Advanced Health Assessment and
Diagnostic Reasoning Exam
With answers
Subjective Data - answer-Things the pt tells you
Objective data - answer-What your seeing, observing, or examining
The chief compliant should use the ____ - answer-Patient's own words
History of present illness nomics - answer--OLDCARTS (onset, location, duration,
characteristics, aggravating/alleviating, radiation, timing, severity)
-OPQRST (onset, provocation, quality, radiation, severity, timing)
Concerning health history findings - answer--Changes in weight
-Fatigue or weakness
-Fever, chills, and night sweats
Concerning health history findings: changes in weight - answer--Rapid or gradual - rapid
changes over a few days suggest changes in fluid, not tissue
-Weight gain: nutrition vs. medical causes
-Weight loss: medical vs. psychosocial causes
Concerning health history findings: fatigue and weakness - answer-Medical vs.
psychosocial
Fatigue - answer-A sense of weariness or loss of energy
Weakness - answer-A demonstrable loss of muscle muscle power
Concerning health history findings: fever, chills, and night sweats - answer--Ask about
exposure to illness or any recent travel
-Some medications may cause elevated temperature
What are the types of pain? - answer--Nociceptive (somatic)
-Neuropathic
-Idiopathic
-Psychogenic
-Chronic
Nociceptive (somatic) - answer--Damage to tissue or viscera but sensory nerves intact
-Described as dull, pressing, pulling, throbbing, boring, spasmodic, or colicky
Neuropathic - answer--Direct trauma to the peripheral or central nervous system
-Described as shock like, stabbing, burning, pins and needles
,Idiopathic - answer-No identifiable etiology
Psychogenic - answer-Related to factors that influence the patient's report of pain
(psychiatric conditions, personality and coping style, cultural norms, social support
systems)
ChronicN - answer--Not due to cancer or illness lasting > 3-6 months
-Lasting > 1 month beyond the course of an illness
-Recurring at intervals over months or years
All notes should start with the following documentation: - answer--Date of encounter
-Patient name (age is also important)
-Informant and reliability
SOAP format - answer--Subjective
-Objective
-Assessment
-Plan
BMI - answer--Weight (lbs) x 700/height (inches)
-Weight (kgs)/height (m^2)
BMI: underweight - answer-< 18.5
BMI: normal - answer-18.5 - 24.9
BMI: overweight - answer-25-29.9
BMI: obesity - answer--I: 30 - 34.9
-II: 35 - 39.9
BMI: extreme obesity - answer-III: > (or equal to) 40
Orthostasis - answer-Systolic BP drops >20 mm Hg or diastolic BP drops >10 mm Hg
Heart rate and rhythm - answer--Count 30 seconds (if rate is 50-90 and rhythm regular)
-Count 60 seconds (if rate is <50 or >90 and/or rhythm is irregular)
Respiratory rate - answer--Normal rate: 12-20 breaths/minute
-Count for a full 60 seconds
-Observe
Rhythm: regular, irregular
Depth: shallow, gasping
, Effort: normal, labored
A patient presents with a 6-day history of rapid weight gain. The most likely explanation
is:
-A. Dysphagia
-B. Excessive absorption of nutrients
-C. Diabetes mellitus
-D. Accumulation of body fluids - answer-D
A patient presents a routine check-up. You see that the patient's vital signs have already
been recorded as follows: T 98.4 F, HR 74, R 18, BP 180/98 What would be the MOST
appropriate action related to this patient's vital signs?
-A. The blood pressure should be repeated at the next visit
-B. Repeat the blood pressure and verify in contralateral arm
-C. Check the heart rate again to see if it is regular
-D. Listen to the patient's lungs for adventitious sounds - answer-B
Your patient presents with a chief complaint of chest pain. Which of the following would
be the most appropriate first question/statement?
-A. Tell me about your chest pain
-B. Does your pain radiate to any other area?
-C. How many steps can you climb before the pain begins?
-D. Do you have any nausea/vomiting/diarrhea?
-E. When did your pain start? - answer-A
In which of the following sections would you use the OLDCARTS mnemonic to attain the
required information?
-A. Chief complaint
-B. History of present illness
-C. Social history
-D. Personal history
-E. Review of systems - answer-B
Identify if the following are subjective or objective
-A. The patient presented with a chief complaint of fever for the last 6 days ----B.The
patient is well groomed and appears withdrawn
-C.You obtained vital signs at this visit
-D.The patient denies ever smoking, admits to 2-12oz beers daily, and denies any illicit
drug use
-E.The patient has ring shaped burns on the forearms resembling the coil of a stove
-F.The patient's chest pain radiates to the left arm - answer--A: S
-B: O
-C:O
-D: S
Diagnostic Reasoning Exam
With answers
Subjective Data - answer-Things the pt tells you
Objective data - answer-What your seeing, observing, or examining
The chief compliant should use the ____ - answer-Patient's own words
History of present illness nomics - answer--OLDCARTS (onset, location, duration,
characteristics, aggravating/alleviating, radiation, timing, severity)
-OPQRST (onset, provocation, quality, radiation, severity, timing)
Concerning health history findings - answer--Changes in weight
-Fatigue or weakness
-Fever, chills, and night sweats
Concerning health history findings: changes in weight - answer--Rapid or gradual - rapid
changes over a few days suggest changes in fluid, not tissue
-Weight gain: nutrition vs. medical causes
-Weight loss: medical vs. psychosocial causes
Concerning health history findings: fatigue and weakness - answer-Medical vs.
psychosocial
Fatigue - answer-A sense of weariness or loss of energy
Weakness - answer-A demonstrable loss of muscle muscle power
Concerning health history findings: fever, chills, and night sweats - answer--Ask about
exposure to illness or any recent travel
-Some medications may cause elevated temperature
What are the types of pain? - answer--Nociceptive (somatic)
-Neuropathic
-Idiopathic
-Psychogenic
-Chronic
Nociceptive (somatic) - answer--Damage to tissue or viscera but sensory nerves intact
-Described as dull, pressing, pulling, throbbing, boring, spasmodic, or colicky
Neuropathic - answer--Direct trauma to the peripheral or central nervous system
-Described as shock like, stabbing, burning, pins and needles
,Idiopathic - answer-No identifiable etiology
Psychogenic - answer-Related to factors that influence the patient's report of pain
(psychiatric conditions, personality and coping style, cultural norms, social support
systems)
ChronicN - answer--Not due to cancer or illness lasting > 3-6 months
-Lasting > 1 month beyond the course of an illness
-Recurring at intervals over months or years
All notes should start with the following documentation: - answer--Date of encounter
-Patient name (age is also important)
-Informant and reliability
SOAP format - answer--Subjective
-Objective
-Assessment
-Plan
BMI - answer--Weight (lbs) x 700/height (inches)
-Weight (kgs)/height (m^2)
BMI: underweight - answer-< 18.5
BMI: normal - answer-18.5 - 24.9
BMI: overweight - answer-25-29.9
BMI: obesity - answer--I: 30 - 34.9
-II: 35 - 39.9
BMI: extreme obesity - answer-III: > (or equal to) 40
Orthostasis - answer-Systolic BP drops >20 mm Hg or diastolic BP drops >10 mm Hg
Heart rate and rhythm - answer--Count 30 seconds (if rate is 50-90 and rhythm regular)
-Count 60 seconds (if rate is <50 or >90 and/or rhythm is irregular)
Respiratory rate - answer--Normal rate: 12-20 breaths/minute
-Count for a full 60 seconds
-Observe
Rhythm: regular, irregular
Depth: shallow, gasping
, Effort: normal, labored
A patient presents with a 6-day history of rapid weight gain. The most likely explanation
is:
-A. Dysphagia
-B. Excessive absorption of nutrients
-C. Diabetes mellitus
-D. Accumulation of body fluids - answer-D
A patient presents a routine check-up. You see that the patient's vital signs have already
been recorded as follows: T 98.4 F, HR 74, R 18, BP 180/98 What would be the MOST
appropriate action related to this patient's vital signs?
-A. The blood pressure should be repeated at the next visit
-B. Repeat the blood pressure and verify in contralateral arm
-C. Check the heart rate again to see if it is regular
-D. Listen to the patient's lungs for adventitious sounds - answer-B
Your patient presents with a chief complaint of chest pain. Which of the following would
be the most appropriate first question/statement?
-A. Tell me about your chest pain
-B. Does your pain radiate to any other area?
-C. How many steps can you climb before the pain begins?
-D. Do you have any nausea/vomiting/diarrhea?
-E. When did your pain start? - answer-A
In which of the following sections would you use the OLDCARTS mnemonic to attain the
required information?
-A. Chief complaint
-B. History of present illness
-C. Social history
-D. Personal history
-E. Review of systems - answer-B
Identify if the following are subjective or objective
-A. The patient presented with a chief complaint of fever for the last 6 days ----B.The
patient is well groomed and appears withdrawn
-C.You obtained vital signs at this visit
-D.The patient denies ever smoking, admits to 2-12oz beers daily, and denies any illicit
drug use
-E.The patient has ring shaped burns on the forearms resembling the coil of a stove
-F.The patient's chest pain radiates to the left arm - answer--A: S
-B: O
-C:O
-D: S
