TEST BANK FOR ADVANCED ASSESSMENT:
INTERPRETING FINDINGS AND FORMULATING
DIFFERENTIAL DIAGNOSES 5TH EDITION,
MARY JO GOOLSBY, LAURIE GRUBBS ISBN-10;
1719645930 / ISBN-13; 978-1719645935
# TEST BANK FOR ADVANCED ASSESSMENT: INTERPRETING FINDINGS AND FORMULATING
DIFFERENTIAL DIAGNOSES 5TH EDITION
---
## Chapter 1: Clinical Decision-Making
**1. Which type of clinical decision-making is most reliable?**
A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
**ANS: B**
Crosberry (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
**ANS: D**
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
**ANS: C**
Vital signs are part of the physical examination portion of patient assessment, not part of the health
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
**ANS: D**
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.
---
**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
**ANS: C**
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 the estimation based on a provider's experience, although these
are rarely accurate. 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 used to develop resources to facilitate
clinical decision-making.
---
**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
**ANS: D**
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
**ANS: A**
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.
---
**8. If a diagnostic study has high specificity, this indicates a:**
A. Low percentage of healthy individuals will show a normal result
INTERPRETING FINDINGS AND FORMULATING
DIFFERENTIAL DIAGNOSES 5TH EDITION,
MARY JO GOOLSBY, LAURIE GRUBBS ISBN-10;
1719645930 / ISBN-13; 978-1719645935
# TEST BANK FOR ADVANCED ASSESSMENT: INTERPRETING FINDINGS AND FORMULATING
DIFFERENTIAL DIAGNOSES 5TH EDITION
---
## Chapter 1: Clinical Decision-Making
**1. Which type of clinical decision-making is most reliable?**
A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
**ANS: B**
Crosberry (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
**ANS: D**
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
**ANS: C**
Vital signs are part of the physical examination portion of patient assessment, not part of the health
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
**ANS: D**
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.
---
**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
**ANS: C**
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 the estimation based on a provider's experience, although these
are rarely accurate. 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 used to develop resources to facilitate
clinical decision-making.
---
**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
**ANS: D**
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
**ANS: A**
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.
---
**8. If a diagnostic study has high specificity, this indicates a:**
A. Low percentage of healthy individuals will show a normal result
