test bank for advanced assessment: interpreting findings and formulating differential diagnoses

Test Bank for Advanced Assessment: Interpreting Findings
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and Formulating Differential Diagnoses, 5th Edition, Mary JoGo
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olsby, Laurie GrubbsChapter 1 - 22 | Complete
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,Chapter 1.Assessment and Clinical Decision-Making: Overview
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Multiple Choice
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Identify the choice that best completes the statement or answers the question.
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ll 1. Whichtype ofclinical decision-making is most reliable?
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A. Intuitive
B. Analytical
C. Experiential
D. Augenblick

ll 2. Which ofthe following is false?To obtain adequate history, health-care providers must be:
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A. Methodical and systematic l ll



B. Attentive to the patient’s verbaland nonverbal language ll ll ll ll l ll ll



C. Able to accurately interpret the patient’s responses
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D. Adept at reading into the patient’s statements ll ll ll ll ll l




Essentialparts of a health history include all of the following except:
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ll 3. A. Chiefcomplaint l



B. Historyof the present illness l ll ll ll



C. Current vitalsigns ll l



D. All of the above are essential historycomponents
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Which of the following is false? While performing the physicalexamination, the examiner must beable
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ll 4. to: ll



A. Differentiate between normal and abnormal findings ll ll ll ll ll



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 ll ll ll ll ll ll ll ll ll



D. Foresee unpredictable findings l ll




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



B. Primary reports of research l ll ll



C. Estimation based on a provider’s experience l ll ll ll ll



D. Published meta-analyses ll




The following can be used to assist in sound clinical decision-making:
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ll 6. A. Algorithmpublished in a peer-reviewed journal article l ll ll l ll l



B. Clinical practice guidelines l ll



C. Evidence-based research ll



D. All of the above ll ll ll




Ifa diagnostic studyhas 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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ll 7. 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 ll ll ll

,ll 8. Ifa diagnostic studyhas high specificity, this indicates a:
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A. Low percentage of healthy individuals will show a normalresult
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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 percentageof individuals with a disorder will show an abnormal result
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ll 9. Alikelihood ratio above 1 indicates that a diagnostic test showing a:
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A. Positive result is stronglyassociated with the disease
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B. Negative result is stronglyassociated with absence of the disease
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C. Positive result is weaklyassociated withthe disease
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D. Negative result is weakly associated with absence ofthe disease
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ll lllll l 10. Which of the following clinical reasoning tools is defined as evidence-
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based resource based on mathematical modeling to express the likelihood of a condition in select situ
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ations, settings, and/orpatients?
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A. Clinicalpractice guideline l ll l



B. Clinical decision rule Clini ll ll ll



C. cal algorithm Clinical reco
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D. mmendation

, Chapter 1.Assessment and Clinical Decision-Making: Overview
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AnswerSectionl




MULTIPLECHOICE l




1. ANS: B l l



Croskerry (2009) describes two major types of clinical diagnostic decision- ll ll ll ll ll ll ll ll ll



making: intuitive and analytical. Intuitive decision-making (similar to Augenblink decision-
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making) is based on the experience and intuition of the clinician and is less reliable and paired with fai
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rly common errors. In contrast, analytical decision-
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making is based on careful consideration and has greater reliabilitywith rare errors.
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PTS: 1
2. ANS: D l l



Toobtainadequate history, providers must be well organized, attentive to the patient’s verbalandnon
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verbal language, and able to accurately interpret the patient’s responses to questions. Rather than r
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eading into the patient’s statements, they clarifyany areas of uncertainty.
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PTS: 1
3. ANS: C l l



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



While performing the physical examination, the examiner must be able to differentiate betweennor
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mal and abnormal findings, recall knowledge of a range of conditions, including their associated sign
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s and symptoms, recognize how certain conditions affect the response to other conditions, and disti
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nguish the relevance of varied abnormal findings. ll ll ll ll ll ll




PTS: 1
5. ANS: C l l



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

PTS: 1
6. ANS: D l l



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