TEST BANK FOR ADVANCED ASSESSMENT:
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INTERPRETING FINDINGS AND
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FORMULATING DIFFERENTIAL
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DIAGNOSES 5TH EDITION, MARY JO
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GOOLSBY, LAURIE GRUBBS ISBN-10;
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1719645930 / ISBN-13; 978-1719645935
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,Chapter 1. Assessment and Clinical Decision-Making: Overview
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Multiple Choice
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Identify the choice that best completes the statement or answers the question.
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ji 1. Which type of clinical decision-making is most reliable?
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A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
ji 2. Which of the following is false? To obtain adequate history, health-care providers must be:
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A. Methodical and systematic ji ji
B. Attentive to the patient’s verbal and nonverbal language ji ji ji ji ji ji ji
C. Able to accurately interpret the patient’s responses
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D. Adept at reading into the patient’s statements ji ji ji ji ji ji
ji 3. Essential parts of a health history include all of the following except:
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A. Chief complaint ji
B. History of the present illness ji ji ji ji
C. Current vital signs ji ji
D. All of the above are essential history components
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ji 4. Which of the following is false? While performing the physical examination, the examiner must
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beable to:
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A. Differentiate between normal and abnormal findings ji ji ji ji ji
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 ji ji ji ji ji ji ji ji ji
D. Foresee unpredictable findings ji ji
ji 5. The following is the least reliable source of information for diagnostic statistics:
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A. Evidence-based investigations ji
B. Primary reports of research ji ji ji
C. Estimation based on a provider’s experience ji ji ji ji ji
D. Published meta-analyses ji
ji 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 ji ji ji ji ji ji
B. Clinical practice guidelines ji ji
C. Evidence-based research ji
D. All of the above ji ji ji
ji 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 ji ji ji
,ji 8. If a diagnostic studyhas 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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ji 9. Alikelihood 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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ji ji ji j i 10. Which of the following clinical reasoning tools is defined as evidence-based resource based on
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mathematical modeling to express the likelihood of a condition in select situations, settings,
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and/orpatients?
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A. Clinical practice guideline ji ji
B. Clinical decision rule ji ji
C. Clinical algorithm ji
D. Clinical recommendation ji
, Answer Section
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MULTIPLE CHOICE
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1. ANS: B j i
Croskerry (2009) describes two major types of clinical diagnostic decision-making: intuitive and
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analytical. Intuitive decision-making (similar to Augenblink decision-making) is based on the
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experience and intuition of the clinician and is less reliable and paired with fairly common errors.
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In contrast, analytical decision-making is based on careful consideration and has greater
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reliabilitywith rare errors.
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PTS: 1
2. ANS: D j i
To obtain adequate history, providers must be well organized, attentive to the patient’s verbal
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andnonverbal language, and able to accurately interpret the patient’s responses to questions. Rather
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than reading into the patient’s statements, they clarify any areas of uncertainty.
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PTS: 1
3. ANS: C j i
Vital signs are part of the physical examination portion of patient assessment, not part of the
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healthhistory.
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4. ANS: D j i
While performing the physical examination, the examiner must be able to differentiate
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betweennormal and abnormal findings, recall knowledge of a range of conditions, including their
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associated signs and symptoms, recognize how certain conditions affect the response to other
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conditions, and distinguish the relevance of varied abnormal findings.
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PTS: 1
5. ANS: C j i
Sources for diagnostic statistics include textbooks, primary reports of research, and published
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meta-analyses. Another source of statistics, the one that has been most widely used and available
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for application to the reasoning process, is the estimation based on a provider’s experience,
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although these are rarely accurate. Over the past decade, the availability of evidence on which to
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base clinical reasoning is improving, and there is an increasing expectation that clinical
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reasoningbe based on scientific evidence. Evidence-based statistics are also increasingly being
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used to develop resources to facilitate clinical decision-making.
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PTS: 1
6. ANS: D j i
To assist in clinical decision-making, a number of evidence-based resources have been developedto
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assist the clinician. Resources, such as algorithms and clinical practice guidelines, assist in clinical
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reasoning when properly applied.
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