Test Bank for Advanced Assessment: Interpreting Findings
and Formulating Differential Diagnoses, 5th Edition, Mary Jo
Goolsby, Laurie Grubbs Chapter 1 - 22 | Complete
,Chapter 1. Assessment and Clinical Decision-Making: Overview
Multiple Choice
Identify the choice that best completes the statement or2answers the question.
1. Which type of clinical decision-making is most reliable?
A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
2. Which of the2following is false? To obtain adequate history, health-care providers must2be:
A. Methodical and2systematic
B. Attentive to the patient’s verbal and nonverbal language
C. Able2to accurately interpret the patient’s responses
D. Adept at reading into the patient’s statements
3. Essential parts of a health history include all of the following except:
A. Chief complaint
B. History of the2present illness
C. Current vital signs
D. All of the above are essential history components
4. Which of the following is false? While performing2the physical2examination, the examiner must bea
ble to:
A. Differentiate between normal and abnormal2findings
B. Recall knowledge of a range of conditions and their associated signs and symptoms
C. Recognize how certain conditions affect the response2to2other conditions
D. Foresee2unpredictable findings
5. The following is the least reliable source of2information for diagnostic statistics:
A. Evidence-based investigations
B. Primary reports of2research
C. Estimation based2on2a provider’s2experience
D. Published meta-analyses
6. The following2can be used to2assist in sound2clinical decision-making:
A. Algorithm2published in2a2peer-reviewed journal article
B. Clinical2practice guidelines
C. Evidence-based2research
D. All of the above
7. If a diagnostic2study has high sensitivity, this indicates a:
A. High percentage2of persons with the given condition will have an abnormal result
B. Low percentage of persons with the given condition will have an abnormal result
C. Low likelihood of normal result in persons without a given condition
D. None of the above
, 8. If a diagnostic study has high specificity, this indicates a:
A. Low percentage of healthy individuals will show a normal result
B. High percentage of healthy individuals will show a normal result
C. High percentage2of individuals with a disorder will show a normal result
D. Low percentage2of individuals with a disorder will show an abnormal result
9. A likelihood ratio above 1 indicates that a diagnostic test showing2a:
A. Positive result is strongly associated with the disease
B. Negative result is strongly associated2with absence of the disease
C. Positive result is weakly associated with the disease
D. Negative result is weakly associated with absence of the2disease
10. Which of the following2clinical reasoning tools is defined as evidence-
based resource based on mathematical modeling to express the likelihood of a condition in select sit
uations, settings, and/orpatients?
A. Clinical practice guideline
B. Clinical decision rule
C. Clinical algorithm
D. Clinical recommendation
, Chapter 1. Assessment and Clinical Decision-Making: Overview
Answer Section
MULTIPLE CHOICE
1. ANS: B
Croskerry (2009) describes two2major types of clinical diagnostic decision-
making: intuitive and analytical. Intuitive decision-making (similar to Augenblink decision-
making) is based on the experience and intuition of the clinician2and is less reliable and paired with
fairly common errors. In contrast, analytical decision-
making is based2on careful consideration and has greater reliabilitywith rare errors.
PTS: 1
2. ANS: D
To obtain adequate history, providers must be well organized, attentive to2the patient’s verbal2andno
nverbal language, and able2to accurately interpret the2patient’s responses2to questions.2Rather than r
eading into the patient’s statements, they clarify any areas of uncertainty.
PTS: 1
3. ANS: C
Vital signs are part of the physical examination portion2of2patient assessment, not part of the healthhis
tory.
PTS: 1
4. ANS: D
While performing the physical examination, the examiner must be able to differentiate betweennor
mal and abnormal findings, recall knowledge of a range2of conditions, including2their associated sig
ns and symptoms, recognize how2certain conditions2affect the response to other conditions, and disti
nguish the relevance of varied2abnormal findings.
PTS: 1
5. ANS: C
Sources for diagnostic2statistics include2textbooks, primary reports of research, and published met
a-
analyses. Another source2of statistics, the one that has been most widely used and available for app
lication to2the2reasoning process, is the estimation based on a provider’s experience, although thes
e are rarely accurate. Over2the2past decade, the availability of evidence2on which to base clinical re
asoning2is improving,2and there is an increasing expectation that clinical reasoningbe based on scie
ntific evidence.2Evidence-
based statistics2are2also increasingly being used to develop resources to facilitate clinical decision-
making.
PTS: 1
6. ANS: D
To assist in clinical decision-making, a number of evidence-
based2resources have been developedto assist the clinician. Resources, such as algorithms and clinic
al practice guidelines, assist in clinical reasoning when properly applied.
and Formulating Differential Diagnoses, 5th Edition, Mary Jo
Goolsby, Laurie Grubbs Chapter 1 - 22 | Complete
,Chapter 1. Assessment and Clinical Decision-Making: Overview
Multiple Choice
Identify the choice that best completes the statement or2answers the question.
1. Which type of clinical decision-making is most reliable?
A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
2. Which of the2following is false? To obtain adequate history, health-care providers must2be:
A. Methodical and2systematic
B. Attentive to the patient’s verbal and nonverbal language
C. Able2to accurately interpret the patient’s responses
D. Adept at reading into the patient’s statements
3. Essential parts of a health history include all of the following except:
A. Chief complaint
B. History of the2present illness
C. Current vital signs
D. All of the above are essential history components
4. Which of the following is false? While performing2the physical2examination, the examiner must bea
ble to:
A. Differentiate between normal and abnormal2findings
B. Recall knowledge of a range of conditions and their associated signs and symptoms
C. Recognize how certain conditions affect the response2to2other conditions
D. Foresee2unpredictable findings
5. The following is the least reliable source of2information for diagnostic statistics:
A. Evidence-based investigations
B. Primary reports of2research
C. Estimation based2on2a provider’s2experience
D. Published meta-analyses
6. The following2can be used to2assist in sound2clinical decision-making:
A. Algorithm2published in2a2peer-reviewed journal article
B. Clinical2practice guidelines
C. Evidence-based2research
D. All of the above
7. If a diagnostic2study has high sensitivity, this indicates a:
A. High percentage2of persons with the given condition will have an abnormal result
B. Low percentage of persons with the given condition will have an abnormal result
C. Low likelihood of normal result in persons without a given condition
D. None of the above
, 8. If a diagnostic study has high specificity, this indicates a:
A. Low percentage of healthy individuals will show a normal result
B. High percentage of healthy individuals will show a normal result
C. High percentage2of individuals with a disorder will show a normal result
D. Low percentage2of individuals with a disorder will show an abnormal result
9. A likelihood ratio above 1 indicates that a diagnostic test showing2a:
A. Positive result is strongly associated with the disease
B. Negative result is strongly associated2with absence of the disease
C. Positive result is weakly associated with the disease
D. Negative result is weakly associated with absence of the2disease
10. Which of the following2clinical reasoning tools is defined as evidence-
based resource based on mathematical modeling to express the likelihood of a condition in select sit
uations, settings, and/orpatients?
A. Clinical practice guideline
B. Clinical decision rule
C. Clinical algorithm
D. Clinical recommendation
, Chapter 1. Assessment and Clinical Decision-Making: Overview
Answer Section
MULTIPLE CHOICE
1. ANS: B
Croskerry (2009) describes two2major types of clinical diagnostic decision-
making: intuitive and analytical. Intuitive decision-making (similar to Augenblink decision-
making) is based on the experience and intuition of the clinician2and is less reliable and paired with
fairly common errors. In contrast, analytical decision-
making is based2on careful consideration and has greater reliabilitywith rare errors.
PTS: 1
2. ANS: D
To obtain adequate history, providers must be well organized, attentive to2the patient’s verbal2andno
nverbal language, and able2to accurately interpret the2patient’s responses2to questions.2Rather than r
eading into the patient’s statements, they clarify any areas of uncertainty.
PTS: 1
3. ANS: C
Vital signs are part of the physical examination portion2of2patient assessment, not part of the healthhis
tory.
PTS: 1
4. ANS: D
While performing the physical examination, the examiner must be able to differentiate betweennor
mal and abnormal findings, recall knowledge of a range2of conditions, including2their associated sig
ns and symptoms, recognize how2certain conditions2affect the response to other conditions, and disti
nguish the relevance of varied2abnormal findings.
PTS: 1
5. ANS: C
Sources for diagnostic2statistics include2textbooks, primary reports of research, and published met
a-
analyses. Another source2of statistics, the one that has been most widely used and available for app
lication to2the2reasoning process, is the estimation based on a provider’s experience, although thes
e are rarely accurate. Over2the2past decade, the availability of evidence2on which to base clinical re
asoning2is improving,2and there is an increasing expectation that clinical reasoningbe based on scie
ntific evidence.2Evidence-
based statistics2are2also increasingly being used to develop resources to facilitate clinical decision-
making.
PTS: 1
6. ANS: D
To assist in clinical decision-making, a number of evidence-
based2resources have been developedto assist the clinician. Resources, such as algorithms and clinic
al practice guidelines, assist in clinical reasoning when properly applied.
