IUYTRE
TEST BANK
Advanced Assessment: Interpreting Findings and Formulating Differential
Diagnoses
by Mary Jo Goolsby, Laurie Grubbs
SU Fourth Edition
PE
RS
OL
UT
IO
NS
FULL TEST BANK!!!
2024 UYTRE
, IUYTRE
Goolsby Test Bank: Advanced Assessment Interpreting Findings and Formulating
Differential Diagnoses 4th Edition
Chapter 1. Assessment and Clinical Decision-Making:
OverviewMultiple Choice
Identify the choice that best completes the statement or answers the question.
1. Which type of clinical decision-making is most reliable?
1. Intuitive
2. Analytical
3. Experiential
4. Augenblick
2. Which of the following is false? To obtain adequate history,
SU
health-careproviders must be:
PE
1. Methodical and systematic
2. Attentive to the patient’s verbal and
RS
nonverbal language
OL
1. Able to accurately interpret the patient’s
responses
UT
1. Adept at reading into the patient’s
statements
IO
NS
3. Essential parts of a health history include all of the following except:
1. Chief complaint
2. History of the present illness
3. Current vital signs
4. All of the above are essential history
components
4. Which of the following is false? While performing the
physicalexamination, the examiner must be able to:
1. Differentiate between normal and
abnormal findings
1. Recall knowledge of a range of conditions
and their associated signs and symptoms
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, IUYTRE
1. Recognize how certain conditions affect
the response to other conditions
1. Foresee unpredictable findings
5. The following is the least reliable source of information for
diagnosticstatistics:
1. Evidence-based investigations
2. Primary reports of research
3. Estimation based on a provider’s
experience
1. Published meta-analyses
SU
6. The following can be used to assist in sound clinical decision-making:
1. Algorithm published in a peer-reviewed
PE
journal article
RS
1. Clinical practice guidelines
2. Evidence-based research
OL
3. All of the above
7. If a diagnostic study has high sensitivity, this indicates a:
UT
1. High percentage of persons with the given
IO
condition will have an abnormal result
NS
1. Low percentage of persons with the given
condition will have an abnormal result
1. Low likelihood of normal result in
persons without a given condition
1. None of the above
8. If a diagnostic study has high specificity, this indicates a:
1. Low percentage of healthy individuals
will show a normal result
1. High percentage of healthy individuals
will show a normal result
1. High percentage of individuals with a
disorder will show a normal result
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1. 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:
1. Positive result is strongly associated with
the disease
1. Negative result is strongly associated with
absence of the disease
1. Positive result is weakly associated with
the disease
1. Negative result is weakly associated with
absence of the disease
SU
10. Which of the following clinical reasoning tools is defined as
PE
evidencebasedresource based on mathematical modeling to express the
RS
likelihood of a condition in select situations, settings, and/or patients?
OL
1. Clinical practice guideline
2. Clinical decision rule
UT
3. Clinical algorithm
4. Clinical recommendation
IO
Chapter 2. An Overview of Genetic Assessment
NS
Multiple Choice
Identify the choice that best completes the statement or answers the question.
1. The first step in the genomic assessment of a patient is
obtaininginformation regarding:
1. Family history
2. Environmental exposures
3. Lifestyle and behaviors
4. Current medications
2. An affected individual who manifests symptoms of a particular
conditionthrough whom a family with a genetic disorder is ascertained
is called a(n):
1. Consultand
2024 UYTRE
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2. Consulband
3. Index patient
4. Proband
3. An autosomal dominant disorder involves the:
1. X chromosome
2. Y chromosome
3. Mitochondrial DNA
4. Non-sex chromosomes
4. To illustrate a union between two second cousin family
members in apedigree, draw:
1. Arrows pointing to the male and female
2. Brackets around the male and female
3. Double horizontal lines between the male
SU
and female
1. Circles around the male and female
PE
5. To illustrate two family members in an adoptive relationship in a pedigree:
RS
1. Arrows are drawn pointing to the male
and female
OL
1. Brackets are drawn around the male and
UT
female
IO
1. Double horizontal lines are drawn
between the male and female
NS
1. Circles are drawn around the male and
female
6. When analyzing the pedigree for autosomal dominant
disorders, it iscommon to see:
1. Several generations of affected members
2. Many consanguineous relationships
3. More members of the maternal lineage
affected than paternal
1. More members of the paternal lineage
affected than maternal
7. In autosomal recessive (AR) disorders, individuals need:
1. Only one mutated gene on the sex
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, IUYTRE
chromosomes to acquire the disease
1. Only one mutated gene to acquire the
disease
1. Two mutated genes to acquire the disease
2. Two mutated genes to become carriers
8. In autosomal recessive disorders, carriers have:
1. Two mutated genes; one from each parent
that cause disease
1. A mutation on a sex chromosome that
causes a disease
1. A single gene mutation that causes the
disease
SU
1. One copy of a gene mutation but not the
PE
disease
RS
9. With an autosomal recessive disorder, it is important that parents
OL
understand that if they both carry a mutation, the following are the risks to each of
UT
theiroffspring (each pregnancy):
IO
1. 50% chance that offspring will carry the
disease
NS
1. 10% chance of offspring affected by
disease
1. 25% chance children will carry the
disease
1. 10% chance children will be disease free
10. A woman with an X-linked dominant disorder will:
1. Not be affected by the disorder herself
2. Transmit the disorder to 50 % of her
offspring (male or female)
2024 UYTRE
, IUYTRE
1. Not transmit the disorder to her daughters
2. Transmit the disorder to only her
daughters
11. In creating your female patient’s pedigree, you note that she and both of
her sisters were affected by the same genetic disorder. Although neither of her
parents hadindications of the disorder, her paternal grandmother and her paternal
grandmother’s two sisters were affected by the same condition. This pattern
suggests:
1. Autosomal dominant disorder
2. Chromosomal disorder
SU
3. Mitochondrial DNA disorder
4. X-linked dominant disorder
PE
12. A woman affected with an X-linked recessive disorder:
RS
1. Has one X chromosome affected by the
mutation
OL
1. Will transmit the disorder to all of her
children
UT
1. Will transmit the disorder to all of her
IO
sons
NS
1. Will not transmit the mutation to any of
her daughters
13. Which of the following are found in an individual with aneuploidy?
1. An abnormal number of chromosomes
2. An X-linked disorder
3. Select cells containing abnormalappearing
chromosomes
1. An autosomal recessive disorder
14. The pedigree of a family with a mitochondrial DNA disorder is
unique inthat:
1. None of the female offspring will have the
disease
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1. All offspring from an affected female will
have disease
1. None of the offspring of an affected
female will have the disease
1. All the offspring from an affected male
will have disease
15. Which population is at highest risk for the occurrence of
aneuploidy inoffspring?
1. Mothers younger than 18
2. Fathers younger than 18
SU
3. Mothers over age 35
4. Fathers over age 35
16. Approximately what percentage of cancers is due to a
PE
RS
single-genemutation?
1. 50% to
OL
70%
2. 30% to
UT
40%
3. 20% to
25%
IO
4. 5% to
10%
NS
1. 50% to
70%
2. 30% to
40%
3. 20% to
25%
4. 5% to
10%
17. According to the Genetic Information Nondiscrimination Act (GINA):
1. NPs should keep all genetic information
of patients confidential
1. NPs must obtain informed consent prior to
genetic testing of all patients
1. Employers cannot inquire about an
employee’s genetic information
2024 UYTRE
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1. All of the above
18. The leading causes of death in the United States are due to:
1. Multifactorial inheritance
2. Single gene mutations
3. X-linked disorders
4. Aneuploidy
19. Which of the following would be considered a “red flag” that
requiresmore investigation in a patient assessment?
1. Colon cancer in family member at age 70
2. Breast cancer in family member at age 75
3. Myocardial infarction in family member
at age 35
SU
1. All of the above
20. When patients express variable forms of the same hereditary
PE
disorder, thisis due to:
RS
1. Penetrance
OL
2. Aneuploidy
3. De novo mutation
Sporadic inheritance
UT
4.
21. Your 2-year-old patient shows facial features, such as epicanthal folds,
IO
upslantedpalpebral fissures, single transverse palmar crease, and a low nasal
NS
bridge. These
are referred to as:
1. Variable expressivity related to inherited
disease
1. Dysmorphic features related to genetic
disease
1. De novo mutations of genetic disease
2. Different penetrant signs of genetic
disease
22. In order to provide a comprehensive genetic history of a patient,
the NPshould:
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, IUYTRE
1. Ask patients to complete a family history
worksheet
1. Seek out pathology reports related to the
patient’s disorder
1. Interview family members regarding
genetic disorders
1. All of the above
Chapter 3.
SkinMultiple
Choice
Identify the choice that best completes the statement or answers the question.
1. When a patient presents with a skin-related complaint, it is important to
first:
SU
1. Fully inspect all skin lesions before asking
PE
the patient how the lesion in
RS
questiondeveloped
OL
1. Obtain a full history about the
development of the skin lesion prior
UT
to thephysical examination
IO
1. Complete a full physical examination of
NS
the body prior to inspecting the skin lesion
1. Examine the skin lesion without hearing a
health history in order to not
prejudice thediagnosis
2. Jaundice is a state of high bilirubin in the bloodstream. It
is mostcommonly seen first in the:
1. Sclera
2. Nailbeds
3. Palms of the hands
4. Unexposed skin areas
3. Skin turgor is best assessed by pinching skin over the:
2024 UYTRE
TEST BANK
Advanced Assessment: Interpreting Findings and Formulating Differential
Diagnoses
by Mary Jo Goolsby, Laurie Grubbs
SU Fourth Edition
PE
RS
OL
UT
IO
NS
FULL TEST BANK!!!
2024 UYTRE
, IUYTRE
Goolsby Test Bank: Advanced Assessment Interpreting Findings and Formulating
Differential Diagnoses 4th Edition
Chapter 1. Assessment and Clinical Decision-Making:
OverviewMultiple Choice
Identify the choice that best completes the statement or answers the question.
1. Which type of clinical decision-making is most reliable?
1. Intuitive
2. Analytical
3. Experiential
4. Augenblick
2. Which of the following is false? To obtain adequate history,
SU
health-careproviders must be:
PE
1. Methodical and systematic
2. Attentive to the patient’s verbal and
RS
nonverbal language
OL
1. Able to accurately interpret the patient’s
responses
UT
1. Adept at reading into the patient’s
statements
IO
NS
3. Essential parts of a health history include all of the following except:
1. Chief complaint
2. History of the present illness
3. Current vital signs
4. All of the above are essential history
components
4. Which of the following is false? While performing the
physicalexamination, the examiner must be able to:
1. Differentiate between normal and
abnormal findings
1. Recall knowledge of a range of conditions
and their associated signs and symptoms
2024 UYTRE
, IUYTRE
1. Recognize how certain conditions affect
the response to other conditions
1. Foresee unpredictable findings
5. The following is the least reliable source of information for
diagnosticstatistics:
1. Evidence-based investigations
2. Primary reports of research
3. Estimation based on a provider’s
experience
1. Published meta-analyses
SU
6. The following can be used to assist in sound clinical decision-making:
1. Algorithm published in a peer-reviewed
PE
journal article
RS
1. Clinical practice guidelines
2. Evidence-based research
OL
3. All of the above
7. If a diagnostic study has high sensitivity, this indicates a:
UT
1. High percentage of persons with the given
IO
condition will have an abnormal result
NS
1. Low percentage of persons with the given
condition will have an abnormal result
1. Low likelihood of normal result in
persons without a given condition
1. None of the above
8. If a diagnostic study has high specificity, this indicates a:
1. Low percentage of healthy individuals
will show a normal result
1. High percentage of healthy individuals
will show a normal result
1. High percentage of individuals with a
disorder will show a normal result
2024 UYTRE
, IUYTRE
1. 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:
1. Positive result is strongly associated with
the disease
1. Negative result is strongly associated with
absence of the disease
1. Positive result is weakly associated with
the disease
1. Negative result is weakly associated with
absence of the disease
SU
10. Which of the following clinical reasoning tools is defined as
PE
evidencebasedresource based on mathematical modeling to express the
RS
likelihood of a condition in select situations, settings, and/or patients?
OL
1. Clinical practice guideline
2. Clinical decision rule
UT
3. Clinical algorithm
4. Clinical recommendation
IO
Chapter 2. An Overview of Genetic Assessment
NS
Multiple Choice
Identify the choice that best completes the statement or answers the question.
1. The first step in the genomic assessment of a patient is
obtaininginformation regarding:
1. Family history
2. Environmental exposures
3. Lifestyle and behaviors
4. Current medications
2. An affected individual who manifests symptoms of a particular
conditionthrough whom a family with a genetic disorder is ascertained
is called a(n):
1. Consultand
2024 UYTRE
, IUYTRE
2. Consulband
3. Index patient
4. Proband
3. An autosomal dominant disorder involves the:
1. X chromosome
2. Y chromosome
3. Mitochondrial DNA
4. Non-sex chromosomes
4. To illustrate a union between two second cousin family
members in apedigree, draw:
1. Arrows pointing to the male and female
2. Brackets around the male and female
3. Double horizontal lines between the male
SU
and female
1. Circles around the male and female
PE
5. To illustrate two family members in an adoptive relationship in a pedigree:
RS
1. Arrows are drawn pointing to the male
and female
OL
1. Brackets are drawn around the male and
UT
female
IO
1. Double horizontal lines are drawn
between the male and female
NS
1. Circles are drawn around the male and
female
6. When analyzing the pedigree for autosomal dominant
disorders, it iscommon to see:
1. Several generations of affected members
2. Many consanguineous relationships
3. More members of the maternal lineage
affected than paternal
1. More members of the paternal lineage
affected than maternal
7. In autosomal recessive (AR) disorders, individuals need:
1. Only one mutated gene on the sex
2024 UYTRE
, IUYTRE
chromosomes to acquire the disease
1. Only one mutated gene to acquire the
disease
1. Two mutated genes to acquire the disease
2. Two mutated genes to become carriers
8. In autosomal recessive disorders, carriers have:
1. Two mutated genes; one from each parent
that cause disease
1. A mutation on a sex chromosome that
causes a disease
1. A single gene mutation that causes the
disease
SU
1. One copy of a gene mutation but not the
PE
disease
RS
9. With an autosomal recessive disorder, it is important that parents
OL
understand that if they both carry a mutation, the following are the risks to each of
UT
theiroffspring (each pregnancy):
IO
1. 50% chance that offspring will carry the
disease
NS
1. 10% chance of offspring affected by
disease
1. 25% chance children will carry the
disease
1. 10% chance children will be disease free
10. A woman with an X-linked dominant disorder will:
1. Not be affected by the disorder herself
2. Transmit the disorder to 50 % of her
offspring (male or female)
2024 UYTRE
, IUYTRE
1. Not transmit the disorder to her daughters
2. Transmit the disorder to only her
daughters
11. In creating your female patient’s pedigree, you note that she and both of
her sisters were affected by the same genetic disorder. Although neither of her
parents hadindications of the disorder, her paternal grandmother and her paternal
grandmother’s two sisters were affected by the same condition. This pattern
suggests:
1. Autosomal dominant disorder
2. Chromosomal disorder
SU
3. Mitochondrial DNA disorder
4. X-linked dominant disorder
PE
12. A woman affected with an X-linked recessive disorder:
RS
1. Has one X chromosome affected by the
mutation
OL
1. Will transmit the disorder to all of her
children
UT
1. Will transmit the disorder to all of her
IO
sons
NS
1. Will not transmit the mutation to any of
her daughters
13. Which of the following are found in an individual with aneuploidy?
1. An abnormal number of chromosomes
2. An X-linked disorder
3. Select cells containing abnormalappearing
chromosomes
1. An autosomal recessive disorder
14. The pedigree of a family with a mitochondrial DNA disorder is
unique inthat:
1. None of the female offspring will have the
disease
2024 UYTRE
, IUYTRE
1. All offspring from an affected female will
have disease
1. None of the offspring of an affected
female will have the disease
1. All the offspring from an affected male
will have disease
15. Which population is at highest risk for the occurrence of
aneuploidy inoffspring?
1. Mothers younger than 18
2. Fathers younger than 18
SU
3. Mothers over age 35
4. Fathers over age 35
16. Approximately what percentage of cancers is due to a
PE
RS
single-genemutation?
1. 50% to
OL
70%
2. 30% to
UT
40%
3. 20% to
25%
IO
4. 5% to
10%
NS
1. 50% to
70%
2. 30% to
40%
3. 20% to
25%
4. 5% to
10%
17. According to the Genetic Information Nondiscrimination Act (GINA):
1. NPs should keep all genetic information
of patients confidential
1. NPs must obtain informed consent prior to
genetic testing of all patients
1. Employers cannot inquire about an
employee’s genetic information
2024 UYTRE
, IUYTRE
1. All of the above
18. The leading causes of death in the United States are due to:
1. Multifactorial inheritance
2. Single gene mutations
3. X-linked disorders
4. Aneuploidy
19. Which of the following would be considered a “red flag” that
requiresmore investigation in a patient assessment?
1. Colon cancer in family member at age 70
2. Breast cancer in family member at age 75
3. Myocardial infarction in family member
at age 35
SU
1. All of the above
20. When patients express variable forms of the same hereditary
PE
disorder, thisis due to:
RS
1. Penetrance
OL
2. Aneuploidy
3. De novo mutation
Sporadic inheritance
UT
4.
21. Your 2-year-old patient shows facial features, such as epicanthal folds,
IO
upslantedpalpebral fissures, single transverse palmar crease, and a low nasal
NS
bridge. These
are referred to as:
1. Variable expressivity related to inherited
disease
1. Dysmorphic features related to genetic
disease
1. De novo mutations of genetic disease
2. Different penetrant signs of genetic
disease
22. In order to provide a comprehensive genetic history of a patient,
the NPshould:
2024 UYTRE
, IUYTRE
1. Ask patients to complete a family history
worksheet
1. Seek out pathology reports related to the
patient’s disorder
1. Interview family members regarding
genetic disorders
1. All of the above
Chapter 3.
SkinMultiple
Choice
Identify the choice that best completes the statement or answers the question.
1. When a patient presents with a skin-related complaint, it is important to
first:
SU
1. Fully inspect all skin lesions before asking
PE
the patient how the lesion in
RS
questiondeveloped
OL
1. Obtain a full history about the
development of the skin lesion prior
UT
to thephysical examination
IO
1. Complete a full physical examination of
NS
the body prior to inspecting the skin lesion
1. Examine the skin lesion without hearing a
health history in order to not
prejudice thediagnosis
2. Jaundice is a state of high bilirubin in the bloodstream. It
is mostcommonly seen first in the:
1. Sclera
2. Nailbeds
3. Palms of the hands
4. Unexposed skin areas
3. Skin turgor is best assessed by pinching skin over the:
2024 UYTRE
