CCMA Practice Questions

Vital signs Temperature, Pulse, Respiration, BP What balances Body temp? Hypothalamus Another name for eardrum Tympanic Membrane Fluctuating fever that returns to baseline but then rises again Intermittent Normal pulse rate 60-100 BPM Where apex of heart is located 5th intercostal space What is BP cuff inflated to? 30-40 mmHg above the palpatory systolic pressure and released to drop 2-3 mmHg per second Hg in BP measurement stands for this Mercury Branch responsible for the identification of various hazards present in the workplace and the creation of rules and regulations to minimize exposure OSHA We have an expert-written solution to this problem! This is required by Chemical Safety Regulations Label all chemicals with MSDS Most surgical instruments are sterilized by this Steam sterilization/Autoclave Droplets can travel how far? Less than 3 feet Standard running speed of the EKG reading 25mm/sec Who invented the EKG? Einthoven Pt having mild chest pain might be prescribed this Nitroglycerin Liquid portion of blood is called Plasma Thromobocytes assist in Clotting Government based health insurance for people over 65 and others with certain disabilities Medicare CPR Ratio 30 Compressions : 2 Breaths Medical Asepsis The destruction of pathogenic microorganisms AFTER they leave the body through Standard Precautions and Transmission Based Precautions Standard Precautions and Transmission-based Precautions are control measures aimed at preventing the spread of disease at what point in the Chain of Infection Portal of Exit Organization that issued the guidelines known as Standard and Universal Precautions CDC Because of the nature of airborne precautions this is needed to prevent transmission Ventilation Where you would find the spelling for a medication? Physician Desk Reference Where is V2 lead located 4th intercostal space, left sternal border Where is V5 lead located 5th intercostal space, anterior axillary line Poor tracings due to sweat or lotion would lead to this on an EKG Wandering baseline Most critical step in pt testing Identifying the pt Which urinalysis would you use to test for bacteria? Clean Catch Specimen Codes used to describe encounters with circumstances other than disease or injury ICD-9 Supplemental codes that capture the external cause of injury or poisoning, the intent and the place it occured E codes The sounds an MA listens for during a BP Korotkoff sounds CMS-1500 Form is aka Superbill Post-prandial After a meal Complication from repeated venipuncture of the same vein Phlebitis Bacteria, viruses, fungus or parasites belong to which type of hazard Biologic Isolation precautions are condensed into 3 categories: Airborne, Droplet and Contact Unit of measure on a standard Rx Micrograms/mcg Amount of blood pumped by the heart per minute is called Cardiac Output Q wave is always Negative First electrical impulse recorded on EKG P wave Movement away from the baseline on an EKG is called Wave form Several wave forms on an EKG are called Complex A wave form and a segment on an EKG Interval A line between waveforms on an EKG Segment Specific coding instructions for each CPT section are located here Guidelines Required when general practitioner sends pt to a specialist Method of referral The shallow wave that follows the T wave represents Late ventricular repolarization Rhythm indicated by absence of/or inverted P waves Junctional Inferior wall MI is shown in what leads II, III, AVF Leads 1 and AVL show broken recording, you should Check Left Arm Three lead EKG monitor I, II, III Why increase the speed of the EKG Increase speed widens wave forms Placement of leads V1-V6 is important to diagnose Left ventricular Why place V3 on right side of chest on an infant To prevent crowding of the leads Dextrocardia When heart is on opposite side of the body Lead combo for Lateral wall acute MI Leads I, AVL, V5 & V6 ST Segment Elevation indicates Cardiac injury in progress Which leads allow viewing pt's anterior wall of Left Ventricular V3 & V4 EKG line representing zero electrical activity Isoelectric line Patient with a 2 degree heart block would show this Progressively prolonged PR intervals until the QRS complex dropped What is the heart rate with 5 big boxes and 3 little boxes 54 Sequencing 300, 150, 100, 75, 60, 50 The epicardium forms a protective sac around the heart known as the Pericardium Atrio ventricular valves Tricuspid and mitral The last valve to touch de-oxygenated blood is the Pulmonary valve All 4 valves are Unidirectional The right side of the heart has what type of blood De-oxygenated blood The heart is fed by these Coronary arteries The L anterior descending artery is also known as The Widow maker The pathway from the SA node to the AV node is the Internodal pathway Intrinsic rate for the SA node is 60-100 BPMs Eintoven's Triangle does what? shows basic EKG reading Calculating the atrial rate would be The p-p big box method The PR interval is measured from The beginning of the P wave to the beginning of QRS complex This makes a rhythm a "sinus rhythm" a P wave In hospital cardiac monitoring Telemetry On a telemetry monitor what color lead is on the right shoulder White lead The artery used for blood pressure is Brachial The area of the eye you start irrigation in Inner canthus Pulmonary function tests use this Spirometer Heart muscle disease Cardiomyopathy With wave scheduling, which patient would be priority Patient who arrives first Refers to coding procedures CPT Refers to preventative coding like a flu shot V codes Refers to coding diagnoses ICD 9 Refer to coding supplies like crutches HCPCS Most important is to have this before scheduling a procedure A doctor's order To properly identify a pt, an MA must Ask pt to state his/her name At what angle is the needle held for venipuncture 35 degrees Fecal specimen collection is used to detect what disease? Colorectal cancer Which type of urine collection is required for culture and sensitivity testing Clean-catch midstream Hypotension Lower than 90/60 A murmur is an abnormal sound that may indicate this Structural heart disease CDC Center for Disease Control and Prevention Collection tubes with anti-coagulant must be inverted Eight times Deoxygenated blood enters the right atrium via The superior and inferior vena cavae If the finger is excessively milked during a skin puncture Hemolysis and contamination of the specimen with tissue fluids will occur Type of specimen collected in a clean catch Midstream Hemolyzed blood appears to be Pinkish plasma Devices used to collect blood from a skin puncture Capillary tubes Life span of a red blood cell 120 days/4 months Standards of right and wrong Code of Ethics Advance Directive Will of pt regarding his/her own treatment Everyone coming into room must wear gown and gloves is what type of precaution Contact Precautions Destruction of red blood cells Hemolysis Most common complication from phlebotomy Hematoma An unconscious unidentified man is admitted, how do you identify the pt 3 part identification system that uses a temporary arm band and labels for specimens I & O Input and Output (Urine) Boundaries approved for heel punctures Medial line from great toe and lateral line extending from fourth and fifth toe Chemical Hazard Sign Main electrolyte found in blood Sodium Neutrophils are increased in the peripheral blood in cases of Acute bacterial infections Differential blood count is defined as Ratio between types of WBCs Health policies concerning pts constitutional right to privacy confidentiality and informed consent are part of Patient's Bill of Rights The technique pilocarpine iontophoresis is used to Confirm Cystic Fibrosis How is sweat collected for electrolyte analysis Pre-weighed gauze covered securely with plastic H&H Hemoglobin & Hematocrit Supplies blood to the heart muscle Coronary arteries In ER, pts are continuously monitories using modified chest lead 1(MCL1) and Lead II When a person stays in the same position all the time, pressure causes the skin to Weaken and become necrotic Pt is seen for a 3 hour glucose tolerance test. Fasting blood sugar was drawn at 7am, but she finished her glucose at 8am. Next blood draw will be at 8:30am Blood cultures routinely require filling ... of an aerobic and anaerobic bottle The descending aorta is a vessel in which _______ circulation carries oxygenated blood to the rest of the body Systemic Chain of custody is specimen handling for legal proceedings which begins with pt identification and continues until Testing is completed and results are reported Repeated venipuncture from the same vein can cause Phlebitis Quality Control Ensures that Procedural steps are followed and yield consistent results Blood cultures are performed to diagnose Infectious microorganisms/Bacteria Repositioning the pt is done every 2 hrs Proper positioning can promote Good circulation If unsure of a BP reading, deflate the cuff and Retake after 2 minutes Process of blood forming outside the vessel is called Petechiae Strep throat is caused by Streptococcus, Group A Purpose of fecal occult blood test is to help determine Presence of GI bleeding not seen with naked eye/ Blood in stool Which tube must always be completely filled Lt blue Tricuspid valve is located Between the right atrium and the right ventricle JCAHO requires all healthcare institutions to post Evacuation routes and detailed plans to follow Process of listening to sounds from pts body with stethescope Auscultation When can you refuse to perform a task When you have not received the proper training Palpatory method for blood pressure is measured using the Systolic BP Term used to describe the intentional attempt to touch a pt without consent Assault Graphic Sheet or Flow Sheet records BP, Temp, pulse, respirations, weight, I&O & doctor visits Minimal amount of time required for hand washing before applying gloves to do a dressing change 2 min Radial pulse is taken at Thumb side of wrist What causes wandering baseline Tension or pulling on a wire Bicuspid valve AKA Mitral valve Radioactive Hazard Symbol Pacemaker for heart SA node Layer of heart responsible for contraction and relaxation Myocardium In this type of blood vessel you will find oxygenated and deoxygenated blood Capillaries Blood leaves the right ventricle and passes through this valve as it enters the blood vessel Pulmonic Semilunar Ability of cardiac cells to SHORTEN in response to an electrical stimulus Contractility Droplet precautions are required for those infected with Microorganisms transmitted on moist particles T wave is the deflection produced by Ventricular repolarization Correct order of chain of infection Agent/Portal of Exit/Mode of Transmission/Portal of entry/Susceptible host Blood flows from the heart to the lungs via Pulmonary arteries This ensures a check of the internal calibration of the EKG machine Standardization button (1mv button) Normal standardization mark on EKG should measure 10 mm PR interval is measured from Beginning of P wave to beginning of QRS complex SOMR Source Oriented Medical Record Biologic Hazard Symbol Term used to describe ability of cardiac pacemaker cells to spontaneously generate their own electrical impulses within the heart without external stimulaton Automaticity This part of the conduction system of the heart is located at the superior portion of the interventricular septum and has the ability to function as a pacemaker with an intrinsic firing rate of 40-60 bpm Bundle of His Represents the amount of time it takes for the electrical impulse to travel from the AV node to the bundle of His and Perkinje Fibers. PR interval How to figure out target heart rate for a pt 220 minus pt's age When doing blood cultures, is aerobic or anaerobic first? Aerobic Chest pain in a pt with normal baseline EKG would indicate Need for a stress test Negative Holter No significant arrhythmias or ST changes Procedure for Blood cultures Butterfly needle and no alcohol Blood alcohol level procedure No alcohol Semilunar valves aka Aortic and pulmonic valves Arrhythmia produced by an electrical impulse originating from someplace other than the sinus node Ectopic rhythms PR interval should measure 0.12-0.20 seconds In a properly standardized EKG machine, 1mV should produce deflection of: 10mm P wave Deflection produced by atrial depolarization Located at the interventricular septum and conducts electrical impulse to the purkinje fibers Bundle branches There is a delay in electrical activity at this level allowing blood to flow from the atria to the ventricles AV node Left arm is positive and the right arm is negative Lead I Left arm is positive and the other limbs are negative aVL The Clinical Lab Improvement Act of 1988 follows guidelines and standards set by the CDC Samples collected from a pt in a nursing home are sent where Reference lab Policies adopted by some hospitals that in-corporate the patient's constitutional rights to privacy, confidentiality and informed consent are referred to as Patient's Bill of Rights OSHA regulation requires that all health care personnel at risk for exposure to __________ receive vaccination Hepatitis B The quality of the test result depends on Time elapsed between collection of the specimen and analyzing the specimen The purpose of quality control is to Ensure the proper laboratory procedures are being followed Tubes containing additives should be inverted 5-10 times Sterile tube additive SPS or ACD Red Top tube contains No additive What tube would a phlebotomist collect an erythrocyte sedimentation rate? Lavender top tube Blood donation given by a patient for use during his or her surgical procedure Autologous donation A heparinized needle and syringe are necessary in the collection of ABG A hemoguard is A plastic top that fits over the stopper and is used to reduce aerosol and splattering of blood Cold Agglutinin test must be maintained at what temp 37 degrees C (Body temperature) Chilling a specimen will Maintain the specimen stablity during transport NHA phlebotomy Take tourniquet off DURING last tube Order of draw for capillary Lavendar, with additive, without additives Anemia means Low hemoglobin CLIA Wave procedures All "Let's Play" procedures Quality Control Establishes standard for patient care Bilirubin test is ______ sensitive Light sensitive Potassium Oxalate will hold sugar for 24 hours Sodium Flouride holds glucose for 3 days POL Physician's Own Lab- where they do the testing Critical Value A test value that is seriously out of normal range Leaving a tourniquet on can cause Hemoconcentration Needle and tube holder combination is called Adapter Blood that seeped out of a vein is called Hematoma Signs and symptoms of syncope Cold, damp, clammy skin What can cause vein occlusion Chemotherapy What can occur if the phlebotomist punctures a bone Osteomyolitis Veins that are hard and cord like Sclerosed Rupturing of red blood cells Hemolysis High Bilirubin Jaundice which can lead to brain damage Thrombophlebitis Inflammation of a vein WITH A CLOT Aspirin may affect pt's Bleeding time Body fluid collections are collected in A sterile container Prompt delivery to the lab of a semen sample is necessary to determine Viability Blood pH & blood gases Arterial Blood Gases Fecal sample Occult blood analysis NPC culture Nasal Pharyngal Culture- used to diagnose upper respiratory infections SE test Sweat Electrolyte test to diagnose Cystic Fibrosis Who would you perform a capillary stick on? Pt who requires frequent blood draws, pt with burns on the arms, pt at risk from venous thrombosis Why cleanse the first drop of blood from a capillary puncture To rid the specimen of fluid from the tissue Improper cleansing of a venipuncture site can cause Septicemia What does a phlebotomist look for when identifying a newborn The hospital id # and last name Infectious disease-causing microorganism Pathogen Component needed for the chain of infection Causative agent Strict isolation When a pt is highly contagious Enteric isolation Pt who has diarrhea and bacterial gastroenteritis Reverse isolation When hospital staff can give something to pt (neonatal ICU/burn unit) Blood and body fluid precautions Pt who is known to have a blood- transmissable disease Infection The invasion and growth of a pathogen Microorganisms that cause disease Pathogenic Causative agents Bacteria, viruses, protozoa, fungi Elevation of these indicates infection Leukocytes (WBCs) Primary function of an erythrocyte Carry hemoglobin and/or oxygen Most abundant WBC Neutrophil Veins carry DEoxygenated blood BACK to heart Arteries carry Oxygenated blood AWAY from the heart Outermost layer of the heart Epicardium Upper receiving chamber of the heart The atrium Which heart chamber has the thickest myocardium Left ventricle Which are the semi-lunar valves Aortic & Pulmonary Which are the atrioventricular valves Mitral/BiCuspid/Tricuspid The major artery Aorta Pulmonary Vein carries blood TO heart FROM lung Anatomy The structure of the human body Physiology The function of the human body Main function of the kidneys To filter waste from blood Homeostasis Ability of body to return to normal conditions under stress Hemostasis Ability of blood to clot when necessary Building blocks of all living things Cells Groups of cells working together to perform the same job Tissues Three kinds of muscles in the body Voluntary, Involuntary, Cardiac Peristalsis consists of wave like Contractions Substances that speed up digestion Enzymes When you exhale you rid the body of Carbon dioxide The organs of the excretory system Kidneys, Ureter, Bladder, Urethra Specific coding instructions for each CPT section Guidelines Which artifact will show a pt who is cold or scared Somatic tremor Continuous cardiac monitoring Telemetry What tests are included in an electrolyte panel Sodium, Potassium, Chloride, CO2 Three types of blood cells WBC/RBC/Thrombocytes Sweat or Lotion on pt would cause what artifact on an EKG Wandering baseline When ppl can just walk in w/o an appt Open scheduling Additive in Lt Blue tube Sodium Citrate Additive in Tiger tube Silica & glass particles Additive in Green tube Sodium heparin, Lithium heparin, Ammonium heparin Additive in Lavender tube EDTA (anti-coagulant) Additive in Gray tube Sodium Flouride (preserves glucose for 3 days) & Potassium Oxalate Additive in Pink, Dark blue and Tan Tubes EDTA (anti-coagulant) Tubes that get inverted 8 times All except Blue Red & Tiger Inversions for a Red tube 0 Inversions for a Tiger tube 5 Inversions for a Lt Blue Tube 4 Which tubes get filled to top Lavender is 2/3 full Lt Blue is full PT/PTT, Bleeding time tests Light Blue Which tube has thixotropic gel Tiger tube Cardiac enzymes, CKMB, Troponin, Pregnancy tests Tiger tube Ammonia levels, STAT electrolytes Green tube Sed Rate (ESR), H&H, CBC Lavender tube Glucose Tolerance Test, Fasting Blood Sugar, Lactic Acid, Blood alcohol Gray tube Which tubes go to Microbiology Sterile tubes Which tubes go to Chemistry Red, Tiger, Green, Gray Which tubes go to Hematology Lavender Horizontal Recumbent Position Dorsal Recumbent Position High Fowler's Position Semi-Fowler's Position Dorsal Lithotomy Position Prone Position Sim's Position Knee-Chest Position Trendelenburg Position Shock occurs when there is Insufficient return of blood flow to the heart, resulting in inadequate supply of oxygen to all organs and tissues of the body If pt goes into shock you will notice Pale/cold/clammy skin Rapid/weak pulse Increased/shallow breathing Expressionless face Staring eyes First aid for pt in shock Maintain open airway Nothing by mouth Trendelenberg position Attempt to control cause of shock Keep warm Where the pathogen lives Reservoir Portal of exit (how it leaves)