HM Scribe America Exam Questions With Complete
Solution
2+ Carotid Pulse Correct Answer Neck
2+ Dorsalis Pedi Pulse Correct Answer Back of foot
2+ Posterior Tibial Pulse Correct Answer Top of foot
2+ Radial Pulse Correct Answer Wrist
A 43-year-old male presents to the ED with vomiting that began
5 hours ago. He has a history of Type I DM and is s/p right
BKA. On objective evaluation it is found that he is
hyperglycemic with elevated ketones and will be admitted for
DKA. Match the details to the correct section of the H&P note.
Correct Answer Primary Diagnosis: DKA
PSHx: right BKA
PMHx: Type I DM
ED Course Summary: hyperglycemia with elevated ketones
HPI: onset 5 hours ago
CC: vomiting
A 56 y/o female is admitted to the hospital for altered mental
status. On physical exam the provider tells you that the patient is
morbidly obese with GCS of 9. She has dry mucous membranes
, and a left BKA. Match the findings to the corresponding body
system. Correct Answer ENT: dry mucous membrane
Neurological: CGS of 9
General/Constitutional: morbidly obese
Musculoskeletal: left BKA
A 65 y/o male is admitted with chest pain, which of the follow
details should not be included in the HPI? Correct Answer The
patient's father has a history of pancreatic cancer
A 75 y/o female is admitted with pneumonia, which of the
following details should not be included in the HPI? Correct
Answer When asked if she has any pain, the patient states that
her back hurts. Her daughter is at the bedside and notes that the
back pain is chronic
A patient currently in atrial fibrillation with RVR will likely
have all of the following except: Correct Answer Tachypnea
A patient has the following history documented in the note:
breast CA s/p chemoradiation therapy, mastectomy and
occasional alcohol use. Based on this information the note does
not meet level 3 requirements for an H&P and will be down-
coded. What additional finding can be added to this section of
the note to ensure the H&P note meets level 3 requirements?
Correct Answer Her mother also has a history of breast cancer
A patient is 2 days post-op and has not had a bowel movement.
The doctor performs a physical exam and tells you that bowel
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