CPCA Reading Comprehension 4

Question 1

A progress note reads: 'Patient presents for follow-up of her Type 2 DM. HbA1c returned at 9.2%. Patient reports adherence to diet but admits to missing metformin doses frequently.' What does an HbA1c of 9.2% indicate?

Accepted Answer

Poorly controlled blood sugar over the past 2-3 months

Answer

HbA1c reflects average blood glucose over 2-3 months; a level of 9.2% is significantly above the target of <7% for most diabetics, indicating poor control.

Question 2

An operative report states: 'The patient underwent arthroscopic debridement of the right knee with partial medial meniscectomy. The chondral surfaces were inspected and found to be intact.' What does 'debridement' mean in a surgical context?

Accepted Answer

Removal of damaged, necrotic, or foreign tissue to promote healing

Answer

Debridement is the surgical removal of devitalized, damaged, or contaminated tissue to allow healthy tissue to heal.

Question 3

A lab report reads: 'WBC 14.2 K/uL (ref: 4.5–11.0), Neutrophils 88% (ref: 50–70%), Bands 12% (ref: 0–5%).' A coder reviewing this for sepsis criteria notes a 'left shift.' What does a 'left shift' indicate?

Accepted Answer

An increase in immature neutrophils (bands), suggesting acute infection or inflammation

Answer

A left shift refers to the release of immature neutrophils (bands) into circulation, indicating the bone marrow is working overtime during infection or sepsis.

Question 4

A consultation note reads: 'I reviewed the patient's echocardiogram which demonstrates an ejection fraction of 35% with global hypokinesis and moderate mitral regurgitation.' What does an ejection fraction of 35% indicate?

Accepted Answer

Reduced cardiac function, indicating systolic heart failure

Answer

Normal ejection fraction is 55-70%; an EF of 35% indicates the heart is pumping poorly, consistent with systolic (reduced EF) heart failure.

Question 5

A physician documents: 'The patient was seen for an annual wellness exam. She is a G3P2 female with LMP 6 weeks ago. Urine hCG is positive.' What does 'G3P2' mean in obstetric notation?

Accepted Answer

Gravida 3 (3 total pregnancies), Para 2 (2 deliveries after 20 weeks)

Answer

In obstetric notation, G (Gravida) = total number of pregnancies including the current one, and P (Para) = number of deliveries at or beyond 20 weeks.

CPCA Exam Practice Test

CPCA Exam Practice Test

CPCA Reading Comprehension 4