Test Bank for Advanced Assessment: Interpreting Findings
and Formulating Differential Diagnoses, 5th Edition, Mary Jo
Goolsby, Laurie Grubbs Chapter 1 - 22 | Complete
,Chapter431.43Assessment43and43Clinical43Decision-Making:43Overview
Multiple43 Choice
Identify43the43choice43that43 best43 completes43the43statementZorZanswers43the43question.
1. Which43 type43 of43 clinical43 decision-making43 is43 most43 reliable?
A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
2. Which43 of43 the43 following43 is43 false?43To43 obtain43 adequate43 history,43 health-
care43providers43 must43 be:
A. Methodical43 and43 systematic
B. Attentive43 to43 the43 patient’s43 verbal43 and43 nonverbal43 language
C. Able43 to43 accurately43 interpret43 the43 patient’s43 responses
D. Adept43 at43 reading43 into43the43 patient’s43 statements
3. Essential43 parts43 of43 a43 health43 history43 include43 all43 of43 the43 followingZexcept:
A. Chief43 complaint
B. History43 of43 the43 present43 illness
C. Current43 vital43 signs
D. All43 of43 the43 above43 are43 essential43 history43 components
4. Which43of43the43following43is43false?43While43performingZthe43physicalZexamination,43the43exam
iner43must43beable43to:
A. Differentiate43 between43 normal43 and43 abnormal43 findings
B. Recall43 knowledge43 of43 a43 range43 of43 conditions43 and43 theirZassociated43 signs43 and43 symptoms
C. Recognize43 how43 certain43 conditions43 affect43 the43 responseZto43 other43 conditions
D. Foresee43 unpredictable43 findings
5. The43 following43 is43 the43 least43 reliableZsource43 of43 information43 for43 diagnostic43 statistics:
A. Evidence-based43 investigations
B. Primary43 reports43 ofZresearch
C. Estimation43 basedZonZa43provider’sZexperience
D. Published43 meta-analyses
6. The43 followingZcan43 be43 used43 toZassist43in43 sound43 clinical43 decision-making:
A. AlgorithmZpublished43inZaZpeer-reviewed43journal43article
B. ClinicalZpractice43guidelines
C. Evidence-basedZresearch
D. All43 of43 theZabove
7. If43 a43 diagnosticZstudy43 has43 high43 sensitivity,43 this43 indicates43 a:
A. High43 percentage43 of43 persons43 with43 the43 given43 condition43 will43 have43 an43 abnormal43 result
B. Low43 percentage43 of43 persons43 with43 the43 given43 condition43 will43 have43 an43 abnormal43 result
C. Low43 likelihood43 of43 normal43 result43 in43 persons43 without43 a43 given43 condition
D. None43 of43 the43 above
, 8. If43 a43 diagnostic43 study43 has43 high43 specificity,43 this43 indicates43 a:
A. Low43 percentage43 of43 healthy43 individuals43 will43 show43 a43 normal43 result
B. High43 percentage43 of43 healthy43 individuals43 will43 show43 a43 normal43 result
C. High43 percentage43 of43 individuals43 with43 a43 disorder43 will43 show43 a43 normal43 result
D. Low43 percentage43 of43 individuals43 with43 a43 disorder43 will43 show43 an43 abnormal43 result
9. A43likelihood43 ratio43 above43143 indicates43 that43 a43 diagnostic43 test43 showing43 a:
A. Positive43 result43 is43 strongly43 associated43 with43 the43 disease
B. Negative43 result43 is43 strongly43 associated43 with43 absence43 of43 the43 disease
C. Positive43 result43 is43 weakly43 associated43 with43 the43 disease
D. Negative43 result43 is43 weakly43 associated43 with43 absence43 of43 the43 disease
4 3 4 3 10.4 3 Which4 3 of4 3 the4 3 following4 3 clinical4 3 reasoning4 3 tools4 3 is4 3 defined4 3 as4 3 evidence-
based43 resource43 based43 on43 mathematical43 modeling43 to43 express43 the43 likelihood43of43 a43 con
dition43 in43selec43t43situations,43settings,43and/orpatients?
A. Clinical43practice43guideli
B. ne43Clinical43decision43rul
C. e43Clinical43algorithm4 3 C
D. linical43recommendation
, Chapter431.43Assessment43and43Clinical43Decis
Answer
ion- 43Section
MULTIPLE43 CHOICE
1. ANS:4 3 4 3 B
Croskerry43 (2009)43 describes43 two43 major43 types43 of43 clinical43 diagnostic43 decision-
making:43intuitive43and43analytical.43Intuitive43decision-
making43(similar43to43Augenblink43decision-
43making)43is43based43on43the43experience43and43intuition43of43the43clinician43and43is43less43reliab
le43and43paired43with43fairly43common43errors.43In43contrast,43analytical43decision-
making43 is43 based43 on43 careful43 consideration43 and43 has43 greater43 reliabilitywith43 rare43 errors.
PTS: 1
2. ANS:4 3 4 3 D
To43obtain43adequate43history,43providers43must43be43well43organized,43attentiveZto43the43patient’
sZverbal43an43dnonverbal43language,43and43able43to43accurately43interpret43the43patient’sZresponse
s43to43questions.43Rather43than43reading43into43the43patient’s43statements,43they43clarify43any43are
as43ofZuncertainty.
PTS: 1
3. ANS:4 3 4 3 C
Vital43signs43are43part43of43the43physical43examination43portionZof43patient43assessment,43not43part43of4
3the43healt43hhistory.
PTS: 1
4. ANS:4 3 4 3 D
While43performing43the43physical43examination,43the43examinerZmust43be43able43to43differentiate43
betweenn43ormal43and43abnormal43findings,43recallZknowledge43ofZa43range43of43conditions,43inclu
ding43theirZassociat43ed43signs43and43symptoms,43recognize43how43certain43conditions43affect43the4
3response43to43other43conditions,43and43distinguish43the43relevance43ofZvaried43abnormalZfindings.
PTS: 1
5. ANS:4 3 4 3 C
Sources43for43diagnosticZstatistics43include43textbooks,43primary43reports43of43research,43and43
published43meta-
analyses.43Another43source43ofZstatistics,43the43one43that43has43been43most43widely43used43and43
available43for43applicationZtoZthe43reasoningZprocess,43is43the43estimation43based43on43a43provide
r’s43experience,43althoug4 3 h43theseZare43rarely43accurate.ZOver43the43past43decade,43the43availab
ility43of43evidence43on43which43to43base43clinical43reasoning43is43improving,43and43there43is43an4
3increasing43expectation43that43clinical43reasoningbe43based43on43scientificZevidence.43Evidence-
based43statisticsZareZalso43increasingly43being43used43to43develop43resources43to43facilitate43clini
cal43decisi43on-making.
PTS: 1
6. ANS:4 3 4 3 D
To43 assist43 in43 clinical43 decision-making,43 a43 number43 of43 evidence-
based43resources43have43been43developedto43assist43the43clinician.43Resources,43such43as43algorith
ms43and43cli43nical43practice43guidelines,43assist43in43clinical43reasoning43when43properly43applied.
hhhhhhhhhh
and Formulating Differential Diagnoses, 5th Edition, Mary Jo
Goolsby, Laurie Grubbs Chapter 1 - 22 | Complete
,Chapter431.43Assessment43and43Clinical43Decision-Making:43Overview
Multiple43 Choice
Identify43the43choice43that43 best43 completes43the43statementZorZanswers43the43question.
1. Which43 type43 of43 clinical43 decision-making43 is43 most43 reliable?
A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
2. Which43 of43 the43 following43 is43 false?43To43 obtain43 adequate43 history,43 health-
care43providers43 must43 be:
A. Methodical43 and43 systematic
B. Attentive43 to43 the43 patient’s43 verbal43 and43 nonverbal43 language
C. Able43 to43 accurately43 interpret43 the43 patient’s43 responses
D. Adept43 at43 reading43 into43the43 patient’s43 statements
3. Essential43 parts43 of43 a43 health43 history43 include43 all43 of43 the43 followingZexcept:
A. Chief43 complaint
B. History43 of43 the43 present43 illness
C. Current43 vital43 signs
D. All43 of43 the43 above43 are43 essential43 history43 components
4. Which43of43the43following43is43false?43While43performingZthe43physicalZexamination,43the43exam
iner43must43beable43to:
A. Differentiate43 between43 normal43 and43 abnormal43 findings
B. Recall43 knowledge43 of43 a43 range43 of43 conditions43 and43 theirZassociated43 signs43 and43 symptoms
C. Recognize43 how43 certain43 conditions43 affect43 the43 responseZto43 other43 conditions
D. Foresee43 unpredictable43 findings
5. The43 following43 is43 the43 least43 reliableZsource43 of43 information43 for43 diagnostic43 statistics:
A. Evidence-based43 investigations
B. Primary43 reports43 ofZresearch
C. Estimation43 basedZonZa43provider’sZexperience
D. Published43 meta-analyses
6. The43 followingZcan43 be43 used43 toZassist43in43 sound43 clinical43 decision-making:
A. AlgorithmZpublished43inZaZpeer-reviewed43journal43article
B. ClinicalZpractice43guidelines
C. Evidence-basedZresearch
D. All43 of43 theZabove
7. If43 a43 diagnosticZstudy43 has43 high43 sensitivity,43 this43 indicates43 a:
A. High43 percentage43 of43 persons43 with43 the43 given43 condition43 will43 have43 an43 abnormal43 result
B. Low43 percentage43 of43 persons43 with43 the43 given43 condition43 will43 have43 an43 abnormal43 result
C. Low43 likelihood43 of43 normal43 result43 in43 persons43 without43 a43 given43 condition
D. None43 of43 the43 above
, 8. If43 a43 diagnostic43 study43 has43 high43 specificity,43 this43 indicates43 a:
A. Low43 percentage43 of43 healthy43 individuals43 will43 show43 a43 normal43 result
B. High43 percentage43 of43 healthy43 individuals43 will43 show43 a43 normal43 result
C. High43 percentage43 of43 individuals43 with43 a43 disorder43 will43 show43 a43 normal43 result
D. Low43 percentage43 of43 individuals43 with43 a43 disorder43 will43 show43 an43 abnormal43 result
9. A43likelihood43 ratio43 above43143 indicates43 that43 a43 diagnostic43 test43 showing43 a:
A. Positive43 result43 is43 strongly43 associated43 with43 the43 disease
B. Negative43 result43 is43 strongly43 associated43 with43 absence43 of43 the43 disease
C. Positive43 result43 is43 weakly43 associated43 with43 the43 disease
D. Negative43 result43 is43 weakly43 associated43 with43 absence43 of43 the43 disease
4 3 4 3 10.4 3 Which4 3 of4 3 the4 3 following4 3 clinical4 3 reasoning4 3 tools4 3 is4 3 defined4 3 as4 3 evidence-
based43 resource43 based43 on43 mathematical43 modeling43 to43 express43 the43 likelihood43of43 a43 con
dition43 in43selec43t43situations,43settings,43and/orpatients?
A. Clinical43practice43guideli
B. ne43Clinical43decision43rul
C. e43Clinical43algorithm4 3 C
D. linical43recommendation
, Chapter431.43Assessment43and43Clinical43Decis
Answer
ion- 43Section
MULTIPLE43 CHOICE
1. ANS:4 3 4 3 B
Croskerry43 (2009)43 describes43 two43 major43 types43 of43 clinical43 diagnostic43 decision-
making:43intuitive43and43analytical.43Intuitive43decision-
making43(similar43to43Augenblink43decision-
43making)43is43based43on43the43experience43and43intuition43of43the43clinician43and43is43less43reliab
le43and43paired43with43fairly43common43errors.43In43contrast,43analytical43decision-
making43 is43 based43 on43 careful43 consideration43 and43 has43 greater43 reliabilitywith43 rare43 errors.
PTS: 1
2. ANS:4 3 4 3 D
To43obtain43adequate43history,43providers43must43be43well43organized,43attentiveZto43the43patient’
sZverbal43an43dnonverbal43language,43and43able43to43accurately43interpret43the43patient’sZresponse
s43to43questions.43Rather43than43reading43into43the43patient’s43statements,43they43clarify43any43are
as43ofZuncertainty.
PTS: 1
3. ANS:4 3 4 3 C
Vital43signs43are43part43of43the43physical43examination43portionZof43patient43assessment,43not43part43of4
3the43healt43hhistory.
PTS: 1
4. ANS:4 3 4 3 D
While43performing43the43physical43examination,43the43examinerZmust43be43able43to43differentiate43
betweenn43ormal43and43abnormal43findings,43recallZknowledge43ofZa43range43of43conditions,43inclu
ding43theirZassociat43ed43signs43and43symptoms,43recognize43how43certain43conditions43affect43the4
3response43to43other43conditions,43and43distinguish43the43relevance43ofZvaried43abnormalZfindings.
PTS: 1
5. ANS:4 3 4 3 C
Sources43for43diagnosticZstatistics43include43textbooks,43primary43reports43of43research,43and43
published43meta-
analyses.43Another43source43ofZstatistics,43the43one43that43has43been43most43widely43used43and43
available43for43applicationZtoZthe43reasoningZprocess,43is43the43estimation43based43on43a43provide
r’s43experience,43althoug4 3 h43theseZare43rarely43accurate.ZOver43the43past43decade,43the43availab
ility43of43evidence43on43which43to43base43clinical43reasoning43is43improving,43and43there43is43an4
3increasing43expectation43that43clinical43reasoningbe43based43on43scientificZevidence.43Evidence-
based43statisticsZareZalso43increasingly43being43used43to43develop43resources43to43facilitate43clini
cal43decisi43on-making.
PTS: 1
6. ANS:4 3 4 3 D
To43 assist43 in43 clinical43 decision-making,43 a43 number43 of43 evidence-
based43resources43have43been43developedto43assist43the43clinician.43Resources,43such43as43algorith
ms43and43cli43nical43practice43guidelines,43assist43in43clinical43reasoning43when43properly43applied.
hhhhhhhhhh
