Test Bank for Advanced Assessment: Interpreting Findings
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and Formulating Differential Diagnoses, 5th Edition, Mary Jo
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Goolsby, 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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wl 1. Which type of clinical decision-making is most reliable?
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A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
wl 2. Which of the following is false? To obtain adequate history, health-care providers must be:
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A. Methodical and systematic wl wl
B. Attentive to the patient’s verbal and nonverbal language wl wl wl wl wl wl wl
C. Able to accurately interpret the patient’s responses
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D. Adept at reading into the patient’s statements wl wl wl wl wl wl
Essential parts of a health history include all of the following except:
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wl 3. A. Chief complaint wl
B. History of the present illness wl wl wl wl
C. Current vital signs wl wl
D. All of the above are essential history components
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Which of the following is false? While performing the physical examination, the examiner must
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wl 4. beable to: l w
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A. Differentiate between normal and abnormal findings wl wl wl wl wl
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 wl wl
The following is the least reliable source of information for diagnostic statistics:
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wl 5. A. Evidence-based investigations wl
B. Primary reports of research wl wl wl
C. Estimation based on a provider’s experience wl wl wl wl wl
D. Published meta-analyses wl
The following can be used to assist in sound clinical decision-making:
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wl 6. A. Algorithm published in a peer-reviewed journal article wl wl wl wl wl wl
B. Clinical practice guidelines wl wl
C. Evidence-based research wl
D. All of the above wl wl wl
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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wl 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 wl wl wl
,wl 8. If 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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wl 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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wl wlwlw 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 sel
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ect situations, settings, and/orpatients?
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A. Clinical practice guidelin wl wl
B. eClinical decision rule Cl
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C. inical algorithm Clinical wl wl wl
D. recommendation
, Chapter 1. Assessment and Clinical Decision-
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Answer Section
Making: Overview
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MULTIPLE CHOICE
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1. ANS: B w l
Croskerry (2009) describes two major types of clinical diagnostic decision-
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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 paire
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d with fairly 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 w l
To obtain adequate history, providers must be well organized, attentive to the patient’s verbal
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andnonverbal language, and able to accurately interpret the patient’s responses to questions.
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Rather than reading into the patient’s statements, they clarify any areas of uncertainty.
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PTS: 1
3. ANS: C w l
Vital signs are part of the physical examination portion of patient assessment, not part of the healt
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hhistory. w
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4. ANS: D w l
While performing the physical examination, the examiner must be able to differentiate betwee
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nnormal and abnormal findings, recall knowledge of a range of conditions, including their ass
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ociated signs and symptoms, recognize how certain conditions affect the response to other co
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nditions, and distinguish the relevance of varied abnormal findings.
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5. ANS: C w l
Sources for diagnostic statistics include textbooks, primary reports of research, and published
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meta- wl
analyses. Another source of statistics, the one that has been most widely used and available
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for application to the reasoning process, is the estimation based on a provider’s experience,
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although these are rarely accurate. Over the past decade, the availability of evidence on whi
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ch to base clinical reasoning is improving, and there is an increasing expectation that clinical r
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easoningbe based on scientific evidence. Evidence- w
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based statistics are also increasingly being used to develop resources to facilitate clinical deci
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sion-making.
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6. ANS: D w 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
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clinical practice guidelines, assist in clinical reasoning when properly applied.
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Distributionwlofwlthiswldocumentwliswlillegal
wl wl wl wl wl wl wl
and Formulating Differential Diagnoses, 5th Edition, Mary Jo
wl wl wl wl wl wl wl lw
Goolsby, Laurie GrubbsChapter 1 - 22 | Complete
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l wl wl wl wl wl
,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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wl 1. Which type of clinical decision-making is most reliable?
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A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
wl 2. Which of the following is false? To obtain adequate history, health-care providers must be:
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A. Methodical and systematic wl wl
B. Attentive to the patient’s verbal and nonverbal language wl wl wl wl wl wl wl
C. Able to accurately interpret the patient’s responses
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D. Adept at reading into the patient’s statements wl wl wl wl wl wl
Essential parts of a health history include all of the following except:
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wl 3. A. Chief complaint wl
B. History of the present illness wl wl wl wl
C. Current vital signs wl wl
D. All of the above are essential history components
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Which of the following is false? While performing the physical examination, the examiner must
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wl 4. beable to: l w
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A. Differentiate between normal and abnormal findings wl wl wl wl wl
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 wl wl
The following is the least reliable source of information for diagnostic statistics:
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wl 5. A. Evidence-based investigations wl
B. Primary reports of research wl wl wl
C. Estimation based on a provider’s experience wl wl wl wl wl
D. Published meta-analyses wl
The following can be used to assist in sound clinical decision-making:
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wl 6. A. Algorithm published in a peer-reviewed journal article wl wl wl wl wl wl
B. Clinical practice guidelines wl wl
C. Evidence-based research wl
D. All of the above wl wl wl
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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wl 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 wl wl wl
,wl 8. If 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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wl 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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wl wlwlw 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 sel
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ect situations, settings, and/orpatients?
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l
A. Clinical practice guidelin wl wl
B. eClinical decision rule Cl
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C. inical algorithm Clinical wl wl wl
D. recommendation
, Chapter 1. Assessment and Clinical Decision-
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Answer Section
Making: Overview
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MULTIPLE CHOICE
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1. ANS: B w l
Croskerry (2009) describes two major types of clinical diagnostic decision-
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making: intuitive and analytical. Intuitive decision-making (similar to Augenblink decision-
wl wl wl wl wl wl wl wl wl
making) is based on the experience and intuition of the clinician and is less reliable and paire
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d with fairly 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 w l
To obtain adequate history, providers must be well organized, attentive to the patient’s verbal
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andnonverbal language, and able to accurately interpret the patient’s responses to questions.
w
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Rather than reading into the patient’s statements, they clarify any areas of uncertainty.
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PTS: 1
3. ANS: C w l
Vital signs are part of the physical examination portion of patient assessment, not part of the healt
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hhistory. w
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PTS: 1
4. ANS: D w l
While performing the physical examination, the examiner must be able to differentiate betwee
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nnormal and abnormal findings, recall knowledge of a range of conditions, including their ass
w
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ociated signs and symptoms, recognize how certain conditions affect the response to other co
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nditions, and distinguish the relevance of varied abnormal findings.
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PTS: 1
5. ANS: C w l
Sources for diagnostic statistics include textbooks, primary reports of research, and published
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meta- wl
analyses. Another source of statistics, the one that has been most widely used and available
wl wl wl wl wl wl wl wl wl wl wl wl wl wl wl
for application to the reasoning process, is the estimation based on a provider’s experience,
wl wl wl wl wl wl wl wl wl wl wl wl wl wl
although these are rarely accurate. Over the past decade, the availability of evidence on whi
wl wl wl wl wl wl wl wl wl wl wl wl wl wl
ch to base clinical reasoning is improving, and there is an increasing expectation that clinical r
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easoningbe based on scientific evidence. Evidence- w
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based statistics are also increasingly being used to develop resources to facilitate clinical deci
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sion-making.
PTS: 1
6. ANS: D w 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
wl wl wl wl w
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clinical practice guidelines, assist in clinical reasoning when properly applied.
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