TEST BANK For Advanced Assessment Interpreting Findings and Formulating Differential Diagnoses, 5th Edition by Goolsby

TEST BANK FOR ADVANCED ASSESSMENT:
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INTERPRETING FINDINGS AND
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FORMULATING DIFFERENTIAL
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DIAGNOSES 5TH EDITION, MARY JO
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GOOLSBY, LAURIE GRUBBS ISBN-10;
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1719645930 / ISBN-13; 978-1719645935
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,Chapter 1. Assessment
n m nm n m and n m Clinical Decision-Making: n m n m Overview

Multiple Choice
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Identify the choice that best completes the statement or answers the question.
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nm 1. Which type of clinical decision-making is most reliable?
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A. Intuitive
B. Analytical
C. Experiential
D. Augenblick

nm 2. Which of the following is false? To obtain adequate history, health-care providers must be:
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A. Methodical and systematic nm nm


B. Attentive to the patient’s verbal and nonverbal language
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C. Able to accurately interpret the patient’s responses
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D. Adept at reading into the patient’s statements
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nm 3. Essential parts of a health history include all of the following except:
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A. Chief complaint nm


B. History of the present illness nm nm nm nm


C. Current vital signs nm nm


D. All of the above are essential history components
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nm 4. Which of the following is false? While performing the physical examination, the examiner
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must beable to:
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A. Differentiate between normal and abnormal findings nm nm nm nm nm


B. Recall knowledge of a range of conditions and their associated signs and symptoms
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C. Recognize how certain conditions affect the response to other conditions
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D. Foresee unpredictable findings nm nm




nm 5. The following is the least reliable source of information for diagnostic statistics:
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A. Evidence-based investigations nm


B. Primary reports of research nm nm nm


C. Estimation based on a provider’s experience nm nm nm nm nm


D. Published meta-analyses nm




nm 6. The following can be used to assist in sound clinical decision-making:
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A. Algorithm published in a peer-reviewed journal article nm nm nm nm nm nm


B. Clinical practice guidelines nm nm


C. Evidence-based research nm


D. All of the above nm nm nm




nm 7. If a diagnostic study has high sensitivity, this indicates a:
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A. High percentage of persons with the given condition will have an abnormal result
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B. Low percentage of persons with the given condition will have an abnormal result
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C. Low likelihood of normal result in persons without a given condition
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D. None of the above nm nm nm

,nm 8. If nm a diagnostic study has high specificity, this indicates a:
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A. Low percentage of healthy individuals will show a normal result
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B. High percentage of healthy individuals will show a normal result
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C. High percentage of individuals with a disorder will show a normal result
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D. Low percentage of individuals with a disorder will show an abnormal result
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nm 9. A likelihood ratio above 1 indicates that a diagnostic test showing a:
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A. Positive result is strongly associated with the disease
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B. Negative result is strongly associated with absence of the disease
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C. Positive result is weakly associated with the disease
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D. Negative result is weakly associated with absence of the disease
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nm nm nm n m 10. Which of the following clinical reasoning tools is defined as evidence-based resource
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nmbased on mathematical modeling to express the likelihood of a condition in select
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nmsituations, settings, and/orpatients?
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A. Clinical practice guideline
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B. Clinical decision rule nm nm


C. Clinical algorithm nm


D. Clinical recommendation nm

, Answer Section
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MULTIPLE CHOICE
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1. ANS: B n m


Croskerry (2009) describes two major types of clinical diagnostic decision-making:
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intuitive and analytical. Intuitive decision-making (similar to Augenblink decision-making)
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is based on the experience and intuition of the clinician and is less reliable and paired
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with fairly common errors. In contrast, analytical decision-making is based on careful
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consideration and has greater reliabilitywith rare errors.
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PTS: 1
2. ANS: D n m


To obtain adequate history, providers must be well organized, attentive to the patient’s
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verbal andnonverbal language, and able to accurately interpret the patient’s responses to
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questions. Rather than reading into the patient’s statements, they clarify any areas of
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uncertainty.
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PTS: 1
3. ANS: C n m


Vital signs are part of the physical examination portion of patient assessment, not part of the
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healthhistory.
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PTS: 1
4. ANS: D n m


While performing the physical examination, the examiner must be able to differentiate
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between normal and abnormal findings, recall knowledge of a range of conditions,
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including their associated signs and symptoms, recognize how certain conditions affect
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the response to other conditions, and distinguish the relevance of varied abnormal
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findings.
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PTS: 1
5. ANS: C n m


Sources for diagnostic statistics include textbooks, primary reports of research, and
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published meta-analyses. Another source of statistics, the one that has been most widely
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used and available for application to the reasoning process, is the estimation based on a
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provider’s experience, although these are rarely accurate. Over the past decade, the
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availability of evidence on which to base clinical reasoning is improving, and there is
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an increasing expectation that clinical reasoningbe based on scientific evidence.
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Evidence-based statistics are also increasingly being used to develop resources to
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facilitate clinical decision-making.
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PTS: 1
6. ANS: D n m


To assist in clinical decision-making, a number of evidence-based resources have been
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developedto assist the clinician. Resources, such as algorithms and clinical practice
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guidelines, assist in clinical reasoning when properly applied.
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