NU 650 Quiz 1 Week 3
Timing
auscultation
Anchoring bias
A clinician "locks onto" a patient's description of an aura that precedes her headaches as indicative of a migraine and fails
to recognize red flags of increased intracranial pressure that should prompt neuroimaging for this patient
Availability heuristic
A clinician who has recently seen several patients with acute appendicitis does not consider ovarian torsion in an
adolescent girl presenting with acute right lower quadrant abdominal pain
Confirmation bias
A clinician makes a presumptive diagnosis of an upper respiratory infection in a well-appearing patient presenting with
cough, rhinorrhea, and fever, and does not consider pneumonia even after finding asymmetric chest wall excursion and
dullness to chest percussion on examination
Diagnostic momentum
A clinician does not consider acute myocardial infarction in a patient who was recently diagnosed with acid reflux in the
setting of similar symptoms
,Representation error
Clinician who often sees older patients places diverticular bleed high on her differential diagnosis when evaluating rectal
bleeding in an adolescent patient
Framing effect
A patient is presented as having "frequent emergency room visits for asthma exacerbation in the setting of medication
noncompliance." The clinician fails to explore structural forces that drive medication adherence and fails to explore
alternative causes of the current exacerbation
Visceral bias
Clinician assumes that a patient who is homeless will not be able to manage a complicated treatment plan and prescribes
a simpler, less optimal plan, without discussing the options with the patient
Clinical Reasoning Step 1
Gathering initial patient information (health history and physical examination). · Information gathered: historical
information, findings from your physical examination, and any preliminary diagnostic and laboratory testing. information
you have obtained from other clinicians and from your review of the patient's prior health records.
Clinical Reasoning Step 2
Organizing and interpreting information to synthesize the problem (problem representation). · Organize and interpret
these sets of information with the goal of creating a concise and appropriate problem representation (documented in the
clinical record as the summary statement). Make it a point to ask your supervising clinicians to articulate ("think out loud")
this critical step in the clinical reasoning process. Often, experienced clinicians may not be consciously aware of this
cognitive step.
, Clinical Reasoning Step 3
Generating hypotheses (differential diagnosis) for patient's problem. · From this problem representation, generate,
prioritize, and test a list of possible diagnosis until you have selected a working diagnosis
Clinical Reasoning Step 4
Testing hypotheses until a working diagnosis is selected, one that fits your patient's problem best.
Clinical Reasoning Step 5
Planning the diagnostic and treatment strategy. · Your working diagnosis will then be your basis for selecting your patient's
treatment plan.
Which of the following steps will the NP take before beginning the comprehensive physical examination?
All the above
3 multiple choice options
The student NP realizes that he has missed a component of the physical examination. The best response is for the
student NP to:
Examine that area out of sequence
3 multiple choice options
The beginning NP should focus on interpreting the findings of the physical examination.
False
Timing
auscultation
Anchoring bias
A clinician "locks onto" a patient's description of an aura that precedes her headaches as indicative of a migraine and fails
to recognize red flags of increased intracranial pressure that should prompt neuroimaging for this patient
Availability heuristic
A clinician who has recently seen several patients with acute appendicitis does not consider ovarian torsion in an
adolescent girl presenting with acute right lower quadrant abdominal pain
Confirmation bias
A clinician makes a presumptive diagnosis of an upper respiratory infection in a well-appearing patient presenting with
cough, rhinorrhea, and fever, and does not consider pneumonia even after finding asymmetric chest wall excursion and
dullness to chest percussion on examination
Diagnostic momentum
A clinician does not consider acute myocardial infarction in a patient who was recently diagnosed with acid reflux in the
setting of similar symptoms
,Representation error
Clinician who often sees older patients places diverticular bleed high on her differential diagnosis when evaluating rectal
bleeding in an adolescent patient
Framing effect
A patient is presented as having "frequent emergency room visits for asthma exacerbation in the setting of medication
noncompliance." The clinician fails to explore structural forces that drive medication adherence and fails to explore
alternative causes of the current exacerbation
Visceral bias
Clinician assumes that a patient who is homeless will not be able to manage a complicated treatment plan and prescribes
a simpler, less optimal plan, without discussing the options with the patient
Clinical Reasoning Step 1
Gathering initial patient information (health history and physical examination). · Information gathered: historical
information, findings from your physical examination, and any preliminary diagnostic and laboratory testing. information
you have obtained from other clinicians and from your review of the patient's prior health records.
Clinical Reasoning Step 2
Organizing and interpreting information to synthesize the problem (problem representation). · Organize and interpret
these sets of information with the goal of creating a concise and appropriate problem representation (documented in the
clinical record as the summary statement). Make it a point to ask your supervising clinicians to articulate ("think out loud")
this critical step in the clinical reasoning process. Often, experienced clinicians may not be consciously aware of this
cognitive step.
, Clinical Reasoning Step 3
Generating hypotheses (differential diagnosis) for patient's problem. · From this problem representation, generate,
prioritize, and test a list of possible diagnosis until you have selected a working diagnosis
Clinical Reasoning Step 4
Testing hypotheses until a working diagnosis is selected, one that fits your patient's problem best.
Clinical Reasoning Step 5
Planning the diagnostic and treatment strategy. · Your working diagnosis will then be your basis for selecting your patient's
treatment plan.
Which of the following steps will the NP take before beginning the comprehensive physical examination?
All the above
3 multiple choice options
The student NP realizes that he has missed a component of the physical examination. The best response is for the
student NP to:
Examine that area out of sequence
3 multiple choice options
The beginning NP should focus on interpreting the findings of the physical examination.
False
