TEST BANK COMPLETE_
ADVANCED HEALTH ASSESSMENT & CLINICAL DIAGNOSIS IN PRIMARY CARE 7TH EDITION, (2023)
BY JOYCE E. DAINS, LINDA CIOFU BAUMANN & PAMELA SCHEIBEL
ALL CHAPTERS 1-45| 4 UNITS| LATEST VERSION WITH DETAILED ANSWERS| GRADE A+
From: [Bestmaxsolutions.stuvia
,PART I: AN INTRODUCTION TO CLINICAL REASONING ----------------------------------------------------- 4
CHAPTER 1: CLINICAL REASONING, EVIDENCE-BASED PRACTICE, AND SYMPTOM ANALYSIS ----------- 4
CHAPTER 2: EVIDENCE-BASED CLINICAL PRACTICE GUIDELINES ------------------------------------------------- 8
CHAPTER 3: CONTEMPORARY APPROACHES IN PRIMARY CARE SETTINGS --------------------------------- 16
PART II: COMMON SYMPTOMS IN PRIMARY CARE ------------------------------------------------------- 22
CHAPTER 4. ABDOMINAL PAIN ------------------------------------------------------------------------------------------ 22
CHAPTER 5: AFFECTIVE CHANGES --------------------------------------------------------------------------------------- 40
CHAPTER 6: AMENORRHEA ----------------------------------------------------------------------------------------------- 48
CHAPTER 7: BREASTS LUMPS AND NIPPLE DISCHARGE ----------------------------------------------------------- 54
CHAPTER 8: BREAST PAIN ------------------------------------------------------------------------------------------------- 59
CHAPTER 9: CHEST PAIN --------------------------------------------------------------------------------------------------- 65
CHAPTER 10: CONFUSION IN OLDER ADULTS ------------------------------------------------------------------------ 68
CHAPTER 11: CONSTIPATION --------------------------------------------------------------------------------------------- 72
CHAPTER 12: COUGH ------------------------------------------------------------------------------------------------------- 74
CHAPTER 13: DIARRHEA --------------------------------------------------------------------------------------------------- 78
CHAPTER 14: DIZZINESS ---------------------------------------------------------------------------------------------------- 84
CHAPTER 15: DYSPNEA ----------------------------------------------------------------------------------------------------- 88
CHAPTER 16: EARACHE ----------------------------------------------------------------------------------------------------- 98
CHAPTER 17: FATIGUE ---------------------------------------------------------------------------------------------------- 103
CHAPTER 18: FEVER ------------------------------------------------------------------------------------------------------- 106
CHAPTER 19: GENITOURINARY PROBLEMS IN PATIENTS WITH A PENIS OR PROSTATE GLAND ----- 109
CHAPTER 20: HEADACHE ----------------------------------------------------------------------------------------- 122
CHAPTER 21: HEARTBURN AND INDIGESTION --------------------------------------------------------------------- 130
CHAPTER 22: HOARSENESS --------------------------------------------------------------------------------------------- 134
CHAPTER 23: LIMB PAIN: LOWER EXTREMITY --------------------------------------------------------------------- 136
CHAPTER 24: LIMB PAIN: UPPER EXTREMITY ---------------------------------------------------------------------- 141
CHAPTER 25: LOW BACK PAIN ----------------------------------------------------------------------------------------- 145
CHAPTER 26: NASAL SYMPTOMS AND SINUS CONGESTION --------------------------------------------------- 148
CHAPTER 27: PALPITATIONS -------------------------------------------------------------------------------------------- 152
CHAPTER 28: PENILE DISCHARGE -------------------------------------------------------------------------------------- 155
CHAPTER 29: RASHES AND SKIN LESIONS --------------------------------------------------------------------------- 165
, CHAPTER 30: RECTAL PAIN, ITCHING, AND BLEEDING ----------------------------------------------------------- 174
CHAPTER 31: RED EYE ---------------------------------------------------------------------------------------------------- 176
CHAPTER 32: SCROTAL PAIN AND MASSES ------------------------------------------------------------------------- 185
CHAPTER 33: SLEEP PROBLEMS ---------------------------------------------------------------------------------------- 190
CHAPTER 34. SORE THROAT ------------------------------------------------------------------------------------ 197
CHAPTER 35: SYNCOPE --------------------------------------------------------------------------------------------------- 200
CHAPTER 36: URINARY INCONTINENCE ----------------------------------------------------------------------------- 202
CHAPTER 37: URINARY PROBLEMS IN PATIENTS WITH A VAGINA AND ASSOCIATED ANATOMICAL
STRUCTURES ---------------------------------------------------------------------------------------------------------------- 209
CHAPTER 38. VAGINAL BLEEDING ------------------------------------------------------------------------------------- 212
CHAPTER 39. VAGINAL DISCHARGE AND ITCHING---------------------------------------------------------------- 214
CHAPTER 40: VISION LOSS ---------------------------------------------------------------------------------------------- 229
CHAPTER 41: UNINTENTIONAL WEIGHT LOSS OR GAIN --------------------------------------------------------- 241
PART III: POPULATION-CENTERED CARE -------------------------------------------------------------------- 246
CHAPTER 42: CARE OF TRANSGENDER AND GENDER-DIVERSE PATIENTS --------------------------------- 246
CHAPTER 43: VETERANS’ HEALTH ------------------------------------------------------------------------------------- 250
PART IV: DIAGNOSTIC IMAGING ------------------------------------------------------------------------------ 255
CHAPTER 44: ABDOMINAL X-RAY ------------------------------------------------------------------------------------- 255
CHAPTER 45: CHEST X-RAY ---------------------------------------------------------------------------------------------- 262
,PART I: AN INTRODUCTION TO CLINICAL REASONING
CHAPTER 1: CLINICAL REASONING, EVIDENCE-BASED PRACTICE, AND SYMPTOM ANALYSIS
JOYCE E. DAINS: ADVANCED HEALTH ASSESSMENT & CLINICAL DIAGNOSIS IN PRIMARY CARE 7TH EDITION, (2023) TEST BANK
MULTIPLE CHOICE
IDENTIFY THE CHOICE THAT BEST COMPLETES THE STATEMENT OR ANSWERS THE QUESTION.
1. WHICH TYPE OF CLINICAL DECISION-MAKING IS MOST RELIABLE?
A. INTUITIVE
B. ANALYTICAL
C. EXPERIENTIAL
D. AUGENBLICK
2. WHICH OF THE FOLLOWING IS FALSE? TO OBTAIN ADEQUATE HISTORY, HEALTH-
CARE PROVIDERS MUST BE:
A. METHODICAL AND SYSTEMATIC
B. ATTENTIVE TO THE PATIENT’S VERBAL AND NONVERBAL LANGUAGE
C. ABLE TO ACCURATELY INTERPRET THE PATIENT’S RESPONSES
D. ADEPT AT READING INTO THE PATIENT’S STATEMENTS
3. ESSENTIAL PARTS OF A HEALTH HISTORY INCLUDE ALL OF THE FOLLOWING
EXCEPT:
A. CHIEF COMPLAINT
B. HISTORY OF THE PRESENT ILLNESS
C. CURRENT VITAL SIGNS
D. ALL OF THE ABOVE ARE ESSENTIAL HISTORY COMPONENTS
4. WHICH OF THE FOLLOWING IS FALSE? WHILE PERFORMING THE PHYSICAL
EXAMINATION, THE EXAMINER MUST BE ABLE TO:
A. DIFFERENTIATE BETWEEN NORMAL AND ABNORMAL FINDINGS
B. RECALL KNOWLEDGE OF A RANGE OF CONDITIONS AND THEIR ASSOCIATED SIGNS
AND SYMPTOMS
C. RECOGNIZE HOW CERTAIN CONDITIONS AFFECT THE RESPONSE TO OTHER
CONDITIONS
D. FORESEE UNPREDICTABLE FINDINGS
5. THE FOLLOWING IS THE LEAST RELIABLE SOURCE OF INFORMATION FOR
DIAGNOSTIC STATISTICS:
A. EVIDENCE-BASED INVESTIGATIONS
B. PRIMARY REPORTS OF RESEARCH
C. ESTIMATION BASED ON A PROVIDER’S EXPERIENCE
D. PUBLISHED META-ANALYSES
,6. THE FOLLOWING CAN BE USED TO ASSIST IN SOUND CLINICAL DECISION-MAKING:
A. ALGORITHM PUBLISHED IN A PEER-REVIEWED JOURNAL ARTICLE
B. CLINICAL PRACTICE GUIDELINES
C. EVIDENCE-BASED RESEARCH
D. ALL OF THE ABOVE
7. IF A DIAGNOSTIC STUDY HAS HIGH SENSITIVITY, THIS INDICATES A:
A. HIGH PERCENTAGE OF PERSONS WITH THE GIVEN CONDITION WILL HAVE AN
ABNORMAL RESULT
B. LOW PERCENTAGE OF PERSONS WITH THE GIVEN CONDITION WILL HAVE AN
ABNORMAL RESULT
C. LOW LIKELIHOOD OF NORMAL RESULT IN PERSONS WITHOUT A GIVEN CONDITION
D. NONE OF THE ABOVE
8. IF A DIAGNOSTIC STUDY HAS HIGH SPECIFICITY, THIS INDICATES A:
A. LOW PERCENTAGE OF HEALTHY INDIVIDUALS WILL SHOW A NORMAL RESULT
B. HIGH PERCENTAGE OF HEALTHY INDIVIDUALS WILL SHOW A NORMAL RESULT
C. HIGH PERCENTAGE OF INDIVIDUALS WITH A DISORDER WILL SHOW A NORMAL
RESULT
D. LOW PERCENTAGE OF INDIVIDUALS WITH A DISORDER WILL SHOW AN ABNORMAL
RESULT
9. A LIKELIHOOD RATIO ABOVE 1 INDICATES THAT A DIAGNOSTIC TEST SHOWING A:
A. POSITIVE RESULT IS STRONGLY ASSOCIATED WITH THE DISEASE
B. NEGATIVE RESULT IS STRONGLY ASSOCIATED WITH ABSENCE OF THE DISEASE
C. POSITIVE RESULT IS WEAKLY ASSOCIATED WITH THE DISEASE
D. NEGATIVE RESULT IS WEAKLY ASSOCIATED WITH ABSENCE OF THE DISEASE
10. WHICH OF THE FOLLOWING CLINICAL REASONING TOOLS IS DEFINED AS
EVIDENCE-BASED RESOURCE BASED ON MATHEMATICAL MODELING TO EXPRESS
THE LIKELIHOOD OF A CONDITION IN SELECT SITUATIONS, SETTINGS, AND/OR
PATIENTS?
A. CLINICAL PRACTICE GUIDELINE
B. CLINICAL DECISION RULE
C. CLINICAL ALGORITHM
CHAPTER 1: CLINICAL REASONING, EVIDENCE-BASED PRACTICE, AND SYMPTOM
ANALYSIS (ANSWER SECTION)
MULTIPLE CHOICE
,1. ANS: B
CROSKERRY (2009) DESCRIBES TWO MAJOR TYPES OF CLINICAL DIAGNOSTIC DECISION-
MAKING: INTUITIVE AND ANALYTICAL. INTUITIVE DECISION- MAKING (SIMILAR TO
AUGENBLINK DECISION-MAKING) IS BASED ON THE EXPERIENCE AND INTUITION OF THE
CLINICIAN AND IS LESS RELIABLE ANDPAIRED WITH FAIRLY COMMON ERRORS. IN
CONTRAST, ANALYTICAL DECISION-MAKING IS BASED ON CAREFUL CONSIDERATION
AND HAS GREATER RELIABILITY WITH RARE ERRORS.
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 TO ACCURATELY
INTERPRET THE PATIENT’S RESPONSES TO QUESTIONS. RATHER THAN READING INTO THE
PATIENT’S STATEMENTS, THEY CLARIFY ANY AREAS OF UNCERTAINTY.
PTS: 1
3. ANS: C
VITAL SIGNS ARE PART OF THE PHYSICAL EXAMINATION PORTION OF PATIENT
ASSESSMENT, NOT PART OF THE HEALTH HISTORY.
PTS: 1
4. ANS: D
WHILE PERFORMING THE PHYSICAL EXAMINATION, THE EXAMINER MUST BE ABLE TO
DIFFERENTIATE BETWEEN NORMAL AND ABNORMAL FINDINGS, RECALL KNOWLEDGE OF
A RANGE OF CONDITIONS, INCLUDING THEIR ASSOCIATED SIGNS AND SYMPTOMS,
RECOGNIZE HOW CERTAIN CONDITIONS AFFECTTHE RESPONSE TO OTHER CONDITIONS,
AND DISTINGUISH THE RELEVANCE OF VARIED ABNORMAL FINDINGS.
PTS: 1
5. ANS: C
SOURCES FOR DIAGNOSTIC STATISTICS INCLUDE TEXTBOOKS, PRIMARY REPORTS OF
RESEARCH, AND PUBLISHED META-ANALYSES. ANOTHER SOURCE OF STATISTICS, THE
ONE THAT HAS BEEN MOST WIDELY USED AND AVAILABLE FOR APPLICATION TO THE
REASONING PROCESS, IS THE ESTIMATION BASED ON A PROVIDER’S EXPERIENCE,
ALTHOUGH THESE ARE RARELY ACCURATE. OVER THE PAST DECADE, THE
AVAILABILITY OF EVIDENCE ON WHICH TO BASE CLINICAL REASONING IS IMPROVING,
AND THERE IS AN INCREASING EXPECTATION THAT CLINICAL REASONING BE BASED ON
SCIENTIFIC EVIDENCE.
EVIDENCE-BASED STATISTICS ARE ALSO INCREASINGLY BEING USED TO DEVELOP
RESOURCES TO FACILITATE CLINICAL DECISION-MAKING.
PTS: 1
6. ANS: D
, TO ASSIST IN CLINICAL DECISION-MAKING, A NUMBER OF EVIDENCE-BASED RESOURCES
HAVE BEEN DEVELOPED TO ASSIST THE CLINICIAN.RESOURCES, SUCH AS ALGORITHMS
AND CLINICAL PRACTICE GUIDELINES, ASSIST IN CLINICAL REASONING WHEN PROPERLY
APPLIED.
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,RESULT. A HIGH
SENSITIVITY INDICATES THAT A GREATER PERCENTAGE OF PERSONS WITH THE GIVEN
CONDITION WILL HAVE AN ABNORMAL RESULT.
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 THESPECIFICITY, THE
GREATER THE PERCENTAGE OF INDIVIDUALS WHO WILL HAVE NEGATIVE, OR NORMAL,
RESULTS IF THEY DO NOT HAVE THE TARGET CONDITION.
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 A NEGATIVE
RESULT WILL BE ASSOCIATED WITH A HEALTHY PERSON. A LIKELIHOOD RATIO ABOVE 1
INDICATES THAT A POSITIVE RESULT IS ASSOCIATED WITH THE DISEASE; A LIKELIHOOD
RATIO LESS THAN 1 INDICATES THAT A NEGATIVE RESULT IS ASSOCIATED WITH AN
ABSENCE OF THE DISEASE.
PTS: 1
10. ANS: B
CLINICAL DECISION (OR PREDICTION) RULES PROVIDE ANOTHER SUPPORT FOR CLINICAL
REASONING. CLINICAL DECISION RULES ARE EVIDENCE-BASED RESOURCES THAT
PROVIDE PROBABILISTIC STATEMENTS REGARDING THE LIKELIHOOD THAT A CONDITION
EXISTS IF CERTAIN VARIABLES ARE MET WITH REGARD TO THE PROGNOSIS OF PATIENTS
WITH SPECIFIC FINDINGS. DECISION RULES USE MATHEMATICAL MODELS AND ARE
SPECIFIC TO CERTAIN SITUATIONS, SETTINGS, AND/OR PATIENT CHARACTERISTICS.
PTS: 1
ADVANCED HEALTH ASSESSMENT & CLINICAL DIAGNOSIS IN PRIMARY CARE 7TH EDITION, (2023)
BY JOYCE E. DAINS, LINDA CIOFU BAUMANN & PAMELA SCHEIBEL
ALL CHAPTERS 1-45| 4 UNITS| LATEST VERSION WITH DETAILED ANSWERS| GRADE A+
From: [Bestmaxsolutions.stuvia
,PART I: AN INTRODUCTION TO CLINICAL REASONING ----------------------------------------------------- 4
CHAPTER 1: CLINICAL REASONING, EVIDENCE-BASED PRACTICE, AND SYMPTOM ANALYSIS ----------- 4
CHAPTER 2: EVIDENCE-BASED CLINICAL PRACTICE GUIDELINES ------------------------------------------------- 8
CHAPTER 3: CONTEMPORARY APPROACHES IN PRIMARY CARE SETTINGS --------------------------------- 16
PART II: COMMON SYMPTOMS IN PRIMARY CARE ------------------------------------------------------- 22
CHAPTER 4. ABDOMINAL PAIN ------------------------------------------------------------------------------------------ 22
CHAPTER 5: AFFECTIVE CHANGES --------------------------------------------------------------------------------------- 40
CHAPTER 6: AMENORRHEA ----------------------------------------------------------------------------------------------- 48
CHAPTER 7: BREASTS LUMPS AND NIPPLE DISCHARGE ----------------------------------------------------------- 54
CHAPTER 8: BREAST PAIN ------------------------------------------------------------------------------------------------- 59
CHAPTER 9: CHEST PAIN --------------------------------------------------------------------------------------------------- 65
CHAPTER 10: CONFUSION IN OLDER ADULTS ------------------------------------------------------------------------ 68
CHAPTER 11: CONSTIPATION --------------------------------------------------------------------------------------------- 72
CHAPTER 12: COUGH ------------------------------------------------------------------------------------------------------- 74
CHAPTER 13: DIARRHEA --------------------------------------------------------------------------------------------------- 78
CHAPTER 14: DIZZINESS ---------------------------------------------------------------------------------------------------- 84
CHAPTER 15: DYSPNEA ----------------------------------------------------------------------------------------------------- 88
CHAPTER 16: EARACHE ----------------------------------------------------------------------------------------------------- 98
CHAPTER 17: FATIGUE ---------------------------------------------------------------------------------------------------- 103
CHAPTER 18: FEVER ------------------------------------------------------------------------------------------------------- 106
CHAPTER 19: GENITOURINARY PROBLEMS IN PATIENTS WITH A PENIS OR PROSTATE GLAND ----- 109
CHAPTER 20: HEADACHE ----------------------------------------------------------------------------------------- 122
CHAPTER 21: HEARTBURN AND INDIGESTION --------------------------------------------------------------------- 130
CHAPTER 22: HOARSENESS --------------------------------------------------------------------------------------------- 134
CHAPTER 23: LIMB PAIN: LOWER EXTREMITY --------------------------------------------------------------------- 136
CHAPTER 24: LIMB PAIN: UPPER EXTREMITY ---------------------------------------------------------------------- 141
CHAPTER 25: LOW BACK PAIN ----------------------------------------------------------------------------------------- 145
CHAPTER 26: NASAL SYMPTOMS AND SINUS CONGESTION --------------------------------------------------- 148
CHAPTER 27: PALPITATIONS -------------------------------------------------------------------------------------------- 152
CHAPTER 28: PENILE DISCHARGE -------------------------------------------------------------------------------------- 155
CHAPTER 29: RASHES AND SKIN LESIONS --------------------------------------------------------------------------- 165
, CHAPTER 30: RECTAL PAIN, ITCHING, AND BLEEDING ----------------------------------------------------------- 174
CHAPTER 31: RED EYE ---------------------------------------------------------------------------------------------------- 176
CHAPTER 32: SCROTAL PAIN AND MASSES ------------------------------------------------------------------------- 185
CHAPTER 33: SLEEP PROBLEMS ---------------------------------------------------------------------------------------- 190
CHAPTER 34. SORE THROAT ------------------------------------------------------------------------------------ 197
CHAPTER 35: SYNCOPE --------------------------------------------------------------------------------------------------- 200
CHAPTER 36: URINARY INCONTINENCE ----------------------------------------------------------------------------- 202
CHAPTER 37: URINARY PROBLEMS IN PATIENTS WITH A VAGINA AND ASSOCIATED ANATOMICAL
STRUCTURES ---------------------------------------------------------------------------------------------------------------- 209
CHAPTER 38. VAGINAL BLEEDING ------------------------------------------------------------------------------------- 212
CHAPTER 39. VAGINAL DISCHARGE AND ITCHING---------------------------------------------------------------- 214
CHAPTER 40: VISION LOSS ---------------------------------------------------------------------------------------------- 229
CHAPTER 41: UNINTENTIONAL WEIGHT LOSS OR GAIN --------------------------------------------------------- 241
PART III: POPULATION-CENTERED CARE -------------------------------------------------------------------- 246
CHAPTER 42: CARE OF TRANSGENDER AND GENDER-DIVERSE PATIENTS --------------------------------- 246
CHAPTER 43: VETERANS’ HEALTH ------------------------------------------------------------------------------------- 250
PART IV: DIAGNOSTIC IMAGING ------------------------------------------------------------------------------ 255
CHAPTER 44: ABDOMINAL X-RAY ------------------------------------------------------------------------------------- 255
CHAPTER 45: CHEST X-RAY ---------------------------------------------------------------------------------------------- 262
,PART I: AN INTRODUCTION TO CLINICAL REASONING
CHAPTER 1: CLINICAL REASONING, EVIDENCE-BASED PRACTICE, AND SYMPTOM ANALYSIS
JOYCE E. DAINS: ADVANCED HEALTH ASSESSMENT & CLINICAL DIAGNOSIS IN PRIMARY CARE 7TH EDITION, (2023) TEST BANK
MULTIPLE CHOICE
IDENTIFY THE CHOICE THAT BEST COMPLETES THE STATEMENT OR ANSWERS THE QUESTION.
1. WHICH TYPE OF CLINICAL DECISION-MAKING IS MOST RELIABLE?
A. INTUITIVE
B. ANALYTICAL
C. EXPERIENTIAL
D. AUGENBLICK
2. WHICH OF THE FOLLOWING IS FALSE? TO OBTAIN ADEQUATE HISTORY, HEALTH-
CARE PROVIDERS MUST BE:
A. METHODICAL AND SYSTEMATIC
B. ATTENTIVE TO THE PATIENT’S VERBAL AND NONVERBAL LANGUAGE
C. ABLE TO ACCURATELY INTERPRET THE PATIENT’S RESPONSES
D. ADEPT AT READING INTO THE PATIENT’S STATEMENTS
3. ESSENTIAL PARTS OF A HEALTH HISTORY INCLUDE ALL OF THE FOLLOWING
EXCEPT:
A. CHIEF COMPLAINT
B. HISTORY OF THE PRESENT ILLNESS
C. CURRENT VITAL SIGNS
D. ALL OF THE ABOVE ARE ESSENTIAL HISTORY COMPONENTS
4. WHICH OF THE FOLLOWING IS FALSE? WHILE PERFORMING THE PHYSICAL
EXAMINATION, THE EXAMINER MUST BE ABLE TO:
A. DIFFERENTIATE BETWEEN NORMAL AND ABNORMAL FINDINGS
B. RECALL KNOWLEDGE OF A RANGE OF CONDITIONS AND THEIR ASSOCIATED SIGNS
AND SYMPTOMS
C. RECOGNIZE HOW CERTAIN CONDITIONS AFFECT THE RESPONSE TO OTHER
CONDITIONS
D. FORESEE UNPREDICTABLE FINDINGS
5. THE FOLLOWING IS THE LEAST RELIABLE SOURCE OF INFORMATION FOR
DIAGNOSTIC STATISTICS:
A. EVIDENCE-BASED INVESTIGATIONS
B. PRIMARY REPORTS OF RESEARCH
C. ESTIMATION BASED ON A PROVIDER’S EXPERIENCE
D. PUBLISHED META-ANALYSES
,6. THE FOLLOWING CAN BE USED TO ASSIST IN SOUND CLINICAL DECISION-MAKING:
A. ALGORITHM PUBLISHED IN A PEER-REVIEWED JOURNAL ARTICLE
B. CLINICAL PRACTICE GUIDELINES
C. EVIDENCE-BASED RESEARCH
D. ALL OF THE ABOVE
7. IF A DIAGNOSTIC STUDY HAS HIGH SENSITIVITY, THIS INDICATES A:
A. HIGH PERCENTAGE OF PERSONS WITH THE GIVEN CONDITION WILL HAVE AN
ABNORMAL RESULT
B. LOW PERCENTAGE OF PERSONS WITH THE GIVEN CONDITION WILL HAVE AN
ABNORMAL RESULT
C. LOW LIKELIHOOD OF NORMAL RESULT IN PERSONS WITHOUT A GIVEN CONDITION
D. NONE OF THE ABOVE
8. IF A DIAGNOSTIC STUDY HAS HIGH SPECIFICITY, THIS INDICATES A:
A. LOW PERCENTAGE OF HEALTHY INDIVIDUALS WILL SHOW A NORMAL RESULT
B. HIGH PERCENTAGE OF HEALTHY INDIVIDUALS WILL SHOW A NORMAL RESULT
C. HIGH PERCENTAGE OF INDIVIDUALS WITH A DISORDER WILL SHOW A NORMAL
RESULT
D. LOW PERCENTAGE OF INDIVIDUALS WITH A DISORDER WILL SHOW AN ABNORMAL
RESULT
9. A LIKELIHOOD RATIO ABOVE 1 INDICATES THAT A DIAGNOSTIC TEST SHOWING A:
A. POSITIVE RESULT IS STRONGLY ASSOCIATED WITH THE DISEASE
B. NEGATIVE RESULT IS STRONGLY ASSOCIATED WITH ABSENCE OF THE DISEASE
C. POSITIVE RESULT IS WEAKLY ASSOCIATED WITH THE DISEASE
D. NEGATIVE RESULT IS WEAKLY ASSOCIATED WITH ABSENCE OF THE DISEASE
10. WHICH OF THE FOLLOWING CLINICAL REASONING TOOLS IS DEFINED AS
EVIDENCE-BASED RESOURCE BASED ON MATHEMATICAL MODELING TO EXPRESS
THE LIKELIHOOD OF A CONDITION IN SELECT SITUATIONS, SETTINGS, AND/OR
PATIENTS?
A. CLINICAL PRACTICE GUIDELINE
B. CLINICAL DECISION RULE
C. CLINICAL ALGORITHM
CHAPTER 1: CLINICAL REASONING, EVIDENCE-BASED PRACTICE, AND SYMPTOM
ANALYSIS (ANSWER SECTION)
MULTIPLE CHOICE
,1. ANS: B
CROSKERRY (2009) DESCRIBES TWO MAJOR TYPES OF CLINICAL DIAGNOSTIC DECISION-
MAKING: INTUITIVE AND ANALYTICAL. INTUITIVE DECISION- MAKING (SIMILAR TO
AUGENBLINK DECISION-MAKING) IS BASED ON THE EXPERIENCE AND INTUITION OF THE
CLINICIAN AND IS LESS RELIABLE ANDPAIRED WITH FAIRLY COMMON ERRORS. IN
CONTRAST, ANALYTICAL DECISION-MAKING IS BASED ON CAREFUL CONSIDERATION
AND HAS GREATER RELIABILITY WITH RARE ERRORS.
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 TO ACCURATELY
INTERPRET THE PATIENT’S RESPONSES TO QUESTIONS. RATHER THAN READING INTO THE
PATIENT’S STATEMENTS, THEY CLARIFY ANY AREAS OF UNCERTAINTY.
PTS: 1
3. ANS: C
VITAL SIGNS ARE PART OF THE PHYSICAL EXAMINATION PORTION OF PATIENT
ASSESSMENT, NOT PART OF THE HEALTH HISTORY.
PTS: 1
4. ANS: D
WHILE PERFORMING THE PHYSICAL EXAMINATION, THE EXAMINER MUST BE ABLE TO
DIFFERENTIATE BETWEEN NORMAL AND ABNORMAL FINDINGS, RECALL KNOWLEDGE OF
A RANGE OF CONDITIONS, INCLUDING THEIR ASSOCIATED SIGNS AND SYMPTOMS,
RECOGNIZE HOW CERTAIN CONDITIONS AFFECTTHE RESPONSE TO OTHER CONDITIONS,
AND DISTINGUISH THE RELEVANCE OF VARIED ABNORMAL FINDINGS.
PTS: 1
5. ANS: C
SOURCES FOR DIAGNOSTIC STATISTICS INCLUDE TEXTBOOKS, PRIMARY REPORTS OF
RESEARCH, AND PUBLISHED META-ANALYSES. ANOTHER SOURCE OF STATISTICS, THE
ONE THAT HAS BEEN MOST WIDELY USED AND AVAILABLE FOR APPLICATION TO THE
REASONING PROCESS, IS THE ESTIMATION BASED ON A PROVIDER’S EXPERIENCE,
ALTHOUGH THESE ARE RARELY ACCURATE. OVER THE PAST DECADE, THE
AVAILABILITY OF EVIDENCE ON WHICH TO BASE CLINICAL REASONING IS IMPROVING,
AND THERE IS AN INCREASING EXPECTATION THAT CLINICAL REASONING BE BASED ON
SCIENTIFIC EVIDENCE.
EVIDENCE-BASED STATISTICS ARE ALSO INCREASINGLY BEING USED TO DEVELOP
RESOURCES TO FACILITATE CLINICAL DECISION-MAKING.
PTS: 1
6. ANS: D
, TO ASSIST IN CLINICAL DECISION-MAKING, A NUMBER OF EVIDENCE-BASED RESOURCES
HAVE BEEN DEVELOPED TO ASSIST THE CLINICIAN.RESOURCES, SUCH AS ALGORITHMS
AND CLINICAL PRACTICE GUIDELINES, ASSIST IN CLINICAL REASONING WHEN PROPERLY
APPLIED.
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,RESULT. A HIGH
SENSITIVITY INDICATES THAT A GREATER PERCENTAGE OF PERSONS WITH THE GIVEN
CONDITION WILL HAVE AN ABNORMAL RESULT.
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 THESPECIFICITY, THE
GREATER THE PERCENTAGE OF INDIVIDUALS WHO WILL HAVE NEGATIVE, OR NORMAL,
RESULTS IF THEY DO NOT HAVE THE TARGET CONDITION.
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 A NEGATIVE
RESULT WILL BE ASSOCIATED WITH A HEALTHY PERSON. A LIKELIHOOD RATIO ABOVE 1
INDICATES THAT A POSITIVE RESULT IS ASSOCIATED WITH THE DISEASE; A LIKELIHOOD
RATIO LESS THAN 1 INDICATES THAT A NEGATIVE RESULT IS ASSOCIATED WITH AN
ABSENCE OF THE DISEASE.
PTS: 1
10. ANS: B
CLINICAL DECISION (OR PREDICTION) RULES PROVIDE ANOTHER SUPPORT FOR CLINICAL
REASONING. CLINICAL DECISION RULES ARE EVIDENCE-BASED RESOURCES THAT
PROVIDE PROBABILISTIC STATEMENTS REGARDING THE LIKELIHOOD THAT A CONDITION
EXISTS IF CERTAIN VARIABLES ARE MET WITH REGARD TO THE PROGNOSIS OF PATIENTS
WITH SPECIFIC FINDINGS. DECISION RULES USE MATHEMATICAL MODELS AND ARE
SPECIFIC TO CERTAIN SITUATIONS, SETTINGS, AND/OR PATIENT CHARACTERISTICS.
PTS: 1
