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Advanced Health Assessment and Clinical Diagnosis in Primary Care
Test Bank For Advanced Health Assessment & Clinical Diagnosis in Primary Care 5th Edition by Joyce E. Dains; Linda Ciofu Baumann; Pamela Scheibel 6253, 8, 7280, 4 1: Clinical reasoning, differential diagnosis, evidence-based practice, and symptom analysis 2: Evidence-based health screening 3: Abdom...
TEST BANK ADVANCED HEALTH ASSESSMENT & CLINICAL DIAGNOSIS IN PRIMARY CARE, 6TH EDITION Joyce E. Dains, Linda Ciofu Baumann & Pamela Scheibel 2024-2025
JARVIS Health Assessment practice questions: Chapters 1, 4, and 8 Exam With Verified Solutions 2024/2025.
Health Assessment Mental/ Neuro (Ch. 5&22) Test Bank Exam 2024/2025 Questions With Completed & Verified Solutions.
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Advanced Health Assessment & Clinical Diagnosis in Primary Care 6th Edition
Dains Test Bank
Chapter 1: Clinical reasoning, differential diagnosis, science-based practice, and symptom ana
Multiple response
Identify the response that best completes the statement or Answerwers the question.
1. Which type of clinical decision-making is most reliable?
A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
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 components 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. science-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. science-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
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
9. A likelihood ratio above 1 indicates that a diagnostic test showing a:
A. Positive result is strongly associated with the disease
B. Negative result is strongly associated with absence of the disease
C. Positive result is weakly associated with the disease
D. Negative result is weakly associated with absence of the disease
10. Which of the following clinical reasoning tools is defined as science-based resource based on mathematical modeling
to express the likelihood of a condition in select situations, settings, and/or patients?
, A. Clinical practice guideline
B. Clinical decision rule
C. Clinical algorithm
Chapter 1: Clinical reasoning, differential diagnosis, science-based practice, and symptom ana
Answerwer Section
MULTIPLE response
1. Answer: B
Croskerry (2009) describes two major types of clinical diagnostic decision-making: intuitive and analytical. Intuitive decision-
making (similar to Augenblink decision-making) is based on the experience and intuition of the clinician and is less reliable and
paired with fairly common errors. In contrast, analytical decision-making is based on careful consideration and has greater
reliability with rare errors.
PTS: 1
2. Answer: D
To obtain adequate history, providers must be well organized, attentive to the patient’s verbal and nonverbal language, and able
to accurately interpret the patient’s responses to questions. Rather than reading into the patient’s statements, they clarify any
areas of uncertainty.
PTS: 1
3. Answer: C
Vital signs are part of the physical examination portion of patient assessment, not part of the health history.
PTS: 1
4. Answer: 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. Answer: 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.
science-based statistics are also increasingly being used to develop resources to facilitate clinical decision-making.
PTS: 1
6. Answer: D
To assist in clinical decision-making, a number of science-based resources have been developed to assist the clinician. Resources,
such as algorithms and clinical practice guidelines, assist in clinical reasoning when properly applied.
PTS: 1
7. Answer: A
The sensitivity of a diagnostic study is the percentage of individuals with the target condition who 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.
PTS: 1
8. Answer: B
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 negative, or normal, results if they do not have the target
condition.
PTS: 1
9. Answer: A
The likelihood ratio is the probability that a positive test result will be associated with a person who has the target condition and a
negative result will be associated with a healthy person. A 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.
, PTS: 1
10. Answer: B
Clinical decision (or prediction) rules provide another support for clinical reasoning. Clinical decision rules are science-based
resources that provide probabilistic statements regarding the likelihood that a condition exists if certain variables are met with
regard to the prognosis of patients with specific findings. Decision rules use mathematical models and are specific to certain
situations, settings, and/or patient characteristics.
PTS: 1
Chapter 2. science-based health screening
Multiple response
Identify the response that best completes the statement or Answerwers the question.
1. The first step in the genomic assessment of a patient is obtaining information regarding:
A. Family history
B. Environmental exposures
C. Lifestyle and behaviors
D. Current medications
2. An affected individual who manifests symptoms of a particular condition through whom a family with a genetic
disorder is ascertained is called a(n):
A. Consultand
B. Consulband
C. Index patient
D. Proband
3. An autosomal dominant disorder involves the:
A. X chromosome
B. Y chromosome
C. Mitochondrial DNA
D. Non-sex chromosomes
4. To illustrate a union between two second cousin family members in a pedigree, draw:
A. Arrows pointing to the man and feman
B. Brackets around the man and feman
C. Double horizontal lines between the man and feman
D. Circles around the man and feman
5. To illustrate two family members in an adoptive relationship in a pedigree:
A. Arrows are drawn pointing to the man and feman
B. Brackets are drawn around the man and feman
C. Double horizontal lines are drawn between the man and feman
D. Circles are drawn around the man and feman
6. When accessing the pedigree for autosomal dominant disorders, it is common to see:
A. Several generations of affected members
B. several consanguineous relationships
C. More members of the maternal lineage affected than paternal
D. More members of the paternal lineage affected than maternal
7. In autosomal recessive (AR) disorders, individuals need:
A. Only one mutated gene on the sex chromosomes to acquire the disease
B. Only one mutated gene to acquire the disease
C. Two mutated genes to acquire the disease
D. Two mutated genes to become carriers
8. In autosomal recessive disorders, carriers have:
A. Two mutated genes; one from each parent that cause disease
B. A mutation on a sex chromosome that causes a disease
C. A single gene mutation that causes the disease
D. One copy of a gene mutation but not the disease
9. With an autosomal recessive disorder, it is important that parents understand that if they both carry a mutation, the
following are the risks to each of their offspring (each pregnancy):
A. 50% chance that offspring will carry the disease
B. 10% chance of offspring affected by disease
, C. 25% chance children will carry the disease
D. 10% chance children will be disease free
10. A woman with an X-linked dominant disorder will:
A. Not be affected by the disorder herself
B. TrAnswermit the disorder to 50 % of her offspring (man or
feman)
C. Not trAnswermit the disorder to her daughters
D. TrAnswermit the disorder to only her daughters
11. In creating your feman patient’s pedigree, you note that she and both of her sisters were affected by the same genetic
disorder. Although neither of her parents had indications of the disorder, her paternal grandmother and her paternal
grandmother’s two sisters were affected by the same condition. This pattern suggests:
A. Autosomal dominant disorder
B. Chromosomal disorder
C. Mitochondrial DNA disorder
D. X-linked dominant disorder
12. A woman affected with an X-linked recessive disorder:
A. Has one X chromosome affected by the mutation
B. Will trAnswermit the disorder to all of her children
C. Will trAnswermit the disorder to all of her sons
D. Will not trAnswermit the mutation to any of her
daughters
13. Which of the following are found in an individual with aneuploidy?
A. An abnormal number of chromosomes
B. An X-linked disorder
C. Select cells containing abnormal-appearing chromosomes
D. An autosomal recessive disorder
14. The pedigree of a family with a mitochondrial DNA disorder is unique in that:
A. None of the feman offspring will have the disease
B. All offspring from an affected feman will have disease
C. None of the offspring of an affected feman will have the disease
D. All the offspring from an affected man will have disease
15. Which population is at highest risk for the occurrence of aneuploidy in offspring?
A. Mothers younger than 18
B. Fathers younger than 18
C. Mothers over age 35
D. Fathers over age 35
16. Approximately what percentage of cancers is due to a single-gene mutation?
A. 50% to 70%
B. 30% to 40%
C. 20% to 25%
D. 5% to 10%
17. According to the Genetic Information Nondiscrimination Act (GINA):
A. NPs should keep all genetic information of patients confidential
B. NPs must obtain informed consent prior to genetic testing of all patients
C. Employers cannot inquire about an employee’s genetic information
D. All of the above
18. The leading causes of death in the United States are due to:
A. Multifactorial inheritance
B. Single gene mutations
C. X-linked disorders
D. Aneuploidy
19. Which of the following would be considered a “red flag” that requires more investigation in a patient assessment?
A. Colon cancer in family member at age 70
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