Chapter 9: General Patient Care

What body part is used with the following instrument during physical examinations? And what is it's purpose? : Ophthalmoscope

Eyes The purpose of an ophthalmoscope is to inspect the interior structures of the eye

TRUE OR FALSE? Consent for administration of a medication should be obtained from the provider prior to preparing the medication.

FALSE: Consent for administration of a medication should be obtained from the PATIENT OR GUARDIAN prior to preparing the medication.

TRUE OR FALSE? The provider must conduct examinations with assistance from a medical assistant.

FALSE: The provider must conduct examinations without assistance, sometimes the MA is needed as a chaperone.

Which of the following is a anthropometric measurement that a medical assistant should collect from a 2-year-old child? A- Tympanic Temperature B- Head Circumference C- Apical Pulse D- Blood Pressure

Head circumfrence

Describe the following patient position for physical exams: Dorsal Recumbent

Lying flat on the back with the knees bent.

Describe the following patient position for physical exams: Lithotomy

Lying flat on the table with buttocks at the end of the table and feet resting stirrups.

Describe the following patient position for physical exams: Jack-knife

Lying over an exam table that is lifted in the middle.

Where, when, and why should you clean and disinfect the rooms?

Surfaces, including counters and exam tables, should be cleaned at the beginning and end of each day, and between patients to reduce the risk of transmitting infectious agents.

TRUE OR FALSE? During a pelvic examination, MA's cannot serve as a non-sterile circulating staff for procedures.

TRUE: The MA can serve as the non-sterile circulating staff for procedures such as suturing, which can include setting up and adding items to a sterile field. During pelvic examinations, the medical assistant might need to hand the provider instruments and receive specimens obtained during the examination.

A BMI of less than 18.5 is considered _________________. A- underweight B- normal C- overweight D- obese

underweight (BMI)

A medical assistant is assisting a provider with an adult patient who sustained a wound from a dirty metal object. Which of the following orders should the medical assistant expect the provider to give for the patient? A- "You do not need to receive a tetanus booster if you received the DTaP series as a child." B- "You should receive a tetanus booster if your last one was administered more than 2 years ago." C- "You should receive a tetanus booster if your last one was administered more than 5 years ago." D- "You should receive a tetanus booster every time a laceration occurs"

"You should receive a tetanus booster if your last one was administered more than 5 years ago."

Describe the following patient position for physical exams: Supine

Lying flat on the back with arms down to the side.

When interviewing the patient for a procedure, what THREE mandatory steps must be complete?

1) Chief Complaint 2) Review of Medications 3) Assessment of Allergies

When administering medications the MA must check the medications, describe what occurs at each check.

1) Compare the medication order to the medication 2) Occurs after the medication is prepared for administration 3) Completed immediately prior to administering the medication to the patient

What TWO things must be done prior to any procedure?

1) Consider what equipment and supplies are needed 2) Ensure the room is ready for the examination

When a MA is checking the medication order, what FOUR things must they look for?

1) Name of Medication 2) Dosage 3) Time 4) Route of administration

What are THREE steps that must be taken when starting any procedure?

1) Routine Introduction 2) Patient Interview 3) Collection of vital signs and anthropometric measurements

When speaking to the patients prior to the administration of a medication, what FOUR things must be said?

1) Tell pt. what the medication is 2) what it is given for 3) the dosage 4) the route that will be used

Which of the following patients should a medical assistant recognize as the top priority to receive immediate care? A- A patient has sustained an animal bite on the left leg and has a low-grade fever B- A patient has had an episode of syncope but is responsive and able to answer questions C- A patient has a laceration on the right forearm and is bleeding from the site D- A patient has epistaxis and is takiing warfarin

A patient has epistaxis and is taking warfarin

Describe the patient position used for the following examination: - Catheterization - Genital examinations of younger children, adolescents

Dorsal recumbent

What body part is used with the following instrument during physical examinations? And what is it's purpose? : Otoscope

Ears The purpose of an otoscope is to inspect the tympanic membrane and external ear canal

What demonstrates a well-run organized facility?

Anticipating items that might be needed for the visit and preparing the room in advance. doing these things each day enhances patient confidence and assists in operational efficiency.

What body part is used with the following instrument during physical examinations? And what is it's purpose? : Sphygmomanometer

Arm The purpose of a sphygmomanometer is to measure systolic and diastolic blood pressure (BP)

What should a medical assistant do when the child is not cooperating while trying to obtain height measurements?

Ask a parent to hold the infant in place for an accurate height.

how should you prepare examination and procedure rooms?

At the end of each day, disinfect the work area and stock the exam rooms. Upon arriving to work the next day, recheck the rooms for cleanliness and adequacy of supplies.

A medical assistant notices that the patient is slurring speech and has developed a slight drooping of one side of the mouth. These manifestations are indications of which of the following emergent conditions? A- Myocardial Infarction B- Syncope C- Anxiety Attack D- Cerebrovascular Accident (CVA)

Cerebrovascular accident (CVA)

How many times should a MA check the medication prior to administration? What is the purpose?

Check the medication THREE (3) times. This will help prevent medication errors.

A medical assistant is preparing a patient for an examination. Which of the following is a component of the patient's medical history? A- Objective Data B- Treatment Plan C- Chief Complaint D- Informed consent form

Chief complaint

Which of the following actions should the medical assistant take to prevent patient accidents in the clinical setting? A- Stand with feet together when transferring a patient. B- Bundle computer cables that cross walkways with cable ties. C- Clean a spill on the hallway floor using a towel. D- Store cleaning supplies on top of cabinets.

Clean a spill on the hallway floor using a towel

What should the medical assistant not preform?

Do not preform testing prior to the provider reviewing the medical record or examining the patient and prescribing the test.

What body part is used with the following instrument during physical examinations? And what is it's purpose? : Thermometer

Forehead The purpose of a thermometer is to measure body temperature

Describe the patient position used for the following examination: Exams involving the eyes, ears, chest, nose, & throat.

Fowler's

Specialty exams depend on services provided by the provider and the availability to provide these services. Which of the following is a procedure where the MA might need to provide assistance? A- Gynecological Exams B- Allergy Test C- Cardiac Stress Test D- All of the Above

Gynecological Exams, Allergy Test, & Cardiac Stress Test are all procedures that a medical assistant might need to provide assistance.

What are the two methods the Joint Commission stresses to be used for patient identification to validate that care and treatment are delivered to the correct patient? what should you avoid?

Have patient state their full name and date of birth. Avoid stating the patients name and then asking them to confirm it because they could respond to the wrong name in a time of crisis, stress, or illness.

How should the medical assistant obtain the weight of infant?

Have the infant lie down or sit in an infant scale (scale in pounds and ounces making it more accurate). Weigh infants without clothing or a diaper.

What body part is used with the following instrument during physical examinations? And what is it's purpose? : Tuning Fork

Head The purpose of a tuning fork is to test auditory function and vibratory sensation

What body part is used with the following instrument during physical examinations? And what is it's purpose? : Stethoscope

Heart, Lungs, Abdomen The purpose of a stethoscope is to auscultate (listen to) body sounds

What are three pediatric measurements completed during a routine physical examination?

Height, weight, & head circumference

Why should you review the daily schedule?

It identifies the patients name and reason for their visit. This helps determine how to approach the patient and how to prepare for the visit.

What is the Body Mass Index (BMI)?

It is a tool to screen patients and classify results into weight categories.

Pediatric measurements are important in physical assessments of children up to three. The measurements are plotted on a growth chart. What is the purpose of growth charts?

It provides a visual representation of growth. Alerting the provider of any potential concerns. Also provides a piece of data to have conversations with parents or guardians regarding concerns such as malnutrition or obesity.

Describe the patient position used for the following examination: Rectal exams or instrumentation (flexible sigmoidoscopy)

Jack-knife

Describe the patient position used for the following examination: - Gynecological or Rectal exams - Treatments of spinal adjustments

Knee-chest

What body part is used with the following instrument during physical examinations? And what is it's purpose? : Reflex Hammer

Knees The purpose of a reflex hammer is to test deep tendon reflexes

How should the medical assistant obtain the height of infant (a child that can not stand up)?

Lay the child/infant flat on a paper-covered table. Place a mark on the top of the head and at the heel of the flexed foot. Record the measurements in cm or inches. Repeat the height twice to confirm the results.

Describe the following patient position for physical exams: Sims' (lateral)

Laying on the left side with the left leg slightly flexed and right leg flexed at a 90 degree angle.

Describe the following patient position for physical exams: Trendelenburg / modified trendelenburg

Legs elevated above the head to force circulation to vital organs.

Describe the patient position used for the following examination: Female pelvic exams

Lithotomy

Describe the following patient position for physical exams: Prone

Lying flat on the abdomen with the arms above the head.

Which of the following are considered nuances of the provider (frequently worked with) that MA's must know? A- What size gloves that the provider prefers B- Patient's confidence in the skills and abilities of the healthcare team. C- All of the Above D- None of the Above

MA's have to remember what size gloves that the provider prefers assists with the efficiency of the examination and the patient's confidence in the skills and abilities of the healthcare team. The MA should feel comfortable asking the provider questions and be willing to take constructive criticism to improve techniques and processes.

The medical assistant is responsible for preparing the patients based on the reason for the examination. What are the preparations that must be done before an examination?

Medical assistants must provide the patient instructions and appropriate disrobing. Provide a gown, cape, or drape if disrobing is required. Protecting patient privacy through proper draping is vital.

What body part is used with the following instrument during physical examinations? And what is it's purpose? : Speculum

Nose The purpose of a speculum is to dilate nares for inspection of the nose.

What are appropriate equipment and supplies for a visit?

Stock routine items such as personal protective equipment (PPE), sharps and biohazard waste containers, exam gowns, and table paper. add other items that might be used for a specific visit. (ex: EKG or a patient with chest pain).

During a surgical procedure, a provider requests sterile solution form a medical assistant. Which of the following actions should the medical assistant take? A- Pick up the sterile solution bottle, remove the cap, and hand the bottle to the provider. B- Open the bottle, pour the contents into the container, and set the container on the sterile field C- Place a sterile container on the field and pour a small amount of sterile solution into the container D- Draw the sterile solution up in a syringe and place the syringe on the sterile field for the provider.

Place a sterile container on the field and pour a small amount of sterile solution into the container

A patient in a clinic is experiencing symptoms of myocardial infarction. The provider prescribes sublingual nitroglycerin. Which of the following actions should the medical assistant take? A- Apply the medication to the skin B- Place the medication under the tongue C- Place the medication into the rectum D- Inject the medication into a muscle

Place the medication under the tongue

A provider instructs a medical assistant to position a patient for an examination of the dorsal cavity. The medical assistant should place the patient in which of the following positions? A- Lithotomy B- Supine C- Prone D- Semi-Fowler's

Prone

Describe the patient position used for the following examination: Exams involving the back of the body including the bottoms of the feet.

Prone

Describe the following patient position for physical exams: Knee-chest

Prone and bent at the waist resting on the knee with the arms above the head.

A medical assistants preparing to obtain vital signs from an adult patient during a routine physical examination. Which of the following arteries should the medical assistant use to palpate the patient's pulse? A- Carotid B- Brachial C- Radial D- Femoral

Radial

If the medical assistant is unable to get a measurement of the patient, what should the medical assistant do as a last resort?

Record the measurements as reported by the patient or caretaker. If this is done, make a note in the chart to explain how the measurement was obtained.

A medical assistant is performing suture removal. Which of the following actions should the medical assistant take? A- Remove each suture after cutting next to the knot B- Remove sutures from the center of the wound moving outward C- Remove the sutures in the opposite order of insertion D- Remove the sutures after placing adhesive skin closures

Remove each suture after cutting next to the knot

Describe the patient position used for the following examination: - Exams involving the front of the body. - Administration of CPR

Supine

Which of the following actions should a medical assistant take when closing the clinical area at the end of the day? A- Restock medical supplies in the examination rooms. B- Prepare and cover a sterile field for the next day. C- Discard the biohazard bags from the examination rooms in the trash. D- Refrigerate all collected blood specimens for retrieval the next day.

Restock medical supplies in the examination rooms

Describe the following patient position for physical exams: Semi-Fowler's

Seated leaning against the back of a table that has been raised to a 45 degree angle.

Describe the patient position used for the following examination: - Exams involving the chest. - Exams that should be administrated in a supine position but the patient is unable to lay flat. - Exams for patients experiencing shortness of breath.

Semi-Fowler's

Describe the patient position used for the following examination: Exams involving the rectum, enemas

Sims' (lateral)

Describe the following patient position for physical exams: Fowler's

Sitting position with the back of the exam table raised to a 90 degree angle.

What are the most common solutions used to disinfect surfaces?

Sodium Hypochlorite solution (1:10 dilution of household bleach to water) or a commercial chemical surface disinfectant.

How can a medical assistant determine the best method to obtain anthropometric measurements?

The medical assistant must be aware of normal growth and development as well as the patient's physical and medical status.

A medical assistant is performing an ear irrigation. The patient reports dizziness. These symptoms could be caused by which of the following? A- Pressure from the water has caused the cerumen to move. B- The speed at which the water is being introduced is too slow C- Trapped air is increasing the pressure against the tympanic membrane. D- The temperature of the water is too cold

The temperature of the water is too cold

Why should you always further review the medical record in advance?

To get familiar with the patient and allows for an enhanced understanding of the patients history and concerns while interacting with the patient.

Describe the patient position used for the following examination: Shock

Trendelenburg

A medical assistant is caring for a patient who has conjunctivitis. Which of the following actions should the medical assistant take when performing an eye instillation? A- Ensure the medication is instilled in the upper conjunctiva B- Instruct the patient to look down when instilling the medication C- Use gloves when instilling the medication D- Use a seperate bottle of medication for each eye

Use gloves when instilling the medication

How should a medical assistant measure a child's head circumference?

Using a tape measure, measure at the widest area of the head, which is usually right across the eyebrows, measuring in inches or centimeters. Repeat the head circumference twice to confirm the results.

A provider has instructed a medical assistant to prepare a wound for suturing. When performing basic wound care, which of the following steps should the medical assistant take to ensure proper cleansing of the wound area? A- Wipe the center of the wound with an antiseptic swab, moving toward the edges in a circular motion B- Scrub the wound with an antiseptic swab in a back and forth motion for 5 min C- Flood the wound with hydrogen peroxide prior to wiping it with sterile gauze D- Cleanse the wound a minimum of three times using alcohol prep pads

Wipe the center of the wound with an antiseptic swab, moving toward the edges in a circular motion

A BMI of 18.5-24.9 is considered _________________. A- underweight B- normal C- overweight D- obese

normal (BMI)

A BMI of greater than 30.0 is considered _________________. A- underweight B- normal C- overweight D- obese

obese (BMI)

A BMI of greater than 24.9 is considered _________________. A- underweight B- normal C- overweight D- obese

overweight (BMI)