Clinical Diagnosis in Primary Care 6th Edition
by Joyce E. Dains
ALL CHAPTERS INCLUDED 1-42| VERIFIED
EXAM QUESTIONS AND ANSWERS
ANSWERS ARE AT THE END OF EACH
CHAPTER WITH RATIONALES
TB
Ac
er
1|Page
, 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
TB
B. Attentive to the patient‘s verbal and nonverbal language
C. Able to accurately interpret the patient‘s responses
Ac
D. Adept at reading into the patient‘s statements
er
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 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
2|Page
,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
TB
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
Ac
B. Low percentage of persons with the given condition will have an abnormal result
er
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
3|Page
, 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 analysis
TB
Answer Section
MULTIPLE CHOICE
Ac
1. CORRECT ANSWER: B
er
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. CORRECT ANSWER: 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. CORRECT ANSWER: C
4|Page