TESTBANK zk
ADVANCED HEALTH ASSESSMENT & CLINICAL DIAGNOSIS IN
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PRIMARY CARE, 6TH EDITION
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Joyce E. Dains, Linda Ciofu Baumann & Pamela Scheibel
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, lOMoARcPSD|126 567 13
Test Bank for Advanced Health Assessment & Clinical Diagnosis in Primary Care 6t
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h Edition Dains zk zk
Chapter 1: Clinical Reasoning, Differential Diagnosis, Evidence-Based Practice, and Symptom Analysis
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Multiple Choice zk
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:
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A. Methodical and systematic zk zk
B. Attentive to the patient’s verbal and nonverbal language
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C. Able to accurately interpret the patient’s responses
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D. Adept at reading into the patient’s statements
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3. Essential parts of a health history include all of the following except:
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A. Chief complaint zk
B. History of the present illness zk zk zk zk
C. Current vital signs zk zk
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 zk zk zk zk zk
B. Recall knowledge 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 zk zk
5. The following is the least reliable source of information for diagnostic statistics:
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A. Evidence-based investigations zk
B. Primary reports of research zk zk zk
C. Estimation based on a provider’s experience zk zk zk zk zk
D. Published meta-analyses zk
6. The following can be used to assist in sound clinical decision-making:
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A. Algorithm published in a peer-reviewed journal article zk zk zk zk zk zk
B. Clinical practice guidelines zk zk
C. Evidence-based research zk
D. All of the above
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7. If a diagnostic study has 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 zk zk zk
8. If a diagnostic study has high specificity, this indicates a:
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A. Low percentage of healthy individuals will show a normal result
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B. High percentage of healthy individuals will show a normal result
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C. High percentage of individuals 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 weakly associated with absence of the disease
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10. Which of the following clinical reasoning tools is defined as evidence-
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based resource based on mathematical modeling to express the likelihood of a condition in select situations, settings, and/or p
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atients?
, lOMoARcPSD|126 567 13
A. Clinical practice guideline zk zk
B. Clinical decision rule zk zk
C. Clinical algorithm zk
Chapter 1: Clinical reasoning, differential diagnosis, evidence-based practice, and symptom ana
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Answer Section
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MULTIPLE CHOICE zk
1. ANS: B
Croskerry (2009) describes two major types of clinical diagnostic decision-
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making: intuitive and analytical. Intuitive decision- 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
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contrast, 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
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to accurately interpret the patient’s responses to questions. Rather than reading into the patient’s statements, they clarify an
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y areas of uncertainty.
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PTS: 1
3. ANS: C
Vital signs are part of the physical examination portion of patient assessment, not part of the 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,
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recall knowledge of a range of conditions, including their associated signs and symptoms, recognize how certain conditions aff
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ect the response 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 widely used and available for application to the reasoning proc
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ess, is the estimation based on a provider’s experience, although these are rarely accurate. Over the past decade, the availabili
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ty of evidence on which to base clinical reasoning is improving, and there is an increasing expectation that clinical reasonin
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g be based on scientific evidence.
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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, ass
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ist in 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 positiv
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e, result. 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 th
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e specificity, the greater the percentage of individuals who will have negative, or normal, results if they do not have the targ
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et condition.
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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
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a negative result will be associated with a healthy person. A likelihood ratio above 1 indicates that a positive result is associa
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ted with the disease; a likelihood ratio less than 1 indicates that a negative result is associated with an absence of the disease.
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, lOMoARcPSD|126 567 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
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met with regard to the prognosis of patients with specific findings. Decision rules use mathematical models and are specific
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to certain situations, settings, and/or patient characteristics.
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PTS: 1
ADVANCED HEALTH ASSESSMENT & CLINICAL DIAGNOSIS IN
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PRIMARY CARE, 6TH EDITION
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Joyce E. Dains, Linda Ciofu Baumann & Pamela Scheibel
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, lOMoARcPSD|126 567 13
Test Bank for Advanced Health Assessment & Clinical Diagnosis in Primary Care 6t
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h Edition Dains zk zk
Chapter 1: Clinical Reasoning, Differential Diagnosis, Evidence-Based Practice, and Symptom Analysis
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Multiple Choice zk
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:
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A. Methodical and systematic zk zk
B. Attentive to the patient’s verbal and nonverbal language
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C. Able to accurately interpret the patient’s responses
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D. Adept at reading into the patient’s statements
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3. Essential parts of a health history include all of the following except:
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A. Chief complaint zk
B. History of the present illness zk zk zk zk
C. Current vital signs zk zk
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 zk zk zk zk zk
B. Recall knowledge 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 zk zk
5. The following is the least reliable source of information for diagnostic statistics:
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A. Evidence-based investigations zk
B. Primary reports of research zk zk zk
C. Estimation based on a provider’s experience zk zk zk zk zk
D. Published meta-analyses zk
6. The following can be used to assist in sound clinical decision-making:
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A. Algorithm published in a peer-reviewed journal article zk zk zk zk zk zk
B. Clinical practice guidelines zk zk
C. Evidence-based research zk
D. All of the above
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7. If a diagnostic study has 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 zk zk zk
8. If a diagnostic study has high specificity, this indicates a:
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A. Low percentage of healthy individuals will show a normal result
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B. High percentage of healthy individuals will show a normal result
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C. High percentage of individuals 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 weakly associated with absence of the disease
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10. Which of the following clinical reasoning tools is defined as evidence-
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based resource based on mathematical modeling to express the likelihood of a condition in select situations, settings, and/or p
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atients?
, lOMoARcPSD|126 567 13
A. Clinical practice guideline zk zk
B. Clinical decision rule zk zk
C. Clinical algorithm zk
Chapter 1: Clinical reasoning, differential diagnosis, evidence-based practice, and symptom ana
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Answer Section
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MULTIPLE CHOICE zk
1. ANS: B
Croskerry (2009) describes two major types of clinical diagnostic decision-
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making: intuitive and analytical. Intuitive decision- 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
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contrast, 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
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to accurately interpret the patient’s responses to questions. Rather than reading into the patient’s statements, they clarify an
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y areas of uncertainty.
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PTS: 1
3. ANS: C
Vital signs are part of the physical examination portion of patient assessment, not part of the 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,
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recall knowledge of a range of conditions, including their associated signs and symptoms, recognize how certain conditions aff
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ect the response 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 widely used and available for application to the reasoning proc
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ess, is the estimation based on a provider’s experience, although these are rarely accurate. Over the past decade, the availabili
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ty of evidence on which to base clinical reasoning is improving, and there is an increasing expectation that clinical reasonin
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g be based on scientific evidence.
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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, ass
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ist in 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 positiv
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e, result. 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 th
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e specificity, the greater the percentage of individuals who will have negative, or normal, results if they do not have the targ
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et condition.
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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
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a negative result will be associated with a healthy person. A likelihood ratio above 1 indicates that a positive result is associa
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ted with the disease; a likelihood ratio less than 1 indicates that a negative result is associated with an absence of the disease.
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, lOMoARcPSD|126 567 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
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met with regard to the prognosis of patients with specific findings. Decision rules use mathematical models and are specific
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to certain situations, settings, and/or patient characteristics.
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PTS: 1
