1 Flashcards
_ Protects confidentiality and phi stored on, transmitted through, a computer, network, or internet
The security rule
Who mandates “infection control procedures”?
OSHA
Patients have the right to talk in confidence With providers which is known as ______.
confidentality of health information
T or F
Charts can be left in the examination room while the patient is waiting for the physician
False
What is the medical assistant doing when he/she asks a patient a series of screening questions to ascertain the nature, extent, and urgency of his condition?
Triage
What is the statement of guidelines or rules given on a topic?
Policy
Mail weighing more than 13 ounces is _________.
Priority mail
Principal above all else in scheduling
Flexibility
The typical scheduling time for an ep routine follow up appointment is ________.
15 minutes
How often should infection control, qualify improvement, and risk management procedures be reviewed?
Regularly
Implementation of compliance and ______ standards are based on the development of written standards and_______.
Practice, procedures
Who mandated HIPPA?
Department of health and human services
What does NCCI do?
Determines the extent in which Medicare pays for services
Erroneous claims are______ billing errors or mistakes
Innocent
A filing system in which a intermediary source of reference, such as a file card, must be consulted to locate specific files is called a(n)______ system.
Indirect filing
Plan that allows patients to go to any physician
Fee for service
A notice a provider should give a patient before services are provided, if, based on Medicare coverage rules, the provider has realms to believe Medicare will not pay for the service.
Advance beneficiary notice (abn)
An advance beneficiary notice (abn) is also known as a(n)______.
Waiver of liability
The schedule matrix__________.
Prevents booking of patients during meetings and hospital rounds
The principal advantage of using wave method when designing the scheduling process is that it_________.
Allows flexibility to accommodate the Unpredictable
Medigap policy
A Medicare supplemental insurance policy sold by private insurance companies
What is created and managed for a single provider N single health care organization
EMR
Most common type of letter written In clinic/doctors office
Block style
Statement of guidelines or rules on a given topic
Policy
What does cert do?
Measures improper payments in the Medicare fee-for-service program
Organization that developed the bloodborne pathogen standards
OSHA
How long should arm rest before reinflating bp cuff?
1-2 minutes
Ratio of bleach to water
1:10
When taking a Childs pulse. Which pulse point is most commonly used and is also used when obtaining a bp
Brachial
Example of febrile temperature
102.0f
What could occur when using a bp cuff that is too large?
Inaccurate bp, lower than usual.
A reason to use a contrast media during diagnostic imaging
Highlights inner contours of body.
Position used with shock patients
Trendelenburg ( head declined below level of feet while supine( laying) on table)
Geriatric depressin tool relates to
Dally activity interests and feelings
Pediculosis
Head lice
How long should hand washing last when first arriving to work?
1-2 minutes
Difference between systolic and diastolic blood pressme
Pulse pressure
Normal newborn heartrate
120-160
Position where patient is sitting up at 90° at the end of the examination table
Fowlers
Which test measures a patient’s hearing using air and bone conduction
Tuning fork test
Normal range of specific gravity of urine in adults with normal diet and fluid intake
1.015-1.025
Bending the forearm towards the body
Flexion
When performing a rapid strep test, you should______.
Bring The reagents and devices to room temperature before obtaining the specimen
Water soluble vitamins
Vitamins b and c
Food with vitamin c?
Oranges
Most current recommended immunization schedule to post in the pediatric office is found
CDC
Chemical analysis of urine
Clia-waived
Goniometers
Measures range of motion
Antibiotic is for
Bacteria
A gram of fat is equal to how many calories?
9
Position: lie on left side with left arm and leg drawn back and the right arm and leg flexed up and is commonly used to examine rectum or hemorrhoids
Sims
Endocrinologist for________.
Diabetes mellitus
Bacteria with rod shape
Bacillus
Bid
2 times a day
If a patient is diagnosed with a blood clot in their lower left leg, what would most likely be prescribed for the patient per iv solution?
Heparin
In EKG: which lead is placed on the left side of the sternum at the fourth intercostal space?
V2
The risk of developing coronary artery disease is increased by what?
Smoking
Properly calibrated ekg machine should indicate
10 mm high
25 mm/second
Government agency that regulates controlled
Substances
Dea
Which EKG leads are augmented?
AFV ALV AVR
Hearts natural pacemaker
Sa node
Snellen: patient can read the 20/30 line with 3 errors. What is the next step?
Have patient move to 20/40 line and continue testing the right eye
Schedule lI drug
Methadone
Drug accepted for medical use but has highest potential for abuse
Schedule II
What is a checks and balances system when the physician prescribes administration of a medication for a patient being seen in the office?
Seven rights
Sub-cut
Subcutaneous
ID
Intradermal
I’m
Intramuscular
IV
Intravenous
Nas
Nasal
Po
By mouth
Tint
Tincture
UNG
Ointment
Sol, sold
Solution
Cap
Capsule
Tab(s)
Tablets
Gr
Grain
Gtt(s)
Drop (s)
Ac
Before meals
Pc
After meals
Ad lib
As desired
D
Day
-find-
After
PRN
As needed
what
Every hour
Qid
Four times a day
Tid
Three times a day
Bid
Twice a day
Qam
Every morning
Asa
Aspirin
Apap
Acetaminophen
MOM
Milk of
Magnesia
Ns
Normal saline
qs
Quantity sufficient
Sig
Give the following directions
Vo
Verbal order
Analgesic
Reduces or eliminates pain
- Tool for
Measuring height and width of ECG waves and intervals
Caliper
Heart islocated on the right side of the chest and the apex is pointing to the right
Dextrocardia
Unoxygenated Blood goes to right atrium from head, neck, and upper extremities via
Superior vena cava
Unoxygenated Blood goes to right atrium from thorax, abdomen, pelvis, and lower extremities
Inferior vena cava
Unoxygenated Blood goes to right atrium from the coronary veins
Coronary sinus
: A straight line that is also called the baseline. It represents a period of time with no electrical activity.
Isoelectric line
any movement away from the baseline in the tracing. reflect the heart’s electrical flow.
Deflection
Upward movement is called a ——- deflection. Downward movement is a ———- deflection.
Positive
Negative
A deflection from the baseline.
Wave
A form made up of many waves (e.g., QRS)
Complex
: A part of a line between two points (e.g., the ST ____ starts at the end of the S wave and ends at the start of the T wave).
Segment
: A period of time between two points or events. many waves can occur.
Interval
______is the first deflection in the tracing. It is created from the electrical impulses moving through the right and left atria.
P wave
Small “hill” in EKG (positive deflection seen on lead 2)
P wave
ECG isoelectric line
Pr segment
_ Complex
QRS
ECG
Negative defection
Q wave
ECG
Positive triangular
Deflection
R wave
ECG
Any downward deflection following
The r wave
S wave
ECG 2nd isoelectric line
St segment
ECG
2nd positive defection (upright and rounded in lead 2
T wave
ECG usually not seen
U wave
ECG
____leads placed
____leads read
12 10
ECG
Augmented voltage -right arm
aVR
ECG
Augmented voltage -left arm
aVL
ECG
Augmented voltage -left leg
aVF
RA (white)
Placed just above the wrist or upper arm, indicated in the operator’s manual
Right Arm
LA (black)
Placed just above the wrist or upper arm, indicated in the operator’s manual
Left Arm
RL (green) Placed on the inner lower leg, just above the ankle
Right Leg
LL (red) Placed on the inner lower leg, just above the ankle
Left Leg
Fourth intercostal space at the right sternal edge
V1 (red)
Fourth intercostal space at the left sternal edge
V2 (yellow)
Midway between V2 and V4
V3 (green)
Fifth intercostal space on the midclavicular line
V4 (blue)
Same horizontal plane as V4 at the left anterior axillary line or the midpoint between V4 and V6
V5 (orange)
Same horizontal plane as V4 at the midaxillary line
V6 (purple)
ECG: The adult heart rate is below 60 beats per minute. This is a normal finding in well-conditioned athletes. It is abnormal in other individuals.
Sinus bradycardia:
ECG: The adult heart rate is above 100 beats per minute. This is normal in a person doing aerobic exercise. It is abnormal in a resting individual.
Sinus tachycardia:
occur when there is a problem with the SA node starting the impulse. They can also occur due to a conduction problem in the atria.
Atrial arrhythmias
Occur when the atria contract sooner than they should. The P wave can be abnormally shaped, or an extra P wave can be seen. PACs can be seen in people who smoke or consume large amounts of caffeine. An occasional PAC is not abnormal. More than six PACs in a minute is considered abnormal.
Premature atrial contractions (PACs)
Occurs when the atria contract faster than the ventricles (up to 300 beats per minute). They become out of sync with the ventricles. Extra P waves are seen with regular QRS complexes. Atrial flutter can be caused by alcohol and stimulants (cocaine, caffeine, diet pills, and cold medications). It can also be caused by coronary heart disease, hypertension, cardiomyopathy, heart valve diseases, hyperthyroidism, obstructive pulmonary disease, and pulmonary embolism diseases. reversed with medication to slow the heart or with cardioversion (electrical shock).
Atrial flutter:
The impulse slows as it moves from the atria to the ventricles. This creates a longer PR segment. First-degree heart block may not cause symptoms. It may not require treatment.
First-degree heart block:
The impulse slows or is blocked as it moves into the ventricles. When blocked, there is no QRS complex after the P wave, and the ventricles do not contract. When the impulse slows, the PR segment is longer. This arrhythmia requires a pacemaker to help maintain the heart rate.
Second-degree heart block:
The impulse does not reach the ventricles. As a backup system, special ventricular cells create an impulse that causes the ventricles to contract. On the ECG tracing, the P wave is faster than normal and the QRS complex is not coordinated with the P wave. This is a life-threatening arrhythmia and requires emergency treatment and a pacemaker.
Third-degree heart block:
abnormalities in the ventricles. Most are life-threatening rhythms.
Ventricular arrhythmias
Occur when the ventricles contract sooner than they should. An impulse originating in the ventricles creates this abnormality. The QRS complex appears before a P wave. The P wave can also be absent. PVCs can be caused by tobacco, alcohol, epinephrine, and anxiety. They can also be caused by hypertension, coronary artery disease, and lung disease. Infrequent can be normal. More than six in a minute is abnormal and can lead to a life-threatening condition.
Premature ventricular contractions (PVCs)
Occurs when the ventricles beat at a rapid rate (up to 250 beats per minute). It may be seen with multiple PVCs in a row. It may be a short run of fast beats or may last longer than 30 seconds . life-threatening condition. If it is not reversed with drugs and/or cardioversion, it can become ventricular fibrillation.
Ventricular tachycardia (V-tach)
Occurs when the ventricles quiver uncontrollably . They are essentially ineffective at pumping any blood. The patient has no pulse, is not breathing, and is unresponsive. This is the most critical, life-threatening arrhythmia. Cardioversion with a defibrillator is necessary to restore normal function of the electrical conduction system.
Ventricular fibrillation (V-fib)
Results in the absence of a heartbeat. A flat line appears on the tracing
Asystole
A pager-sized monitor that connects to two chest electrodes by wires. The monitor continuously records the ECG. When the memory is full, it overwrites from the beginning. When a patient has symptoms, he or she activates the monitor. The ECG from prior to, during, and for a short while after the event is stored. It does not overwrite the stored ECGs.
Looping memory monitor (also called a cardiac loop recorder)
Can be a handheld device or worn on the wrist. When symptoms are felt, the patient activates the monitor and places it on the chest. Small metal discs on the back of the monitor act as electrodes. The current ECG is recorded and stored. Unlike the looping memory monitor, cannot record and store the ECG prior to the symptoms.
Symptom event monitor (also called a post-event monitor)
For a resting 12-lead ECG, ____ leads are bipolar, ___ are augmented, and the remaining ___ are precordial
3,3,6
The bipolar leads are created from a measurement of current traveling from a ____ pole to the _____ pole
negative; positive
Lead I: Right ___ to left ___
arm; arm
Lead II: Right ____ to left ____
arm; leg
Lead III: Left l___ to left ___
leg; arm
Each ____ lead uses all three extremity electrodes (RA, LA, and LL) to create the picture.
augmented;
The six ___ leads are labeled V1, V2, V3, V4, V5, and V6.
precordial
Midpoint between two of the electrodes is the ____ pole.
negative
The _____ leads provide information on the horizontal (front to back) plane of the heart.
precordial
is an upward and downward movement of the waveform. The medical assistant should clean the skin, replace the electrode with a new one, make sure all electrodes and lead wires are firmly attached, and turn on the baseline filter.
Wandering baseline artifact
appears as jagged peaks with irregular heights and spacing. The medical assistant should help the patient relax and encourage him or her not to talk or move during the procedure.
Somatic tremor artifact
appears as a series of small spikes that creates a thick-looking tracing. The medical assistant should unplug the ECG machine and other electrical devices. The lead wires should not overlap, and no cell phones should be near the patient.
AC interference artifact
occurs when the tracing looks normal at the beginning, but then it disappears or goes all over when the electrical connection is interrupted. The medical assistant should check that all electrodes and lead wires are attached.
Interrupted baseline artifact
Atrial arrhythmias occur when there is a problem with the ___ ____ starting the impulse.
SA Node
____ ___ include PACs and atrial flutter.
Atrial arrhythmias
Each time you prepare and give medication, it is important that you follow the ____ rights of medication administration.
nine
pull up ___ medication than ordered; then push ___ medication back in with any ___ ____.
more; extra; air bubbles
check for ___ ____ in the syringe
air bubbles
IM injections \_\_\_\_\_ muscle \_\_\_ gauge \_\_\_ to \_\_\_ inch needle \_\_\_ mL syringe
deltoid; 22; 1; 1/2; 3
7 Rights
Patient Duge Dose Time Route Technique Documentation
Medication Checks
When removing from box
Before drawing
Before administering
(After administering)
IM Injection
___ degrees
90
Aspirate the syringe to see if ___ appears. Start again if it does
blood
Withdraw the needle at ____ angle as inserted
same
Patient observation for ___ to ___ minutes after injection
20; 30
Which injection site is considered the safest for infants?
Vastus lateralis (thigh)
Which muscle is used for a ventrogluteal injection?
Gluteus medius
Which parenteral medication form contains a single dose of a single-compound?
Ampules
A needle with a length of 3/8 inch is commonly used with which injections?
ID
medication administered sublingually?
buccal tablet
tests are included in a CBC?
hemoglobin and hematocrit
Which vitamin increases clotting time and can affect warfarin dosing?
Vitamin K
Hematocrit normal values include a range of __ to __ percent for males and __ to __ percent for females
42 to 52
36 to 48
hemoglobin normal values include a range of ___ to ___ g/dL for males and ___ to ___ g/dL for females.
14 to 17
12 to 16
T or F:
When a blood smear is prepared for a differential test, a drop of blood is placed on a clean glass slide to preparea cover glass smear, a spun smear or a wedge smear.
T
CLIA-waived tests that can be completed with a capillary puncture
.Total cholesterol Liver enzymes AST and ALT
Prothrombin time of PT
When a fasting blood sugar is ordered, the patient would be educated to fast for __ to ___ hours prior to the test.
12 to 14
A normal FBS level
60 and 100 mg/dL
a normal GTT after two hours should be below
140 mg/dL
a normal total cholesterol should be below
200 mg/dL.
CLIA requires that any abnormal test results are rapidly reported to
Provider
Sutures are categorized as
absorbable or nonabsorbable.
Which surgical instrument is used to grasp tissue during a surgical procedure?
Forceps
surgical solutions is a common antiseptic solution used for minor office surgery?
Betadine
What is the table that can serve as an area to place a sterile field and contains surgical instruments during a minor procedure?
Mayo
characteristic of suture needles
Curved or straight Incorrect
Tapered or cutting edge
Attached to suture material
Which surgical instrument is used to clamp small vessels?
Hemostat forceps
is used with some local anesthetics to slow bleeding and to prolong the effect of the anesthetic.
Epinephrine
Which procedure method involves the use of a camera and light source
Endoscopy
T or F
Recommended temperature for sterilization using an autoclave is 121-123⁰C or 250-255⁰ F.
True
What is the physician accomplishing when he or she provides the patient with the reason for surgery, potential risks and benefits, alternative treatments and possible risks as well as risks if the surgery is not performed?
Informed consent
chemical sterilization
Use of a solution
Complete destruction of organisms
surgical asepsis
Which PPE should the Clinical Medical Assistant wear with autoclave use.
Heat-resistant gloves
Face shield or goggles
Laboratory coat
Which is a surgical method involving the use of liquid nitrogen to freeze a wart for destruction?
Cryosurgery
t or F
Sanitization and disinfection are both performed before sterilization.
true
signs might indicate a possible stroke victim
Slurred speech
Why is an AED used?
An AED, or automated external defibrillator, is used on a patient in cardiac arrest, sending an electrical current through the myocardium to resume normal heart rhythm using self-adhesive pads.
Who is legally liable for the care the medical assistant provides to a patient during an emergency in the ambulatory care center?
provider
For a possible fractured, the patient should be placed in a position that supports the affected area at the joints ___ and ___ the suspected fracture.
above; below
___are assessed using the “Rule of Nines,” which divides body areas into sections representing 9% each.
burns
Glucose or sugar is provided to a patient with ____ ____
insulin shock
insulin is provided to patient in a ____ _____
diabetic coma.
How do you respond to a choking infant?
blows to the back and thrusts to the chest
t or f
The office “crash cart” contains emergency supplies such as a portable oxygen tank, hot and cold packs and an AED.
true
The first aid for a patient having a seizure is to protect the patient from possible injury, and the patient should be placed in which position when the seizure is over?
recovery position
A CBC was ordered by the physician. Which tube should be drawn by the clinical medical assistant?
Lavender
The provider ordered a blood culture on a patient. Which tube should the Clinical Medical Assistant draw first?
Yellow
Which of the following are potentially infectious materials requiring special handling?
Wound drainage, Liquid blood, Unknown body fluid
All of the above
When venipuncture is being performed for specimens to be sent to the laboratory, when should the tubes be labeled?
Immediately after the draw
Inspection of the wound prior to removal of sutures reveals exudate, or crusted blood. What should the Clinical Medical Assistant have the patient do before removing the sutures?
Soak the wound
For an elderly patient with very small veins, which type of venipuncture method should be used by the medical assistant?
Butterfly needle
How many times are tubes inverted when they contain additives?
Eight to ten times
If a patient presented with complaint of chest pain when running, which of the following might be ordered by the physician?
Stress test
If a prescription is written for amoxicillin 75 mg t.i.d. for 10 days, how many pills are taken with each dose if amoxicillin 50 mg is dispensed?
1.5
Which is an injection administered at a 45-90 degree angle into fatty tissue?
Subcutaneous
If the Clinical Medical Assistant receives an order from the physician to administer a parenteral medication, which of the following methods could be used?I
IM injection
What is a checks and balance system for the Clinical Medical Assistant when the physician prescribes administration of a medication for a patient being seen in the office?
Seven Rights
For which condition would a diabetic patient be given juice after developing sweating, anxiety, irritability, and headache?
Insulin shock
Which leads on an ECG are augmented leads?
Leads AVF, AVL, and AVR
What does “sig” represent on a prescription?
How to take the medication
Which of the following represents a pre-analytical error during collection of blood?
Extended tourniquet time, Wrong order of draw, Hemolysis
Which of the following represents the heart in a resting state with no electrical activity?
Polarization
If a tuberculosis, or TB, test is ordered by the physician, which of the following methods would the Clinical Medical Assistant use for this injection?
Intradermal
Which is an injection administered at 10-15 degree angle with formation of a wheal?
Intradermal
Use your index finger when you __________ a vein?
Palpate
To be taken by mouth is represented by which abbreviation?
PO
If a prescription indicates BID, how often does the patient take the medication?
Twice a day
When performing an ECG, which lead is placed on the left side of the sternum at the fourth intercostal space?
V2
A clinical medical assistant using a 3/8 needle, the shortest length available, is administering which type of injection?
Intradermal
Dr. Smith prescribed Prednisone 10mg to be taken ii tab stat, I tab tid x 3d, i tab bid x 3d, i tab qd x 3d. How many tablets should be dispensed?
20
When using a capillary puncture device, the puncture must not penetrate more than what depth?
2.0 mm on an infant or child
A gram of fat is equal to how many calories?
9
When providing community resources, which of the following information should be included?
Names and locations
Which artifact is caused by the patient moving or a poor electrode attachment?
Wandering baseline
How many days will a prescription for cefaclor 250 mg/5 mL, 150 mL last if the dose is one teaspoonful three times a day?
10
After assisting with a minor surgical procedure, the medical assistant must follow which precaution when cleaning the instruments?
Wear utility gloves
The physician indicated that the patient should take the medication bid. How often should the medical assistant educate the patient to take the medication?
Twice a day
When determining tool ____, look for parts that determine use: box lock, serrations, finger rings, cutting edge, non cutting edge, thumb type, teeth ratchets, and electric attachemtns
names
7 Rights (checks and balances system)
MEDICATION DOSE ROUTE TIME PATIENT EDUCATION TO REFUSE TECHNIQUE DOCUENTATION
M___ D____R___T___,PETs T___ D___
maybe dogs really talk, pets truly do
grasp the patients ___ with the ____ hand and anchor the vein by stretching the skin ___ ____ the collection site with the thumb of the ____ hand
arm; non dominate; downward below; non dominate
centerfuige: align the ___ end of the capillary tube with the zero line and plasma meniscus with the ___ line
sealed; 100%
label the tubes ____ after completing venipuncture
immediately
___ each tube after removal ____ placing it on the rack
invert; before
anchor the vein and insert needle at ___degree angel
15
Tube collection order
Yellow Light blue red gold (or red gray) gree lavender gray
Sterile blood culture tube color
Yellow
if drawing blood cultures, an ____ solution is used
iodine
___ inversion of tubes prevents blood clotting, whereas ____ mixing may cause hemolysis
gentle; vigorous
With the bevel ___ and the needle allligned ____ to the vein, insert the needle at ___ degree angle through the skin and into the vein ____ and ____.
up; parallel; 15;quickly and smoothly
accidental stick exposure
wash stick area for ___ minutes with antimicrobial soap or antiseptic
____ to supervisor and complete incident report
obtain referral to ___ for confidential assessment and follow-up care
10
report
physician
Y L R G G L G
YOLANDA LOVES RED GOLDEN GRAPES LIKE GARY
Byproducts of drug metabolism
metabolites
Comparing a document with another document to ensure that they are consistent.
reconciling
Medications taken by mouth.
Oral (po)
Injected directly in the bloodstream and has the fastest absorption rate.
Intravenous (IV)
Injected just below the skin; moves into the capillaries or the lymphatic vessels and is brought to the bloodstream. This process is slower than the absorption of intramuscular drugs.
Subcutaneous (subcut)
Injected into the muscle. The greater the number of blood vessels in the muscle, the quicker the absorption.
• Subcutaneous (subcut): Injected just below the skin; mov
Intramuscular (IM):
Placed between the cheek and the gums dissolve and absorb quickly.
Buccal
Placed under the tongue to dissolve; absorbs quickly into the bloodstream.
Sublingual (SL):
the movement of metabolites out of the body.
Excretion
Most drugs are excreted through the ____ and ___.
large intestine and kidneys
The large intestine excretes the undigested drug products in the ___. The kidneys excrete metabolites in the ____
stool; urine
____ or ___is the study of how genetic factors influence a person’s metabolic response to a specific medication.
Pharmacogenomics or pharmacogenetics
A peculiar response to a certain drug. For instance, Benadryl causes drowsiness. When it is given to children, they often get extremely agitated.
Idiosyncrasy
For medications taken routinely, often the prior dose is not completely metabolized and excreted before the next dose is given. This can lead to a buildup of medication or byproducts that can produce toxic effects.
Cumulative effect
___ One drug reduces or blocks the effect of another drug. Example: Naloxone is given for narcotic overdosage.
• Antagonism:
The combined effect of two drugs used together is greater than the sum of each drug’s effect (e.g., 1 + 1 > 2). Example of a harmful interaction: Alcohol has a synergistic effect on antidepressants.
Synergism:
A type of synergism; one drug increases the effect of the second drug. With L-dopa and carbidopa, one drug has no effect but increases the effect of the other drug (e.g., 0 + 1 > 1).
Potentiation
____: Vaccines, blood, and blood products
Biologics
____ ____Represents the drug’s exact chemical formula. For example, the chemical name of ibuprofen is 2-(4-isobutylphenyl) propanoic acid.
Chemical name:
___ ___Assigned by the US Adopted Names (USAN) Council. Similar medications are given similar-sounding generic names. All drugs need to have the generic name on the packaging. For example, ibuprofen is a generic name.
Generic name:
___ ___ Used to list the medication in the United States Pharmacopeia and the National Formulary (USP–NF). This book provides the standards (strength, purity, etc.) for drugs in the United States. In many cases, the official name is the same as the generic name. For example, ibuprofen is also the drug’s official name.
Official name:
____ ____ Also called the trade name. The manufacturer assigns and registers the medication name. No other company can use that name. Usually the brand name begins with a capital letter and is followed by the registered sign (®). For example, brand names of ibuprofen include Advil and Motrin.
Brand name:
Reduces smooth muscle spasms
Anticholinergic
Slows or stops the growth of cancer cells
Antineoplastic
Promotes blood cell production
Hematopoietic
Blocks the action of substances that cause asthma and allergic rhinitis
Leukotriene receptor antagonist
Drains excessive fluid from the eye, used for glaucoma
miotic
____ Dilates the pupil, used for ophthalmic procedures
`Mydriatic
•: Provides information on the absorption, distribution, metabolism, and excretion of the medication. Information on when the drug is at its highest level in the body or when the drug starts working may be included.
Pharmacokinetics
Medication taken at a regular interval until it is canceled or expired.
Routine order:
Order applies to all patients who meet specific criteria. For departments, usually all providers agree collectively on standing orders and sign the order.
• Standing order:
VO
verbal order
x
times
There are ___ parts to a prescription: superscription, inscription, signature, and subscription. All prescriptions need to include the date of issue; patient information; provider’s full name and address; drug name, strength, and dosage form; quantity prescribed; directions for use; number of refills; NPI; and if a generic is acceptable.
four
_____ A packaging method for drugs; holds a specified quantity of medication in a single-use container
unit dose packaging
Leave a ___ between the number and the abbreviation. Do not use a ____ with the abbreviations.
space; period
Write a fraction of a dose as a decimal.
- Correct examples: 0.2 mg and 0.5 mg
* Incorrect examples: Image 1/5 mg and Image 1/2 mg
If the dose is less than 1, place a ___ to the left of the decimal point. This reduces the risk of misreading the dose as a whole number.
zero
Do not place a ___ ___ and a ___ after a whole number. This can be easily misread, and the patient would be given an overdose of medication.
decimal point; zero
- Weight is measured in ___
- Volume is measured in ___
- Length is measured in ___-
grams (g).
liters (L).
meters (m).
____ ____ ____Crushing, chewing, or cutting the tablet can cause a person to get the dose faster than he or she should, resulting in an overdose.
slow- or extended-release tablets:
___ ____ ___: Crushing, chewing, or cutting the tablet causes the protective nature of the coating to be lost. The person could have more stomach distress.
Enteric-coated tablets
____: Very potent solution of alcohol or alcohol and water and the active medicine.
tincture
Example: Iodine tincture.
____ ____Alcoholic plant source extractions; very concentrated and more potent than tinctures.
fluid extract:
: An alcoholic solution with substances that easily evaporate.
spirit
: Clear sweetened liquid preparation that contains alcohol.
e lixir
: A sugar and water solution that contains flavoring and medicinal substance
Syrup
If the active medication does not dissolve and becomes suspended in the liquid, it is called a ____.
suspension
: A suspension of oil and water.
e mulsion
Suspensions consisting of minerals and water. Gels are semisolids and contain finer particles than magmas. The minerals settle out with standing. Shake before using
Gel and magma:
: A suspension that is rubbed on the skin; used to reduce pain and stiffness.
Liniment
: A water-based suspension that is applied to the skin
Lotion
: A suspension of medication in a gas, usually used for respiratory or sinus conditions
Aerosol
Oral medications that coat the mouth or throat should not be immediately followed with ___.
water
Oral medications that require water for swallowing call for more than a ___. Some medications require a glass of water after taking the medication.
sip
A ___ should be used for liquid medications that stain the teeth.
straw
Do not ___ ___ ____prior to taking SL and buccal medications.
eat or smoke
Do not___ ___ ____ SL or buccal medications.
chew or swallow
Water can be taken ___ to the medication to wet the mouth. No liquids can be taken until the medication has dissolved.
prior
___ cheeks used for buccal medication to avoid mucosal irritation.
Alternate
Transdermal medications provide a ___ action
systemic
topical medications, which provide a ____ action
local
The medication is absorbed ___ ___ ___ through the rectal mucous membrane.
slowly and irregularly
: Attaches or screws onto the syringe
Hub
: Where the needle attaches
Hilt
: Slanted end of the shaft
Bevel
: Hollow space inside the needle; the size is indicated by the gauge number
Lumen
Using a wider lumen needle (smaller gauge number) would be better for ____ medications. Using a finer lumen needle (a larger gauge number) would be more appropriate for ___ medications.
thicker
watery
The needle ____ used is dependent on the type of injection given and the size of the patient.
length
A ___ needle on a syringe is used to aspirate the ampule medication into the syringe.
filter
____injections are given just under the epidermis
Intradermal (ID)
Syringe used 1 mL (tuberculin syringe)
Needle size 1/4 to 5/8 inch; 25−27 gauge
Angle of entry 5 to 15 degrees with bevel facing upward
Maximum volume 0.1 mL
Common sites Forearm, upper arm, and back
Additional sites Separate by at least 2 inches
Patient position Sitting with arm extended
Administration Pull skin taut at injection site
Intradermal (ID) injections
Syringe used 3 mL most common; 1 mL could be used
Needle size and angle of entry 25 gauge; 1/2 inch with a 90-degree angle of entry or 5/8 inch with a 45-degree angle of entry; the bevel position does not matter
Maximum volume 0.5–1.5 mL (0.5 mL in children)
Common sites Lower abdomen, anterior thigh, and upper outer arm
Sites for vaccines
<1 year of age: anterior thigh
> 1 year of age: upper outer arm or anterior thigh
Additional sites Separate sites by 1 inch
Patient position Sitting
Administration technique Pinch site; if 2 inches of tissue can be pinched, insert the needle at a 90-degree angle; if 1 inch of tissue can be pinched, insert the needle at a 45-degree angle; rotate sites
subcutaneous injections
For medications given by IM injection, ____medications should be given with a higher gauge needle than that used for _____ medications.
aqueous (watery)
oil-based
When giving an ____ ____ it is important to aspirate prior to injecting the medication. Once the needle is in the site, the medical assistant should pull back on the plunger for 5 seconds and check the barrel of the syringe. Lack of blood in the barrel means the needle is ___ in a blood vessel, so it is safe to inject the medication. If blood appears in the barrel, remove the needle, discard the syringe, and restart the procedure.
intramuscular injection,
not`
Immunizations ____need to be aspirated, according to the CDC.
do not
When an IM injection is given, the air lock technique can be used. Remove the bubbles in the syringe, and measure the exact amount of medication needed. Once these steps have been done, add 0.2 to 0.5 mL of air into the syringe. This is the known as the ___ ____ ___ When the IM injection is given, the medication is pushed in first, followed by the air. When the needle is withdrawn, the air creates a “lock,” keeping the medication in the muscle. The air fills in the needle hole. The air lock prevents the irritating medication from tracking back up the tissues to the skin, creating pain for the patient.
air lock technique.
The ___ ____ ___should be used for irritating medications. The ventrogluteal site is the recommended site for injections of irritating medications. the skin is pulled laterally with the medical assistant’s nondominant hand. The site is cleansed, and the injection is given As the needle is withdrawn, the skin is released
Z-track technique
The ___ muscle site is used to give a small volume of aqueous medications, such as vitamin B12 and vaccines. The CDC recommends this site be used when vaccines are given to teens and adults.
deltoid
Palpate the acromion process. Place a finger on the acromion process and then 2 fingers below that. The top of the site is 1 to 2 inches (or 2 fingerbreadths) below the acromion process. The bottom of the site is at the anterior axillary fold (top of the axilla). The injection site should be somewhere between the top and the bottom of the site. Once the medical assistant finds the site, it is a good idea to have the patient lift his or her arm. The medical assistant can find the bulk (biggest part) of the deltoid muscle. The injection should be given into the bulk of the deltoid muscle.
deltoid muscle injection (IM)
The most complex part of using the ___ site is to ensure that the correct hand is used to find the site. Remember to use the hand ____ the injection site. For instance, if the injection site is on the patient’s left side, then use your right hand
ventrogluteal
opposite
Common IV therapy concerns
- Edema (swelling) or increasing pain at the IV insertion site
- Blood moving up the IV tubing
- An almost-empty bag of fluids
- A patient who is having difficulty breathing or who has increased audible wheezing
A very small, round hemorrhage in the skin or mucous membrane.
petechiae
The liquid portion of a clotted blood specimen. It no longer contains active clotting agents.
serum
Because a tourniquet slows blood flow, leaving it on for longer than 1 minute greatly increases the possibility of ___ and altered test results.
hemoconcentration
The length of the shaft has ___ ____ on the venipuncture procedure.
no bearing
Be sure to ____ the needle gauge to the size of the tube. A large vacuum tube is more likely to hemolyze the blood if a high-gauge needle (i.e., small lumen) is used.
match
A small, 23-gauge needle is used to collect blood from small or fragile veins, such as those in ___ adults and very young patients. Routine ___ venipuncture requires a 20- to 21-gauge needle.
older
adult
___ are used when there is concern that the strong vacuum in a stoppered vacuum tube might collapse the vein.
Syringes
With the needle still in the arm, the medical assistant grasps the tail of the butterfly with the dominant hand while the nondominant hand presses the button just below the wings, causing the needle to retract into the butterfly body as it leaves the vein.
Push-button butterfly safety device
Feel for a vein that has “____” when lightly palpated
bounce
Consider the 3 Ds of __ selection; depth below the surface, diameter of the vein, and direction through the antecubital region
vein
In adults and children (older than 1 year), capillary puncture sites include the___ __ ___ finger
ring or middle
___ puncture of an infant should be done on the heel of the foot
Dermal
For tests that require ___, the plasma should be removed from the cells as soon as possible. This can be done by centrifuging the tube and then aspirating the plasma off the cells. The plasma is then transferred to another tube using a disposable transfer pipet.
plasma
) Most abundant plasma protein in human blood. It is important in regulating the water balance of blood.
albumin
In many viral infections stimulated or reactive lymphs are called ___ ____. They are commonly seen in infectious mononucleosis, or “mono.”
atypical lymphs
The cell substance that fills the area between the nucleus and the cell membrane. Contains organelles of the cell.
cytoplasm
A special protein that speeds up the chemical reaction in the body.
enzyme
The oxygen-carrying pigment of red blood cells.
hemoglobin
A group of related proteins that function as antibodies. They are found in plasma and other body fluids.
immunoglobulin
A laboratory or clinical technique that uses the specific binding between an antigen and antibody to identify and quantify a substance in a sample. The sample in this technique moves in a sideways motion, usually on absorbent paper.
lateral flow immunoassay
Caused by or involving disease.
pathologic
Consistent with the normal function of the body.
physiologic
A disorder characterized by an abnormal increase in the number of red blood cells in the blood.
polycythemia
cell An old or aging cell that can no longer divide and reproduce.
senescent
is a measurement of the percentage of packed RBCs in a volume of blood
hematocrit (Hct)
A ___ ____ is prepared by placing a drop of blood from a fingerstick or an EDTA tube (using a DIFF-SAFE blood dispenser) onto a clean glass slide
blood smear
The best specimen for a blood smear is ____ blood that has no anticoagulant adde
capillary
- Place a small drop of blood 1/2 inch from the frosted end (placed to the right) of a glass slide.
- The end of a second glass spreader slide is placed in front (to the left) of the drop of blood at an angle of 30 to 35 degrees.
- The spreader slide is brought back into the drop with a quick but smooth gliding motion until the blood spreads along the edge of the spreader slide.
- The spreader slide is then pushed to the left with a quick, steady motion, spreading the blood across the slide
wedge smear
Capable of burning, corroding, or destroying living tissue.
Caustic
Not permitting penetration
Impervious
A metal probe that is inserted into or passed through a catheter, needle, or tube used for clearing purposes or to facilitate passage into a body orifice.
stylus
Blunt probe tip
- Easily inserted under bandages with relative safety
- Used to remove bandages and dressings
Lister bandage scissors
- 5 to 6 inches long
- Curved or straight blade tips
- Used to cut and dissect tissue
Operating scissors
- Blade has beak or hook to slide under sutures
* Used to remove sutures
Suture scissors
____Handles: No. 3 is the standard handle; No. 3L and No. 7 are used in deeper cavities.
scalple
____Blades: No. 15 is commonly used; Nos. 10, 11, and 12 are used for specialty incisions.
scalple
- Jaws may be fully or partly serrated, without teeth
- May be curved or straight
- Used to clamp small vessels or hold tissue
- Mosquito forceps (4 inches) are smaller and used for very small vessels
- Kelly forceps (6 to 7 inches) are larger
Hemostatic forceps
- 4 to 7 inches long
- Jaws are shorter and stronger than hemostat jaws
- Jaws may be serrated or may have a groove in the center
- Used to grasp a suture needle firmly
Needle holder
- Design and construction vary
* Fine tip for foreign object retrieval
Splinter forceps
- Manufactured in lengths from 4 to 12 inches
- Varying types of serrated jaws but no teeth
- Used to insert packing into or remove objects from deep cavities
Plain thumb (dressing) forceps
- Various lengths from 3 to 6½ inches
- May have sharp or atraumatic (dull-edged) tips
- Used to hold drapes in place during surgery
Towel clamp
- Available in different lengths and jaw widths
* Used to grasp tissue, muscle, or skin surrounding a wound
Allis tissue forceps
- Manufactured in 4- to 18-inch lengths
- Pincher grip
- Used to grasp tissue, muscle, or skin surrounding a wound
Toothed tissue forceps
- Used to hold gauze squares to sponge the surgical site
- Used as transfer forceps to arrange items on a sterile tray
- Straight or curved, with or without serrations
Foerster sponge forceps
- Designed to hold sponges or dressings
- Capable of reaching the cervix through the vagina
- Used to swab the area or apply medication
Bozeman sponge forceps
- Very sharp, pointed tips
- Used to hold tissue (e.g., the cervix) while a tissue specimen is obtained or to lift the cervix so that the fornix can be seen
Tenaculum forceps
_____ instruments hold tissue away from the surgical wound (incision). Depending on the provider’s preference, handheld skin hooks and Senn retractors are used to retract during most minor surgical procedures.
retracting
___ can be used to search for a foreign body in a wound or to enter a fistula
Probes
____ are used to stretch a cavity or opening for examination or before inserting another instrument to obtain a tissue specimen
Dilators
- Lengths range from 4 to 12 inches; available with or without bulbous tip
- May be smooth or may have a grooved director
- Used to find foreign bodies embedded in dermal tissue or muscle or to trace a wound tract
Probes
- Available in various sizes
- Consist of a sharply pointed stylus (obturator) contained in a cannula
- Used to withdraw fluids from cavities or for draining and irrigating with a catheter
Trocars and obturators
- Most common dilator used
- Valves are spread apart, dilating the opening
- Used to open or distend a body orifice or cavity
- The most common of these is the vaginal speculum used during gynecologic examinations (see Fig. 9.16C). Vaginal specula can be stainless steel (reusable) or plastic (disposable) and can also have a light source for illumination.
Specula
• Used to remove tissue from the uterus
Placenta forceps
- Smaller than the uterine curette
* Used in the same way as the uterine curette
Endocervical curette
- Available in several sizes
- Hollow and spoon shaped; used for scraping
- Used to remove polyps, secretions, and bits of placental tissue
Sims uterine curette
- Very sharp, pointed tips
- Used to hold tissue (e.g., the cervix) while a tissue specimen is obtained or to lift the cervix so that the fornix can be seen
Schroeder uterine vulsellum forceps
- Available in sets
- Double or single ended
- Used to dilate the cervix for dilation and curettage
Hegar uterine dilators
Used to check the patency of the cervical os or the urethral meatus
Sims uterine sounds
- Wire loop at the tip that can be tightened
* Used to remove polyps from the nares
Krause nasal snare
• Used to depress the tongue for oral examinations
Metal tongue depressor
3 1/2-inch shaft; made in a variety of styles
- Action of the jaw similar to that of an alligator’s jaws
- Used to remove foreign bodies or polyps
Hartmann “alligator” ear forceps
- Made in various sizes
- May have a nonfogging surface
- Used for examination of the larynx and postnasal area
Laryngeal mirror
- 6 to 9 inches long with curved end for use in throat or postnasal areas
- Holds cotton in place with its roughened end; used to swab or sponge throat or postnasal tissue
- Used to remove foreign bodies embedded in the pharynx
Ivan laryngeal metal applicator
- Manufactured in various sizes
- Available as disposable curettes in many different sizes
- Has a stainless steel loop at the end
- Made with sharp or blunt scraper ends
- Used to remove foreign matter from the ear canals
“Buck” ear curette
Used to remove debris from the ear canal
Sharp ear dissector
- Angled, with serrated tips
- Provides easier access to the ear canal and nasal cavities
- Used for packing after ear or nasal procedures
- Can be used to remove foreign bodies
Wilde ear forceps
- Available with or without teeth
* Used to obtain cervical specimens for diagnostic examination
Cervical biopsy forceps
- Available in different lengths and styles
- Manufactured with interchangeable stems
- Used through a proctoscope or sigmoidoscope
Rectal biopsy punch
- Manufactured with a split cannula
- Stylus is removed, and cannula is inserted to retrieve the specimen
- Needle biopsy can eliminate the need for surgical incision
Silverman biopsy needle
- Manufactured in sizes 8 to 32 French with a double rubber lining toward the tip (each French unit is equal to 1.32 mm; the higher the number, the larger the lumen)
- After insertion, sterile solution is injected into the inner lining (inflating the balloon) to hold it in the bladder
- Used as an indwelling catheter
Foley catheter with inflated balloon
- Soft rubber urethral catheter in sizes 8 to 32 French
* Inserted temporarily into the bladder for drainage or to obtain a specimen
Red Robinson catheter
- Slightly curved catheter tip
* Designed to allow it to navigate past obstructions in the urinary tract, such as a swollen prostate in men
Coudé-tip catheter
- Typically used to inject sterile saline into a catheter to inflate the balloon at the tip of an indwelling catheter
- Used for injecting amounts greater than 5 mL
12-mL Luer-Lok syringe
Using a ___ ___ ____prior to the application of Steri-Strips can help them remain in place longer
tincture of benzoin
Do not mix ___ ___instruments with others made of different metals, when putting together for sterilization
stainless steel
In an autoclave, the steam is contained within a chamber and is under __ pounds per square inch (psi) of pressure. This pressure allows the steam to reach ____
15
250° F (121° C).
Wrap all hinged instruments in the___ position to allow full steam penetration of the joint.
open
Place a ____ around the tips of sharp instruments to prevent them from piercing the wrapping material.
gauze square
materials in a polypropylene pan take longer to autoclave than the same materials in a ____ pan.
stainless-stee
Near, close together.
approximated
Early scar tissue that appears pale, contracted, and firm.
cicatrix
Vapor, smoke, and particle debris produced by laser procedures.
plume
Cleansing the patient’s skin before surgery with surgical soap and an antiseptic and shaving the area if needed is called a ___ ____
skin prep
Pass the scalpel with the blade ___ and present the handle to the provider. Hold all instruments by their ___ and pass the handle ends into the provider’s palm or fingers
down; tips``
___ ___ remove the specimen from the sterile field until the provider gives the order.
Do not
After the procedure is ____, place the specimen in an appropriate container, label it, and send it to the laboratory for analysis.
complete
Redness.
erythema
Within bone; route for delivery of fluids and medications through a needle inserted into the marrow of certain bones (e.g., humerus, tibia, and femur).
intraosseous
`Open.
patent
Itching.
pruritus
The sucking in of tissues between the intercostal spaces and neck due to respiratory distress; classic sign of severe asthma.
retractions
• ___ is a metal or flexible plastic wire inserted into the ET tube to create a firm, curved tube After the ET tube is in place, the stylet is removed.
Stylet
____ is given to unconscious patients with diabetes. This hormone stimulates the liver to release glucose into the bloodstream, thus increasing the blood glucose level.
Glucagon
___ shock: Due to heart muscle damage caused by a myocardial infarction (also known as MI, heart attack); the heart cannot pump enough blood to the other organs.
Cardiogenic
Due to heavy bleeding (i.e., accident or internal bleeding) or dehydration; blood volume is too low to provide nutrients and oxygen to the organs.
Hypovolemic shock:
___ shock: Caused by a severe allergic reaction ; blood pressure drops and the airway narrows. Not enough blood gets to the vital organs, and the narrowed airway prevents adequate oxygenation.
Anaphylactic
___ shock: Caused by a severe infection (severe sepsis) that affects the functioning of vital organs (e.g., heart, brain, kidneys). The blood pressure falls, and major organs can fail.
Septic
_____shock: Due to a central nervous system injury (e.g., spinal cord injury). Leads to vasodilation (not enough blood can return to the heart) and low blood pressure.
Neurogenic
A provider has requested a dissecting instrument on a sterile tray that a medical assistant is preparing. What is a dissecting instrument?
scissors
A medical assistant is replacing a sharps container in an examination room and receives a small laceration on her arm from the plastic lid. What form should she complete?
OSHA Form 301
Which of the following methods is used to notify a provider of the denial of a claim by an insurance carrier? remittance advie coordination of benefits eligibility for insurance CMS 1500 claim form
Remittance advice: itemizes all paid, denied, and allowable charges for a patient
EKG artifact caused by disconnected electrode and results in the tracing going into the margins of the paper?
interrupted baseline
Simplified Letter Style has A ___
subject line in all capital letters
V5 Placement
on the left anterior axillary line, horizontal to V$
5’7” converted to CM
170cm
5’7” to 67 inches…67x2.54=170.18cm
Wounds should be wrapped from ___ to ___
distal; proximal
A patient is seen in an urgent care center for a laceration to the left foot. The provider evaluated the injury, determines sutures are not needed, applies a dressing, and releases the patient. What examination level is used for the procedural coding?
problem focused examination (limited to a single body area or system mentioned in the CC)
Prior to a patients follow-up appointment, which information should be reported to the provider?
Recent Lab Results
A medication that suppresses the cough reflex
Antitrussive
Transdermal patches should use ____ application location
different
___ position for healthy patient for rectal exam
sims
___ are hairlike projections in the lungs that help mobilize and secrete musus
cilia
Inspect the ___ of the needles seal before starting venipuncture
integrity
A medical assistant has requested a reauthorization for a patients referral to a specialist. What is a reason for the claim submitted by the specialist to be denied?
The service is provided after the expiration date
First step to take when preparing a community resource library
compile a list of local community guidelines
Liniments contain a ___ portion of oil than medicated lotions
higher
Distal femur
just above the knee
A patient reports getting a bill that includes services that she did not receive. What should the medical assistant do to reconcile these charges?
Review that days encounter forms to determine if another patient received the services
___ the pharmacy after faxing an RX
call (to confirm_
Correct way to use spirometry test
fast and steady flow with no varibility
Check ____ ____ before using pulse ox
capillary refill
What item included on the CMS 1500 claim form should a medical assistant recognize as indicating the medical necessity of a procedure.
diagnosis code
Pears with skin are a good source of ____ ____
insoluble fiber
hold sharps by ___ end to avoid a needle stick injury
blunt
Routine cleaning for EKG machine
Disinfection
For heparin, spread the skin _____ over the injection site
taut
Bipolar leads
I II III
What should the MA identify as the purpose of a Cat II code in procedural coding?
indicates special circumstances
a modifier is used to provide further clarification when used in conjunction with a Cat I code.
Electrode for fifth intercostal space, left midclavical line
V4
___ are used in suturing procedure
hemostats
Liver is located in the ____ ____ quadrant
right upper
Vigorously __ the patients skin prior to electrode placement for Holter monitor
dry
Tympanic Membrane
in ear
MA role in pulumary function testing PFT
coach and encourage
First Step in cleaning surgery tools
Sanitization
Webster test
ask if the patient hears the vibration louder in one ear than the other
___ are solid elevations that are less than 0.5cm or 0.2 inches in diameter. a common cause is allergic eczema
papules
If claim is denied for “non covered service” but deemed emergent by the provider the MA should ___
instruct the patient to contact the insurer about the denial of paymetn
Pinworms are ____
helminths
HR from EKG tracing
Divide 1500 by the number of small boxes between two R waves
