r1
, r1
Test Bank for Advanced Health Assessment & Clinical Diagnosis in Primary Care 7t
r1 r1 r1 r1 r1 r1 r1 r1 r1 r1 r1 r1
h Edition Dains r1 r1
Chapter 1: Clinical Reasoning, Differential Diagnosis, Evidence-Based Practice, and Symptom Analysis
r1 r1 r1 r1 r1 r1 r1 r1 r1 r1
Multiple Choicer1
Identify the choice that best completes the statement or answers the question.
r1 r1 r1 r1 r1 r1 r1 r1 r1 r1 r1
1. Whichr1typer1ofr1clinicalr1decision-makingr1isr1mostr1reliable?
A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
2. Whichr1ofr1ther1followingr1isr1false?r1Tor1obtainr1adequater1history,r1health-carer1providersr1mustr1be:
A. Methodicalr1andr1systematic
B. Attentiver1tor1ther1patient‘sr1verbalr1andr1nonverbalr1language
C. Abler1tor1accuratelyr1interpretr1ther1patient‘sr1responses
D. Adeptr1atr1readingr1intor1ther1patient‘sr1statements
3. Essentialr1partsr1ofr1ar1healthr1historyr1includer1allr1ofr1ther1followingr1except:
A. Chiefr1complaint
B. Historyr1ofr1ther1presentr1illness
C. Currentr1vitalr1signs
D. Allr1ofr1ther1abover1arer1essentialr1historyr1components
4. Whichr1ofr1ther1followingr1isr1false?r1Whiler1performingr1ther1physicalr1examination,r1ther1examinerr1mustr1ber1abler1to:
A. Differentiater1betweenr1normalr1andr1abnormalr1findings
B. Recallr1knowledger1ofr1ar1ranger1ofr1conditionsr1andr1theirr1associatedr1signsr1andr1symptom
s
C. Recognizer1howr1certainr1conditionsr1affectr1ther1responser1tor1otherr1conditions
D. Foreseer1unpredictabler 1 findings
5. Ther1followingr1isr1ther1leastr1reliabler1sourcer1ofr1informationr1forr1diagnosticr1statistics:
A. Evidence-basedr 1 investigations
B. Primaryr1reportsr1ofr1research
C. Estimationr1basedr1onr1ar1provider‘sr1experience
D. Publishedr 1 meta-analyses
6. Ther1followingr1canr1ber1usedr1tor1assistr1inr1soundr1clinicalr1decision-making:
A. Algorithmr1publishedr1inr1ar1peer-reviewedr1journalr1article
B. Clinicalr1practicer1guidelines
C. Evidence-basedr 1 research
D. Allr1ofr1ther1above
7. Ifr1ar1diagnosticr1studyr1hasr1highr1sensitivity,r1 thisr1indicatesr1a:
A. Highr1percentager1ofr1personsr1withr1ther1givenr1conditionr1willr1haver1anr1abnormalr1resul
t
B. Lowr1percentager1ofr1personsr1withr1ther1givenr1conditionr1willr1haver1anr1abnormalr1resul
t
C. Lowr1likelihoodr1ofr1normalr1resultr1inr1personsr1withoutr1ar1givenr1condition
D. Noner1ofr1ther1above
8. Ifr1ar1diagnosticr1studyr1hasr1highr1specificity,r1 thisr1indicatesr1a:
A. Lowr1percentager1ofr1healthyr1individualsr1willr1showr1ar1normalr1result
B. Highr1percentager1ofr1healthyr1individualsr1willr1showr1ar1normalr1result
C. Highr1percentager1ofr1individualsr1withr1ar1disorderr1willr1showr1ar1normalr1result
D. Lowr1percentager1ofr1individualsr1withr1ar1disorderr1willr1showr1anr1abnormalr1resu
lt
9. Ar1likelihoodr1ratior1abover11r1indicatesr1thatr1ar1diagnosticr1testr1showingr1a:
A. Positiver1resultr1isr1stronglyr1associatedr1withr1ther1disease
B. Negativer1resultr1isr1stronglyr1associatedr1withr1absencer1ofr1ther1diseas
e
C. Positiver1resultr1isr1weaklyr1associatedr1withr1ther1disease
D. Negativer1resultr1isr1weaklyr1associatedr1withr1absencer1ofr1ther1disease
10. Whichr1ofr1ther1followingr1clinicalr1reasoningr1toolsr1isr1definedr1asr1evidence-
basedr1resourcer1basedr1onr1mathematicalr1modelingr1tor1expressr1ther1likelihoodr1ofr1ar1conditionr1inr1selectr1situations,r1settings,r1and/or
r1patients?
, r1
A. Clinicalr1practicer1guideline
B. Clinicalr1decisionr1rule
C. Clinicalr1algorithm
Chapter 1: Clinical reasoning, differential diagnosis, evidence-based practice, and symptom ana
r1 r1 r1 r1 r1 r1 r1 r1 r1 r1
Answer Section
r1
MULTIPLEr1CHOICE
1. ANS: B
Croskerryr1(2009)r1describesr1twor1majorr1typesr1ofr1clinicalr1diagnosticr1decision-
making:r1intuitiver1andr1analytical.r1Intuitiver1decision-r1makingr1(similarr1tor1Augenblinkr1decision-
making)r1isr1basedr1onr1ther1experiencer1andr1intuitionr1ofr1ther1clinicianr1andr1isr1lessr1reliabler1andr1pairedr1withr1fairlyr1commonr1errors.r1I
nr1contrast,r1analyticalr1decision-makingr1isr1basedr1onr1carefulr1considerationr1andr1hasr1greaterr1reliabilityr1withr1rarer1errors.
PTS: 1
2. ANS: D
Tor1obtainr1adequater1history,r1providersr1mustr1ber1wellr1organized,r1attentiver1tor1ther1patient‘sr1verbalr1andr1nonverbalr1language,r1andr1a
bler1tor1accuratelyr1interpretr1ther1patient‘sr1responsesr1tor1questions.r1Ratherr1thanr1readingr1intor1ther1patient‘sr1statements,r1theyr1clarif
yr1anyr1areasr1ofr1uncertainty.
PTS: 1
3. ANS: C
Vitalr1signsr1arer1partr1ofr1ther1physicalr1examinationr1portionr1ofr1patientr1assessment,r1notr1partr1ofr1ther1healthr1history.
PTS: 1
4. ANS: D
Whiler1performingr1ther1physicalr1examination,r1ther1examinerr1mustr1ber1abler1tor1differentiater1betweenr1normalr1andr1abnormalr1findin
gs,r1recallr1knowledger1ofr1ar1ranger1ofr1conditions,r1includingr1theirr1associatedr1signsr1andr1symptoms,r1recognizer1howr1certainr1conditio
nsr1affectr1ther1responser1tor1otherr1conditions,r1andr1distinguishr1ther1relevancer1ofr1variedr1abnormalr1findings.
PTS: 1
5. ANS: C
Sourcesr1forr1diagnosticr1statisticsr1includer1textbooks,r1primaryr1reportsr1ofr1research,r1andr1publishedr1meta-
analyses.r1Anotherr1sourcer1ofr1statistics,r1ther1oner1thatr1hasr1beenr1mostr1widelyr1usedr1andr1availabler1forr1applicationr1tor1ther1reasoningr1p
rocess,r1isr1ther1estimationr1basedr1onr1ar1provider‘sr1experience,r1althoughr1theser1arer1rarelyr1accurate.r1Overr1ther1pastr1decade,r1ther1avai
labilityr1ofr1evidencer1onr1whichr1tor1baser1clinicalr1reasoningr1isr1improving,r 1 andr1therer1isr1anr1increasingr1expectationr1thatr1clinicalr1re
asoningr1ber1basedr1onr1scientificr1evidence.
Evidence-basedr1statisticsr1 arer1 alsor1increasinglyr1beingr1usedr1tor1developr 1 resourcesr1tor1facilitater 1 clinicalr 1 decision-making.
PTS: 1
6. ANS: D
Tor1assistr1inr1clinicalr1decision-making,r1ar1numberr1ofr1evidence-
basedr1resourcesr1haver1beenr1developedr1tor1assistr1ther1clinician.r1Resources,r1suchr1asr1algorithmsr1andr1clinicalr1practicer1guidelines,r1
assistr1inr1clinicalr1reasoningr1whenr1properlyr1applied.
PTS: 1
7. ANS: A
Ther1sensitivityr1ofr1ar1diagnosticr1studyr1isr1ther1percentager1ofr1individualsr1withr1ther1targetr1conditionr1whor1showr1anr1abnormal,r1orr 1 pos
itive,r1result.r1Ar1highr1sensitivityr1indicatesr1thatr1ar1greaterr1percentager1ofr1personsr1withr1ther1givenr1conditionr1willr1haver1anr1abnormalr1
result.
PTS: 1
8. ANS: B
Ther1specificityr1ofr1ar1diagnosticr1studyr1isr1ther1percentager1ofr1normal,r1healthyr1individualsr1whor1haver1ar1normalr1result.r1Ther1greaterr1
ther1specificity,r1ther1greaterr1ther1percentager1ofr1individualsr1whor1willr1haver1negative,r1orr1normal,r1resultsr1ifr1theyr1dor1notr1haver1ther1
targetr1condition.
PTS: 1
9. ANS: A
Ther1likelihoodr1ratior1isr1ther1probabilityr1thatr1ar1positiver1testr1resultr1willr1ber1associatedr1withr1ar1personr1whor1hasr1ther1targetr1conditionr1
andr1ar1negativer1resultr1willr1ber1associatedr1withr1ar1healthyr1person.r1Ar1likelihoodr1ratior1abover11r1indicatesr1thatr1ar1positiver1resultr1isr1a
ssociatedr1withr1ther1disease;r1ar1likelihoodr1ratior1lessr1thanr11r1indicatesr1thatr1ar1negativer1resultr1isr1associatedr1withr1anr1absencer1ofr1ther1
disease.
, r1
PTS: 1
10. ANS: B
Clinicalr1decisionr1(orr1prediction)r1rulesr1provider1anotherr1supportr1forr1clinicalr1reasoning.r1Clinicalr1decisionr1rulesr1arer1evidence-
basedr1resourcesr1thatr1provider1probabilisticr1statementsr1regardingr1ther1likelihoodr1thatr1ar1conditionr1existsr1ifr1certainr1variablesr1arer1
metr1withr1regardr1tor1ther1prognosisr1ofr1patientsr1withr1specificr1findings.r1Decisionr1rulesr1user1mathematicalr1modelsr1andr1arer1specifi
cr1tor1certainr1situations,r1settings,r1and/orr1patientr1characteristics.
PTS: 1
, r1
Test Bank for Advanced Health Assessment & Clinical Diagnosis in Primary Care 7t
r1 r1 r1 r1 r1 r1 r1 r1 r1 r1 r1 r1
h Edition Dains r1 r1
Chapter 1: Clinical Reasoning, Differential Diagnosis, Evidence-Based Practice, and Symptom Analysis
r1 r1 r1 r1 r1 r1 r1 r1 r1 r1
Multiple Choicer1
Identify the choice that best completes the statement or answers the question.
r1 r1 r1 r1 r1 r1 r1 r1 r1 r1 r1
1. Whichr1typer1ofr1clinicalr1decision-makingr1isr1mostr1reliable?
A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
2. Whichr1ofr1ther1followingr1isr1false?r1Tor1obtainr1adequater1history,r1health-carer1providersr1mustr1be:
A. Methodicalr1andr1systematic
B. Attentiver1tor1ther1patient‘sr1verbalr1andr1nonverbalr1language
C. Abler1tor1accuratelyr1interpretr1ther1patient‘sr1responses
D. Adeptr1atr1readingr1intor1ther1patient‘sr1statements
3. Essentialr1partsr1ofr1ar1healthr1historyr1includer1allr1ofr1ther1followingr1except:
A. Chiefr1complaint
B. Historyr1ofr1ther1presentr1illness
C. Currentr1vitalr1signs
D. Allr1ofr1ther1abover1arer1essentialr1historyr1components
4. Whichr1ofr1ther1followingr1isr1false?r1Whiler1performingr1ther1physicalr1examination,r1ther1examinerr1mustr1ber1abler1to:
A. Differentiater1betweenr1normalr1andr1abnormalr1findings
B. Recallr1knowledger1ofr1ar1ranger1ofr1conditionsr1andr1theirr1associatedr1signsr1andr1symptom
s
C. Recognizer1howr1certainr1conditionsr1affectr1ther1responser1tor1otherr1conditions
D. Foreseer1unpredictabler 1 findings
5. Ther1followingr1isr1ther1leastr1reliabler1sourcer1ofr1informationr1forr1diagnosticr1statistics:
A. Evidence-basedr 1 investigations
B. Primaryr1reportsr1ofr1research
C. Estimationr1basedr1onr1ar1provider‘sr1experience
D. Publishedr 1 meta-analyses
6. Ther1followingr1canr1ber1usedr1tor1assistr1inr1soundr1clinicalr1decision-making:
A. Algorithmr1publishedr1inr1ar1peer-reviewedr1journalr1article
B. Clinicalr1practicer1guidelines
C. Evidence-basedr 1 research
D. Allr1ofr1ther1above
7. Ifr1ar1diagnosticr1studyr1hasr1highr1sensitivity,r1 thisr1indicatesr1a:
A. Highr1percentager1ofr1personsr1withr1ther1givenr1conditionr1willr1haver1anr1abnormalr1resul
t
B. Lowr1percentager1ofr1personsr1withr1ther1givenr1conditionr1willr1haver1anr1abnormalr1resul
t
C. Lowr1likelihoodr1ofr1normalr1resultr1inr1personsr1withoutr1ar1givenr1condition
D. Noner1ofr1ther1above
8. Ifr1ar1diagnosticr1studyr1hasr1highr1specificity,r1 thisr1indicatesr1a:
A. Lowr1percentager1ofr1healthyr1individualsr1willr1showr1ar1normalr1result
B. Highr1percentager1ofr1healthyr1individualsr1willr1showr1ar1normalr1result
C. Highr1percentager1ofr1individualsr1withr1ar1disorderr1willr1showr1ar1normalr1result
D. Lowr1percentager1ofr1individualsr1withr1ar1disorderr1willr1showr1anr1abnormalr1resu
lt
9. Ar1likelihoodr1ratior1abover11r1indicatesr1thatr1ar1diagnosticr1testr1showingr1a:
A. Positiver1resultr1isr1stronglyr1associatedr1withr1ther1disease
B. Negativer1resultr1isr1stronglyr1associatedr1withr1absencer1ofr1ther1diseas
e
C. Positiver1resultr1isr1weaklyr1associatedr1withr1ther1disease
D. Negativer1resultr1isr1weaklyr1associatedr1withr1absencer1ofr1ther1disease
10. Whichr1ofr1ther1followingr1clinicalr1reasoningr1toolsr1isr1definedr1asr1evidence-
basedr1resourcer1basedr1onr1mathematicalr1modelingr1tor1expressr1ther1likelihoodr1ofr1ar1conditionr1inr1selectr1situations,r1settings,r1and/or
r1patients?
, r1
A. Clinicalr1practicer1guideline
B. Clinicalr1decisionr1rule
C. Clinicalr1algorithm
Chapter 1: Clinical reasoning, differential diagnosis, evidence-based practice, and symptom ana
r1 r1 r1 r1 r1 r1 r1 r1 r1 r1
Answer Section
r1
MULTIPLEr1CHOICE
1. ANS: B
Croskerryr1(2009)r1describesr1twor1majorr1typesr1ofr1clinicalr1diagnosticr1decision-
making:r1intuitiver1andr1analytical.r1Intuitiver1decision-r1makingr1(similarr1tor1Augenblinkr1decision-
making)r1isr1basedr1onr1ther1experiencer1andr1intuitionr1ofr1ther1clinicianr1andr1isr1lessr1reliabler1andr1pairedr1withr1fairlyr1commonr1errors.r1I
nr1contrast,r1analyticalr1decision-makingr1isr1basedr1onr1carefulr1considerationr1andr1hasr1greaterr1reliabilityr1withr1rarer1errors.
PTS: 1
2. ANS: D
Tor1obtainr1adequater1history,r1providersr1mustr1ber1wellr1organized,r1attentiver1tor1ther1patient‘sr1verbalr1andr1nonverbalr1language,r1andr1a
bler1tor1accuratelyr1interpretr1ther1patient‘sr1responsesr1tor1questions.r1Ratherr1thanr1readingr1intor1ther1patient‘sr1statements,r1theyr1clarif
yr1anyr1areasr1ofr1uncertainty.
PTS: 1
3. ANS: C
Vitalr1signsr1arer1partr1ofr1ther1physicalr1examinationr1portionr1ofr1patientr1assessment,r1notr1partr1ofr1ther1healthr1history.
PTS: 1
4. ANS: D
Whiler1performingr1ther1physicalr1examination,r1ther1examinerr1mustr1ber1abler1tor1differentiater1betweenr1normalr1andr1abnormalr1findin
gs,r1recallr1knowledger1ofr1ar1ranger1ofr1conditions,r1includingr1theirr1associatedr1signsr1andr1symptoms,r1recognizer1howr1certainr1conditio
nsr1affectr1ther1responser1tor1otherr1conditions,r1andr1distinguishr1ther1relevancer1ofr1variedr1abnormalr1findings.
PTS: 1
5. ANS: C
Sourcesr1forr1diagnosticr1statisticsr1includer1textbooks,r1primaryr1reportsr1ofr1research,r1andr1publishedr1meta-
analyses.r1Anotherr1sourcer1ofr1statistics,r1ther1oner1thatr1hasr1beenr1mostr1widelyr1usedr1andr1availabler1forr1applicationr1tor1ther1reasoningr1p
rocess,r1isr1ther1estimationr1basedr1onr1ar1provider‘sr1experience,r1althoughr1theser1arer1rarelyr1accurate.r1Overr1ther1pastr1decade,r1ther1avai
labilityr1ofr1evidencer1onr1whichr1tor1baser1clinicalr1reasoningr1isr1improving,r 1 andr1therer1isr1anr1increasingr1expectationr1thatr1clinicalr1re
asoningr1ber1basedr1onr1scientificr1evidence.
Evidence-basedr1statisticsr1 arer1 alsor1increasinglyr1beingr1usedr1tor1developr 1 resourcesr1tor1facilitater 1 clinicalr 1 decision-making.
PTS: 1
6. ANS: D
Tor1assistr1inr1clinicalr1decision-making,r1ar1numberr1ofr1evidence-
basedr1resourcesr1haver1beenr1developedr1tor1assistr1ther1clinician.r1Resources,r1suchr1asr1algorithmsr1andr1clinicalr1practicer1guidelines,r1
assistr1inr1clinicalr1reasoningr1whenr1properlyr1applied.
PTS: 1
7. ANS: A
Ther1sensitivityr1ofr1ar1diagnosticr1studyr1isr1ther1percentager1ofr1individualsr1withr1ther1targetr1conditionr1whor1showr1anr1abnormal,r1orr 1 pos
itive,r1result.r1Ar1highr1sensitivityr1indicatesr1thatr1ar1greaterr1percentager1ofr1personsr1withr1ther1givenr1conditionr1willr1haver1anr1abnormalr1
result.
PTS: 1
8. ANS: B
Ther1specificityr1ofr1ar1diagnosticr1studyr1isr1ther1percentager1ofr1normal,r1healthyr1individualsr1whor1haver1ar1normalr1result.r1Ther1greaterr1
ther1specificity,r1ther1greaterr1ther1percentager1ofr1individualsr1whor1willr1haver1negative,r1orr1normal,r1resultsr1ifr1theyr1dor1notr1haver1ther1
targetr1condition.
PTS: 1
9. ANS: A
Ther1likelihoodr1ratior1isr1ther1probabilityr1thatr1ar1positiver1testr1resultr1willr1ber1associatedr1withr1ar1personr1whor1hasr1ther1targetr1conditionr1
andr1ar1negativer1resultr1willr1ber1associatedr1withr1ar1healthyr1person.r1Ar1likelihoodr1ratior1abover11r1indicatesr1thatr1ar1positiver1resultr1isr1a
ssociatedr1withr1ther1disease;r1ar1likelihoodr1ratior1lessr1thanr11r1indicatesr1thatr1ar1negativer1resultr1isr1associatedr1withr1anr1absencer1ofr1ther1
disease.
, r1
PTS: 1
10. ANS: B
Clinicalr1decisionr1(orr1prediction)r1rulesr1provider1anotherr1supportr1forr1clinicalr1reasoning.r1Clinicalr1decisionr1rulesr1arer1evidence-
basedr1resourcesr1thatr1provider1probabilisticr1statementsr1regardingr1ther1likelihoodr1thatr1ar1conditionr1existsr1ifr1certainr1variablesr1arer1
metr1withr1regardr1tor1ther1prognosisr1ofr1patientsr1withr1specificr1findings.r1Decisionr1rulesr1user1mathematicalr1modelsr1andr1arer1specifi
cr1tor1certainr1situations,r1settings,r1and/orr1patientr1characteristics.
PTS: 1
