Advanced Health Assessment
With Questions And Correct
Answers Graded A+ part 1
1. What is included under each section of the SOAP note. - correct-answers-
• Include date, name, occupation, marital status, source of information,
reliability, referral source
• Subjective data- the information including the absence or
presence of pertinent symptoms that the patient tells you. Chief
complaint, HPI, medications, allergies, tobacco, alcohol, drugs,
past medical history, family and social history, review of systems
that are pertinent
• Objective data- your direct observations from what you see,
hear, smell, and touch. ROS (same as from subjective data), vital
signs, height and weight
• Assessment- your interpretations and conclusions, your
rationale, the diagnostic possibilities, present and anticipated
problems
• Plan- diagnostic testing, therapeutic modalities, need for
consultation, and rationale, medication, education
2. Be able to recognize examples of objective data and subjective data. -
correct-answers-• Subjective data- information the patient tells you,
quality or character of pain, also absence of symptoms, "denies n/v/d",
"sharp abdominal pain", "feels tired"
• Objective data- what you can directly see, touch, hear, and
measure, physical findings from inspection, palpation,
auscultation, and percussion, examples: vital signs, "distended
abdomen with tenderness", "vaginal discharge", "wheezing on
inspiration".
,3. What are the components of the health history (chief complaint, present
illness, past history, family history, ROS, functional history, etc.) and
what is included under each section. - correct-answers-• Chief complaint-
brief description of patients reason for seeking care
• History of present illness- description of problem; OLDCARTS
• Past medical history- surgeries, illnesses, injuries,
immunizations, medications, allergies, emotional status, recent
lab tests
• Family history-pedigree of 3 generations with medical problems
(HTN, DM, CA)
• Review of systems- General, skin, head, neck, EENT, chest,
lungs, breasts, vasculature, GI, GU, diet, endocrine,
musculoskeletal, neuro, psych
• Functional history/Personal and social history- cultural
background, home conditions, occupation, environment of
work/school/home, health habits (diet, exercise, smoking,
alcohol, drugs), any handicap or disability, exposure to
chemicals, sexual health, concerns about costs or health
coverage.
4. After someone presents with a complaint, what is the next step in the
health assessment process? (Hint...what do you do prior to initiating the
physical exam) - correct-answers-History of present illness: onset,
location, duration, character, aggravating and associated factors,
relieving factors, temporal factors, and severity: medications, allergies
5. THEN
6. Past medical history: hospitalizations, surgeries, childhood illnesses,
adult illnesses, serious injuries, immunizations, medications, allergies,
transfusions, mood disorders, OBGYN.
7. What is included in the general survey, when is it begun, what is
assessed, and where within the SOAP note is it recorded? - correct-
answers-General survey is the first part of the Review of Symptoms. Can
, include symptoms such as fever, chills, fatigue, weight loss. An example
could be: "Patient is an alert, young woman, sitting comfortably on the
examination table". You could assess this as soon as you see the patient
with observation. Seidel 801 and General Survey Notes under
Interviewing and health history
8. Herpetic lesions - correct-answers-o Primary infection is grouped vesicles
on an erythematous base at the site of inoculation
Can occur anywhere on body but most common areas are
genitals and thighs...mouth, lips, and chin.
Regional lymphadenopathy
May be preceded by a prodrome of tingling, itching,
burning, or tenderness at site
9. Psoriasis - correct-answers-o Well-demarcated, ham-colored plaques and
papules with silvery scale
Chronic recurrent pruritis is common
Favors elbows, knees, and scalp...intertriginous areas
may involve nails
Not contagious
10. Impetigo - correct-answers-o Vesicular infection
Honey-colored crusts and erosions
Can be seen on the face and any area of body with
aminor wound...especially excoriated lesions
Very contagious
11. Allergic (atopic) skin reactions - correct-answers-o Contact dermatitis
(inflammatory reaction to poison ivy, etc.): Papulovesicular or bullous
eruption surrounded by erythema
Weeping of exudates...noncontagious
Moderate to intense pruritus
Not sure if this also includes eczema, psoriasis, and
seborrheic dermatitis?? They are found on same pages.
With Questions And Correct
Answers Graded A+ part 1
1. What is included under each section of the SOAP note. - correct-answers-
• Include date, name, occupation, marital status, source of information,
reliability, referral source
• Subjective data- the information including the absence or
presence of pertinent symptoms that the patient tells you. Chief
complaint, HPI, medications, allergies, tobacco, alcohol, drugs,
past medical history, family and social history, review of systems
that are pertinent
• Objective data- your direct observations from what you see,
hear, smell, and touch. ROS (same as from subjective data), vital
signs, height and weight
• Assessment- your interpretations and conclusions, your
rationale, the diagnostic possibilities, present and anticipated
problems
• Plan- diagnostic testing, therapeutic modalities, need for
consultation, and rationale, medication, education
2. Be able to recognize examples of objective data and subjective data. -
correct-answers-• Subjective data- information the patient tells you,
quality or character of pain, also absence of symptoms, "denies n/v/d",
"sharp abdominal pain", "feels tired"
• Objective data- what you can directly see, touch, hear, and
measure, physical findings from inspection, palpation,
auscultation, and percussion, examples: vital signs, "distended
abdomen with tenderness", "vaginal discharge", "wheezing on
inspiration".
,3. What are the components of the health history (chief complaint, present
illness, past history, family history, ROS, functional history, etc.) and
what is included under each section. - correct-answers-• Chief complaint-
brief description of patients reason for seeking care
• History of present illness- description of problem; OLDCARTS
• Past medical history- surgeries, illnesses, injuries,
immunizations, medications, allergies, emotional status, recent
lab tests
• Family history-pedigree of 3 generations with medical problems
(HTN, DM, CA)
• Review of systems- General, skin, head, neck, EENT, chest,
lungs, breasts, vasculature, GI, GU, diet, endocrine,
musculoskeletal, neuro, psych
• Functional history/Personal and social history- cultural
background, home conditions, occupation, environment of
work/school/home, health habits (diet, exercise, smoking,
alcohol, drugs), any handicap or disability, exposure to
chemicals, sexual health, concerns about costs or health
coverage.
4. After someone presents with a complaint, what is the next step in the
health assessment process? (Hint...what do you do prior to initiating the
physical exam) - correct-answers-History of present illness: onset,
location, duration, character, aggravating and associated factors,
relieving factors, temporal factors, and severity: medications, allergies
5. THEN
6. Past medical history: hospitalizations, surgeries, childhood illnesses,
adult illnesses, serious injuries, immunizations, medications, allergies,
transfusions, mood disorders, OBGYN.
7. What is included in the general survey, when is it begun, what is
assessed, and where within the SOAP note is it recorded? - correct-
answers-General survey is the first part of the Review of Symptoms. Can
, include symptoms such as fever, chills, fatigue, weight loss. An example
could be: "Patient is an alert, young woman, sitting comfortably on the
examination table". You could assess this as soon as you see the patient
with observation. Seidel 801 and General Survey Notes under
Interviewing and health history
8. Herpetic lesions - correct-answers-o Primary infection is grouped vesicles
on an erythematous base at the site of inoculation
Can occur anywhere on body but most common areas are
genitals and thighs...mouth, lips, and chin.
Regional lymphadenopathy
May be preceded by a prodrome of tingling, itching,
burning, or tenderness at site
9. Psoriasis - correct-answers-o Well-demarcated, ham-colored plaques and
papules with silvery scale
Chronic recurrent pruritis is common
Favors elbows, knees, and scalp...intertriginous areas
may involve nails
Not contagious
10. Impetigo - correct-answers-o Vesicular infection
Honey-colored crusts and erosions
Can be seen on the face and any area of body with
aminor wound...especially excoriated lesions
Very contagious
11. Allergic (atopic) skin reactions - correct-answers-o Contact dermatitis
(inflammatory reaction to poison ivy, etc.): Papulovesicular or bullous
eruption surrounded by erythema
Weeping of exudates...noncontagious
Moderate to intense pruritus
Not sure if this also includes eczema, psoriasis, and
seborrheic dermatitis?? They are found on same pages.
