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Test bank-Advanced Health Assessment & Clinical Diagnosis in Primary Care
6th Edition Dains-100% Top scores-2024-2025
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A. Clinical practice guideline
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B. Clinical decision rule
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C. Clinical algorithm
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Answer Section MULTIPLE C HOICE
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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-
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making) is based on the experience and intuition of the clinician and is less reliable andp aired with fairly common errors. In contrast, a
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nalytical decision-makingis based on careful consideration and has greater reliability with rare errors.
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2. ANS: D
To obtain adequate history, providers must be well organized, attentive to the patient‘s verbal and nonverbal language, and ablet o acc
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urately interpret the patient‘s responses to questions. Rather than readinginto the patient‘s statements, they clarify any areas of uncert
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ainty.
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3. ANS: C
Vitalsigns arep art of thep hysical examination portion ofp atient assessment, not part oft he health history.
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4. ANS: D
While performingthe physical examination, the examiner must be able to differentiate between normal and abnormal findings, recall kn
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owledge of a range of conditions, includingtheir associated signs and symptoms, recognize how certain conditions affect t he response to
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other conditions, and distinguish the relevance of varied abnormal findings.
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5. ANS: C
Sources for diagnostic statistics include textbooks, primary reports of research, and published meta-
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analyses. Another source of statistics,t he one that has been most widely used and available forapplication tot he reasoningp rocess, is the
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estimation based ona provider‘s experience, although these are rarely accurate. Over the past decade, the availability of evidence on wh
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ich to base clinical reasoningis improving, and there is an increasingexpectation that clinical reasoningbe based on scientific evidence.
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Evidence-based statistics are also increasingly beingused to develop resources t o facilitate clinical decision-making.
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6. ANS: D
To assist in clinical decision-making, a number of evidence-
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based resources have been developed to assist the clinician.R esources, such as algorithms and clinical practice guidelines, ass
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ist in clinical reasoningwhen properly applied.
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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.
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Ahigh sensitivity indicates that a greater percentage of persons with thegiven condition will have an abnormal result.
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8. ANS: B
The specificity of a diagnostic study is the percentage of normal, healthy individuals who have a normal result. The greater thespecifi
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city, the greater the percentage of individuals who will have negative, or normal, results if they do not have the target condition.
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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 anegativ
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e result will be associated with a healthy person. A likelihood ratio above 1 indicates that a positive result is associated with thedisease; a
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likelihood ratio less than 1 indicates that a negative result is associated with an absence of t he disease.
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10. ANS: B
Clinical decision (or prediction) rules provide another support for clinical reasoning. Clinical decision rules are evidence-
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basedresources that provide probabilistic statements regardingthe likelihood that a condition exists if certain variables are met with r
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egard to the prognosis of patients with specific findings. Decision rules use mathematical models and are specific to certain situations
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, settings, and/or patient characteristics.
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