Test Bank for Symptom to Diagnosis: An Evidence-Based Guide, 4th Edition (2020) | All Chapters (33 Chapters) | Clinical Reasoning MCQs & Verified Answers |

, Symptom to Diagnosis: An
Evidence-Based Guide
Edition/Reference: 4th Edition
(2020) – Test Bank
Parts Included:
 Part 1: Patient with a Problem  Part 19: GI Bleeding
 Part 2: Healthy Patient  Part 20: Headache
 Part 3: Abdominal Pain  Part 21: Hematuria
 Part 4: Acid-Base Abnormality  Part 22: Hypercalcemia
 Part 5: AIDS-related Complaints  Part 23: Hypertension
 Part 6: Anemia  Part 24: Hyponatremia
 Part 7: Low Back Pain  Part 25: Hypotension
 Part 8: Bleeding Disorder  Part 26: Jaundice or Abnormal
 Part 9: Chest Pain Liver Enzymes
 Part 10: Cough and Congestion  Part 27: Joint Pain
 Part 11: Delirium or Dementia  Part 28: Acute Kidney Injury
 Part 12: Diabetes  Part 29: Rash
 Part 13: Diarrhea  Part 30: Sore Throat
 Part 14: Dizziness  Part 31: Transient Loss of
 Part 15: Dyspnea Consciousness
 Part 16: Dysuria  Part 32: Unintentional Weight
 Part 17: Edema Loss
 Part 18: Fatigue  Part 33: Wheezing or Stridor

,Par t 1: Patient with a Pr oblem
Question 1. A 52-year-old woman presents with features most
consistent with the clinical chapter focus on patient with a problem.
Vital signs show BP 98/64 mmHg, HR 72/min, RR 14/min. In this
context, what is the initial stabilization priority?
A. Immediate stabilization and targeted reassessment
B. Stepwise laboratory evaluation before advanced testing
C. Condition-specific imaging only when red flags are present
D. Prevent predictable complications proactively

✅ Correct Answer: A. Immediate stabilization and targeted
reassessment
Rationale: This is correct because in patient with a problem
presentations, immediate stabilization and targeted reassessment
improves diagnostic accuracy while minimizing avoidable harm
and delay. The other options are less appropriate here because they
either overgeneralize the workup, miss immediate risk priorities, or
apply sequencing that is better reserved for a different pretest
probability profile. Using a chapter-aligned, evidence-first
approach ensures resources are matched to acuity and key decision
points.
DIF: Moderate
TOP: Part 1: Patient with a Problem — initial stabilization priority

,MSC: NCLEX Client Needs Category: Physiological Integrity


Question 2. A 59-year-old man presents with features most
consistent with the clinical chapter focus on patient with a problem.
Vital signs show BP 103/64 mmHg, HR 75/min, RR 15/min. In
this context, what is the most informative focused history element?
A. Interpret tests in full clinical context
B. Prevent predictable complications proactively
C. Deliver high-impact patient safety counseling
D. Focused symptom chronology with trigger mapping

✅ Correct Answer: D. Focused symptom chronology with trigger
mapping
Rationale: The best answer is this option because in patient with a
problem presentations, focused symptom chronology with trigger
mapping improves diagnostic accuracy while minimizing
avoidable harm and delay. The other options are less appropriate
here because they either overgeneralize the workup, miss
immediate risk priorities, or apply sequencing that is better
reserved for a different pretest probability profile. Using a chapter-
aligned, evidence-first approach ensures resources are matched to
acuity and key decision points.
DIF: Easy

,TOP: Part 1: Patient with a Problem — most informative focused
history element
MSC: NCLEX Client Needs Category: Health Promotion and
Maintenance


Question 3. A 66-year-old woman presents with features most
consistent with the clinical chapter focus on patient with a problem.
Vital signs show BP 108/64 mmHg, HR 78/min, RR 16/min. In
this context, what is the highest-yield physical examination
maneuver?
A. Track process and outcome quality measures
B. Immediate stabilization and targeted reassessment
C. Stepwise laboratory evaluation before advanced testing
D. Comprehensive but symptom-directed physical examination

✅ Correct Answer: D. Comprehensive but symptom-directed
physical examination
Rationale: Evidence-based diagnostic sequencing supports this
choice because in patient with a problem presentations,
comprehensive but symptom-directed physical examination
improves diagnostic accuracy while minimizing avoidable harm
and delay. The other options are less appropriate here because they
either overgeneralize the workup, miss immediate risk priorities, or

,apply sequencing that is better reserved for a different pretest
probability profile. Using a chapter-aligned, evidence-first
approach ensures resources are matched to acuity and key decision
points.
DIF: Moderate
TOP: Part 1: Patient with a Problem — highest-yield physical
examination maneuver
MSC: NCLEX Client Needs Category: Physiological Integrity


Question 4. A 73-year-old man presents with features most
consistent with the clinical chapter focus on patient with a problem.
Vital signs show BP 113/64 mmHg, HR 81/min, RR 17/min. In
this context, what is the most appropriate first-line laboratory test?
A. Deliver high-impact patient safety counseling
B. Comprehensive but symptom-directed physical examination
C. Stepwise laboratory evaluation before advanced testing
D. Prefer targeted over indiscriminate testing

✅ Correct Answer: C. Stepwise laboratory evaluation before
advanced testing
Rationale: This option is preferred because in patient with a
problem presentations, stepwise laboratory evaluation before
advanced testing improves diagnostic accuracy while minimizing

,avoidable harm and delay. The other options are less appropriate
here because they either overgeneralize the workup, miss
immediate risk priorities, or apply sequencing that is better
reserved for a different pretest probability profile. Using a chapter-
aligned, evidence-first approach ensures resources are matched to
acuity and key decision points.
DIF: Moderate
TOP: Part 1: Patient with a Problem — most appropriate first-line
laboratory test
MSC: NCLEX Client Needs Category: Physiological Integrity


Question 5. A 23-year-old woman presents with features most
consistent with the clinical chapter focus on patient with a problem.
Vital signs show BP 118/64 mmHg, HR 84/min, RR 18/min. In
this context, what is the best initial imaging strategy?
A. Condition-specific imaging only when red flags are present
B. Use pathophysiology-guided differential narrowing
C. Track process and outcome quality measures
D. Initiate evidence-based empiric therapy

✅ Correct Answer: A. Condition-specific imaging only when red
flags are present

, Rationale: Clinically, this is most appropriate because in patient
with a problem presentations, condition-specific imaging only
when red flags are present improves diagnostic accuracy while
minimizing avoidable harm and delay. The other options are less
appropriate here because they either overgeneralize the workup,
miss immediate risk priorities, or apply sequencing that is better
reserved for a different pretest probability profile. Using a chapter-
aligned, evidence-first approach ensures resources are matched to
acuity and key decision points.
DIF: Moderate
TOP: Part 1: Patient with a Problem — best initial imaging
strategy
MSC: NCLEX Client Needs Category: Physiological Integrity


Question 6. A 30-year-old man presents with features most
consistent with the clinical chapter focus on patient with a problem.
Vital signs show BP 123/64 mmHg, HR 87/min, RR 19/min. In
this context, what is the red-flag feature requiring urgent escalation?
A. Act on findings that alter immediate management
B. Prioritize exclusion of life-threatening etiologies
C. Focused symptom chronology with trigger mapping
D. Urgent escalation to higher level care