Deck 25: Taking the Next Steps: Critical Thinking

Question 1

Self-analysis assists providers in giving proper context to:

A) history and physical findings.
B) therapeutic options.
C) attitudes, values, and feelings.
D) differential diagnoses.

Answer 1

attitudes, values, and feelings.

Question 2

The likelihood of your diagnosis being related to your findings is dependent on:

A) the number and magnitude of the presenting problems.
B) the prevalence of both in the particular population.
C) your ability to validate your first impression.
D) your experience with the particular condition.

Answer 2

the prevalence of both in the particular population.

Question 3

When evaluating results of laboratory tests, a test that is highly sensitive implies that the test:

A) suggests that a disease is present when it actually is not.
B) is able to confirm a diagnosis, even when disease is not present.
C) suggests that a disease is absent when it is absent.
D) is able to identify the disease being tested correctly.

Answer 3

is able to identify the disease being tested correctly.

Question 4

The adage that "common problems occur commonly" advises the practitioner to:

A) always diagnose the patient's problem in terms of what their practice usually sees.
B) refer any uncommon complaints to specialists as soon as possible.
C) consider the most likely cause of the patient's problem before considering the obscure.
D) examine uncommon problems critically before assuming that the issue is an unusual presentation of a common problem.

Question 5

Which of the following statements represents a valid threat posed by computers in patient care areas?

A) Computers pose a serious threat to confidentiality.
B) Computers increase the cost of the care of each visit.
C) Computer software cannot increase productivity.
D) Computers emit hazardous electromagnetic radiation.

Question 6

Positive outcomes depend on the:

A) number of laboratory tests ordered.
B) quality of decisions made.
C) use of pharmacologic modalities.
D) time saved by the use of ancillary personnel.

Question 7

To limit uncertainty in diagnostic decision making, the ratio of fact to conjecture must be:

A) positive.
B) negative.
C) negligible.
D) inverse.

Question 8

The most important guide to sequencing actions should be:

A) probability and utility.
B) assumption and intuition.
C) costs and risks of procedures.
D) reimbursement potential and patient acceptance.

Question 9

Mr. Johnson actually has streptococcal pharyngitis; however, the throat culture is initially read as negative. This situation describes a test with a:

A) low sensitivity.
B) high sensitivity.
C) high specificity.
D) low specificity.

Question 10

Which of the following is an accepted method of making a diagnosis?

A) Relying on intuition
B) Making maximal use of laboratory tests
C) Using first assumptions
D) Using algorithms

Question 11

New findings of unknown causes are:

A) problems to be noted on the problem list.
B) deferred for subsequent visits.
C) diagnosed before physical examination.
D) reserved for specialists.

Question 12

Medical decision making requires a balance between:

A) trust and suspicion.
B) ethical and unethical behavior.
C) remembering and superstition.
D) mechanism and probability.

Question 13

A specific test is one that has the ability to:

A) correctly identify those who have the disease.
B) correctly identify those who do not have the disease.
C) be exclusively used to make a diagnosis.
D) exclude competing explanations for another test finding.

Question 14

In practice, the use of evidence:

A) disciplines intuitive responses.
B) replaces intuitive responses.
C) makes intuitive responses inconsequential.
D) affirms intuitive responses.

Question 15

After the subjective and objective data have been prioritized, the next step is to:

A) order laboratory tests.
B) formulate a problem list.
C) initiate appropriate referrals.
D) initiate therapy.

Question 16

Which of the following is true regarding the clinical use of computers?

A) It can be a useful substitute for critical thinking.
B) It can remind us about unrecognized possibilities in diagnosis.
C) It helps protect against breached confidentiality.
D) It allows for the detection of human subtleties.

Question 17

LG, age 58 years, has a chief complaint of diffuse, crampy abdominal pain, which has progressed to a severity scale of 7 of 10. He is afebrile and denies nausea, vomiting and diarrhea. Family history is positive for intestinal polyps, diabetes mellitus, and Alzheimer disease. His past medical history is positive for kidney stones, gastroesophageal reflux disease, and hypercholesterolemia. The physical examination is positive for guarding and tenderness in the epigastric region but is otherwise normal. In an effort to confirm your hypothesis, you should schedule a(n):

A) electrocardiogram, because you think he has referred cardiac pain.
B) colonoscopy, because you think he has diverticulitis.
C) flat and erect abdominal x-ray study, because you think he has a perforated peptic ulcer.
D) glucose tolerance test, because you think he has diabetes-related gastroparesis.

Question 18

A valid history and physical examination can serve to:

A) create higher health care costs.
B) limit the indiscriminate use of diagnostics.
C) threaten patient satisfaction.
D) increase the risk of liability.

Question 19

The use of computers in health care is:

A) an appropriate substitute for critical thinking.
B) nonthreatening.
C) helpful for recording and providing information.
D) a substitute for patient-provider interaction.

Question 20

Examiner experience should result in:

A) the ability to analyze data with more confidence.
B) reliance on intuition.
C) an ability to order more laboratory tests.
D) the need to spend more time with patients.

Question 21

In setting priorities for the evaluation and management plan, which of the following should be included?

A) Consultations
B) Laboratory studies
C) Patient transportation
D) Occam's razor
E) Medications

Question 22

The proportion of persons with an observation characteristic of a disease who have the disease is known as the ____________ value.

Question 23

When determining actions for the management plan, the practitioner should first address:

A) problems in the order of their chronologic development.
B) the patient's concern about a particular problem.
C) the patient's social and economic circumstances.
D) the most urgent problem.

Question 24

The ability of an observation to identify correctly those who have the disease is called ____________.

Question 25

Which of the following is not a component of a management plan?

A) Presumptive diagnosis
B) Referral for a surgical procedure
C) Diet modification
D) Physical therapy