INSTRUCTIONS The importance of the history and physical in diagnosis
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- Registration deadline is April 30, 2016.
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The importance of the history and physical in diagnosis
General Purpose: To identify the importance of the patient history and physical in selecting diagnostic testing and in reaching an accurate diagnosis. Learning Objectives: After reading this article and taking the test, you should be able to: 1. Describe common pitfalls in the clinical evaluation process. 2. Identify strategies for increasing the accuracy and reducing the cost of diagnosis.
- The author asserts that broad testing strategies
- are increasingly important as visit times become shorter.
- are vital for confirmation of diagnoses.
- may provide less information than the history and physical.
- are important to reduce healthcare costs.
- Which patient issue often complicates the clinician visit?
- rising healthcare costs
- bringing multiple concerns
- shorter visit times
- greater volume of visits
- In the clinical evaluation process, which is the first step to an accurate diagnosis?
- advanced physical exam skills
- scheduling longer visit times
- refining the art of the history
- requiring patients to complete detailed history forms
- Which approach will best help the provider determine the cause of a patient's dizziness?
- reviewing the detailed history form
- asking if he or she feels faint or anxious
- asking the family about unsteady gait or behavioral changes
- asking the patient to describe what he or she means by “dizzy”
- Which statement about comprehensive history taking is not accurate?
- It will elicit the correct diagnosis less than 50% of the time.
- It may be more efficient than ordering diagnostic studies.
- It is a reliable diagnostic tool.
- It requires the clinician to listen to the patient.
- Research by Beckman and Frankel demonstrated that patients and providers may not agree on the purpose of the visit because of
- incomplete information on the previsit survey form.
- family members' input to the provider contradicting the patient's.
- providers interrupting patients.
- patient unwillingness to disclose the real reason for the visit.
- Asking the patient whether there is something else they want to address in the visit would
- best be done at the end of the visit.
- increase the length of the visit.
- eliminate all unmet concerns.
- help to construct an appointment agenda.
- One approach to help elicit the patient's concerns is to
- have the patient complete an extensive health history form.
- extend the length of the visit.
- ask an open-ended question.
- involve a family member during the visit.
- The best reason for conducting a thorough physical exam is to
- reduce the number of diagnostic tests.
- reach an accurate diagnosis faster.
- reduce the list of potential diagnoses.
- confirm the patient history.
- Ordering too many diagnostic tests is a stressor to providers and patients when they result in
- large medical bills.
- lab results not supporting the provisional diagnosis.
- unexpected positive findings that cannot be ignored.
- test results all being normal.
- Which statement relating to diagnostic accuracy is supported by the literature?
- Diagnostic studies should not be used to rule out a diagnosis.
- Basing diagnostic studies on the history and physical is cost-effective.
- An accurate diagnosis can be confirmed only by diagnostic testing.
- Diagnostic testing results always support a thorough history and physical.
- When providers rely on imaging scans rather than their exam skills to make a diagnosis, they
- risk losing physical exam skills.
- increase diagnostic accuracy.
- detect pivotal physical signs more accurately.
- save time and reduce costs.
- Evidence-based practice studies have shown that
- physical exam skills are ineffective in preventing disease.
- eliminating annual physical exams is important only in young adults.
- diseases can be detected best with diagnostic testing.
- certain physical signs are unreliable.
- The Top 5 list consists of
- the most commonly ordered tests.
- a list of procedures to avoid.
- the most common patient complaints.
- the most commonly missed diagnoses.
- What is the first step in helping patients become active participants in their own care?
- discussing recommended interventions with the patients
- sharing information with patients
- involving patients in decision making about diagnostic tests
- eliciting a comprehensive patient history