NURS 5220 SOAP Note Assignment 1 – Practice Questions with Verified
Answers & Detailed Rationales | 2026/2027
Section 1: SOAP Note Structure & Fundamentals (Questions 1–30)
1. What does the acronym SOAP stand for in clinical documentation?
A) Symptoms, Observations, Assessment, Prescription
B) Subjective, Objective, Assessment, Plan
C) Summary, Objective, Analysis, Prescription
D) Subjective, Observable, Analysis, Plan
Answer B: — Subjective, Objective, Assessment, Plan
Rationale: SOAP is the standard format for clinical documentation. The
Subjective section contains what the patient reports; Objective contains
measurable findings; Assessment is the clinical synthesis and diagnosis; and
Plan outlines treatment and follow-up. This systematic approach ensures all
clinical notes are orderly and understandable to all staff. ---
,2. In a SOAP note, which section contains the patient's chief complaint and
history of present illness (HPI)?
A) Objective section
B) Assessment section
C) Subjective section
D) Plan section
Answer C: — Subjective section
Rationale: The Subjective section captures information reported by the
patient or family, including the chief complaint (CC), history of present illness
(HPI), past medical history (PMH), family history (FH), social history (SH), and
review of systems (ROS). This is the patient's "story". ---
3. In a SOAP note, which section contains vital signs and physical
examination findings?
A) Subjective section
B) Objective section
C) Assessment section
D) Plan section
Answer B: — Objective section
Rationale: The Objective section includes measurable, observable data
collected by the provider, including vital signs, physical examination findings,
,and diagnostic test results. This information is reproducible and readily
demonstrable. ---
4. What is the correct order of the SOAP note sections?
A) Subjective, Assessment, Objective, Plan
B) Objective, Subjective, Assessment, Plan
C) Subjective, Objective, Assessment, Plan
D) Assessment, Plan, Subjective, Objective
Answer C: — Subjective, Objective, Assessment, Plan
Rationale: The SOAP note follows a logical sequence: Subjective (what the
patient reports), Objective (what the provider observes and measures),
Assessment (clinical interpretation and diagnosis), and Plan (treatment and
follow-up). ---
5. Approximately what percentage of a diagnosis comes from the history
alone?
A) 50%
B) 60%
C) 80%
D) 95%
Answer C: — 80%
, Rationale: Approximately 80% of a diagnosis comes from the history alone.
This emphasizes the critical importance of thorough history-taking in clinical
practice. ---
6. The Subjective section of a SOAP note includes: (Select all that apply) E)
Vital signs
A) Chief Complaint (CC)
B) History of Present Illness (HPI)
C) Past Medical History (PMH)
D) Review of Systems (ROS)
Answer A: , B, C, D
Rationale: The Subjective section captures the patient's narrative: CC, HPI,
past medical history (PMH), family history (FH), and review of systems (ROS).
Vital signs belong in the Objective section. ---
7. Which documentation principle ensures that a SOAP note can serve as
legal evidence?
A) Using abbreviations and medical jargon extensively
B) Writing entries that are clear, timely, accurate, and complete
C) Documenting only positive findings to conserve space
D) Backdating entries to ensure chronological accuracy
Answers & Detailed Rationales | 2026/2027
Section 1: SOAP Note Structure & Fundamentals (Questions 1–30)
1. What does the acronym SOAP stand for in clinical documentation?
A) Symptoms, Observations, Assessment, Prescription
B) Subjective, Objective, Assessment, Plan
C) Summary, Objective, Analysis, Prescription
D) Subjective, Observable, Analysis, Plan
Answer B: — Subjective, Objective, Assessment, Plan
Rationale: SOAP is the standard format for clinical documentation. The
Subjective section contains what the patient reports; Objective contains
measurable findings; Assessment is the clinical synthesis and diagnosis; and
Plan outlines treatment and follow-up. This systematic approach ensures all
clinical notes are orderly and understandable to all staff. ---
,2. In a SOAP note, which section contains the patient's chief complaint and
history of present illness (HPI)?
A) Objective section
B) Assessment section
C) Subjective section
D) Plan section
Answer C: — Subjective section
Rationale: The Subjective section captures information reported by the
patient or family, including the chief complaint (CC), history of present illness
(HPI), past medical history (PMH), family history (FH), social history (SH), and
review of systems (ROS). This is the patient's "story". ---
3. In a SOAP note, which section contains vital signs and physical
examination findings?
A) Subjective section
B) Objective section
C) Assessment section
D) Plan section
Answer B: — Objective section
Rationale: The Objective section includes measurable, observable data
collected by the provider, including vital signs, physical examination findings,
,and diagnostic test results. This information is reproducible and readily
demonstrable. ---
4. What is the correct order of the SOAP note sections?
A) Subjective, Assessment, Objective, Plan
B) Objective, Subjective, Assessment, Plan
C) Subjective, Objective, Assessment, Plan
D) Assessment, Plan, Subjective, Objective
Answer C: — Subjective, Objective, Assessment, Plan
Rationale: The SOAP note follows a logical sequence: Subjective (what the
patient reports), Objective (what the provider observes and measures),
Assessment (clinical interpretation and diagnosis), and Plan (treatment and
follow-up). ---
5. Approximately what percentage of a diagnosis comes from the history
alone?
A) 50%
B) 60%
C) 80%
D) 95%
Answer C: — 80%
, Rationale: Approximately 80% of a diagnosis comes from the history alone.
This emphasizes the critical importance of thorough history-taking in clinical
practice. ---
6. The Subjective section of a SOAP note includes: (Select all that apply) E)
Vital signs
A) Chief Complaint (CC)
B) History of Present Illness (HPI)
C) Past Medical History (PMH)
D) Review of Systems (ROS)
Answer A: , B, C, D
Rationale: The Subjective section captures the patient's narrative: CC, HPI,
past medical history (PMH), family history (FH), and review of systems (ROS).
Vital signs belong in the Objective section. ---
7. Which documentation principle ensures that a SOAP note can serve as
legal evidence?
A) Using abbreviations and medical jargon extensively
B) Writing entries that are clear, timely, accurate, and complete
C) Documenting only positive findings to conserve space
D) Backdating entries to ensure chronological accuracy
