Deck 4: Clinical Reasoning

Question 1

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.

Answer 1

low sensitivity.

Question 2

A valid history and physical examination can serve to:

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

Answer 2

limit the indiscriminate use of diagnostics.

Question 3

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.

Answer 3

correctly identify those who do not have the disease.

Question 4

Which 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 5

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) not consider more than one diagnosis unless necessary.
D) examine uncommon problems critically before assuming that the issue is an unusual presentation of a common problem.

Question 6

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 7

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 8

Medical decision making requires a balance between:

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

Question 9

When utilizing a joint approach with the patient, which factors are likely to be considered? (Select all that apply.)

A) Consultations
B) Laboratory studies
C) Assistive technology
D) Patient education
E) Practitioner background

Question 10

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.

Question 11

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 12

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 13

Utilitarianism can be described as:

A) balancing interests.
B) preventing harm.
C) choosing wisely.
D) doing good.

Question 14

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 15

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

A) Presumptive diagnosis
B) Patient education
C) Diet modification
D) Physical therapy