Test Bank for Advanced Assessment: Interpreting Findings
and Formulating Differential Diagnoses, 5th Edition, Mary Jo
Goolsby, Laurie Grubbs Chapter 1 - 22 | Complete
,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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fr 1. Which type of clinical decision-making is most reliable?
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A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
fr 2. Which of the following is false? To obtain adequate history, health-care providers must be:
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A. Methodical and systematic fr fr
B. Attentive to the patient’s verbal and nonverbal language fr fr fr fr fr fr fr
C. Able to accurately interpret the patient’s responses
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D. Adept at reading into the patient’s statements fr fr fr fr fr fr
fr 3. Essential parts of a health history include all of the following except:
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A. Chief complaint fr
B. History of the present illness fr fr fr fr
C. Current vital signs fr fr
D. All of the above are essential history components
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fr 4. Which of the following is false? While performing the physical examination, the examiner must beabl
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e to: fr
A. Differentiate between normal and abnormal findings fr fr fr fr fr
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 fr fr fr fr fr fr fr fr fr
D. Foresee unpredictable findings fr fr
fr 5. The following is the least reliable source of information for diagnostic statistics:
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A. Evidence-based investigations fr
B. Primary reports of research fr fr fr
C. Estimation based on a provider’s experience fr fr fr fr fr
D. Published meta-analyses fr
fr 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 fr fr fr fr fr fr
B. Clinical practice guidelines fr fr
C. Evidence-based research fr
D. All of the above fr fr fr
fr 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 fr fr fr
,fr 8. If a diagnostic study has 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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fr 9. A likelihood 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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fr 10. Which of the following clinical reasoning tools is defined as evidence-
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based resource based on mathematical modeling to express the likelihood of a condition in select situ
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ations, settings, and/orpatients?
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A. Clinical practice guideline fr fr
B. Clinical decision rule fr fr
C. Clinical algorithm fr
D. Clinical recommendation fr
, Chapter 1. Assessment and Clinical Decision-Making: Overview
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Answer Section
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MULTIPLE CHOICE fr
1. ANS: B f r
Croskerry (2009) describes two major types of clinical diagnostic decision- fr fr fr fr fr fr fr fr fr
making: intuitive and analytical. Intuitive decision-making (similar to Augenblink decision-
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making) is based on the experience and intuition of the clinician and is less reliable and paired with fa
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irly common errors. In contrast, analytical decision-
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making is based on careful consideration and has greater reliabilitywith rare errors.
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PTS: 1
2. ANS: D f r
To obtain adequate history, providers must be well organized, attentive to the patient’s verbal andnonv
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erbal language, and able to accurately interpret the patient’s responses to questions. Rather than readi
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ng into the patient’s statements, they clarify any areas of uncertainty.
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PTS: 1
3. ANS: C f r
Vital signs are part of the physical examination portion of patient assessment, not part of the healthhisto
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ry.
PTS: 1
4. ANS: D f r
While performing the physical examination, the examiner must be able to differentiate betweennorma
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l and abnormal findings, recall knowledge of a range of conditions, including their associated signs a
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nd symptoms, recognize how certain conditions affect the response to other conditions, and distingui
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sh the relevance of varied abnormal findings.
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PTS: 1
5. ANS: C f r
Sources for diagnostic statistics include textbooks, primary reports of research, and published meta-
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analyses. Another source of statistics, the one that has been most widely used and available for appli
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cation to the reasoning process, is the estimation based on a provider’s experience, although these ar
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e rarely accurate. Over the past decade, the availability of evidence on which to base clinical reasoni
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ng is improving, and there is an increasing expectation that clinical reasoningbe based on scientific e
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vidence. Evidence- fr
based statistics are also increasingly being used to develop resources to facilitate clinical decision-
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making.
PTS: 1
6. ANS: D f r
To assist in clinical decision-making, a number of evidence-
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based resources have been developedto assist the clinician. Resources, such as algorithms and clinica
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l practice guidelines, assist in clinical reasoning when properly applied.
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