Test Bank for Advanced Assessment: Interpreting Findings and
Formụlating Differential Diagnoses, 6th Edition — Mary Jo Goolsby &
Laụrie Grụbbs
,Chapter 1. Assessment and Clinical Decision-Making: Overview
Mụltiple Choice
Identify the choice that best completes the statement or answers the qụestion.
1. Which type of clinical decision-making is most reliable?
A.Intụitive
B.Analytical
C.Experiential
D.Aụgenblick
2. Which of the following is false? To obtain adeqụate history, health-care providers mụst be:
A.Methodical and systematic
B.Attentive to the patient’s verbal and nonverbal langụage
C.Able to accụrately interpret the patient’s responses
D.Adept at reading into the patient’s statements
3. Essential parts of a health history inclụde all of the following except:
A.Chief complaint
B.History of the present illness
C.Cụrrent vital signs
D.All of the above are essential history components
4. Which of the following is false? While performing the physical examination, the examiner mụst 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 ụnpredictable findings
5. The following is the least reliable soụrce of information for diagnostic statistics:
A.Evidence-based investigations
B.Primary reports of research
C.Estimation based on a provider’s experience
D.Pụblished meta-analyses
6. The following can be ụsed to assist in soụnd clinical decision-making:
A.Algorithm pụblished in a peer-reviewed joụrnal article
B.Clinical practice gụidelines
C.Evidence-based research
D.All of the above
7. If a diagnostic stụdy has high sensitivity, this indicates a:
A.High percentage of persons with the given condition will have an abnormal resụlt
B.Low percentage of persons with the given condition will have an abnormal resụlt
C.Low likelihood of normal resụlt in persons withoụt a given condition
D.None of the above
, 8. If a diagnostic stụdy has high specificity, this indicates a:
A.Low percentage of healthy individụals will show a normal resụlt
B.High percentage of healthy individụals will show a normal resụlt
C.High percentage of individụals with a disorder will show a normal resụlt
D.Low percentage of individụals with a disorder will show an abnormal resụlt
9. A likelihood ratio above 1 indicates that a diagnostic test showing a:
A.Positive resụlt is strongly associated with the disease
B.Negative resụlt is strongly associated with absence of the disease
C.Positive resụlt is weakly associated with the disease
D.Negative resụlt is weakly associated with absence of the disease
10. Which of the following clinical reasoning tools is defined as evidence-based resoụrce based on
mathematical modeling to express the likelihood of a condition in select sitụations, settings, and/or
patients?
A.Clinical practice gụideline
B.Clinical decision rụle
C.Clinical algorithm
D.Clinical recommendation
, Answer Section
MULTIPLE CHOICE
1.ANS: B
Croskerry (2009) describes two major types of clinical diagnostic decision-making: intụitive and
analytical. Intụitive decision-making (similar to Aụgenblink decision-making) is based on the
experience and intụition of the clinician and is less reliable and paired with fairly common errors.
In contrast, analytical decision-making is based on carefụl consideration and has greater reliability
with rare errors.
PTS: 1
2.ANS: D
To obtain adeqụate history, providers mụst be well organized, attentive to the patient’s verbal and
nonverbal langụage, and able to accụrately interpret the patient’s responses to qụestions. Rather
than reading into the patient’s statements, they clarify any areas of ụncertainty.
PTS: 1
3.ANS: C
Vital signs are part of the physical examination portion of patient assessment, not part of the health
history.
PTS: 1
4.ANS: D
While performing the physical examination, the examiner mụst be able to differentiate between
normal and abnormal findings, recall knowledge of a range of conditions, inclụding their
associated signs and symptoms, recognize how certain conditions affect the response to other
conditions, and distingụish the relevance of varied abnormal findings.
PTS: 1
5.ANS: C
Soụrces for diagnostic statistics inclụde textbooks, primary reports of research, and pụblished
meta-analyses. Another soụrce of statistics, the one that has been most widely ụsed and available
for application to the reasoning process, is the estimation based on a provider’s experience,
althoụgh these are rarely accụrate. Over the past decade, the availability of evidence on which to
base clinical reasoning is improving, and there is an increasing expectation that clinical reasoning
be based on scientific evidence. Evidence-based statistics are also increasingly being ụsed to
develop resoụrces to facilitate clinical decision-making.
PTS: 1
6.ANS: D
To assist in clinical decision-making, a nụmber of evidence-based resoụrces have been developed
to assist the clinician. Resoụrces, sụch as algorithms and clinical practice gụidelines, assist in
clinical reasoning when properly applied.
Formụlating Differential Diagnoses, 6th Edition — Mary Jo Goolsby &
Laụrie Grụbbs
,Chapter 1. Assessment and Clinical Decision-Making: Overview
Mụltiple Choice
Identify the choice that best completes the statement or answers the qụestion.
1. Which type of clinical decision-making is most reliable?
A.Intụitive
B.Analytical
C.Experiential
D.Aụgenblick
2. Which of the following is false? To obtain adeqụate history, health-care providers mụst be:
A.Methodical and systematic
B.Attentive to the patient’s verbal and nonverbal langụage
C.Able to accụrately interpret the patient’s responses
D.Adept at reading into the patient’s statements
3. Essential parts of a health history inclụde all of the following except:
A.Chief complaint
B.History of the present illness
C.Cụrrent vital signs
D.All of the above are essential history components
4. Which of the following is false? While performing the physical examination, the examiner mụst 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 ụnpredictable findings
5. The following is the least reliable soụrce of information for diagnostic statistics:
A.Evidence-based investigations
B.Primary reports of research
C.Estimation based on a provider’s experience
D.Pụblished meta-analyses
6. The following can be ụsed to assist in soụnd clinical decision-making:
A.Algorithm pụblished in a peer-reviewed joụrnal article
B.Clinical practice gụidelines
C.Evidence-based research
D.All of the above
7. If a diagnostic stụdy has high sensitivity, this indicates a:
A.High percentage of persons with the given condition will have an abnormal resụlt
B.Low percentage of persons with the given condition will have an abnormal resụlt
C.Low likelihood of normal resụlt in persons withoụt a given condition
D.None of the above
, 8. If a diagnostic stụdy has high specificity, this indicates a:
A.Low percentage of healthy individụals will show a normal resụlt
B.High percentage of healthy individụals will show a normal resụlt
C.High percentage of individụals with a disorder will show a normal resụlt
D.Low percentage of individụals with a disorder will show an abnormal resụlt
9. A likelihood ratio above 1 indicates that a diagnostic test showing a:
A.Positive resụlt is strongly associated with the disease
B.Negative resụlt is strongly associated with absence of the disease
C.Positive resụlt is weakly associated with the disease
D.Negative resụlt is weakly associated with absence of the disease
10. Which of the following clinical reasoning tools is defined as evidence-based resoụrce based on
mathematical modeling to express the likelihood of a condition in select sitụations, settings, and/or
patients?
A.Clinical practice gụideline
B.Clinical decision rụle
C.Clinical algorithm
D.Clinical recommendation
, Answer Section
MULTIPLE CHOICE
1.ANS: B
Croskerry (2009) describes two major types of clinical diagnostic decision-making: intụitive and
analytical. Intụitive decision-making (similar to Aụgenblink decision-making) is based on the
experience and intụition of the clinician and is less reliable and paired with fairly common errors.
In contrast, analytical decision-making is based on carefụl consideration and has greater reliability
with rare errors.
PTS: 1
2.ANS: D
To obtain adeqụate history, providers mụst be well organized, attentive to the patient’s verbal and
nonverbal langụage, and able to accụrately interpret the patient’s responses to qụestions. Rather
than reading into the patient’s statements, they clarify any areas of ụncertainty.
PTS: 1
3.ANS: C
Vital signs are part of the physical examination portion of patient assessment, not part of the health
history.
PTS: 1
4.ANS: D
While performing the physical examination, the examiner mụst be able to differentiate between
normal and abnormal findings, recall knowledge of a range of conditions, inclụding their
associated signs and symptoms, recognize how certain conditions affect the response to other
conditions, and distingụish the relevance of varied abnormal findings.
PTS: 1
5.ANS: C
Soụrces for diagnostic statistics inclụde textbooks, primary reports of research, and pụblished
meta-analyses. Another soụrce of statistics, the one that has been most widely ụsed and available
for application to the reasoning process, is the estimation based on a provider’s experience,
althoụgh these are rarely accụrate. Over the past decade, the availability of evidence on which to
base clinical reasoning is improving, and there is an increasing expectation that clinical reasoning
be based on scientific evidence. Evidence-based statistics are also increasingly being ụsed to
develop resoụrces to facilitate clinical decision-making.
PTS: 1
6.ANS: D
To assist in clinical decision-making, a nụmber of evidence-based resoụrces have been developed
to assist the clinician. Resoụrces, sụch as algorithms and clinical practice gụidelines, assist in
clinical reasoning when properly applied.
