Bates, Chapter 1: Overview Exam.
1. What type of
assessment should you -comprehensive assessment
perform on patients
you are seeing for the
first time?
2. What does this include? -all elements of the health history
-complete physical examination
3. In what parts of the med- -history
ical chart is -review of systems
subjective data
recorded?
4. In what parts of the med- -physical examination findings
ical chart is objective data
recorded?
5. List six components 1. chief complaint(s)
of the 2. history of present illness
"comprehensive
health history." 3. past medical history
4. family history
5. social history
6. review of systems
6. What identifying data
should you collect from -age
a patient? -gender
-occupation
7. What is a patient's -marital status
chief complaint?
-the one or more symptoms that are causing the patient to
8. An adult patient's past seek care
1. medical
medical history should in- 2. surgical
1/
6
, Bates, Chapter 1: Overview Exam.
clude information 3. ob/gyn
from what four
categories? 4. psychiatric
9. What does a person's -education level
so- cial history include? -family origin
-current household
-personal interests
-lifestyle
10. What should the
history -a complete, clear, and chronologic account of the problems
that
of present illness include? caused a patient to seek care
11. Each principal system 1. location
de- scribed by the
patient should include 2. quality
descrip- tions of what 3. quantity or severity
seven fac- tors? 4. timing, including onset, duration, and frequency
5. setting in which it occurs
6. factors that have aggravated or relieved the symptom
12. What information 7. associated symptoms
should be recorded
about the medications
that a pa- tient is 1. name
taking? 2. dose
3. route
13. What might the review 4. frequency of use
of systems questions
uncov- er?
-problems that the patient has overlooked
14. ROS: General. 1. weight change
2. weakness
3. fatigue
4. fever
2/
6
1. What type of
assessment should you -comprehensive assessment
perform on patients
you are seeing for the
first time?
2. What does this include? -all elements of the health history
-complete physical examination
3. In what parts of the med- -history
ical chart is -review of systems
subjective data
recorded?
4. In what parts of the med- -physical examination findings
ical chart is objective data
recorded?
5. List six components 1. chief complaint(s)
of the 2. history of present illness
"comprehensive
health history." 3. past medical history
4. family history
5. social history
6. review of systems
6. What identifying data
should you collect from -age
a patient? -gender
-occupation
7. What is a patient's -marital status
chief complaint?
-the one or more symptoms that are causing the patient to
8. An adult patient's past seek care
1. medical
medical history should in- 2. surgical
1/
6
, Bates, Chapter 1: Overview Exam.
clude information 3. ob/gyn
from what four
categories? 4. psychiatric
9. What does a person's -education level
so- cial history include? -family origin
-current household
-personal interests
-lifestyle
10. What should the
history -a complete, clear, and chronologic account of the problems
that
of present illness include? caused a patient to seek care
11. Each principal system 1. location
de- scribed by the
patient should include 2. quality
descrip- tions of what 3. quantity or severity
seven fac- tors? 4. timing, including onset, duration, and frequency
5. setting in which it occurs
6. factors that have aggravated or relieved the symptom
12. What information 7. associated symptoms
should be recorded
about the medications
that a pa- tient is 1. name
taking? 2. dose
3. route
13. What might the review 4. frequency of use
of systems questions
uncov- er?
-problems that the patient has overlooked
14. ROS: General. 1. weight change
2. weakness
3. fatigue
4. fever
2/
6
