NR511 Midterm COMPREHENSIVE QUESTIONS AND
VERIFIED ANSWERS (DETAILED & ELABORATED)
ACTUAL EXAM 2025 TEST 100% SOLVED 2025!!
Define diagnostic reasoning - (ANSWER)Reflective thinking because the process
involves questioning one's thinking to determine if all possible avenues have been
explored and if the conclusions that are being drawn are based on evidence.
Seen as a kind of critical thinking.
What is subjective data? - (ANSWER)Anything the patient tells you or complains
of regarding their symptoms
Chief complaint
HPI
ROS
What is objective data? - (ANSWER)Anything YOU can see, touch, feel, hear, or
smell as part of your exam
Includes lab data, diagnostic test results, etc.
Identify components of HPI - (ANSWER)Specifically related to the chief complaint
only
,Detailed breakdown of CC
OLDCARTS
Describe the differences between medical billing and medical coding. -
(ANSWER)Medical billing: process of submitting and following up on claims made
to a payer in order to receive payment for medical services rendered by a
healthcare provider
Medical coding: the use of codes to communicate with payers about which
procedures were performed and why.
Compare and contrast the two coding classification systems that are currently
used in the US healthcare system. - (ANSWER)ICD: International classification of
disease codes are used to provide payer info on necessity of visit or procedure
performed. Shorthand for pt's dx.
CPT: common procedural terminology codes offer the official procedural coding
rules and guidelines required when reporting medical services and procedures
performed by physician and non-physician providers. Must have corresponding
ICD.
How do specificity, sensitivity, and predictive value contribute to the usefulness of
diagnostic data? - (ANSWER)Specificity: ability of a test to correctly detect a
specific condition. If a pt has a condition but test is negative, it is a false negative.
If pt does NOT have condition but test is positive, it is false positive.
,Sensitivity: test that has few false negatives. Ability of a test to correctly identify a
specific condition when it is present. The higher the sensitivity, the lesser the
likelihood of a false negative.
Predictive value: The likelihood that the pt actually has the condition and is, in
part, dependent upon the prevalence of the condition in the population. If a
condition is highly likely, the positive result would be more accurate.
Diagnostic tests can be used to confirm or rule out hypotheses.
Diagnostic tests may be used to screen for conditions.
Diagnostic tests may be used to monitor the progress in managing a chronic
condition.
Discuss the elements that need to be considered when developing a plan. -
(ANSWER)Pt's preferences and actions
Research evidence
Clinical state/circumstances
Clinical expertise
Describe the components of medical decision making in E&M coding. -
(ANSWER)Risk, data, diagnosis
, The more time and consideration involved in dealing with a pt, the higher the
reimbursement from the payer.
Documentation must reflect MDM
Correctly order the E&M office visit codes based on complexity from least to most
complex. - (ANSWER)New pt:
1. Minimal/RN visit: 99201
2. Problem focused: 99202
3. Expanded problem focused: 99203
4. Detailed: 99204
5. Comprehensive: 99205
Established pt:
1. Minimal/RN visit: 99211
2. Problem focused: 99212
3. Expanded problem focused: 99213
4. Detailed: 99214
5. Comprehensive: 99215
The 5 key components of a comprehensive treatment plan are: - (ANSWER)1.
Diagnostics
VERIFIED ANSWERS (DETAILED & ELABORATED)
ACTUAL EXAM 2025 TEST 100% SOLVED 2025!!
Define diagnostic reasoning - (ANSWER)Reflective thinking because the process
involves questioning one's thinking to determine if all possible avenues have been
explored and if the conclusions that are being drawn are based on evidence.
Seen as a kind of critical thinking.
What is subjective data? - (ANSWER)Anything the patient tells you or complains
of regarding their symptoms
Chief complaint
HPI
ROS
What is objective data? - (ANSWER)Anything YOU can see, touch, feel, hear, or
smell as part of your exam
Includes lab data, diagnostic test results, etc.
Identify components of HPI - (ANSWER)Specifically related to the chief complaint
only
,Detailed breakdown of CC
OLDCARTS
Describe the differences between medical billing and medical coding. -
(ANSWER)Medical billing: process of submitting and following up on claims made
to a payer in order to receive payment for medical services rendered by a
healthcare provider
Medical coding: the use of codes to communicate with payers about which
procedures were performed and why.
Compare and contrast the two coding classification systems that are currently
used in the US healthcare system. - (ANSWER)ICD: International classification of
disease codes are used to provide payer info on necessity of visit or procedure
performed. Shorthand for pt's dx.
CPT: common procedural terminology codes offer the official procedural coding
rules and guidelines required when reporting medical services and procedures
performed by physician and non-physician providers. Must have corresponding
ICD.
How do specificity, sensitivity, and predictive value contribute to the usefulness of
diagnostic data? - (ANSWER)Specificity: ability of a test to correctly detect a
specific condition. If a pt has a condition but test is negative, it is a false negative.
If pt does NOT have condition but test is positive, it is false positive.
,Sensitivity: test that has few false negatives. Ability of a test to correctly identify a
specific condition when it is present. The higher the sensitivity, the lesser the
likelihood of a false negative.
Predictive value: The likelihood that the pt actually has the condition and is, in
part, dependent upon the prevalence of the condition in the population. If a
condition is highly likely, the positive result would be more accurate.
Diagnostic tests can be used to confirm or rule out hypotheses.
Diagnostic tests may be used to screen for conditions.
Diagnostic tests may be used to monitor the progress in managing a chronic
condition.
Discuss the elements that need to be considered when developing a plan. -
(ANSWER)Pt's preferences and actions
Research evidence
Clinical state/circumstances
Clinical expertise
Describe the components of medical decision making in E&M coding. -
(ANSWER)Risk, data, diagnosis
, The more time and consideration involved in dealing with a pt, the higher the
reimbursement from the payer.
Documentation must reflect MDM
Correctly order the E&M office visit codes based on complexity from least to most
complex. - (ANSWER)New pt:
1. Minimal/RN visit: 99201
2. Problem focused: 99202
3. Expanded problem focused: 99203
4. Detailed: 99204
5. Comprehensive: 99205
Established pt:
1. Minimal/RN visit: 99211
2. Problem focused: 99212
3. Expanded problem focused: 99213
4. Detailed: 99214
5. Comprehensive: 99215
The 5 key components of a comprehensive treatment plan are: - (ANSWER)1.
Diagnostics
