2022/2023 AANP Complete Review 2-2 Study Guide for
Brand New Questions
• SUBJECTIVE
• Reported symptoms – not physical findings or diagnoses
• Do not document objective
• General statement of health
,2022/2023 AANP Complete Review 2-2 Study Guide for
Brand New Questions
• Any weight changes, fatigue, fevers, sweats?
• For females: always include menstrual history
• For a comprehensive ROS, you ask and document on each body system
• For focused ROS, not all body systems will be necessary
• Only include those pertinent to the chief complaint that you are working up
• If a patient presents to you with complaints of nasal congestion, you
do not need to ask about musculoskeletal system ROS questions
• ALWAYS inquire about cardiac and respiratory complaints, and infectious disease
complaints such as fever, chills, etc.
• If you have documented some components of your ROS in the HPI
• You can list the system with the note that follows to “see HPI”
• If other areas of that system are pertinent to the system but not to the HPI for
that clinical encounter, those would be documented in the ROS section
• Example – Cardiovascular: See HPI; denies murmur or palpitations
• Do not integrate ROS within the physical assessment
• Interview considerations (interviewing techniques and good interviewing practices, dealing with special
considerations, ways to avoid interviewing errors)
▪ General to specific (open-ended, non-leading questions)
• Less personal questions to more personal questions
▪ Skilled listening:
• Nonverbal cues
• Listen to the story the patient needs to tell the clinician
• Listening itself is a major therapeutic act
• Greatest afflictions of our patients: fear, despair, fatigue, pain
• May have no objective findings
• At the end of the history, you want to know what the patient worried about
• Is there something they “fear” is wrong?
• Approachable professional demeanor and attire
• Comfort with silence – remember it is the patient telling the story so listen
• Nonverbal communication
• Facilitate the interview through clarification, reflection, confrontation,
interpretation, focusing, and empathy
▪ Skilled interviewing techniques:
• Active or attentive listening – the heart of all interviewing techniques
• Paying close attention to what the patient is telling us and being aware of their
emotional state and their verbal/ nonverbal cues
• Guided questioning
• Provides options for expanding and clarifying the patient’s story and
facilitating full communication in the patient’s own words
• Shows that you have a sustained interest in your patient
• Empathic responses
• The capacity of the clinician to identify with the patient and feel like
patient’s feelings both nonverbal and verbal such as recognizing
unexpressed feelings from the patient’s face, voice, behavior and verbal ways
such as statements made
, 2022/2023 AANP Complete Review 2-2 Study Guide for
Brand New Questions
• Summarization
• This communicates that you have listened effectively and carefully and have
heard what they are telling you
• Transitions
• Tells the patient when you are changing directions
Brand New Questions
• SUBJECTIVE
• Reported symptoms – not physical findings or diagnoses
• Do not document objective
• General statement of health
,2022/2023 AANP Complete Review 2-2 Study Guide for
Brand New Questions
• Any weight changes, fatigue, fevers, sweats?
• For females: always include menstrual history
• For a comprehensive ROS, you ask and document on each body system
• For focused ROS, not all body systems will be necessary
• Only include those pertinent to the chief complaint that you are working up
• If a patient presents to you with complaints of nasal congestion, you
do not need to ask about musculoskeletal system ROS questions
• ALWAYS inquire about cardiac and respiratory complaints, and infectious disease
complaints such as fever, chills, etc.
• If you have documented some components of your ROS in the HPI
• You can list the system with the note that follows to “see HPI”
• If other areas of that system are pertinent to the system but not to the HPI for
that clinical encounter, those would be documented in the ROS section
• Example – Cardiovascular: See HPI; denies murmur or palpitations
• Do not integrate ROS within the physical assessment
• Interview considerations (interviewing techniques and good interviewing practices, dealing with special
considerations, ways to avoid interviewing errors)
▪ General to specific (open-ended, non-leading questions)
• Less personal questions to more personal questions
▪ Skilled listening:
• Nonverbal cues
• Listen to the story the patient needs to tell the clinician
• Listening itself is a major therapeutic act
• Greatest afflictions of our patients: fear, despair, fatigue, pain
• May have no objective findings
• At the end of the history, you want to know what the patient worried about
• Is there something they “fear” is wrong?
• Approachable professional demeanor and attire
• Comfort with silence – remember it is the patient telling the story so listen
• Nonverbal communication
• Facilitate the interview through clarification, reflection, confrontation,
interpretation, focusing, and empathy
▪ Skilled interviewing techniques:
• Active or attentive listening – the heart of all interviewing techniques
• Paying close attention to what the patient is telling us and being aware of their
emotional state and their verbal/ nonverbal cues
• Guided questioning
• Provides options for expanding and clarifying the patient’s story and
facilitating full communication in the patient’s own words
• Shows that you have a sustained interest in your patient
• Empathic responses
• The capacity of the clinician to identify with the patient and feel like
patient’s feelings both nonverbal and verbal such as recognizing
unexpressed feelings from the patient’s face, voice, behavior and verbal ways
such as statements made
, 2022/2023 AANP Complete Review 2-2 Study Guide for
Brand New Questions
• Summarization
• This communicates that you have listened effectively and carefully and have
heard what they are telling you
• Transitions
• Tells the patient when you are changing directions
