Chapter 9

The ADA accessibility guidelines require the following:

* A doorway at least 36 inches wide to allow a person in a wheelchair to pass through * A clearance space in rooms and hallways that is 60 inches in diameter to allow a person to make a 180 degree turn * Stable, firm, slip-resistant flooring * Door-opening hardware that can be grasped with one hand and does not require the twisting of the wrist to use * Door closers adjusted to allow time for a person in a wheelchair to enter or exit through the door * Grab bars in the lavatory

Fixative

A solution sprayed on a slide immediately after the specimen is applied. It is used to preserve and hold the cells in place until a microscopic examination is performed.

Lubricant

A water-soluble gel used during examination of the rectum or vaginal cavity.

Which of the following instruments should go through the process of sanitization? * Exam table * Stethoscope * Blood pressure cuff * All of the above

All of the above

In an exam room, the blank should be positioned in the center of the room or come out from the wall

Examining table

What instrument is used to look inside the ear?

Otoscope

A medical assistant's duties in prepping an exam room includes

Preparing and maintaining the room

In accordance with physical safety in the exam room, cords and cables should

Run along walls

Ultrasonic cleaning is blank for fragile instruments

Safe

What is the definition of the sanitization of equipment?

Scrubbed to remove contaminants

Which of the following describes sanitized equipment? * Deep clean by intense heat * Ready for surgical procedures * Scrubbed to remove contaminants * Wiping down with a wet rag

Scrubbed to remove contaminants

In accordance with physical safety in the exam room, rugs should not have

Tears

What is the first step in preventing infection transmission between patients?

Wash hands between patients

What disinfectant should you use to disinfect exam room surfaces?

10% solution of household bleach

The Americans with Disabilities Act requires that the doorway should be at least blank inches wide

36 inches

The customary size for an exam room is

8 by 12

Occult blood

Blood contained in some other substance, not visible to the naked eye

In accordance with physical safety in an exam room, the floor should be

Clean, dry, and free of objects

How often should you discard a 10% bleach solution?

Daily

Disinfection

Destruction of pathogenic microorganisms or their toxins or vectors by direct exposure to chemical or physical agents.

The exam room is used to

Dispense treatment Examine patients Listen to patient's signs and symptoms

What type of detergent is used to clean instruments?

Low sudsing and neutral pH

Doors and interior walls should be

Soundproofed

The complete destruction of all living organisms is

Sterilization

Consumable

Supplies that can be emptied or used up in an exam

Bacterial spores

Thick-walled, reproductive bodies capable of resisting harsh conditions

What is the first step of the disinfection of an exam room?

Wash your hands and put on utility gloves

Fixative

A chemical spray used for preserving a specimen obtained from the body for pathologic exam

Examination light

A flexible arm light source used for better visualization of a patient during an examination.

To confirm a patient's health or diagnose a problem, a physician performs a

A general physical exam

Spores

A resistant form of certain species of bacteria

Penlight

A small flashlight used when additional light is necessary to examine a small area or check pupil reaction

laryngeal mirror

A small mirrored instrument used to examine the inside of the mouth and throat.

Consumable

Able to be emptied or used up, as with supplies.

A patient vomits in exam room 2. Which of the following would be your best course of action? * Immediately call the housekeeping department to clean it up * Spray the room with deodorizer and leave it empty for at least 15 minutes * Clean up the vomit and then open the window or spray a room deodorizer * Clean up the vomit, then turn off the ventilation system so the odor does not permeate the entire office *Turn on the ventilation system and spray deodorizer

Clean up the vomit and then open the window or spray a room deodorizer

Which of the following furnishings are appropriate for an exam room? Television Exam table Chairs Plants

Exam table and chairs

Which of the following consumable supplies is used to preserve a specimen obtained during an exam? * Lubricant * Alcohol * Fixative

Fixative

In accordance with physical safety in the exam room, cabinets and drawers should be

Kept closed when not in use

The care and maintenance of the medical office is generally the responsibility of what team member?

Medical assistant

A rack for the patient's blank hangs on the wall directly outside the exam room

Medical record

What is the most important factor in determining the number of exam rooms in a medical practice?

Number of physicians

Examples of instruments and equipment that you can sanitize and reuse without further disinfection or sterilization include the following:

* Blood pressure cuff * Opthalmoscope (an instrument containing a mirror and lenses used to examine the interior of the eye * Otoscope (an instrument used for inspecting the ear) * Penlight * Reflex hammer * Stethoscope * Tape measure * Tuning fork

Instruments and equipment that you can disinfect and reuse without sterilization include the following:

* Enamelware * Endotracheal tubes (tubes used to establish an artificial airway through the nose, mouth, or direct tracheal route) * Glassware * Laryngoscopes (tubes equipped with lighting used to examine the interior of the larynx through the mouth) * Nasal specula (instruments used to enlarge the opening of the nose to permit viewing)

Besides utility gloves, what other additional protection would you want when sanitizing equipment?

* Eye protection * Mask * Protective clothing

Generally, you should disinfect instruments and equipment by using one or more of the following agents:

* Germicidal soap products * Alcohol * Chlorine and chlorine products * Formaldehyde * Hydrogen peroxide * Iodine and iodine compounds * Acid products

A medical assistant is best able to promote infection control by

* Making hand hygiene a priority * Keeping the examining table clean * Disinfecting all work schedules

When handling disinfected items, you should handle them with

* Sterilization forceps * Transfer forceps * Gloves

The office is closing for the day. In this scenario, what task is the medical assistant responsible for?

Change paper and spray

What are the steps meant for scrubbing instruments that need to be sanitized?

1. Drain the disinfectant solution the instruments were soaking in from the sink or container 2. Rinse each instrument under hot, running water 3. Scrub each instrument with hot, soapy water and a plastic scrub brush 4. Rinse the soap from the instrument 5. Place the instrument in a towel and roll it dry

When should surfaces in an exam room be cleaned?

After being contaminated with blood or bodily fluids and at the end of your shift

In which of the following situations would alcohol-based hand cleaner most likely be acceptable for use? * After cleaning up a blood spill * After changing the paper on the exam table * After assisting with suturing * After your break * After helping a patient in the restroom

After your break

Hand washing is the first step in the prevention of infectious transmission of microorganisms in the exam room. Which of the following requires hand washing with soap and water? * Before and after contact with each patient * Before application of gloves * Before and after using the restroom * Before leaving for the day * All of the above

All of the above

The blank requires that businesses, services, and public transportation provide "reasonable accommodations" for the disabled

Americans with Disabilities Act of 1990 (ADA)

general physical examination

An examination performed by a physician to confirm a patient's health or to diagnose a medical problem.

Nasal speculum

An instrument used to enlarge the nasal opening in order to permit viewing inside the nose

Anoscope

An instrument used to open the anus for examination.

Reflex hammer

An instrument with a hard triangular head used to check a patient's reflexes

Cleaning products used on human skin to reduce or eliminate infectious organisms are

Antiseptics

A patient comes in for her yearly pap smear. In this scenario, what task is the medical assistant responsible for?

Change paper and spray

Occult blood

Blood contained in some other substance, not visible to the naked eye.

Which of the following is considered a disposable supply? * Penlight * Thermometer * Tape measure * Curette * Cervical broom

Cervical broom

A patient comes in for a pre-employment physical. In this scenario, what task is the medical assistant responsible for?

Change paper

a patient comes in for a blood pressure check. In this scenario, what task is the medical assistant responsible for?

Change paper

A patient comes in for an I&D (incision and drainage). In this scenario, what is the medical assistant responsible for?

Change paper and spray

Disinfectant is usually sufficient for instruments that

Do not penetrate a patient's skin or that come in contact only with a patient's mucous membranes or other surfaces not considered sterile

Door-opening hardware required by the ADA can be grasped with one hand and

Does not require twisting the wrist to open

Which of the following is a disposable supply? * Glass slides * Lubricant * Fixative * Isopropyl alcohol * Nasal speculum

Glass slides

Which disinfectant would LEAST likely be corrosive or require ventilation when in use? * Alcohol * Bleach * Hydrogen peroxide * Formaldehyde * Iodine

Hydrogen peroxide

What is the eighth step of the disinfection of an exam room?

If you keep a container of 10% bleach solution on hand for disinfection purposes, replace the solution to ensure its disinfecting potency

How should disinfected equipment be stored?

In a clean and moisture-free environment

What is the fourth step of the disinfection of an exam room?

In the event of an accident involving a broken container, use tongs, a dustpan and brush, or forceps to pick up shattered glass, which may be contaminated

Which of the following would you be LEAST likely to find in an examination room? * High intensity lamp * Medications * Bio-hazardous sharps container * Rolling stool * Metal wastebasket with lid

Medications

Which of the following may be sanitized and re-used without further disinfection or sterilization? * Curette * Otoscope * Laryngeal mirror * Anoscope * Vaginal speculum

Otoscope

In accordance with physical safety in the exam room, extension cords should not be

Overloaded

The furnishings in an exam room should be arranged for

Patient comfort and efficiency for the physician

When preparing instruments for sanitization you should

Place them in a sink or container with a neutral pH

Ultrasonic cleaning involves

Placing instruments in a specific bath. The cleaner generates sound waves through a cleaning solution, loosening contaminants. Ultrasonic cleaning is safe for even very fragile instruments.

Disinfectants used on exam room surfaces may include which of the following * 20% bleach solution * Soap and water * Products approved by the EPA * Water-soluble lubricant * Neutral pH detergent

Products approved by the EPA

You have just finished disinfecting an exam room using clean rags. What should you do with the rags you used?

Put them in a bio-hazardous waste receptacle

What is the fifth step of the disinfection of an exam room?

Remove and replace protective coverings, such as plastic wrap or aluminum foil on equipment if equipment or coverings have been contaminated. After removing the coverings, disinfect the equipment and allow it to air-dry.

What is the second step of the disinfection of an exam room?

Remove any visible soil from exam surfaces with disposable paper towels or a rag

What is the seventh step of the disinfection of an exam room?

Remove the gloves and wash your hands

What are the tasks done to prepare an exam room?

Restocking Organizing Cleaning

What is the correct way to remove the exam table covering?

Roll it with the contaminated side on the inside

In accordance with physical safety in the exam room, furniture should not have

Sharp corners

Sterilization

The destruction of all microorganisms, including bacterial spores, by specific means

Accessibility in an exam room refers to

The ease in which people can move in and out of the room

What should be done to instruments prior to sterilization?

They should be wrapped

What is the third step of the disinfection of an exam room?

Thoroughly wipe all surfaces with the disinfectant

OSHA requires storing regulations for bio-hazardous materials in the office. While handling specimens, which of the following routes of exposure can spread infection through absorption through a crack in the skin? * Inhalation * Transcutaneous * Ingestion * Urethral * IV infusion

Transcutaneous

During the previous patient's treatment, a glass container broke when it was dropped to the floor. Which of the following is an appropriate way to clean up the shattered glass? * Put on exam gloves and carefully pick up the glass * Use a damp paper towel to wipe the entire floor * Use a paper towel to sweep the glass carefully into a dustpan * Use a brush to sweep he glass into a dustpan

Use a brush to sweep the glass into a dustpan

In order to comply with the Americans with Disabilities Act, the exam room in a medical office must have features that make the area accessible to patients who use

Wheelchairs

What is the sixth step of the disinfection of an exam room?

When you finish cleaning, dispose of the paper towels or rags in a bio-hazardous waste receptacle

Sanitization

a reduction of the number of microorganisms on an object or a surface to a fairly safe level. this is done by scrubbing instruments and equipment with special brushes and detergent to remove blood, mucus, and other contaminants or media where pathogens can grow. Sanitization is used to clean items that touch only healthy, intact skin. For other equipment, sanitization is the first step before disinfection and sterilization.