TEST BANK FOR ADVANCED ASSESSMENT INTERPRETING
FINDINGS AND FORMULATING DIFFERENTIAL DIAGNOSES 5th
EDITION GOOLSBY CHAPTERS 1 - 22 | COMPLETE
, Chapter 1. Assessment and Clinical Decision Making: An Overview
Multiple Choice
Identify the choice that best completes the statement or accurate answer:->s 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. Primaryreports 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. Algorithmpublished 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. Alikelihood ratio above 1 indicates that a diagnostic test showing a:
A. Positive result is strongly associated with the sickness
B. Negative result is strongly associated with absence of the sickness
C. Positive result is weakly associated with the sickness
D. Negative result is weakly associated with absence of the sickness
, 10. Which of the following clinical reasoning tools is defined as evidence-based resource based on mathematical modeling
A. Clinical practice guideline
B. Clinical decision rule
C. Clinical algorithm
Chapter 1: Clinical reasoning, differential diagnosis, evidence-based practice, and symptom ana
Accurate answer:-> Section
MULTIPLE CHOICE
1. ACCURATE ANSWER:->: 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.
POINTS: 1
2. ACCURATE ANSWER:->: D
To obtain adequate history, providers must be well organized, attentive to the patient’s verbal and nonverbal language, and
ableto accurately interpret the patient’s responses to questions. Rather than reading into the patient’s statements, they clarify
any areas of uncertainty.
POINTS: 1
3. ACCURATE ANSWER:->: C
Vital signs are part of the physical examination portion of patient assessment, not part of the health history.
POINTS: 1
4. ACCURATE ANSWER:->: 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.
POINTS: 1
5. ACCURATE ANSWER:->: 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 widelyused and available for application to the reasoning process, is the estimation based ona
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.
POINTS: 1
6. ACCURATE ANSWER:->: 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.
POINTS: 1
7. ACCURATE ANSWER:->: 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.
POINTS: 1
8. ACCURATE ANSWER:->: B
The specificity of a diagnostic study is the percentage of normal, healthy individuals who have a normal result. The greater the
specificity, the greater the percentage of individuals who will have negative, or normal, results if they do not have the target
condition.
POINTS: 1
9. ACCURATE ANSWER:->: 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
sickness; a likelihood ratio less than 1 indicates that a negative result is associated with an absence of the sickness.
, POINTS: 1
10. ACCURATE ANSWER:->: 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.
POINTS: 1
