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
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Multiple Choice
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Identify the choice that best completes the statement or accurate answer:->s the question.
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1. Which type of clinical decision-makingis most reliable?
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A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
2. Which of the following is false? To obtain adequate history, health-care providers must be:
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A. Methodical and systematic bn bn
B. Attentive to the patient’s verbal and nonverbal language
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C. Able to accurately interpret the patient’s responses
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D. Adept at reading into the patient’s statements
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3. Essential parts of a health history include all of the following except:
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A. Chief complaint bn
B. History of the present illness
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C. Current vital signs bn bn
D. All of the above are essential history components
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4. Which of the following is false? While performing the physical examination, the examiner must be able to:
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A. Differentiate between normal and abnormal findings
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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
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D. Foresee unpredictable findings
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5. The following is the least reliable source of information for diagnostic statistics:
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A. Evidence-based investigations bn
B. Primaryreports of research bn bn
C. Estimation based on a provider’s experiencebn bn bn bn bn
D. Published meta-analyses bn
6. The following can be used to assist in sound clinical decision-making:
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A. Algorithmpublished in a peer-reviewed journal article bn bn bn bn bn
B. Clinical practice guidelines
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C. Evidence-based research bn
D. All of the above
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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 abovebn bn bn
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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9. Alikelihood ratio above 1 indicates that a diagnostic test showing a:
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A. Positive result is strongly associated with the sickness
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B. Negative result is strongly associated with absence of the sickness
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C. Positive result is weakly associated with the sickness
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D. Negative result is weakly associated with absence of the sickness
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, 10. Which of the following clinical reasoning tools is defined as evidence-
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based resource based on mathematical modeling
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A. Clinical practice guideline bn bn
B. Clinical decision rule bn bn
C. Clinical algorithm bn
Chapter 1: Clinical reasoning, differential diagnosis, evidence-based practice, and symptom ana
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Accurate answer:-> Section
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MULTIPLE CHOICE bn
1. ACCURATE ANSWER:->: B bn
Croskerry (2009) describes two major types of clinical diagnostic decision-making: intuitive and analytical. Intuitive decision-
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making (similar to Augenblink decision-
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making) is based on the experience and intuition of the clinician and is less reliable andpaired with fairly common errors. In contr
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ast, analytical decision-making is based on careful consideration and has greater reliability with rare errors.
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POINTS: 1
2. ACCURATE ANSWER:->: D bn
To obtain adequate history, providers must be well organized, attentive to the patient’s verbal and nonverbal language, and ab
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leto accurately interpret the patient’s responses to questions. Rather than reading into the patient’s statements, they clarify any
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areas of uncertainty. bn bn
POINTS: 1
3. ACCURATE ANSWER:->: C bn
Vital signs are part of the physical examination portion of patient assessment, not part of the health history.
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POINTS: 1
4. ACCURATE ANSWER:->: D bn
While performing the physical examination, the examiner must be able to differentiate between normal and abnormal findings, recall
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knowledge of a range of conditions, including their associated signs and symptoms, recognize how certain conditions affectthe
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response to other conditions, and distinguish the relevance of varied abnormal findings.
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POINTS: 1
5. ACCURATE ANSWER:->: C bn
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 widelyused and available for application to the reasoning process,
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is the estimation based ona provider’s experience, although these are rarely accurate. Over the past decade, the availability of evidenc
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e on which to base clinical reasoning is improving, and there is an increasing expectation that clinical reasoning be based on scientif
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ic evidence.
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Evidence-based statistics are also increasingly being used to develop resources to facilitate clinical decision-making.
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POINTS: 1
6. ACCURATE ANSWER:->: D bn
To assist in clinical decision-making, a number of evidence-
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based resources have been developed to assist the clinician. Resources, such as algorithms and clinical practice guidelines, assi
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st in clinical reasoning when properly applied.
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POINTS: 1
7. ACCURATE ANSWER:->: A bn
The sensitivity of a diagnostic study is the percentage of individuals with the target condition who show an abnormal, or positive,resul
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t. A high sensitivity indicates that a greater percentage of persons with the given condition will have an abnormal result.
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POINTS: 1
8. ACCURATE ANSWER:->: B bn
The specificity of a diagnostic study is the percentage of normal, healthy individuals who have a normal result. The greater t
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he specificity, the greater the percentage of individuals who will have negative, or normal, results if they do not have the ta
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rget condition. bn
POINTS: 1
9. ACCURATE ANSWER:->: A bn
The likelihood ratio is the probability that a positive test result will be associated with a person who has the target condition an
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d a negative result will be associated with a healthy person. A likelihood ratio above 1 indicates that a positive result is associated wit
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h the sickness; a likelihood ratio less than 1 indicates that a negative result is associated with an absence of the sickness.
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, POINTS: 1
10. ACCURATE ANSWER:->: bn B
Clinical decision (or prediction) rules provide another support for clinical reasoning. Clinical decision rules are evidence-
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based resources that provide probabilistic statements regarding the likelihood that a condition exists if certain variables are me
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t with regard to the prognosis of patients with specific findings. Decision rules use mathematical models and are specific t
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o certain situations, settings, and/or patient characteristics.
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POINTS: 1
