NCP- Documentation

Which of the following is a standard component of a patient's medical record?

• Patient's family photos

• History and physical examination

• Hospital visitor log

• Employee training checklist

The section of the medical record that includes vital signs, biochemical markers, and imaging reports is known as:

• Social history

• Diagnostic and laboratory data

• Nutrition screening

• Administrative information

Which component of the medical record contains the healthcare provider’s plan for patient care?

• Progress notes

• Consent forms

• Billing statements

• Admission order sheet

In the Philippines, who is primarily responsible for updating the nutrition care notes in a patient’s medical record?

• Nurse on duty

• RND

• Attending physician

• Medical technologist

Which document within the medical record legally permits treatment or procedures to be performed?

• Problem list

• Progress notes

• Informed consent form

• Intake-output chart

What does the abbreviation “NPO” stand for in a nutrition care context?

• Nutrition per oral

• Nothing by mouth

• Nutritional patient order

• No processed options

Which of the following abbreviations indicates a patient should receive nutrition via a feeding tube into the stomach?

• IV

• TPN

• PEG

• NGT

In the NCP, which abbreviation refers to a total nutritional formula delivered intravenously?

• PO

• TPN

• EN

• BMI

If a dietitian writes “PO diet tolerated,” what does “PO” mean?

• Post-operation

• By mouth (per os)

• Protein-only

• Physician’s order

Which abbreviation refers to a type of nutritional support that is delivered directly into the bloodstream?

• EN

• NPO

• TPN

• PEG