TESTBANK aq
ADVANCEDHEALTHASSESSMENT&CLINICALDIAGNOSISIN P
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RIMARY CARE, 6TH EDITION
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Joyce E. Dains, Linda Ciofu Baumann & Pamela Scheibel
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lOMoARcPSD|126
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Test Bank for Advanced Health Assessment & Clinical Diagnosis in Primary Care 6th
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Edition Dains aq
Chapter 1: Clinical Reasoning, Differential Diagnosis, Evidence-Based Practice, and Symptom Analysis
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Multiple Choice aq
Identify the choice that best completes the statement oranswers the question.
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1. Which type of clinical decision-making is most reliable? aq aq aq aq aq aq aq
A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
2. Which of the following is false? To obtain adequate history, health-care providers must be:
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A. Methodical and systematic aq aq
B. Attentive to the patient’s verbal and nonverbal language aq aq aq aq aq aq aq
C. Able to accurately interpret the patient’s responses
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D. Adept at reading into thepatient’s statements
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3. Essential parts of a health history include all of the following except: aq aq aq aq aq aq aq aq aq aq aq
A. Chief complaint aq
B. Historyof the present illness aq aq aq aq
C. Current vital signs aq aq
D. All of the above are essential history components
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4. Which of the following is false? While performing the physical examination, the examiner must be able to:
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A. Differentiate between normal and abnormal findings aq aq aq aq aq
B. Recallknowledge of a range of conditions and their associated signs and symptoms
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C. Recognize how certain conditions affect the response to other conditions
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D. Foresee unpredictable findings aq aq
5. The following is the least reliable source of information for diagnostic statistics:
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A. Evidence-based investigations aq
B. Primaryreports of research aq aq aq
C. Estimation based on a provider’s experience aq aq aq aq aq
D. Published meta-analyses aq
6. The following can be used to assist in sound clinical decision-making:
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A. Algorithmpublished in apeer-reviewed journal article aq aq aq aq aq aq
B. Clinical practice guidelines aq aq
C. Evidence-based research aq
D. All of the above
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7. Ifa diagnostic studyhas high sensitivity, this indicates a:
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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
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C. Low likelihood of normal result in persons without a given condition
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D. None of the above aq aq aq
8. Ifa diagnostic studyhas high specificity, this indicates a:
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A. Low percentage of healthyindividuals will show a normal result
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B. High percentage of healthyindividuals will show a normal result
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C. High percentage ofindividuals with a disorder will show a normal result
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D. Low percentage of individuals with a disorder will show an abnormal result
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9. A likelihood ratio above 1 indicates that a diagnostic test showing a:
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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 weaklyassociated with absence of the disease
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10. Which of the following clinical reasoning tools is defined as evidence- aq aq aq aq aq aq aq aq aq aq
based resource based on mathematical modeling to express the likelihood of a condition in select situations, settings, and/or patie
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nts?
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A. Clinical practice guideline aq aq
B. Clinical decision rule aq aq
C. Clinical algorithm aq
Chapter 1: Clinical reasoning, differential diagnosis, evidence-based practice, and symptom ana
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Answer Section
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MULTIPLE CHOICE aq
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 Augenblink decision-
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making) is based on the experience and intuition of the clinician and is less reliable and paired with fairly common errors. In contra
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st, analytical decision-making is based on careful consideration and has greater reliability with rare errors.
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PTS: 1
2. ANS: D
To obtain adequate history, providers must be well organized, attentive to the patient’s verbal and nonverbal language, and able to a
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ccurately 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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PTS: 1
3. ANS: C
Vital signs are part ofthe physical examination portion ofp atient assessment, not part ofthe health history.
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PTS: 1
4. ANS: D
While performing the physical examination, the examiner must be able to differentiate between normal and abnormal findings, rec
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all knowledge of a range of conditions, including their associated signs and symptoms, recognize how certain conditions affect the re
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sponse to other conditions, and distinguish the relevance of varied abnormal findings.
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PTS: 1
5. ANS: C
Sources for diagnostic statistics include textbooks, primary reports of research, and published meta-
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analyses. Another source of statistics, the one that has been most widelyused and available for application to the reasoning process, is
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the estimation based on a provider’s experience, although these are rarely accurate. Over the past decade, the availability of evide
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nce on which to base clinical reasoning is improving, and there is an increasing expectation that clinical reasoning be based on sc
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ientific evidence. aq
Evidence-based statistics are also increasingly being used to develop resources to facilitate clinical decision-making.
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PTS: 1
6. ANS: D
To assist in clinical decision-making, a number of evidence-
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based resources have been developed to assist the clinician. Resources, such as algorithms and clinical practice guidelines, assist i
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n clinical reasoning when properly applied.
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PTS: 1
7. ANS: A
The sensitivity of a diagnostic study is the percentage of individuals with the target condition who show an abnormal, or positive, res
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ult. A high sensitivity indicates 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 specificity of a diagnostic study is the percentage of normal, healthy individuals who have a normal result. The greater the spe
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cificity, the greater the percentage of individuals who will have negative, or normal, results if they do not have the target conditio
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n.
PTS: 1
9. ANS: A
The likelihood ratio is the probability that a positive test result will be associated with a person who has the target condition and a neg
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ative 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 ratio less than 1 indicates that a negative result is associated with an absence of the disease.
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, aq 567
lOMoARcPSD|126
a q 13
PTS: 1
10. ANS: B
Clinical decision (or prediction) rules provide another support for clinical reasoning. Clinical decision rules are evidence-
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based resources that provide probabilistic statements regarding the likelihood that a condition exists if certain variables are met
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with regard to the prognosis of patients with specific findings. Decision rules use mathematical models and are specific to certain
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situations, settings, and/or patient characteristics.
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PTS: 1
ADVANCEDHEALTHASSESSMENT&CLINICALDIAGNOSISIN P
aq aq aq aq aq aq aq
RIMARY CARE, 6TH EDITION
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Joyce E. Dains, Linda Ciofu Baumann & Pamela Scheibel
aq aq aq aq aq aq aq aq
, aq 567
lOMoARcPSD|126
a q 13
Test Bank for Advanced Health Assessment & Clinical Diagnosis in Primary Care 6th
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Edition Dains aq
Chapter 1: Clinical Reasoning, Differential Diagnosis, Evidence-Based Practice, and Symptom Analysis
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Multiple Choice aq
Identify the choice that best completes the statement oranswers the question.
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1. Which type of clinical decision-making is most reliable? aq aq aq aq aq aq aq
A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
2. Which of the following is false? To obtain adequate history, health-care providers must be:
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A. Methodical and systematic aq aq
B. Attentive to the patient’s verbal and nonverbal language aq aq aq aq aq aq aq
C. Able to accurately interpret the patient’s responses
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D. Adept at reading into thepatient’s statements
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3. Essential parts of a health history include all of the following except: aq aq aq aq aq aq aq aq aq aq aq
A. Chief complaint aq
B. Historyof the present illness aq aq aq aq
C. Current vital signs aq aq
D. All of the above are essential history components
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4. Which of the following is false? While performing the physical examination, the examiner must be able to:
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A. Differentiate between normal and abnormal findings aq aq aq aq aq
B. Recallknowledge of a range of conditions and their associated signs and symptoms
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C. Recognize how certain conditions affect the response to other conditions
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D. Foresee unpredictable findings aq aq
5. The following is the least reliable source of information for diagnostic statistics:
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A. Evidence-based investigations aq
B. Primaryreports of research aq aq aq
C. Estimation based on a provider’s experience aq aq aq aq aq
D. Published meta-analyses aq
6. The following can be used to assist in sound clinical decision-making:
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A. Algorithmpublished in apeer-reviewed journal article aq aq aq aq aq aq
B. Clinical practice guidelines aq aq
C. Evidence-based research aq
D. All of the above
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7. Ifa diagnostic studyhas high sensitivity, this indicates a:
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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
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C. Low likelihood of normal result in persons without a given condition
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D. None of the above aq aq aq
8. Ifa diagnostic studyhas high specificity, this indicates a:
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A. Low percentage of healthyindividuals will show a normal result
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B. High percentage of healthyindividuals will show a normal result
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C. High percentage ofindividuals with a disorder will show a normal result
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D. Low percentage of individuals with a disorder will show an abnormal result
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9. A likelihood ratio above 1 indicates that a diagnostic test showing a:
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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 weaklyassociated with absence of the disease
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10. Which of the following clinical reasoning tools is defined as evidence- aq aq aq aq aq aq aq aq aq aq
based resource based on mathematical modeling to express the likelihood of a condition in select situations, settings, and/or patie
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nts?
, aq 567
lOMoARcPSD|126
a q 13
A. Clinical practice guideline aq aq
B. Clinical decision rule aq aq
C. Clinical algorithm aq
Chapter 1: Clinical reasoning, differential diagnosis, evidence-based practice, and symptom ana
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Answer Section
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MULTIPLE CHOICE aq
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 Augenblink decision-
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making) is based on the experience and intuition of the clinician and is less reliable and paired with fairly common errors. In contra
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st, analytical decision-making is based on careful consideration and has greater reliability with rare errors.
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PTS: 1
2. ANS: D
To obtain adequate history, providers must be well organized, attentive to the patient’s verbal and nonverbal language, and able to a
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ccurately 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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PTS: 1
3. ANS: C
Vital signs are part ofthe physical examination portion ofp atient assessment, not part ofthe health history.
aq aq aq aq aq aq aq aq aq aq aq aq aq aq aq aq aq
PTS: 1
4. ANS: D
While performing the physical examination, the examiner must be able to differentiate between normal and abnormal findings, rec
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all knowledge of a range of conditions, including their associated signs and symptoms, recognize how certain conditions affect the re
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sponse to other conditions, and distinguish the relevance of varied abnormal findings.
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PTS: 1
5. ANS: C
Sources for diagnostic statistics include textbooks, primary reports of research, and published meta-
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analyses. Another source of statistics, the one that has been most widelyused and available for application to the reasoning process, is
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the estimation based on a provider’s experience, although these are rarely accurate. Over the past decade, the availability of evide
aq aq aq aq aq aq aq aq aq aq aq aq aq aq aq aq aq aq aq
nce on which to base clinical reasoning is improving, and there is an increasing expectation that clinical reasoning be based on sc
aq aq aq aq aq aq aq aq a q aq aq aq aq aq aq aq aq aq aq aq aq
ientific evidence. aq
Evidence-based statistics are also increasingly being used to develop resources to facilitate clinical decision-making.
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PTS: 1
6. ANS: D
To assist in clinical decision-making, a number of evidence-
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based resources have been developed to assist the clinician. Resources, such as algorithms and clinical practice guidelines, assist i
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n clinical reasoning when properly applied.
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PTS: 1
7. ANS: A
The sensitivity of a diagnostic study is the percentage of individuals with the target condition who show an abnormal, or positive, res
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ult. A high sensitivity indicates 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 specificity of a diagnostic study is the percentage of normal, healthy individuals who have a normal result. The greater the spe
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cificity, the greater the percentage of individuals who will have negative, or normal, results if they do not have the target conditio
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n.
PTS: 1
9. ANS: A
The likelihood ratio is the probability that a positive test result will be associated with a person who has the target condition and a neg
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ative 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 ratio less than 1 indicates that a negative result is associated with an absence of the disease.
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, aq 567
lOMoARcPSD|126
a q 13
PTS: 1
10. ANS: B
Clinical decision (or prediction) rules provide another support for clinical reasoning. Clinical decision rules are evidence-
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based resources that provide probabilistic statements regarding the likelihood that a condition exists if certain variables are met
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with regard to the prognosis of patients with specific findings. Decision rules use mathematical models and are specific to certain
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situations, settings, and/or patient characteristics.
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PTS: 1