Test Bank for Seidel's Guide to Physical Examination 9th Edition Ball All chapters

Test Bank for Seidel's Guide to Physical Examination 9th Edition Ball Chapter 03: Examination Techniques and Equipment Ball: Seidel’s Guide to Physical Examination, 9th Edition MULTIPLE CHOICE 1. Guidelines for Standard Precautions indicate that mask and eye protection or a face mask should be worn while performing: a. suture removal. b. trachea care and suctioning. c. wet-to-dry dressing changes. d. patient bathing. e. tube feedings. ANS: B Masks and eye protection or a face mask are indicated during procedures that are likely to generate splashes or sprays of body fluids, which include endotracheal secretions. TOP: Discipline: Pathophysiology MSC: Organ System: General 2. Standard Precautions apply to all patients: a. with bloodborne infections. b. with infected, draining wounds. c. in intensive care units. d. receiving care in hospitals or office settings. e. believed to have an infectious disease. ANS: D Although all of these statements are true, the best answer is patients receiving care in hospitals. Standard Precautions were developed with the intent of application to the care of all hospitalized or outpatients; however, the standard has merit and should be applied to all cases of patient care regardless of the environment where care is delivered. TOP: Discipline: Pathophysiology MSC: Organ System: General 3. Which patient is at the highest risk for the development of latex allergy? a. A new patient who has no chronic illness and has never been hospitalized b. A patient who has had multiple procedures or surgeries c. A patient who is allergic to eggs d. A patient who is allergic to contrast dye e. A patient who is a vegetarian ANS: B A patient who has had multiple procedures or surgeries has a higher exposure rate to rubber gloves and to equipment and supplies that contain latex and therefore is at a higher risk for developing an allergic response. TOP: Discipline: Pathophysiology MSC: Organ System: General 4. Which patient position is useful for auscultating heart tones? a. Lithotomy b. Dorsal recumbent c. Left lateral recumbent d. Right Sims e. Prone ANS: C The left lateral recumbent position places the left ventricle closer to the chest wall and is recommended for hearing low-pitched sounds such as the third and fourth heart sounds. TOP: Discipline: Pathophysiology MSC: Organ System: General 5. The use of secondary, tangential lighting is most helpful in the detection of: a. variations in skin color. b. enlarged tonsils. c. foreign objects in the nose or ear. d. variations in contour of the body surface. e. variations in texture and mobility. ANS: D Tangential lighting is used to cast shadows so as to best observe contours and variations in body surfaces. All the other choices are best observed with direct lighting that does not cast shadows. TOP: Discipline: Pathophysiology MSC: Organ System: General 6. You are conducting a head to toe examination as part of a patient's preventive health assessment. The room has adequate lighting, and you have access to both sides of the examining table. What positi N on s R hou I ld y G ou B as . su C me M while conducting this examination? a. Behind the patient b. To the left side of the patient U S N T c. Seated in a chair in front of the patient d. To the right side of the patient e. Standing in front of the patient ANS: D Although conventionally taught to approach an examination from the patient's right side, it is not always practical. Therefore, it is important that the examiner develop the skills necessary to approach either side of the patient. TOP: Discipline: Pathophysiology MSC: Organ System: General 7. Which part of the examiner's hand is best for palpating vibration? a. Dorsal surface b. The thumb c. Fingertips d. Ulnar surface and base of the fingers e. Finger pads ANS: D The ulnar surface of the hand and the base of the fingers can best feel vibratory sensations such as thrills and fremitus. TOP: Discipline: Pathophysiology MSC: Organ System: General 8. The degree of percussion tone is determined by the density of the medium through which the sound waves travel. Which statement is true regarding the relationship between density of the medium and percussion tone? a. The more dense the medium, the louder the percussion tone. b. The less dense the medium, the louder the percussion tone. c. The more hollow the area percussed, the quieter the percussion tone. d. Percussion over bony areas produces the loudest percussion tones. e. Percussion tones are produced by the structure immediately beneath the skin. ANS: B Percussion sounds vary according to the tissue being percussed. Whereas less dense tissue (e.g., over a normal lung) produces a loud tone, more dense tissue (e.g., a muscle) produces a softer tone. Percussion tones arise from vibrations 4 to 6 cm deep in the body tissue. TOP: Discipline: Pathophysiology MSC: Organ System: General 9. Expected normal percussion tones include: a. dullness over the lungs. b. hyperresonance over the lungs. c. tympany over an empty stomach. d. flatness over an empty stomach. e. resonance over the liver. ANS: C Whereas a normal lung produces resonance percussion tones, an empty stomach is expected to produce tympany. Dull percu N ss io R n U to I n S es G a N re B h . ea C rd T o M ver the liver. O TOP: Discipline: Pathophysiology MSC: Organ System: General 10. When percussing, a dull tone is expected to be heard over: a. most of the abdomen. b. emphysemic lungs. c. the liver. d. healthy lung tissue. e. an empty stomach. ANS: C Dull tones are expected over more dense areas such as the liver. TOP: Discipline: Pathophysiology MSC: Organ System: General 11. During percussion, the downward snap of the striking fingers should originate from the: a. wrist. b. forearm. c. shoulder. d. interphalangeal joint. e. elbow. ANS: A The dominant hand's middle finger strikes the stationary finger with a wrist motion and is lifted quickly off the striking surface. TOP: Discipline: Pathophysiology MSC: Organ System: General 12. During auscultation, you can limit your perceptual field best by: a. asking patients to describe their symptoms. b. listening through the patient's clothing. c. closing your eyes. d. performing palpation before percussion. e. turning out the lights in the examination room. ANS: C By closing your eyes, your sense of hearing becomes more acute, increasing your ability to isolate sounds. TOP: Discipline: Pathophysiology MSC: Organ System: General 13. When examining the abdomen, which technique should be used first? a. Inspection b. Light palpation c. Percussion d. Auscultation e. Direct palpation ANS: A Inspection is always used as the first technique in all physical examinations, including the abdomen. TOP: Discipline: Pathophysiology MSC: Organ System: General 14. Auscultation should be carried out last except when examining: a. the neck area. b. the abdomen. c. the lungs. d. the heart. e. none of the above; auscultation is always carried out last in a proper physical examination. ANS: B Auscultation is the last examination technique used for all areas except the abdomen. In this case, it is performed after inspection. TOP: Discipline: Pathophysiology MSC: Organ System: General 15. Which of the following statements is true regarding tympanic membrane temperature? a. It is taken by placing an infrared probe anterior to the ear. b. The probe is placed in the external auditory canal to occlude it. c. Temperatures taken with a tympanic thermometer never vary from those taken by the oral or rectal route. d. It is an accurate measurement of body temperature because the tympanic membrane shares its blood supply with the hypothalamus. e. It is taken by placing an infrared probe posterior to the ear. ANS: D The tympanic membrane shares its blood supply with the hypothalamus and is therefore an accurate measurement of body temperature. Tympanic thermometer probes are gently placed at the external opening of the ear canal, but not in the canal, and they should not occlude the canal. TOP: Discipline: Pathophysiology MSC: Organ System: General 16. A scale used to assess a patient's weight should be calibrated: a. when the patient tells you the weight is not correct. b. by a qualified technician at regularly scheduled intervals. c. each time it is used. d. when necessary, with the patient standing on the scale. e. only by the manufacturer. ANS: C Obtaining weight begins with a manual calibration of the scale before the patient stands on the scale. Electronic scales are automatically calibrated before each reading. TOP: Discipline: Pathophysiology MSC: Organ System: General 17. An infant should be placed in which position to have his or her height or length measured? a. Vertical, with the examiner's hands under the infant's axilla b. Supine on a measuring board c. While being held by a parent d. In the lateral position wit N h th R e to I es a G gain B st . a C me M asuring board e. Prone on a measuring board ANS: B U S N T O An infant should be placed supine on a measuring board to measure height or length. TOP: Discipline: Pathophysiology MSC: Organ System: General 18. The stethoscope's diaphragm is most useful in the assessment of sounds. a. high-pitched b. dull c. low-pitched d. rhythmic e. tympanic ANS: A The diaphragm is best for hearing high-pitched sounds, such as breath sounds, bowel sounds, and normal heart tones. TOP: Discipline: Pathophysiology MSC: Organ System: General 19. Which of the following occurs when firm pressure is used to apply the stethoscope's bell endpiece to the skin? a. It transmits low-pitched sounds. b. It functionally converts to a diaphragm endpiece. c. Assessment findings are more accurate. d. Most sounds are occluded. e. Abnormally low sounds are better transmitted. ANS: B Applying firm pressure to the bell endpiece causes the skin to act as a diaphragm, obliterating the low-pitched sounds. TOP: Discipline: Pathophysiology MSC: Organ System: General 20. Weak pulses, fetal heart activity, and vessel patency are all best assessed with which type of stethoscope? a. Diaphragm end of an acoustic stethoscope b. Electronic c. Ultrasonic d. Magnetic e. Bell end of an acoustic stethoscope ANS: C Only the ultrasonic stethoscope, the Doppler, can detect blood flow rather than amplify sounds, which is needed in assessing weak pulses, fetal heart activity, and vessel patency. TOP: Discipline: Pathophysiology MSC: Organ System: General 21. A patient in the emergency department has a concussion to the head. You suspect that the patient may also have a retinal hemorrhage. You are using the ophthalmoscope to examine the retina of this patient. Which aperture of the ophthalmoscope is most appropriate for this patient? a. StrabismoScope b. Red-free filter c. Slit lamp d. Small aperture e. Grid ANS: B The red-free filter permits recognition of hemorrhages. The grid estimates the size of lesions, the slit lamp examines the anterior eye and assesses the elevation of lesions, and the small aperture is used with small pupils. The strabismoScope is used for detecting strabismus. TOP: Discipline: Pathophysiology MSC: Organ System: General 22. Which type of speculum should be used to examine a patient's tympanic membrane? a. The smallest speculum that will illuminate the ear b. The largest speculum that will fit comfortably in the ear c. The shortest speculum available d. Any speculum that will fit the otoscope head e. The longest speculum available ANS: B To visualize the tympanic membrane adequately, the largest speculum that can comfortably fit in the car canal should be used. The other choices do not ensure greater visibility of the membrane and landmarks. TOP: Discipline: Pathophysiology MSC: Organ System: General 23. The pneumatic attachment for the otoscope is used to evaluate: a. ear canal patency. b. eardrum landmarks. c. hearing acuity. d. tympanic membrane movement. e. tympanic membrane temperature. ANS: D The pneumatic attachment on the otoscope produces a puff or air to the tympanic membrane, resulting in its movement. TOP: Discipline: Pathophysiology MSC: Organ System: General 24. Tuning forks with a frequency of 500 to 1000 Hz are most commonly used to measure: a. vibratory sensations. b. hearing from bone conduction. c. hearing range of normal speech. d. noise above the threshold level. e. peripheral motor nerve damage. ANS: C Normal speech has a range of 300 to 3000 Hz; therefore, a 500- to 1000-Hz fork is used most often because it can estimate hearing loss in the range of normal speech. TOP: Discipline: Pathophysiol ogy N R I G MS C: B Orga .C U S N T O n System: General M 25. A variant of the percussion hammer is a neurologic hammer, which is equipped with which of the following? a. Brush and needle b. Tuning fork and cotton swab c. Penlight and goniometer d. Ruler and bell e. Transilluminator ANS: A A neurologic hammer unscrews at the handle to reveal a soft brush, and the knob on the head unscrews, to which a sharp needle is attached. TOP: Discipline: Pathophysiology MSC: Organ System: General 26. Transillumination functions on the principle that: a. infrared radiation is easily detected. b. black light causes certain substances to fluoresce. c. converging and diverging light brings structures into focus. d. tangential light casts shadows that illuminate contours. e. air, fluid, and tissue transmit light differentially. ANS: E Transillumination functions to differentiate between various media in a cavity. It can distinguish among air, fluid, and tissue. It consists of a strong light in the visible spectrum with a narrow beam. TOP: Discipline: Pathophysiology MSC: Organ System: General 27. For a woman with a small vaginal opening, the examiner should use a _ speculum. a. plastic Graves b. Pederson c. pediatric d. nasal e. metal Graves ANS: B The Pederson speculum has blades that are as long as those of the Graves speculum, but are narrower and flatter and are therefore more comfortable for women with small vaginal openings. Pediatric or nasal speculums would be too small for adult use. Plastic speculums are similar in use to their metal counterparts. TOP: Discipline: Pathophysiology MSC: Organ System: General 28. You are performing a vaginal examination on a patient with a history of spina bifida. As you insert the metal speculum, the patient suddenly feels nauseated and is sweating, and her skin turns blotchy. What is your most immediate reaction to this situation? a. Replace the metal speculum with a plastic one. b. Put a blanket over the patient's legs. c. Remove the speculum. d. Take her blood pressure. e. Raise her legs above her heart. ANS: C This patient is experiencing symptoms of autonomic hyperreflexia. The first reaction should be for the examiner to remove the source of the stimulation. Cold tables, stirrups, insertion of a speculum, and pressure during pelvic examinations are examples of stimulations. TOP: Discipline: Pathophysiology MSC: Organ System: General Chapter 04: Clinical Reasoning Ball: Seidel’s Guide to Physical Examination, 9th Edition MULTIPLE CHOICE 1. After the subjective and objective data have been prioritized, the next step is to: a. order laboratory tests. b. formulate a problem list. c. establish the diagnosis. d. initiate therapy. e. initiate appropriate consultations. ANS: B Formulate a problem list problems as specifically as possible. Identify and list the signs and symptoms associated with each of patient's concerns as well as abnormalities discovered during the physical examination. TOP: Discipline: Behavioral Science MSC: Organ System: General 2. New symptoms or findings of unknown etiology are: a. problems to be noted on the problem list. b. deferred for subsequent visits. c. diagnosed before physical examination. d. reserved for specialists. e. usually ―red herrings.‖ ANS: A New findings of unknown causes are added to the problem list, but do not let them become a ―red herring‖ that distracts your attention from the central issues. TOP: Discipline: Behavioral Science MSC: Organ System: General 3. Which of the following is an accepted method of making a diagnosis? a. Always unifying your findings into one diagnosis b. Making maximal use of laboratory tests c. Using first assumptions d. Using algorithms e. Relying on intuition ANS: D Methods to make a diagnosis include recognizing patterns, sampling the universe, and using algorithms. Unifying all of your findings into one diagnosis is not always possible. More than one disease process can exist at one time in the same patient. Do not rely on intuition, extensive use of laboratory findings, or always going with your first assumptions. TOP: Discipline: Behavioral Science MSC: Organ System: General 4. Medical decision making requires a balance between: a. speculation and feelings. b. opinions and beliefs. c. knowledge and superstition. d. Mechanism and probability. e. trust and suspicion. ANS: D Medical decision making must have a balance between mechanism and probability (certainty in knowledge is impossible). TOP: Discipline: Behavioral Science MSC: Organ System: General 5. When evaluating results of laboratory tests, a test that is highly sensitive implies that the test: a. suggests that a disease is present when it actually is not. b. will not have any false-positive results. c. suggests that a disease is absent when it is absent. d. is able to correctly identify for the disease being tested. e. is able to confirm a diagnosis even when the disease is not present. ANS: D Testing that is sensitive is a test that will be able to correctly identify persons with the disease that the test has been designed to test for. Positive results are more likely to be positive for the disease. High specificity suggests the ability of an observation to identify correctly those who do not have the disease. TOP: Discipline: Biostatistics MSC: Organ System: General 6. A specific test is one that has the ability to: a. correctly identify those who have the disease. b. correctly identify those w N ho R do n I ot h G ave B th . e C dis M ease. U S N T c. be exclusively used to make a diagnosis. d. suggest the presence of a disease that is not present. e. exclude competing explanations for another test finding. ANS: B The specificity of a test is determined by its ability to identify those who do not have the disease that the test is designed to test for. Negative results are more likely to be valid. TOP: Discipline: Biostatistics MSC: Organ System: General 7. The proportion of persons with an observation characteristic of a disease that have the disease is known as value. a. sensitivity positive specific b. negative specific c. positive predictive d. negative predictive e. true negative ANS: C A positive predictive value is defined as the proportion of persons thought to have a disease who actually have the disease. TOP: Discipline: Biostatistics MSC: Organ System: General 8. Which of the following is not a component of a management plan? a. Presumptive diagnosis b. Subspecialty consultation c. Diet modification d. Follow-up visit e. Patient education ANS: A The management plan details what you are going to do about a patient problem such as subspecialty consultations, diet modifications, follow-up visits, and any necessary patient education. TOP: Discipline: Behavioral Science MSC: Organ System: General 9. When determining priorities for planned actions, the practitioner should: a. address problems in the order of their chronologic development. b. consider whether the patient is concerned about a particular problem before addressing it. c. ignore the patient's social and economic circumstances. d. address the most urgent problem first. e. never consider if the cost of care will impact other areas of the patient's life. ANS: D In developing patient care plans, priority should be given to the most life threatening and urgent physical needs of the patient. Then focus on addressing the patient's social and economic circumstances and whether the cost of care will impact other areas of the patient's life. TOP: Discipline: Behavioral Science MSC: Organ System: General 10. Bits of information that are distracting and draw your thinking away from central issues are referred to as: a. Bayes theorem. b. true negatives. c. mechanism and probability d. red herrings. e. false negatives. ANS: D Beware of red herrings, the bits of information that are distracting and draw your thinking away from central issues. Critically evaluate unexpected or unusual findings but do not let them distort full consideration of all you have learned. TOP: Discipline: Behavioral Science MSC: Organ System: General 11. In issues surrounding ethical decision making, beneficence refers to the: a. appropriate use of medical resources. b. care provider acting as a father or mother figure. c. care provider knowing what is best for the patient. d. need to avoid harming the patient. e. need to do good for the patient. ANS: E The definition of beneficence is to do good, not being paternalistic, and the need to avoid harm refers to nonmaleficence. Utilitarianism is the appropriate use of resources for the greater good of the larger community. TOP: Discipline: Behavioral Science MSC: Organ System: General 12. The term denoting the caregiver's need to do no harm to the patient is: a. autonomy. b. deontologic imperative. c. nonmaleficence. d. utilitarianism. e. beneficence. ANS: C The definition of nonmaleficence is to do no harm. TOP: Discipline: Behavioral Science MSC: Organ System: General 13. Which of the following is initially appropriate in the management of a patient's diagnosed problem? a. Inform the patient of the treatment plan. b. Give the patient detailed written instructions regarding the treatment plan. c. Inform the patient that the plan has been tailored to his needs. d. Inform the patient of treatment options and possible results. e. Lead the patient to an understanding that you know the best treatment option. ANS: D An initial approach to a patient's problem should allow for the greatest patient autonomy and should promote patient participation. The well-informed patient is better able to exercise autonomy. Only informing the patient of treatment options and possible results does this. TOP: Discipline: Behavioral Science MSC: Organ System: General Chapter 05: Documentation Ball: Seidel’s Guide to Physical Examination, 9th Edition MULTIPLE CHOICE 1. During the course of the interview, you should: a. take no notes of any kind. b. take brief written notes. c. take detailed written notes. d. repeat pertinent comments into a Dictaphone. e. interrupt the interview to formulate your thoughts. ANS: B During the interviewing process, it is important to maintain eye contact with the patient and to spend as little time as possible looking at your notes, so brief written notes are more practical. Later you can go back and formulate a well-versed history by linking all the pieces together. TOP: Discipline: Behavioral Science MSC: Organ System: General 2. Subjective and symptomatic data are: a. documented in your assessment. b. not mentioned in the legal chart. c. placed in the history sections. d. recorded with the examination technique. e. documented with the findings. ANS: C Subjective data, as well as symptomatic data, should not be part of the physical examination findings; rather, their documentation is appropriate for the history portion. TOP: Discipline: Behavioral Science MSC: Organ System: General 3. The quality of a symptom, such as pain, is subjective information that should be: a. deferred until the cause is determined. b. described in the history using a 0 to 10 scale. c. placed in the past medical history section. d. placed in the history with objective data. e. interpreted in light of your physical findings. ANS: B Pain is subjective, and only the patient can rate the perceived severity. Pain, therefore, should be recorded in the history using a 0 to 10 scale. TOP: Discipline: Behavioral Science MSC: Organ System: General 4. Drawing of stick figures is most useful to: a. compare findings in the extremities. b. demonstrate radiation of pain. c. indicate organ enlargement. d. indicate mobility of masses. e. indicate consistency of lymph nodes. ANS: A Simple drawings, such as stick figures, are more practical illustrations for findings in the extremities. Radiation of pain, organ enlargement, consistency of lymph nodes, and mobility of masses would not be adequately described by such simple drawings. TOP: Discipline: Behavioral Science MSC: Organ System: General 5. Which of the following is an example of a problem requiring recording on the patient's problem list? a. Common age variations b. Expected findings c. Findings of unknown origin d. Minor variations e. Only findings that have a clear etiology ANS: C Any problem is worth noting on the patient problem list even if the etiology or significance is unknown. Common age variations, expected findings, and minor variations within normal limits should not be classified as problems. TOP: Discipline: Behavioral Science MSC: Organ System: General 6. Differential diagnoses belong in the: a. history. b. physical examination. c. assessment. d. plan. e. laboratory data. ANS: C Differential diagnoses for problems that have not been diagnosed are placed in the assessment category for each problem. The differentials are prioritized, and contributing factors are identified. TOP: Discipline: Behavioral Science MSC: Organ System: General 7. When recording assessments during the construction of the problem-oriented medical record, the examiner should: a. combine all data into one assessment. b. create an assessment for each problem on the problem list. c. create an assessment for every abnormal physical finding. d. create an assessment for every symptom presented in the history. e. create an assessment for each abnormal laboratory finding. ANS: B After the examiner has a list of problems constructed, an assessment is made for each unique problem. TOP: Discipline: Behavioral Science MSC: Organ System: General 8. Your patient returns for a blood pressure check 2 weeks after a visit during which you performed a complete history and physical examination. This visit would be documented by creating a(n): a. progress note. b. incident report. c. problem-oriented medical record. d. triage note. e. new problem list. ANS: A A second visit with the clinician is always recorded on a progress note, noting any updates to the condition. TOP: Discipline: Behavioral Science MSC: Organ System: General 9. The effect of the chief concern on the patient's lifestyle is recorded in which section of the medical record? a. Chief complaint b. History of present illness c. Past medical history d. General patient information e. Social history ANS: B The effect of the patient's complaint on his or her current everyday lifestyle or work performance is recorded in the history of present illness. TOP: Discipline: Behavioral S N ci en R ce U S I N G M S B C . : C Or ga M n System: General 10. The patient's perceived disabilities and functional limitations are recorded in the: a. problem list. b. general patient information. c. social history. d. review of systems. e. past medical history. ANS: E T O Past medical history contains information about the patient's lifetime as well as disabilities or functional limitations that alter activities of daily living. TOP: Discipline: Behavioral Science MSC: Organ System: General 11. The review of systems is a component of the: a. physical examination. b. health history. c. assessment. d. past medical and surgical history. e. personal and social history. ANS: E Review of systems relates health history according to physical systems and is related just before the actual physical examination. TOP: Discipline: Behavioral Science MSC: Organ System: General 12. Allergies to drugs and foods are generally listed in which section of the medical record? a. General patient information b. Past medical history c. Social history d. Problem list e. History of present illness ANS: B The past medical history section contains information such as drugs, foods, and environmental allergies. TOP: Discipline: Behavioral Science MSC: Organ System: General 13. Objective data are usually recorded: a. by body systems. b. in the history. c. subsequent to the assessment and plan. d. before the health history. e. in the problem list. ANS: A All objective data are recorded by body systems and anatomic locations. TOP: Discipline: Behavioral Science MSC: Organ System: General 14.1 Information recorded about N 4 U R S I N G T B.C infant's: an infant differs from ha . a. attention span. b. developmental status. c. nutritional differences. d. source of information. e. limited past medical history. ANS: B O t M t of an adult, mainly because of the The organizational structure of an infant's record is different because the infant's current and future health is referenced in terms of developmental status. TOP: Discipline: Behavioral Science MSC: Organ System: General 15. In which section of the newborn history would you find details of gestational assessment and extrauterine adjustment data? a. Family b. General patient information c. Personal and social d. Present problem e. Past medical ANS: D For a newborn, the focus of recorded information is the details of the mother's pregnancy, the gestational development, and events occurring since birth. These data are recorded in the present problem section of the history. TOP: Discipline: Behavioral Science MSC: Organ System: General 16. Data relevant to the social history of older adults include information on: a. family support systems. b. extra time to assume positions. c. over-the-counter medication intake. d. date of last cancer screening. e. previous healthcare visits. ANS: A The social history of older adults includes community and family support systems. Healthcare visits, medications, cancer screenings, and extra time to assume positions for the physical examination are not part of the social history. TOP: Discipline: Behavioral Science MSC: Organ System: General 17. A SOAP note is used in which type of recording system? a. Preventive care b. Pedigree c. Systems review d. Traditional treatment e. Problem oriented ANS: E A SOAP note, which includes subjective problem data, objective problem data, assessment, and plan, is a type of recording system that has a problem-oriented style. TOP: Discipline: Behavioral Science MSC: Organ System: General 18. The examiner's evaluation of a patient's mental status belongs in the: a. history of present illness. b. review of systems. c. physical examination. d. patient education. e. problem list. ANS: C Mental status assessment, including cognitive and emotional stability and speech and language, is part of the physical examination. Anything subjective is part of the review of systems and those findings that are objective are part of the provider's assessment. TOP: Discipline: Behavioral Science MSC: Organ System: General 19. When recording physical findings, which data are recorded first for all systems? a. Review of systems b. Percussion c. Palpation d. Auscultation