TESTBANKFORADVANCEDHEALTHASSESSMENT&
CLINICALDIAGNOSISINPRIMARYCARE6THEDITION
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DAINSISBN:9780323594554
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TestBankforAdvancedHealthAssessment&ClinicalDiagnosisinPrimaryCare6th
EditionDains c
Chapter1:Clinical Reasoning,DifferentialDiagnosis,Evidence-BasedPractice,andSymptomAnalysis
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MultipleChoice
Identifythechoicethatbestcompletesthestatementoranswersthequestion.
1. Whichtypeofclinicaldecision-makingis mostreliable? n
A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
2. Whichofthefollowingisfalse?Toobtainadequatehistory,health-careproviders mustbe:
c c c n
A. Methodical andsystematic n
B. Attentiveto thepatient‘s verbal and nonverballanguage
c N c c N
C. Abletoaccuratelyinterpret thepatient‘sresponses c
D. Adeptatreading intothepatient‘s statements c c
3. Essential parts ofa health historyincludeall ofthefollowingexcept:
n c c n c n
A. Chiefcomplaint
n
B. Historyofthepresent illness n
C. Currentvitalsigns
D. Alloftheaboveareessentialhistorycomponents
c c c
4. Which of thefollowingis false?Whileperformingthephysical examination,theexaminer mustbeableto:
c N c c c c
A. Differentiatebetweennormaland abnormal findings c c
B. Recallknowledge ofarangeof conditions and theirassociated signs andsymptoms c n c N N c
C. Recognizehowcertainconditionsaffect theresponsetootherconditions
c c c c c
D. Foresee unpredictable findings
n c
5. Thefollowingistheleastreliablesourceofinformationfor diagnosticstatistics: c c c c c
A. Evidence-based investigations c
B. Primaryreports ofresearch c
C. Estimation based on aprovider‘sexperience n n n
D. Publishedmeta-analyses c
6. Thefollowingcanbeusedtoassistinsound clinical decision-making: c c
A. Algorithmpublished in apeer-reviewed journal article N c c c
B. Clinicalpractice guidelines
c c
C. Evidence-based research c
D. Alloftheabove
7. Ifadiagnosticstudyhashighsensitivity, thisindicatesa: c
A. Highpercentageof persons withthegivenconditionwillhaveanabnormalresult
n n n n n
B. Lowpercentageofpersonswith thegivencondition willhaveanabnormal result c c c c
C. Lowlikelihood of normalresult in p ersonswithoutagiven condition
c n c
D. Noneoftheabove
8. Ifadiagnosticstudyhashighspecificity, thisindicatesa: c c c
A. Lowpercentage ofhealthyindividuals willshowanormal result c c c N
B. High percentage ofhealthyindividualswillshowa normal result
n c N c
C. High percentage ofindividuals with adisorderwillshowanormalresult
n c n n
D. Lowpercentageofindividualswithadisorderwill showan abnormal result n
9. A likelihood ratio above 1indicatesthata diagnostictest showing a:
N c N c n N c n c
A. Positive resultisstronglyassociatedwiththedisease
c c
B. Negativeresultis stronglyassociated withabsence of thedisease c n c c c
C. Positiveresultis weaklyassociated withthedisease N n
D. Negativeresultis weaklyassociated withabsenceofthedisease c c c
10. Which of thefollowingclinical reasoning toolsisdefinedasevidence-based resourcebased onmathematical modeling to
N n N n c c c n
cexpress thelikelihood ofa condition in select situations, settings, and/or patients?
c c c c c c c c c c c
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A. Clinical practiceguideline N c
B. Clinical decisionrule N
C. Clinicalalgorithm c
Chapter1:Clinicalreasoning,differentialdiagnosis,evidence-basedpractice,andsymptomana
AnswerSection
MULTIPLECHOICE
1. ANS: B
Croskerry(2009) describestwomajortypes of clinicaldiagnostic decision-making:intuitiveand analytical.Intuitivedecision-
n c n n n n c
making(similartoAugenblinkdecision-making) isbasedontheexperience andintuitionoftheclinician and islessreliableand paired
c c n n c n c c
withfairlycommon errors.In contrast, analytical decision-makingisbased oncarefulconsideration and hasgreaterreliability with
c c c c c c c c c c c c c c n c c c
rareerrors.
c c
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
c c c c c c c c c c c c c c c c c c
accurately interpret the patient‘s responses to questions. Rather than reading into the patient‘s statements, they clarify any areas of
c c c c c c c c c c c c c c c c c c c
uncertainty.
c
PTS: 1
3. ANS: C
Vitalsignsare partofthephysical examination portionofpatientassessment, not part of the health history.
c c c c c n c c N n
PTS: 1
4. ANS: D
Whileperformingthephysicalexamination,theexaminermustbeabletodifferentiatebetweennormalandabnormalfindings,recall
c c c c c c c c c c c c c c c c c
knowledgeofa rangeofconditions,includingtheirassociated signs andsymptoms, recognizehowcertain conditionsaffect theresponse to
c n n n n n c n n c c c
other conditions, and distinguish the relevance of varied abnormal findings.
c c c c c c c c c c
PTS: 1
5. ANS: C
Sources fordiagnostic statistics includetextbooks,primaryreports of research, and published meta-analyses. Anothersourceof
n n c n n c n n c
statistics,theonethathasbeen most widelyused and available forapplication tothereasoningprocess,istheestimation basedon a
c n n c N c c n c
provider‘s experience, although these are rarelyaccurate. Over the past decade, the availability of evidence on which to base clinical
c c c c c c c c c c c c c c c c c c c c
reasoningis improving, andthereis an increasing expectation that clinical reasoning be based on scientific evidence. Evidence-
c c c c c c c c c c c c c c c
based statistics are also increasinglybeingused todevelop resourcesto facilitate clinical decision-making.
c c c n n c n c c
PTS: 1
6. ANS: D
Toassistinclinicaldecision-making,anumberofevidence-basedresourceshavebeen developed toassisttheclinician. Resources, such as n c n c c c
algorithms and clinical practice guidelines, assistin clinical reasoning when properlyapplied.
c c c c c c c c c c c
PTS: 1
7. ANS: A
The sensitivityofa diagnosticstudyis the percentage of individuals with the target condition who show an abnormal, or positive, result.
c c c c c c c c c c c c c c c c c c c
Ahighsensitivityindicatesthatagreaterpercentageofpersonswiththegivenconditionwillhaveanabnormalresult.
c c c c c c c c c c c c c c c c c
PTS: 1
8. ANS: B
The specificityof a diagnostic studyis the percentage of normal, healthyindividuals who have a normal result. The greater the
c c c c c c c c c c c c c c c c c
specificity,thegreater thepercentageofindividualswho willhave negative,ornormal, resultsiftheydo nothavethetarget condition.
c c c c c c c c c c c c c c c c c c c c c c
PTS: 1
9. ANS: A
Thelikelihood ratioistheprobabilitythat a positivetest result will beassociated with aperson who hasthetarget conditionanda
c c c n c c c n c c c c n c c c
negativeresultwillbeassociated witha healthyperson.Alikelihoodratioabove1indicates thata positiveresultisassociatedwiththe
c n n n c c
disease;alikelihood ratiolessthan1 indicatesthata negative result isassociated withan absenceofthedisease.
c c c c c c c c c n c c c c c c c c
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PTS: 1
10. ANS: B
Clinicaldecision(orprediction)rulesprovideanothersupportforclinicalreasoning.Clinicaldecisionrulesareevidence-basedresources
n n c c
cthatprovideprobabilistic statements regarding thelikelihoodthata condition existsifcertainvariablesare metwith regard to the
n n c n c c c c
cprognosis ofpatients with specific findings. Decision rulesuse mathematical models and are specific to certain situations, settings, and/or
n c c c c c c c n c c c c c
patientcharacteristics.
c c
PTS: 1