Medical History and Physical Examination: Master the Basics for Medical Assistants

Question 1

In the proper documentation order for a patient's medical history, what is the first step?

Accepted Answer

Chief complaint

Answer

Present illness

Answer

Past history

Answer

Family history

Question 2

Which term accurately describes a symptom that is experienced and reported by the patient themselves?

Accepted Answer

Symptom

Answer

Sign

Answer

Observation

Answer

Diagnosis

Question 3

Which of the following is NOT typically included in a patient's medical history?

Accepted Answer

Recent laboratory results

Answer

Current symptoms

Answer

Past medical conditions

Answer

Family medical history

Question 4

What is the medical term for an abnormal heart sound?

Accepted Answer

Murmur

Answer

Auscultation

Answer

Palpation

Answer

Percussion

Question 5

Which abbreviation stands for 'temperature, pulse, respirations, blood pressure'?

Accepted Answer

TPR

Answer

BMI

Answer

BP

Answer

ECG

Question 6

Which of the following terms refers to inflammation of the joints?

Accepted Answer

Arthritis

Answer

Pneumonia

Answer

Dermatitis

Answer

Myositis

Question 7

What is the primary purpose of obtaining a patient's family medical history?

Accepted Answer

To identify potential genetic risks

Answer

To eliminate environmental causes of illness

Answer

To establish a holistic view of the patient's health

Answer

To predict future health issues

Question 8

Which symptom is commonly associated with a urinary tract infection?

Accepted Answer

Dysuria

Answer

Hemoptysis

Answer

Arthralgia

Answer

Enanthem

Question 9

What is the medical term for a physical examination of the abdomen?

Accepted Answer

Abdominal exam

Answer

Auscultation

Answer

Palpation

Answer

Percussion

Question 10

Which of the following is not considered a type of medical record?

Accepted Answer

Financial statement

Answer

Patient chart

Answer

Laboratory report

Answer

Imaging results

Question 11

What is the primary reason for documenting a patient's medical history in their chart?

Accepted Answer

To create a comprehensive record for future reference

Answer

To fulfill legal and regulatory requirements

Answer

To assist in insurance processing

Answer

To facilitate communication among healthcare providers

Question 12

What are some potential consequences of errors in medical history and physical examination documentation?

Accepted Answer

Misdiagnosis

Accepted Answer

Delayed treatment

Accepted Answer

Legal liability

Question 13

Which of the following is NOT a category of medical history?

Accepted Answer

Physical examination

Answer

Medical history

Answer

Social history

Answer

Occupational history

Question 14

Which of the following is NOT included in the steps of taking a medical history?

Accepted Answer

Performing a physical examination

Answer

Asking open-ended questions

Answer

Actively listening to patient responses

Answer

Documenting patient information

Question 15

What is the medical term for the process of listening to sounds within the body?

Accepted Answer

Auscultation

Answer

Examination

Answer

Measurement

Answer

Testing

Question 16

Which of the following is a common symptom associated with a respiratory infection?

Accepted Answer

Cough

Answer

Fever

Answer

Headache

Answer

Nausea

Question 17

What is the abbreviation used in medical records for 'chief complaint'?

Accepted Answer

CC

Answer

HPI

Answer

ROS

Answer

PMH

Question 18

Which assessment technique involves touching the patient's skin to evaluate its texture and integrity?

Accepted Answer

Palpation

Answer

Auscultation

Answer

Percussion

Answer

Inspection

Question 19

What medical term describes difficulty breathing?

Accepted Answer

Dyspnea

Answer

Tachypnea

Answer

Bradypnea

Answer

Apnea

Question 20

Which of the following is NOT a component of a comprehensive medical history?

Accepted Answer

Treatment plan

Answer

Review of systems

Answer

Social history

Answer

Family history

Question 21

What is the correct order in which a medical history is typically taken?

Accepted Answer

Chief complaint, present illness, past medical history, social history, family history

Answer

Present illness, chief complaint, past medical history, family history, social history

Answer

Chief complaint, present illness, social history, family history, past medical history

Question 22

What is the overarching purpose of conducting a physical examination?

Accepted Answer

To objectively evaluate the patient's physical condition and identify any abnormalities or areas of concern.

Answer

To solely provide a treatment plan

Answer

To develop a conclusive diagnosis

Question 23

Which of the following components is NOT typically included in a comprehensive physical examination?

Accepted Answer

Nutritional status

Answer

Cardiovascular evaluation

Answer

Musculoskeletal assessment

Answer

Respiratory examination

Question 24

What medical term refers to the practice of tapping on the chest to assess underlying structures?

Accepted Answer

Percussion

Answer

Auscultation

Answer

Palpation

Answer

Inspection

Question 25

What is the primary purpose of auscultation during a physical examination?

Accepted Answer

To listen for sounds produced within the body, such as heartbeats and lung sounds.

Answer

To detect abnormalities through touch

Answer

To observe the patient's physical appearance

Question 26

Which of the following tests is considered a neurological examination?

Accepted Answer

Romberg test

Answer

Urinalysis

Answer

Liver function test

Answer

Complete blood count

Question 27

Why is proper documentation essential in medical history taking and physical examinations?

Accepted Answer

Accurate documentation ensures the creation of complete and reliable patient records, facilitating effective treatment and continuity of care.

Answer

To solely impress patients

Answer

To primarily avoid legal liability