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Test Bank for Advanced Health Assessment & Clinical Diagnosis in Primary Care
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7th Edition Dains f f f
Chapter 1: Clinical Reasoning, Differential Diagnosis, Evidence-Based Practice, and Symptom Analysis
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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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f 1. Which ftype fof fclinical fdecision-making fis fmost freliable?
A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
f 2. Which fof fthe ffollowing fis ffalse? fTo fobtain fadequate fhistory, fhealth-care fproviders fmust fbe:
A. Methodical fand fsystematic
B. Attentive fto fthe fpatient’s fverbal fand fnonverbal flanguage
C. Able fto faccurately finterpret fthe fpatient’s fresponses
D. Adept fat freading finto fthe fpatient’s fstatements
f 3. Essential fparts fof fa fhealth fhistory finclude fall fof fthe ffollowing fexcept:
A. Chief fcomplaint
B. Historyfof fthe fpresent fillness
C. Current fvital fsigns
D. All fof fthe fabove fare fessential fhistory fcomponents
f 4. Which fof fthe ffollowing fis ffalse? fWhile fperforming fthe fphysical f examination, fthe fexaminer fmust fbe fable fto:
A. Differentiate fbetween fnormal fand fabnormal ffindings
B. Recall fknowledge fof fa frange fof fconditions fand ftheir fassociated fsigns fand fsymptoms
C. Recognize fhow fcertain fconditions faffect fthe fresponse fto fother fconditions
D. Foresee funpredictable ffindings
f 5. The ffollowing fis fthe fleast freliable fsource fof finformation ffor fdiagnostic fstatistics:
A. Evidence-based finvestigations
B. Primaryfreports fof fresearch
C. Estimation fbased fon fa fprovider’s fexperience
D. Published fmeta-analyses
f 6. The ffollowing fcan fbe fused fto fassist fin fsound fclinical fdecision-making:
A. Algorithmfpublished fin fa fpeer-reviewed fjournal farticle
B. Clinical fpractice fguidelines
C. Evidence-based fresearch
D. All fof fthe fabove
f 7. If fa fdiagnostic fstudyfhas fhigh fsensitivity, f this findicates fa:
A. High fpercentage fof fpersons fwith fthe fgiven fcondition fwill fhave fan fabnormal fresult
B. Low fpercentage fof fpersons fwith fthe fgiven fcondition fwill fhave fan fabnormal fresult
C. Low flikelihood fof fnormal fresult fin fpersons fwithout fa fgiven fcondition
D. None fof fthe fabove
f 8. If fa fdiagnostic fstudyfhas fhigh fspecificity, f this findicates fa:
A. Low fpercentage fof fhealthyfindividuals fwill fshow fa fnormal fresult
B. High fpercentage fof fhealthy findividuals fwill fshow fa fnormal fresult
C. High fpercentage fof findividuals fwith fa fdisorder fwill fshow fa fnormal fresult
D. Low fpercentage fof findividuals fwith fa fdisorder fwill fshow fan fabnormal fresult
f 9. Aflikelihood f ratio fabove f1 findicates fthat fa fdiagnostic ftest fshowing fa:
A. Positive fresult fis fstronglyfassociated fwith fthe fdisease
B. Negative fresult fis fstrongly fassociated fwith fabsence fof fthe fdisease
C. Positive fresult fis fweakly fassociated fwith fthe fdisease
D. Negative fresult fis fweaklyfassociated fwith fabsence fof fthe fdisease
f 10. Which fof fthe ffollowing fclinical freasoning ftools fis fdefined fas fevidence-based fresource fbased fon fmathematical f modeling
to fexpress fthe flikelihood fof fa fcondition fin fselect fsituations, fsettings, fand/or fpatients?
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A. Clinical fpractice fguideline
B. Clinical fdecision frule
C. Clinical falgorithm
Chapter 1: Clinical reasoning, differential diagnosis, evidence-based practice, and symptom ana
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Answer Section
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MULTIPLE fCHOICE
1. ANS: B
Croskerry f(2009) fdescribes ftwo fmajor ftypes fof fclinical fdiagnostic fdecision-making: fintuitive fand fanalytical. fIntuitive fdecision-
fmaking f(similar fto fAugenblink fdecision-making) fis fbased fon fthe fexperience fand fintuition fof fthe fclinician fand fis fless freliable
fandfpaired fwith ffairly fcommon ferrors. fIn fcontrast, fanalytical fdecision-making fis fbased fon fcareful fconsideration fand fhas fgreater
freliability fwith frare ferrors.
PTS: 1
2. ANS: D
To fobtain fadequate fhistory, fproviders fmust fbe fwell forganized, fattentive fto fthe fpatient’s fverbal fand fnonverbal flanguage, fand fable
fto faccurately finterpret fthe fpatient’s fresponses fto fquestions. fRather fthan freading finto fthe fpatient’s fstatements, fthey fclarify fany
fareas fof funcertainty.
PTS: 1
3. ANS: C
Vital fsigns fare fpart fof fthe fphysical fexamination fportion fof fpatient fassessment, fnot fpart fof fthe fhealth fhistory.
PTS: 1
4. ANS: D
While fperforming fthe fphysical fexamination, fthe fexaminer fmust fbe fable fto fdifferentiate fbetween fnormal fand fabnormal ffindings,
frecall fknowledge fof fa frange fof fconditions, fincluding ftheir fassociated fsigns fand fsymptoms, frecognize fhow fcertain fconditions
faffectfthe fresponse fto fother f conditions, fand fdistinguish fthe frelevance f of fvaried fabnormal f findings.
PTS: 1
5. ANS: C
Sources ffor fdiagnostic fstatistics finclude ftextbooks, fprimary freports fof fresearch, fand fpublished fmeta-analyses. fAnother fsource fof
fstatistics, fthe fone fthat fhas fbeen f most fwidely fused fand favailable f for fapplication f to fthe freasoning fprocess, fis fthe festimation fbased fon
fa fprovider’s fexperience, falthough fthese fare frarely faccurate. fOver fthe fpast fdecade, fthe f availability fof fevidence fon fwhich fto fbase
fclinical freasoning fis fimproving, f and fthere fis fan fincreasing fexpectation f that fclinical freasoning fbe fbased f on fscientific fevidence.
Evidence-based fstatistics fare falso fincreasingly fbeing fused fto fdevelop fresources fto ffacilitate fclinical fdecision-making.
PTS: 1
6. ANS: D
To fassist fin fclinical fdecision-making, fa fnumber fof fevidence-based fresources fhave fbeen fdeveloped fto fassist fthe fclinician.
fResources, f such f as falgorithms fand f clinical fpractice fguidelines, fassist fin fclinical freasoning fwhen fproperly fapplied.
PTS: 1
7. ANS: A
The fsensitivity fof fa fdiagnostic fstudy fis fthe fpercentage fof findividuals fwith fthe ftarget fcondition fwho fshow fan fabnormal, for
fpositive,fresult. fA fhigh fsensitivity findicates fthat fa fgreater fpercentage fof fpersons f with fthe fgiven f condition f will fhave fan fabnormal
fresult.
PTS: 1
8. ANS: B
The fspecificity fof fa fdiagnostic fstudy fis fthe fpercentage fof fnormal, fhealthy findividuals fwho fhave fa fnormal fresult. fThe fgreater
fthefspecificity, fthe fgreater fthe fpercentage fof findividuals fwho fwill fhave fnegative, for fnormal, fresults fif fthey fdo fnot fhave fthe
ftarget fcondition.
PTS: 1
9. ANS: A
The flikelihood fratio fis fthe fprobability fthat fa fpositive ftest fresult fwill fbe fassociated fwith fa fperson fwho fhas fthe ftarget fcondition fand
fafnegative fresult fwill fbe fassociated fwith fa fhealthy fperson. fA flikelihood fratio fabove f1 findicates fthat fa f positive fresult fis fassociated
fwith fthe fdisease; fa flikelihood f ratio fless fthan f1 findicates fthat fa fnegative f result fis fassociated f with fan fabsence fof fthe fdisease.
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PTS: 1
10. ANS: B
Clinical fdecision f(or fprediction) frules fprovide fanother fsupport ffor fclinical freasoning. fClinical fdecision frules fare fevidence-
basedfresources fthat fprovide fprobabilistic fstatements fregarding fthe flikelihood fthat fa fcondition fexists fif fcertain fvariables fare fmet
fwith fregard fto fthe fprognosis fof fpatients fwith fspecific ffindings. fDecision frules fuse fmathematical fmodels fand fare fspecific fto
fcertain fsituations, fsettings, fand/or f patient fcharacteristics.
PTS: 1
