Medical Assistant Knowledge Assessment, Exams of Nursing

Download Medical Assistant Knowledge Assessment and more Exams Nursing in PDF only on Docsity! NCCT Practice Exam: Questions & Answers The medical assistant should refer to which of the following agencies to access updated immunization schedules? A. CDC B. FEMA C. FDA D. OSHA (>>- Correct response: CDC Rationale: Centers for Disease Control (CDC) maintains the most current and up to date immunization schedule recommendations online. The Food & Drug Administration (FDA) is a federal agency of the United States Department of Health and Human Services and is tasked with providing accurate, science-based health information to the public. The Occupational Safety and Health Administration (OSHA), a federal agency of the United States that regulates workplace safety and health. Federal Emergency Management Agency (FEMA): a US government body intended to coordinate responses to a disaster in the US itself. Forced Vital Capacity is measured by instructing the patient to A. exhale as fast and hard as possible and document the reading. B. move the one way valve to a minimum of 4000 ml capacity. C. forcefully breath air out and continue to exhale for at least 6 seconds. D. complete a minimum of eight acceptable efforts to validate the test. (>>- Correct response: forcefully breath air out and continue to exhale for at least 6 seconds. Rationale: Respiratory tests are performed to assess and/or monitor lung function. A spirometer measures how fast and how much air is pushed/forced out of the lungs. Forced Vital Capacity (FVC) is measured by instructing the patient to forcefully breath air out and continue to exhale for at least 6 seconds. When doing spirometry testing, the total attempts should be limited to 8, not a minimum of 8. The one way valve should not be moved to 4000 mL capacity. A patient should blow out as hard and fast for as long as possible, and 3 acceptable attempts are documented to ensure test validity (not just the highest reading). An older adult patient arrives to have blood drawn. While assessing the arms for venipuncture, the medical assistant notices scar tissue in the antecubital areas and is unable to palpate a vein. Which of the following is an appropriate alternative course of action? A. Draw blood from the hand using an evacuated tube system. B. Use a larger gauge needle to penetrate through the scar tissue. C. Draw blood from the hand using a winged infusion set. D. Perform a capillary puncture on the lateral thumb. (>>- Correct response: Draw blood from the hand using a winged infusion set. Rationale: Areas with visible scar tissue should be avoided when selecting a site for venipuncture. Scarring can cause the area to be difficult to puncture and may obstruct blood flow. So, the best approach is to draw blood from the hand using a winged infusion set (a.k.a. butterfly). Use of an evacuated tube could collapse the vein due to the vacuum pressure. A capillary puncture would not be the best approach because a venous draw on the hand would give a superior specimen. When managing multiple incoming calls, the medical assistant should handle which of the following calls first? A. A patient calling to schedule a follow-up visit for uncontrolled pain after hip surgery. B. A neurologist seeing a patient on consult. C. A patient calling to cancel today's appointment for a needle biopsy of a breast mass. D. A lawyer with a subpoena asking for patient information. (>>- Correct response: A neurologist seeing a patient on consult. Rationale: The medical assistant's main priority is to handle the most urgent call promptly. A neurologist calling to report on a referred patient does not have the authority to change, alter, or down code the code without consulting the physician. Which of the following is the purpose of scheduling preadmission testing (PAT) prior to surgery? A. To ensure the procedure is covered by the patient's insurance. B. To assess preparation and recovery time needed before and after surgery. C. To provide documentation to the insurance company to waive the copay. D. To assess patients' health to make sure they can tolerate the proposed surgical procedure. (>>- Correct response: To assess patients' health to make sure they can tolerate the proposed surgical procedure. Rationale: Testing is performed prior to a surgery as an assessment of the patient's health. It is used to measure whether or not the surgical procedure can be tolerated. It's a matter of risk versus benefit. If the preadmission testing shows that the patient is not "strong" enough ("healthy" enough) to tolerate the surgical procedure, it could be more harmful to proceed with the surgery than to delay or cancel it (since the surgery could do more harm than good). Which of the following is a CLIA waived test that can be performed by the medical assistant? A. chemical urinalysis B. differential C. Gram stain analysis D. crossmatch (>>- Correct response: chemical urinalysis Rationale: A medical assistant can perform a chemical urinalysis test, which shows if the patient has protein or glucose in their urine, but would require intervention by the primary care provider. A chemical urinalysis can also tell what the specific gravity of the urine, meaning how diluted or concentrated it is. The test is done with a small dipstick that changes color when it comes into contact with urine. The medical assistant then compares the stick to a chart to see what is in the urine and if anything is abnormal. A differential is done by a laboratory technician. It is done by drawing blood and then placing the blood on a glass slide to look for any signs of infection or anemia. A Gram stain analysis is also done in the lab under a microscope when a bacterial or viral infection is suspected. Cross- matching is a test administered before a blood transfusion to ensure the donor's blood is compatible with the recipient. This test is performed by a certified laboratory technologist. Which of the following acts involves the termination of a patient from the care of a physician without reasonable, written notice of withdrawal from the case? A. slander B. battery C. discrimination D. abandonment (>>- Correct response: abandonment Rationale: A physician or primary care provider who wishes to end a patient-physician relationship must follow a formal notification process to avoid a claim of patient abandonment. The medical assistant may help with this process to ensure proper completion. Steps include writing a formal notification letter informing the patient, including reason(s) for withdrawal and effective time frame, mailing the letter certified with return receipt, ensuring a copy of the letter and all documentation is placed in the patient's medical record, documenting the termination in the patient's record and actions taken. The medical assistant should stamp checks with the restrictive endorsement "for deposit only" to prevent A. loss or theft. B. overdraft fees. C. stop-payment. D. nonsufficient funds. (>>- Correct response: loss or theft. Rationale: Endorsement is required to ensure transfer funds from one party to another under the Uniform Negotiable Instrument Act, applicable in all states. For how many years should a provider store medical records (select the least number of years that maintains compliance with state and federal regulations)? A. 15 years B. 10 years C. 5 years D. 20 years (>>- Correct response: 10 years Rationale: Federal and state regulations require a minimum storage time frame for medical records. State regulations may require a longer or shorter time frame, depending on the state. Every medical provider should routinely check state and federal requirements to remain compliant. As of the date this question was submitted (2015), a 7 to 10 year time frame would meet all federal and state medical record storage requirements. Flow charts, progress notes, and narrative notation are all examples of A. medical record charting styles. B. patient documentation in a SOAP format. C. recording patient information in a medical record. D. patient chart filing systems. (>>- Correct response: recording patient information in a medical record. Rationale: Patient information can be recorded in the medical record in a variety of ways. Progress notes, flow charts and narrative notation are all effective ways to document a patient's medical information. The SOAP format is the documentation system chosen by many physicians. S=Subjective patient interview information, O=Objective information such as vitals, lab values, etc., A=Assessment of the "S" and "O" data, P=Plan for treatment or follow-up. Medical records of various styles are generally kept in charts, which are filed according to a filing system. etc.) to transmit the disease. The mode of infection refers to how infectious diseases are spread: by contact, by vehicle, by vector, and by inhalation. The infectious agent enters a susceptible host through a portal of entry.Correct response: reservoir host, portal of exit, means of transmission, portal of entry, susceptible host Rationale: Infectious diseases are spread through a series of steps known as the "chain of infection". For an infection to occur and spread, each of the six links of the chain must take place. Removing any link in the chain will stop the cycle. Therefore, identifying and instituting appropriate actions at different steps in the cycle will halt the spread of the infection. The chain begins with the infectious agent (bacteria, virus,etc.) and spreads to a reservoir (place to live, like an animal, insect, water, etc.). The portal of exit is a way for the microorganism to leave the reservoir (in a cough, feces, etc.) to transmit the disease. The mode of infection refers to how infectious diseases are spread: by contact, by vehicle, by vector, and by inhalation. The infectious agent enters The medical assistant schedules a follow-up appointment for a patient following surgical removal of their uterus. The medical term for this procedure is A. amniocentesis. B. oophorectomy. C. uteroscopy. D. hysterectomy (>>- Correct response: hysterectomy. Rationale: The definition of a Hysterectomy is Hyster- = uterus, ectomy = surgical removal of. An Oophorectomy is the surgical removal of an ovary or ovaries, an Ureteroscopy is an examination of the upper urinary tract, and Amniocentesis is a test used to determine whether an unborn baby has any genetic abnormalities. When inspecting a patient's arm before performing a venipuncture, the most desirable site appears to be the back of the hand. Which of the following venipuncture methods is most appropriate in this situation? A. butterfly needle B. capillary puncture C. needle and syringe D. evacuated tube (>>- Correct response: butterfly needle Rationale: The best choice in this situation is to use a butterfly needle, a winged needle with flexible tubing that is short in length. Butterfly needles are easier to insert into tiny, fragile, and/or rolling surface veins close to the skin. If a butterfly is not available, a needle and syringe would be the next choice. The vacuum pressure of evacuated tubes can collapse small or fragile veins such as those on the back of the hand. A capillary puncture would be the last option here, and would be used in the instance of a failed butterfly or syringe attempt (provided there are no other veins available). A medical assistant is positioning a patient for sigmoidoscopy. Which of the following positions would be appropriate for the procedure? A. supine B. Trendelenburg C. lithotomy D. Sims (>>- Correct response: Sims Rationale: For a sigmoidoscopy, the patient will need to lie on the left side with the right knee bent, which is also referred to as the Sims position. This allows the physician to insert the sigmoidoscope through the anus to the colon to get a clear look at the area. The lithotomy position is when the patient lies on their back with the thighs spread apart and the hips and knees bent. This position is mostly used for vaginal examinations and childbirth, and would not be the best position for a sigmoidoscopy. The Trendelenburg position is when the patient lies flat on their back with the feet elevated higher than the head by 15-30 degrees, and the supine position is achieved when the patient is lying flat on their back with no part of the body elevated. The Trendelenburg and supine positions would not typically be used for a sigmoidoscopy, because if the patient is lying on their back it does not allow the physician to easily insert the sigmoidoscope into the anus to get a clear view of the sigmoid colon. An established patient who has Chronic Obstructive Pulmonary Disease is evaluated in the medical office for hypertension. What is the importance of identifying the reason for today's visit related to billing? A. to assign a two-digit modifier B. to assign a V code C. to determine the primary diagnosis D. to ensure a secondary diagnosis is not listed on the claim form (>>- Correct response: to determine the primary diagnosis Rationale: In this example, hypertension should be listed as the primary diagnosis (main reason the patient sought care for visit) and COPD as secondary (this will disease will be considered when medications are prescribed for HTN.) A large open container of isopropyl alcohol is spilled on the floor in the clinic waiting area. The medical office assistant should use which of the following resources for information about the chemical and any necessary procedure? A. Poison Control Center B. Physician's Desk Reference C. Material Safety Data Sheet D. Clinical Laboratory Improvement Amendments (>>- Correct response: Material Safety Data Sheet Rationale: Access to Material Safety Data Sheets is an OSHA compliance requirement. Each MSDS contains information on the potential hazards (health, fire, reactivity and environmental) and how to work safely with chemical products. It is an essential starting point for the development of a complete health and safety program. Clinical Laboratory Improvement Rationale: This is an example of the anger stage, when this patient is forced to come to terms with the debilitating disease or condition for which there are limited treatment options without expectation of cure. Depression is when the patient experiences significant loss of hope and sadness. When patients are in denial, they act as though the situation is not real and deny there is an issue. Patients in the acceptance phase actually come to terms with the situation and make peace with the circumstance. Which of the following describes proper aseptic technique in the cleaning of the venipuncture site? A. Wipe the site in a back and forth motion with an alcohol wipe B. Let the alcohol air dry before inserting the needle C. Allow the alcohol to soak into the skin, then wipe off excess with sterile gauze D. Wave above the site with a gloved hand to dry the alcohol faster (>>- Correct response: from the inside out Rationale: The medical assistant should clean from the inside out to prevent contamination. Cleaning back and forth, up and down, or from the outside in would all cause contamination at the site and would not be the best way to cleanse the area. Which of the following describes proper aseptic technique in the cleaning of the venipuncture site? A. Let the alcohol air dry before inserting the needle B. Allow the alcohol to soak into the skin, then wipe of excess with sterile gauze C. Wipe the site in a back and forth motion with an alcohol wipe D. Wave above the site with a gloved hand to dry the alcohol faster (>>- Correct response: Let the alcohol air dry before inserting the needle Rationale: Proper preparation for venipuncture requires that the site be cleansed (70% isopropyl alcohol or other antiseptic agent as indicated by the manufacturer's instructions). Human skin harbors normal flora (bacteria that naturally lives on the surface of the skin). To prevent introduction of said bacteria into the patient or the blood samples, the phlebotomist should apply the antiseptic to the venipuncture site (in concentric circles to avoid contaminating cleansed areas with the antiseptic applicator). The antiseptic should be allowed to air dry, allowing ample time for the antiseptic action to take effect. Residual (undried) alcohol could lead to hemolysis of the specimen and could create a burning sensation for the patient upon needle insertion. Older adult patients are the population most at risk for which of the following medication complications due to a declining liver function? A. tinnitus B. anaphylaxis C. polyuria D. toxicity (>>- Correct response: toxicity Rationale: In older adults, the rate of drug metabolism is decreased, and this increases the risk of toxicity, which is the build-up of medication in the blood stream. Anaphylaxis is a serious allergic reaction, tinnitus is ringing in the ears, and polyuria is a large amount of urine. The patient is given an incorrect dose of acetaminophen (Tylenol) in the medical office. The medical assistant should complete an incident report in this situation in order to A. prevent legal action against the practice. B. ensure it becomes part of the patient's medical record. C. understand the circumstances and prevent future occurrences. D. begin disciplinary action against the responsible employee. (>>- Correct response: understand the circumstances and prevent future occurrences. Rationale: The reporting of medical errors is essential to patient safety improvement and risk management in all health care settings. Incident reports are not part of a patient's medical record, but may be used in litigation. It should not be documented in the patient's medical record that an incident report was submitted. Which of the following needle gauges is most commonly used for venipuncture? A. 21-23 B. 18-20 C. 16-17 D. 24-25 (>>- Correct response: 21-23 Rationale: The gauge of a needle refers to its outer diameter (smaller numbers= larger diameters and vice versa). The most commonly used needle for venipuncture is a 21-23 gauge. The needle size must be large enough to prevent hemolysis (break down of blood cells). While scheduling an appointment, the medical office assistant's computer freezes. When attempting to restart the program, which of the following should the medical office assistant do first? A. Unplug computer from the outlet source. B. Shut down the computer. C. Restart the computer. D. Press the Ctrl, Alt and Delete keys. (>>- Correct response: Press the Ctrl, Alt and Delete keys. Rationale: By pressing the CTRL, ALT and Delete keys, at one time, the computer can reboot by shutting down and then restarting. By pulling the power cord, you can run the risk of damaging the files and hardware. Which of the following types of licensure must a physician have and maintain to legally dispense, prescribe, or administer controlled substances? A. narcotics B. business C. pharmaceutical D. occupational (>>- Correct response: Which of the following phone calls should be handled first? A. A patient concerned about laboratory results about HIV B. A physician returning a page C. A patient complaining of chest pain and shortness of breath D. A patient previously treated with a blood pressure of 142/90 aggressively asking for refills (>>- Correct response: A patient complaining of chest pain and shortness of breath Rationale: By following the ABC rule (airway, breathing, circulation), the patient complaining of chest pain and shortness of breath should be handled first since he/she is exhibiting signs of respiratory distress. The other patients do not require immediate medical attention, therefore, they should be handled after the patient with chest pain and shortness of breath. The medical assistant preps the median cubital vein for a venipuncture procedure. How should the medical assistant prep the patient's skin? A. Wipe the area from top to bottom. B. Use a circular motion, from the inside out. C. Use a circular motion, from the outside in. D. Wipe the area from bottom to top. (>>- Correct response: Use a circular motion, from the inside out. Rationale: A venipuncture is considered a minimally invasive procedure. The fact that the skin will be punctured leaves open the potential to introduce an infection. Therefore, proper care should be taken to minimize the risk of contamination (of the sample) and infection (to the patient). Prep the puncture site with an alcohol pad or equivalent by using a circular motion, from the inside out. A basic rule of thumb is to use a "clean to dirty" approach. The circular motion is the appropriate prepping motion (instead of up and down or side to side). Which of the following actions should the medical assistant take to eliminate the artifact shown in the strip shown above? A. Ensure proper adhesion of the electrodes. B. Check the bed plugin at the wall socket or unplug the bed. C. Have the patient remove jewelry. D. Have the patient sit on their hands. (>>- Correct response: Check the bed plugin at the wall socket or unplug the bed. Rationale: Check for any electrical equipment in use around or in the room; check where the bed is plugged into the wall. This is an artifact called 60 cycle interference caused by electrical interference. Wearing Jewelry or loose electrodes would not have this kind of effect of artifact. Sitting on hands is not a solution. Electrodes are properly adhered to the skin in this instance. Which of the following mail classifications is the most cost-efficient for sending an office newsletter to patients and associates? A. certified B. priority C. express D. standard (>>- Correct response: standard Rationale: Standard mail is the most cost-effective for bulk mailings, because the newsletter doesn't need to be delivered by a certain time and standard mail is the cheapest. Priority, express, and certified mail are not the most cost-efficient option, because they require more paperwork and time to prepare. The medical assistant performs a urine hCG on a patient whose results are inconclusive. Which of the following actions should the medical assistant take next? A. Ask the patient to clarify the date of her LMP. B. Ensure the daily quality control has been performed. C. Immediately retest the sample. D. Collect another urine sample. (>>- Correct response: Ensure the daily quality control has been performed. Rationale: The first thing a medical assistant should do in this instance is to check to make sure quality control has been performed. There can be various reasons for an inconclusive result, one of which is a malfunction of some sort. Quality control should be completed at the appropriate intervals (as set by the manufacturer or laboratory) to ensure that the assay is performing appropriately. If there is an issue with the hCG assay, it is likely that the controls could be out of range. Retesting of the sample would not be advisable if the quality controls have not been run or if they are not within acceptable parameters (so it is important to check QC first). Drawing a blood specimen should not be the first approach, since it is an invasive procedure to the patient and the assay itself could be performing inadequately. The medical assistant is scheduling a patient for a gallbladder study. Which of the following terms should the medical assistant use on the patient test order? A. cystography B. angiography C. cholangiography D. cholecystography (>>- Correct response: cholecystography Rationale: The suffix "graphy" refers to writing, recording or otherwise representing something (data, image, etc.). Angio= blood or vessel Cysto= cyst, urinary bladder or sack of fluid Chole= gall or bile Therefore, a gallbladder study would include a cholecystography. Which of the following ECG leads records the electrical activity of the inferior surface of the left ventricle and is closest to the heart? A. aVL B. aVR C. lead I D. lead II (>>- Correct response: lead II Rationale: Lead II records tracings between the right arm and left leg. This is the lead recorded on a rhythm strip at the bottom of a 12 lead ECG. The transfer of information such as patient eligibility, payment remittances, claims, claim status, authorizations and referrals are addressed under the HIPAA Administrative Simplification and Compliance Act as electronic A. remittance advice. B. report management. C. OSHA D. CLIA (>>- Correct response: CLIA Rationale: CLIA - Clinical Laboratory Improvements Amendments of 1988 are United States federal regulatory standards that apply to all clinical laboratory testing performed on humans in the United States, except clinical trials and basic research. OSHA - Occupational Safety and Health Administration, a federal agency of the United States that regulates workplace safety and health. FDA - Food & Drug Administration is a federal agency of the United States Department of Health and Human Services. DEA - Drug Enforcement Administration is a United States federal law enforcement agency under the U.S. Department of Justice, tasked with combating drug smuggling and use within the United States. The medical assistant documented an IM injection as follows: 10/12/XX @ 1030, Rocephin 1 gram IM patient tolerated procedure well. Amy Ray, medical assistant. Which of the following necessary pieces of documentation is missing? A. physician signature B. site of administration C. frequency of administration D. use of the medication (>>- Correct response: site of administration Rationale: Anatomical site of injection should always be documented for reassessment of local and/or systemic reaction. Every intramuscular injection should be documented with date, time, injection site, medication, dosage, person who gave the injection, and record anything relative to the patient's tolerance of the procedure and response to the medication. Immediately report to the physician any adverse effects from the injection. Physician signature should be on the order, so it isn't necessarily needed on the injection documentation. Medication uses and frequency should be noted elsewhere on the medical record as well. Which of the following resources should the medical assistant use to look up the side effects of (enoxaparin) Lovenox in the medical office? A. laboratory reference manual B. Physician's Desk Reference (PDR) C. Healthcare Common Procedure Coding System (HCPCS) D. Current Procedural Terminology (CPT) (>>- Correct response: Physician's Desk Reference (PDR) Rationale: The PDR (Physician's Desk Reference) is published annually, and is the most common drug reference book. It provides information about medications, their functions, side effects, contraindications, etc. The Healthcare Common Procedure Coding System (HCPCS) is a system of healthcare codes put in place to ensure insurance claims are handled correctly. A laboratory reference manual would contain information about laboratory tests, not medications. Current Procedural Terminology (CPT) codes are used to classify medical procedures and services, therefore these codes don't include information on medication side effects. The endocrinologist requested the patient to return to the outpatient clinic the next day for a glucose tolerance test. Which of the following preparations should the medical assistant instruct the patient to do the night before the test? A. NPO after midnight. B. Ingest 10 ounces of oral glucose solution. C. Drink at least 32 ounces of water. D. Refrain from tobacco use for 24 hours. (>>- Correct response: NPO after midnight. Rationale: Before a glucose tolerance test the patient needs to be NPO (nothing by mouth) after midnight the night before the test. The glucose tolerance test is administered to determine how the body breaks down sugar, so the patient should not eat or drink anything after midnight to ensure the results are not skewed. The patient will ingest the oral glucose solution close to the time of the test. It is recommended that the patient refrain from tobacco use and since the patient needs to be NPO, drinking water the night before is incorrect. A clean-catch midstream urinalysis is ordered for a female patient to rule out a urinary tract infection. The medical assistant should instruct the patient before urinating in the specimen cup to wipe using antiseptic towelettes A. back and forth. B. in concentric circles. C. from front to back. D. from back to front. (>>- Correct response: from front to back. Rationale: The patient should be instructed to always wipe from front to back to prevent infection. When a patient wipes from back to front, in circles, or back and forth, germs from the rectum can be spread to the hand and the urethra. This can get into the urinary tract and cause infections, so it is extremely important that the patient knows to always wipe from front to back. A parent calls the pediatrician's office very upset because her child is vomiting and has a temperature of 103.3 F. The medical assistant should A. instruct the parent to take the child to the emergency room immediately. B. place the parent on hold and transfer the call to the physician. C. schedule a same day work-in appointment. D.suggest an over the counter anti-pyretic. (>>- Correct response: schedule a same day work-in appointment. Rationale: A child presenting with a high fever is an acute situation. In this case, it is best to work the child in for an appointment that same day. Treatment should be started as soon as possible to minimize the side effects brought on by a high fever. The patient is referred to a neurosurgeon. Entering the specialist's NPI number and number of visits requested into the patient's insurance carrier's website is part of which of the following processes? A. assignment of benefits B. electronic claims submission C. precertification D. compensation (>>- Correct response: precertification B. cotton tipped swabs C. blood culture media D. viral transport media (>>- Correct response: bacterial culture swabs Rationale: When helping with a deep wound culture, the medical assistant needs to have bacterial culture swabs available in order to try to identify what bacteria is causing the infection. Bacteria causing infection in a deep wound would likely be anaerobic (because oxygen is not prevalent in a deep wound). For this reason, it is important to make sure the bacterial swab is collected and transported in the appropriate swab system to sustain anaerobic bacteria. Blood culture media is taken by performing a venipuncture to see if an infection is present. Since the physician is looking for a bacterial infection, the viral transport media would not be used, and cotton tipped swabs would not be the appropriate swab to use since the goal is to determine what kind of bacteria is causing the infection. The medical assistant witnesses the medical office receptionist taking money from the cash drawer. The receptionist learns the medical assistant saw her and asks her not to tell the office manager, as it was to pay for her electric bill. Which of the following actions should the medical assistant take? A. Tell the receptionist that she will not tell as long as the money is put back in one week B. Tell the office manager about the incident and request that confidentiality be maintained C. Tell other employees in the office so it will get back to the office manager D. Tell the receptionist that she understands why she is taking the money (>>- Correct response: Tell the office manager about the incident and request that confidentiality be maintained Rationale: The medical assistant has a legal and ethical responsibility to the employer to uphold the highest professional standards. This includes communicating with leadership if unethical behavior is witnessed. In this situation, the best choice for the MA would be to tell the office manager about the incident and request that confidentiality be maintained. The other options in this question, though some may seem compassionate and sympathetic toward a coworker, do not follow ethical practice standards. The adult patient has a puncture wound on the sole of the right foot due to stepping on a nail in a construction area. Which of the following immunizations is particularly important for the medical assistant to ask about while taking the patient's history? A. Td B. PCV C. DTaP D. HepB (>>- Correct response: Td Rationale: Td = Tetanus booster recommended every 10 years. If a person has a deep or contaminated wound, a booster may be prescribed if it has been more than 5 years since the last dose. DTaP series is completed during the childhood immunization schedule. Adults should receive a one- time dose of Tdap if they have not received a previous dose. Tetanus is a neuromuscular disease, also known as lockjaw, preventable with immunization. When performing a 12-lead ECG, which of the following positions demonstrates correct lead placement? A. V4 is placed left midclavicular 5th intercostal space B. V5 is paced left midclavicular 4th intercostal space C. V5 is placed left midaxillary 5th intercostal space D. V4 is placed left midclavicular 4th intercostal space (>>- Correct response: V4 is placed left midclavicular 5th intercostal space Rationale: The precordial chest lead is positioned at the apex of the heart, where the apical pulse is auscultated and Point of Maximal Impulse (PMI) can be felt. V4 is placed on the left midclavicular 5th intercostal space, at the mitral valve (left ventricular) area. Which of the following pieces of equipment should the medical assistant anticipate using when taking a patient's blood pressure? A. sphygmomanometer B. pulse oximeter C. otoscope D. speculum (>>- Correct response: sphygmomanometer Rationale: A sphygmomanometer is used to auscultate and measure blood pressure readings. An otoscope is used to examine the ear, a speculum is used to examine body cavities, and a pulse oximeter is used to see what a person's oxygen saturation is in the body. Which of the following actions should the medical assistant take first after coming in direct contact with a patient's blood via needlestick injury? A. Apply pressure at the site to stop bleeding. B. Flush the area with water and thoroughly wash it. C. Obtain the Hep B vaccine if not currently immunized. D. Inform the patient about the incident. (>>- Correct response: Flush the area with water and thoroughly wash it. Rationale: Immediately after a needlestick injury, wash or clean the injury at the needle stick site with soap and water and/or flush mucous membranes. Bleeding could be a good thing, as it serves to help flush pathogens out rather than keep them in the wound. Depending on Hepatitis B vaccination status, it might be necessary to continue the shots (but that would not be the first action after a needlestick). There would be no need to alarm the patient in this case. However, it may be necessary to inform the patient later. A patient is discharged from the hospital with a diagnosis of HIV and MRSA and comes to the office for a follow-up appointment. What is the best method the medical assistant could use to clean the nasal speculum, forceps, and hemostat used in the exam? A. disinfect with 70% isopropyl alcohol B. disinfect with sodium hypochlorite (1:10) C. chemical sterilization D. 10 mm laceration noted above the left eye. (>>- Correct response: 10 mm laceration noted above the left eye. Rationale: The SOAP note method (Subjective, Objective, Assessment, and Plan) is a charting system. The Objective notes are based on measurable signs, observable facts or data (such as a 10 mm laceration noted above the left eye). Subjective notes cover the chief complaint of the patient and other details of condition: reports stabbing pain in the RUQ after meals, complains of fatigue and low energy levels, or generalized pruritis following detergent brand change yesterday. Assessment is basically the doctor's diagnosis for that visit. Plan refers to the treatment plan (further testing, referrals, medications, etc.). A patient notices the symbol above on the door and asks what it means. The medical assistant should tell the patient the symbol means A. radiation in use. B. isolation precautions required. C. emergency eye wash station. D. biohazard material present. (>>- Correct response: biohazard material present. Rationale: This symbol accompanied by the term 'biohazard' serves as a warning that materials in or around the area constitute a health risk and could cause human disease or harm. What does the color of an evacuated collection tube represent? A. the minimum volume of blood to be obtained B. the personal protective equipment required for collection C. the type or absence of an additive D. a visual identifier for tests expected to be above or below normal range (>>- Correct response: the type or absence of an additive Rationale: There are a variety of blood collection tubes. The colors of the caps indicate the presence or absence of additive. Particular laboratory tests may require a specific additive. For instance, if a test requires serum, a red top tube that allows the blood to clot would suffice. A lavender/purple top tube contains K3 EDTA anticoagulant that will keep blood from clotting, allowing for whole blood testing such as a CBC and Differential. Depending upon the type of tube and additive therein, a minimum blood volume may be required. A child's weight should be recorded in A. mcg. B. grams. C. lbs. D. kg. (>>- Correct response: kg. Rationale: To ensure accuracy in medication dosing (weight-based in kg for infants/ children), tracking growth, and important in tracking fluid/ hydration needs. Weigh infants at the same time, same scale, same clothing when possible. Carefully document as the gram difference of one diaper may affect treatment decisions. [1 kg = 2.2 lbs.] Commitment to privacy, continuity of care, advance directives, and the authority to refuse treatment are granted according to which of the following? A. Informed Consent B. The Patient's Bill of Rights C. Good Samaritan Law D. Americans with Disabilities Act (>>- Correct response: The Patient's Bill of Rights Rationale: Patients are guaranteed certain standards of care listed in this question by The Patient's Bill of Rights. In 2010, in conjunction with the Affordable Care Act, a new Patient's Bill of Rights was set forth to include protections associated with insurance companies. Patients do have a right to be fully informed of a procedure or treatment option and have the right to consent to it or refuse. The Americans with Disabilities Act (ADA) addresses discrimination of disabled individuals. The Good Samaritan Law protects individuals who are willing to help someone in an emergency situation. The medical assistant is assisting a physician with an I & D of a gangrenous abscess. In addition to mask and gloves, the medical assistant must wear which of the following personal protective equipment when performing this procedure? A. hazmat suit B. sterile gown C. protective eyewear D. N95 respirator mask (>>- Correct response: protective eyewear Rationale: I & D refers to incision and drainage. The staff should be protected from splashes and spurts to prevent transmission of bloodborne pathogens. Proper infection control with personal protective equipment would include masks, gloves, and protective eyewear. This simple medical office procedure would not require the use of a N95 respirator (the infection risk is not airborne), a hazmat suit (there is no hazardous material risk) or sterile gown (this is not considered a sterile surgical procedure). Which of the following is the correct definition of Standard Precautions? A. Control measures that treat all body fluid as if it could be infectious. B. Control measures that are taken when handling specimens known to be infected. C. OSHA guidelines stating that health care workers should take proper precautions. D. Control measures that are taken with patients that are known to be infected. (>>- Correct response: Control measures that treat all body fluid as if it could be infectious. Rationale: The CDC issues publications on the proper handling of blood borne pathogens with guidelines outlining that blood and body fluid precautions are consistently used for all patients regardless of their blood borne infection status. The recommendations call for blood and body fluid precautions when a patient was known or suspected to be infected with blood borne pathogens. Recommendations were based upon the following reasons: 1) body fluids to which universal precautions apply, 2) use of protective barriers, 3) use of gloves for phlebotomy, 4) selection of gloves for use while observing universal precautions, and 5) need for making Which type of medication is used to increase urinary output? A. diuretic B. vasopressor C. cathartic D. antiemetic (>>- Correct response: diuretic Rationale: Diuretics are medications that act by promoting the excretion of excess fluid in the body which is eliminated through the kidneys. A vasopressor is used to raise blood pressure, an antiemetic is used to treat and prevent nausea and vomiting, and a cathartic increases the amount of defecation. The medical assistant prepares a written prescription for the physician as follows. What information did the medical assistant leave out? A. quantity to dispense and directions for taking the medication B. quantity to dispense and EIN C. directions for taking the medication and superscription D. superscription and EIN (>>- Correct response: quantity to dispense and directions for taking the medication Rationale: The medical assistant neglected to include the quantity to dispense and directions for taking the medication. The superscription would contain the date of the prescription written order, patient's age (date of birth), name and address, in addition to the Rx symbol. EIN refers to an employer identification number. Depending on the state, the doctor's state license number may be required. The Drug Enforcement Administration (DEA) number is required for controlled substances. The medical assistant is completing front office opening tasks prior to the start of the day. Which of the following indicates the reception area is prepared to receive patients? (Select the three (3) correct answers.) A. Magazines are stacked on the side tables. B. Sharps containers are placed by the entrance for biohazard pick-up. C. The path from the entrance to the front desk is direct and unobstructed. D. A throw rug is folded up at one corner. E. Lights are turned on. (>>- Correct response: Magazines are stacked on the side tables., Lights are turned on., The path from the entrance to the front desk is direct and unobstructed. Rationale: Maintaining a clutter-free environment demonstrates professionalism and promotes safety in the medical office. Also making the environment attractive and "welcoming" is also part of concern for all patients. They perceive that the office is professional and inviting. Other activities are part of the rest of the daily work but not necessarily a first priority. The physician orders the following blood work to evaluate a patient for sepsis: CBC, Blood Culture, and BMP. When using the evacuated tube method for venipuncture, in which of the following orders should the tubes be drawn? A. blood culture, red top, lavender top B. red top, blood culture, lavender top C. lavender top, red top, blood culture D. blood culture, lavender top, gray top (>>- Correct response: blood culture, red top, lavender top Rationale: To assure the accuracy of patient test results, evacuated tubes must be filled in a particular order. Contamination of the blood by the needle entering a stopper or by contact with additives in the tubes can cause erroneous patient test results, leading to improper diagnosis and treatment of the patient. In this case, the Blood Culture should be collected first, followed by the BMP (red top), then the CBC (lavender top). A patient calls requesting to see their provider with report of intense burning and urgency upon urination. This is an example of which of the following types of special scheduling? A. modified wave B. procedural C. same-day appointment D. grouping (>>- Correct response: same-day appointment Rationale: This patient's situation calls for an urgent care, same-day appointment. For urgent problems that require priority care, patients are seen on the day they call for an appointment (according to availability and office guidelines). Grouping, modified wave and procedural scheduling methods are effective for routine care, but all require contingency plans for special/urgent care situations. A patient presents to the medical office with nausea and vomiting. Which of the following types of medication is likely to be prescribed? A. antidiarrheal B. antiarrhythmic C. antitussive D. antiemetic (>>- Correct response: antiemetic Rationale: The physician would likely prescribe an antiemetic, which can help nauseous, vomiting patients. Antitussives are prescribed for coughing. Antidiarrheal medications help alleviate diarrhea. If a patient were experiencing abnormal heart rhythms, the physician may prescribe an antiarrythmic medication. The physician believes a patient might have problems with her spleen. Where would the doctor palpate to feel for the spleen? A. middle of the patient's abdomen beneath the diaphragm B. left side of the patient's abdomen beneath the diaphragm C. left lower portion of the patient's abdomen D. right side of the patient's abdomen beneath the diaphragm (>>- Correct response: left side of the patient's abdomen beneath the diaphragm Rationale: The spleen is located in the left upper quadrant of the abdomen beneath the diaphragm. It is located in the same quadrant as the stomach, pancreas, left lobe of the liver, part of the left kidney, and sections of the colon. would be able to read about office policies and procedures and refer back to the brochure in the future. Answering questions as they arise would not be the most effective way to communicate because a lot of information could be missed if the patient forgets to ask about it. Referring queries to the practice manager and answering questions at the initial visit would also not be the most effective techniques because all information regarding the policies and procedures may not be covered. Which of the following actions by the medical assistant demonstrates compliance with the ADA? A. maintain confidentiality of protected health information B. wear personal protective equipment prior to irrigating a wound C. obtain hepatitis B vaccination series offered by employer D. ensure hallways to exam rooms remain free of obstructions (>>- Correct response: ensure hallways to exam rooms remain free of obstructions Rationale: The ADA requires that hallways to exam rooms remain free of obstructions to allow those with physical limitations and/or disabilities to easily and safely move through doors and hallways. The ADA does not regulate PPE, vaccination protocols, or patient health information. The physician orders a random blood sugar on an adult patient newly diagnosed with diabetes who is right hand dominant. The medical assistant notices inappropriate puncture markings on the patient's fingers. Which of the following statements should the medical assistant use when re- educating the patient in capillary puncture? A. "It's best to use the outer edge of the under-side of your big toe when performing capillary punctures." B. "You should consider using the center of the middle finger on either hand for your blood sugar testing." C. "It's best to use the outer edge of the middle or ring finger on your left hand when doing your finger stick." D. "Do not use your right hand when checking your blood sugar." (>>- Correct response: "It's best to use the outer edge of the middle or ring finger on your left hand when doing your finger stick." Rationale: Regular blood sugar testing is an important tool for managing diabetes, and newly diagnosed diabetics need guidance on how best to obtain accurate blood sugar readings on their glucose meter. Capillary blood from the fingertips is one of the best sources from which to obtain results that are a true reflection of the blood sugar status. Alternative site testing (forearm, palm, stomach, and thigh) can also be utilized, however the glucose readings may not be a true reflection of current sugar levels. For example, it could take 20 to 30 minutes before the blood glucose reading from the fingertip reaches the forearm. Patients are generally instructed to utilize the middle or ring finger of the non-dominant hand. The sides of the finger have better blood flow and are not as painful as the pad of the finger. Therefore, the medical assistant should instruct the patient in this instance to use the outer edge of the middle or ring finger on the left hand. Venipuncture should be avoided on an arm with A. alopecia. B. excessive hair. C. muscular hypertrophy. D. an elbow splint. (>>- Correct response: an elbow splint. Rationale: A patient with a cast/splint in place may have ongoing extremity swelling during the healing process. Use as a venipuncture site should be avoided. Though not always optimal, it is okay to collect from an arm with excessive hair, muscular hypertrophy (large muscles), or alopecia (hair loss). The medical assistant schedules the patient with a sebaceous cyst for an I & D. Which of the following statements best describes this procedure? A. Excision of lacerated, dead, or contaminated tissue and removal of foreign matter from a wound. B. Excision of a small, painless sac containing a build-up of sebum. C. Debridement of tissue and skin lesions by using extremely cold temperatures. D. Incision into a localized area of infection (abscess), to drain the exudate from the area. (>>- Correct response: Incision into a localized area of infection (abscess), to drain the exudate from the area. Rationale: An I&D is the abbreviation for incision and drainage, and is when an incision is made into a localized are of infection, and then exudate is drained from the area. A debridement is the excision of lacerated, dead, or contaminated tissue and removal of foreign matter from a wound. An I&D doesn't include debriding the tissue and skin lesions with extreme cold, and also doesn't include cutting small, painless sacs containing a build-up of sebum. Which of the following blood components are visible in a centrifuged, evacuated red top tube? (Select the two (2) correct answers.) A. individual erythrocytes B. serum C. platelets D. plasma E. blood clot (>>- Correct response: serum, blood clot Rationale: A centrifuged sample in a red top tube will have a liquid portion at the top and a solid portion on the bottom. Since the red top contains no anticoagulant, the blood will clot. This means the top liquid portion is serum and the bottom portion is the blood clot. Conversely, centrifugation of an anticoagulated specimen will have plasma as the top liquid part of whole blood, and red cells, white cells and platelets on bottom (no blood clot forms because the specimen has anticoagulant). The medical assistant is providing instructions for a patient with pneumonia. The optimal time a sputum specimen should be collected is A. after breakfast. B. after lunch. C. at bedtime. "I will take prescribed medications regularly at the same time each day.", "I will monitor my blood pressure and record readings daily.", "I will incorporate moderate exercise into my daily routine." Rationale: The patient should take their medications regularly at the same time each day and they should also monitor their blood pressure and record their readings every day. Sodium should be decreased or eliminated in the diet of patients with hypertension as it causes the body to hold on to excess fluid, which increases the workload of the heart. The patient should also incorporate moderate exercise into their daily routine, because this will help to keep their hypertension under control. Checking the blood sugar regularly would not be a priority for a person with hypertension. Which of the following is the most common means of transmission of Hepatitis A? A. forceful coughing B. contact with contaminated needles C. contact with fecal contaminated food/water D. sexual contact (>>- Correct response: contact with fecal contaminated food/water Rationale: Hepatitis A is a virus most commonly transmitted by contact with disease contaminated food/water or from close contact with an infected individual. Restaurants are often cited in the news as the source of Hepatitis A outbreaks stemming from an infected worker who did not practice good hand hygiene. As with many hygiene-associated diseases, Hepatitis A is common in poor countries that lack common hygiene practices and safe, clean water sources. It is not generally considered a pathogen that would be contracted by contaminated needles, nor is it generally associated with forceful coughing or sexual contact. When giving a nebulizer treatment with bronchodilator, the medical assistant should most closely monitor for which of the following complications? A. persistent tachycardia B. epistaxis C. nausea and vomiting D. hyperventilation (>>- Correct response: persistent tachycardia Rationale: The medical assistant should monitor for persistent tachycardia when giving a nebulizer treatment with a bronchodilator. Bronchodilators are medications that open up the bronchioles, and by doing this, the heart rate can increase. Hyperventilation (increased respiratory rate), nausea and vomiting, and epistaxis (nosebleed) are not typical side effects of pairing a nebulizer treatment with a bronchodilator. To prevent the likelihood of somatic tremor artifact, the medical assistant should A. attach V2 at the fourth intercostal space at the right margin of the sternum. B. move limb electrodes as far away from the trunk as possible. C. ask the patient to remove any metal objects to reduce interference. D. make the patient calm and comfortable to minimize movement. (>>- Correct response: make the patient calm and comfortable to minimize movement. Rationale: Muscle movement produces a measurable electrical impulse. Reduce patient anxiety, warm a patient who is shivering, instruct them to remain as still as possible and refrain from talking. Moving limb electrodes as close to the trunk as possible can reduce interference. Which of the following resources should the medical assistant use to look up the code for a laceration repair? A. Healthcare Common Procedural Coding System B. Physician's Desk Reference C. International Classification of Disease D. Current Procedural Terminology (>>- Correct response: Current Procedural Terminology Rationale: A laceration repair would be found in the CPT code book. Current Procedural Terminology identifies services and procedures. International Classification of Diseases (ICD) identifies diagnoses. Healthcare Common Procedure Coding System (HCPCS) - identifies additional services and procedures not listed in CPT; drugs dispensed in the physician's office or other facility (including injectables, topicals, and orally administered); supplies and equipment dispensed to the patient. The Physicians Desk Reference is a publication that compiles drug information for medical professionals and consumers alike. The medical assistant should instruct the patient obtaining a 24 hour urine collection to A. void mid-stream into the collection container. B. keep the sample at room temperature. C. collect samples exactly two hours after each meal. D. discard the first morning sample. (>>- Correct response: discard the first morning sample. Rationale: When doing a 24-hour urine collection it is important the patient knows to discard the first morning sample. This allows the collection to begin with fresh urine to ensure the results of the test are not skewed. The sample should be refrigerated during the collection and all urine should be collected, not just urine excreted after meals. The patient should be instructed to collect all urine during the 24-hour period and not just to catch urine mid-stream. Which of the following are legitimate reasons to document in a patient's chart when he "no-shows" for his appointment? (Select the three (3) correct answers.) A. To ensure the schedule is open for further appointments. B. To protect the physician from liability in case his condition worsens. C. To document whether or not he rescheduled. D. To cancel his subsequent appointments. E. To communicate the reason he missed his appointment. (>>- Correct response: To protect the physician from liability in case his condition worsens., To communicate the reason he missed his appointment., To document whether or not he rescheduled. Rationale: No-shows are patients who simply do not show up for their appointment. A Patient who does not show up for a scheduled D. Depress the patient's tongue and place the swab in a viral media tube following collection. (>>- Correct response: Use a tongue depressor and swab both sides of the throat. Rationale: To ensure an adequate sample of secretions is obtained from both tonsils and the back of throat, a tongue depressor is used and both sides of the throat are swabbed. A viral media tube would not be necessary, and the swab wouldn't go into the nostril or touch the tongue or sides of the mouth since a throat culture is what is needed. The importance of accurate anatomic positioning of leads on a patient when performing an ECG is to A. allow interruption of negative electrical conduction. B. capture true cardiac activity. C. ensure proper machine calibration with universal measurements. D. stimulate positive electrical impulses. (>>- Correct response: capture true cardiac activity. Rationale: Incorrect placement of leads is a known cause of artifact changes in the ECG, and leaves the patient at risk for error. Patients may receive potentially harmful treatment if not placed correctly. Incorrect placement of the precordial electrodes (V1-V6, forming the horizontal plane on the chest wall closest to the heart) changes the ECG significantly. The physician excises a mole and wants to send it to the pathology laboratory for further analysis. The sample should be placed with care into which of the following collection containers? A. sterile test tube with anticoagulant B. sterile swab collection and transport system C. sterile Thin-PrepTM collection container D. sterile specimen container with formalin (>>- Correct response: sterile specimen container with formalin Rationale: The sample would be contained according to the guidelines provided by the laboratory doing the testing (depending on which testing the physician wants to do on the sample). In this scenario, the mole would be placed in medium to preserve the tissue and inhibit growth of undesirable microorganisms (so a sterile container with formalin would be the best choice). A sterile swab collection container would be utilized if the physician wanted to culture the area around the mole, but not for containing the actual mole. A sterile test tube with anticoagulant would be used to collect a blood sample. The Thin-Prep media is generally used for pap smears and similar specimens, not for moles. The post office returns a patient's bill to the clinic with the notation "address unknown." Which of the following steps are appropriate in handling this situation? (Select the three (3) correct answers.) A. Prepare a new envelope with the corrected address and new postage. B. Document the postmark date. C. Resend the bill to the same address requesting return receipt. D. Verify the mailing address on file in the clinic database. E. Call the patient's emergency contact number. (>>- Correct response: Verify the mailing address on file in the clinic database., Document the postmark date., Prepare a new envelope with the corrected address and new postage. Rationale: Immediate action should be taken in handling returned statements. The first step would be to verify the mailing address on file and documenting the date the mail was returned in the file. Once the address is verified, a new envelope with the new address can be prepared. Resending the bill to the same address with a return receipt only guarantees the sender with proof of delivery but would be inappropriate handling with an invalid address. An incorrect dose of medication is delivered to a patient in the medical clinic. As a result, the patient experienced mild kidney damage. The responsible health care providers and/or clinic is at risk for which of the following? A. slander B. libel C. defamation D. negligence (>>- Correct response: negligence Rationale: This is a case of negligence, a failure to practice within the standard of care. Defamation occurs when someone intentionally says or writes something false that causes harm to the person's reputation. Slander is a form of defamation that is heard/spoken. Libel is a form of defamation that is visible (written, produced, etc.). A 6-month-old child is at the clinic for their well-child visit and routine vaccines. Which of the following is the preferred site for an intramuscular injection on this patient? A. vastus lateralis B. dorsogluteal C. ventrogluteal D. deltoid (>>- Correct response: vastus lateralis Rationale: The preferred site for an intramuscular injection on a 6-month old child is the vastus lateralis, or outer thigh, because infants have the most muscle mass in that area. The deltoid muscle isn't typically used for intramuscular injections until age 3 and older; the ventrogluteal muscle, the hip, isn't used for infants until 7 months or older. The dorsogluteal muscle, the buttocks, is only used for children and adults. Which of the following types of scheduling provides built in flexibility to accommodate unforeseen situations, such as patients who require more time with the physician. A. wave B. double booking C. specified time D. procedures grouping (>>- Correct response: wave Rationale: The best type of scheduling to accommodate unforeseen situations is wave scheduling. Wave scheduling allows for a group of patients to be assigned to appointment times at the beginning of each other. It allows flexibility since some patients may not take as long as others. By scheduling each patient to a specified time, time is not available for unforeseen situations because the physician would not be able to spend Which of the following actions is an example of compliance with Quality Control (QC) guidelines for phlebotomy? A. Ensure reusable supplies in venipuncture trays are recycled. B. Run glucose meter controls between each patient sample. C. Ensure supplies in venipuncture trays are no more than one month beyond the expiration date. D. Run the daily control checks on urinalysis dipsticks. (>>- Correct response: Run the daily control checks on urinalysis dipsticks. Rationale: Proper Quality Control ensures accuracy and reliability of test results while detecting and eliminating errors. It is an important component of patient care to make sure results are accurate, therefore it is important to check controls on urinalysis dipsticks daily. Supplies (in venipuncture trays or anywhere) should not be used beyond the expiration date. Recycling is not a quality control measure. Glucose meter controls should be checked at least daily (or more frequently). It is important to follow whatever quality control protocols are in place for each piece of equipment or manual test performed. Always check to make sure quality control is up to date and within acceptable parameters before running any patient samples. A patient with diabetes has missed all scheduled appointments in the past 18 months. The physician requests that written notification be sent to the patient to make an appointment immediately. This letter should be sent A. Standard. B. Certified. C. Priority. D. Express. (>>- Correct response: Certified. Rationale: The letter to the patient should be sent Certified so that the physician can see when the patient receives the letter. With Certified mail, the patient must sign for the letter when he/she receives it. This ensures that it was delivered to the correct person. Since the patient has diabetes, it is important for him/her to see a physician regularly to prevent the disease from getting worse. If a letter is sent Priority it will ship faster than general or first-class mail but would not be the best choice because the medical assistant needs to make sure that the patient received the letter about his/her upcoming appointment. Express mail is an international service that allows people to send mail from country to country and would not be needed in this case because the patient and physician are in the same country. Standard mail is not sent first-class and items typically sent by standard mail are newspapers, flyers, and magazines. This also would not be the best choice because the medical assistant would not have confirmation that the patient received the letter. For which of the following incidents is employer provided post-exposure follow-up indicated? A. loss of power during an ECG procedure B. a polycup containing urine splashed into the eye of an employee C. an employee fall in the parking lot, resulting in a hand laceration D. an employee fall from a step stool while obtaining medical records (>>- Correct response: a polycup containing urine splashed into the eye of an employee Rationale: In compliance with OSHA regulations, a post exposure follow up plan includes incidents of occupational exposure to direct contact with blood or other potentially infectious body fluids. An injury from a fall, whether inside or outside the facility, is not considered an exposure-related injury. Loss of power during any procedure is not related to an exposure, it is an electrical problem (not an injury); no exposure follow-up is indicated in this instance. Place the following PPE in the correct order of removal prior to leaving the exam room of a patient who is in contact-droplet isolation. (Click and drag the options in the left column to their correct order in the right column). gown bonnet mask gloves (>>- Correct response: gloves, gown, bonnet, mask Rationale: First, the medical assistant would remove the gloves, gown, bonnet and lastly the mask. Since the patient is on contact-droplet precautions, the medical assistant should take the gloves off inside out without touching the skin. The gown should be removed by grabbing the inside of the gown and pulling it away from the body. The outside of the gown should never be touched. The mask should be removed last and should not come off until the medical assistant leaves the patient's room. What is the proper term describing when a patient is informed about the possible consequences of both having and not having a medical procedure? A. preoperational briefing B. informational waiver C. due diligence D. informed consent (>>- Correct response: informed consent Rationale: It is a patient's right to be fully informed of a medical procedure. In order to do a medical procedure, personnel must obtain an informed consent form signed by the patient indicating that information about the procedure has been received. A preoperative briefing occurs among the medical staff before a surgical procedure. Due diligence indicates that reasonable steps have been taken to prevent or avoid patient harm. An informational waiver refers to a patient waiving a right or claim associated with treatment. Which of the following is required for permission to treat a patient scheduled for a complex procedure? implied consent informed consent advanced directive living will (>>- Correct response: informed consent Rationale: Before a patient can undergo a complex procedure he/she must first sign an informed consent. Informed consent states that the patient agrees with the procedure they are having and understand what will occur. Rationale: When testing the hematocrit (hct) level in the blood it is important that the medical assistant read from the top of the packed cells. The hematocrit level in the blood tells how much of the blood is composed of red blood cells, therefore, the medical assistant must look at the packed red blood cells to get an accurate reading. Looking at the bottom of the plasma, top of the buffy coat, or the bottom of the meniscus will not give an accurate reading of the hematocrit level because they will not show the total amount of red blood cells in the sample. A patient's encounter form contributes to the efficiency and flow of information in the medical office at check-out in which of the following ways? A. Provides written documentation about medications prescribed during the visit. B. Outlines discharge instructions related to the patient's condition. C. Summarizes limitations and exclusions in the patient's insurance policy. D. Lists codes for services and procedures performed during the visit. (>>- Correct response: Lists codes for services and procedures performed during the visit. Rationale: An encounter form can be a preprinted form that must be updated annually to reflect current codes for reimbursement. The encounter form is commonly referred to as a superbill or charge slip in the medical office. A form would be issued during each visit (encounter) and would provide a place to record the codes for services and procedures performed during that visit. It won't necessarily include insurance policy explanations, medications, or discharge instructions. Placement of the ground lead on an ECG is on the A. LL on the soft tissue of the leg. B. LL on the muscular portion of the leg. C. RL on the soft tissue of the leg. D. RL on the muscular portion of the leg. (>>- Correct response: RL on the soft tissue of the leg. Rationale: When performing an ECG, the RL ground lead should be positioned on the soft tissue of the right leg. The mother of a 6-month-old patient arrives at a busy clinic and states the child has a high fever. The medical assistant measures the patient's temperature and confirms a temperature of 103°F. Which of the following is an acceptable course of action for the medical assistant? A. Perform venipuncture for a blood culture and a CBC with Diff. B. Activate EMS. C. Assess the remaining vital signs and notify the physician. D. Administer Tylenol 160 mg PO immediately. (>>- Correct response: Assess the remaining vital signs and notify the physician. Rationale: After measuring the patient's temperature, the acceptable course of action for the medical assistant would be to assess the remaining vital signs and notify the physician. The physician will need to know all vital signs before he/she can prescribe any medication or take the next course of action. The medical assistant would not administer Tylenol without the order from the physician, and it would not be appropriate to activate EMS at the time because the patient is showing no signs of respiratory distress or heart problems. Performing venipuncture would not be necessary at this time without knowing all of the vital signs. A patient presents to the clinic with a paper towel wrapped around a deep laceration to his hand. The medical assistant removes the paper towel and finds it is heavily saturated with blood. The paper towel should be disposed of in a A. biohazard sharps container. B. biohazard waste bin. C. yellow trash bin. D. medical waste recycling container. (>>- Correct response: biohazard waste bin. Rationale: An item that is saturated with blood would be considered biohazard waste. There are several different types of waste generated in a medical facility. Biohazard/medical waste would be disposed of in red biohazard containers. Pharmacy hazardous waste (such as a chemotherapy drug) is disposed of in yellow containers. A sharps container is generally a red biohazard container that has hard sides so needles and sharp objects will not poke through the sides. Generally speaking, non- contaminated plastics and paper products can sometimes be recycled. The use of smaller electrodes while running an ECG on a four year old pediatric patient will require which of the following modifications? A. Place the patient in Sim's position. B. Increase the paper speed. C. Decrease the paper speed. D. Place the patient in a dorsal recumbent position. (>>- Correct response: Increase the paper speed. Rationale: Any adjustment to the ECG instrument should be noted on the recording to avoid erroneous interpretation. The paper speed should be increased on pediatric patients (who have faster heart rates) so the physician can view each deflection on the tracing. An ECG on an infant or child is generally performed when the patient is in the supine position. Occasionally, a pediatric patient will become restless or distressed, in which case the ECG can be performed from a sitting position. A female patient has come in for an ECG following a mastectomy. ECG electrodes should be placed A. three inches above the surgery site to avoid disruption of the site. B. as close to the surgery site as possible without touching the site. C. three inches lower than the surgery site in order to avoid disruption of the site. D. in the intercostal spaces above the heart to avoid the surgical site. (>>- Correct response: as close to the surgery site as possible without touching the site. Rationale: If a female patient needing an ECG has had a mastectomy, the technician should place the electrodes as close to the area they would normally be placed without touching the site of surgery. If the technician were to place the electrodes three inches above or below the surgery site, the electrodes would be too far away from the correct placement and therefore could give false recordings. What does the abbreviation HIPAA stand for? B. grey C. red D. light green (>>- Correct response: light blue Rationale: A light blue top on the tube means that the tube contains buffered sodium citrate, an additive that removes calcium to prevent blood from clotting. Therefore, this tube would be the one used for the PT/PTT test since those tests are done to see how well the blood clots. The light green tubes are used for STAT tests and will counteract the clotting tubes. Red tubes are for tests on hormones, and gray tubes are typically used for glucose testing and for testing blood alcohol content. If a medical assistant has questions about disposing of outdated hazardous chemicals, where should the medical assistant look to find this information? A. MSDS B. CLIA C. NIOSH D. HIPAA (>>- Correct response: MSDS Rationale: A Material Safety Data Sheet (MSDS) is a hazardous chemical reference. It provides healthcare workers with procedures for working with substances safety to ensure regulatory compliance. Clinical Laboratory Improvement Amendments (CLIA) of 1988 are United States federal regulatory standards that apply to all clinical laboratory testing performed on humans in the United States, except clinical trials and basic research. HIPAA (Health Insurance Portability and Accountability Act) requires medical professionals to protect the confidentiality of patients' health information. The National Institute for Occupational Safety and Health (NIOSH) makes recommendations for preventing illness and injury acquired on the job. The patient was seen in the office for follow up evaluation post CVA. The doctor noticed significant weakness on the patient's left side. Which of the following should the medical assistant expect to perform? A. Full weight bearing exercise assistance B. Crutch training C. Active assist range of motion D. Cold chemical pack application (>>- Correct response: Active assist range of motion Rationale: The medical assistant should expect to perform active assistive range of motion with the patient since the patient has major weakness on one side. This type of exercise is done when a patient is able to perform some movements and exercises with the affected side, but still needs some help to get that side even stronger. Full weight bearing exercises are done to improve bone strength, and are done while the patient is on both feet and putting all of their weight against gravity. This would not be the exercise that this particular patient needs because the patient has weakness on one side. He needs to strengthen that side before he can perform full weight bearing exercises. Crutch training is typically done when a patient is suffering from a leg problem, but since this patient has weakness on his whole left side this would not be appropriate. Cold chemical pack application is typically done for patients suffering from minor injuries, such as an ankle sprain. This would also not be the best choice for this patient since he needs to get more strength back on the whole left side of his body. A medical assistant obtains the tracing shown above on a patient. Which of the following actions should the medical assistant take? Replace the electrodes on the patient's extremities. Place the patient in Trendelenburg's position. Ensure precordial lead wires are crossed to balance polarization. Remind the patient to remain as still as possible. (>>- Correct response: Remind the patient to remain as still as possible. Rationale: Muscle movement produces a measurable electrical impulse. Reduce patient anxiety, warm a patient who is shivering, instruct them to remain as still as possible and refrain from talking. Moving limb electrodes as close to the trunk as possible can reduce interference. The main function of a centrifuge is to freeze cells for transport. determine the concentration of glucose. magnify blood components. separate cells from plasma. (>>- Correct response: separate cells from plasma. Rationale: A centrifuge is an essential laboratory instrument that rotates at varying speeds to separate blood components (i.e. separates cells from plasma or serum). Care should be taken to correctly load, balance, and remove tubes. The centrifuge does not freeze or magnify samples, nor does it make glucose concentration determinations. It is merely a laboratory instrument that helps process samples for testing. Which of the following are the major filing systems used in the health care setting? (Select the three (3) correct answers.) numeric color alphabetic subject surname (>>- Correct response: numeric, alphabetic, subject Rationale: A variety of filing systems exist among medical practices. The numeric system organizes patients based on numerical order. Numbers can be assigned a variety of ways, and the system can be easily learned by office personnel. An alphabetic system organizes records by last and first name (allows quick and easy identification, but can have confidentiality issues). Subject filing can be based on a particular subject, such as insurance provider or patient case information. This can lead to confusion if a patient's file fits more than one subject category, but can be easy to organize into basic common subject areas. Systems using color coding alone or surname alone are not generally recommended because they can lead to identification errors. If either is used, it is often used in concordance with another major filing system. An adult patient presents with fever, muscular pain, and congestion. Which of the following is the appropriate response for the medical assistant following the physician's orders? test, the patient starts out at a walk and then the pace is later increased (the patient does not start at a rapid pace). Which of the following types of appointment scheduling would be the best method for an office with standard hours, multiple practitioners, and accommodating work-in appointments? clustering open office hours double booking wave (>>- Correct response: wave Rationale: Since the office has standard hours and multiple practitioners, the wave scheduling would provide the best outcome. This type of scheduling works best when there is sufficient staff and multiple rooms for patients to be seen in. Wave scheduling is done by scheduling a few patients at the top and bottom of each hour. The first patient to arrive is typically seen first, unless there is a patient with a greater health concern. This allows all of the practitioners to see patients, and provides adequate time for walk-in patients to be seen. The clustering form of scheduling does not allow much time for walk-in appointments as multiple patients with similar problems are scheduled at the same time of day. Stream scheduling is typically used when only one practitioner is available as one patient is assigned to a certain time. Double booking is also typically used when only one practitioner is available; multiple patients are scheduled for the same time. Open office hours lump all patients as walk-ins and they are seen in the order in which they check in. This can lead to extensive wait times if several patients come at the same time. Which of the following conditions may occur if a tourniquet is left in place on a patient's extremity for longer than 60 seconds? venous stasis petechiae hemolytic anemia hematoma (>>- Correct response: venous stasis Rationale: A tourniquet left in place for longer than 60 seconds predisposes the formation of blood clots due to slow blood flow (a.k.a. venous stasis). Petechiae are pinpoint spots on the skin that appear when the capillaries break and release blood. Hemolytic anemia refers to a condition defined by red blood cell destruction, which leads to an overall reduction of healthy red blood cells left to circulate and deliver oxygen throughout the body. Hemangioma is a term used to describe a condition in which blood vessels abnormally congregate in a place on the body, causing a non-cancerous tumor. A physician's office is about to convert from paper format to an electronic format. The office manager has implemented a Medical Practice Management Program. Which of the following is a task the medical office assistant should be able to do with the new software? patient registration charting transcribe a report fax a consent form (>>- Correct response: patient registration Rationale: Electronic record manangement software, once patients are first registered with the medical office, allows users to capture patient demographics, schedule appointments, maintain lists of insurance payors, perform billing tasks, and generate reports. A patient with dyspnea comes in for an ECG. In which of the following positions should the patient be placed for the procedure? supine semi Fowlers Trendelenburg Sims (>>- Correct response: semi Fowlers Rationale: Dyspnea is a condition that causes a patient to be short of breath (SOB), so when the technician does an ECG, the patient normally lays in a supine position. If the patient suffers from dyspnea it is difficult for them to lay flat so putting he/she in a semi Fowlers position will allow them to breath and be as close to the supine position as possible. In Fowlers position, the head of the bed is moved up approximately 30 degrees, so semi Fowlers would not be quite as high. The technician would not want to place the patient in the Trendelenburg position because that would mean the bed is tilted so the head is down and feet are up. The medical assistant applies pressure to the venipuncture site using gauze. After two minutes the medical assistant observes that bleeding has not stopped. The next appropriate action would be to elevate the arm while applying pressure. wrap the arm with a pressure dressing. continue to apply pressure while bending the arm at the elbow. notify the physician immediately. (>>- Correct response: elevate the arm while applying pressure. Rationale: Elevating the arm reduces the pressure from the flow of blood, i.e., the blood is flowing down the arm. The venipuncture wound will heal more easily without the pressure from the blood flow. The medical assistant should administer nitroglycerin by which of the following methods? buccal sublingual intramuscular intradermal (>>- Correct response: sublingual Rationale: The medical assistant should administer the nitroglycerin sublingually, which is done by placing the tablet under the patient's tongue and letting it dissolve. Taking nitroglycerin in this form is typically done when the patient is experiencing acute angina, because it is easily absorbed by the body when taken sublingually. The buccal area refers to the area between the cheek and the gums, and intramuscular requires the medication to be injected into one of the major muscles, such as the deltoid in the arm or the vastus lateralis in the leg. Intradermal administration means injecting the medicine into the dermis (the outer layer of skin).