NR511 Final Exam Study Guide 2026 | Latest
Updated Real Exam Questions & Verified Answers
| Graded A+ Nursing Exam Success Bundle
Week 1
1. Define diagnostic reasoning
a. Involves critical thinking in a way that evaluates new data to support
the hypothesis and reduce alternative hypothesis. This is done by
evaluating all the avenues to reach a conclusion that gives the best
evidence to support the main theory or hypothesis.
b. Examples of diagnostic reasoning are problem solving, health
promotion, and screening for disease or illness. All of these will
require sensitivity, complexity, contest, and a sense of probability
and uncertainty.
2. Discuss and identify subjective & objective data
a. Subjective- what the patient reports as the CC and the
responses to the questions in the interview. Includes ROS, CC,
and HPI
b. Objective – Information gained through exam, labs, imaging and other
diagnostic tests.
3. Discuss and identify the components of the HPI
a. Describes the reason the patient came in and include information
using the acronym OLDCARTS
i. Onset
ii. Location
iii. Duration
iv. Characteristics
v. Aggravating factors
, vi. Relieving Factors
vii. Treatments tried
viii. Severity of the level of pain
4. Describe the differences between medical billing and medical coding
a. Medical billing is the process of submitting and following up on claims
made to a payer in order to receive payment for medical services
rendered by a healthcare provider.
b. Medical coding is the use of code to communicate with payers
about the procedures performed and why.
5. Compare and contrast the 2 coding classification systems that are currently
used in the US healthcare system – The two systems need to be in line i.e. the
CPT code for the activity performed should be followed with a relevant
Diagnosis for the procedure performed.
a. ICD 10- the newest version of shorthand for the patients
diagnosis. It is necessary for all diagnosis and procedures
performed.
b. CPT- common procedural terminology represented by a 5 digit code that provides
a uniform language to describe medical, surgical, and diagnostic services. Allows
for tracking of treatments, trend and outcomes. Therer is 3 levels of CPT codes:
Category I- used in contemporary medical practice, Category II -tracking codes
used for new or performance measurement, and Category III-Temporary coding
used for new procedures, technology and services.
i. Catergory I has six sections
1. Evaluation and Management
2. Anesthesiology
3. Surgery
4. Radiology
5. Pathology
6. Medicine
,6. Discuss how specificity, sensitivity & predictive value contribute to the
usefulness of the diagnostic data
a. Specificity of a test = greater when it has few false positives
no. of true negatives
specificity =
no. of all tested indiv, who do not have the dz
b. Sensitivity of a test = greater when it has few false
negatives no. of the true positives
sensitivity =
no. of tested indiv that have the dz
Predictive value = is in part dependent on the prevalence of
the condition true +
positive predictive value = -----------
all +
true -
Negative predictive value = ----------
all –
False positive - when a pt that does not have the condition has
a positive reading
False negative - when a pt that does have the condition but has
a negative reading
7. Discuss the elements that need to be considered when developing a plan
, a. Diagnostic testing-what tests need to be conducted to clarify assessment
b. Education-specific problems being managed
c. Follow-up: when will the patient be seen again
d. Be honest
e. Negotiate what to cover
8. Describe the components of Medical Decision Making in E&M coding
a. There is three key components the determine risk-based E&M codes
i. History
ii. Physical
iii. Medical Decision Making- a way of quantifying the complexity of
the thinking that is required for the visit. And gives credit for the
excess work involved in management of a more complex patient.
1. Complexity of a visit is based on
a. Risk
b. Data
c. diagnosis
b. Reason for consultation
c. HPI
d. ROS
e. Physical exam
f. Recommendation for testing and treatment
9. Correctly order the E&M office visit codes based on complexity from least
to most complex
a. New:
Updated Real Exam Questions & Verified Answers
| Graded A+ Nursing Exam Success Bundle
Week 1
1. Define diagnostic reasoning
a. Involves critical thinking in a way that evaluates new data to support
the hypothesis and reduce alternative hypothesis. This is done by
evaluating all the avenues to reach a conclusion that gives the best
evidence to support the main theory or hypothesis.
b. Examples of diagnostic reasoning are problem solving, health
promotion, and screening for disease or illness. All of these will
require sensitivity, complexity, contest, and a sense of probability
and uncertainty.
2. Discuss and identify subjective & objective data
a. Subjective- what the patient reports as the CC and the
responses to the questions in the interview. Includes ROS, CC,
and HPI
b. Objective – Information gained through exam, labs, imaging and other
diagnostic tests.
3. Discuss and identify the components of the HPI
a. Describes the reason the patient came in and include information
using the acronym OLDCARTS
i. Onset
ii. Location
iii. Duration
iv. Characteristics
v. Aggravating factors
, vi. Relieving Factors
vii. Treatments tried
viii. Severity of the level of pain
4. Describe the differences between medical billing and medical coding
a. Medical billing is the process of submitting and following up on claims
made to a payer in order to receive payment for medical services
rendered by a healthcare provider.
b. Medical coding is the use of code to communicate with payers
about the procedures performed and why.
5. Compare and contrast the 2 coding classification systems that are currently
used in the US healthcare system – The two systems need to be in line i.e. the
CPT code for the activity performed should be followed with a relevant
Diagnosis for the procedure performed.
a. ICD 10- the newest version of shorthand for the patients
diagnosis. It is necessary for all diagnosis and procedures
performed.
b. CPT- common procedural terminology represented by a 5 digit code that provides
a uniform language to describe medical, surgical, and diagnostic services. Allows
for tracking of treatments, trend and outcomes. Therer is 3 levels of CPT codes:
Category I- used in contemporary medical practice, Category II -tracking codes
used for new or performance measurement, and Category III-Temporary coding
used for new procedures, technology and services.
i. Catergory I has six sections
1. Evaluation and Management
2. Anesthesiology
3. Surgery
4. Radiology
5. Pathology
6. Medicine
,6. Discuss how specificity, sensitivity & predictive value contribute to the
usefulness of the diagnostic data
a. Specificity of a test = greater when it has few false positives
no. of true negatives
specificity =
no. of all tested indiv, who do not have the dz
b. Sensitivity of a test = greater when it has few false
negatives no. of the true positives
sensitivity =
no. of tested indiv that have the dz
Predictive value = is in part dependent on the prevalence of
the condition true +
positive predictive value = -----------
all +
true -
Negative predictive value = ----------
all –
False positive - when a pt that does not have the condition has
a positive reading
False negative - when a pt that does have the condition but has
a negative reading
7. Discuss the elements that need to be considered when developing a plan
, a. Diagnostic testing-what tests need to be conducted to clarify assessment
b. Education-specific problems being managed
c. Follow-up: when will the patient be seen again
d. Be honest
e. Negotiate what to cover
8. Describe the components of Medical Decision Making in E&M coding
a. There is three key components the determine risk-based E&M codes
i. History
ii. Physical
iii. Medical Decision Making- a way of quantifying the complexity of
the thinking that is required for the visit. And gives credit for the
excess work involved in management of a more complex patient.
1. Complexity of a visit is based on
a. Risk
b. Data
c. diagnosis
b. Reason for consultation
c. HPI
d. ROS
e. Physical exam
f. Recommendation for testing and treatment
9. Correctly order the E&M office visit codes based on complexity from least
to most complex
a. New:
