NCCT Sample Exam Questions With Complete Solution 2023/2024 (QNA Graded A+)

NCCT Sample Exam Questions With Complete Solution 2023/2024 (QNA Graded A+). When inspecting a patient's arm before performing a venipuncture, the most desirable site appears to be the back of the hand. Which of the following venipuncture methods is most appropriate in this situation? A. butterfly needle B. capillary puncture C. needle and syringe D. evacuated tube - ANSWER Correct response: butterfly needle Rationale: The best choice in this situation is to use a butterfly needle, a winged needle with flexible tubing that is short in length. Butterfly needles are easier to insert into tiny, fragile, and/or rolling surface veins close to the skin. If a butterfly is not available, a needle and syringe would be the next choice. The vacuum pressure of evacuated tubes can collapse small or fragile veins such as those on the back of the hand. A capillary puncture would be the last option here, and would be used in the instance of a failed butterfly or syringe attempt (provided there are no other veins available). A medical assistant is positioning a patient for sigmoidoscopy. Which of the following positions would be appropriate for the procedure? A. supine B. Trendelenburg C. lithotomy D. Sims - ANSWER Correct response: Sims Rationale: For a sigmoidoscopy, the patient will need to lie on the left side with the right knee bent, which is also referred to as the Sims position. This allows the physician to insert the sigmoidoscope through the anus to the colon to get a clear look at the area. The lithotomy position is when the patient lies on their back with the thighs spread apart and the hips and knees bent. This position is mostly used for vaginal examinations and childbirth, and would not be the best position for a sigmoidoscopy. The Trendelenburg position is when the patient lies flat on their back with the feet elevated higher than the head by 15-30 degrees, and the supine position is achieved when the patient is lying flat on their back with no part of the body elevated. The Trendelenburg and supine positions would not typically be used for a sigmoidoscopy, because if the patient is lying on their back it does not allow the physician to easily insert the sigmoidoscope into the anus to get a clear view of the sigmoid colon. An established patient who has Chronic Obstructive Pulmonary Disease is evaluated in the medical office for hypertension. What is the importance of identifying the reason for today's visit related to billing? A. to assign a two-digit modifier B. to assign a V code C. to determine the primary diagnosis D. to ensure a secondary diagnosis is not listed on the claim form - ANSWER Correct response: to determine the primary diagnosis Rationale: In this example, hypertension should be listed as the primary diagnosis (main reason the patient sought care for visit) and COPD as secondary (this will disease will be considered when medications are prescribed for HTN.) A large open container of isopropyl alcohol is spilled on the floor in the clinic waiting area. The medical office assistant should use which of the following resources for information about the chemical and any necessary procedure? A. Poison Control Center B. Physician's Desk Reference C. Material Safety Data Sheet D. Clinical Laboratory Improvement Amendments - ANSWER Correct response: Material Safety Data Sheet Rationale: Access to Material Safety Data Sheets is an OSHA compliance requirement. Each MSDS contains information on the potential hazards (health, fire, reactivity and environmental) and how to work safely with chemical products. It is an essential starting point for the development of a complete health and safety program. Clinical Laboratory Improvement Amendments (CLIA) of 1988 are United States federal regulatory standards that apply to all clinical laboratory testing performed on humans in the United States, except clinical trials and basic research. A poison control center is a medical facility that is able to provide immediate, free, and expert treatment advice and assistance over the telephone in case of exposure to poisonous or hazardous substances. The purpose of the Physician's Desk Reference is to provide a compendium compiled annually, containing information supplied by drug manufacturers about drugs, primarily prescription drugs and products used in diagnostic procedures in the United States. A Material Safety Data Sheet includes information such as physical, health, and environmental health hazards; protective measures; and safety precautions for handling, storing, and transporting chemicals including all safe handling practices, and emergency control measures in the medical office. Which of the following diseases is a healthcare worker at the greatest risk of developing following an exposure incident with blood from a needle stick injury? A. HSV B. HAV C. HPV D. HBV - ANSWER Correct response: HBV Rationale: Of the options listed, Hepatitis B is the most transmissible infection via needle stick (it is also the only one preventable by vaccination). HSV is Herpes Simplex Virus and is generally transmitted by contact. HAV (Hepatitis A Virus) is most often transmitted as a result of poor hygiene and is spread via fecal-oral contamination. HPV (Human Papilloma Virus) is transmitted by contact (skin to skin or through sexual contact). Which of the following rhythms is shown in the strip above? A. atrial fibrillation B. atrial tachycardia C. premature atrial complex D. atrial flutter - ANSWER Correct response: atrial flutter Rationale: Atrial flutter represents an arterial arrhythmia in which ectopic foci in the atria become irritated and fire in rapid succession (fluttering, a rhythm that presents a sawtooth pattern as seen on this strip). An area in the atrium continues to initiate an impulse that causes repetitive conduction at a rate of >250 bpm. The medical assistant should access which of the following sections of the electronic health record or paper chart to retrieve patient contact information? A. billing B. laboratory orders C. consultations D. progress notes - ANSWER Correct response: billing Rationale: Billing information will have the current patient demographics associated with each encounter. Laboratory orders, progress notes and consultations will not contain the necessary patient contact information. The medical assistant asks a patient, "How are you doing today?" The patient yells, "How do you think I'm doing? I just got out of that terrible hospital and they didn't help me at all! I still have cancer don't I?" The medical assistant recognizes that this patient is most likely experiencing which of the following stages of dying/grief according to Kubler-Ross? A. anger B. denial C. bargaining D. depression - ANSWER Correct response: anger Rationale: This is an example of the anger stage, when this patient is forced to come to terms with the debilitating disease or condition for which there are limited treatment options without expectation of cure. Depression is when the patient experiences significant loss of hope and sadness. When patients are in denial, they act as though the situation is not real and deny there is an issue. Patients in the acceptance phase actually come to terms with the situation and make peace with the circumstance. Which of the following describes proper aseptic technique in the cleaning of the venipuncture site? A. Wipe the site in a back and forth motion with an alcohol wipe B. Let the alcohol air dry before inserting the needle C. Allow the alcohol to soak into the skin, then wipe off excess with sterile gauze D. Wave above the site with a gloved hand to dry the alcohol faster - ANSWER Correct response: from the inside out Rationale: The medical assistant should clean from the inside out to prevent contamination. Cleaning back and forth, up and down, or from the outside in would all cause contamination at the site and would not be the best way to cleanse the area. Which of the following describes proper aseptic technique in the cleaning of the venipuncture site? A. Let the alcohol air dry before inserting the needle B. Allow the alcohol to soak into the skin, then wipe of excess with sterile gauze C. Wipe the site in a back and forth motion with an alcohol wipe D. Wave above the site with a gloved hand to dry the alcohol faster - ANSWER Correct response: Let the alcohol air dry before inserting the needle Rationale: Proper preparation for venipuncture requires that the site be cleansed (70% isopropyl alcohol or other antiseptic agent as indicated by the manufacturer's instructions). Human skin harbors normal flora (bacteria that naturally lives on the surface of the skin). To prevent introduction of said bacteria into the patient or the blood samples, the phlebotomist should apply the antiseptic to the venipuncture site (in concentric circles to avoid contaminating cleansed areas with the antiseptic applicator). The antiseptic should be allowed to air dry, allowing ample time for the antiseptic action to take effect. Residual (undried) alcohol could lead to hemolysis of the specimen and could create a burning sensation for the patient upon needle insertion. Older adult patients are the population most at risk for which of the following medication complications due to a declining liver function? A. tinnitus B. anaphylaxis C. polyuria D. toxicity - ANSWER Correct response: toxicity Rationale: In older adults, the rate of drug metabolism is decreased, and this increases the risk of toxicity, which is the build-up of medication in the blood stream. Anaphylaxis is a serious allergic reaction, tinnitus is ringing in the ears, and polyuria is a large amount of urine. The patient is given an incorrect dose of acetaminophen (Tylenol) in the medical office. The medical assistant should complete an incident report in this situation in order to A. prevent legal action against the practice. B. ensure it becomes part of the patient's medical record. C. understand the circumstances and prevent future occurrences. D. begin disciplinary action against the responsible employee. - ANSWER Correct response: understand the circumstances and prevent future occurrences. Rationale: The reporting of medical errors is essential to patient safety improvement and risk management in all health care settings. Incident reports are not part of a patient's medical record, but may be used in litigation. It should not be documented in the patient's medical record that an incident report was submitted. Which of the following needle gauges is most commonly used for venipuncture?