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Test bank- f
Advanced Health Assessment & Clinical Diagnosis in Prim
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ary Care 6th Edition Dains-100% Top scores-2023-2024
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Chapterf1:fClinicalfreasoning,fdifferentialfdiagnosis,fevidence-basedfpractice,fandfsymptomfana
MultiplefChoice
Identifyfthefchoicefthatfbestfcompletesfthefstatementforfanswersfthefquestion.
1. Whichftypefoffclinicalfdecision-makingfisfmostfreliable?
A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
2. Whichfofftheffollowingfisffalse?fTofobtainfadequatefhistory,fhealth-carefprovidersfmustfbe:
A. Methodicalfandfsystematic
B. Attentiveftofthefpatient’sfverbalfandfnonverbalflanguage
C. Ableftofaccuratelyfinterpretfthefpatient’sfresponses
D. Adeptfatfreadingfintofthefpatient’sfstatements
3. Essentialfpartsfoffafhealthfhistoryfincludefallfofftheffollowingfexcept:
A. Chieffcomplaint
B. Historyfoffthefpresentfillness
C. Currentfvitalfsigns
D. Allfoffthefabovefarefessentialfhistoryfcomponents
4. Whichfofftheffollowingfisffalse?fWhilefperformingfthefphysicalfexamination,fthefexaminerfmustfbefablefto:
A. Differentiatefbetweenfnormalfandfabnormalffindings
B. Recallfknowledgefoffafrangefoffconditionsfandftheirfassociatedfsignsfandfsymptoms
C. Recognizefhowfcertainfconditionsfaffectfthefresponseftofotherfconditions
D. Foreseefunpredictableffindings
5. Theffollowingfisfthefleastfreliablefsourcefoffinformationfforfdiagnosticfstatistics:
A. Evidence-basedfinvestigations
B. Primaryfreportsfoffresearch
C. Estimationfbasedfonfafprovider’sfexperience
D. Publishedf meta-analyses
6. Theffollowingfcanfbefusedftofassistfinfsoundfclinicalfdecision-making:
A. Algorithmfpublishedfinfafpeer-reviewedfjournalfarticle
B. Clinicalfpracticefguidelines
C. Evidence-basedf research
D. Allfoffthefabove
7. Iffafdiagnosticfstudyfhasfhighfsensitivity,fthisfindicatesfa:
A. Highfpercentagefoffpersonsfwithfthefgivenfconditionfwillfhavefanfabnormalfresult
B. Lowfpercentagefoffpersonsfwithfthefgivenfconditionfwillfhavefanfabnormalfresult
C. Lowflikelihoodfoffnormalfresultfinfpersonsfwithoutfafgivenfcondition
D. Nonefoffthefabove
8. Iffafdiagnosticfstudyfhasfhighfspecificity,fthisfindicatesfa:
A. Lowfpercentagefoffhealthyfindividualsfwillfshowfafnormalfresult
B. Highfpercentagefoffhealthyfindividualsfwillfshowfafnormalfresult
C. Highfpercentagefoffindividualsfwithfafdisorderfwillfshowfafnormalfresult
D. Lowfpercentagefoffindividualsfwithfafdisorderfwillfshowfanfabnormalfresult
9. Aflikelihoodfratiofabovef1findicatesfthatfafdiagnosticftestfshowingfa:
A. Positivefresultfisfstronglyfassociatedfwithfthefdisease
B. Negativefresultfisfstronglyfassociatedfwithfabsencefoffthefdisease
C. Positivefresultfisfweaklyfassociatedfwithfthefdisease
D. Negativefresultfisfweaklyfassociatedfwithfabsencefoffthefdisease
10. Whichfofftheffollowingfclinicalfreasoningftoolsfisfdefinedfasfevidence-
basedfresourcefbasedfonfmathematicalfmodelingftofexpressftheflikelihoodfoffafconditionfinfselectfsituations,fsettings,fand/orfpatient
s?
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A. Clinicalfpracticefguideline
B. Clinicalfdecisionfrule
C. Clinicalfalgorithm
Chapterf1:fClinicalfreasoning,fdifferentialfdiagnosis,fevidence-basedfpractice,fandfsymptomfana
AnswerfSection
MULTIPLEfCHOICE
1. ANS: B
Croskerryf(2009)fdescribesftwofmajorftypesfoffclinicalfdiagnosticfdecision-making:fintuitivefandfanalytical.fIntuitivefdecision-
fmakingf(similarftofAugenblinkfdecision-
making)fisfbasedfonfthefexperiencefandfintuitionfoffthefclinicianfandfisflessfreliablefandfpairedfwithffairlyfcommonferrors.fInfcontras
t,fanalyticalfdecision-makingfisfbasedfonfcarefulfconsiderationfandfhasfgreaterfreliabilityfwithfrareferrors.
PTS: 1
2. ANS: D
Tofobtainfadequatefhistory,fprovidersfmustfbefwellforganized,fattentiveftofthefpatient’sfverbalfandfnonverbalflanguage,fandfableftofa
ccuratelyfinterpretfthefpatient’sfresponsesftofquestions.fRatherfthanfreadingfintofthefpatient’sfstatements,ftheyfclarifyfanyfareasfoffu
ncertainty.
PTS: 1
3. ANS: C
Vitalfsignsfarefpartfoffthefphysicalfexaminationfportionfoffpatientfassessment,fnotfpartfoffthefhealthfhistory.
PTS: 1
4. ANS: D
Whilefperformingfthefphysicalfexamination,fthefexaminerfmustfbefableftofdifferentiatefbetweenfnormalfandfabnormalffindings,frecal
lfknowledgefoffafrangefoffconditions,fincludingftheirfassociatedfsignsfandfsymptoms,frecognizefhowfcertainfconditionsfaffectfthefresp
onseftofotherfconditions,fandfdistinguishfthefrelevancefoffvariedfabnormalffindings.
PTS: 1
5. ANS: C
Sourcesfforfdiagnosticfstatisticsfincludeftextbooks,fprimaryfreportsfoffresearch,fandfpublishedfmeta-
analyses.fAnotherfsourcefoffstatistics,fthefonefthatfhasfbeenfmostfwidelyfusedfandfavailablefforfapplicationftofthefreasoningfprocess,fi
sfthefestimationfbasedfonfafprovider’sfexperience,falthoughfthesefarefrarelyfaccurate.fOverfthefpastfdecade,fthefavailabilityfoffeviden
cefonfwhichftofbasefclinicalfreasoningfisfimproving,fandftherefisfanfincreasingfexpectationfthatfclinicalfreasoningfbefbasedfonfscient
ificfevidence.
Evidence-basedfstatisticsfarefalsofincreasinglyfbeingfusedftofdevelopfresourcesftoffacilitatefclinicalfdecision-making.
PTS: 1
6. ANS: D
Tofassistfinfclinicalfdecision-making,fafnumberfoffevidence-
basedfresourcesfhavefbeenfdevelopedftofassistfthefclinician.fResources,fsuchfasfalgorithmsfandfclinicalfpracticefguidelines,fassistfinf
clinicalfreasoningfwhenfproperlyfapplied.
PTS: 1
7. ANS: A
Thefsensitivityfoffafdiagnosticfstudyfisfthefpercentagefoffindividualsfwithftheftargetfconditionfwhofshowfanfabnormal,forfpositive,fres
ult.fAfhighfsensitivityfindicatesfthatfafgreaterfpercentagefoffpersonsfwithfthefgivenfconditionfwillfhavefanfabnormalfresult.
PTS: 1
8. ANS: B
Thefspecificityfoffafdiagnosticfstudyfisfthefpercentagefoffnormal,fhealthyfindividualsfwhofhavefafnormalfresult.fThefgreaterfthefspeci
ficity,fthefgreaterfthefpercentagefoffindividualsfwhofwillfhavefnegative,forfnormal,fresultsfifftheyfdofnotfhaveftheftargetfcondition.
PTS: 1
9. ANS: A
Theflikelihoodfratiofisfthefprobabilityfthatfafpositiveftestfresultfwillfbefassociatedfwithfafpersonfwhofhasftheftargetfconditionfandfafneg
ativefresultfwillfbefassociatedfwithfafhealthyfperson.fAflikelihoodfratiofabovef1findicatesfthatfafpositivefresultfisf associatedfwithfthefd
isease;faflikelihoodfratioflessfthanf1findicatesfthatfafnegativefresultfisfassociatedfwithfanfabsencefoffthefdisease.
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PTS: 1
10. ANS: B
Clinicalfdecisionf(orfprediction)frulesfprovidefanotherfsupportfforfclinicalfreasoning.fClinicalfdecisionfrulesfarefevidence-
basedfresourcesfthatfprovidefprobabilisticfstatementsfregardingftheflikelihoodfthatfafconditionfexistsfiffcertainfvariablesfarefmetfwit
hfregardftofthefprognosisfoffpatientsfwithfspecificffindings.fDecisionfrulesfusefmathematicalfmodelsfandfarefspecificftofcertainfsituat
ions,fsettings,fand/orfpatientfcharacteristics.
PTS: 1
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Chapterf2.fEvidence-basedfhealthfscreening
MultiplefChoice
Identifyfthefchoicefthatfbestfcompletesfthefstatementforfanswersfthefquestion.
1. Theffirstfstepfinfthefgenomicfassessmentfoffafpatientfisfobtainingfinformationfregarding:
A. Familyfhistory
B. Environmentalfexposures
C. Lifestylefandfbehaviors
D. Currentfmedications
2. Anfaffectedfindividualfwhofmanifestsfsymptomsfoffafparticularfconditionfthroughfwhomfaffamilyfwithfafgeneticfdi
sorderfisfascertainedfisfcalledfa(n):
A. Consultand
B. Consulband
C. Indexfpatient
D. Proband
3. Anfautosomalfdominantfdisorderfinvolvesfthe:
A. Xfchromosome
B. Yfchromosome
C. MitochondrialfDNA
D. Non-sexfchromosomes
4. Tofillustratefafunionfbetweenftwofsecondfcousinffamilyfmembersfinfafpedigree,fdraw:
A. Arrowsfpointingftofthefmalefandffemale
B. Bracketsfaroundfthefmalefandffemale
C. Doublefhorizontalflinesfbetweenfthefmalefandffemale
D. Circlesfaroundfthefmalefandffemale
5. Tofillustrateftwoffamilyfmembersfinfanfadoptivefrelationshipfinfafpedigree:
A. Arrowsfarefdrawnfpointingftofthefmalefandffemale
B. Bracketsfarefdrawnfaroundfthefmalefandffemale
C. Doublefhorizontalflinesfarefdrawnfbetweenfthefmalefandffemale
D. Circlesfarefdrawnfaroundfthefmalefandffemale
6. Whenfanalyzingfthefpedigreefforfautosomalfdominantfdisorders,fitfisfcommonftofsee:
A. Severalfgenerationsfoffaffectedfmembers
B. Manyfconsanguineousfrelationships
C. Morefmembersfoffthefmaternalflineagefaffectedfthanfpaternal
D. Morefmembersfoffthefpaternalflineagefaffectedfthanfmaternal
7. Infautosomalfrecessivef(AR)fdisorders,findividualsfneed:
A. Onlyfonefmutatedfgenefonfthefsexfchromosomesftofacquirefthefdisease
B. Onlyfonefmutatedfgeneftofacquirefthefdisease
C. Twofmutatedfgenesftofacquirefthefdisease
D. Twofmutatedfgenesftofbecomefcarriers
8. Infautosomalfrecessivefdisorders,fcarriersfhave:
A. Twofmutatedfgenes;foneffromfeachfparentfthatfcausefdisease
B. Afmutationfonfafsexfchromosomefthatfcausesfafdisease
C. Afsinglefgenefmutationfthatfcausesfthefdisease
D. Onefcopyfoffafgenefmutationfbutfnotfthefdisease
9. Withfanfautosomalfrecessivefdisorder,fitfisfimportantfthatfparentsfunderstandfthatfifftheyfbothfcarryfafmutation,ftheffol
lowingfarefthefrisksftofeachfofftheirfoffspringf(eachfpregnancy):
A. 50%fchancefthatfoffspringfwillfcarryfthefdisease
B. 10%fchancefoffoffspringfaffectedfbyfdisease