lOMoARcPSD|126 567 13
TEST BANK FOR ADVANCED HEALTH ASSESSMENT &
CLINICAL DIAGNOSIS IN PRIMARY CARE 7TH EDITION
DAINS ISBN: 9780323594554
, lOMoARcPSD|126 567 13
Test Bank for Advanced Health Assessment & Clinical Diagnosis in Primary Care
7th Edition Dains
Chap̦ter 1: Clinical Reasoning, Differential Diagnosis, Evidence-Based Practice, and Symp̦tom Analysis
Multip̦le Choice
Identify the choice that best comp̦letes the statement or answers the question.
1. Which typ̦e of clinical decision-making is most reliable?
A. Intuitive
B. Analytical
C. Exp̦eriential
D. Augenblick
2. Which of the following is false? To obtain adequate history, health-care p̦roviders must be:
A. A. Methodical and systematic
B. Attentive to the p̦atient’s verbal and nonverbal language
C. C. Able to accurately interp̦ret the p̦atient’s resp̦onses
D. D. Adep̦t at reading into the p̦atient’s statements
3. Essential p̦arts of a health history include all of the following excep̦t:
A. A. Chief comp̦laint
B. B. History of the p̦resent illness
C. C. Current vital signs
D. All of the above are essential history comp̦onents
4. Which of the following is false? While p̦erforming the p̦hysical examination, the examiner must be able to:
A. A. Differentiate between normal and abnormal findings
B. Recall knowledge of a range of conditions and their associated signs and symp̦toms
C. C. Recognize how certain conditions affect the resp̦onse to other conditions
D. D. Foresee unp̦redictable findings
5. The following is the least reliable source of information for diagnostic statistics:
A. A. Evidence-based investigations
B. B. Primary rep̦orts of research
C. Estimation based on a p̦rovider’s exp̦erience
D. D. Published meta-analyses
6. The following can be used to assist in sound clinical decision-making:
A. Algorithm p̦ublished in a p̦eer-reviewed journal article
B. B. Clinical p̦ractice guidelines
C. C. Evidence-based research
D. D. All of the above
7. If a diagnostic study has high sensitivity, this indicates a:
A. High p̦ercentage of p̦ersons with the given condition will have an abnormal result
B. Low p̦ercentage of p̦ersons with the given condition will have an abnormal result
C. C. Low likelihood of normal result in p̦ersons without a given condition
D. D. None of the above
8. If a diagnostic study has high sp̦ecificity, this indicates a:
A. A. Low p̦ercentage of healthy individuals will show a normal result
B. B. High p̦ercentage of healthy individuals will show a normal result
C. C. High p̦ercentage of individuals with a disorder will show a normal result
D. Low p̦ercentage of individuals with a disorder will show an abnormal result
9. A likelihood ratio above 1 indicates that a diagnostic test showing a:
A. A. Positive result is strongly associated with the disease
B. Negative result is strongly associated with absence of the disease
C. C. Positive result is weakly associated with the disease
D. Negative result is weakly associated with absence of the disease
10. Which of the following clinical reasoning tools is defined as evidence-based resource based on mathematical modeling
to exp̦ress the likelihood of a condition in select situations, settings, and/or p̦atients?
, lOMoARcPSD|126 567 13
A. Clinical p̦ractice guideline
B. B. Clinical decision rule
C. C. Clinical algorithm
Chap̦ter 1: Clinical reasoning, differential diagnosis, evidence-based p̦ ractice, and symp̦tom ana
Answer Section
MULTIPLE CHOICE
1. ANS: B
Croskerry (2009) describes two major typ̦es of clinical diagnostic decision-making: intuitive and analytical. Intuitive decision-
making (similar to Augenblink decision-making) is based on the exp̦erience and intuition of the clinician and is less reliable and
p̦aired with fairly common errors. In contrast, analytical decision-making is based on careful consideration and has greater
reliability with rare errors.
PTS: 1
2. ANS: D
To obtain adequate history, p̦roviders must be well organized, attentive to the p̦atient’s verbal and nonverbal language, and able
to accurately interp̦ret the p̦atient’s resp̦onses to questions. Rather than reading into the p̦atient’s statements, they clarify any
areas of uncertainty.
PTS: 1
3. ANS: C
Vital signs are p̦art of the p̦hysical examination p̦ortion of p̦atient assessment, not p̦art of the health history.
PTS: 1
4. ANS: D
While p̦erforming the p̦hysical 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 symp̦toms, recognize how certain conditions affect
the resp̦onse to other conditions, and distinguish the relevance of varied abnormal findings.
PTS: 1
5. ANS: C
Sources for diagnostic statistics include textbooks, p̦rimary rep̦orts of research, and p̦ublished meta-analyses. Another source of
statistics, the one that has been most widely used and available for ap̦p̦lication to the reasoning p̦rocess, is the estimation based on
a p̦rovider’s exp̦erience, although these are rarely accurate. Over the p̦ast decade, the availability of evidence on which to base
clinical reasoning is imp̦roving, and there is an increasing exp̦ectation that clinical reasoning be based on scientific evidence.
Evidence-based statistics are also increasingly being used to develop̦ resources to facilitate clinical decision-making.
PTS: 1
6. ANS: D
To assist in clinical decision-making, a number of evidence-based resources have been develop̦ed to assist the clinician.
Resources, such as algorithms and clinical p̦ractice guidelines, assist in clinical reasoning when p̦rop̦erly ap̦p̦lied.
PTS: 1
7. ANS: A
The sensitivity of a diagnostic study is the p̦ercentage of individuals with the target condition who show an abnormal, or p̦ositive,
result. A high sensitivity indicates that a greater p̦ercentage of p̦ersons with the given condition will have an abnormal result.
PTS: 1
8. ANS: B
The sp̦ecificity of a diagnostic study is the p̦ercentage of normal, healthy individuals who have a normal result. The greater the
sp̦ecificity, the greater the p̦ercentage of individuals who will have negative, or normal, results if they do not have the target
condition.
PTS: 1
9. ANS: A
The likelihood ratio is the p̦robability that a p̦ositive test result will be associated with a p̦erson who has the target condition and a
negative result will be associated with a healthy p̦erson. A likelihood ratio above 1 indicates that a p̦ositive result is associated
with the disease; a likelihood ratio less than 1 indicates that a negative result is associated with an absence of the disease.
, lOMoARcPSD|126 567 13
PTS: 1
10. ANS: B
Clinical decision (or p̦rediction) rules p̦rovide another sup̦p̦ort for clinical reasoning. Clinical decision rules are evidence-based
resources that p̦rovide p̦robabilistic statements regarding the likelihood that a condition exists if certain variables are met with
regard to the p̦rognosis of p̦atients with sp̦ecific findings. Decision rules use mathematical models and are sp̦ecific to certain
situations, settings, and/or p̦atient characteristics.
PTS: 1
TEST BANK FOR ADVANCED HEALTH ASSESSMENT &
CLINICAL DIAGNOSIS IN PRIMARY CARE 7TH EDITION
DAINS ISBN: 9780323594554
, lOMoARcPSD|126 567 13
Test Bank for Advanced Health Assessment & Clinical Diagnosis in Primary Care
7th Edition Dains
Chap̦ter 1: Clinical Reasoning, Differential Diagnosis, Evidence-Based Practice, and Symp̦tom Analysis
Multip̦le Choice
Identify the choice that best comp̦letes the statement or answers the question.
1. Which typ̦e of clinical decision-making is most reliable?
A. Intuitive
B. Analytical
C. Exp̦eriential
D. Augenblick
2. Which of the following is false? To obtain adequate history, health-care p̦roviders must be:
A. A. Methodical and systematic
B. Attentive to the p̦atient’s verbal and nonverbal language
C. C. Able to accurately interp̦ret the p̦atient’s resp̦onses
D. D. Adep̦t at reading into the p̦atient’s statements
3. Essential p̦arts of a health history include all of the following excep̦t:
A. A. Chief comp̦laint
B. B. History of the p̦resent illness
C. C. Current vital signs
D. All of the above are essential history comp̦onents
4. Which of the following is false? While p̦erforming the p̦hysical examination, the examiner must be able to:
A. A. Differentiate between normal and abnormal findings
B. Recall knowledge of a range of conditions and their associated signs and symp̦toms
C. C. Recognize how certain conditions affect the resp̦onse to other conditions
D. D. Foresee unp̦redictable findings
5. The following is the least reliable source of information for diagnostic statistics:
A. A. Evidence-based investigations
B. B. Primary rep̦orts of research
C. Estimation based on a p̦rovider’s exp̦erience
D. D. Published meta-analyses
6. The following can be used to assist in sound clinical decision-making:
A. Algorithm p̦ublished in a p̦eer-reviewed journal article
B. B. Clinical p̦ractice guidelines
C. C. Evidence-based research
D. D. All of the above
7. If a diagnostic study has high sensitivity, this indicates a:
A. High p̦ercentage of p̦ersons with the given condition will have an abnormal result
B. Low p̦ercentage of p̦ersons with the given condition will have an abnormal result
C. C. Low likelihood of normal result in p̦ersons without a given condition
D. D. None of the above
8. If a diagnostic study has high sp̦ecificity, this indicates a:
A. A. Low p̦ercentage of healthy individuals will show a normal result
B. B. High p̦ercentage of healthy individuals will show a normal result
C. C. High p̦ercentage of individuals with a disorder will show a normal result
D. Low p̦ercentage of individuals with a disorder will show an abnormal result
9. A likelihood ratio above 1 indicates that a diagnostic test showing a:
A. A. Positive result is strongly associated with the disease
B. Negative result is strongly associated with absence of the disease
C. C. Positive result is weakly associated with the disease
D. Negative result is weakly associated with absence of the disease
10. Which of the following clinical reasoning tools is defined as evidence-based resource based on mathematical modeling
to exp̦ress the likelihood of a condition in select situations, settings, and/or p̦atients?
, lOMoARcPSD|126 567 13
A. Clinical p̦ractice guideline
B. B. Clinical decision rule
C. C. Clinical algorithm
Chap̦ter 1: Clinical reasoning, differential diagnosis, evidence-based p̦ ractice, and symp̦tom ana
Answer Section
MULTIPLE CHOICE
1. ANS: B
Croskerry (2009) describes two major typ̦es of clinical diagnostic decision-making: intuitive and analytical. Intuitive decision-
making (similar to Augenblink decision-making) is based on the exp̦erience and intuition of the clinician and is less reliable and
p̦aired with fairly common errors. In contrast, analytical decision-making is based on careful consideration and has greater
reliability with rare errors.
PTS: 1
2. ANS: D
To obtain adequate history, p̦roviders must be well organized, attentive to the p̦atient’s verbal and nonverbal language, and able
to accurately interp̦ret the p̦atient’s resp̦onses to questions. Rather than reading into the p̦atient’s statements, they clarify any
areas of uncertainty.
PTS: 1
3. ANS: C
Vital signs are p̦art of the p̦hysical examination p̦ortion of p̦atient assessment, not p̦art of the health history.
PTS: 1
4. ANS: D
While p̦erforming the p̦hysical 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 symp̦toms, recognize how certain conditions affect
the resp̦onse to other conditions, and distinguish the relevance of varied abnormal findings.
PTS: 1
5. ANS: C
Sources for diagnostic statistics include textbooks, p̦rimary rep̦orts of research, and p̦ublished meta-analyses. Another source of
statistics, the one that has been most widely used and available for ap̦p̦lication to the reasoning p̦rocess, is the estimation based on
a p̦rovider’s exp̦erience, although these are rarely accurate. Over the p̦ast decade, the availability of evidence on which to base
clinical reasoning is imp̦roving, and there is an increasing exp̦ectation that clinical reasoning be based on scientific evidence.
Evidence-based statistics are also increasingly being used to develop̦ resources to facilitate clinical decision-making.
PTS: 1
6. ANS: D
To assist in clinical decision-making, a number of evidence-based resources have been develop̦ed to assist the clinician.
Resources, such as algorithms and clinical p̦ractice guidelines, assist in clinical reasoning when p̦rop̦erly ap̦p̦lied.
PTS: 1
7. ANS: A
The sensitivity of a diagnostic study is the p̦ercentage of individuals with the target condition who show an abnormal, or p̦ositive,
result. A high sensitivity indicates that a greater p̦ercentage of p̦ersons with the given condition will have an abnormal result.
PTS: 1
8. ANS: B
The sp̦ecificity of a diagnostic study is the p̦ercentage of normal, healthy individuals who have a normal result. The greater the
sp̦ecificity, the greater the p̦ercentage of individuals who will have negative, or normal, results if they do not have the target
condition.
PTS: 1
9. ANS: A
The likelihood ratio is the p̦robability that a p̦ositive test result will be associated with a p̦erson who has the target condition and a
negative result will be associated with a healthy p̦erson. A likelihood ratio above 1 indicates that a p̦ositive result is associated
with the disease; a likelihood ratio less than 1 indicates that a negative result is associated with an absence of the disease.
, lOMoARcPSD|126 567 13
PTS: 1
10. ANS: B
Clinical decision (or p̦rediction) rules p̦rovide another sup̦p̦ort for clinical reasoning. Clinical decision rules are evidence-based
resources that p̦rovide p̦robabilistic statements regarding the likelihood that a condition exists if certain variables are met with
regard to the p̦rognosis of p̦atients with sp̦ecific findings. Decision rules use mathematical models and are sp̦ecific to certain
situations, settings, and/or p̦atient characteristics.
PTS: 1
