Medical Terminology and Concepts, Exams of Nursing

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MEDICAL ASSISTANT CERTIFICATION EXAM 2024/2025 What are the 4 parts to a patient's medical history? - Precise Answer ✔✔chief complaint (CC), history of present illness (HPI), Past, Family and Social History (PFSH), and review of systems (ROS) Vital signs reflect the functions of what three body processes necessary for life? - Precise Answer ✔✔body temperature, respiration and heart function what are the 4 vital signs of body function? - Precise Answer ✔✔temperature, pulse, respiration and blood pressure Give the normal temp ranges for the following sites: rectal, oral, axillary and tympanic membrane? - Precise Answer ✔✔rectal 98.6-100 oral 97.6-99.6 axillary 96.6-98.6 tympanic 9.8.6 febrile v afebrile - Precise Answer ✔✔febrile is the presence of fever, afebrile is absence of fever 3 types of fever? - Precise Answer ✔✔intermittent, remittent and continuous oral temperature is not taken from which patients? - Precise Answer ✔✔infants and children less than 6 yo, patients who had face, neck nose or mouth surgery, those receiving oxygen, patients w altered mental status and others how long should you wait for patients who just finished eating drinking or smoking to take temp? - Precise Answer ✔✔30 minutes What method of taking temp is the least accurate? - Precise Answer ✔✔axillary (underarm) normal adult pulse range - Precise Answer ✔✔60-100 BPM what is the site most commonly used for taking pulse? - Precise Answer ✔✔radial artery in wrist normal range for adults respiration? - Precise Answer ✔✔12-20 per minute what are 3 respiration rate abnormalities? - Precise Answer ✔✔apnea- temporary complete absence of breathing tachypnea- rate > 40.min bradypnea- decease in number of respirations knee-chest position - Precise Answer ✔✔used for rectal and vaginal exams trendelenburg position - Precise Answer ✔✔used for surgical procedures of pelvis and abdomen Which organization is responsible for the identification of the various hazards present in the workplace and for the creation of rules and regulation to minimize exposure to hazards? - Precise Answer ✔✔Occupational Safety and Health Administration (OSHA) What are the 3 categories for safety hazards? - Precise Answer ✔✔physical hazards, chemical hazards, biological hazards for an external hemorrhage how is bleeding controlled? - Precise Answer ✔✔elevating the affected part above heart level and applying direct pressure to the wound when does shock occur? - Precise Answer ✔✔when there is insuffcient return of blood flow to the heart, resulting in inadequate supply of oxygen what are the common symptoms of shock? - Precise Answer ✔✔pale, cold clammy skin, rapid weak pulse, increased shallow breathing rate, expressionless face first aid for shcok - Precise Answer ✔✔maintain an open airway, call for assistance, keep victim lying dow, attempt to control cause of shock what are agents? - Precise Answer ✔✔infectious microorganisms that can be classified into groups portal of exit and portal of entry - Precise Answer ✔✔portal of exit is the method by which infectious agent leaves its resevoir; portal of entry allows infectious agent access to suceptible host mode of transmition - Precise Answer ✔✔specific ways in which microorganisms travel from resevoir to susceptible host. 5 main types: contact, droplet, airborne, common vehicle and vectorborne define medical asepsis - Precise Answer ✔✔the destruction of pathogenic microorganisms after they leave the body what procedure is used in medical aspesis using various chemicals that can destroy pathogenic microorganisms? - Precise Answer ✔✔disinfection what is the least expensive and most readily available disenfection? - Precise Answer ✔✔a 1:10 solution of household beach 4 methods of sterilization - Precise Answer ✔✔gas sterilization, dry heat sterilization, chemcial and steam (autoclave) what is the most important means of preventing the spread of infection? - Precise Answer ✔✔hand washing what are the 3 categories of isolation? - Precise Answer ✔✔contact precautions, airborne precautions and droplet percautions po (abb) - Precise Answer ✔✔by mouth/orally pr (abb) - Precise Answer ✔✔per rectum sl (abb) - Precise Answer ✔✔sublingual (under tongue) SQ (abb) - Precise Answer ✔✔subcutaneous pc (abb) - Precise Answer ✔✔after meals qhs (abb) - Precise Answer ✔✔each night prn (abb) - Precise Answer ✔✔as needed The heart is located in the thoracic cavity between the lungs in what space? - Precise Answer ✔✔mediastenum, just behind the sternum where are the coronary arteries located? - Precise Answer ✔✔on the epidcardium what are the two branches of the left coronary artery? - Precise Answer ✔✔Left anterior descending (LAD) artery and Left Circumflex (LCX) artery what is the main artery that supplies the right side of the heart? - Precise Answer ✔✔Right Coronary Artery (RCA) What is the period of contractions of both atria and ventricles? - Precise Answer ✔✔systole what is the period of relaxation and filling of all cardiac chambers? - Precise Answer ✔✔diastole heart sounds are caused by what? - Precise Answer ✔✔closure of the heart vavles when does the S1 first heart sound (Lubb) occur? - Precise Answer ✔✔occurs during ventricle contraction and closure of AV valves when does the S2 second heart sound (Dupp) occur? - Precise Answer ✔✔occurs during ventricular relaxation when SL valves close heart murmurs are caused by what? - Precise Answer ✔✔diseases of the valves or other structural abnormalities define heart rate - Precise Answer ✔✔number of heart contractions per minute what two things control heart rate? - Precise Answer ✔✔chemo- receptors (chemical sensors) and Baro-receptors (pressure receptors) located in the aortic arch and carotid arteries the heart is under the influence of which nervous system? - Precise Answer ✔✔the autonomic nervous system which is subdivided into the sypathetic and parasypathetic which division of the ANS has an inhibitory effect via acetylcholine? - Precise Answer ✔✔parasympathetic (vagus nerve) what division of the ANS has a excitatory effect via norepinephrine? - Precise Answer ✔✔sypathetic acetylcholine effects in body? - Precise Answer ✔✔slows SA pacemaker and heart rate, slows conduction of electricity in AV node, decreases strength of atrial and ventricular contraction norepinphrine effects in body? - Precise Answer ✔✔increase HR, increases force of contraction, increases blood pressure, dopaminergic receptors increase the diameter of visceral blood vessels True or false. the blood volume ejected outside the heart is equal to the blood volume returning back into the heart - Precise Answer ✔✔TRUE what is stroke volume (preload)? - Precise Answer ✔✔the blood volume ejected outside the ventricle after each contraction; depends on volume of blood, force of myocardium contraction and vascular resistance what is the Starling Law? - Precise Answer ✔✔the greater the volume of blood inside the heart during diastole, the stronger the heart contraction force during systole. the lower the resistance in the vessels, the MORE OR LESS easily blood can be ejected outside heart through circulation? - Precise Answer ✔✔MORE what is cardiac output? - Precise Answer ✔✔the amount of blood ejected outside heart per minute cardiac output equals (X) * (Y) - Precise Answer ✔✔x- stroke volume y- HRper/min what is the primary pacemaker of the heart and where is it located? - Precise Answer ✔✔SA or sinus node; normal rate of 60-100 BPM; found in the upper posterior portion of the right atrial wall if the sinus node fails to fire, what is the backup pacemaker, what is its rate and where is it located? - Precise Answer ✔✔AV node; 40-60 BPM, located at the posterior septal wall of the right atrium just above the tricuspid valve Bundle of His: where is it. intrinsic firing rate? - Precise Answer ✔✔superior portion of the interventricular septum; 40-60 BPM The bundle of his divides into WHAT to conduct the electrical impulse of WHAT throughout the ventricles? - Precise Answer ✔✔right and left bundle branches; Purkinje fibers where are purkije fibers located and what is their rate? - Precise Answer ✔✔within the ventricular endocardium; 20-40BPM conduction system of heart - Precise Answer ✔✔ an EKG is a WHAT that measures what? - Precise Answer ✔✔galvanometer that measures the heart electricity traveling through the conductive system an EKG is an important tool for what? - Precise Answer ✔✔monitoring patients HR, evaluating injuries to the heart muscle, evaluating pacemakers and conductive system function, define electrode - Precise Answer ✔✔a paper, plastic or metal sensor palced on the patient's skin on a specific location define cable and lead - Precise Answer ✔✔cable is a wire that connects the electrode to the EKG machine the lead is a recorded tracing of the heart electricity from one or two electrodes that provides a specific view of the heart What are your standard bipolar limb leads? - Precise Answer ✔✔Lead 1- LA positive, RA negative (LA-RA) Lead 2- LL positive, RA neg (LL-RA) Lead 3- LL positive, LA neg (LL-LA) which electrode is used as a ground electrode for the standard bipolar limb leads? - Precise Answer ✔✔right leg what do augmented unipolar leads do? - Precise Answer ✔✔record the heart electricity from one limb and compare it with a zero voltage lead in the center of the heartt what are augmented unipolar leads? - Precise Answer ✔✔Lead aVR- right arm is positive other limbs are neg Lead aVL- left arm is positive other limbs neg LeadaVF- left leg is positive other limbs neg the standard bipolar limb leads and the augmented unipolar leads record in which plane? - Precise Answer ✔✔frontal plane the precordial chest unipolar leads record in what plane? - Precise Answer ✔✔horizontal the electrods for precordial chest unipolar leads are all what sign? - Precise Answer ✔✔positive How many leads are there for the precordial chest? - Precise Answer ✔✔V1-V6, so six leads the usual routine EKG consits of placing how many electrodes? - Precise Answer ✔✔10 producing 12 leads: I,II,III, aVR, aVF, aVL; V1-V6 On EKG paper 1mm equals how many seconds? - Precise Answer ✔✔.04s the vertical axis on EKG paper represents what? - Precise Answer ✔✔voltage, measurred in millivolts what is the running speed of an EKG? - Precise Answer ✔✔25mm/sec ventricular rate; count large boxes s btw P waves for artrial rate; used for regular rhythms how to perform little box method? - Precise Answer ✔✔count number of small boxes between an RR inteval and divide into 1500 **regular rhythms only sequence method (memorization method) - Precise Answer ✔✔select the R that falls on a dark vertical line; number next dark line as 300,150,75,60,50. note where next R wave falls in relation to dark lines, that is the HR Analyzing the EKG strip involves what 6 steps? - Precise Answer ✔✔1. assess the HR 2. assess rhythm/regularity 3. identify and examine P wabes 4. asses intervals (PR, QRS, QT) 5. Evauluate ST segments and T waves 6. General evaluation and conclusion cardiac arrythmias are due to what 4 mechanisms? - Precise Answer ✔✔1. arrythmias of sinus origin 2. ectopic rhythms 3. conduction blocks 4. pre-excitation syndromes what are ectopic rhythms? - Precise Answer ✔✔electrical impulses originate from somewhere other than sinus node what are conduction blocks? - Precise Answer ✔✔electrical impulses go down the usual pathway but encounter blocks and delays what are pre-excitation syndromes? - Precise Answer ✔✔electrical impulses bypass the normal pathway and go down an accessory shortcut instead what is the normal sinus rate and what is it called when its above and below this rate? - Precise Answer ✔✔60-100 BPM >100 tachycardia <60 bradycardia normal sinus rhythym - Precise Answer ✔✔(SINUS RHYTHMS) notice all PQRST waves are equal and present. Diastolic period can be easily identified a. HR 60-100 b. similar P in all leads in front of QRS c. constant PR (.12-.2) sec interval sinus bradycardia - Precise Answer ✔✔(SINUS RHYTHM) notice all waves are present and in normal size. a very long diastolic period is easily identified a. HR less than 60 b. diastolic pause is longer c. bradycardia decreases the blood flow in the brain and other tissues sinus tachycardia - Precise Answer ✔✔(SINUS RHYTHM) diastolic period can not be seen well, P and T waves are very close together a. HR over 100 b. diastolic pause is small or nonexistent c. tachycardia reduces the blood supply to the cardiac muscle sinus arrhythmia - Precise Answer ✔✔(SINUS RHYTHM) notice that PQRST waves are equal and normal in size, but diastolic periods are different after each heart systole a. HR 60-100 b. different diastolic pause after each systole supraventricular tachycardia - Precise Answer ✔✔(ATRIAL RHYTHM) Atrial Tachycardia (AT) is caused by an irritable focus in the atria that fires electrical impulses after normal firing of SA node pacemaker HR btw 100- 150 AV Reentry Tachcardia is caused when the electrical impulse passes a passage other than AV node. cardiac rhythm regular but up to 250 BPM **EMERGENCY NOTIFY DOCTOR Type I Second Degree AV block - Precise Answer ✔✔PR interval lengthens in each interval until one QRS disapears; Notice gradual increase in PR intervene, and then sudden disapear of QRS complex Type II Second Degree AV Block - Precise Answer ✔✔conducted P waves have a constant PR interval; but there is always non-conducted P waves btw cardiac cycles, usu producing a conduction ratio btw atria and vertircles (2 P waves per QRS) Third Degree AV block - Precise Answer ✔✔(aka complete heart block) impulses generated by the SA node are completely blocked . atria and ventricles beat independently of one another; no relationship btw P waves and QRS complexes what is ischemia? - Precise Answer ✔✔insufficient blood supply to the myocardium what is myocardial infarction (MI) - Precise Answer ✔✔sudden death of myocardial tissue due to an abrupt cessation of blood flow What are the 2 ischemic EKG characteristics? - Precise Answer ✔✔1. subendocardial ischemic injury is manifest by ST segment depression 2. subepicardial and transmural injury is manifested by ST segment elevation myocardial infarction EKG - Precise Answer ✔✔Notice ST segment depression in aVL leads on the trace; note that changes in ST segments and T wave inversion are the early signs of myocardial infarction the World Health Organization (WHO) criteria for diagnosis of myocardial infarction are presence of at least two of the following? - Precise Answer ✔✔-clinical history of ischemic-type of chest discomfort -changes on serial EKG tracings -rise and fall in serum cardiac markers what is artifact? - Precise Answer ✔✔unwanted interference or jitter on the EKG rcording what are the 4 common artifacts? - Precise Answer ✔✔1. somatic tremor 2. wandering baseline 3. 60-cycle interference 4. broken recording somatic tremor - Precise Answer ✔✔notice jittering pattern on the aVR and aVL leads wandering baseline - Precise Answer ✔✔the iso-electric line moved up and down strip 60-cycle interference - Precise Answer ✔✔caused by improperly grounded electrical equipment broken recording artifact - Precise Answer ✔✔caused by a damaged wire or loose electrodes What are two methods of stress testing? - Precise Answer ✔✔-exercise stress test -pharmacologic stress test what is ambulatory EKG monitoring used for? - Precise Answer ✔✔diagnosis of cardiac dysrhythmias and can evaluate the HR, rhythm and function during daily activites using a Holter monitor what is a Holter monitor - Precise Answer ✔✔ambulatory EKG where 5 electrodes are attached to patient's trunk instead of arms and leg to prevent muscle artifact What are the 10 cardiovascular agents? - Precise Answer ✔✔1. oxygen 2. epinephrine 3. isoproterenol (Isuprel) 4. Dopamine (intropin) 5. Beta Blockers 6. Lidcocaine 7. Verapamil afferent-venules, veins and superior and inferior vena cava composed of entholelial cells, what connects the arterioles and venules? - Precise Answer ✔✔the capillaries capillary blood is a mixture of what? - Precise Answer ✔✔arterial and venous blood liquid portion of the blood is known as? - Precise Answer ✔✔plasma plasma comprises what portion of blood? - Precise Answer ✔✔55 percent other 45 percent is formed elements what are the 3 "formed elements" in the blood? - Precise Answer ✔✔erythrocytes (RBCS) and leukocytes (WBC) and thrombocytes (platelets) erythrocytes contain what? - Precise Answer ✔✔hemoglobin, the oxygen-carrying protein function of leukocytes - Precise Answer ✔✔provide body protection from infection leukocytosis v leakopenia - Precise Answer ✔✔leukocytosis in an increase in WBCS leukopenia is a decrease in WBCs What are the 5 types of WBCs in the body? - Precise Answer ✔✔1.neutrophils-most numerous; phagocytic cells 2.lymphocytes- increase in viral infection 3.monocytes-increase in intracellular infections 4. eosinophils - active agains attibody foreign molecules 5. basophils- carry histamine hemostasis - Precise Answer ✔✔the process by which blood vessels are repaired after injury; 5 stages what are the 5 stages of hemostasis? - Precise Answer ✔✔1. vasuclar phase 2. platelet phase 3. coagulation phase 4. fibrinolysis what is the preferred site for venipuncture? - Precise Answer ✔✔antecubital fossa of upper extreminties what are the 3 veins located in the antecubital fossa? - Precise Answer ✔✔1. median cubital vein 2. cephalic 3. basilic what are unsuitable veins for venipuncture? - Precise Answer ✔✔sclerosed veins, thrombotic veins and tortous veins true or false you can recap a needle without a safety device? - Precise Answer ✔✔FALSE what are the 3 skills a medical assistant uses when contacting patients for phlebotomy? - Precise Answer ✔✔social, clerical and technical what is an accessioning order? - Precise Answer ✔✔a number to identify all paperwork and supplies associated with each patient what is edema - Precise Answer ✔✔the accumulation of fluid in the tissues what is a fistula - Precise Answer ✔✔the permanent surgical connetion betw an ertery and a vein true or false you can label the blood tubes prior to venipuncture - Precise Answer ✔✔false in a venipunctrue when do you release the tourniquet? - Precise Answer ✔✔once blood flow as begun what is the order of draw for capillary specimens? - Precise Answer ✔✔lavender tube, tubes with other additives, tubes without additives lavender top tube: what does it contain? common tests? - Precise Answer ✔✔contains EDTA which inhibits coagulation by binding to calcium present in specimen; invert 8 times. Used for CDCs Light-blue top tube: what does it contain? common tests? - Precise Answer ✔✔contains sodium citrate, which prevents coagulation; fill completely and invert 3-4 times common tests: coagulation studies (PT), APPT, PTT green top tube: what does it contain? common tests? - Precise Answer ✔✔contains Heparin combined with sodium lithium or ammonium, works by inhibiting thrombin in coagulation; invert times common tests: chemistry tests such as ammonia STAT electrolytes gray top tube: what does it contain? common tests: - Precise Answer ✔✔contains additives and anticoagulant; invert 8 times common tests: FBS, GTT, blood alcohol levels, lactic acid Red/gray (tiger) top tube (SST) - Precise Answer ✔✔contain clot activators; invert tubes 5 times commonly used for chemistry tests Red top tube - Precise Answer ✔✔also known as plain vacuum tube and contains no additive or anticoagulant, no need to invert commonly used for serum chem tests and blood bank yellow top tube (sterile) - Precise Answer ✔✔contains anticoagulant SPS; used to collect specimens to be cultured for presence of microorganisms; invert 8 times What is the primary purpose of Quality Control (QC)? - Precise Answer ✔✔to provide reliable data about the patient's health status by ensuring the accuracy of test results while detecting and eliminating errors true or false proficiency testing systems are a requirement for labs - Precise Answer ✔✔TRUE what is electrophoresis? - Precise Answer ✔✔analyzes chemical components of blood such as hemoglobin and serum, urine and CSF what is toxicology program? - Precise Answer ✔✔analyzes plasma levels of drugs and posions what is immunochemistry? - Precise Answer ✔✔uses techniques such as RIA and enzyme immunoassay to detect and measure hormones, enzymes, drugs what tests may be included in a liver profile? - Precise Answer ✔✔ALP, AST, ALT, GGT, Bilirubin what tests may be included in a coronary risk profle? - Precise Answer ✔✔chol, TRIG, HDL, LDL What are the four blood groups based on the antigens present? - Precise Answer ✔✔A, B, AB, O what determines whether a person is Rh positive or neg? - Precise Answer ✔✔the presence or absence of the D antifen (Rh factor) on the RBC membrane D antigen present in 85 percent pop what is the serology (immunology) section responsible for? - Precise Answer ✔✔performing tests to evaluate the patient's immune response through production of antibodis What are the four subsections of microbiology? - Precise Answer ✔✔bacteriology, parasitology, mycology, virology give the power setting for all the microscope obectives - Precise Answer ✔✔low power objective: 10x (used for light adjustment) high power objective, 40x (used for urinary sediments detail) oil immersion ob, 100x (used for osbserving bacteria the presence of increased numbers of leukocytes or WBC in urine is an indicator of what? - Precise Answer ✔✔bacteriuria or UTI increased levels of WHAT are a natural marker for pregnancy? - Precise Answer ✔✔hCG What is the key concept of HIPAA? - Precise Answer ✔✔patient confidentiality what is negligence? - Precise Answer ✔✔failure to exercise the standard of care that a reasonable person would give under similar crcum and someone suffers an injury what are the 4 elements of negligence (4 Ds) - Precise Answer ✔✔duty, derelict, direct cause, damage what is tort? - Precise Answer ✔✔a wrongful act that results in injury ex: battery, invasion of privacy, defamation of character what is the organization that has a Code of Ethics that sets guidelines for medical assistants in the practice? - Precise Answer ✔✔American Association of Medical Assistants (AAMA) pain has what two categorizatins - Precise Answer ✔✔acute or chronic what are the 3 main types of pain? - Precise Answer ✔✔physical, psychological and phantom What are the three methods commonly used to rate pain? - Precise Answer ✔✔1. numerical or symbolic scale 2. face scale 3. full body picture removal or organs or tissues is based on what three factors? - Precise Answer ✔✔1. source of donation- cadaver or live donor 2. waiting period - cold or warm ishemic 3. removal order what organization oversees tissue and organ harvest? - Precise Answer ✔✔United network for organ sharing (UNOS) what is a living will? - Precise Answer ✔✔a document declaring a persons wish to die naturally OSHA requires that which vaccination be offer to ever healthcare worker within 10 days beginning employment? - Precise Answer ✔✔Hepatitis B Tx (abbrev) - Precise Answer ✔✔prescription qd (abb) - Precise Answer ✔✔everyday aerobes v anaerobes - Precise Answer ✔✔aerobes are microorganisms that require oxygen whereas anaerobes lack oxygen true or false: under healthy conditions urine is sterile - Precise Answer ✔✔TRUE what is aespesis - Precise Answer ✔✔the practice of maintaining a pathogen free environment to prevent the spread of illness and disease what agency studies and monitors diseases and disease prevention and works to protect public health and safety - Precise Answer ✔✔centers for disease control and prevention (CDC) Universal Precautions were established by the CDC to what? - Precise Answer ✔✔reduce the risk of hepatitis and AIDS surgical aespsis is also known as what - Precise Answer ✔✔sterile or aspetic technique sanitization does what? - Precise Answer ✔✔inhibits bacterial growth or inactivates pathogens; but does not destroy microorganisms disinfection does what - Precise Answer ✔✔destroys or inhibits pathogenic microorganisms but does not kill spores how long should you wait for patients who just finished eating drinking or smoking to take temp? - Precise Answer ✔✔30 minutes What method of taking temp is the least accurate? - Precise Answer ✔✔axillary (underarm) normal adult pulse range - Precise Answer ✔✔60-100 BPM what is the site most commonly used for taking pulse? - Precise Answer ✔✔radial artery in wrist normal range for adults respiration? - Precise Answer ✔✔12-20 per minute what are 3 respiration rate abnormalities? - Precise Answer ✔✔apnea- temporary complete absence of breathing tachypnea- rate > 40.min bradypnea- decease in number of respirations What are to abnormalities in respiratory rhythm? - Precise Answer ✔✔Cheyne-Stokes- regular pattern of irregular breathing rate Orthopnea- difficult to breathe unless in upwright position what does depth of respiration refer to? - Precise Answer ✔✔amount of air that is inspired and expired during respiration what are three abnormalities in depth of respirations? - Precise Answer ✔✔hypoventilation-reduced amt of air enters lungs hypernea- abnormal inc in depth and rate of breathing hyperventilation- increased amt of air entering lungs Define blood pressure - Precise Answer ✔✔measurement of the amt of force exerted by the blood on the peripheral arterial walls and is expressed in mmHg BP consists of what 2 components? - Precise Answer ✔✔highest (systole) and lowest (diastole) amt of pressure exerted during cardiac cycle Name some common errors in blood pressure measurmens - Precise Answer ✔✔improper cuff size, arm is not at heart level, cuff not deflated, improper cuff placement anthropometric refers to what? - Precise Answer ✔✔comparative measurements of the bdoy What are the 4 principles of physical examination? - Precise Answer ✔✔inspection, palpation, percussion, ausculatationq to make a diagnosis the physician utilizes what 3 sources? - Precise Answer ✔✔patient's health history, physical exam, and lab tests horizontal recumbent position - Precise Answer ✔✔used for most physical exams dorsal recumbent position - Precise Answer ✔✔ fowler's position - Precise Answer ✔✔used to promote drainage or ease breathing dorsal lithotomy position - Precise Answer ✔✔used for exam of pelvic orgns prone position - Precise Answer ✔✔used to examine spine and back Sim's position - Precise Answer ✔✔used for rectal examination knee-chest position - Precise Answer ✔✔used for rectal and vaginal exams trendelenburg position - Precise Answer ✔✔used for surgical procedures of pelvis and abdomen po (abb) - Precise Answer ✔✔by mouth/orally pr (abb) - Precise Answer ✔✔per rectum sl (abb) - Precise Answer ✔✔sublingual (under tongue) SQ (abb) - Precise Answer ✔✔subcutaneous pc (abb) - Precise Answer ✔✔after meals qhs (abb) - Precise Answer ✔✔each night prn (abb) - Precise Answer ✔✔as needed The heart is located in the thoracic cavity between the lungs in what space? - Precise Answer ✔✔mediastenum, just behind the sternum give layers of heart deep to superficial - Precise Answer ✔✔endocardium, myocardium, pericardium what is the "heart skeleton" made of? - Precise Answer ✔✔four rings of thick connective tissue what are the layers of fluid separating the parietal pericardium and visceral pericardium? - Precise Answer ✔✔pericardial sac what structure in the middle of the heart divides the heart into two sides? - Precise Answer ✔✔septim what kind of blood does the left and right side of the heart pump? - Precise Answer ✔✔right pumps deoxygenated blood w low pressure from veins into lungs (pulmonary circulation) and left pumps oxygenated blood with high pressure (blood pressure) toward the tissues through the arteries (systemic circulation) What are the four heart chambers? - Precise Answer ✔✔right atrium, left atrium, right ventricle, left ventricle what are the only arteries in the body that carry oxygenated blood? - Precise Answer ✔✔pulmonary arteries (efferent) what are the only veins in the body that carry oxygenated blood? - Precise Answer ✔✔pulmonary veins (afferent) what is the largest artery in the body? - Precise Answer ✔✔the aorta be familiar with heart anatomy - Precise Answer ✔✔ what is the purpose of heart vavles? - Precise Answer ✔✔to prevent the backflow of blood therby assuring uni-directional flow through the heart what are the subdivisions of the heart valves? - Precise Answer ✔✔Atrioventricular valves (AV): Tricuspid + Bicuspid Mitral semilunar valves: Pulmonic + Aortic What are the AV cuspid valves characteristcs? - Precise Answer ✔✔have tough fibrous rings, long and strong leaflets (cuspids), accessory organs (ie papillary muscles, chordae tendinae) give the location of the AV cuspid valves? - Precise Answer ✔✔tricuspid is btw the right atrium and right ventricle, bicuspid mitral is btw left atrium and left ventricle characteristics of semilunar valves? - Precise Answer ✔✔three leaflests, shallow in depth, no accessory organs give location of semilunar valves? - Precise Answer ✔✔pulmonic btq right ventricle and pulmonary trunk, aortic btw left ventricle and aorta where are the coronary arteries located? - Precise Answer ✔✔on the epidcardium True or false. the blood volume ejected outside the heart is equal to the blood volume returning back into the heart - Precise Answer ✔✔TRUE what is stroke volume (preload)? - Precise Answer ✔✔the blood volume ejected outside the ventricle after each contraction; depends on volume of blood, force of myocardium contraction and vascular resistance what is the Starling Law? - Precise Answer ✔✔the greater the volume of blood inside the heart during diastole, the stronger the heart contraction force during systole. the lower the resistance in the vessels, the MORE OR LESS easily blood can be ejected outside heart through circulation? - Precise Answer ✔✔MORE what is cardiac output? - Precise Answer ✔✔the amount of blood ejected outside heart per minute cardiac output equals (X) * (Y) - Precise Answer ✔✔x- stroke volume y- HRper/min what is peripheral vascular resistance? - Precise Answer ✔✔the force exerted against the blood flow determined by diameter of the vessel; lower the vascular resistance the less force needed to eject blood define blood pressure - Precise Answer ✔✔the force exerted by circulating blood volume on the walls of the artery during circulation formula for BP - Precise Answer ✔✔BP equals (cardiac output) * (vascular resistance) define EKG - Precise Answer ✔✔graphical presentation of heart electricity over time. electricity created by pacemaker cells how is the electricity created by pacemaker cells? - Precise Answer ✔✔elecrtical impulses created by passing of ions through the cell membrane What are the 4 properties of cardiac cells? - Precise Answer ✔✔automaticity excitability conductivity contractility when does depolarization occur? - Precise Answer ✔✔when the postively charged ions rapidly move from outside the myocardial cell membrane to the inside, changing charge from negative to positive depolarization results in what? - Precise Answer ✔✔contraction what is repolarization and when does it occur? - Precise Answer ✔✔occurs immediately after depolarization and is the movement of positively charged ions back to the outside of the cell, returning cell back to original polarized state what is the absolute refractory period? - Precise Answer ✔✔the first phase of repolarization in which a myocardial cell is unable to react to any electrical stimulus what is the relative refractory period? - Precise Answer ✔✔the 2nd phase of repolarization during which a strong enough electrical stimulus might cause new depolarization and contraction what does the conduction ststem of the heart? - Precise Answer ✔✔system that generates and delivers electricity to all the muscle fibers of the heart resulting in a smooth, complete contraction the cardiac muscle fibers which ejects blood from the ehart what 5 things does the conduction system of the heart consist of? - Precise Answer ✔✔SA Node, AV junction (node), Bundle of His, Bundle branches and Purkinje fibers what is the primary pacemaker of the heart and where is it located? - Precise Answer ✔✔SA or sinus node; normal rate of 60-100 BPM; found in the upper posterior portion of the right atrial wall the standard bipolar limb leads and the augmented unipolar leads record in which plane? - Precise Answer ✔✔frontal plane the precordial chest unipolar leads record in what plane? - Precise Answer ✔✔horizontal the electrods for precordial chest unipolar leads are all what sign? - Precise Answer ✔✔positive How many leads are there for the precordial chest? - Precise Answer ✔✔V1-V6, so six leads the usual routine EKG consits of placing how many electrodes? - Precise Answer ✔✔10 producing 12 leads: I,II,III, aVR, aVF, aVL; V1-V6 On EKG paper 1mm equals how many seconds? - Precise Answer ✔✔.04s the vertical axis on EKG paper represents what? - Precise Answer ✔✔voltage, measurred in millivolts what is the running speed of an EKG? - Precise Answer ✔✔25mm/sec Define waveform, segment, interval and complex - Precise Answer ✔✔waveform- refers to movement away from the isoelectric line either upward or downward segment- line btw two waveforms interval- waveform plus segment complex- several waveforms What is a P wave? - Precise Answer ✔✔first deflection after the diastolic, produced by atrial depolarization True or false there is no wave for atrial repolarization - Precise Answer ✔✔True because it is obscured by the larger QRS complex What does a QRS complex represent? - Precise Answer ✔✔ventricular depolarization (activation) A T wave represents what? - Precise Answer ✔✔the first wave after the QRS complex is produced by ventricular repolarization; slightly asymmetric U wave - Precise Answer ✔✔deflection seen following T wave but preceding the diastole; represents repolarization of Purkinje fibers How is the PR segment measured and what does it represent? - Precise Answer ✔✔measured from the end of the P wave to the beginning of the QRS complex; represents depolarization of the AV node and its dely and depolarization of the Bundle of His and Bundle branches How is ST segment measured and what does it represent? - Precise Answer ✔✔represents time of ventricular contraction and beginning of repolarization of both ventricles; measured from the end of QRS to beginning of the T wave what is a normal PR interval? - Precise Answer ✔✔0.12 - 0.2 seconds what does the QT interval represent? - Precise Answer ✔✔total ventricular activity what are the 4 methods to calculate heart rate (EKG)? - Precise Answer ✔✔6 second method large boxes method small boxes method sequence method "memorization" how do you perfrom the 6 second method? - Precise Answer ✔✔count number of QRS complexes btw 6 sec marks and multiply by 10 **used for estimating slow and irregular rhythyms how to perform the large boxes method? - Precise Answer ✔✔count number of large boxes btw 2 RR intervals and divide into 300 for ventricular rate; count large boxes s btw P waves for artrial rate; used for regular rhythms c. bradycardia decreases the blood flow in the brain and other tissues sinus tachycardia - Precise Answer ✔✔(SINUS RHYTHM) diastolic period can not be seen well, P and T waves are very close together a. HR over 100 b. diastolic pause is small or nonexistent c. tachycardia reduces the blood supply to the cardiac muscle sinus arrhythmia - Precise Answer ✔✔(SINUS RHYTHM) notice that PQRST waves are equal and normal in size, but diastolic periods are different after each heart systole a. HR 60-100 b. different diastolic pause after each systole supraventricular tachycardia - Precise Answer ✔✔(ATRIAL RHYTHM) Atrial Tachycardia (AT) is caused by an irritable focus in the atria that fires electrical impulses after normal firing of SA node pacemaker HR btw 100- 150 AV Reentry Tachcardia is caused when the electrical impulse passes a passage other than AV node. cardiac rhythm regular but up to 250 BPM **EMERGENCY NOTIFY DOCTOR atrial flutter - Precise Answer ✔✔(atrial rhythm) notie that there are no more "p waves" only saw-tooth-like wave called F wave a. characterized by rapid depolarization of a single atrial focus at a rate of 250-350 BPM b.typically a slower ventricular rate **EMERGENCY NOTIFY DOCTOR atrial fibrillation - Precise Answer ✔✔(atrial rhythm) no more p waves, instead they are substituted by small trembling waves, while QRST complex are almost normal a. caused by multiple irritable sites all over the atria firing at rate >350 b. no identifiable P waves, fibrillatory eratic "f" waves **EMERGENCY NOTIFY DOCTOR Premature Ventricular Complex (PVC) - Precise Answer ✔✔(ventricular rhythm) observe difference btw the normal QRS complexes and the wide inverted abnormal QRS of the PVC and full compensatory pause a. QRS and PVC greater than .12 s because ventricular depolarization is abnormal b. T waves usu in opposite direction of QRS ventricular tachycardia (VT) - Precise Answer ✔✔(ventricular rhythm) notice there are no more p waves but wide, bizarre QRS complexes at a rate >100 a. 3 or more PVCs in a row b. regular fast rhythm c. no P waves ** EMERGENCY ND ventricular fibrillation (VF) - Precise Answer ✔✔notice the quivering eratic waves that do not resemble any of the normal waves or QRS complexes a. chaotic deflection of different waves that vary in size shape and duration b. no visible waves EMERGENCY requires defibrillationa nd CPR Asystole (Cardiac Arrest) - Precise Answer ✔✔just an isoelectric line, no waves are seen patient is clinically dead EMERGENCY!! What are the 4 types of Atrio-ventricular blocks (AV blocks) - Precise Answer ✔✔1. Type I First Degree AV block 2. Type I Second Degree (Wenckebach, Mobitz I) 3. Type II Second Degree AV block (Mobits II) 4. Third Degree AV block Type I First Degree AV block - Precise Answer ✔✔characterized by a delay of impulses at the level of the AV node; PR interval prolonged and greater than 0.2s; Notice prolonged P wave 60-cycle interference - Precise Answer ✔✔caused by improperly grounded electrical equipment broken recording artifact - Precise Answer ✔✔caused by a damaged wire or loose electrodes What are two methods of stress testing? - Precise Answer ✔✔-exercise stress test -pharmacologic stress test what is ambulatory EKG monitoring used for? - Precise Answer ✔✔diagnosis of cardiac dysrhythmias and can evaluate the HR, rhythm and function during daily activites using a Holter monitor what is a Holter monitor - Precise Answer ✔✔ambulatory EKG where 5 electrodes are attached to patient's trunk instead of arms and leg to prevent muscle artifact What are the 10 cardiovascular agents? - Precise Answer ✔✔1. oxygen 2. epinephrine 3. isoproterenol (Isuprel) 4. Dopamine (intropin) 5. Beta Blockers 6. Lidcocaine 7. Verapamil 8. Digitalis 9. Morphine sulfate 10. nitroglycerin what is the cardiovascular agent given to all paitents with angina pectoris (acute severe chest pains) - Precise Answer ✔✔oxygen what sympathetic drug is used to manage cardiac arrest by increasing heart contractibility? - Precise Answer ✔✔epinephrine what do beta blockers do? - Precise Answer ✔✔reduce heart rate, blood pressure, myocardial contractility, and myocardial oxygen consumption what cardiovasular agent produces an overall increase in heart rate and myocardial contractility? - Precise Answer ✔✔isoproterenol which drug is used in cases with hypotension that causes vasoconstriction? - Precise Answer ✔✔dopamine what is the drug of choice for the suppression of ventricular ectopy contractions? - Precise Answer ✔✔lidocaine what is Verapamil used to treat? - Precise Answer ✔✔paroxysmal supraventricular tachycardia (PSVT) digitalis increases the force of what? - Precise Answer ✔✔cardiac contraction as well as cardiac output morphine sulfate is the traditional drug of choice for what? - Precise Answer ✔✔pain and anxiety what is nitroglycerin? - Precise Answer ✔✔powerful smooth muscle relaxant chambers of the heart - Precise Answer ✔✔ what is the function of the circulatory system? - Precise Answer ✔✔to deliver oxygen, nutrients, hormones and enzymes to cells and transport cellular wast to the organs where they can be expelled? List all the blood vessels - Precise Answer ✔✔aorta, arteries, arterioles, capillaries, venules, veins, superior and inferior vena cavae list the three layers of the blood vessels - Precise Answer ✔✔tunica adventitia tunica media tunica intima which blood vessels carry oxygenated blood (efferent)? WHich blood vessels carry deoxygenated blood (afferently)? - Precise Answer ✔✔efferent-aorta, arteries, arterioes 3. basilic what are unsuitable veins for venipuncture? - Precise Answer ✔✔sclerosed veins, thrombotic veins and tortous veins true or false you can recap a needle without a safety device? - Precise Answer ✔✔FALSE what are the 3 skills a medical assistant uses when contacting patients for phlebotomy? - Precise Answer ✔✔social, clerical and technical what is an accessioning order? - Precise Answer ✔✔a number to identify all paperwork and supplies associated with each patient what is edema - Precise Answer ✔✔the accumulation of fluid in the tissues what is a fistula - Precise Answer ✔✔the permanent surgical connetion betw an ertery and a vein true or false you can label the blood tubes prior to venipuncture - Precise Answer ✔✔false in a venipunctrue when do you release the tourniquet? - Precise Answer ✔✔once blood flow as begun what is the correct order of draw? (BeCause Better Speciments Generate Perfect Goals) - Precise Answer ✔✔1. blood cultures 2. light blue top tubes 3. serum or non-additive tube (red or red/gray) 4. green top tubes 5. lavender top tubes 6. gray top tubes what are three causses of failure to obtain blood? - Precise Answer ✔✔1. tube has lost its vacuum 2. improperly positioned needle 3. collapsed vein what is a hematoma? - Precise Answer ✔✔most common complication of phlebotomy; blood has accumulated in the tissue surrounding the vein what is hemoconcentration? - Precise Answer ✔✔increase in proportion of formed elements to plasma caused by torniquet being left on too long what is phlebitis? - Precise Answer ✔✔inflammation of a vein as a result of repeated venipunctrue on thatt vein what is petechiae? - Precise Answer ✔✔tiny non-raised red spots that appear on the skin for rupturing capillaries what is a thrombus? - Precise Answer ✔✔a blood clot usually a consquence of insufficient pressure applied after withdrawal of needle what is the two-hour postprandial test used for? - Precise Answer ✔✔to evaluate diabetes mellitus OGTT - Precise Answer ✔✔oral glucose tolerance test what is therapeutic drug monitoring - Precise Answer ✔✔used to monitor the blood levels of certain medication to ensure patient safety and maintain a plasma level What are blood cultures ordered for? - Precise Answer ✔✔to detect presence of microorganisms in the patient's blood What is a PKU? - Precise Answer ✔✔a test ordered for infants to detect phenylketouria, a genetic disease that causes mental retardation and brain damage what are cold agglutinins - Precise Answer ✔✔antibodies produced in ressponse to Mycoplasma pneomoniae infection (atypical pneumonia) american academy of pediatrics recommends that heel punctures for infants does not exceed what? - Precise Answer ✔✔2.0mm what tests may be included in a liver profile? - Precise Answer ✔✔ALP, AST, ALT, GGT, Bilirubin what tests may be included in a coronary risk profle? - Precise Answer ✔✔chol, TRIG, HDL, LDL What are the four blood groups based on the antigens present? - Precise Answer ✔✔A, B, AB, O what determines whether a person is Rh positive or neg? - Precise Answer ✔✔the presence or absence of the D antifen (Rh factor) on the RBC membrane D antigen present in 85 percent pop what is the serology (immunology) section responsible for? - Precise Answer ✔✔performing tests to evaluate the patient's immune response through production of antibodis What are the four subsections of microbiology? - Precise Answer ✔✔bacteriology, parasitology, mycology, virology give the power setting for all the microscope obectives - Precise Answer ✔✔low power objective: 10x (used for light adjustment) high power objective, 40x (used for urinary sediments detail) oil immersion ob, 100x (used for osbserving bacteria a meter is how many inches long? - Precise Answer ✔✔39.37 inches .3 meters is how many inches? - Precise Answer ✔✔12 inches what percent bleach solution is desired for areas w possibility of blood contam? - Precise Answer ✔✔10 percent what is the formula for dilution? - Precise Answer ✔✔desired strength/ over available strength equals X (amount needed)/ amt avail What are ABGs used for? - Precise Answer ✔✔to help assess a patients ventilation, oxygenation and acid-base balance what is the Gram Stain used for? - Precise Answer ✔✔to classify bacteria on the basis of their form, size, cellular morphology and gram stain recation when exposed to gram stain, bacteria stain positive (purpley blue) or negative (red) based on what? - Precise Answer ✔✔differences in the cell wall composition and structure what makes up the urinary system? - Precise Answer ✔✔two kidneys, two ureters, urinary bladder and urethra what are the functions of the kidney? - Precise Answer ✔✔to remove metabolic waste from the blood stream ,maintin acid-base balance and regulate hydration anuria - Precise Answer ✔✔the absence of urine hematuria - Precise Answer ✔✔presence of blood in urine polyuria - Precise Answer ✔✔passage of large volumes of urine proteinuria - Precise Answer ✔✔presence of excess proteins in urine Which urine sample is most commonly used for routine urinalysis? - Precise Answer ✔✔first morning smale which urine test provides the clearest, most accurate results? - Precise Answer ✔✔clean-catch specimen urine formed by a healthy kidney has what composition? - Precise Answer ✔✔96 percent water and 4 percent dissolved substances what are the 3 parts to routine urinalysis? - Precise Answer ✔✔physical exam, chemical exam, microscopic exam what is the urine pH of healthy patients - Precise Answer ✔✔around 6 qd (abb) - Precise Answer ✔✔everyday aerobes v anaerobes - Precise Answer ✔✔aerobes are microorganisms that require oxygen whereas anaerobes lack oxygen true or false: under healthy conditions urine is sterile - Precise Answer ✔✔TRUE what is aespesis - Precise Answer ✔✔the practice of maintaining a pathogen free environment to prevent the spread of illness and disease what agency studies and monitors diseases and disease prevention and works to protect public health and safety - Precise Answer ✔✔centers for disease control and prevention (CDC) Universal Precautions were established by the CDC to what? - Precise Answer ✔✔reduce the risk of hepatitis and AIDS surgical aespsis is also known as what - Precise Answer ✔✔sterile or aspetic technique sanitization does what? - Precise Answer ✔✔inhibits bacterial growth or inactivates pathogens; but does not destroy microorganisms disinfection does what - Precise Answer ✔✔destroys or inhibits pathogenic microorganisms but does not kill spores sterilization does what? - Precise Answer ✔✔destroys all living forms of microorganisms, including sporest define therapeutic effect? - Precise Answer ✔✔the desired effect of a drug what are analgesics? - Precise Answer ✔✔drugs that help to reduce pain without altering level of consciousness what federal act sets guidelines for the storage, record keeping and safekeeping of controlled substance - Precise Answer ✔✔Controlled substances act (CSA) bacteria are classified what two ways? - Precise Answer ✔✔1. by morphology or shape 2. by gram reaction what is a nephron? - Precise Answer ✔✔a microscopic tubular structure connected at one end of the arterial blood supply of the kidneys and other end to the urine drainage system what are the 4 main nitrogenous waste compounds? - Precise Answer ✔✔urea, uric acid, creatine and ammonium saltsm salts