TEST BANK FOR ADVANCED ASSESSMENT:
v v v v v
INTERPRETING FINDINGS AND
v v v v
FORMULATING DIFFERENTIAL
v v v
DIAGNOSES 5TH EDITION, MARY JO
v v v v v v
GOOLSBY, LAURIE GRUBBS ISBN-10;
v v v v
1719645930 / ISBN-13;978-1719645935
v v v v
,Chapter 1. Assessment and Clinical Decision-Making: Overview
v v v v v v
Multiple Choice
v
Identify the choice that best completes the statement or answers the question.
v v v v v v v v v v v
1. Which type of clinical decision-making is most reliable?
v v v v v v v
A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
2. Which of the following is false? To obtain adequate history, health-care providers must be:
v v v v v v v v v v v v v
A. Methodical and systematic v v
B. Attentive to the patient’s verbal and nonverbal language v v v v v v v
C. Able to accurately interpret the patient’s responses
v v v v v v
D. Adept at reading into the patient’s statementsv v v v v v
3. Essential parts of a health history include all of the following except:
v v v v v v v v v v v
A. Chief complaint v
B. History of the present illness v v v v
C. Current vital signs v v
D. All of the above are essential history components
v v v v v v v
4. Which of the following is false? While performing the physical examination, the examiner must be
v v v v v v v v v v v v v v
able to:v v
A. Differentiate between normal and abnormal findings v v v v v
B. Recall knowledge of a range of conditions and their associated signs and symptoms
v v v v v v v v v v v v
C. Recognize how certain conditions affect the response to other conditions v v v v v v v v v
D. Foresee unpredictable findings v v
5. The following is the least reliable source of information for diagnostic statistics:
v v v v v v v v v v v
A. Evidence-based investigations v
B. Primary reports of research v v v
C. Estimation based on a provider’s experience v v v v v
D. Published meta-analyses v
6. The following can be used to assist in sound clinical decision-making:
v v v v v v v v v v
A. Algorithm published in a peer-reviewed journal article v v v v v v
B. Clinical practice guidelines v v
C. Evidence-based research v
D. All of the above v v v
7. If a diagnostic study has high sensitivity, this indicates a:
v v v v v v v v v
A. High percentage of persons with the given condition will have an abnormal result
v v v v v v v v v v v v
B. Low percentage of persons with the given condition will have an abnormal result
v v v v v v v v v v v v
C. Low likelihood of normal result in persons without a given condition
v v v v v v v v v v
D. None of the above v v v
, 8. If a diagnostic study has high specificity, this indicates a:
v v v v v v v v v
A. Low percentage of healthy individuals will show a normal result
v v v v v v v v v
B. High percentage of healthy individuals will show a normal result
v v v v v v v v v
C. High percentage of individuals with a disorder will show a normal result
v v v v v v v v v v v
D. Low percentage of individuals with a disorder will show an abnormal result
v v v v v v v v v v v
9. A likelihood ratio above 1 indicates that a diagnostic test showing a:
v v v v v v v v v v v
A. Positive result is strongly associated with the disease
v v v v v v v
B. Negative result is strongly associated with absence of the disease
v v v v v v v v v
C. Positive result is weakly associated with the disease
v v v v v v v
D. Negative result is weakly associated with absence of the disease
v v v v v v v v v
v 10. Which of the following clinical reasoning tools is defined as evidence-based resource based on
v v v v v v v v v v v v v v
mathematical modeling to express the likelihood of a condition in select situations, settings, and/or
v v v v v v v v v v v v v v
patients?
v
A. Clinical practice guideline
v v
B. Clinical decision rule v v
C. Clinical algorithm v
D. Clinical recommendation v
, Answer Section
v
MULTIPLE CHOICE
v
1. ANS: B v v
Croskerry (2009) describes two major types of clinical diagnostic decision-making: intuitive and
v v v v v v v v v v v
analytical. Intuitive decision-making (similar to Augenblink decision-making) is based on the
v v v v v v v v v v v
experience and intuition of the clinician and is less reliable and paired with fairly common errors.
v v v v v v v v v v v v v v v v
In contrast, analytical decision-making is based on careful consideration and has greater reliability
v v v v v v v v v v v v v
with rare errors.
v v v
PTS: 1
2. ANS: D v v
To obtain adequate history, providers must be well organized, attentive to the patient’s verbal and
v v v v v v v v v v v v v v
nonverbal language, and able to accurately interpret the patient’s responses to questions. Rather
v v v v v v v v v v v v v
than reading into the patient’s statements, they clarify any areas of uncertainty.
v v v v v v v v v v v v
PTS: 1
3. ANS: C v v
Vital signs are part of the physical examination portion of patient assessment, not part of the health
v v v v v v v v v v v v v v v v
history.
v
PTS: 1
4. ANS: D v v
While performing the physical examination, the examiner must be able to differentiate between
v v v v v v v v v v v v
normal and abnormal findings, recall knowledge of a range of conditions, including their
v v v v v v v v v v v v v
associated signs and symptoms, recognize how certain conditions affect the response to other
v v v v v v v v v v v v v
conditions, and distinguish the relevance of varied abnormal findings.
v v v v v v v v v
PTS: 1
5. ANS: C v v
Sources for diagnostic statistics include textbooks, primary reports of research, and published
v v v v v v v v v v v
meta-analyses. Another source of statistics, the one that has been most widely used and available
v v v v v v v v v v v v v v v
for application to the reasoning process, is the estimation based on a provider’s experience,
v v v v v v v v v v v v v v
although these are rarely accurate. Over the past decade, the availability of evidence on which to
v v v v v v v v v v v v v v v v
base clinical reasoning is improving, and there is an increasing expectation that clinical reasoning
v v v v v v v v v v v v v v
be based on scientific evidence. Evidence-based statistics are also increasingly being used to
v v v v v v v v v v v v v
develop resources to facilitate clinical decision-making.
v v v v v v
PTS: 1
6. ANS: D v v
To assist in clinical decision-making, a number of evidence-based resources have been developed
v v v v v v v v v v v v
to assist the clinician. Resources, such as algorithms and clinical practice guidelines, assist in
v v v v v v v v v v v v v v
clinical reasoning when properly applied.
v v v v v
