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TESTBANKFORADVANCEDHEALTHASSESSMENT&
n CLINICALDIAGNOSISINPRIMARYCARE6THEDITION
DAINSISBN:9780323594554
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ThisTestBankisDirectlyfromThePublisher
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nHasAllChaptersWith100%Correct Answers
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n INSTANTDOWNLOAD n
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TestBankforAdvancedHealthAssessment&ClinicalDiagnosisinPrimaryCare6th
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EditionDains n
Chapter1:Clinical Reasoning,DifferentialDiagnosis,Evidence-BasedPractice,andSymptomAnalysis
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MultipleChoice
Identifythechoice thatbestcompletesthestatementoranswers thequestion.
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1. Which type ofclinical decision-makingis mostreliable?
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A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
2. Which ofthefollowingis false?Toobtainadequatehistory, health-care providers must be:
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A. Methodical andsystematic n
B. Attentive to the patient‘s verbal and nonverbal language N n n N N
C. Ableto accuratelyinterpret thepatient‘s responses
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D. Adept at reading into thepatient‘s statements
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3. Essential parts ofa health historyinclude all ofthefollowingexcept:
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A. Chiefcomplaint n
B. Historyofthe present illness n n n
C. Current vital signs n n
D. All ofthe above areessential historycomponents
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4. Which of the followingis false? Whileperformingthephysical examination,the examiner must beableto:
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A. Differentiatebetweennormal and abnormal findings n N n
B. Recallknowledge of arange of conditions and their associated signs and symptoms n n n N N n N n N
C. Recognize howcertain conditionsaffect the responseto other conditions
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D. Foresee unpredictable findingsn n
5. Thefollowingistheleast reliablesource of information for diagnosticstatistics: n n N n n
A. Evidence-based investigations n
B. Primaryreports ofresearch n
C. Estimation based on aprovider‘sexperience n n n n
D. Published meta-analyses n
6. The followingcan be used to assist insound clinical decision-making:
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A. Algorithm published in a peer-reviewed journal article
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B. Clinical practice guidelines N n
C. Evidence-based research n
D. All oftheabove
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7. Ifa diagnosticstudyhas high sensitivity, thisindicates a:
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A. High percentageof persons withthegivencondition will haveanabnormalresult
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B. Lowpercentage of persons with the given condition willhave anabnormal result n N n n n n n n n
C. Lowlikelihood of normal result inpersons withouta given condition
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D. None oftheabove n
8. Ifadiagnosticstudyhas high specificity, this indicates a:
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A. Lowpercentage ofhealthyindividuals will show a normal result n n n n N
B. High percentage ofhealthyindividualswillshowa normal result
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C. High percentage ofindividuals with adisorderwillshowa normalresult
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D. Lowpercentage ofindividuals withadisorder will showan abnormal result
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9. A likelihood ratio above 1 indicatesthat a diagnostictestshowing a:
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A. Positive resultis stronglyassociated withthedisease
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B. Negativeresult is stronglyassociated with absence of the disease n N n n n N n
C. Positiveresultis weaklyassociated withthedisease
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D. Negativeresultis weaklyassociated withabsence ofthe disease n n n n
10. Which of thefollowingclinical reasoning toolsisdefinedasevidence-based resource based on mathematical modeling to
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nexpress the likelihood of a condition in select situations, settings, and/or patients?
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A. Clinical practice guideline N n
B. Clinical decision rule N n
C. Clinical algorithm n
Chapter1:Clinicalreasoning,differentialdiagnosis,evidence-basedpractice,and symptomana
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AnswerSection
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MULTIPLECHOICE
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1. ANS: B
Croskerry(2009) describes two major types of clinical diagnostic decision-making: intuitive and analytical. Intuitive decision-
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making (similar to Augenblinkdecision-making) is based on the experience and intuition ofthe clinician and is less reliable and paired
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with fairly common errors. In contrast, analytical decision-making is based on careful consideration and has greater reliability
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with rare errors.
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PTS: 1
2. ANS: D
To obtain adequate history, providers must be well organized, attentive tothe patient‘s verbal and nonverbal language, and able to
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accurately interpret the patient‘s responses to questions. Rather than reading into the patient‘s statements, they clarify any areas of
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uncertainty.
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3. ANS: C
Vitalsigns arepart ofthephysical examination portion ofpatient assessment, not part of the health history.
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4. ANS: D
While performing the physical examination, the examiner must be able to differentiate between normal and abnormal findings, recall
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knowledge ofa range ofconditions, includingtheir associated signs and symptoms, recognize howcertain conditionsaffect the response
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to other conditions, and distinguish the relevance of varied abnormal findings.
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PTS: 1
5. ANS: C
Sources for diagnostic statistics includetextbooks, primaryreports of research, and published meta-analyses. Another source of
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statistics,theonethathasbeen most widelyused and available for application tothereasoningprocess,istheestimation basedon a
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provider‘s experience, although these are rarely accurate. Over the past decade, the availability of evidence on which to base
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clinical reasoning is improving, and there is an increasing expectation that clinical reasoning be based on scientific evidence.
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Evidence-based statistics are also increasinglybeing used to develop resourcesto facilitate clinical decision-making.
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6. ANS: D
To assist in clinical decision-making, anumber ofevidence-based resourceshavebeen developed toassist the clinician. Resources, such
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as algorithms and clinical practice guidelines, assist in clinical reasoning when properlyapplied.
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PTS: 1
7. ANS: A
The sensitivityof a diagnostic studyis the percentage of individuals with the target condition who show an abnormal, or positive,
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result. Ahigh sensitivityindicates that a greater percentage of persons with the given condition will have an abnormal result.
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PTS: 1
8. ANS: B
The specificityof a diagnostic studyis the percentage of normal, healthyindividuals who have a normal result. The greater the
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specificity, the greater the percentage of individuals who will have negative, or normal, results if they do not have the target
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condition.
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9. ANS: A
The likelihood ratio is the probabilitythat a positive test result willbe associated with a person who hasthetarget condition and a
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negative result will be associated with a healthy person. A likelihood ratio above 1 indicates that a positive result is associated with the
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disease; a likelihood ratioless than 1 indicates that a negative result is associated with an absence of the disease.
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10. ANS: B
Clinicaldecision (or prediction) rules provideanother support for clinical reasoning. Clinical decision rules areevidence-based resources
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that provide probabilistic statements regarding the likelihood that a condition exists if certain variables are met with regard to the
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nprognosis of patients with specific findings. Decision rules use mathematical models and are specific to certain situations, settings,
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nand/or patient characteristics.
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PTS: 1