TEST BANK for Advanced Assessment Interpreting Findings and Formulating Differential Diagnoses 5th Edition by Goolsby Chapters 1-22, Complete for Advanced Assessment Interpreting Findings and Formulating Differential Diagnoses 5th Edition by Goolsby Chapt

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Test Bank for Advanced Assessment: Interpreting Findings and Formulating
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ss Differential Diagnoses, 5th Edition, Mary Jo Goolsby, Laurie Grubbs
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ss Chapter 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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1. Which type of clinical decision-making is most reliable?
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A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
2. Which of the following is false? To obtain adequate history, health-care providers must be:
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A. Methodical and systematic ss ss



B. Attentive to the patient’s verbal and nonverbal language ss ss ss ss ss ss ss



C. Able to accurately interpret the patient’s responses
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D. Adept at reading into the patient’s statements ss ss ss ss ss ss




3. Essential parts of a health history include all of the following except:
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A. Chief complaint ss



B. History of the present illness ss ss ss ss



C. Current vital signs ss ss



D. All of the above are essential history components
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4. Which of the following is false? While performing the physical examination, the examiner must be
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able to: ss ss



A. Differentiate between normal and abnormal findings ss ss ss ss ss



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 ss ss ss ss ss ss ss ss ss



D. Foresee unpredictable findings ss ss




5. The following is the least reliable source of information for diagnostic statistics:
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A. Evidence-based investigations ss



B. Primary reports of research ss ss ss



C. Estimation based on a provider’s experience ss ss ss ss ss



D. Published meta-analyses ss




6. The following can be used to assist in sound clinical decision-making:
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A. Algorithm published in a peer-reviewed journal article ss ss ss ss ss ss



B. Clinical practice guidelines ss ss



C. Evidence-based research ss



D. All of the above ss ss ss




7. 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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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 ss ss ss

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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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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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s s 10. Which of the following clinical reasoning tools is defined as evidence-based resource based on
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mathematical modeling to express the likelihood of a condition in select situations, settings, and/or
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patients?
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A. Clinical practice guideline ss ss



B. Clinical decision rule ss ss



C. Clinical algorithm ss



D. Clinical recommendation ss

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Chapter 1. Assessment and Clinical Decision-Making: Overview Answer
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Section
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MULTIPLE CHOICE ss




1. ANS: B s s s s



Croskerry (2009) describes two major types of clinical diagnostic decision-making: intuitive and
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analytical. Intuitive decision-making (similar to Augenblink decision-making) is based on the
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experience and intuition of the clinician and is less reliable and paired with fairly common errors.
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In contrast, analytical decision-making is based on careful consideration and has greater reliability
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with rare errors.
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PTS: 1
2. ANS: D s s s s



To obtain adequate history, providers must be well organized, attentive to the patient’s verbal and
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nonverbal language, and able to interpret the patient’s responses to questions accurately. Rather
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than reading into the patient’s statements, they clarify any areas of uncertainty.
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PTS: 1
3. ANS: C s s s s



Vital signs are part of the physical examination portion of patient assessment, not part of the health
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history.
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PTS: 1
4. ANS: D s s s s



While performing the physical examination, the examiner must be able to differentiate between
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normal and abnormal findings, recall knowledge of a range of conditions, including their
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associated signs and symptoms, recognize how certain conditions affect the response to other
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conditions, and distinguish the relevance of varied abnormal findings.
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PTS: 1
5. ANS: C s s s s



Sources for diagnostic statistics include textbooks, primary reports of research, and published
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meta-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 which to
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base clinical reasoning is improving, and there is an increasing expectation that clinical reasoning
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be based on scientific evidence. Evidence-based statistics are also increasingly being used to
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develop resources to facilitate clinical decision-making.
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PTS: 1
6. ANS: D s s s s



To assist in clinical decision-making, a number of evidence-based resources have been developed to
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assist the clinician. Resources, such as algorithms and clinical practice guidelines, assist in
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clinical reasoning when properly applied.
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