9/26/23,412:384PM Advanced4Health4Assessment4&4Clinical4Diagnosis4 in4Primary4 Care46…
Advanced4Health4Assessment4&4Clinical4Diagnosis4in4Primary4Care47th4Edition4Dai
ns4Test4Bank
Chapter41:4Clinical4reasoning,4differential4diagnosis,4evidence-based4practice,4and4symptom4ana
Multiple4 Choice
Identify4 the4 choice4 that4best4 completes4the4 statement4 or4answers4 the4question.
1. Which4type4of4clinical4decision-making4is4most4reliable?
A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
2. Which4 of4 the4following4is4 false?4To4obtain4adequate4 history,4 health-care4 providers4 must4be:
A. Methodical4and4 systematic
B. Attentive4to4the4patient’s4verbal4and4nonverbal4language
C. Able4to4 accurately4interpret4the4 patient’s4responses
D. Adept4at4reading4 into4the4patient’s4statements
3. Essential4parts4of4a4 health4 history4include4 all4 of4 the4 following4 except:
A. Chief4complaint
B. History4of4 the4 present4 illness
C. Current4vital4signs
D. All4of4 the4 above4are4 essential4history4components
4. Which4of4the4following4is4false?4While4performing4the4 physical4examination,4the4 examiner4must4be4able4to:
A. Differentiate4between4normal4and4abnormal4findings
B. Recall4knowledge4 of4a4range4of4conditions4and4their4associated4signs4and4symptoms
C. Recognize4 how4 certain4conditions4 affect4 the4 response4to4 other4 conditions
D. Foresee4unpredictable4findings
5. The4following4is4the4 least4reliable4source4of4 information4for4diagnostic4statistics:
A. Evidence-based4investigations
B. Primary4reports4 of4 research
C. Estimation4based4 on4a4provider’s4 experience
D. Published4 meta-analyses
6. The4following4can4be4used4to4assist4in4sound4clinical4decision-making:
A. Algorithm4published4in4a4peer-reviewed4 journal4article
B. Clinical4practice4 guidelines
C. Evidence-based4 research
D. All4of4the4above
7. If4a4diagnostic4study4has4high4sensitivity,4this4 indicates4 a:
A. High4percentage4 of4persons4 with4the4 given4condition4will4have4an4abnormal4result
B. Low4percentage4 of4 persons4 with4the4 given4condition4will4have4 an4abnormal4result
C. Low4likelihood4 of4normal4result4 in4persons4 without4a4given4condition
D. None4of4the4above
8. If4a4 diagnostic4study4has4 high4specificity,4this4 indicates4 a:
A. Low4percentage4 of4 healthy4individuals4will4show4a4 normal4result
B. High4percentage4 of4 healthy4individuals4will4show4a4normal4result
C. High4percentage4 of4individuals4with4a4disorder4 will4show4a4 normal4result
D. Low4percentage4 of4individuals4 with4a4 disorder4 will4show4an4abnormal4result
9. A4likelihood4 ratio4above414 indicates4that4a4diagnostic4test4showing4a:
A. Positive4 result4is4strongly4associated4 with4the4 disease
B. Negative4 result4 is4strongly4associated4 with4 absence4 of4 the4 disease
C. Positive4result4 is4 weakly4associated4 with4the4 disease
D. Negative4result4 is4 weakly4associated4 with4 absence4 of4 the4 disease
10. Which4of4the4following4clinical4reasoning4tools4is4 defined4as4evidence-based4resource4based4 on4mathematical4 modeling
to4 express4the4 likelihood4 of4a4 condition4in4select4situations,4settings,4and/or4patients?
A. Clinical4practice4 guideline
B. Clinical4 decision4 rule
C. Clinical4 algorithm
Chapter41:4Clinical4reasoning,4differential4diagnosis,4evidence-based4practice,4and4symptom4ana
Answer4Section
MULTIPLE4CHOICE
about:blank 1/189
,9/26/23,412:384PM Advanced4Health4Assessment4&4Clinical4Diagnosis4 in4Primary4 Care46…
A. Clinical4practice4 guideline
B. Clinical4 decision4 rule
C. Clinical4 algorithm
Chapter41:4Clinical4reasoning,4differential4diagnosis,4evidence-based4practice,4and4symptom4ana
Answer4Section
MULTIPLE4CHOICE
1. ANS:4 4 B
Croskerry4(2009)4describes4two4major4types4of4clinical4diagnostic4decision-
making:4intuitive4and4analytical.4Intuitive4decision-4 making4(similar4to4Augenblink4decision-
making)4is4based4on4the4experience4and4intuition4of4the4clinician4and4is4less4reliable4and4 paired4with4fairly4common4errors.
4In4contrast,4analytical4decision-making4is4based4on4careful4consideration4and4has4greater4 reliability4 with4rare4 errors.
PTS: 1
2. ANS:4 4 D
To4obtain4adequate4history,4providers4must4be4well4organized,4attentive4to4the4patient’s4verbal4and4nonverbal4language,4and4
able4 to4accurately4interpret4the4patient’s4responses4to4questions.4Rather4than4reading4into4the4patient’s4statements,4they4c
larify4any4 areas4of4uncertainty.
PTS: 1
3. ANS:4 4 C
Vital4signs4are4part4of4 the4 physical4 examination4portion4of4patient4assessment,4 not4part4of4the4 health4 history.
PTS: 1
4. ANS:4 4 D
While4performing4the4physical4examination,4the4examiner4must4be4able4to4differentiate4between4normal4and4abnormal4findin
gs,4 recall4knowledge4of4a4range4of4conditions,4including4their4associated4signs4and4symptoms,4recognize4how4certain4condition
s4affect4 the4response4to4other4conditions,4and4distinguish4the4relevance4of4varied4abnormal4findings.
PTS: 1
5. ANS:4 4 C
Sources4for4diagnostic4statistics4include4textbooks,4primary4reports4of4research,4and4published4meta-
analyses.4Another4source4of4 statistics,4the4 one4 that4 has4been4 most4 widely4used4 and4 available4 for4 application4to4the4 reasoning
4 process,4 is4 the4 estimation4based4 on4 a4provider’s4experience,4although4these4are4rarely4accurate.4Over4the4past4decade,4the4
availability4of4evidence4on4which4to4base4 clinical4reasoning4is4improving,4 and4there4is4an4increasing4expectation4that4clinical4
reasoning4be4based4on4scientific4evidence.
Evidence-based4statistics4are4also4increasingly4being4used4to4develop4resources4to4facilitate4clinical4decision-making.
PTS: 1
6. ANS:4 4 D
To4assist4in4clinical4decision-making,4a4number4of4evidence-
based4resources4have4been4developed4to4assist4the4clinician.4 Resources,4such4as4algorithms4and4clinical4practice4guidelines
,4assist4in4clinical4reasoning4when4properly4applied.
PTS: 1
7. ANS:4 4 A
The4sensitivity4of4a4diagnostic4study4is4the4percentage4of4individuals4with4the4target4condition4who4show4an4abnormal,4or4positi
ve,4 result.4A4high4sensitivity4indicates4that4a4greater4percentage4of4persons4with4the4given4condition4will4have4an4abnormal4
result.
PTS: 1
8. ANS:4 4 B
The4specificity4of4a4diagnostic4study4is4the4percentage4of4normal,4healthy4individuals4who4have4a4normal4result.4The4great
er4the4 specificity,4the4greater4the4percentage4of4individuals4who4will4have4negative,4or4normal,4results4if4they4do4not4hav
e4the4target4 condition.
PTS: 1
9. ANS:4 4 A
The4likelihood4ratio4is4the4probability4that4a4positive4test4result4will4be4associated4with4a4person4who4has4the4target4condition4
and4a4 negative4result4will4be4associated4with4a4healthy4person.4A4likelihood4ratio4above414indicates4that4a4positive4result4is4a
ssociated4 with4the4disease;4a4likelihood4ratio4less4than414indicates4that4a4negative4result4is4associated4with4an4absence4of4the
4disease.
PTS: 1
10. ANS:4 4 B
Clinical4decision4(or4prediction)4rules4provide4another4support4for4clinical4reasoning.4Clinical4decision4rules4are4evidence-
based4 resources4that4provide4probabilistic4statements4regarding4the4likelihood4that4a4condition4exists4if4certain4variables4a
re4met4with4 regard4to4the4prognosis4of4patients4with4specific4findings.4Decision4rules4use4mathematical4models4and4are4
specific4to4certain4 situations,4settings,4and/or4patient4 characteristics.
about:blank 2/189
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PTS: 1
about:blank 3/189
, 9/26/23,412:384PM Advanced4Health4Assessment4&4Clinical4Diagnosis4 in4Primary4 Care46…
PTS: 1
10. ANS:4 4 B
Clinical4decision4(or4prediction)4rules4provide4another4support4for4clinical4reasoning.4Clinical4decision4rules4are4evidence-
based4 resources4that4provide4probabilistic4statements4regarding4the4likelihood4that4a4condition4exists4if4certain4variables4a
re4met4with4 regard4to4the4prognosis4of4patients4with4specific4findings.4Decision4rules4use4mathematical4models4and4are4
specific4to4certain4 situations,4settings,4and/or4patient4 characteristics.
PTS: 1
Chapter42.4 Evidence-based4health4screening
Multiple4 Choice
Identify4 the4 choice4 that4best4 completes4the4 statement4 or4answers4 the4question.
1. The4first4step4in4the4 genomic4assessment4of4a4patient4is4 obtaining4information4regarding:
about:blank 4/189
Advanced4Health4Assessment4&4Clinical4Diagnosis4in4Primary4Care47th4Edition4Dai
ns4Test4Bank
Chapter41:4Clinical4reasoning,4differential4diagnosis,4evidence-based4practice,4and4symptom4ana
Multiple4 Choice
Identify4 the4 choice4 that4best4 completes4the4 statement4 or4answers4 the4question.
1. Which4type4of4clinical4decision-making4is4most4reliable?
A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
2. Which4 of4 the4following4is4 false?4To4obtain4adequate4 history,4 health-care4 providers4 must4be:
A. Methodical4and4 systematic
B. Attentive4to4the4patient’s4verbal4and4nonverbal4language
C. Able4to4 accurately4interpret4the4 patient’s4responses
D. Adept4at4reading4 into4the4patient’s4statements
3. Essential4parts4of4a4 health4 history4include4 all4 of4 the4 following4 except:
A. Chief4complaint
B. History4of4 the4 present4 illness
C. Current4vital4signs
D. All4of4 the4 above4are4 essential4history4components
4. Which4of4the4following4is4false?4While4performing4the4 physical4examination,4the4 examiner4must4be4able4to:
A. Differentiate4between4normal4and4abnormal4findings
B. Recall4knowledge4 of4a4range4of4conditions4and4their4associated4signs4and4symptoms
C. Recognize4 how4 certain4conditions4 affect4 the4 response4to4 other4 conditions
D. Foresee4unpredictable4findings
5. The4following4is4the4 least4reliable4source4of4 information4for4diagnostic4statistics:
A. Evidence-based4investigations
B. Primary4reports4 of4 research
C. Estimation4based4 on4a4provider’s4 experience
D. Published4 meta-analyses
6. The4following4can4be4used4to4assist4in4sound4clinical4decision-making:
A. Algorithm4published4in4a4peer-reviewed4 journal4article
B. Clinical4practice4 guidelines
C. Evidence-based4 research
D. All4of4the4above
7. If4a4diagnostic4study4has4high4sensitivity,4this4 indicates4 a:
A. High4percentage4 of4persons4 with4the4 given4condition4will4have4an4abnormal4result
B. Low4percentage4 of4 persons4 with4the4 given4condition4will4have4 an4abnormal4result
C. Low4likelihood4 of4normal4result4 in4persons4 without4a4given4condition
D. None4of4the4above
8. If4a4 diagnostic4study4has4 high4specificity,4this4 indicates4 a:
A. Low4percentage4 of4 healthy4individuals4will4show4a4 normal4result
B. High4percentage4 of4 healthy4individuals4will4show4a4normal4result
C. High4percentage4 of4individuals4with4a4disorder4 will4show4a4 normal4result
D. Low4percentage4 of4individuals4 with4a4 disorder4 will4show4an4abnormal4result
9. A4likelihood4 ratio4above414 indicates4that4a4diagnostic4test4showing4a:
A. Positive4 result4is4strongly4associated4 with4the4 disease
B. Negative4 result4 is4strongly4associated4 with4 absence4 of4 the4 disease
C. Positive4result4 is4 weakly4associated4 with4the4 disease
D. Negative4result4 is4 weakly4associated4 with4 absence4 of4 the4 disease
10. Which4of4the4following4clinical4reasoning4tools4is4 defined4as4evidence-based4resource4based4 on4mathematical4 modeling
to4 express4the4 likelihood4 of4a4 condition4in4select4situations,4settings,4and/or4patients?
A. Clinical4practice4 guideline
B. Clinical4 decision4 rule
C. Clinical4 algorithm
Chapter41:4Clinical4reasoning,4differential4diagnosis,4evidence-based4practice,4and4symptom4ana
Answer4Section
MULTIPLE4CHOICE
about:blank 1/189
,9/26/23,412:384PM Advanced4Health4Assessment4&4Clinical4Diagnosis4 in4Primary4 Care46…
A. Clinical4practice4 guideline
B. Clinical4 decision4 rule
C. Clinical4 algorithm
Chapter41:4Clinical4reasoning,4differential4diagnosis,4evidence-based4practice,4and4symptom4ana
Answer4Section
MULTIPLE4CHOICE
1. ANS:4 4 B
Croskerry4(2009)4describes4two4major4types4of4clinical4diagnostic4decision-
making:4intuitive4and4analytical.4Intuitive4decision-4 making4(similar4to4Augenblink4decision-
making)4is4based4on4the4experience4and4intuition4of4the4clinician4and4is4less4reliable4and4 paired4with4fairly4common4errors.
4In4contrast,4analytical4decision-making4is4based4on4careful4consideration4and4has4greater4 reliability4 with4rare4 errors.
PTS: 1
2. ANS:4 4 D
To4obtain4adequate4history,4providers4must4be4well4organized,4attentive4to4the4patient’s4verbal4and4nonverbal4language,4and4
able4 to4accurately4interpret4the4patient’s4responses4to4questions.4Rather4than4reading4into4the4patient’s4statements,4they4c
larify4any4 areas4of4uncertainty.
PTS: 1
3. ANS:4 4 C
Vital4signs4are4part4of4 the4 physical4 examination4portion4of4patient4assessment,4 not4part4of4the4 health4 history.
PTS: 1
4. ANS:4 4 D
While4performing4the4physical4examination,4the4examiner4must4be4able4to4differentiate4between4normal4and4abnormal4findin
gs,4 recall4knowledge4of4a4range4of4conditions,4including4their4associated4signs4and4symptoms,4recognize4how4certain4condition
s4affect4 the4response4to4other4conditions,4and4distinguish4the4relevance4of4varied4abnormal4findings.
PTS: 1
5. ANS:4 4 C
Sources4for4diagnostic4statistics4include4textbooks,4primary4reports4of4research,4and4published4meta-
analyses.4Another4source4of4 statistics,4the4 one4 that4 has4been4 most4 widely4used4 and4 available4 for4 application4to4the4 reasoning
4 process,4 is4 the4 estimation4based4 on4 a4provider’s4experience,4although4these4are4rarely4accurate.4Over4the4past4decade,4the4
availability4of4evidence4on4which4to4base4 clinical4reasoning4is4improving,4 and4there4is4an4increasing4expectation4that4clinical4
reasoning4be4based4on4scientific4evidence.
Evidence-based4statistics4are4also4increasingly4being4used4to4develop4resources4to4facilitate4clinical4decision-making.
PTS: 1
6. ANS:4 4 D
To4assist4in4clinical4decision-making,4a4number4of4evidence-
based4resources4have4been4developed4to4assist4the4clinician.4 Resources,4such4as4algorithms4and4clinical4practice4guidelines
,4assist4in4clinical4reasoning4when4properly4applied.
PTS: 1
7. ANS:4 4 A
The4sensitivity4of4a4diagnostic4study4is4the4percentage4of4individuals4with4the4target4condition4who4show4an4abnormal,4or4positi
ve,4 result.4A4high4sensitivity4indicates4that4a4greater4percentage4of4persons4with4the4given4condition4will4have4an4abnormal4
result.
PTS: 1
8. ANS:4 4 B
The4specificity4of4a4diagnostic4study4is4the4percentage4of4normal,4healthy4individuals4who4have4a4normal4result.4The4great
er4the4 specificity,4the4greater4the4percentage4of4individuals4who4will4have4negative,4or4normal,4results4if4they4do4not4hav
e4the4target4 condition.
PTS: 1
9. ANS:4 4 A
The4likelihood4ratio4is4the4probability4that4a4positive4test4result4will4be4associated4with4a4person4who4has4the4target4condition4
and4a4 negative4result4will4be4associated4with4a4healthy4person.4A4likelihood4ratio4above414indicates4that4a4positive4result4is4a
ssociated4 with4the4disease;4a4likelihood4ratio4less4than414indicates4that4a4negative4result4is4associated4with4an4absence4of4the
4disease.
PTS: 1
10. ANS:4 4 B
Clinical4decision4(or4prediction)4rules4provide4another4support4for4clinical4reasoning.4Clinical4decision4rules4are4evidence-
based4 resources4that4provide4probabilistic4statements4regarding4the4likelihood4that4a4condition4exists4if4certain4variables4a
re4met4with4 regard4to4the4prognosis4of4patients4with4specific4findings.4Decision4rules4use4mathematical4models4and4are4
specific4to4certain4 situations,4settings,4and/or4patient4 characteristics.
about:blank 2/189
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PTS: 1
about:blank 3/189
, 9/26/23,412:384PM Advanced4Health4Assessment4&4Clinical4Diagnosis4 in4Primary4 Care46…
PTS: 1
10. ANS:4 4 B
Clinical4decision4(or4prediction)4rules4provide4another4support4for4clinical4reasoning.4Clinical4decision4rules4are4evidence-
based4 resources4that4provide4probabilistic4statements4regarding4the4likelihood4that4a4condition4exists4if4certain4variables4a
re4met4with4 regard4to4the4prognosis4of4patients4with4specific4findings.4Decision4rules4use4mathematical4models4and4are4
specific4to4certain4 situations,4settings,4and/or4patient4 characteristics.
PTS: 1
Chapter42.4 Evidence-based4health4screening
Multiple4 Choice
Identify4 the4 choice4 that4best4 completes4the4 statement4 or4answers4 the4question.
1. The4first4step4in4the4 genomic4assessment4of4a4patient4is4 obtaining4information4regarding:
about:blank 4/189
