test bank for advanced health assessment clinical diagnosis in primary care 6thedition dains.

TESTBANK 8




ADVANCED HEALTH ASSESSMENT & CLINICAL DIAGNOSIS IN
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PRIMARY CARE, 6TH EDITION
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Joyce E. Dains, Linda Ciofu Baumann & Pamela Scheibel
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Test Bank for Advanced Health Assessment & Clinical Diagnosis in Primary Care 6t
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h Edition Dains 8 8




Chapter81:8Clinical8Reasoning,8Differential8Diagnosis,8Evidence-Based8Practice,8and8Symptom8Analysis

Multiple8Choice
Identify8the8choice8that8best8completes8the8statement8or8answers8the8question.
1. Which8type8of8clinical8decision-making8is8most8reliable?
A. Intuitive
B. Analytical
C. Experiential
D. Augenblick

2. Which8of8the8following8is8false?8To8obtain8adequate8history,8health-care8providers8must8be:
A. Methodical8and8systematic
B. Attentive8to8the8patient’s8verbal8and8nonverbal8language
C. Able8to8accurately8interpret8the8patient’s8responses
D. Adept8at8reading8into8the8patient’s8statements

3. Essential8parts8of8a8health8history8include8all8of8the8following8except:
A. Chief8complaint
B. History8of8the8present8illness
C. Current8vital8signs
D. All8of8the8above8are8essential8history8components

4. Which8of8the8following8is8false?8While8performing8the8physical8examination,8the8examiner8must8be8able8to:
A. Differentiate8between8normal8and8abnormal8findings
B. Recall8knowledge8of8a8range8of8conditions8and8their8associated8signs8and8symptoms
C. Recognize8how8certain8conditions8affect8the8response8to8other8conditions
D. Foresee8unpredictable8 findings

5. The8following8is8the8least8reliable8source8of8information8for8diagnostic8statistics:
A. Evidence-based8investigations
B. Primary8reports8of8research
C. Estimation8based8on8a8provider’s8experience
D. Published8meta-analyses

6. The8following8can8be8used8to8assist8in8sound8clinical8decision-making:
A. Algorithm8published8in8a8peer-reviewed8journal8article
B. Clinical8practice8guidelines
C. Evidence-based8research
D. All8of8the8above

7. If8a8diagnostic8study8has8high8sensitivity,8 this8indicates8a:
A. High8percentage8of8persons8with8the8given8condition8will8have8an8abnormal8result
B. Low8percentage8of8persons8with8the8given8condition8will8have8an8abnormal8result
C. Low8likelihood8of8normal8result8in8persons8without8a8given8condition
D. None8of8the8above

8. If8a8diagnostic8study8has8high8specificity,8this8indicates8a:
A. Low8percentage8of8healthy8individuals8will8show8a8normal8result
B. High8percentage8of8healthy8individuals8will8show8a8normal8result
C. High8percentage8of8individuals8with8a8disorder8will8show8a8normal8result
D. Low8percentage8of8individuals8with8a8disorder8will8show8an8abnormal8result

9. A8likelihood8ratio8above818indicates8that8a8diagnostic8test8showing8a:
A. Positive8result8is8strongly8associated8with8the8disease
B. Negative8result8is8strongly8associated8with8absence8of8the8disease
C. Positive8result8is8weakly8associated8with8the8disease
D. Negative8result8is8weakly8associated8with8absence8of8the8disease

10. Which8of8the8following8clinical8reasoning8tools8is8defined8as8evidence-
based8resource8based8on8mathematical8modeling8to8express8the8likelihood8of8a8condition8in8select8situations,8settings,8and/or8pa
tients?

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A. Clinical8practice8guideline
B. Clinical8decision8rule
C. Clinical8algorithm
Chapter81:8Clinical8reasoning,8differential8diagnosis,8evidence-based8practice,8and8symptom8ana
Answer8Section

MULTIPLE8CHOICE

1. ANS: B
Croskerry8(2009)8describes8two8major8types8of8clinical8diagnostic8decision-making:8intuitive8and8analytical.8Intuitive8decision-
8making8(similar8to8Augenblink8decision-

making)8is8based8on8the8experience8and8intuition8of8the8clinician8and8is8less8reliable8and8paired8with8fairly8common8errors.8In8c
ontrast,8analytical8decision-making8is8based8on8careful8consideration8and8has8greater8reliability8with8rare8errors.

PTS: 1
2. ANS: D
To8obtain8adequate8history,8providers8must8be8well8organized,8attentive8to8the8patient’s8verbal8and8nonverbal8language,8and8able
8to8accurately8interpret8the8patient’s8responses8to8questions.8Rather8than8reading8into8the8patient’s8statements,8they8clarify8any8

areas8of8uncertainty.

PTS: 1
3. ANS: C
Vital8signs8are8part8of8the8physical8examination8portion8of8patient8assessment,8not8part8of8the8health8history.

PTS: 1
4. ANS: D
While8performing8the8physical8examination,8the8examiner8must8be8able8to8differentiate8between8normal8and8abnormal8findings,8r
ecall8knowledge8of8a8range8of8conditions,8including8their8associated8signs8and8symptoms,8recognize8how8certain8conditions8affect
8the8response8to8other8conditions,8and8distinguish8the8relevance8of8varied8abnormal8findings.



PTS: 1
5. ANS: C
Sources8for8diagnostic8statistics8include8textbooks,8primary8reports8of8research,8and8published8meta-
analyses.8Another8source8of8statistics,8the8one8that8has8been8most8widely8used8and8available8for8application8to8the8reasoning8proc
ess,8is8the8estimation8based8on8a8provider’s8experience,8although8these8are8rarely8accurate.8Over8the8past8decade,8the8availabilit
y8of8evidence8on8which8to8base8clinical8reasoning8is8improving,8 and8there8is8an8increasing8expectation8that8clinical8reasoning8b
e8based8on8scientific8evidence.
Evidence-based8statistics8are8also8increasingly8being8used8to8develop8resources8to8facilitate8clinical8 decision-making.

PTS: 1
6. ANS: D
To8assist8in8clinical8decision-making,8a8number8of8evidence-
based8resources8have8been8developed8to8assist8the8clinician.8Resources,8such8as8algorithms8and8clinical8practice8guidelines,8assi
st8in8clinical8reasoning8when8properly8applied.

PTS: 1
7. ANS: A
The8sensitivity8of8a8diagnostic8study8is8the8percentage8of8individuals8with8the8target8condition8who8show8an8abnormal,8or8positive
,8result.8A8high8sensitivity8indicates8that8a8greater8percentage8of8persons8with8the8given8condition8will8have8an8abnormal8result.

PTS: 1
8. ANS: B
The8specificity8of8a8diagnostic8study8is8the8percentage8of8normal,8healthy8individuals8who8have8a8normal8result.8The8greater8the
8specificity,8the8greater8the8percentage8of8individuals8who8will8have8negative,8or8normal,8results8if8they8do8not8have8the8target8

condition.

PTS: 1
9. ANS: A
The8likelihood8ratio8is8the8probability8that8a8positive8test8result8will8be8associated8with8a8person8who8has8the8target8condition8and8
a8negative8result8will8be8associated8with8a8healthy8person.8A8likelihood8ratio8above818indicates8that8a8positive8result8is8associated
8with8the8disease;8a8likelihood8ratio8less8than818indicates8that8a8negative8result8is8associated8with8an8absence8of8the8disease.

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PTS: 1
10. ANS: B
Clinical8decision8(or8prediction)8rules8provide8another8support8for8clinical8reasoning.8Clinical8decision8rules8are8evidence-
based8resources8that8provide8probabilistic8statements8regarding8the8likelihood8that8a8condition8exists8if8certain8variables8are8me
t8with8regard8to8the8prognosis8of8patients8with8specific8findings.8Decision8rules8use8mathematical8models8and8are8specific8to8ce
rtain8situations,8settings,8and/or8patient8characteristics.

PTS: 1