full test bank
advanced health assessment & clinical diagnosis in primary
care 6th edition by dains (with answer key)
,table of contents
chapter 1: clinical reasoning, differential diagnosis, evidence-based practice, and
symptom ana ...................................................................................................... 4
chapter 2. evidence-based health screening ........................................................ 9
chapter 3. abdomen .......................................................................................... 21
chapter 4: affective changes ............................................................................. 49
chapter 5: amenorrhea ..................................................................................... 61
chapter 6. breasts lumps and nipple discharge .................................................. 64
chapter 7. breast pain ....................................................................................... 71
chapter 8: chest pain......................................................................................... 74
chapter 9. confusion in older adults .................................................................. 79
chapter 10: constipation ................................................................................... 85
chapter 11: cough ............................................................................................. 87
chapter 12: diarrhea ......................................................................................... 92
chapter 13: dizziness ....................................................................................... 100
chapter 14. dyspnea........................................................................................ 103
chapter 15. earache ........................................................................................ 117
chapter 16: fatigue ......................................................................................... 124
chapter 17. fever ............................................................................................. 128
chapter 18: male genitourinary problems ....................................................... 132
chapter 19. headache ..................................................................................... 152
chapter 20: heartburn and indigestion ............................................................ 163
chapter 22: lower extremity limb pain ............................................................ 168
chapter 23: upper extremity limb pain ............................................................ 171
chapter 24: low back pain (acute) ................................................................... 173
chapter 25.: nasal symptoms and sinus congestion ......................................... 176
chapter 26: palpitations .................................................................................. 182
chapter 27 penile discharge ............................................................................ 185
,chapter 28 rashes and skin lesions .................................................................. 200
chapter 29: rectal pain, itching, and bleeding ................................................. 214
chapter 30. red eye ......................................................................................... 216
chapter 31: sleep problems ............................................................................. 229
chapter 32. sore throat ................................................................................... 239
chapter 33: syncope ........................................................................................ 242
chapter 34 urinary incontinence ...................................................................... 245
chapter 35 urinary problems in females and children ...................................... 255
chapter 36. vaginal bleeding ........................................................................... 259
chapter 37. vaginal discharge and itching ....................................................... 263
chapter 38: vision loss ..................................................................................... 285
chapter 39: weight loss/gain(unintentional) ................................................... 303
,chapter 1: clinical reasoning, differential diagnosis, evidence-based practice, and
symptom ana
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. ans: 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 and paired with fairly common errors. in contrast,
analytical decision-making is based on careful consideration and has greater
reliability with rare errors.
pts: 1
2. ans: d
to obtain adequate history, providers must be well organized, attentive to the
patient’s verbal and nonverbal language, and able to 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. ans: c
vital signs are part of the physical examination portion of patient assessment,
not part of the health history.
pts: 1
4. ans: 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
advanced health assessment & clinical diagnosis in primary
care 6th edition by dains (with answer key)
,table of contents
chapter 1: clinical reasoning, differential diagnosis, evidence-based practice, and
symptom ana ...................................................................................................... 4
chapter 2. evidence-based health screening ........................................................ 9
chapter 3. abdomen .......................................................................................... 21
chapter 4: affective changes ............................................................................. 49
chapter 5: amenorrhea ..................................................................................... 61
chapter 6. breasts lumps and nipple discharge .................................................. 64
chapter 7. breast pain ....................................................................................... 71
chapter 8: chest pain......................................................................................... 74
chapter 9. confusion in older adults .................................................................. 79
chapter 10: constipation ................................................................................... 85
chapter 11: cough ............................................................................................. 87
chapter 12: diarrhea ......................................................................................... 92
chapter 13: dizziness ....................................................................................... 100
chapter 14. dyspnea........................................................................................ 103
chapter 15. earache ........................................................................................ 117
chapter 16: fatigue ......................................................................................... 124
chapter 17. fever ............................................................................................. 128
chapter 18: male genitourinary problems ....................................................... 132
chapter 19. headache ..................................................................................... 152
chapter 20: heartburn and indigestion ............................................................ 163
chapter 22: lower extremity limb pain ............................................................ 168
chapter 23: upper extremity limb pain ............................................................ 171
chapter 24: low back pain (acute) ................................................................... 173
chapter 25.: nasal symptoms and sinus congestion ......................................... 176
chapter 26: palpitations .................................................................................. 182
chapter 27 penile discharge ............................................................................ 185
,chapter 28 rashes and skin lesions .................................................................. 200
chapter 29: rectal pain, itching, and bleeding ................................................. 214
chapter 30. red eye ......................................................................................... 216
chapter 31: sleep problems ............................................................................. 229
chapter 32. sore throat ................................................................................... 239
chapter 33: syncope ........................................................................................ 242
chapter 34 urinary incontinence ...................................................................... 245
chapter 35 urinary problems in females and children ...................................... 255
chapter 36. vaginal bleeding ........................................................................... 259
chapter 37. vaginal discharge and itching ....................................................... 263
chapter 38: vision loss ..................................................................................... 285
chapter 39: weight loss/gain(unintentional) ................................................... 303
,chapter 1: clinical reasoning, differential diagnosis, evidence-based practice, and
symptom ana
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. ans: 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 and paired with fairly common errors. in contrast,
analytical decision-making is based on careful consideration and has greater
reliability with rare errors.
pts: 1
2. ans: d
to obtain adequate history, providers must be well organized, attentive to the
patient’s verbal and nonverbal language, and able to 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. ans: c
vital signs are part of the physical examination portion of patient assessment,
not part of the health history.
pts: 1
4. ans: 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
