TEST BANK FOR ADVANCED
HEALTH ASSESSMENT & CLINICAL
DIAGNOSIS IN PRIMARY CARE 7TH
EDITION BY JOYCE E. DAINS ALL
CHAPTERS LATEST
Advanced Health Assessment & Clinical Diagnosis in
Primary Care — Exam
Textbook: Dains, Baumann & Scheibel (7th Edition, 2024)
Format: Multiple-choice with bolded correct answers and rationales
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
Rationale: Croskerry (2009) describes two major types of clinical diagnostic decision-
making: intuitive and analytical. Intuitive decision-making (similar to Augenblick
,decision-making) is based on the experience and intuition of the clinician and is less
reliable and paired with fairly common errors. In contrast, analytical decision-making is
based on careful consideration and has greater reliability with rare errors .
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
Rationale: To obtain adequate history, providers must be well organized, attentive to
the patient's verbal and nonverbal language, and able to accurately interpret the
patient's responses to questions. Rather than reading into the patient's statements, they
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
Rationale: Vital signs are part of the physical examination portion of patient
assessment, not part of the health history. The health history includes chief complaint,
history of the present illness, past medical history, family history, and social 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
Rationale: While performing the physical examination, the examiner must be able to
differentiate between normal and abnormal findings, recall knowledge of a range of
conditions including their associated signs and symptoms, recognize how certain
conditions affect the response to other conditions, and distinguish the relevance of
varied abnormal findings. Foreseeing unpredictable findings is not a required skill as
examination findings cannot be predicted with certainty .
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
Rationale: Sources for diagnostic statistics include textbooks, primary reports of
research, and published meta-analyses. Another source of statistics—the one that has
been most widely used and available for application to the reasoning process—is
estimation based on a provider's experience, although these are rarely accurate .
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
Rationale: To assist in clinical decision-making, a number of evidence-based resources
have been developed to assist the clinician. Resources such as algorithms and clinical
practice guidelines assist in clinical reasoning when properly applied .
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
Rationale: The sensitivity of a diagnostic study is the percentage of individuals with the
target condition who show an abnormal, or positive, result. A high sensitivity indicates
that a greater percentage of persons with the given condition will have an abnormal
result. High sensitivity is useful for ruling out a condition when the test is negative
(SnNout) .
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
Rationale: The specificity of a diagnostic study is the percentage of normal, healthy
individuals who have a normal result. The greater the specificity, the greater the
percentage of individuals who will have negative, or normal, results if they do not have
the target condition. High specificity is useful for ruling in a condition when the test is
positive (SpPin) .
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
HEALTH ASSESSMENT & CLINICAL
DIAGNOSIS IN PRIMARY CARE 7TH
EDITION BY JOYCE E. DAINS ALL
CHAPTERS LATEST
Advanced Health Assessment & Clinical Diagnosis in
Primary Care — Exam
Textbook: Dains, Baumann & Scheibel (7th Edition, 2024)
Format: Multiple-choice with bolded correct answers and rationales
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
Rationale: Croskerry (2009) describes two major types of clinical diagnostic decision-
making: intuitive and analytical. Intuitive decision-making (similar to Augenblick
,decision-making) is based on the experience and intuition of the clinician and is less
reliable and paired with fairly common errors. In contrast, analytical decision-making is
based on careful consideration and has greater reliability with rare errors .
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
Rationale: To obtain adequate history, providers must be well organized, attentive to
the patient's verbal and nonverbal language, and able to accurately interpret the
patient's responses to questions. Rather than reading into the patient's statements, they
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
Rationale: Vital signs are part of the physical examination portion of patient
assessment, not part of the health history. The health history includes chief complaint,
history of the present illness, past medical history, family history, and social 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
Rationale: While performing the physical examination, the examiner must be able to
differentiate between normal and abnormal findings, recall knowledge of a range of
conditions including their associated signs and symptoms, recognize how certain
conditions affect the response to other conditions, and distinguish the relevance of
varied abnormal findings. Foreseeing unpredictable findings is not a required skill as
examination findings cannot be predicted with certainty .
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
Rationale: Sources for diagnostic statistics include textbooks, primary reports of
research, and published meta-analyses. Another source of statistics—the one that has
been most widely used and available for application to the reasoning process—is
estimation based on a provider's experience, although these are rarely accurate .
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
Rationale: To assist in clinical decision-making, a number of evidence-based resources
have been developed to assist the clinician. Resources such as algorithms and clinical
practice guidelines assist in clinical reasoning when properly applied .
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
Rationale: The sensitivity of a diagnostic study is the percentage of individuals with the
target condition who show an abnormal, or positive, result. A high sensitivity indicates
that a greater percentage of persons with the given condition will have an abnormal
result. High sensitivity is useful for ruling out a condition when the test is negative
(SnNout) .
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
Rationale: The specificity of a diagnostic study is the percentage of normal, healthy
individuals who have a normal result. The greater the specificity, the greater the
percentage of individuals who will have negative, or normal, results if they do not have
the target condition. High specificity is useful for ruling in a condition when the test is
positive (SpPin) .
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
