Essential Scribe Entrance Exam Review Questions With Well Elaborated Solutions

Essential Scribe Entrance Exam Review Questions With Well Elaborated Solutions RUQ- Right upper quadrant - ANSWER -location of gallbladder RLQ- Right lower quadrant - ANSWER -location of the appendix and the right ovary in females LUQ- Left upper quadrant - ANSWER -Location of the stomach and spleen LLQ- Left Lower Quadrant - ANSWER -Location of the sigmoid colon and left ovary in females Abdominal regions - ANSWER -any of the topographical subdivisions of the abdomen Epigastrica region (Midepigastric region) - ANSWER -the upper abdomen immediately below the ribs Periumbilical region (Umbilical region) - ANSWER -Region surrounding the umbilicus Suprapubic region (pelvic region) - ANSWER -Region of the abdomen located below the umbilical region CVA- Costovertebral angle (Right and left flanks) - ANSWER -Region on the back between the 12th rib and the vertebral column Skull regions - ANSWER -divided by three of the four cranial structures which fuse together over time Frontal region - ANSWER -region overlying the forehead Retro orbital (sphenoid) region - ANSWER -region behind the eyes Temporal region - ANSWER -region over the temples/ears Parietal region - ANSWER -region at the top of the head Occipital region - ANSWER -region at the back of the head Note - ANSWER -patients encounter note EHR- Electronic health record - ANSWER -notes in a computer program Acute care setting - ANSWER -Emergency department, urgent care Ambulatory care setting - ANSWER -primary care clinic, specialty medicine clinics Note section - ANSWER -reason for visit, history of present illness, review of systems, past medical history, physical exam, medical decision making, impression/diagnosis, disposition, plan Reason for visit/chief complaint - ANSWER -main reason the patient is being seen HPI- History of present illness - ANSWER -the paragraph further expanding on and describing the reason for visit ROS- Review of systems - ANSWER -template of body systems which each contain specific symptoms Past histories - ANSWER -past medical + surgical, family, and social histories Past medical history - ANSWER -patients long term, previously diagnosed medical conditions past surgical history - ANSWER -patients prior medical procedures and surgeries past family history - ANSWER -long term diagnosed medical conditions that affect a patients immediate family members past social history - ANSWER -patients social status and habits that may affect their medical history Physical examination - ANSWER -template of body systems, each of which contain specific findings MDM- Medical decision making - ANSWER -documentation for everything that occurred to or for the patient during their visit Differential diagnosis - ANSWER -initial list of possible conditions of diseases that could be causing the patients symptoms Labs- laboratory studies - ANSWER -tests ordered to measure levels of specific chemicals int he patients body Imaging studies - ANSWER -techniques and processes of creating visual representations of the interior of a body Procedures - ANSWER -actively directed at or performed on a patient with the purpose of improving health, treating disease or injury or determining a diagnosis Reevaluations - ANSWER -when the providers attention is brought back to the patient case after the initial evaluation Consultations - ANSWER -when the provider speaks with another healthcare professional for assistance on the patients case Impression/ Assessment/ diagnosis - ANSWER -clinical summation of information and / or an opinion based upon the patients symptoms Disposition - ANSWER -where the patient goes after leaving a health care setting Plan - ANSWER -how the provider would like to treat the patients diagnosis Patient instructions - ANSWER -shorter easy to read version of the plan Patient education - ANSWER -educational materials on each specific diagnosis which is often printed and handed Acute complaint - ANSWER -a new symptom of problem the patient would like evaluated by a health care provider