l l
Test Bank for Advanced Health Assessment & Clinical Diagnosis in Primary Care 7th Edi
l l l l l l l l l l l l l
tion Dains l
Chapter 1: Clinical Reasoning, Differential Diagnosis, Evidence-Based Practice, and Symptom Analysis
l l l l l l l l l l
Multiple Choice l
Identify the choice that best completes the statement or answers the question.
l l l l l l l l l l l
, l l
1. Whichltypeloflclinicalldecision-makinglislmostlreliable?
A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
2. Whichloflthelfollowinglislfalse?lTolobtainladequatelhistory,lhealth-carelproviderslmustlbe:
A. Methodicallandlsystematic
B. Attentiveltolthelpatient‘slverballandlnonverballlanguage
C. Ableltolaccuratelylinterpretlthelpatient‘slresponses
D. Adeptlatlreadinglintolthelpatient‘slstatements
3. Essentiallpartsloflalhealthlhistorylincludelallloflthelfollowinglexcept:
A. Chieflcomplaint
B. Historyloflthelpresentlillness
C. Currentlvitallsigns
D. Allloflthelabovelarelessentiallhistorylcomponents
4. Whichloflthelfollowinglislfalse?lWhilelperforminglthelphysicallexamination,lthelexaminerlmustlbelablelto:
A. Differentiatelbetweenlnormallandlabnormallfindings
B. Recalllknowledgeloflalrangeloflconditionslandltheirlassociatedlsignslandlsymptoms
C. Recognizelhowlcertainlconditionslaffectlthelresponseltolotherlconditions
D. Foreseelunpredictablel findings
5. Thelfollowinglislthelleastlreliablelsourceloflinformationlforldiagnosticlstatistics:
A. Evidence-basedl investigations
B. Primarylreportsloflresearch
C. Estimationlbasedlonlalprovider‘slexperience
D. Publishedl meta-analyses
6. Thelfollowinglcanlbelusedltolassistlinlsoundlclinicalldecision-making:
A. Algorithmlpublishedlinlalpeer-reviewedljournallarticle
B. Clinicallpracticelguidelines
C. Evidence-basedl research
D. Allloflthelabove
7. Iflaldiagnosticlstudylhaslhighlsensitivity,l thislindicatesla:
A. Highlpercentageloflpersonslwithlthelgivenlconditionlwilllhavelanlabnormallresult
B. Lowlpercentageloflpersonslwithlthelgivenlconditionlwilllhavelanlabnormallresult
C. Lowllikelihoodloflnormallresultlinlpersonslwithoutlalgivenlcondition
D. Noneloflthelabove
8. Iflaldiagnosticlstudylhaslhighlspecificity,lthislindicatesla:
A. Lowlpercentageloflhealthylindividualslwilllshowlalnormallresult
B. Highlpercentageloflhealthylindividualslwilllshowlalnormallresult
C. Highlpercentageloflindividualslwithlaldisorderlwilllshowlalnormallresult
D. Lowlpercentageloflindividualslwithlaldisorderlwilllshowlanlabnormallresult
9. Allikelihoodlratiolabovel1lindicateslthatlaldiagnosticltestlshowingla:
A. Positivelresultlislstronglylassociatedlwithltheldisease
B. Negativelresultlislstronglylassociatedlwithlabsencelofltheldisease
C. Positivelresultlislweaklylassociatedlwithltheldisease
D. Negativelresultlislweaklylassociatedlwithlabsencelofltheldisease
10. Whichloflthelfollowinglclinicallreasoningltoolslisldefinedlaslevidence-
basedlresourcelbasedlonlmathematicallmodelingltolexpresslthellikelihoodloflalconditionlinlselectlsituations,lsettings,land/orlpatients?
, l l
A. Clinicallpracticelguideline
B. Clinicalldecisionlrule
C. Clinicallalgorithm
Chapter 1:Clinical reasoning, differentialdiagnosis,evidence-based practice,and symptom ana
l l l l l l l l l l
Answer Section
l
MULTIPLElCHOICE
1. ANS: B
Croskerryl(2009)ldescribesltwolmajorltypesloflclinicalldiagnosticldecision-making:lintuitivelandlanalytical.lIntuitiveldecision-
lmakingl(similar ltolAugenblinkldecision-
making)lislbasedlonlthelexperiencelandlintuitionloflthelclinicianlandlisllesslreliablelandlpairedlwithlfairlylcommonlerrors.lInlcontrast,la
nalyticalldecision-makinglislbasedlonlcarefullconsiderationlandlhaslgreaterlreliabilitylwithlrarelerrors.
PTS: 1
2. ANS: D
Tolobtainladequatelhistory,lproviderslmustlbelwelllorganized,lattentiveltolthelpatient‘slverballandlnonverballlanguage,landlableltolaccu
ratelylinterpretlthelpatient‘slresponsesltolquestions.lRatherlthanlreadinglintolthelpatient‘slstatements,ltheylclarifylanylareaslofluncertai
nty.
PTS: 1
3. ANS: C
Vitallsignslarelpartloflthelphysicallexaminationlportionloflpatientlassessment,lnotlpartloflthelhealthlhistory.
PTS: 1
4. ANS: D
Whilelperforminglthelphysicallexamination,lthelexaminerlmustlbelableltoldifferentiatelbetweenlnormallandlabnormallfindings,lrecalllk
nowledgeloflalrangeloflconditions,lincludingltheirlassociatedlsignslandlsymptoms,lrecognizelhowlcertainlconditionslaffectlthelresponsel
tolotherlconditions,landldistinguishlthelrelevanceloflvariedlabnormallfindings.
PTS: 1
5. ANS: C
Sourceslforldiagnosticlstatisticslincludeltextbooks,lprimarylreportsloflresearch,landlpublishedlmeta-
analyses.lAnotherlsourceloflstatistics,lthelonelthatlhaslbeenlmostlwidelylusedlandlavailablelforlapplicationltolthelreasoninglprocess,lislth
elestimationlbasedlonlalprovider‘slexperience,lalthoughltheselarelrarelylaccurate.lOverlthelpastldecade,lthelavailabilityloflevidencelonl
whichltolbaselclinicallreasoninglislimproving,l andltherelislanlincreasinglexpectationlthatlclinicallreasoninglbelbasedlonlscientificlevid
ence.
Evidence-basedlstatisticslarel alsolincreasinglylbeinglusedltoldevelopl resourcesltolfacilitatel clinicall decision-making.
PTS: 1
6. ANS: D
Tolassistlinlclinicalldecision-making,lalnumberloflevidence-
basedlresourceslhavelbeenldevelopedltolassistlthelclinician.lResources,lsuchlaslalgorithmslandlclinicallpracticelguidelines,lassistlinlcli
nicallreasoninglwhenlproperlylapplied.
PTS: 1
7. ANS: A
Thelsensitivityloflaldiagnosticlstudylislthelpercentageloflindividualslwithltheltargetlconditionlwholshowlanlabnormal,lorl positive,lresult.l
Alhighlsensitivitylindicateslthatlalgreaterlpercentageloflpersonslwithlthelgivenlconditionlwilllhavelanlabnormallresult.
PTS: 1
8. ANS: B
Thelspecificityloflaldiagnosticlstudylislthelpercentageloflnormal,lhealthylindividualslwholhavelalnormallresult.lThelgreaterlthelspecifici
ty,lthelgreaterlthelpercentageloflindividualslwholwilllhavelnegative,lorlnormal,lresultslifltheyldolnotlhaveltheltargetlcondition.
PTS: 1
9. ANS: A
Thellikelihoodlratiolislthelprobabilitylthatlalpositiveltestlresultlwilllbelassociatedlwithlalpersonlwholhasltheltargetlconditionlandlalnegativ
elresultlwilllbelassociatedlwithlalhealthylperson.lAllikelihoodlratiolabovel1lindicateslthatlalpositivelresultlislassociatedlwithltheldisease;l
allikelihoodlratiollesslthanl1lindicateslthatlalnegativelresultlislassociatedlwithlanlabsencelofltheldisease.
, l l
PTS: 1
10. ANS: B
Clinicalldecisionl(orlprediction)lruleslprovidelanotherlsupportlforlclinicallreasoning.lClinicalldecisionlruleslarelevidence-
basedlresourceslthatlprovidelprobabilisticlstatementslregardinglthellikelihoodlthatlalconditionlexistsliflcertainlvariableslarelmetlwithlr
egardltolthelprognosisloflpatientslwithlspecificlfindings.lDecisionlrulesluselmathematicallmodelslandlarelspecificltolcertainlsituations,l
settings,land/orlpatientlcharacteristics.
PTS: 1
Test Bank for Advanced Health Assessment & Clinical Diagnosis in Primary Care 7th Edi
l l l l l l l l l l l l l
tion Dains l
Chapter 1: Clinical Reasoning, Differential Diagnosis, Evidence-Based Practice, and Symptom Analysis
l l l l l l l l l l
Multiple Choice l
Identify the choice that best completes the statement or answers the question.
l l l l l l l l l l l
, l l
1. Whichltypeloflclinicalldecision-makinglislmostlreliable?
A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
2. Whichloflthelfollowinglislfalse?lTolobtainladequatelhistory,lhealth-carelproviderslmustlbe:
A. Methodicallandlsystematic
B. Attentiveltolthelpatient‘slverballandlnonverballlanguage
C. Ableltolaccuratelylinterpretlthelpatient‘slresponses
D. Adeptlatlreadinglintolthelpatient‘slstatements
3. Essentiallpartsloflalhealthlhistorylincludelallloflthelfollowinglexcept:
A. Chieflcomplaint
B. Historyloflthelpresentlillness
C. Currentlvitallsigns
D. Allloflthelabovelarelessentiallhistorylcomponents
4. Whichloflthelfollowinglislfalse?lWhilelperforminglthelphysicallexamination,lthelexaminerlmustlbelablelto:
A. Differentiatelbetweenlnormallandlabnormallfindings
B. Recalllknowledgeloflalrangeloflconditionslandltheirlassociatedlsignslandlsymptoms
C. Recognizelhowlcertainlconditionslaffectlthelresponseltolotherlconditions
D. Foreseelunpredictablel findings
5. Thelfollowinglislthelleastlreliablelsourceloflinformationlforldiagnosticlstatistics:
A. Evidence-basedl investigations
B. Primarylreportsloflresearch
C. Estimationlbasedlonlalprovider‘slexperience
D. Publishedl meta-analyses
6. Thelfollowinglcanlbelusedltolassistlinlsoundlclinicalldecision-making:
A. Algorithmlpublishedlinlalpeer-reviewedljournallarticle
B. Clinicallpracticelguidelines
C. Evidence-basedl research
D. Allloflthelabove
7. Iflaldiagnosticlstudylhaslhighlsensitivity,l thislindicatesla:
A. Highlpercentageloflpersonslwithlthelgivenlconditionlwilllhavelanlabnormallresult
B. Lowlpercentageloflpersonslwithlthelgivenlconditionlwilllhavelanlabnormallresult
C. Lowllikelihoodloflnormallresultlinlpersonslwithoutlalgivenlcondition
D. Noneloflthelabove
8. Iflaldiagnosticlstudylhaslhighlspecificity,lthislindicatesla:
A. Lowlpercentageloflhealthylindividualslwilllshowlalnormallresult
B. Highlpercentageloflhealthylindividualslwilllshowlalnormallresult
C. Highlpercentageloflindividualslwithlaldisorderlwilllshowlalnormallresult
D. Lowlpercentageloflindividualslwithlaldisorderlwilllshowlanlabnormallresult
9. Allikelihoodlratiolabovel1lindicateslthatlaldiagnosticltestlshowingla:
A. Positivelresultlislstronglylassociatedlwithltheldisease
B. Negativelresultlislstronglylassociatedlwithlabsencelofltheldisease
C. Positivelresultlislweaklylassociatedlwithltheldisease
D. Negativelresultlislweaklylassociatedlwithlabsencelofltheldisease
10. Whichloflthelfollowinglclinicallreasoningltoolslisldefinedlaslevidence-
basedlresourcelbasedlonlmathematicallmodelingltolexpresslthellikelihoodloflalconditionlinlselectlsituations,lsettings,land/orlpatients?
, l l
A. Clinicallpracticelguideline
B. Clinicalldecisionlrule
C. Clinicallalgorithm
Chapter 1:Clinical reasoning, differentialdiagnosis,evidence-based practice,and symptom ana
l l l l l l l l l l
Answer Section
l
MULTIPLElCHOICE
1. ANS: B
Croskerryl(2009)ldescribesltwolmajorltypesloflclinicalldiagnosticldecision-making:lintuitivelandlanalytical.lIntuitiveldecision-
lmakingl(similar ltolAugenblinkldecision-
making)lislbasedlonlthelexperiencelandlintuitionloflthelclinicianlandlisllesslreliablelandlpairedlwithlfairlylcommonlerrors.lInlcontrast,la
nalyticalldecision-makinglislbasedlonlcarefullconsiderationlandlhaslgreaterlreliabilitylwithlrarelerrors.
PTS: 1
2. ANS: D
Tolobtainladequatelhistory,lproviderslmustlbelwelllorganized,lattentiveltolthelpatient‘slverballandlnonverballlanguage,landlableltolaccu
ratelylinterpretlthelpatient‘slresponsesltolquestions.lRatherlthanlreadinglintolthelpatient‘slstatements,ltheylclarifylanylareaslofluncertai
nty.
PTS: 1
3. ANS: C
Vitallsignslarelpartloflthelphysicallexaminationlportionloflpatientlassessment,lnotlpartloflthelhealthlhistory.
PTS: 1
4. ANS: D
Whilelperforminglthelphysicallexamination,lthelexaminerlmustlbelableltoldifferentiatelbetweenlnormallandlabnormallfindings,lrecalllk
nowledgeloflalrangeloflconditions,lincludingltheirlassociatedlsignslandlsymptoms,lrecognizelhowlcertainlconditionslaffectlthelresponsel
tolotherlconditions,landldistinguishlthelrelevanceloflvariedlabnormallfindings.
PTS: 1
5. ANS: C
Sourceslforldiagnosticlstatisticslincludeltextbooks,lprimarylreportsloflresearch,landlpublishedlmeta-
analyses.lAnotherlsourceloflstatistics,lthelonelthatlhaslbeenlmostlwidelylusedlandlavailablelforlapplicationltolthelreasoninglprocess,lislth
elestimationlbasedlonlalprovider‘slexperience,lalthoughltheselarelrarelylaccurate.lOverlthelpastldecade,lthelavailabilityloflevidencelonl
whichltolbaselclinicallreasoninglislimproving,l andltherelislanlincreasinglexpectationlthatlclinicallreasoninglbelbasedlonlscientificlevid
ence.
Evidence-basedlstatisticslarel alsolincreasinglylbeinglusedltoldevelopl resourcesltolfacilitatel clinicall decision-making.
PTS: 1
6. ANS: D
Tolassistlinlclinicalldecision-making,lalnumberloflevidence-
basedlresourceslhavelbeenldevelopedltolassistlthelclinician.lResources,lsuchlaslalgorithmslandlclinicallpracticelguidelines,lassistlinlcli
nicallreasoninglwhenlproperlylapplied.
PTS: 1
7. ANS: A
Thelsensitivityloflaldiagnosticlstudylislthelpercentageloflindividualslwithltheltargetlconditionlwholshowlanlabnormal,lorl positive,lresult.l
Alhighlsensitivitylindicateslthatlalgreaterlpercentageloflpersonslwithlthelgivenlconditionlwilllhavelanlabnormallresult.
PTS: 1
8. ANS: B
Thelspecificityloflaldiagnosticlstudylislthelpercentageloflnormal,lhealthylindividualslwholhavelalnormallresult.lThelgreaterlthelspecifici
ty,lthelgreaterlthelpercentageloflindividualslwholwilllhavelnegative,lorlnormal,lresultslifltheyldolnotlhaveltheltargetlcondition.
PTS: 1
9. ANS: A
Thellikelihoodlratiolislthelprobabilitylthatlalpositiveltestlresultlwilllbelassociatedlwithlalpersonlwholhasltheltargetlconditionlandlalnegativ
elresultlwilllbelassociatedlwithlalhealthylperson.lAllikelihoodlratiolabovel1lindicateslthatlalpositivelresultlislassociatedlwithltheldisease;l
allikelihoodlratiollesslthanl1lindicateslthatlalnegativelresultlislassociatedlwithlanlabsencelofltheldisease.
, l l
PTS: 1
10. ANS: B
Clinicalldecisionl(orlprediction)lruleslprovidelanotherlsupportlforlclinicallreasoning.lClinicalldecisionlruleslarelevidence-
basedlresourceslthatlprovidelprobabilisticlstatementslregardinglthellikelihoodlthatlalconditionlexistsliflcertainlvariableslarelmetlwithlr
egardltolthelprognosisloflpatientslwithlspecificlfindings.lDecisionlrulesluselmathematicallmodelslandlarelspecificltolcertainlsituations,l
settings,land/orlpatientlcharacteristics.
PTS: 1
