TEST BANK FOR ADVANCED ASSESSMENT: INTERPRETING FINDINGS AND FORMULATING DIFFERENTIAL DIAGNOSES 5th Edition by Goolsby

TEST BANK FOR ADVANCED ASSESSMENT:
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INTERPRETING FINDINGS AND
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FORMULATING DIFFERENTIAL
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DIAGNOSES 5TH EDITION, MARY JO
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GOOLSBY, LAURIE GRUBBS ISBN-10;
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1719645930 / ISBN-13;978-1719645935
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,Chapter 1. Assessment and Clinical Decision-Making: Overview
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Multiple Choice
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Identify the choice that best completes the statement or answers the question.
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1. Which type of clinical decision-making is most reliable?
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A. Intuitive
B. Analytical
C. Experiential
D. Augenblick

2. Which of the following is false? To obtain adequate history, health-care providers must be:
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A. Methodical and systematic vv vv


B. Attentive to the patient’s verbal and nonverbal languagevv vv vv vv vv vv vv


C. Able to accurately interpret the patient’s responses
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D. Adept at reading into the patient’s statements
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3. Essential parts of a health history include all of the following except:
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A. Chief complaint vv


B. History of the present illness vv vv vv vv


C. Current vital signs vv vv


D. All of the above are essential history components
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4. Which of the following is false? While performing the physical examination, the examiner
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must be able to:
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A. Differentiate between normal and abnormal findings vv vv vv vv vv


B. Recall knowledge of a range of conditions and their associated signs and symptoms
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C. Recognize how certain conditions affect the response to other conditions
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D. Foresee unpredictable findings vv vv




5. The following is the least reliable source of information for diagnostic statistics:
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A. Evidence-based investigations vv


B. Primary reports of research vv vv vv


C. Estimation based on a provider’s experience vv vv vv vv vv


D. Published meta-analyses vv




6. The following can be used to assist in sound clinical decision-making:
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A. Algorithm published in a peer-reviewed journal article vv vv vv vv vv vv


B. Clinical practice guidelines vv vv


C. Evidence-based research vv


D. All of the above vv vv vv




7. If a diagnostic study has high sensitivity, this indicates a:
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A. High percentage of persons with the given condition will have an abnormal result
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B. Low percentage of persons with the given condition will have an abnormal result
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C. Low likelihood of normal result in persons without a given condition
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D. None of the above vv vv vv

, 8. If a diagnostic study has high specificity, this indicates a:
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A. Low percentage of healthy individuals will show a normal result
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B. High percentage of healthy individuals will show a normal result
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C. High percentage of individuals with a disorder will show a normal result
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D. Low percentage of individuals with a disorder will show an abnormal result
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9. A likelihood ratio above 1 indicates that a diagnostic test showing a:
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A. Positive result is strongly associated with the disease
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B. Negative result is strongly associated with absence of the disease
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C. Positive result is weakly associated with the disease
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D. Negative result is weakly associated with absence of the disease
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v v 10. Which of the following clinical reasoning tools is defined as evidence-based resource based
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on mathematical modeling to express the likelihood of a condition in select situations,
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settings, and/or patients?
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A. Clinical practice guideline
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B. Clinical decision rule vv vv


C. Clinical algorithm vv


D. Clinical recommendation vv

, Answer Section
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MULTIPLE CHOICE
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1. ANS: B vv vv


Croskerry (2009) describes two major types of clinical diagnostic decision-making: intuitive
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and analytical. Intuitive decision-making (similar to Augenblink decision-making) is based
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on the experience and intuition of the clinician and is less reliable and paired with fairly
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common errors. In contrast, analytical decision-making is based on careful consideration and
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has greater reliability with rare errors.
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PTS: 1
2. ANS: D vv vv


To obtain adequate history, providers must be well organized, attentive to the patient’s verbal
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and nonverbal language, and able to accurately interpret the patient’s responses to questions.
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Rather than reading into the patient’s statements, they clarify any areas of uncertainty.
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PTS: 1
3. ANS: C vv vv


Vital signs are part of the physical examination portion of patient assessment, not part of the
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health history.
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PTS: 1
4. ANS: D vv vv


While performing the physical examination, the examiner must be able to differentiate between
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normal and abnormal findings, recall knowledge of a range of conditions, including their
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associated signs and symptoms, recognize how certain conditions affect the response to
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other conditions, and distinguish the relevance of varied abnormal findings.
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PTS: 1
5. ANS: C vv vv


Sources for diagnostic statistics include textbooks, primary reports of research, and
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published meta-analyses. Another source of statistics, the one that has been most widely
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used and available for application to the reasoning process, is the estimation based on a
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provider’s experience, although these are rarely accurate. Over the past decade, the
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availability of evidence on which to base clinical reasoning is improving, and there is an
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increasing expectation that clinical reasoning be based on scientific evidence. Evidence-
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based statistics are also increasingly being used to develop resources to facilitate clinical
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decision-making.
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PTS: 1
6. ANS: D vv vv


To assist in clinical decision-making, a number of evidence-based resources have been
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developed to assist the clinician. Resources, such as algorithms and clinical practice
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guidelines, assist in clinical reasoning when properly applied.
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