lOMoAR L cPSD|
L 12263423
TEST BANK FOR ADVANCED ASSESSMENT: L L L L L
INTERPRETING FINDINGS AND FORMULATING
L L L L L
DIFFERENTIAL DIAGNOSES 4th Edition, Mary Jo L L L L L L
Goolsby, Laurie Grubbs-A+ GRADES-2023-2024
L L L L
Chapter 1: Clinical reasoning, differential diagnosis, evidence-based practice, and symptom ana
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.
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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:
L L L L L L L L L L L L L
A. Methodical and systematic L L
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 L
B. History of the present illness
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C. Current vital signs L L
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 L L L L L
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
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5. The following is the least reliable source of information for diagnostic statistics:
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A. Evidence-based investigations L
B. Primary reports of research L L L
C. Estimation based on a provider’s experience L L L L L
D. Published meta-analyses L
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
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B. Clinical practice guidelines L L
C. Evidence-based research L
D. All of the above
L L L
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
L L L
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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, lOMoAR L cPSD|
10. Which of the following clinical reasoning tools is defined as evidence-based resource based on mathematical modeling
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L 12263423
L L L L L L L
to express the likelihood of a condition in select situations, settings, and/or patients?
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A. Clinical practice guideline L L
B. Clinical decision rule L L
C. Clinical algorithm L
Chapter 1: Clinical reasoning, differential diagnosis, evidence-based practice, and symptom ana
L L L L L L L L L L
Answer Section
L
MULTIPLE CHOICEL
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-making) is based on the experience and intuition of the clinician and is less reliable
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and paired with fairly common errors. In contrast, analytical decision-making is based on careful consideration and has
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greater reliability with rare errors.
L L L L L
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 any
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areas of uncertainty.
L L L
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
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affect the response to other conditions, and distinguish the relevance of varied abnormal findings.
L L L L L L L L L L L L L L
PTS: 1
5. ANS: C
Sources for diagnostic statistics include textbooks, primary reports of research, and published meta-analyses. Another source
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of statistics, the one that has been most widely used and available for application to the reasoning process, is the estimation based
L L L L L L L L L L L L L L L L L L L L L L
on a provider’s experience, although these are rarely accurate. Over the past decade, the availability of evidence on which to
L L L L L L L L L L L L L L L L L L L L
base clinical reasoning is improving, and there is an increasing expectation that clinical reasoning be based on scientific
L L L L L L L L L L L L L L L L L L
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-based resources have been developed to assist the clinician.
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Resources, such as algorithms and clinical practice guidelines, assist 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 positive,
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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 the
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specificity, the greater the percentage of individuals who will have negative, or normal, results if they do not have the target
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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
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Lassociated with the disease; a likelihood ratio less than 1 indicates that a negative result is associated with an absence of the
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disease.
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L 12263423
PTS: 1
10. ANS: B
Clinical decision (or prediction) rules provide another support for clinical reasoning. Clinical decision rules are evidence-based
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resources that provide probabilistic statements regarding the likelihood that a condition exists if certain variables are met with
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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.
L L L L L
PTS: 1
Downloaded by Anna Maina ()
L L L L
, lOMoAR L cPSD|
L 12263423
Chapter 2. Evidence-based health screening
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
1. The first step in the genomic assessment of a patient is obtaining information regarding:
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A. Family history L
B. Environmental exposures L
C. Lifestyle and behaviors L L
D. Current medications L
2. An affected individual who manifests symptoms of a particular condition through whom a family with a genetic
L L L L L L L L L L L L L L L L
disorder is ascertained is called a(n):
L L L L L L
A. Consultand
B. Consulband
C. Index patient L
D. Proband
3. An autosomal dominant disorder involves the:
L L L L L
A. X chromosome
L
B. Y chromosome
L
C. Mitochondrial DNA L
D. Non-sex chromosomes L
4. To illustrate a union between two second cousin family members in a pedigree, draw:
L L L L L L L L L L L L L
A. Arrows pointing to the male and female
L L L L L L
B. Brackets around the male and female L L L L L
C. Double horizontal lines between the male and female
L L L L L L L
D. Circles around the male and female
L L L L L
5. To illustrate two family members in an adoptive relationship in a pedigree:
L L L L L L L L L L L
A. Arrows are drawn pointing to the male and female
L L L L L L L L
B. Brackets are drawn around the male and female
L L L L L L L
C. Double horizontal lines are drawn between the male and female
L L L L L L L L L
D. Circles are drawn around the male and female
L L L L L L L
6. When analyzing the pedigree for autosomal dominant disorders, it is common to see:
L L L L L L L L L L L L
A. Several generations of affected members
L L L L
B. Many consanguineous relationships
L L
C. More members of the maternal lineage affected than paternal
L L L L L L L L
D. More members of the paternal lineage affected than maternal
L L L L L L L L
7. In autosomal recessive (AR) disorders, individuals need:
L L L L L L
A. Only one mutated gene on the sex chromosomes to acquire the disease
L L L L L L L L L L L
B. Only one mutated gene to acquire the disease
L L L L L L L
C. Two mutated genes to acquire the disease
L L L L L L
D. Two mutated genes to become carriers
L L L L L
8. In autosomal recessive disorders, carriers have:
L L L L L
A. Two mutated genes; one from each parent that cause disease
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B. A mutation on a sex chromosome that causes a disease
L L L L L L L L L
C. A single gene mutation that causes the disease
L L L L L L L
D. One copy of a gene mutation but not the disease
L L L L L L L L L
9. With an autosomal recessive disorder, it is important that parents understand that if they both carry a mutation, the
L L L L L L L L L L L L L L L L L L
following are the risks to each of their offspring (each pregnancy):
L L L L L L L L L L L
A. 50% chance that offspring will carry the disease
L L L L L L L
B. 10% chance of offspring affected by disease
L L L L L L
Downloaded by Anna Maina () L L L L
L 12263423
TEST BANK FOR ADVANCED ASSESSMENT: L L L L L
INTERPRETING FINDINGS AND FORMULATING
L L L L L
DIFFERENTIAL DIAGNOSES 4th Edition, Mary Jo L L L L L L
Goolsby, Laurie Grubbs-A+ GRADES-2023-2024
L L L L
Chapter 1: Clinical reasoning, differential diagnosis, evidence-based practice, and symptom ana
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
1. Which type of clinical decision-making is most reliable?
L L L L L L L
A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
2. Which of the following is false? To obtain adequate history, health-care providers must be:
L L L L L L L L L L L L L
A. Methodical and systematic L L
B. Attentive to the patient’s verbal and nonverbal language
L L L L L L L
C. Able to accurately interpret the patient’s responses
L L L L L L
D. Adept at reading into the patient’s statements
L L L L L L
3. Essential parts of a health history include all of the following except:
L L L L L L L L L L L
A. Chief complaint L
B. History of the present illness
L L L L
C. Current vital signs L L
D. All of the above are essential history components
L L L L L L L
4. Which of the following is false? While performing the physical examination, the examiner must be able to:
L L L L L L L L L L L L L L L L
A. Differentiate between normal and abnormal findings L L L L L
B. Recall knowledge of a range of conditions and their associated signs and symptoms
L L L L L L L L L L L L
C. Recognize how certain conditions affect the response to other conditions
L L L L L L L L L
D. Foresee unpredictable findings
L L
5. The following is the least reliable source of information for diagnostic statistics:
L L L L L L L L L L L
A. Evidence-based investigations L
B. Primary reports of research L L L
C. Estimation based on a provider’s experience L L L L L
D. Published meta-analyses L
6. The following can be used to assist in sound clinical decision-making:
L L L L L L L L L L
A. Algorithm published in a peer-reviewed journal article
L L L L L L
B. Clinical practice guidelines L L
C. Evidence-based research L
D. All of the above
L L L
7. If a diagnostic study has high sensitivity, this indicates a:
L L L L L L L L L
A. High percentage of persons with the given condition will have an abnormal result
L L L L L L L L L L L L
B. Low percentage of persons with the given condition will have an abnormal result
L L L L L L L L L L L L
C. Low likelihood of normal result in persons without a given condition
L L L L L L L L L L
D. None of the above
L L L
8. If a diagnostic study has high specificity, this indicates a:
L L L L L L L L L
A. Low percentage of healthy individuals will show a normal result
L L L L L L L L L
B. High percentage of healthy individuals will show a normal result
L L L L L L L L L
C. High percentage of individuals with a disorder will show a normal result
L L L L L L L L L L L
D. Low percentage of individuals with a disorder will show an abnormal result
L L L L L L L L L L L
9. A likelihood ratio above 1 indicates that a diagnostic test showing a:
L L L L L L L L L L L
A. Positive result is strongly associated with the disease
L L L L L L L
B. Negative result is strongly associated with absence of the disease
L L L L L L L L L
C. Positive result is weakly associated with the disease
L L L L L L L
D. Negative result is weakly associated with absence of the disease
L L L L L L L L L
Downloaded by Anna Maina () L L L L
, lOMoAR L cPSD|
10. Which of the following clinical reasoning tools is defined as evidence-based resource based on mathematical modeling
L L L L L L L L
L 12263423
L L L L L L L
to express the likelihood of a condition in select situations, settings, and/or patients?
L L L L L L L L L L L L L
A. Clinical practice guideline L L
B. Clinical decision rule L L
C. Clinical algorithm L
Chapter 1: Clinical reasoning, differential diagnosis, evidence-based practice, and symptom ana
L L L L L L L L L L
Answer Section
L
MULTIPLE CHOICEL
1. ANS: B
Croskerry (2009) describes two major types of clinical diagnostic decision-making: intuitive and analytical. Intuitive decision-
L L L L L L L L L L L L L L
making (similar to Augenblink decision-making) is based on the experience and intuition of the clinician and is less reliable
L L L L L L L L L L L L L L L L L L
and paired with fairly common errors. In contrast, analytical decision-making is based on careful consideration and has
L L L L L L L L L L L L L L L L L
greater reliability with rare errors.
L L L L L
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
L L L L L L L L L L L L L L L L L L
to accurately interpret the patient’s responses to questions. Rather than reading into the patient’s statements, they clarify any
L L L L L L L L L L L L L L L L L L
areas of uncertainty.
L L L
PTS: 1
3. ANS: C
Vital signs are part of the physical examination portion of patient assessment, not part of the health history.
L L L L L L L L L L L L L L L L L
PTS: 1
4. ANS: D
While performing the physical examination, the examiner must be able to differentiate between normal and abnormal findings,
L L L L L L L L L L L L L L L L
recall knowledge of a range of conditions, including their associated signs and symptoms, recognize how certain conditions
L L L L L L L L L L L L L L L L L
affect the response to other conditions, and distinguish the relevance of varied abnormal findings.
L L L L L L L L L L L L L L
PTS: 1
5. ANS: C
Sources for diagnostic statistics include textbooks, primary reports of research, and published meta-analyses. Another source
L L L L L L L L L L L L L L
of statistics, the one that has been most widely used and available for application to the reasoning process, is the estimation based
L L L L L L L L L L L L L L L L L L L L L L
on a provider’s experience, although these are rarely accurate. Over the past decade, the availability of evidence on which to
L L L L L L L L L L L L L L L L L L L L
base clinical reasoning is improving, and there is an increasing expectation that clinical reasoning be based on scientific
L L L L L L L L L L L L L L L L L L
evidence.
L
Evidence-based statistics are also increasingly being used to develop resources to facilitate clinical decision-making.
L L L L L L L L L L L L L
PTS: 1
6. ANS: D
To assist in clinical decision-making, a number of evidence-based resources have been developed to assist the clinician.
L L L L L L L L L L L L L L L L
Resources, such as algorithms and clinical practice guidelines, assist in clinical reasoning when properly applied.
L L L L L L L L L L L L L L L
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,
L L L L L L L L L L L L L L L L L L L L
result. A high sensitivity indicates that a greater percentage of persons with the given condition will have an abnormal result.
L L L L L L L L L L L L L L L L L L L L
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
L L L L L L L L L L L L L L L L L L L L
specificity, the greater the percentage of individuals who will have negative, or normal, results if they do not have the target
L L L L L L L L L L L L L L L L L L L L L
condition.
L
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
L L L L L L L L L L L L L L L L L L L L L L
a negative result will be associated with a healthy person. A likelihood ratio above 1 indicates that a positive result is
L L L L L L L L L L L L L L L L L L L L L
Lassociated with the disease; a likelihood ratio less than 1 indicates that a negative result is associated with an absence of the
L L L L L L L L L L L L L L L L L L L L L
disease.
L
Downloaded by Anna Maina () L L L L
, lOMoAR L cPSD|
L 12263423
PTS: 1
10. ANS: B
Clinical decision (or prediction) rules provide another support for clinical reasoning. Clinical decision rules are evidence-based
L L L L L L L L L L L L L L L
resources that provide probabilistic statements regarding the likelihood that a condition exists if certain variables are met with
L L L L L L L L L L L L L L L L L L
regard to the prognosis of patients with specific findings. Decision rules use mathematical models and are specific to certain
L L L L L L L L L L L L L L L L L L L
situations, settings, and/or patient characteristics.
L L L L L
PTS: 1
Downloaded by Anna Maina ()
L L L L
, lOMoAR L cPSD|
L 12263423
Chapter 2. Evidence-based health screening
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
1. The first step in the genomic assessment of a patient is obtaining information regarding:
L L L L L L L L L L L L L
A. Family history L
B. Environmental exposures L
C. Lifestyle and behaviors L L
D. Current medications L
2. An affected individual who manifests symptoms of a particular condition through whom a family with a genetic
L L L L L L L L L L L L L L L L
disorder is ascertained is called a(n):
L L L L L L
A. Consultand
B. Consulband
C. Index patient L
D. Proband
3. An autosomal dominant disorder involves the:
L L L L L
A. X chromosome
L
B. Y chromosome
L
C. Mitochondrial DNA L
D. Non-sex chromosomes L
4. To illustrate a union between two second cousin family members in a pedigree, draw:
L L L L L L L L L L L L L
A. Arrows pointing to the male and female
L L L L L L
B. Brackets around the male and female L L L L L
C. Double horizontal lines between the male and female
L L L L L L L
D. Circles around the male and female
L L L L L
5. To illustrate two family members in an adoptive relationship in a pedigree:
L L L L L L L L L L L
A. Arrows are drawn pointing to the male and female
L L L L L L L L
B. Brackets are drawn around the male and female
L L L L L L L
C. Double horizontal lines are drawn between the male and female
L L L L L L L L L
D. Circles are drawn around the male and female
L L L L L L L
6. When analyzing the pedigree for autosomal dominant disorders, it is common to see:
L L L L L L L L L L L L
A. Several generations of affected members
L L L L
B. Many consanguineous relationships
L L
C. More members of the maternal lineage affected than paternal
L L L L L L L L
D. More members of the paternal lineage affected than maternal
L L L L L L L L
7. In autosomal recessive (AR) disorders, individuals need:
L L L L L L
A. Only one mutated gene on the sex chromosomes to acquire the disease
L L L L L L L L L L L
B. Only one mutated gene to acquire the disease
L L L L L L L
C. Two mutated genes to acquire the disease
L L L L L L
D. Two mutated genes to become carriers
L L L L L
8. In autosomal recessive disorders, carriers have:
L L L L L
A. Two mutated genes; one from each parent that cause disease
L L L L L L L L L
B. A mutation on a sex chromosome that causes a disease
L L L L L L L L L
C. A single gene mutation that causes the disease
L L L L L L L
D. One copy of a gene mutation but not the disease
L L L L L L L L L
9. With an autosomal recessive disorder, it is important that parents understand that if they both carry a mutation, the
L L L L L L L L L L L L L L L L L L
following are the risks to each of their offspring (each pregnancy):
L L L L L L L L L L L
A. 50% chance that offspring will carry the disease
L L L L L L L
B. 10% chance of offspring affected by disease
L L L L L L
Downloaded by Anna Maina () L L L L
