas!zhigh!zsensitivity,!z this!zindicates!za:
A. High!zpercentage!zof!zpersons!zwith!zthe!zgiven!zcondition!zwill!zhave!zan!zabnormal!zresult
B. Low!zpercentage!zof!zpersons!zwith!zthe!zgiven!zcondition!zwill!zhave!zan!zabnormal!zresult
C. Low!zlikelihood!zof!znormal!zresult!zin!zpersons!zwithout!za!zgiven!zcondition
D. None!zof!zthe!zabove
8. If!za!zdiagnostic!zstudy!zhas!zhigh!zspecificity,!zthis!zindicates!za:
A. Low!zpercentage!zof!zhealthy!zindividuals!zwill!zshow!za!znormal!zresult
B. High!zpercentage!zof!zhealthy!zindividuals!zwill!zshow!za!znormal!zresult
C. High!zpercentage!zof!zindividuals!zwith!za!zdisorder!zwill!zshow!za!znormal!zresult
D. Low!zpercentage!zof!zindividuals!zwith!za!zdisorder!zwill!zshow!zan!zabnormal!zresult
9. A!zlikelihood!zratio!zabove!z1!zindicates!zthat!za!zdiagnostic!ztest!zshowing!za:
A. Positive!zresult!zis!zstrongly!zassociated!zwith!zthe!zdisease
B. Negative!zresult!zis!zstrongly!zassociated!zwith!zabsence!zof!zthe!zdisease
C. Positive!zresult!zis!zweakly!zassociated!zwith!zthe!zdisease
D. Negative!zresult!zis!zweakly!zassociated!zwith!zabsence!zof!zthe!zdisease
10. Which!zof!zthe!zfollowing!zclinical!zreasoning!ztools!zis!zdefined!zas!zevidence-
based!zresource!zbased!zon!zmathematical!zmodeling!zto!zexpress!zthe!zlikelihood!zof!za!zcondition!zin!zselect!zsituations,!zsettings,!zand/or!z
patients?
, !z
lOMoARcPSD| 126 567
!z 13
A. Clinical!zpractice!zguideline
B. Clinical!zdecision!zrule
C. Clinical!zalgorithm
Chapter 1: Clinical reasoning, differential diagnosis, evidence-based practice, and symptom ana
!z !z !z !z !z !z !z !z !z !z
Answer Section
!z
MULTIPLE!zCHOICE
1. ANS: B
Croskerry!z(2009)!zdescribes!ztwo!zmajor!ztypes!zof!zclinical!zdiagnostic!zdecision-
making:!zintuitive!zand!zanalytical.!zIntuitive!zdecision-!zmaking!z(similar!zto!zAugenblink!zdecision-
making)!zis!zbased!zon!zthe!zexperience!zand!zintuition!zof!zthe!zclinician!zand!zis!zless!zreliable!zand!zpaired!zwith!zfairly!zcommon!zerrors.!zIn
!zcontrast,!zanalytical!zdecision-making!zis!zbased!zon!zcareful!zconsideration !zand!zhas!zgreater!zreliability!zwith!zrare!zerrors.
PTS: 1
2. ANS: D
To!zobtain!zadequate!zhistory,!zproviders!zmust!zbe!zwell!zorganized,!zattentive!zto!zthe!zpatient’s!zverbal!zand!znonverbal!zlanguage,!zand!zab
le!zto!zaccurately!zinterpret!zthe!zpatient’s!zresponses!zto!zquestions.!zRather!zthan!zreading!zinto!zthe!zpatient’s!zstatements,!zthey!zclarify!z
any!zareas!zof!zuncertainty.
PTS: 1
3. ANS: C
Vital!zsigns!zare!zpart!zof!zthe!zphysical!zexamination!zportion!zof!zpatient!zassessment,!znot!zpart!zof!zthe!zhealth!zhistory.
PTS: 1
4. ANS: D
While!zperforming!zthe!zphysical!zexamination,!zthe!zexaminer!zmust!zbe!zable!zto!zdifferentiate!zbetween!znormal!zand!zabnormal!zfinding
s,!zrecall!zknowledge!zof!za!zrange!zof!zconditions,!zincluding!ztheir!zassociated!zsigns!zand!zsymptoms,!zrecognize!zhow!zcertain!zconditions!z
affect!zthe!zresponse!zto!zother!zconditions,!zand!zdistinguish!zthe!zrelevance!zof!zvaried!zabnormal!zfindings.
PTS: 1
5. ANS: C
Sources!zfor!zdiagnostic!zstatistics!zinclude!ztextbooks,!zprimary!zreports!zof!zresearch,!zand!zpublished!zmeta-
analyses.!zAnother!zsource!zof!zstatistics,!zthe!zone!zthat!zhas!zbeen!zmost!zwidely!zused!zand!zavailable!zfor!zapplication!zto!zthe!zreasoning!zpr
ocess,!zis!zthe!zestimation!zbased!zon!za!zprovider’s!zexperience,!zalthough!zthese!zare!zrarely!zaccurate.!zOver!zthe!zpast!zdecade,!zthe!zavaila
bility!zof!zevidence!zon!zwhich!zto!zbase!zclinical!zreasoning!zis!zimproving,! z and!zthere!zis!zan!zincreasing!zexpectation!zthat!zclinical!zreaso
ning!zbe!zbased!zon!zscientific!zevidence.
Evidence-based!zstatistics!z are! z also!zincreasingly!zbeing!zused!zto!zdevelop! z resources!zto!zfacilitate! z clinical! z decision-making.
PTS: 1
6. ANS: D
To!zassist!zin!zclinical!zdecision-making,!za!znumber!zof!zevidence-
based!zresources!zhave!zbeen!zdeveloped!zto!zassist!zthe!zclinician.!zResources,!zsuch!zas!zalgorithms!zand!zclinical!zpractice!zguidelines,!za
ssist!zin!zclinical!zreasoning!zwhen!zproperly!zapplied.
PTS: 1
7. ANS: A
The!zsensitivity!zof!za!zdiagnostic!zstudy!zis!zthe!zpercentage!zof!zindividuals!zwith!zthe!ztarget!zcondition!zwho!zshow!zan!zabnormal,!zor! z posit
ive,!zresult.!zA!zhigh!zsensitivity!zindicates!zthat!za!zgreater!zpercentage!zof!zpersons!zwith!zthe!zgiven!zcondition!zwill!zhave!zan!zabnormal!zre
sult.
PTS: 1
8. ANS: B
The!zspecificity!zof!za!zdiagnostic!zstudy!zis!zthe!zpercentage!zof!znormal,!zhealthy!zindividuals!zwho!zhave!za!znormal!zresult.!zThe!zgreater!zt
he!zspecificity,!zthe!zgreater!zthe!zpercentage!zof!zindividuals!zwho!zwill!zhave!znegative,!zor!znormal,!zresults!zif!zthey!zdo!znot!zhave!zthe!zta
rget!zcondition.
PTS: 1
9. ANS: A
The!zlikelihood!zratio!zis!zthe!zprobability!zthat!za!zpositive!ztest!zresult!zwill!zbe!zassociated!zwith!za!zperson!zwho!zhas!zthe!ztarget!zcondition!za
nd!za!znegative!zresult!zwill!zbe!zassociated!zwith!za!zhealthy!zperson.!zA!zlikelihood!zratio!zabove!z1!zindicates!zthat!za!zpositive!zresult!zis!zass
ociated!zwith!zthe!zdisease;!za!zlikelihood!zratio!zless!zthan!z1!zindicates!zthat!za!znegative!zresult!zis!zassociated!zwith!zan!zabsence!zof!zthe!zdise
ase.
, !z
lOMoARcPSD| 126 567
!z 13
PTS: 1
10. ANS: B
Clinical!zdecision!z(or!zprediction)!zrules!zprovide!zanother!zsupport!zfor!zclinical!zreasoning.!zClinical!zdecision!zrules!zare!zevidence-
based!zresources!zthat!zprovide!zprobabilistic!zstatements!zregarding!zthe!zlikelihood!zthat!za!zcondition!zexists!zif!zcertain!zvariables!zare!z
met!zwith!zregard!zto!zthe!zprognosis!zof!zpatients!zwith!zspecific!zfindings.!zDecision!zrules!zuse!zmathematical!zmodels!zand!zare!zspecific!
zto!zcertain!zsituations,!zsettings,!zand/or!zpatient!zcharacteristics.
PTS: 1
