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TEST BANK FOR ADVANCED HEALTH ASSESSMENT &
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nx CLINICALDIAGNOSISIN PRIMARYCARE6THEDITION
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DAINS ISBN: 9780323594554
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This Test Bank is Directlyfrom The Publisher
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nxHasAllChaptersWith100%CorrectAnswers
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TestBankfor Advanced Health Assessment & Clinical Diagnosisin Primary Care 6th
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Edition Dains nx nx
Chapter1: Clinical Reasoning, DifferentialDiagnosis, Evidence-Based Practice, and SymptomAnalysis
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MultipleChoice xn
Identifythechoice thatbest completesthestatement oranswers thequestion.
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1. Which type ofclinical decision-makingis mostreliable? nx nx nx nx nx nx x
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A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
2. Which ofthefollowingis false?Toobtainadequatehistory, health-care providers must be: nx nx nx nx nx nx nx nx x
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A. Methodical andsystematic nx nx
B. Attentivetothepatient‘s verbal andnonverballanguage x
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C. Abletoaccuratelyinterpret the patient‘s responses
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D. Adept at readingintothepatient‘s statements
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3. Essential parts of ahealth historyinclude all ofthefollowingexcept: nx nx nx nx nx nx nx nx nx nx nx
A. Chief complaint nx
B. Historyof the present illness x
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C. Currentvital signs nx nx
D. All ofthe above areessential historycomponents
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4. Whichofthe followingis false? Whileperformingthephysical examination,theexaminer must beableto:
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A. Differentiatebetweennormal andabnormal findings nx nx nx nx nx
B. Recallknowledge of arangeofconditionsandtheirassociated signs andsymptoms
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C. Recognize howcertain conditionsaffect theresponsetoother conditions nx nx nx nx nx nx x
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D. Foresee unpredictable findings nx n x
5. Thefollowingistheleast reliablesource ofinformation for diagnosticstatistics:
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A. Evidence-based investigations n x
B. Primaryreports ofresearch x
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C. Estimation based on aprovider‘sexperience nx nx nx nx nx
D. Published meta-analyses n x
6. The followingcan beusedtoassist insound clinical decision-making:
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A. Algorithmpublishedin apeer-reviewed journal article nx nx nx nx nx nx
B. Clinicalpractice guidelines x
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C. Evidence-based research n x
D. All oftheabove
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7. Ifa diagnosticstudyhas high sensitivity, thisindicates a:
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A. High percentage ofpersons withthe given condition will haveanabnormal result
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B. Lowpercentage ofpersonswiththe given condition willhave anabnormal result
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C. Lowlikelihood ofnormal result inpersons without a given condition
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D. None oftheabove nx nx nx
8. Ifa diagnosticstudyhas highspecificity, thisindicates a:
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A. Lowpercentage ofhealthyindividuals will show anormalresult
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B. High percentage ofhealthyindividualswillshow anormal result
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C. High percentage ofindividuals with adisorderwillshowa normal result
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D. Lowpercentage ofindividuals withadisorder will showanabnormal result
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9. Alikelihood ratioabove 1 indicates that adiagnostictestshowinga:
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A. Positive resultis stronglyassociated withthedisease nx nx nx nx nx nx nx
B. Negativeresult isstronglyassociated with absence ofthe disease x
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C. Positiveresult is weaklyassociated with thedisease nx nx nx nx nx nx nx
D. Negativeresultis weaklyassociated withabsence ofthedisease x
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10. Which ofthefollowingclinicalreasoningtoolsisdefined asevidence-based resource based on mathematical modeling to
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express the likelihood of a condition in select situations, settings, and/or patients?
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A. Clinicalpractice guideline x
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B. Clinicaldecision rule x
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C. Clinical algorithm nx
Chapter1:Clinicalreasoning,differentialdiagnosis,evidence-basedpractice,and symptomana
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Answer Section
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MULTIPLECHOICE nx
1. ANS: B
Croskerry (2009) describes two major types of clinical diagnostic decision-making: intuitive and analytical. Intuitive decision-
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making(similar to Augenblink decision-making) is based on the experience and intuition of the clinician andis less reliable and paired
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with fairly common errors. In contrast, analytical decision-making is based on careful consideration and has greater reliability with
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rare errors.
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2. ANS: D
To obtain adequate history, providers must be well organized, attentive tothe patient‘s verbal and nonverbal language, and able to
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accurately interpret the patient‘s responses to questions. Rather than reading into the patient‘s statements, they clarify any areas of
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uncertainty.
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3. ANS: C
Vitalsignsarepart ofthephysical examination portion ofpatient assessment, not part ofthehealth history.
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4. ANS: D
While performing the physical examination, the examiner must be able to differentiate between normal and abnormal findings, recall
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knowledge of a range of conditions, including their associated signs and symptoms, recognize how certain conditions affect the
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response to other conditions, and distinguish the relevance of varied abnormal findings.
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5. ANS: C
Sources for diagnostic statistics include textbooks, primary reports of research, and published meta-analyses. Another source of
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statistics,theonethat hasbeen most widelyusedandavailable for application tothereasoningprocess, istheestimation basedon a
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provider‘s experience, although these are rarely accurate. Over the past decade, the availability of evidence on which to base clinical
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reasoningis improving, and there is an increasing expectation that clinical reasoning be based on scientific evidence.
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Evidence-based statistics are also increasinglybeing used to develop resources to facilitate clinical decision-making. nx nx nx nx nx nx nx nx n x nx nx n x n x
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6. ANS: D
To assist in clinical decision-making, a number of evidence-based resources have been developed toassist the clinician. Resources,
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such as algorithms and clinical practice guidelines, assist in clinical reasoning when properlyapplied.
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7. ANS: A
The sensitivityof a diagnostic studyis the percentage of individuals with the target condition who show an abnormal, or positive, result.
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Ahigh sensitivityindicates that a greater percentage of persons with the given condition will have an abnormal result.
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8. ANS: B
The specificityof a diagnostic studyis the percentage of normal, healthyindividuals who have a normal result. The greater the
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specificity, the greater the percentage of individuals who will have negative, or normal, results if they do not have the target
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condition.
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9. ANS: A
The likelihood ratio is the probabilitythat a positive test result willbe associated with a person who hasthetarget condition and a negative
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result will be associated with a healthy person. A likelihood ratio above 1 indicates that a positive result is associated with the disease; a
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likelihood ratioless than 1 indicates that a negative result is associated with an absence of the disease.
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10. ANS: B
Clinical decision (or prediction) rules provide another support for clinical reasoning. Clinical decision rules are evidence-based
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resources that provide probabilistic statements regarding the likelihood that a condition exists if certain variables are met with regard
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to the prognosis of patients with specific findings. Decision rules use mathematical models and are specific to certain situations,
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settings, and/or patient characteristics.
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