ADVANCED HEALTH ASSESSMENT
AND CLINICAL DIAGNOSIS IN
PRIMARY CARE 5TH EDITION (DAINS)
COMPREHENSIVE TEST BANK
QUESTIONS AND ANSWERS
1. Which clinical reasoning model focuses on the process of making a diagnosis by developing
a list of potential diseases and then using history and physical exam findings to rule them
out?
A. Pattern recognition
B. Hypothetico-deductive reasoning
C. Algorithmic thinking
D. Heuristic processing
Answer: B
Conceptual Explanation: Hypothetico-deductive reasoning is the process of generating
hypotheses based on initial data and then testing those hypotheses through targeted data
collection (history/physical exam).
,2. A clinician fails to consider an alternative diagnosis because they are overly influenced by
the first piece of information obtained. This cognitive bias is known as:
A. Availability bias
B. Confirmation bias
C. Anchoring bias
D. Premature closure
Answer: C
Conceptual Explanation: Anchoring bias occurs when a clinician ‘anchors’ onto early
information and fails to adjust their diagnostic impressions as new data emerges.
3. During a respiratory exam, you note increased tactile fremitus over the right lower lobe.
This finding is most consistent with:
A. Lobar pneumonia
B. Pleural effusion
C. Pneumothorax
D. Chronic obstructive pulmonary disease (COPD)
Answer: A
Conceptual Explanation: Tactile fremitus increases with consolidation (fluid or solid mass
inside the lung tissue), as seen in pneumonia. Fluid or air outside the lung
(effusion/pneumothorax) decreases it.
, 4. When assessing a patient with a suspected meniscus tear, which physical examination
maneuver is most appropriate?
A. Lachman test
B. McMurray test
C. Valgus stress test
D. Anterior drawer test
Answer: B
Conceptual Explanation: The McMurray test is used to evaluate for meniscal tears by
rotating the knee and extending it from a flexed position.
5. A 45-year-old patient presents with a ‘stabbing’ chest pain that worsens when lying flat
and improves when leaning forward. What is the most likely diagnosis?
A. Acute myocardial infarction
B. Acute pericarditis
C. Pulmonary embolism
D. Gastroesophageal reflux disease
Answer: B
Conceptual Explanation: Pleuritic chest pain that is positional (relieved by leaning
forward) is a classic presentation of pericarditis.
AND CLINICAL DIAGNOSIS IN
PRIMARY CARE 5TH EDITION (DAINS)
COMPREHENSIVE TEST BANK
QUESTIONS AND ANSWERS
1. Which clinical reasoning model focuses on the process of making a diagnosis by developing
a list of potential diseases and then using history and physical exam findings to rule them
out?
A. Pattern recognition
B. Hypothetico-deductive reasoning
C. Algorithmic thinking
D. Heuristic processing
Answer: B
Conceptual Explanation: Hypothetico-deductive reasoning is the process of generating
hypotheses based on initial data and then testing those hypotheses through targeted data
collection (history/physical exam).
,2. A clinician fails to consider an alternative diagnosis because they are overly influenced by
the first piece of information obtained. This cognitive bias is known as:
A. Availability bias
B. Confirmation bias
C. Anchoring bias
D. Premature closure
Answer: C
Conceptual Explanation: Anchoring bias occurs when a clinician ‘anchors’ onto early
information and fails to adjust their diagnostic impressions as new data emerges.
3. During a respiratory exam, you note increased tactile fremitus over the right lower lobe.
This finding is most consistent with:
A. Lobar pneumonia
B. Pleural effusion
C. Pneumothorax
D. Chronic obstructive pulmonary disease (COPD)
Answer: A
Conceptual Explanation: Tactile fremitus increases with consolidation (fluid or solid mass
inside the lung tissue), as seen in pneumonia. Fluid or air outside the lung
(effusion/pneumothorax) decreases it.
, 4. When assessing a patient with a suspected meniscus tear, which physical examination
maneuver is most appropriate?
A. Lachman test
B. McMurray test
C. Valgus stress test
D. Anterior drawer test
Answer: B
Conceptual Explanation: The McMurray test is used to evaluate for meniscal tears by
rotating the knee and extending it from a flexed position.
5. A 45-year-old patient presents with a ‘stabbing’ chest pain that worsens when lying flat
and improves when leaning forward. What is the most likely diagnosis?
A. Acute myocardial infarction
B. Acute pericarditis
C. Pulmonary embolism
D. Gastroesophageal reflux disease
Answer: B
Conceptual Explanation: Pleuritic chest pain that is positional (relieved by leaning
forward) is a classic presentation of pericarditis.
