,Test Bank for Advanced Health Assessment & Clinical Diagnosis in Primary Care
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7th Edition Dains gh gh
Chapter1: Clinical Reasoning, Differential Diagnosis, Evidence-Based Practice, and Symptom Analysis
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Multiple Choicegh
Identify thechoice thatbest completesthe statement oranswers thequestion.
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1. Which ghtype ghof ghclinical ghdecision-makingghis ghmost ghreliable?
A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
2. Which ghofghthe ghfollowingghis ghfalse? ghTo ghobtain ghadequate ghhistory, gh health-care ghproviders ghmust ghbe:
A. Methodical ghand ghsystematic
B. Attentive ghto ghthe ghpatient’s ghverbal ghand ghnonverbal
ghlanguage
C. Able ghtoghaccuratelyinterpret gh the ghpatient’s ghresponses
D. Adept gh at gh reading ghintothe ghpatient’s ghstatements
3. Essential ghparts ghof gha ghhealth ghhistoryinclude ghall g h of ghthe ghfollowing ghexcept:
A. Chief ghcomplaint
B. Historyof ghthe gh present ghillness
C. Current ghvital ghsigns
D. All gh of ghthe ghabove ghare ghessential
gh historycomponents
4. Which ghof ghthe ghfollowing ghis gh false? ghWhile ghperformingghthe ghphysical g h examination, ghthe ghexaminer gh must ghbeghableto:
A. Differentiatebetween ghnormal gh and ghabnormal ghfindings
B. Recall ghknowledge ghof gha ghrange ghof ghconditions ghandftheir ghassociated ghsigns ghand
ghsymptoms
C. Recognize ghhow ghcertain ghconditions ghaffect gh the ghresponseghto ghother ghconditions
D. Foresee ghunpredictable gh findings
5. The ghfollowingghis ghthe ghleast ghreliable ghsource ghof ghinformation ghfor gh diagnostic ghstatistics:
A. Evidence-based ghinvestigations
B. Primaryreports g h of ghresearch
C. Estimation ghbased ghon ghaghprovider’s
ghexperience
D. Published ghmeta-analyses
6. The ghfollowing ghcan ghbe ghused ghtoghassist ghin ghsound gh clinical ghdecision-making:
A. Algorithmpublished ghin gh a ghpeer-reviewed ghjournal
gh article
B. Clinical ghpractice ghguidelines
C. Evidence-based ghresearch
D. All ghof ghthefabove
7. If gha ghdiagnostic ghstudyhas ghhigh ghsensitivity, g h this ghindicates gha:
A. High ghpercentage ghofghpersons ghwith ghthe ghgiven ghcondition ghwill ghhave ghan ghabnormal
ghresult
B. Low ghpercentage ghof ghpersons ghwith ghthe ghgiven ghcondition ghwill ghhave ghan ghabnormal
ghresult
C. Low ghlikelihood ghof ghnormal ghresult ghin ghpersons ghwithout gha ghgiven ghcondition
D. None ghof ghtheabove
8. If gha ghdiagnostic ghstudyhas gh high ghspecificity, g h this ghindicates gha:
A. Low ghpercentage gh of ghhealthyindividuals gh will ghshow gha ghnormalghresult
B. High gh percentage gh of ghhealthyindividuals ghwill ghshow gha ghnormal ghresult
C. High gh percentage gh ofindividuals gh with gh a ghdisorder ghwill ghshow gha ghnormal
ghresult
D. Low ghpercentage ghofghindividuals ghwith gha ghdisorder ghwill ghshow ghan ghabnormal
ghresult
9. Aflikelihood gh ratio ghabove gh 1 ghindicates ghthat gha ghdiagnostic ghtest ghshowing gha:
A. Positive gh result ghis ghstronglyassociated ghwith ghthe ghdisease
B. Negative ghresult ghis ghstronglyassociated ghwith ghabsence gh of ghthe
gh disease
C. Positive ghresult ghis ghweaklyassociated gh with ghthe ghdisease
D. Negativeresult gh is gh weaklyassociated g h with ghabsence ghof ghthe
gh disease
10. Which ghof ghthe ghfollowing ghclinical ghreasoningghtools ghis ghdefined ghas ghevidence-based ghresource ghbased ghon ghmathematical
,gh modeling ghto ghexpress ghthe ghlikelihood g h of gha ghcondition ghin ghselect ghsituations, ghsettings, ghand/or ghpatients?
, A. Clinical ghpractice ghguideline
B. Clinicalghdecision ghrule
C. Clinical ghalgorithm
Chapter 1: Clinical reasoning, differential diagnosis, evidence-based practice, and symptom ana
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Answer Section
gh
MULTIPLE ghCHOICE
1. ANS: B
Croskerry gh(2009) ghdescribes ghtwo ghmajor ghtypes ghof ghclinical ghdiagnostic ghdecision-making: ghintuitive ghand ghanalytical. ghIntuitive
gh decision-making gh (similar gh to gh Augenblink gh decision-making) gh is gh based gh on gh the gh experience gh and gh intuition gh of gh the gh clinician
gh and gh is gh less gh reliable gh and fpaired gh with gh fairly gh common gh errors. gh In gh contrast, gh analytical gh decision-making gh is gh based gh on
gh careful gh consideration gh and ghhas gh greater gh reliabilitywith gh rare gh errors.
PTS: 1
2. ANS: D
To ghobtain ghadequate ghhistory, ghproviders ghmust ghbe ghwell ghorganized, ghattentive ghto ghthe ghpatient’s ghverbal ghand ghnonverbal ghlanguage,
ghand ghable gh to gh accurately gh interpret gh the gh patient’s gh responses gh to gh questions. gh Rather gh than gh reading gh into gh the gh patient’s
gh statements, gh they gh clarify gh any gh areas gh of gh uncertainty.
PTS: 1
3. ANS: C
Vitalghsigns ghare ghpart ghofghthe ghphysical ghexamination ghportion ghofghpatient ghassessment, ghnot ghpart ghofthe ghhealth ghhistory.
PTS: 1
4. ANS: D
While ghperforming ghthe ghphysical ghexamination, ghthe ghexaminer ghmust ghbe ghable ghto ghdifferentiate ghbetween ghnormal ghand
gh abnormal gh findings, gh recall gh knowledge gh of gh a gh range gh of gh conditions, gh including gh their gh associated gh signs gh and gh symptoms,
gh recognize gh how gh certain gh conditions gh affectthe ghresponse gh to ghother gh conditions, gh and gh distinguish gh the gh relevance gh of gh varied
gh abnormal gh findings.
PTS: 1
5. ANS: C
Sources ghfor ghdiagnostic ghstatistics ghinclude ghtextbooks, ghprimary ghreports ghof ghresearch, ghand ghpublished ghmeta-analyses. ghAnother
gh source gh of gh statistics, ghthe ghone ghthat ghhas ghbeen gh most gh widelyused ghand ghavailable g h for gh application g h to ghthe ghreasoning ghprocess, gh is
ghthe ghestimation gh based ghon gh a gh provider’s gh experience, gh although gh these gh are gh rarely gh accurate. gh Over gh the gh past gh decade, gh the
gh availability gh of gh evidence gh on gh which gh to gh base gh clinical gh reasoningis ghimproving, g h and ghthere ghis gh an gh increasing ghexpectation
gh that gh clinical gh reasoning ghbe gh based gh on ghscientific gh evidence.
Evidence-based ghstatistics ghare gh also ghincreasinglybeing ghused ghto ghdevelop g h resources ghto ghfacilitate g h clinical g h decision-making.
PTS: 1
6. ANS: D
To ghassist ghin ghclinical ghdecision-making, gha ghnumber ghof ghevidence-based ghresources ghhave ghbeen ghdeveloped ghto ghassist ghthe
gh clinician. gh Resources, gh such gh as ghalgorithms gh and gh clinical gh practice gh guidelines, gh assist gh in gh clinical gh reasoning gh when
gh properlyapplied.
PTS: 1
7. ANS: A
The ghsensitivity ghof gha ghdiagnostic ghstudy ghis ghthe ghpercentage ghof gh individuals ghwith ghthe ghtarget ghcondition ghwho ghshow ghan
gh abnormal, gh or gh positive,result. gh Ahigh ghsensitivityindicates ghthat gh a ghgreater gh percentage gh of ghpersons ghwith ghthe gh given gh condition
gh will gh have ghan gh abnormal gh result.
PTS: 1
8. ANS: B
The ghspecificity ghof gha ghdiagnostic ghstudy ghis ghthe ghpercentage ghof ghnormal, ghhealthy gh individuals ghwho ghhave gha ghnormal gh result.
gh The gh greater gh thef specificity, gh the gh greater gh the gh percentage gh of gh individuals gh who gh will gh have gh negative, gh or gh normal, gh results gh if
gh they gh do gh not gh have gh the gh target gh condition.
PTS: 1
9. ANS: A
The ghlikelihood ghratio gh is ghthe ghprobability ghthat gha ghpositive ghtest ghresult ghwill ghbe ghassociated ghwith gha gh person ghwho ghhas ghthe ghtarget
gh condition gh and gh afnegative gh result gh will gh be gh associated gh with gh a gh healthy gh person. gh A gh likelihood gh ratio gh above gh 1 gh indicates gh that
gh a gh positive gh result gh is gh associated gh with ghthe ghdisease; gha gh likelihood g h ratio ghless gh than gh1 gh indicates ghthat gh a gh negative g h result gh is
gh associated gh with ghan gh absence gh of ghthe gh disease.
gh gh gh gh gh gh gh gh gh gh gh
7th Edition Dains gh gh
Chapter1: Clinical Reasoning, Differential Diagnosis, Evidence-Based Practice, and Symptom Analysis
gh gh gh f gh gh gh gh gh
Multiple Choicegh
Identify thechoice thatbest completesthe statement oranswers thequestion.
gh gh gh gh gh gh
1. Which ghtype ghof ghclinical ghdecision-makingghis ghmost ghreliable?
A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
2. Which ghofghthe ghfollowingghis ghfalse? ghTo ghobtain ghadequate ghhistory, gh health-care ghproviders ghmust ghbe:
A. Methodical ghand ghsystematic
B. Attentive ghto ghthe ghpatient’s ghverbal ghand ghnonverbal
ghlanguage
C. Able ghtoghaccuratelyinterpret gh the ghpatient’s ghresponses
D. Adept gh at gh reading ghintothe ghpatient’s ghstatements
3. Essential ghparts ghof gha ghhealth ghhistoryinclude ghall g h of ghthe ghfollowing ghexcept:
A. Chief ghcomplaint
B. Historyof ghthe gh present ghillness
C. Current ghvital ghsigns
D. All gh of ghthe ghabove ghare ghessential
gh historycomponents
4. Which ghof ghthe ghfollowing ghis gh false? ghWhile ghperformingghthe ghphysical g h examination, ghthe ghexaminer gh must ghbeghableto:
A. Differentiatebetween ghnormal gh and ghabnormal ghfindings
B. Recall ghknowledge ghof gha ghrange ghof ghconditions ghandftheir ghassociated ghsigns ghand
ghsymptoms
C. Recognize ghhow ghcertain ghconditions ghaffect gh the ghresponseghto ghother ghconditions
D. Foresee ghunpredictable gh findings
5. The ghfollowingghis ghthe ghleast ghreliable ghsource ghof ghinformation ghfor gh diagnostic ghstatistics:
A. Evidence-based ghinvestigations
B. Primaryreports g h of ghresearch
C. Estimation ghbased ghon ghaghprovider’s
ghexperience
D. Published ghmeta-analyses
6. The ghfollowing ghcan ghbe ghused ghtoghassist ghin ghsound gh clinical ghdecision-making:
A. Algorithmpublished ghin gh a ghpeer-reviewed ghjournal
gh article
B. Clinical ghpractice ghguidelines
C. Evidence-based ghresearch
D. All ghof ghthefabove
7. If gha ghdiagnostic ghstudyhas ghhigh ghsensitivity, g h this ghindicates gha:
A. High ghpercentage ghofghpersons ghwith ghthe ghgiven ghcondition ghwill ghhave ghan ghabnormal
ghresult
B. Low ghpercentage ghof ghpersons ghwith ghthe ghgiven ghcondition ghwill ghhave ghan ghabnormal
ghresult
C. Low ghlikelihood ghof ghnormal ghresult ghin ghpersons ghwithout gha ghgiven ghcondition
D. None ghof ghtheabove
8. If gha ghdiagnostic ghstudyhas gh high ghspecificity, g h this ghindicates gha:
A. Low ghpercentage gh of ghhealthyindividuals gh will ghshow gha ghnormalghresult
B. High gh percentage gh of ghhealthyindividuals ghwill ghshow gha ghnormal ghresult
C. High gh percentage gh ofindividuals gh with gh a ghdisorder ghwill ghshow gha ghnormal
ghresult
D. Low ghpercentage ghofghindividuals ghwith gha ghdisorder ghwill ghshow ghan ghabnormal
ghresult
9. Aflikelihood gh ratio ghabove gh 1 ghindicates ghthat gha ghdiagnostic ghtest ghshowing gha:
A. Positive gh result ghis ghstronglyassociated ghwith ghthe ghdisease
B. Negative ghresult ghis ghstronglyassociated ghwith ghabsence gh of ghthe
gh disease
C. Positive ghresult ghis ghweaklyassociated gh with ghthe ghdisease
D. Negativeresult gh is gh weaklyassociated g h with ghabsence ghof ghthe
gh disease
10. Which ghof ghthe ghfollowing ghclinical ghreasoningghtools ghis ghdefined ghas ghevidence-based ghresource ghbased ghon ghmathematical
,gh modeling ghto ghexpress ghthe ghlikelihood g h of gha ghcondition ghin ghselect ghsituations, ghsettings, ghand/or ghpatients?
, A. Clinical ghpractice ghguideline
B. Clinicalghdecision ghrule
C. Clinical ghalgorithm
Chapter 1: Clinical reasoning, differential diagnosis, evidence-based practice, and symptom ana
gh gh gh gh gh gh gh gh gh gh
Answer Section
gh
MULTIPLE ghCHOICE
1. ANS: B
Croskerry gh(2009) ghdescribes ghtwo ghmajor ghtypes ghof ghclinical ghdiagnostic ghdecision-making: ghintuitive ghand ghanalytical. ghIntuitive
gh decision-making gh (similar gh to gh Augenblink gh decision-making) gh is gh based gh on gh the gh experience gh and gh intuition gh of gh the gh clinician
gh and gh is gh less gh reliable gh and fpaired gh with gh fairly gh common gh errors. gh In gh contrast, gh analytical gh decision-making gh is gh based gh on
gh careful gh consideration gh and ghhas gh greater gh reliabilitywith gh rare gh errors.
PTS: 1
2. ANS: D
To ghobtain ghadequate ghhistory, ghproviders ghmust ghbe ghwell ghorganized, ghattentive ghto ghthe ghpatient’s ghverbal ghand ghnonverbal ghlanguage,
ghand ghable gh to gh accurately gh interpret gh the gh patient’s gh responses gh to gh questions. gh Rather gh than gh reading gh into gh the gh patient’s
gh statements, gh they gh clarify gh any gh areas gh of gh uncertainty.
PTS: 1
3. ANS: C
Vitalghsigns ghare ghpart ghofghthe ghphysical ghexamination ghportion ghofghpatient ghassessment, ghnot ghpart ghofthe ghhealth ghhistory.
PTS: 1
4. ANS: D
While ghperforming ghthe ghphysical ghexamination, ghthe ghexaminer ghmust ghbe ghable ghto ghdifferentiate ghbetween ghnormal ghand
gh abnormal gh findings, gh recall gh knowledge gh of gh a gh range gh of gh conditions, gh including gh their gh associated gh signs gh and gh symptoms,
gh recognize gh how gh certain gh conditions gh affectthe ghresponse gh to ghother gh conditions, gh and gh distinguish gh the gh relevance gh of gh varied
gh abnormal gh findings.
PTS: 1
5. ANS: C
Sources ghfor ghdiagnostic ghstatistics ghinclude ghtextbooks, ghprimary ghreports ghof ghresearch, ghand ghpublished ghmeta-analyses. ghAnother
gh source gh of gh statistics, ghthe ghone ghthat ghhas ghbeen gh most gh widelyused ghand ghavailable g h for gh application g h to ghthe ghreasoning ghprocess, gh is
ghthe ghestimation gh based ghon gh a gh provider’s gh experience, gh although gh these gh are gh rarely gh accurate. gh Over gh the gh past gh decade, gh the
gh availability gh of gh evidence gh on gh which gh to gh base gh clinical gh reasoningis ghimproving, g h and ghthere ghis gh an gh increasing ghexpectation
gh that gh clinical gh reasoning ghbe gh based gh on ghscientific gh evidence.
Evidence-based ghstatistics ghare gh also ghincreasinglybeing ghused ghto ghdevelop g h resources ghto ghfacilitate g h clinical g h decision-making.
PTS: 1
6. ANS: D
To ghassist ghin ghclinical ghdecision-making, gha ghnumber ghof ghevidence-based ghresources ghhave ghbeen ghdeveloped ghto ghassist ghthe
gh clinician. gh Resources, gh such gh as ghalgorithms gh and gh clinical gh practice gh guidelines, gh assist gh in gh clinical gh reasoning gh when
gh properlyapplied.
PTS: 1
7. ANS: A
The ghsensitivity ghof gha ghdiagnostic ghstudy ghis ghthe ghpercentage ghof gh individuals ghwith ghthe ghtarget ghcondition ghwho ghshow ghan
gh abnormal, gh or gh positive,result. gh Ahigh ghsensitivityindicates ghthat gh a ghgreater gh percentage gh of ghpersons ghwith ghthe gh given gh condition
gh will gh have ghan gh abnormal gh result.
PTS: 1
8. ANS: B
The ghspecificity ghof gha ghdiagnostic ghstudy ghis ghthe ghpercentage ghof ghnormal, ghhealthy gh individuals ghwho ghhave gha ghnormal gh result.
gh The gh greater gh thef specificity, gh the gh greater gh the gh percentage gh of gh individuals gh who gh will gh have gh negative, gh or gh normal, gh results gh if
gh they gh do gh not gh have gh the gh target gh condition.
PTS: 1
9. ANS: A
The ghlikelihood ghratio gh is ghthe ghprobability ghthat gha ghpositive ghtest ghresult ghwill ghbe ghassociated ghwith gha gh person ghwho ghhas ghthe ghtarget
gh condition gh and gh afnegative gh result gh will gh be gh associated gh with gh a gh healthy gh person. gh A gh likelihood gh ratio gh above gh 1 gh indicates gh that
gh a gh positive gh result gh is gh associated gh with ghthe ghdisease; gha gh likelihood g h ratio ghless gh than gh1 gh indicates ghthat gh a gh negative g h result gh is
gh associated gh with ghan gh absence gh of ghthe gh disease.
