Test Bank For Advanced Health Assessment and Clinical Diagnosis in Primary Care, 6th Edition

Name: Test Bank For Advanced Health Assessment and Clinical Diagnosis in Primary Care, 6th Edition
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Author: Daniel Kim

Make the most of your study time with Test Bank For Advanced Health Assessment and Clinical Diagnosis in Primary Care, 6th Edition, an exam guide designed to enhance retention and recall.

Daniel Kim

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Chapter 1 Clinical Reasoning, Differential Diagnosis, Evidence-Based Practice, and Symptom Analysis
Multiple Choice
Identify the choice that best completes the statement or answers 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
C
D
Attentive to the patient’s verbal and nonverbal language Able to
accurately interpret the patient’s responses Adept at reading into the
patient’s statements
____ 3. Essential parts 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
C
Recall knowledge of a range of conditions and their associated signs and symptoms 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 Evidence-based investigations
B Primary reports of research
C Estimation based on a provider’s experience
D Published meta-analyses
____ 6.
A
The following can be used to assist in sound clinical decision-making: Algorithm
published in a peer-reviewed journal article
B Clinical practice guidelines
C Evidence-based research
D All of the above
____ 7. If a diagnostic study has high sensitivity, this indicates a:
A
B
C
High percentage of persons with the given condition will have an abnormal result
Low percentage of persons with the given condition will have an abnormal result 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
C
D
High percentage of healthy individuals will show a normal result
High percentage of individuals with a disorder will show a normal result
Low percentage of individuals with a disorder will show an abnormal result
____ 9.
A
B
C
D
A likelihood ratio above 1 indicates that a diagnostic test showing a: Positive result is strongly associated with the
disease
Negative result is strongly associated with absence of the disease Positive result is weakly associated with the disease
Negative result is weakly associated with absence of the disease
____ 10. Which of the following clinical reasoning tools is defined as evidence-based resource based on mathematical
modeling to express the likelihood of a condition in select situations, settings, and/or patients?
A
B
Clinical practice guideline
Clinical decision rule
C Clinical algorithm
Answer Section
MULTIPLE CHOICE
1. ANS: 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.
2. ANS: 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.
3. ANS: C
Vital signs are part of the physical examination portion of patient assessment, not part of the health history.
4. ANS: 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.
5. ANS: 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. Evidence-based statistics are also increasingly being used to develop resources to facilitate clinical
decision-making.
6. ANS: D
To assist in clinical decision-making, a number of evidence-based resources have been developed to assist the clinician.
Resources, such as algorithms and clinical practice guidelines, assist in clinical reasoning when properly applied.
7. ANS: 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.
8. ANS: 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.
9. ANS: 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.
10. ANS: B
Clinical decision (or prediction) rules provide another support for clinical reasoning. Clinical decision rules are
evidence-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.

____
Chapter 2 Evidence-Based Health Screening
Multiple Choice
Identify the choice that best completes the statement or answers the question.
1. The first step in the genomic assessment of a patient is obtaining information regarding:
A Family history
B
C
D
Environmental exposures
Lifestyle and behaviors
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
C
Consulband
Index patient
D Proband
____ 3. An autosomal dominant disorder involves the:
A X chromosome
B Y chromosome
C
D
Mitochondrial DNA Non-
sex chromosomes
____ 4. To illustrate a union between two second cousin family members in a pedigree, draw:
A Arrows pointing to the male and female
B Brackets around the male and female
C Double horizontal lines between the male and female
D Circles around the male and female
____ 5.
A
To illustrate two family members in an adoptive relationship in a pedigree: Arrows are
drawn pointing to the male and female
B Brackets are drawn around the male and female
C Double horizontal lines are drawn between the male and female
D Circles are drawn around the male and female
____ 6. When analyzing the pedigree for autosomal dominant disorders, it is common to see:
A Several generations of affected members
B Many consanguineous relationships
C
D
More members of the maternal lineage affected than paternal More
members of the paternal lineage affected than maternal
____ 7.
A
In autosomal recessive (AR) disorders, individuals need:
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

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