TEST BANK
ADVANCED HEALTH ASSESSMENT & CLINICAL DIAGNOSIS IN
PRIMARY CARE, 6TH EDITION
Joyce E. Dains, Linda Ciofu Baumann & Pamela Scheibel
, lOMoARcPSD|126 567 13
Test Bank for Advanced Health Assessment & Clinical Diagnosis in Primary Care
6th Edition Dains
Chapter 1: Clinical Reasoning, Differential Diagnosis, Evidence-Based Practice, and Symptom Analysis
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?
, lOMoARcPSD|126 567 13
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 d(2009) ddescribes dtwo dmajor dtypes dof dclinical ddiagnostic ddecision-making: dintuitive dand danalytical.
dIntuitive ddecision- dmaking d(similar dto dAugenblink ddecision-making) dis dbased don dthe dexperience dand dintuition dof
dthe dclinician dand dis dless dreliable dand dpaired dwith dfairly dcommon derrors. dIn dcontrast, danalytical ddecision-making
dis dbased don dcareful dconsideration dand dhas dgreater dreliability dwith drare derrors.
PTS: 1
2. ANS: D
To dobtain dadequate dhistory, dproviders dmust dbe dwell dorganized, dattentive dto dthe dpatient’s dverbal dand dnonverbal
dlanguage, dand dable dto daccurately dinterpret dthe dpatient’s dresponses dto dquestions. dRather dthan dreading dinto dthe
dpatient’s dstatements, dthey dclarify dany dareas dof duncertainty.
PTS: 1
3. ANS: C
Vital dsigns dare dpart dof dthe dphysical dexamination dportion dof dpatient dassessment, dnot dpart dof dthe dhealth dhistory.
PTS: 1
4. ANS: D
While dperforming dthe dphysical dexamination, dthe dexaminer dmust dbe dable dto ddifferentiate dbetween dnormal dand
dabnormal dfindings, drecall dknowledge dof da drange dof dconditions, dincluding dtheir dassociated dsigns dand dsymptoms,
drecognize dhow dcertain dconditions daffect dthe dresponse dto dother dconditions, dand ddistinguish dthe drelevance dof dvaried
dabnormal dfindings.
PTS: 1
5. ANS: C
Sources dfor ddiagnostic dstatistics dinclude dtextbooks, dprimary dreports dof dresearch, dand dpublished dmeta-analyses.
dAnother dsource dof dstatistics, dthe done dthat dhas dbeen dmost dwidely dused dand davailable dfor dapplication dto dthe
dreasoning dprocess, dis dthe destimation dbased don da dprovider’s dexperience, dalthough dthese dare drarely daccurate. dOver
dthe dpast ddecade, dthe davailability dof devidence don dwhich dto dbase dclinical dreasoning dis dimproving, d and dthere dis dan
dincreasing dexpectation dthat dclinical dreasoning dbe dbased don dscientific devidence.
Evidence-based dstatistics dare d also dincreasingly dbeing dused dto ddevelop d resources dto dfacilitate d clinical d decision-making.
PTS: 1
6. ANS: D
To dassist din dclinical ddecision-making, da dnumber dof devidence-based dresources dhave dbeen ddeveloped dto dassist dthe
dclinician. dResources, dsuch das dalgorithms dand dclinical dpractice dguidelines, dassist din dclinical dreasoning dwhen
dproperly dapplied.
PTS: 1
7. ANS: A
The dsensitivity dof da ddiagnostic dstudy dis dthe dpercentage dof dindividuals dwith dthe dtarget dcondition dwho dshow dan
dabnormal, dor dpositive, dresult. dA dhigh dsensitivity dindicates dthat da dgreater dpercentage dof dpersons dwith dthe dgiven
dcondition dwill dhave dan dabnormal dresult.
PTS: 1
8. ANS: B
The dspecificity dof da ddiagnostic dstudy dis dthe dpercentage dof dnormal, dhealthy dindividuals dwho dhave da dnormal dresult.
dThe dgreater dthe dspecificity, dthe dgreater dthe dpercentage dof dindividuals dwho dwill dhave dnegative, dor dnormal, dresults
dif dthey ddo dnot dhave dthe dtarget dcondition.
PTS: 1
9. ANS: A
The dlikelihood dratio dis dthe dprobability dthat da dpositive dtest dresult dwill dbe dassociated dwith da dperson dwho dhas dthe
dtarget dcondition dand da dnegative dresult dwill dbe dassociated dwith da dhealthy dperson. dA dlikelihood dratio dabove d1
dindicates dthat da dpositive dresult dis dassociated dwith dthe ddisease; da dlikelihood dratio dless dthan d1 dindicates dthat da
dnegative dresult dis dassociated dwith dan dabsence dof dthe ddisease.
, lOMoARcPSD|126 567 13
PTS: 1
10. ANS: B
Clinical ddecision d(or dprediction) drules dprovide danother dsupport dfor dclinical dreasoning. dClinical ddecision drules dare
devidence-based dresources dthat dprovide dprobabilistic dstatements dregarding dthe dlikelihood dthat da dcondition dexists dif
dcertain dvariables dare dmet dwith dregard dto dthe dprognosis dof dpatients dwith dspecific dfindings. dDecision drules duse
dmathematical dmodels dand dare dspecific dto dcertain dsituations, dsettings, dand/or dpatient dcharacteristics.
PTS: 1
ADVANCED HEALTH ASSESSMENT & CLINICAL DIAGNOSIS IN
PRIMARY CARE, 6TH EDITION
Joyce E. Dains, Linda Ciofu Baumann & Pamela Scheibel
, lOMoARcPSD|126 567 13
Test Bank for Advanced Health Assessment & Clinical Diagnosis in Primary Care
6th Edition Dains
Chapter 1: Clinical Reasoning, Differential Diagnosis, Evidence-Based Practice, and Symptom Analysis
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?
, lOMoARcPSD|126 567 13
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 d(2009) ddescribes dtwo dmajor dtypes dof dclinical ddiagnostic ddecision-making: dintuitive dand danalytical.
dIntuitive ddecision- dmaking d(similar dto dAugenblink ddecision-making) dis dbased don dthe dexperience dand dintuition dof
dthe dclinician dand dis dless dreliable dand dpaired dwith dfairly dcommon derrors. dIn dcontrast, danalytical ddecision-making
dis dbased don dcareful dconsideration dand dhas dgreater dreliability dwith drare derrors.
PTS: 1
2. ANS: D
To dobtain dadequate dhistory, dproviders dmust dbe dwell dorganized, dattentive dto dthe dpatient’s dverbal dand dnonverbal
dlanguage, dand dable dto daccurately dinterpret dthe dpatient’s dresponses dto dquestions. dRather dthan dreading dinto dthe
dpatient’s dstatements, dthey dclarify dany dareas dof duncertainty.
PTS: 1
3. ANS: C
Vital dsigns dare dpart dof dthe dphysical dexamination dportion dof dpatient dassessment, dnot dpart dof dthe dhealth dhistory.
PTS: 1
4. ANS: D
While dperforming dthe dphysical dexamination, dthe dexaminer dmust dbe dable dto ddifferentiate dbetween dnormal dand
dabnormal dfindings, drecall dknowledge dof da drange dof dconditions, dincluding dtheir dassociated dsigns dand dsymptoms,
drecognize dhow dcertain dconditions daffect dthe dresponse dto dother dconditions, dand ddistinguish dthe drelevance dof dvaried
dabnormal dfindings.
PTS: 1
5. ANS: C
Sources dfor ddiagnostic dstatistics dinclude dtextbooks, dprimary dreports dof dresearch, dand dpublished dmeta-analyses.
dAnother dsource dof dstatistics, dthe done dthat dhas dbeen dmost dwidely dused dand davailable dfor dapplication dto dthe
dreasoning dprocess, dis dthe destimation dbased don da dprovider’s dexperience, dalthough dthese dare drarely daccurate. dOver
dthe dpast ddecade, dthe davailability dof devidence don dwhich dto dbase dclinical dreasoning dis dimproving, d and dthere dis dan
dincreasing dexpectation dthat dclinical dreasoning dbe dbased don dscientific devidence.
Evidence-based dstatistics dare d also dincreasingly dbeing dused dto ddevelop d resources dto dfacilitate d clinical d decision-making.
PTS: 1
6. ANS: D
To dassist din dclinical ddecision-making, da dnumber dof devidence-based dresources dhave dbeen ddeveloped dto dassist dthe
dclinician. dResources, dsuch das dalgorithms dand dclinical dpractice dguidelines, dassist din dclinical dreasoning dwhen
dproperly dapplied.
PTS: 1
7. ANS: A
The dsensitivity dof da ddiagnostic dstudy dis dthe dpercentage dof dindividuals dwith dthe dtarget dcondition dwho dshow dan
dabnormal, dor dpositive, dresult. dA dhigh dsensitivity dindicates dthat da dgreater dpercentage dof dpersons dwith dthe dgiven
dcondition dwill dhave dan dabnormal dresult.
PTS: 1
8. ANS: B
The dspecificity dof da ddiagnostic dstudy dis dthe dpercentage dof dnormal, dhealthy dindividuals dwho dhave da dnormal dresult.
dThe dgreater dthe dspecificity, dthe dgreater dthe dpercentage dof dindividuals dwho dwill dhave dnegative, dor dnormal, dresults
dif dthey ddo dnot dhave dthe dtarget dcondition.
PTS: 1
9. ANS: A
The dlikelihood dratio dis dthe dprobability dthat da dpositive dtest dresult dwill dbe dassociated dwith da dperson dwho dhas dthe
dtarget dcondition dand da dnegative dresult dwill dbe dassociated dwith da dhealthy dperson. dA dlikelihood dratio dabove d1
dindicates dthat da dpositive dresult dis dassociated dwith dthe ddisease; da dlikelihood dratio dless dthan d1 dindicates dthat da
dnegative dresult dis dassociated dwith dan dabsence dof dthe ddisease.
, lOMoARcPSD|126 567 13
PTS: 1
10. ANS: B
Clinical ddecision d(or dprediction) drules dprovide danother dsupport dfor dclinical dreasoning. dClinical ddecision drules dare
devidence-based dresources dthat dprovide dprobabilistic dstatements dregarding dthe dlikelihood dthat da dcondition dexists dif
dcertain dvariables dare dmet dwith dregard dto dthe dprognosis dof dpatients dwith dspecific dfindings. dDecision drules duse
dmathematical dmodels dand dare dspecific dto dcertain dsituations, dsettings, dand/or dpatient dcharacteristics.
PTS: 1
