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
vvv vvv vvv v
,Chapter 1. Assessment and Clinical Decision-Making: Overview
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Multiple Choice
vvv
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:
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
A. Methodical and systematic vvv vvv
B. Attentive to the patient’s verbal and nonverbal languagevvv vvv vvv vvv vvv vvv vvv
C. Able to accurately interpret the patient’s responses
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D. Adept at reading into the patient’s statements
vvv vvv vvv vvv vvv vvv
3. Essential parts of a health history include all of the following except:
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
A. Chief complaint vvv
B. History of the present illness vvv vvv vvv vvv
C. Current vital signs vvv vvv
D. All of the above are essential history components
vvv vvv vvv vvv vvv vvv vvv
4. Which of the following is false? While performing the physical examination, the
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
examiner must be able to:
vvv vvv vvv vvv vvv
A. Differentiate between normal and abnormal findings vvv vvv vvv vvv vvv
B. Recall knowledge of a range of conditions and their associated signs and symptoms
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
C. Recognize how certain conditions affect the response to other conditions
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D. Foresee unpredictable findings vvv vvv
5. The following is the least reliable source of information for diagnostic statistics:
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
A. Evidence-based investigations vvv
B. Primary reports of research vvv vvv vvv
C. Estimation based on a provider’s experience vvv vvv vvv vvv vvv
D. Published meta-analyses vvv
6. The following can be used to assist in sound clinical decision-making:
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
A. Algorithm published in a peer-reviewed journal article vvv vvv vvv vvv vvv vvv
B. Clinical practice guidelines vvv vvv
C. Evidence-based research vvv
D. All of the above vvv vvv vvv
7. If a diagnostic study has high sensitivity, this indicates a:
vvv vvv vvv vvv vvv vvv vvv vvv vvv
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
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
C. Low likelihood of normal result in persons without a given condition
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
D. None of the above vvv vvv vvv
, 8. If vvv a diagnostic study has high specificity,
vvv vvv vvv vvv vvv this indicates
vvv vvv a:
vvv
A. Low percentage of healthy individuals
vvv vvv vvv vvv will show a
vvv vvv vvv normal result
vvv vvv
B. High percentage of healthy individuals
vvv vvv vvv vvv will show a
vvv vvv vvv normal result
vvv vvv
C. High percentage of individuals with a
vvv vvv vvv vvv vvv disorder will
vvv vvv show a normal result
vvv vvv vvv vvv
D. Low percentage of individuals with a
vvv vvv vvv vvv vvv vvv disorder will vvv show an abnormal result
vvv vvv vvv vvv
9. A likelihood ratio above 1 indicates that a diagnostic test showing a:
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
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
vvv vvv vvv vvv vvv vvv vvv vvv vvv
v v v 10. Which of the following clinical reasoning tools is defined as evidence-based resource
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based on mathematical modeling to express the likelihood of a condition in select
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situations, settings, and/or patients?
vvv vvv vvv vvv
A. Clinical practice guideline vvv vvv
B. Clinical decision rule vvv vvv
C. Clinical algorithm vvv
D. Clinical recommendation vvv
, Answer Section
vvv
MULTIPLE CHOICE
vvv
1. ANS: B
vvv vvv
Croskerry (2009) describes two major types of clinical diagnostic decision-making:
vvv vvv vvv vvv vvv vvv vvv vvv vvv
intuitive and analytical. Intuitive decision-making (similar to Augenblink decision-
vvv vvv vvv vvv vvv vvv vvv vvv vvv
making) is based on the experience and intuition of the clinician and is less reliable
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
and paired with fairly common errors. In contrast, analytical decision-making is based
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
on careful consideration and has greater reliability with rare errors.
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
PTS: 1
2. ANS: D vvv vvv
To obtain adequate history, providers must be well organized, attentive to the patient’s
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
verbal and nonverbal language, and able to accurately interpret the patient’s responses
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
to questions. Rather than reading into the patient’s statements, they clarify any areas
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of uncertainty.
vvv vvv
PTS: 1
3. ANS: Cvvv vvv
Vital signs are part of the physical examination portion of patient assessment, not part of
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the health history.
vvv vvv vvv
PTS: 1
4. ANS: D vvv vvv
While performing the physical examination, the examiner must be able to differentiate
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
between normal and abnormal findings, recall knowledge of a range of conditions,
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
including their associated signs and symptoms, recognize how certain conditions affect
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
the response to other conditions, and distinguish the relevance of varied abnormal
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
findings.
vvv
PTS: 1
5. ANS: C vvv vvv
Sources for diagnostic statistics include textbooks, primary reports of research, and
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
published meta-analyses. Another source of statistics, the one that has been most
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
widely used and available for application to the reasoning process, is the estimation
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
based on a provider’s experience, although these are rarely accurate. Over the past
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
decade, the availability of evidence on which to base clinical reasoning is improving,
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
and there is an increasing expectation that clinical reasoning be based on scientific
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
evidence. Evidence-based statistics are also increasingly being used to develop
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resources to facilitate clinical decision-making.
vvv vvv vvv vvv vvv
PTS: 1
6. ANS: D vvv vvv
To assist in clinical decision-making, a number of evidence-based resources have been
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
developed to assist the clinician. Resources, such as algorithms and clinical practice
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
guidelines, assist in clinical reasoning when properly applied.
vvv vvv vvv vvv vvv vvv vvv vvv
vvv vvv vvv vvv vvv
INTERPRETING FINDINGS AND
vvv vvv vvv vvv
FORMULATING DIFFERENTIAL
vvv vvv vvv
DIAGNOSES 5TH EDITION, MARY JO
vvv vvv vvv vvv vvv vvv
GOOLSBY, LAURIE GRUBBS ISBN-10;
vvv vvv vvv vvv
1719645930 / ISBN-13;978-1719645935
vvv vvv vvv v
,Chapter 1. Assessment and Clinical Decision-Making: Overview
vvv vvv vvv vvv vvv vvv
Multiple Choice
vvv
Identify the choice that best completes the statement or answers the question.
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
1. Which type of clinical decision-making is most reliable?
vvv vvv vvv vvv vvv vvv vvv
A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
2. Which of the following is false? To obtain adequate history, health-care providers must be:
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
A. Methodical and systematic vvv vvv
B. Attentive to the patient’s verbal and nonverbal languagevvv vvv vvv vvv vvv vvv vvv
C. Able to accurately interpret the patient’s responses
vvv vvv vvv vvv vvv vvv
D. Adept at reading into the patient’s statements
vvv vvv vvv vvv vvv vvv
3. Essential parts of a health history include all of the following except:
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
A. Chief complaint vvv
B. History of the present illness vvv vvv vvv vvv
C. Current vital signs vvv vvv
D. All of the above are essential history components
vvv vvv vvv vvv vvv vvv vvv
4. Which of the following is false? While performing the physical examination, the
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
examiner must be able to:
vvv vvv vvv vvv vvv
A. Differentiate between normal and abnormal findings vvv vvv vvv vvv vvv
B. Recall knowledge of a range of conditions and their associated signs and symptoms
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
C. Recognize how certain conditions affect the response to other conditions
vvv vvv vvv vvv vvv vvv vvv vvv vvv
D. Foresee unpredictable findings vvv vvv
5. The following is the least reliable source of information for diagnostic statistics:
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
A. Evidence-based investigations vvv
B. Primary reports of research vvv vvv vvv
C. Estimation based on a provider’s experience vvv vvv vvv vvv vvv
D. Published meta-analyses vvv
6. The following can be used to assist in sound clinical decision-making:
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
A. Algorithm published in a peer-reviewed journal article vvv vvv vvv vvv vvv vvv
B. Clinical practice guidelines vvv vvv
C. Evidence-based research vvv
D. All of the above vvv vvv vvv
7. If a diagnostic study has high sensitivity, this indicates a:
vvv vvv vvv vvv vvv vvv vvv vvv vvv
A. High percentage of persons with the given condition will have an abnormal result
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
B. Low percentage of persons with the given condition will have an abnormal result
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
C. Low likelihood of normal result in persons without a given condition
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
D. None of the above vvv vvv vvv
, 8. If vvv a diagnostic study has high specificity,
vvv vvv vvv vvv vvv this indicates
vvv vvv a:
vvv
A. Low percentage of healthy individuals
vvv vvv vvv vvv will show a
vvv vvv vvv normal result
vvv vvv
B. High percentage of healthy individuals
vvv vvv vvv vvv will show a
vvv vvv vvv normal result
vvv vvv
C. High percentage of individuals with a
vvv vvv vvv vvv vvv disorder will
vvv vvv show a normal result
vvv vvv vvv vvv
D. Low percentage of individuals with a
vvv vvv vvv vvv vvv vvv disorder will vvv show an abnormal result
vvv vvv vvv vvv
9. A likelihood ratio above 1 indicates that a diagnostic test showing a:
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
A. Positive result is strongly associated with the disease
vvv vvv vvv vvv vvv vvv vvv
B. Negative result is strongly associated with absence of the disease
vvv vvv vvv vvv vvv vvv vvv vvv vvv
C. Positive result is weakly associated with the disease
vvv vvv vvv vvv vvv vvv vvv
D. Negative result is weakly associated with absence of the disease
vvv vvv vvv vvv vvv vvv vvv vvv vvv
v v v 10. Which of the following clinical reasoning tools is defined as evidence-based resource
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
based on mathematical modeling to express the likelihood of a condition in select
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
situations, settings, and/or patients?
vvv vvv vvv vvv
A. Clinical practice guideline vvv vvv
B. Clinical decision rule vvv vvv
C. Clinical algorithm vvv
D. Clinical recommendation vvv
, Answer Section
vvv
MULTIPLE CHOICE
vvv
1. ANS: B
vvv vvv
Croskerry (2009) describes two major types of clinical diagnostic decision-making:
vvv vvv vvv vvv vvv vvv vvv vvv vvv
intuitive and analytical. Intuitive decision-making (similar to Augenblink decision-
vvv vvv vvv vvv vvv vvv vvv vvv vvv
making) is based on the experience and intuition of the clinician and is less reliable
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
and paired with fairly common errors. In contrast, analytical decision-making is based
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
on careful consideration and has greater reliability with rare errors.
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
PTS: 1
2. ANS: D vvv vvv
To obtain adequate history, providers must be well organized, attentive to the patient’s
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
verbal and nonverbal language, and able to accurately interpret the patient’s responses
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
to questions. Rather than reading into the patient’s statements, they clarify any areas
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
of uncertainty.
vvv vvv
PTS: 1
3. ANS: Cvvv vvv
Vital signs are part of the physical examination portion of patient assessment, not part of
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
the health history.
vvv vvv vvv
PTS: 1
4. ANS: D vvv vvv
While performing the physical examination, the examiner must be able to differentiate
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
between normal and abnormal findings, recall knowledge of a range of conditions,
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
including their associated signs and symptoms, recognize how certain conditions affect
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
the response to other conditions, and distinguish the relevance of varied abnormal
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
findings.
vvv
PTS: 1
5. ANS: C vvv vvv
Sources for diagnostic statistics include textbooks, primary reports of research, and
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
published meta-analyses. Another source of statistics, the one that has been most
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
widely used and available for application to the reasoning process, is the estimation
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
based on a provider’s experience, although these are rarely accurate. Over the past
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
decade, the availability of evidence on which to base clinical reasoning is improving,
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
and there is an increasing expectation that clinical reasoning be based on scientific
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
evidence. Evidence-based statistics are also increasingly being used to develop
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
resources to facilitate clinical decision-making.
vvv vvv vvv vvv vvv
PTS: 1
6. ANS: D vvv vvv
To assist in clinical decision-making, a number of evidence-based resources have been
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
developed to assist the clinician. Resources, such as algorithms and clinical practice
vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv vvv
guidelines, assist in clinical reasoning when properly applied.
vvv vvv vvv vvv vvv vvv vvv vvv
