2026 SCRIBEAMERICA OP QUESTIONS AND
ANSWERS SURE A+
✔✔Determine which structure best fits the following Assessment.
"Patient is a 34 y/o female with Acute Pharyngitis. Post nasal drip on exam with no
visible signs of tonsilar exudate. Rapid strep negative." - ✔✔Brief summary
✔✔You see the physician check the patient's pulses in four places; the right wrist, the
top of the right foot, the back of the right foot and the left neck. The doctor states "The
pulses are fine". Match the location with the appropriate pulse that you would document
in the physical exam? - ✔✔- wrist
2+ radial pulse
- top of foot
2+ DP pulse
- neck
2+ carotid pulse
- back of foot
2+ PT pulse
✔✔What condition correctly describes "A blood clot in the extremities"? (HINT: Use the
abbreviation form of the condition) - ✔✔DVT
, ✔✔1) ICD code
2) E&M code
3) HCC code - ✔✔1) codes for diagnosis
2) codes for reimbursement
3) code for risk
✔✔* Determine which structure best fits the following Assessment.
"Patient is a 56 y/o male with CRF first diagnosed 3 years ago in acute exacerbation
today. He reports decreased urinary output that has progressively worsened since onset
5 days ago. Creatinine and BUN elevated and worsening compared to last visit 3 weeks
ago. Patient recommended emergency dialysis today and warned that he may be at risk
for death and other complications if he does not seek further urgent medical attention.
Patient understands and agrees to be transferred to the ED." - ✔✔Comprehensive
summary
✔✔What FHx/SHx information is usually asked for pediatric patients? (Select all that
apply) - ✔✔- Second hand smoke exposure
- Immunization status
✔✔What is the medical term for "pass-out"? - ✔✔Syncope
✔✔Which symptom(s) would a patient most likely present with if they had HLD? (Select
all that apply - ✔✔Asymptomatic
✔✔T/F. Scribes should complete all charts by entering a scribe attestation before
leaving the shift. - ✔✔T
✔✔A 45 year old male presents to the clinic with a constant, ripping, tearing pain to his
central chest radiating straight to his back with associated nausea that began 1 hour
ago. He denies any accompanying dyspnea or diaphoresis. What elements are
missing? - ✔✔- Severity
- Modifying factor
- Relevant context
✔✔A female patient underwent surgery to have her ovary removed. What PSHx would
you record into the chart? (Remember, do not include any spaces before or after the
term/phrase.) - ✔✔oopherectomy
✔✔A patient comes into the clinic for a well woman exam. What type of clinic visit is
this? - ✔✔Health management visit
✔✔A patient has an E&M code of 99215. What information does this code give? (Select
all that apply) - ✔✔- Established pt
ANSWERS SURE A+
✔✔Determine which structure best fits the following Assessment.
"Patient is a 34 y/o female with Acute Pharyngitis. Post nasal drip on exam with no
visible signs of tonsilar exudate. Rapid strep negative." - ✔✔Brief summary
✔✔You see the physician check the patient's pulses in four places; the right wrist, the
top of the right foot, the back of the right foot and the left neck. The doctor states "The
pulses are fine". Match the location with the appropriate pulse that you would document
in the physical exam? - ✔✔- wrist
2+ radial pulse
- top of foot
2+ DP pulse
- neck
2+ carotid pulse
- back of foot
2+ PT pulse
✔✔What condition correctly describes "A blood clot in the extremities"? (HINT: Use the
abbreviation form of the condition) - ✔✔DVT
, ✔✔1) ICD code
2) E&M code
3) HCC code - ✔✔1) codes for diagnosis
2) codes for reimbursement
3) code for risk
✔✔* Determine which structure best fits the following Assessment.
"Patient is a 56 y/o male with CRF first diagnosed 3 years ago in acute exacerbation
today. He reports decreased urinary output that has progressively worsened since onset
5 days ago. Creatinine and BUN elevated and worsening compared to last visit 3 weeks
ago. Patient recommended emergency dialysis today and warned that he may be at risk
for death and other complications if he does not seek further urgent medical attention.
Patient understands and agrees to be transferred to the ED." - ✔✔Comprehensive
summary
✔✔What FHx/SHx information is usually asked for pediatric patients? (Select all that
apply) - ✔✔- Second hand smoke exposure
- Immunization status
✔✔What is the medical term for "pass-out"? - ✔✔Syncope
✔✔Which symptom(s) would a patient most likely present with if they had HLD? (Select
all that apply - ✔✔Asymptomatic
✔✔T/F. Scribes should complete all charts by entering a scribe attestation before
leaving the shift. - ✔✔T
✔✔A 45 year old male presents to the clinic with a constant, ripping, tearing pain to his
central chest radiating straight to his back with associated nausea that began 1 hour
ago. He denies any accompanying dyspnea or diaphoresis. What elements are
missing? - ✔✔- Severity
- Modifying factor
- Relevant context
✔✔A female patient underwent surgery to have her ovary removed. What PSHx would
you record into the chart? (Remember, do not include any spaces before or after the
term/phrase.) - ✔✔oopherectomy
✔✔A patient comes into the clinic for a well woman exam. What type of clinic visit is
this? - ✔✔Health management visit
✔✔A patient has an E&M code of 99215. What information does this code give? (Select
all that apply) - ✔✔- Established pt
