MedTerm CH 4 - The Medical Record

Which of the following is the abbreviation for height?

• HPI

• Hx

• Ht

• Ho

______ chronicle the care throughout a patient's hospital stay.

• consultation reports

• nurse's notes

• pathology reports

• operative reports

In a SOAP progress note, the "s" stands for _____.

• the things the patient describes

• strategies for treatment

• the diagnosis

• observable facts

STAT means _____.

• during treatment

• today

• in one hour

• immediately

The abbreviation for history is _____.

• Ht

• Hs

• Hx

• HPI

When correcting a medical record, you should use correction fluid (white out) so it will be easier to read.

• true

• false

What time is 1300 hours?

• 3:00 pm

• 1:00 pm

• 3:00 am

• 1:00 am

Which of the following abbreviations has been deemed error prone?

• q.n.s.

• NPO

• OU

• PO

_____ means harmful or cancerous.

• beneign

• chronic

• malignant

• idopathic

A list of drugs used, dosages, and times given during surgery is listed on the _____ report.

• nurse's

• anesthesiologist's

• doctor's

• consultation's