9/26/23,512:385PM Advanced5Health5Assessment5&5Clinical5Diagnosis5 in5Primary5 Care57…
Advanced5Health5Assessment5&5Clinical5Diagnosis5in5Primary5Care57th5Edition5Dai
ns5Test5Bank
Chapter51:5Clinical5reasoning,5differential5diagnosis,5evidence-based5practice,5and5symptom5ana
Multiple5 Choice
Identify5 the5 choice5 that5best5 completes5the5 statement5 or5answers5 the5question.
1. Which5type5of5clinical5decision-making5is5most5reliable?
A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
2. Which5 of5 the5following5is5 false?5To5obtain5adequate5 history,5 health-care5 providers5 must5be:
A. Methodical5and5 systematic
B. Attentive5to5the5patient’s5verbal5and5nonverbal5language
C. Able5to5 accurately5interpret5the5 patient’s5responses
D. Adept5at5reading5 into5the5patient’s5statements
3. Essential5parts5of5a5 health5 history5include5 all5 of5 the5 following5 except:
A. Chief5complaint
B. History5of5 the5 present5 illness
C. Current5vital5signs
D. All5of5 the5 above5are5 essential5history5components
4. Which5of5the5following5is5false?5While5performing5the5 physical5examination,5the5 examiner5must5be5able5to:
A. Differentiate5between5normal5and5abnormal5findings
B. Recall5knowledge5 of5a5range5of5conditions5and5their5associated5signs5and5symptoms
C. Recognize5 how5 certain5conditions5 affect5 the5 response5to5 other5 conditions
D. Foresee5unpredictable5findings
5. The5following5is5the5 least5reliable5source5of5 information5for5diagnostic5statistics:
A. Evidence-based5investigations
B. Primary5reports5 of5 research
C. Estimation5based5 on5a5provider’s5 experience
D. Published5 meta-analyses
6. The5following5can5be5used5to5assist5in5sound5clinical5decision-making:
A. Algorithm5published5in5a5peer-reviewed5 journal5article
B. Clinical5practice5 guidelines
C. Evidence-based5 research
D. All5of5the5above
7. If5a5diagnostic5study5has5high5sensitivity,5this5 indicates5 a:
A. High5percentage5 of5persons5 with5the5 given5condition5will5have5an5abnormal5result
B. Low5percentage5 of5 persons5 with5the5 given5condition5will5have5 an5abnormal5result
C. Low5likelihood5 of5normal5result5 in5persons5 without5a5given5condition
D. None5of5the5above
8. If5a5 diagnostic5study5has5 high5specificity,5this5 indicates5 a:
A. Low5percentage5 of5 healthy5individuals5will5show5a5 normal5result
B. High5percentage5 of5 healthy5individuals5will5show5a5normal5result
C. High5percentage5 of5individuals5with5a5disorder5 will5show5a5 normal5result
D. Low5percentage5 of5individuals5 with5a5 disorder5 will5show5an5abnormal5result
9. A5likelihood5 ratio5above515 indicates5that5a5diagnostic5test5showing5a:
A. Positive5 result5is5strongly5associated5 with5the5 disease
B. Negative5 result5 is5strongly5associated5 with5 absence5 of5 the5 disease
C. Positive5result5 is5 weakly5associated5 with5the5 disease
D. Negative5result5 is5 weakly5associated5 with5 absence5 of5 the5 disease
10. Which5of5the5following5clinical5reasoning5tools5is5 defined5as5evidence-based5resource5based5 on5mathematical5 modeling
to5 express5the5 likelihood5 of5a5 condition5in5select5situations,5settings,5and/or5patients?
A. Clinical5practice5 guideline
B. Clinical5 decision5 rule
C. Clinical5 algorithm
Chapter51:5Clinical5reasoning,5differential5diagnosis,5evidence-based5practice,5and5symptom5ana
Answer5Section
MULTIPLE5CHOICE
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,9/26/23,512:385PM Advanced5Health5Assessment5&5Clinical5Diagnosis5 in5Primary5 Care57…
A. Clinical5practice5 guideline
B. Clinical5 decision5 rule
C. Clinical5 algorithm
Chapter51:5Clinical5reasoning,5differential5diagnosis,5evidence-based5practice,5and5symptom5ana
Answer5Section
MULTIPLE5CHOICE
1. ANS:5 5 B
Croskerry5(2009)5describes5two5major5types5of5clinical5diagnostic5decision-
making:5intuitive5and5analytical.5Intuitive5decision-5 making5(similar5to5Augenblink5decision-
making)5is5based5on5the5experience5and5intuition5of5the5clinician5and5is5less5reliable5and5 paired5with5fairly5common5errors.
5In5contrast,5analytical5decision-making5is5based5on5careful5consideration5and5has5greater5 reliability5 with5rare5 errors.
PTS: 1
2. ANS:5 5 D
To5obtain5adequate5history,5providers5must5be5well5organized,5attentive5to5the5patient’s5verbal5and5nonverbal5language,5and5
able5 to5accurately5interpret5the5patient’s5responses5to5questions.5Rather5than5reading5into5the5patient’s5statements,5they5c
larify5any5 areas5of5uncertainty.
PTS: 1
3. ANS:5 5 C
Vital5signs5are5part5of5 the5 physical5 examination5portion5of5patient5assessment,5 not5part5of5the5 health5 history.
PTS: 1
4. ANS:5 5 D
While5performing5the5physical5examination,5the5examiner5must5be5able5to5differentiate5between5normal5and5abnormal5findin
gs,5 recall5knowledge5of5a5range5of5conditions,5including5their5associated5signs5and5symptoms,5recognize5how5certain5condition
s5affect5 the5response5to5other5conditions,5and5distinguish5the5relevance5of5varied5abnormal5findings.
PTS: 1
5. ANS:5 5 C
Sources5for5diagnostic5statistics5include5textbooks,5primary5reports5of5research,5and5published5meta-
analyses.5Another5source5of5 statistics,5the5 one5 that5 has5been5 most5 widely5used5 and5 available5 for5 application5to5the5 reasoning
5 process,5 is5 the5 estimation5based5 on5 a5provider’s5experience,5although5these5are5rarely5accurate.5Over5the5past5decade,5the5
availability5of5evidence5on5which5to5base5 clinical5reasoning5is5improving,5 and5there5is5an5increasing5expectation5that5clinical5
reasoning5be5based5on5scientific5evidence.
Evidence-based5statistics5are5also5increasingly5being5used5to5develop5resources5to5facilitate5clinical5decision-making.
PTS: 1
6. ANS:5 5 D
To5assist5in5clinical5decision-making,5a5number5of5evidence-
based5resources5have5been5developed5to5assist5the5clinician.5 Resources,5such5as5algorithms5and5clinical5practice5guidelines
,5assist5in5clinical5reasoning5when5properly5applied.
PTS: 1
7. ANS:5 5 A
The5sensitivity5of5a5diagnostic5study5is5the5percentage5of5individuals5with5the5target5condition5who5show5an5abnormal,5or5positi
ve,5 result.5A5high5sensitivity5indicates5that5a5greater5percentage5of5persons5with5the5given5condition5will5have5an5abnormal5
result.
PTS: 1
8. ANS:5 5 B
The5specificity5of5a5diagnostic5study5is5the5percentage5of5normal,5healthy5individuals5who5have5a5normal5result.5The5great
er5the5 specificity,5the5greater5the5percentage5of5individuals5who5will5have5negative,5or5normal,5results5if5they5do5not5hav
e5the5target5 condition.
PTS: 1
9. ANS:5 5 A
The5likelihood5ratio5is5the5probability5that5a5positive5test5result5will5be5associated5with5a5person5who5has5the5target5condition5
and5a5 negative5result5will5be5associated5with5a5healthy5person.5A5likelihood5ratio5above515indicates5that5a5positive5result5is5a
ssociated5 with5the5disease;5a5likelihood5ratio5less5than515indicates5that5a5negative5result5is5associated5with5an5absence5of5the
5disease.
PTS: 1
10. ANS:5 5 B
Clinical5decision5(or5prediction)5rules5provide5another5support5for5clinical5reasoning.5Clinical5decision5rules5are5evidence-
based5 resources5that5provide5probabilistic5statements5regarding5the5likelihood5that5a5condition5exists5if5certain5variables5a
re5met5with5 regard5to5the5prognosis5of5patients5with5specific5findings.5Decision5rules5use5mathematical5models5and5are5
specific5to5certain5 situations,5settings,5and/or5patient5 characteristics.
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PTS: 1
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PTS: 1
10. ANS:5 5 B
Clinical5decision5(or5prediction)5rules5provide5another5support5for5clinical5reasoning.5Clinical5decision5rules5are5evidence-
based5 resources5that5provide5probabilistic5statements5regarding5the5likelihood5that5a5condition5exists5if5certain5variables5a
re5met5with5 regard5to5the5prognosis5of5patients5with5specific5findings.5Decision5rules5use5mathematical5models5and5are5
specific5to5certain5 situations,5settings,5and/or5patient5 characteristics.
PTS: 1
Chapter52.5 Evidence-based5health5screening
Multiple5 Choice
Identify5 the5 choice5 that5best5 completes5the5 statement5 or5answers5 the5question.
1. The5first5step5in5the5 genomic5assessment5of5a5patient5is5 obtaining5information5regarding:
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