TEST BANK m
ADVANCED HEALTH ASSESSMENT & CLINICAL DIAGNOSIS I
m m m m m m
N PRIMARY CARE, 6TH EDITION
m m m m
Joyce E. Dains, Linda Ciofu Baumann & Pamela Scheibel
m m m m m m m m
, m
lOMoARcPSD|1
26
567m 13
Test Bank for Advanced Health Assessment & Clinical Diagnosis in Primary Care
m m m m m m m m m m m
6th Edition Dains m m m
Chapterm1:mClinicalmReasoning,mDifferentialmDiagnosis,mEvidence-BasedmPractice,mandmSymptommAnalysis
MultiplemChoice
Identifymthemchoicemthatmbestmcompletesmthemstatementmormanswersmthemquestion.
1. Whichmtypemofmclinicalmdecision-makingmismmostmreliable?
A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
2. Whichmofmthemfollowingmismfalse?mTo mobtainmadequatemhistory,mhealth-care mproviders mmustmbe:
A. Methodicalmandmsystematic
B. Attentivemtomthempatient’s mverbalmand mnonverbalmlangua
ge
C. Ablemtomaccuratelyminterpretmthempatient’s mresponses
D. Adeptmatmreadingmintomthempatient’s mstatements
3. Essentialmpartsmofmamhealthmhistorymincludemallmofmthe mfollowing mexcept:
A. Chiefmcomplaint
B. Historymofmthempresentmillness
C. Currentmvitalmsigns
D. Allmofmthemabovemaremessentialmhistorymcompone
nts
4. Whichmofmthemfollowingmismfalse?mWhilemperforming mthe mphysicalm examination,mthemexaminerm mustmbe mablemto:
A. Differentiatembetweenmnormalmandmabnormalmfindings
B. Recallmknowledgemofmamrangemofmconditions mandmtheirmassociated msigns mandmsympt
oms
C. Recognizemhowmcertainmconditions maffectmthemresponsemtomothermconditions
D. Foreseemunpredictablemfindings
5. Themfollowingmismthemleastmreliablemsourcemof minformation mformdiagnosticmstatistics:
A. Evidence-basedminvestigations
B. Primarymreports mofmresearch
C. Estimationmbasedmonmamprovider’s mexperienc
e
D. Publishedmmeta-analyses
6. Themfollowingmcanmbemusedmtomassist min msoundmclinicalmdecision-making:
A. Algorithmmpublishedminmampeer-
reviewedmjournalmarticle
B. Clinicalmpracticemguidelines
C. Evidence-basedmresearch
D. Allmofmthemabove
7. Ifmamdiagnosticmstudymhasmhighmsensitivity, mthis mindicates ma:
A. Highmpercentagemofmpersons mwithmthemgivenmconditionmwill mhavemanmabnormalmr
esult
B. Lowmpercentagemofmpersons mwithmthemgivenmconditionmwillmhaveman mabnormalmre
sult
C. Lowmlikelihoodmofmnormalmresultminmpersons mwithoutmamgivenmcondition
D. Nonemofmthemabove
8. Ifmamdiagnosticmstudymhasmhighmspecificity,m thismindicates ma:
A. Lowmpercentagemofmhealthymindividuals mwillmshow mamnormal mresult
B. Highmpercentagemofmhealthymindividuals mwillmshow ma mnormalmresult
C. Highmpercentagemofmindividuals mwithmamdisordermwillmshow mamnormalmresult
D. Lowmpercentagemofmindividuals mwithmamdisordermwillmshow man mabnormalmre
sult
9. A mlikelihoodmratiomabovem1mindicates mthatm amdiagnostic mtestmshowingma:
A. Positivemresultmis mstronglymassociatedmwithmthemdisease
B. Negativemresultmismstronglymassociated mwithmabsencemofmthe mdise
ase
C. Positivemresultmismweaklymassociatedmwithmthe mdisease
D. Negativemresultmismweaklymassociatedmwith mabsencemofmthe mdisea
se
10. Whichmofmthemfollowingmclinical mreasoning mtools mismdefinedmasmevidence-
basedmresourcembasedmonmmathematicalm modelingmtom express mthem likelihoodmof mamcondition minmselect msituations,msettings,man
, m
d/ormpatients? lOMoARcPSD|1
567m
26
13
, m
lOMoARcPSD|1
26
567m 13
A. Clinicalmpracticemguideline
B. Clinicalmdecisionmrule
C. Clinicalmalgorithm
Chapterm1:mClinicalmreasoning,mdifferentialmdiagnosis,mevidence-basedmpractice,mandmsymptom mana
AnswermSection
MULTIPLEmCHOICE
1. ANS: B
Croskerrym(2009)mdescribes mtwommajormtypes mofmclinicalmdiagnosticmdecision-
making:mintuitivemandmanalytical.mIntuitivemdecision-m makingm(similarmtomAugenblinkmdecision-
making)mismbasedmonmthemexperiencemandmintuitionmofmthemclinicianm andmismless mreliablemand mpairedmwithmfairly mcommonmerr
ors.mInmcontrast,manalyticalmdecision-makingm ismbasedmonm carefulmconsideration mandmhasmgreatermreliability mwithmraremerrors.
PTS: 1
2. ANS: D
Tomobtainmadequatemhistory,mproviders mmustmbemwellmorganized,mattentivemto mthempatient’s mverbalmand mnonverbalmlanguage,ma
ndmablemtomaccuratelyminterpretmthe mpatient’s mresponses mto mquestions.mRatherm thanmreadingm intomthempatient’s mstatements,mthe
ymclarifymanymareas mofmuncertainty.
PTS: 1
3. ANS: C
Vitalmsignsmarempartmofmthemphysicalmexaminationmportionmofmpatientmassessment,mnot mpartmofmthe mhealthmhistory.
PTS: 1
4. ANS: D
Whilemperformingmthemphysicalmexamination,m themexaminermmust mbemablem tomdifferentiate mbetweenmnormalmand mabnormalmfind
ings,mrecallmknowledgemofmamrangemofmconditions,mincludingmtheirmassociatedmsigns mandmsymptoms,mrecognizemhow mcertainmcon
ditions maffectmthemresponsemtomothermconditions,mandmdistinguishm themrelevancemofmvaried mabnormalmfindings.
PTS: 1
5. ANS: C
Sources mformdiagnosticmstatistics mincludemtextbooks,mprimarymreports mofmresearch, mandmpublishedmmeta-
analyses.mAnothermsourcemofmstatistics,mthemonemthat mhasmbeenmmostmwidelymused mand mavailablemformapplicationm tomthemreasoni
ngmprocess,mismthemestimationmbasedmon mamprovider’s mexperience,malthoughmthesemaremrarelymaccurate.mOverm thempast mdecade,
mthemavailabilitymofmevidencemonmwhichmtombasemclinicalmreasoningmis mimproving,m and mtheremis manm increasingmexpectationm th
atmclinicalmreasoningmbembasedmonmscientific mevidence.
Evidence-basedmstatistics maremalsomincreasinglymbeingmusedmtomdevelopmresources mtomfacilitatemclinicalm decision-making.
PTS: 1
6. ANS: D
Tomassistminmclinicalmdecision-making,ma mnumber mofmevidence-
basedmresources mhavembeenmdevelopedmtomassistmthem clinician.mResources,msuchm asmalgorithms m andmclinicalmpracticemguideline
s,massistminmclinicalmreasoningmwhenmproperlymapplied.
PTS: 1
7. ANS: A
Themsensitivitymofmamdiagnosticmstudymis mthempercentagemofmindividuals mwithmthemtargetmconditionmwhomshow manmabnormal,morm
positive,mresult.mA mhighmsensitivitymindicates mthat mamgreater mpercentagemofmpersons mwithm themgivenmcondition mwill mhavem anmab
normalmresult.
PTS: 1
8. ANS: B
Themspecificitymofmamdiagnosticmstudymis mthempercentagemofmnormal,mhealthymindividuals mwhomhavemamnormal mresult.m Themgre
atermthemspecificity,mthemgreater mthempercentage mofmindividuals mwhomwillmhavemnegative,mormnormal,mresults mifm theymdomnotmh
avemthemtargetmcondition.
PTS: 1
9. ANS: A
Themlikelihoodmratiomismthemprobabilitymthatm ampositivem testmresultmwillmbemassociatedmwithm ampersonmwhomhas mthemtargetmcondit
ionmandmamnegativemresultmwillmbe massociatedmwith mamhealthy mperson.mAmlikelihood mratiomabove m1mindicates mthatmampositive mre
sultmis massociatedmwithmthemdisease;mamlikelihoodmratiomless mthanm1mindicates mthatma mnegativemresultm ismassociatedmwith manmabs
encemofmthemdisease.
ADVANCED HEALTH ASSESSMENT & CLINICAL DIAGNOSIS I
m m m m m m
N PRIMARY CARE, 6TH EDITION
m m m m
Joyce E. Dains, Linda Ciofu Baumann & Pamela Scheibel
m m m m m m m m
, m
lOMoARcPSD|1
26
567m 13
Test Bank for Advanced Health Assessment & Clinical Diagnosis in Primary Care
m m m m m m m m m m m
6th Edition Dains m m m
Chapterm1:mClinicalmReasoning,mDifferentialmDiagnosis,mEvidence-BasedmPractice,mandmSymptommAnalysis
MultiplemChoice
Identifymthemchoicemthatmbestmcompletesmthemstatementmormanswersmthemquestion.
1. Whichmtypemofmclinicalmdecision-makingmismmostmreliable?
A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
2. Whichmofmthemfollowingmismfalse?mTo mobtainmadequatemhistory,mhealth-care mproviders mmustmbe:
A. Methodicalmandmsystematic
B. Attentivemtomthempatient’s mverbalmand mnonverbalmlangua
ge
C. Ablemtomaccuratelyminterpretmthempatient’s mresponses
D. Adeptmatmreadingmintomthempatient’s mstatements
3. Essentialmpartsmofmamhealthmhistorymincludemallmofmthe mfollowing mexcept:
A. Chiefmcomplaint
B. Historymofmthempresentmillness
C. Currentmvitalmsigns
D. Allmofmthemabovemaremessentialmhistorymcompone
nts
4. Whichmofmthemfollowingmismfalse?mWhilemperforming mthe mphysicalm examination,mthemexaminerm mustmbe mablemto:
A. Differentiatembetweenmnormalmandmabnormalmfindings
B. Recallmknowledgemofmamrangemofmconditions mandmtheirmassociated msigns mandmsympt
oms
C. Recognizemhowmcertainmconditions maffectmthemresponsemtomothermconditions
D. Foreseemunpredictablemfindings
5. Themfollowingmismthemleastmreliablemsourcemof minformation mformdiagnosticmstatistics:
A. Evidence-basedminvestigations
B. Primarymreports mofmresearch
C. Estimationmbasedmonmamprovider’s mexperienc
e
D. Publishedmmeta-analyses
6. Themfollowingmcanmbemusedmtomassist min msoundmclinicalmdecision-making:
A. Algorithmmpublishedminmampeer-
reviewedmjournalmarticle
B. Clinicalmpracticemguidelines
C. Evidence-basedmresearch
D. Allmofmthemabove
7. Ifmamdiagnosticmstudymhasmhighmsensitivity, mthis mindicates ma:
A. Highmpercentagemofmpersons mwithmthemgivenmconditionmwill mhavemanmabnormalmr
esult
B. Lowmpercentagemofmpersons mwithmthemgivenmconditionmwillmhaveman mabnormalmre
sult
C. Lowmlikelihoodmofmnormalmresultminmpersons mwithoutmamgivenmcondition
D. Nonemofmthemabove
8. Ifmamdiagnosticmstudymhasmhighmspecificity,m thismindicates ma:
A. Lowmpercentagemofmhealthymindividuals mwillmshow mamnormal mresult
B. Highmpercentagemofmhealthymindividuals mwillmshow ma mnormalmresult
C. Highmpercentagemofmindividuals mwithmamdisordermwillmshow mamnormalmresult
D. Lowmpercentagemofmindividuals mwithmamdisordermwillmshow man mabnormalmre
sult
9. A mlikelihoodmratiomabovem1mindicates mthatm amdiagnostic mtestmshowingma:
A. Positivemresultmis mstronglymassociatedmwithmthemdisease
B. Negativemresultmismstronglymassociated mwithmabsencemofmthe mdise
ase
C. Positivemresultmismweaklymassociatedmwithmthe mdisease
D. Negativemresultmismweaklymassociatedmwith mabsencemofmthe mdisea
se
10. Whichmofmthemfollowingmclinical mreasoning mtools mismdefinedmasmevidence-
basedmresourcembasedmonmmathematicalm modelingmtom express mthem likelihoodmof mamcondition minmselect msituations,msettings,man
, m
d/ormpatients? lOMoARcPSD|1
567m
26
13
, m
lOMoARcPSD|1
26
567m 13
A. Clinicalmpracticemguideline
B. Clinicalmdecisionmrule
C. Clinicalmalgorithm
Chapterm1:mClinicalmreasoning,mdifferentialmdiagnosis,mevidence-basedmpractice,mandmsymptom mana
AnswermSection
MULTIPLEmCHOICE
1. ANS: B
Croskerrym(2009)mdescribes mtwommajormtypes mofmclinicalmdiagnosticmdecision-
making:mintuitivemandmanalytical.mIntuitivemdecision-m makingm(similarmtomAugenblinkmdecision-
making)mismbasedmonmthemexperiencemandmintuitionmofmthemclinicianm andmismless mreliablemand mpairedmwithmfairly mcommonmerr
ors.mInmcontrast,manalyticalmdecision-makingm ismbasedmonm carefulmconsideration mandmhasmgreatermreliability mwithmraremerrors.
PTS: 1
2. ANS: D
Tomobtainmadequatemhistory,mproviders mmustmbemwellmorganized,mattentivemto mthempatient’s mverbalmand mnonverbalmlanguage,ma
ndmablemtomaccuratelyminterpretmthe mpatient’s mresponses mto mquestions.mRatherm thanmreadingm intomthempatient’s mstatements,mthe
ymclarifymanymareas mofmuncertainty.
PTS: 1
3. ANS: C
Vitalmsignsmarempartmofmthemphysicalmexaminationmportionmofmpatientmassessment,mnot mpartmofmthe mhealthmhistory.
PTS: 1
4. ANS: D
Whilemperformingmthemphysicalmexamination,m themexaminermmust mbemablem tomdifferentiate mbetweenmnormalmand mabnormalmfind
ings,mrecallmknowledgemofmamrangemofmconditions,mincludingmtheirmassociatedmsigns mandmsymptoms,mrecognizemhow mcertainmcon
ditions maffectmthemresponsemtomothermconditions,mandmdistinguishm themrelevancemofmvaried mabnormalmfindings.
PTS: 1
5. ANS: C
Sources mformdiagnosticmstatistics mincludemtextbooks,mprimarymreports mofmresearch, mandmpublishedmmeta-
analyses.mAnothermsourcemofmstatistics,mthemonemthat mhasmbeenmmostmwidelymused mand mavailablemformapplicationm tomthemreasoni
ngmprocess,mismthemestimationmbasedmon mamprovider’s mexperience,malthoughmthesemaremrarelymaccurate.mOverm thempast mdecade,
mthemavailabilitymofmevidencemonmwhichmtombasemclinicalmreasoningmis mimproving,m and mtheremis manm increasingmexpectationm th
atmclinicalmreasoningmbembasedmonmscientific mevidence.
Evidence-basedmstatistics maremalsomincreasinglymbeingmusedmtomdevelopmresources mtomfacilitatemclinicalm decision-making.
PTS: 1
6. ANS: D
Tomassistminmclinicalmdecision-making,ma mnumber mofmevidence-
basedmresources mhavembeenmdevelopedmtomassistmthem clinician.mResources,msuchm asmalgorithms m andmclinicalmpracticemguideline
s,massistminmclinicalmreasoningmwhenmproperlymapplied.
PTS: 1
7. ANS: A
Themsensitivitymofmamdiagnosticmstudymis mthempercentagemofmindividuals mwithmthemtargetmconditionmwhomshow manmabnormal,morm
positive,mresult.mA mhighmsensitivitymindicates mthat mamgreater mpercentagemofmpersons mwithm themgivenmcondition mwill mhavem anmab
normalmresult.
PTS: 1
8. ANS: B
Themspecificitymofmamdiagnosticmstudymis mthempercentagemofmnormal,mhealthymindividuals mwhomhavemamnormal mresult.m Themgre
atermthemspecificity,mthemgreater mthempercentage mofmindividuals mwhomwillmhavemnegative,mormnormal,mresults mifm theymdomnotmh
avemthemtargetmcondition.
PTS: 1
9. ANS: A
Themlikelihoodmratiomismthemprobabilitymthatm ampositivem testmresultmwillmbemassociatedmwithm ampersonmwhomhas mthemtargetmcondit
ionmandmamnegativemresultmwillmbe massociatedmwith mamhealthy mperson.mAmlikelihood mratiomabove m1mindicates mthatmampositive mre
sultmis massociatedmwithmthemdisease;mamlikelihoodmratiomless mthanm1mindicates mthatma mnegativemresultm ismassociatedmwith manmabs
encemofmthemdisease.
