Question 1

A likelihood ratio above 1 indicates that a diagnostic test showing a:&#10;A) Positive result is strongly associated with the disease&#10;B) Negative result is strongly associated with absence of the disease&#10;C) Positive result is weakly associated with the disease&#10;D) Negative result is weakly associated with absence of the disease

Accepted Answer

A likelihood ratio above 1 indicates that a positive result is more likely in individuals with the disease than in those without it, which means that a positive result is strongly associated with the disease. A likelihood ratio below 1 indicates that a negative result is more likely in individuals without the disease than in those with it, which means that a negative result is strongly associated with the absence of the disease. Therefore, option A is the only correct choice.

Question 2

If a diagnostic study has high sensitivity,this indicates a:&#10;A) High percentage of persons with the given condition will have an abnormal result&#10;B) Low percentage of persons with the given condition will have an abnormal result&#10;C) Low likelihood of normal result in persons without a given condition&#10;D) None of the above

Accepted Answer

High sensitivity indicates that the test can correctly identify a high percentage of individuals with the given condition, meaning that a high percentage of persons with the condition will have an abnormal result.

Question 3

The following can be used to assist in sound clinical decision-making:&#10;A) Algorithm published in a peer-reviewed journal article&#10;B) Clinical practice guidelines&#10;C) Evidence-based research&#10;D) All of the above

Accepted Answer

All three options are relevant and useful tools in making sound clinical decisions. Algorithms published in peer-reviewed articles can provide step-by-step guidance on diagnosis and treatment based on current evidence. Clinical practice guidelines offer recommendations based on expert consensus and research evidence, and can be especially helpful for complex or uncommon conditions. Evidence-based research explores the efficacy and safety of various treatments, and can provide critical information for decision-making. Using all three resources together allows for a comprehensive and evidence-based approach to clinical decision-making.

Question 4

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) Clinical practice guideline
B) Clinical decision rule
C) Clinical algorithm
D) Clinical recommendation

Accepted Answer

Clinical decision rules use mathematical modeling to determine the likelihood of a condition in specific situations, settings or patients. Clinical practice guidelines provide recommendations for healthcare providers based on a systematic review of the literature. Clinical algorithms provide a step-by-step approach to decision-making for a specific disease or condition. Clinical recommendations are expert opinions or suggestions for clinical practice based on the best available evidence.

Question 5

Essential parts of a health history include all of the following except:&#10;A) Chief complaint&#10;B) History of the present illness&#10;C) Current vital signs&#10;D) All of the above are essential history components

Accepted Answer

While current vital signs are important, they are not considered an essential component of a health history. Chief complaint and history of present illness are critical components of the health history as they provide information on the reason for seeking care and the patient's symptoms. Other essential components include past medical history, family history, social history, and review of systems.

Question 6

Which type of clinical decision-making is most reliable?&#10;A) Intuitive&#10;B) Analytical&#10;C) Experiential&#10;D) Augenblick

Accepted Answer

Analytical decision-making relies on objective data and evidence-based practice, making it the most reliable type of clinical decision-making. Intuitive decision-making relies on personal feelings and emotions, while experiential decision-making relies on past experiences, both of which may not always be accurate or relevant. Augenblick decision-making is more of a quick gut feeling or snap judgement, which is not always reliable in a clinical setting.

Question 7

Which of the following is false? To obtain adequate history,health-care providers must be:&#10;A) Methodical and systematic&#10;B) Attentive to the patient's verbal and nonverbal language&#10;C) Able to accurately interpret the patient's responses&#10;D) Adept at reading into the patient's statements

Accepted Answer

Healthcare providers should not be adept at reading into the patient's statements as this can lead to assumptions or biases. Instead, they should focus on actively listening and asking open-ended questions to allow the patient to fully express their concerns and experiences.

Question 8

If a diagnostic study has high specificity,this indicates a:&#10;A) Low percentage of healthy individuals will show a normal result&#10;B) High percentage of healthy individuals will show a normal result&#10;C) High percentage of individuals with a disorder will show a normal result&#10;D) Low percentage of individuals with a disorder will show an abnormal result

Accepted Answer

Specificity refers to the ability of a diagnostic test to correctly identify individuals without the condition being tested for (i.e. true negatives). A high specificity means that the test is unlikely to produce false positives and has a high proportion of healthy individuals showing a normal result. Therefore, B is the best choice as it correctly indicates that a high percentage of healthy individuals will show a normal result.

Question 9

The following is the least reliable source of information for diagnostic statistics:&#10;A) Evidence-based investigations&#10;B) Primary reports of research&#10;C) Estimation based on a provider's experience&#10;D) Published meta-analyses

Accepted Answer

Estimation based on a provider's experience is the least reliable source of information as it is subjective and may vary between providers. Evidence-based investigations, primary reports of research, and published meta-analyses are more reliable sources as they are based on objective data and scientific research.

Question 10

Which of the following is false? While performing the physical examination,the examiner must be able to:&#10;A) Differentiate between normal and abnormal findings&#10;B) Recall knowledge of a range of conditions and their associated signs and symptoms&#10;C) Recognize how certain conditions affect the response to other conditions&#10;D) Foresee unpredictable findings

Accepted Answer

It is not possible to foresee unpredictable findings during a physical examination as they are unexpected and cannot be predicted beforehand. The other options are true and important skills for a competent examiner.

Deck 1: Assessment and Clinical Decision-Making: Overview