TEST BANK FOR ADVANCED
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ASSESSMENT:INTERPRETING FINDINGS
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AND FORMULATING DIFFERENTIAL
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DIAGNOSES 5TH EDITION, MARY JO
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GOOLSBY, LAURIE GRUBBS ISBN-10;
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1719645930 / ISBN-13;978-1719645935
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,Chapter 1. Assessment and
d d d Clinical d Decision-Making: Overview
Multiple Choice
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Identify the choice that best completes the statement or answers the question.
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d 1. Which type of clinical decision-making is most reliable?
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A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
d 2. Which of the following is false? To obtain adequate history, health-care providers must be:
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A. Methodical and systematic d d
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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d 3. Essential parts of a health history include all of the following except:
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A. Chief complaint d
B. History of the present illness d d d d
C. Current vital signs d d
D. All of the above are essential history components
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d 4. Which of the following is false? While performing the physical examination, the
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examinermust beable to:
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A. Differentiate between normal and abnormal findings d d d d d
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 d d
d 5. The following is the least reliable source of information for diagnostic statistics:
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A. Evidence-based investigations d
B. Primary reports of research d d d
C. Estimation based on a provider’s experience d d d d d
D. Published meta-analyses d
d 6. The following can be used to assist in sound clinical decision-making:
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A. Algorithm published in a peer-reviewed journal article d d d d d d
B. Clinical practice guidelines d d
C. Evidence-based research d
D. All of the above d d d
d 7. If d 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 aboved d d
,d 8. If d a diagnostic study has high specificity,
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A. Low percentage of healthy individuals
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B. High percentage of healthy individuals
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C. High percentage of individuals with a
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D. Low percentage of individuals with a
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d 9. A d likelihood ratio above 1 indicates that a diagnostic test showing a:
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A. Positive result is strongly associated with the disease
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B. Negative result is strongly associated with absence of the disease
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C. Positive result is weakly associated with the disease
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D. Negative result is weakly associated with absence of the disease
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d 10. Which of the following clinical reasoning tools is defined as evidence-based
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dresourcebased on mathematical modeling to express the likelihood of a condition in select
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situations, settings, and/orzpatients?
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A. Clinical practice guideline
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B. Clinical decision rule d d
C. Clinical algorithm d
D. Clinical recommendationd
, Answer Section
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MULTIPLE CHOICE d
1. ANS: B
Croskerry (2009) describes two major types of clinical diagnostic decision-making:
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intuitiveand analytical. Intuitive decision-making (similar to Augenblink decision-making)
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is based on the experience and intuition of the clinician and is less reliable and paired with
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fairlycommon errors. In contrast, analytical decision-making is based on careful
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consideration and has greater reliabilitywith rare errors.
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PTS: 1
2. ANS: D
To obtain adequate history, providers must be well organized, attentive to the patient’s verbal
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andnonverbal language, and able to accurately interpret the patient’s responses to questions.
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Rather than reading into the patient’s statements, they clarify any areas of uncertainty.
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PTS: 1
3. ANS: C
Vital signs are part of the physical examination portion of patient assessment, not part of
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thehealthhistory.
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PTS: 1
4. ANS: D
While performing the physical examination, the examiner must be able to differentiate
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betweennormal and abnormal findings, recall knowledge of a range of conditions,
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includingtheir associated signs and symptoms, recognize how certain conditions affect
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the response to other conditions, and distinguish the relevance of varied abnormal
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findings.
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PTS: 1
5. ANS: C
Sources for diagnostic statistics include textbooks, primary reports of research, and
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published meta-analyses. Another source of statistics, the one that has been most
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dwidely used and available for application to the reasoning process, is the estimation based on a
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provider’s experience, although these are rarely accurate. Over the past decade, the
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availability of evidence on which to base clinical reasoning is improving, and there
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dis an increasing expectation that clinical reasoningbe based on scientific evidence.
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dEvidence- based statistics are also increasingly being used to develop resources to facilitate
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clinical decision-making.
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PTS: 1
6. ANS: D
To assist in clinical decision-making, a number of evidence-based resources have
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beendevelopedto assist the clinician. Resources, such as algorithms and clinical practice
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guidelines, assist in clinical reasoning when properly applied.
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