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TEST BANK FOR ADVANCED ASSESSMENT: INTERPRETING FINDINGS AND FORMULATING DIFFERENTIAL DIAGNOSES 4TH EDITION, MARY JO GOOLSBY, LAURIE GRUBBS

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ADVANCED ASSESSMENT: INTERPRETING

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ADVANCED ASSESSMENT: INTERPRETING

TEST BANK FOR ADVANCED ASSESSMENT: INTERPRETING FINDINGS AND FORMULATING DIFFERENTIAL DIAGNOSES 4TH EDITION, MARY JO GOOLSBY, LAURIE GRUBBSTEST BANK FOR ADVANCED ASSESSMENT: INTERPRETING FINDINGS AND FORMULATING DIFFERENTIAL DIAGNOSES 4TH EDITION, MARY JO GOOLSBY, LAURIE GRUBBS

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4th edition
test bank for advanced assessment interpreting
test bank for advanced assessment
4th edition mary jo goolsby laurie grubbs

Institution ADVANCED ASSESSMENT: INTERPRETING
Course ADVANCED ASSESSMENT: INTERPRETING

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Chapter 1. Assessment and Clinical Decision-Making: Overview
TEST BANK FOR ADVANCED ASSESSMENT:
INTERPRETING FINDINGS AND Multiple Choice
Identify the choice that best completes the statement or answers the question.

FORMULATING DIFFERENTIAL 1. Which type of clinical decision-making is most reliable?
A. Intuitive
DIAGNOSES 5TH EDITION, MARY JO B. Analytical
C. Experiential
GOOLSBY, LAURIE GRUBBS ISBN-10; D. Augenblick

1719645930 / ISBN-13; 978-1719645935 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. Primary reports 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. Algorithm published 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 Answer Section
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 MULTIPLE CHOICE

9. A likelihood ratio above 1 indicates that a diagnostic test showing a: 1. ANS: B
A. Positive result is strongly associated with the disease Croskerry (2009) describes two major types of clinical diagnostic decision-making: intuitive and
B. Negative result is strongly associated with absence of the disease analytical. Intuitive decision-making (similar to Augenblink decision-making) is based on the
C. Positive result is weakly associated with the disease experience and intuition of the clinician and is less reliable and paired with fairly common errors.
D. Negative result is weakly associated with absence of the disease In contrast, analytical decision-making is based on careful consideration and has greater reliability
with rare errors.
10. Which of the following clinical reasoning tools is defined as evidence-based resource based on
mathematical modeling to express the likelihood of a condition in select situations, settings, and/or PTS: 1
patients?
2. ANS: D
A. Clinical practice guideline
To obtain adequate history, providers must be well organized, attentive to the patient’s verbal and
B. Clinical decision rule
nonverbal language, and able to accurately interpret the patient’s responses to questions. Rather
C. Clinical algorithm
than reading into the patient’s statements, they clarify any areas of uncertainty.
D. Clinical recommendation
PTS: 1
3. ANS: C
Vital signs are part of the physical examination portion of patient assessment, not part of the health
history.

PTS: 1
4. ANS: 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 affect the response to other
conditions, and distinguish the relevance of varied abnormal findings.

PTS: 1
5. ANS: 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 widely used and available
for application to the reasoning process, is the estimation based on a 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.

PTS: 1
6. ANS: 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.

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Chapter 2. An Overview of Genetic Assessment
PTS: 1
7. ANS: A
Multiple Choice
The sensitivity of a diagnostic study is the percentage of individuals with the target condition who Identify the choice that best completes the statement or answers the question.
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. 1. The first step in the genomic assessment of a patient is obtaining
information regarding:
PTS: 1
A. Family history
8. ANS: B
B. Environmental exposures
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 C. Lifestyle and behaviors
negative, or normal, results if they do not have the target condition. D. Current medications

2. An affected individual who manifests symptoms of a particular
PTS: 1
condition through whom a family with a genetic disorder is ascertained
9. ANS: A is called a(n):
The likelihood ratio is the probability that a positive test result will be associated with a person
A. Consultand
who has the target condition and a negative result will be associated with a healthy person. A
B. Consulband
likelihood ratio above 1 indicates that a positive result is associated with the disease; a likelihood
ratio less than 1 indicates that a negative result is associated with an absence of the disease. C. Index patient
D. Proband
PTS: 1
3. An autosomal dominant disorder involves the:
10. ANS: B
A. X chromosome
Clinical decision (or prediction) rules provide another support for clinical reasoning. Clinical
decision rules are evidence-based resources that provide probabilistic statements regarding the B. Y chromosome
likelihood that a condition exists if certain variables are met with regard to the prognosis of C. Mitochondrial DNA
patients with specific findings. Decision rules use mathematical models and are specific to certain D. Non-sex chromosomes
situations, settings, and/or patient characteristics.
4. To illustrate a union between two second cousin family members in a
pedigree, draw:
PTS: 1
A. Arrows pointing to the male and
female
B. Brackets around the male and
female
C. Double horizontal lines between
the male and female
D. Circles around the male and
female

5. To illustrate two family members in an adoptive relationship in a
pedigree:
A. Arrows are drawn pointing to the
male and female
B. Brackets are drawn around the
male and female
C. Double horizontal lines are drawn
between the male and female

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D. Circles are drawn around the
male and female 10. A woman with an X-linked dominant disorder will:
A. Not be affected by the disorder
6. When analyzing the pedigree for autosomal dominant disorders, it is herself
common to see: B. Transmit the disorder to 50 % of
A. Several generations of affected her offspring (male or female)
members C. Not transmit the disorder to her
B. Many consanguineous daughters
relationships D. Transmit the disorder to only her
C. More members of the maternal daughters
lineage affected than paternal
11. In creating your female patient’s pedigree, you note that she and both
D. More members of the paternal
lineage affected than maternal of her sisters were affected by the same genetic disorder. Although
neither of her parents had indications of the disorder, her paternal
7. In autosomal recessive (AR) disorders, individuals need: grandmother and her paternal grandmother’s two sisters were affected
A. Only one mutated gene on the by the same condition. This pattern suggests:
sex chromosomes to acquire the A. Autosomal dominant disorder
disease B. Chromosomal disorder
B. Only one mutated gene to C. Mitochondrial DNA disorder
acquire the disease D. X-linked dominant disorder
C. Two mutated genes to acquire
the disease 12. A woman affected with an X-linked recessive disorder:
D. Two mutated genes to become A. Has one X chromosome affected
carriers by the mutation
B. Will transmit the disorder to all of
8. In autosomal recessive disorders, carriers have: her children
A. Two mutated genes; one from C. Will transmit the disorder to all of
each parent that cause disease her sons
B. A mutation on a sex chromosome D. Will not transmit the mutation to
that causes a disease any of her daughters
C. A single gene mutation that
causes the disease 13. Which of the following are found in an individual with aneuploidy?
D. One copy of a gene mutation but A. An abnormal number of
not the disease chromosomes
B. An X-linked disorder
9. With an autosomal recessive disorder, it is important that parents C. Select cells containing abnormal-
understand that if they both carry a mutation, the following are the appearing chromosomes
risks to each of their offspring (each pregnancy): D. An autosomal recessive disorder
A. 50% chance that offspring will
carry the disease 14. The pedigree of a family with a mitochondrial DNA disorder is unique in
B. 10% chance of offspring affected that:
by disease A. None of the female offspring will
C. 25% chance children will carry have the disease
the disease B. All offspring from an affected
D. 10% chance children will be female will have disease
disease free C. None of the offspring of an

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Exam (elaborations)

TEST BANK FOR ADVANCED ASSESSMENT: INTERPRETING FINDINGS AND FORMULATING DIFFERENTIAL DIAGNOSES 4TH EDITION, MARY JO GOOLSBY, LAURIE GRUBBS

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