test bank for
advanced assessment interpreting
findings and formulating differential
diagnoses 4th edition goolsby
complete chapters 18-42||with answer
section
,table of contents
chapter 1. assessment and clinical decision making: an overview ....................... 4
chapter 2. evidence-based health screening ........................................................ 9
chapter 3. abdomen .......................................................................................... 20
chapter 4: affective changes ............................................................................. 46
chapter 5: amenorrhea ..................................................................................... 58
chapter 6. breasts lumps and nipple discharge .................................................. 61
chapter 7. breast pain ....................................................................................... 68
chapter 8: chest pain......................................................................................... 71
chapter 9. confusion in older adults .................................................................. 76
chapter 10: constipation ................................................................................... 82
chapter 11: cough ............................................................................................. 85
chapter 12: diarrhea ......................................................................................... 89
chapter 13: dizziness ......................................................................................... 97
chapter 14. dyspnea........................................................................................ 100
chapter 15. earache ........................................................................................ 114
chapter 16: fatigue ......................................................................................... 120
chapter 17. fever ............................................................................................. 124
chapter 18: male genitourinary problems ....................................................... 129
chapter 19. headache ..................................................................................... 148
chapter 20: heartburn and indigestion ............................................................ 159
chapter 21. hoarseness ................................................................................... 161
chapter 22: lower extremity limb pain ............................................................ 164
chapter 23: upper extremity limb pain ............................................................ 167
chapter 24: low back pain (acute) ................................................................... 169
chapter 25.: nasal symptoms and sinus congestion ......................................... 172
chapter 26: palpitations .................................................................................. 178
chapter 27 penile discharge ............................................................................ 181
,chapter 28 rashes and skin lesions .................................................................. 195
chapter 29: rectal pain, itching, and bleeding ................................................. 207
chapter 30. red eye ......................................................................................... 209
chaper 31: sleep problems .............................................................................. 221
chapter 32. sore throat ................................................................................... 231
chapter 33: syncope ........................................................................................ 234
chapter 34 urinary incontinence ...................................................................... 237
chapter 35 urinary problems in females and children ...................................... 247
chapter 36. vaginal bleeding ........................................................................... 251
chapter 37. vaginal discharge and itching ....................................................... 254
chapter 38: vision loss ..................................................................................... 275
chapter 39: weight loss/gain(unintentional) ................................................... 293
chapter 40: the abdominal x-ray ..................................................................... 301
chapter 41: the chest x-ray.............................................................................. 310
chapter 42. the transgender patient ............................................................... 314
,chapter 1. assessment and clinical decision making: an overview
multiple choice
identify the choice that best completes the statement or answers the question.
1. which type of clinical decision-making is most reliable?
a. intuitive
b. analytical
c. experiential
d. augenblick
2. which of the following is false? to obtain adequate history, health-care
providers must be:
a. methodical and systematic
b. attentive to the patient’s verbal and nonverbal language
c. able to 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 the present illness
c. current vital signs
d. all of the above are essential history components
4. which of the following is false? while performing the physical
examination, the examiner must be able to:
a. differentiate between normal and abnormal findings
,b. recall knowledge of a range of conditions and their associated signs and
symptoms
c. recognize how certain conditions affect the response to other conditions
d. foresee unpredictable findings
5. the following is the least reliable source of information for diagnostic
statistics:
a. evidence-based investigations
b. primary reports of research
c. estimation based on a provider’s experience
d. published meta-analyses
6. the following can be used to assist in sound clinical decision-making:
a. algorithm published in a peer-reviewed journal article
b. clinical practice guidelines
c. evidence-based research
d. all of the above
7. if a diagnostic study has high sensitivity, this indicates a:
a. high percentage of 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 percentage of individuals with a disorder will show a normal result
,d. low percentage of individuals with a disorder will show an abnormal
result
9. a likelihood ratio above 1 indicates that a diagnostic test showing a:
a. positive result is strongly associated with the disease
b. negative result is strongly associated with absence of the disease
c. positive result is weakly associated with the disease
d. negative result is weakly associated with absence of the disease
10. which of the following clinical reasoning tools is defined as evidence-
based resource based on mathematical modeling to express the likelihood of a
condition in select situations, settings, and/or patients?
a. clinical practice guideline
b. clinical decision rule
c. clinical algorithm
chapter 1: clinical reasoning, differential diagnosis, evidence-based practice, and
symptom ana
answer section
multiple choice
1. answer: b
croskerry (2009) describes two major 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
clinician and is less reliable andpaired with fairly common errors. in contrast,
, analytical decision-making is based on careful consideration and has greater
reliability with rare errors.
pts: 1
2. answer: d
to obtain adequate history, providers must be well organized, attentive to the
patient’s verbal and nonverbal language, and ableto accurately interpret the
patient’s responses to questions. rather than reading into the patient’s
statements, they clarify any areas of uncertainty.
pts: 1
3. answer: c
vital signs are part of the physical examination portion of patient assessment,
not part of the health history.
pts: 1
4. answer: d
while performing the physical examination, the examiner must be able to
differentiate between normal and abnormal findings, recall knowledge of a
range of conditions, including their associated signs and symptoms, recognize
how certain conditions affectthe response to other conditions, and distinguish
the relevance of varied abnormal findings.
pts: 1
5. answer: c
sources for diagnostic statistics include textbooks, primary reports of research,
and published meta-analyses. another source of statistics, the one that has been
most widely used and available for application to the reasoning process, is the
estimation based ona provider’s experience, although these are rarely accurate.
over the past decade, the availability of evidence on which to base clinical
reasoning is improving, and there is an increasing expectation that clinical
reasoning be based on scientific evidence.
advanced assessment interpreting
findings and formulating differential
diagnoses 4th edition goolsby
complete chapters 18-42||with answer
section
,table of contents
chapter 1. assessment and clinical decision making: an overview ....................... 4
chapter 2. evidence-based health screening ........................................................ 9
chapter 3. abdomen .......................................................................................... 20
chapter 4: affective changes ............................................................................. 46
chapter 5: amenorrhea ..................................................................................... 58
chapter 6. breasts lumps and nipple discharge .................................................. 61
chapter 7. breast pain ....................................................................................... 68
chapter 8: chest pain......................................................................................... 71
chapter 9. confusion in older adults .................................................................. 76
chapter 10: constipation ................................................................................... 82
chapter 11: cough ............................................................................................. 85
chapter 12: diarrhea ......................................................................................... 89
chapter 13: dizziness ......................................................................................... 97
chapter 14. dyspnea........................................................................................ 100
chapter 15. earache ........................................................................................ 114
chapter 16: fatigue ......................................................................................... 120
chapter 17. fever ............................................................................................. 124
chapter 18: male genitourinary problems ....................................................... 129
chapter 19. headache ..................................................................................... 148
chapter 20: heartburn and indigestion ............................................................ 159
chapter 21. hoarseness ................................................................................... 161
chapter 22: lower extremity limb pain ............................................................ 164
chapter 23: upper extremity limb pain ............................................................ 167
chapter 24: low back pain (acute) ................................................................... 169
chapter 25.: nasal symptoms and sinus congestion ......................................... 172
chapter 26: palpitations .................................................................................. 178
chapter 27 penile discharge ............................................................................ 181
,chapter 28 rashes and skin lesions .................................................................. 195
chapter 29: rectal pain, itching, and bleeding ................................................. 207
chapter 30. red eye ......................................................................................... 209
chaper 31: sleep problems .............................................................................. 221
chapter 32. sore throat ................................................................................... 231
chapter 33: syncope ........................................................................................ 234
chapter 34 urinary incontinence ...................................................................... 237
chapter 35 urinary problems in females and children ...................................... 247
chapter 36. vaginal bleeding ........................................................................... 251
chapter 37. vaginal discharge and itching ....................................................... 254
chapter 38: vision loss ..................................................................................... 275
chapter 39: weight loss/gain(unintentional) ................................................... 293
chapter 40: the abdominal x-ray ..................................................................... 301
chapter 41: the chest x-ray.............................................................................. 310
chapter 42. the transgender patient ............................................................... 314
,chapter 1. assessment and clinical decision making: an overview
multiple choice
identify the choice that best completes the statement or answers the question.
1. which type of clinical decision-making is most reliable?
a. intuitive
b. analytical
c. experiential
d. augenblick
2. which of the following is false? to obtain adequate history, health-care
providers must be:
a. methodical and systematic
b. attentive to the patient’s verbal and nonverbal language
c. able to 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 the present illness
c. current vital signs
d. all of the above are essential history components
4. which of the following is false? while performing the physical
examination, the examiner must be able to:
a. differentiate between normal and abnormal findings
,b. recall knowledge of a range of conditions and their associated signs and
symptoms
c. recognize how certain conditions affect the response to other conditions
d. foresee unpredictable findings
5. the following is the least reliable source of information for diagnostic
statistics:
a. evidence-based investigations
b. primary reports of research
c. estimation based on a provider’s experience
d. published meta-analyses
6. the following can be used to assist in sound clinical decision-making:
a. algorithm published in a peer-reviewed journal article
b. clinical practice guidelines
c. evidence-based research
d. all of the above
7. if a diagnostic study has high sensitivity, this indicates a:
a. high percentage of 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 percentage of individuals with a disorder will show a normal result
,d. low percentage of individuals with a disorder will show an abnormal
result
9. a likelihood ratio above 1 indicates that a diagnostic test showing a:
a. positive result is strongly associated with the disease
b. negative result is strongly associated with absence of the disease
c. positive result is weakly associated with the disease
d. negative result is weakly associated with absence of the disease
10. which of the following clinical reasoning tools is defined as evidence-
based resource based on mathematical modeling to express the likelihood of a
condition in select situations, settings, and/or patients?
a. clinical practice guideline
b. clinical decision rule
c. clinical algorithm
chapter 1: clinical reasoning, differential diagnosis, evidence-based practice, and
symptom ana
answer section
multiple choice
1. answer: b
croskerry (2009) describes two major 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
clinician and is less reliable andpaired with fairly common errors. in contrast,
, analytical decision-making is based on careful consideration and has greater
reliability with rare errors.
pts: 1
2. answer: d
to obtain adequate history, providers must be well organized, attentive to the
patient’s verbal and nonverbal language, and ableto accurately interpret the
patient’s responses to questions. rather than reading into the patient’s
statements, they clarify any areas of uncertainty.
pts: 1
3. answer: c
vital signs are part of the physical examination portion of patient assessment,
not part of the health history.
pts: 1
4. answer: d
while performing the physical examination, the examiner must be able to
differentiate between normal and abnormal findings, recall knowledge of a
range of conditions, including their associated signs and symptoms, recognize
how certain conditions affectthe response to other conditions, and distinguish
the relevance of varied abnormal findings.
pts: 1
5. answer: c
sources for diagnostic statistics include textbooks, primary reports of research,
and published meta-analyses. another source of statistics, the one that has been
most widely used and available for application to the reasoning process, is the
estimation based ona provider’s experience, although these are rarely accurate.
over the past decade, the availability of evidence on which to base clinical
reasoning is improving, and there is an increasing expectation that clinical
reasoning be based on scientific evidence.
