FInal NCCT practice exam
The primary care provider hands the medical assistant a referral for a patient to get an MRI. Which of the following should the medical assistant do first?
Call the insurance company and process an authorization
The patient receiving an albuterol treatment by nebulizer in the clinic complains of tremors, nausea, blurred vision, and headache. Which of the following actions should the medical assistant take?
Report these symptoms to the physician.
The medical assistant prepares a written prescription for the physician as follows. What information did the medical assistant leave out?
Quantity to dispense and directions for taking the medication (if you look at the order closely you will see)
The medical assistant measures the head circumference on a 6-month-old male infant during a well-baby check. The circumference is 42 cm. Which of the following percentiles should the medical assistant assign based on this pediatric growth chart?
10th Rationale: The infant would be placed in the 10th percentile on the pediatric growth chart with a head circumference of 42 cm
Which of the following actions should the medical assistant take to ensure proper monitoring of a patient during a stress test? (Select the three (3) correct answers.) -Instruct the patient to start at a rapid pace. -Instruct the patient to report any symptoms. -Adjust the temperature of the room to the patient's preference. -Measure blood pressure and heart rate frequently. -Observe facial expressions, skin color and perspiration.
-Instruct the patient to report any symptoms -Measure blood pressure and heart rate frequently -Observe facial expressions -skin color and perspiration.
The medical assistant is completing front office opening tasks prior to the start of the day. Which of the following indicates the reception area is prepared to receive patients?
-Magazines are stacked on the side tables. -Lights are turned on -The path from the entrance to the front desk is direct and unobstructed.
The physician has ordered acetaminophen (Tylenol) E.S.1000 mg po q day. The amount on hand is 500 mg tabs. What is the correct dose to administer?
2 tabs
A pediatric patient has been diagnosed with a mild skin infection and the physician orders Amoxicillin. The ordered dose (based on today's weight) is 91 mg every 8 hours. The patient is to receive a first dose of medication before leaving the office and the suspension available is 125 mg/5 mL. How much medication should the medical assistant administer?
3.6 mL Rationale: Use the following formula to calculate the proper medication amount: D/H * V where D= desired dose (91 mg), H= dose on hand (125 mg), and V= volume (5mL in this case) 91/125*5=3.64 or set it up as fractions 125 mg / 5 mL = 91 mg / X mL and solve for X 455=125X, X=3.64 mL Since mL is a Volume measurement, 3.64 mL (round to 3.6) of this suspension would give the desired 91 mg dose.
When managing multiple incoming calls, the medical assistant should handle which of the following calls first? -A patient calling to schedule a follow-up visit for uncontrolled pain after hip surgery. -A patient calling to cancel today's appointment for a needle biopsy of a breast mass. -A lawyer with a subpoena asking for patient information. -A neurologist seeing a patient on consult.
A neurologist seeing a patient on consult. Rationale: The medical assistant's main priority is to handle the most urgent call promptly. A neurologist calling to report on a referred patient would take priority over anyone scheduling or cancelling an appointment. The other calls can be put on hold or they can opt to have their names and phone numbers taken for calls to be returned and handled when time permits. A lawyer with a subpoena can also wait for a return call until all other priorities have been handled.
For which of the following incidents is employer provided post-exposure follow-up indicated? -An employee fall from a step stool while obtaining medical records. -A polycup containing urine splashed into the eye of an employee. -Loss of power during an ECG procedure. -An employee falls in the parking lot, resulting in a hand laceration.
A polycup containing urine splashed into the eye of an employee. Rationale: In compliance with OSHA regulations, a post exposure follow-up plan includes incidents of occupational exposure to direct contact with blood or other potentially infectious body fluids.
While exiting a patient's room after performing a venipuncture, a medical assistant is approached by a nurse in the hallway, who asks if the HIV blood sample was obtained. The medical assistant responds, "Yes." This situation violates the policies of which of the following associations?
AHA (American Hospital Association) Rationale: Discussing confidential information about a patient's medical care without maintaining privacy (i.e. in a hallway where the conversation could be overheard by non-medical personnel) violates the following statues of the Patient's Bill of Rights of the American Hospital Association: The patient has the right to every consideration of privacy.
Which of the following acts involves the termination of a patient from the care of a physician without reasonable, written notice of withdrawal from the case? -Slander -Discrimination -Battery -Abandonment
Abandonment
The patient was seen in the office for follow up evaluation post CVA. The doctor noticed significant weakness on the patient's left side. Which of the following should the medical assistant expect to perform?
Active assist range of motion
Which of the following is a requirement for a healthcare facility to be in compliance with OSHA? -Payment of annual dues -Current certificate of compliance on file -Annual employee safety training -Annual inspections conducted by OSHA
Annual employee safety training a) A written exposure control plan, to be updated annually, Use of universal precautions, b) Consideration, implementation, and use of safer, engineered needles and sharps, c) Use of engineering and work practice controls and appropriate personal protective equipment (gloves face and eye protection, gowns), d) Hepatitis B vaccine provided to exposed employees at no cost, e) Medical follow-up in the event of an "exposure incident", f) Use of labels or color-coding for items such as sharps disposal boxes and g) containers for regulated waste and contaminated laundry.
Which of the following are Schedule IV drugs? -Controlled narcotics such as morphine -Substances with no accepted medical use and a high potential for abuse -Antianxiety agents and hypnotics with a low potential for abuse -Broad spectrum antibiotics
Antianxiety agents and hypnotics with a low potential for abuse Rationale: Controlled substances are classified according to five different schedules. Schedule I drugs have high abuse potential and are not considered medically safe treatment options, thus have no medical use (i.e. heroin). Schedule II drugs also have a high abuse potential that could result in severe physical and/or psychological addiction (i.e. morphine and Vicodin). Schedule III drugs have a low-moderate abuse potential but could still be highly psychologically addictive (i.e. nandrolone). Schedule IV drugs have low potential for abuse such as antianxiety agents and hypnotics (i.e. Valium, Xanax, Ativan). Schedule V drugs have low abuse potential: cough medicines and antidiarrheal medicines that may contain very limited amounts of narcotics (i.e. Robitussin AC). Antibiotics are not addictive, so they are not classified under the controlled substance schedule.
The medical assistant documents a patient's temperature as 101.4F. Which of the following types of medication is this patient most likely to receive?
Antipyretic
The patient complains of joint pain and swelling. The physician wants to remove synovial fluid for analysis. The medical assistant should set up for which of the following procedures?
Arthrocentesis Rationale: Synovial fluid aspiration may be performed diagnostically (to identify cause) or therapeutically (for pain/swelling relief). Arthro= pertaining to the joint, centesis= act of puncturing into a body part or cavity (to remove fluid), scopy= examining or viewing, desis= binding or immobilization, and gram= a written record or drawing.
Which of the following forms must be signed by the patient and kept on file, allowing physicians to be paid directly from the insurance carrier? -HIPAA waiver -CMS-1500 -Assignment of benefits -Living will
Assignment of benefits Rationale: A patient must sign an assignment of benefits form to allow the insurance company to pay the health care provider directly. The CMS-1500 form is the official standard Medicare and Medicaid health insurance claim form. A HIPAA waiver is associated with the privacy and protection of health care records. An advanced directive (a.k.a. living will) is a document outlining the patient's wishes regarding treatment to prolong life.
Which of the following complications occurs from prolonged lack of muscle use?
Atrophy Rationale: Atrophy, which is the wasting away of a muscle, occurs with prolonged lack of muscle use.
When preparing to assist the physician with collection of a deep wound culture, the medical assistant should have which of the following available? -Blood culture media -Viral transport media -Bacterial culture swabs -Cotton tipped swabs
Bacterial culture swabs Rationale: When helping with a deep wound culture, the medical assistant needs to have bacterial culture swabs available in order to try to identify what bacteria is causing the infection.
The medical assistant is preparing to remove her gloves after a venipuncture and notices blood on the gloves. Where should the medical assistant dispose of her gloves?
Biohazard waste container
A CMP is ordered for an older adult patient whose veins continue to collapse despite drinking water. Which of the following is the best collection method for this patient?
Butterfly needle Rationale: A butterfly is a smaller gauge needle device and is used for smaller veins, including fragile veins on all patients, elderly adults and small children. Other phlebotomy systems use larger gauge needles. The vacuum pressure in an evacuated tube system would collapse the vein. A needle and syringe would also have a tendency to collapse the vein (when the plunger of the syringe is pulled back). A capillary collection would be the last resort if all other collection methods failed. The butterfly is the best initial choice in this case.
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?
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 primary objective of which of the following agencies is to regulate and ensure quality of clinical laboratory testing?
CLIA
Which of the following organizations makes on-site visits to inspect medical office laboratories?
CLIA Rationale: All laboratory testing in the United States that is performed on humans is highly regulated.
Which of the following regulations set the minimum standards for medical laboratory practice and quality?
CLIA Rationale: Clinical Laboratory Improvement Amendments (CLIA) are laws put in place to ensure quality assurance standards for medical laboratories, and enforced by the Department of Health and Human Services.
The medical assistant is scheduling a patient for a gallbladder study. Which of the following terms should the medical assistant use on the patient test order?
Cholecystography Rationale: The suffix "graphy" refers to writing, recording or otherwise representing something (data, image, etc.). Angio= blood or vessel Cysto= cyst, urinary bladder or sack of fluid Chole= gall or bile Therefore, a gallbladder study would include a cholecystography.
The patient is not able to distinguish certain numbers on an Ishihara test. This indicates a problem with which of the following? -Rods -Cones -Pupils -Sclera
Cones Rationale: The Ishihara test is used to determine color blindness by means of a series of cards each having colored dots that form one pattern to the normal eye and a different pattern to the eye that is color-blind. In the anatomy of the Eye; the cones are responsible for color vision, the rods are responsible for the black and white and night vision. Both the rods and cones are part of the inner layer of the eye.
The patient presents to the pre-op clinic for a lithotripsy (ESWL) procedure. Which of the following actions should the medical assistant take prior to witnessing the consent form to ensure it is legally binding?
Confirm the surgeon has explained all risks and benefits of the procedure. Rationale: The medical assistant has an ethical obligation to make sure the surgeon has done what is legally required of him/her and has explained all of the risks and benefits of the procedure to the patient. The other options are all important to do as well, but the priority action to ensure the consent form is legally binding is to confirm that the surgeon explained the risks and benefits.
Which of the following resources should the medical assistant use to look up the code for a laceration repair? -International Classification of Disease -Physician's Desk Reference -Healthcare Common Procedural Coding System -Current Procedural Terminology
Current Procedural Terminology Rationale: A laceration repair would be found in the CPT code book.
A patient questions an outstanding balance when insurance coverage is active and the co-pay has been paid. Which of the following is the most likely reason the balance is the patient's responsibility? -Deductible not met -Premiums due -The birthday rule applies -Pre-authorization not obtained
Deductible not met Rationale: The total cost of services for this visit is $252. Insurance paid $140 (plus patient co-pay $20 = $160 paid on a $252 charge). 252-160= $92 The outstanding balance is the patient's responsibility because the deductible is not met. The deductible is $1000. The co-pay is $20. 1000-20= $980 to meet deductible.
A patient presents to the provider's office with a complaint of persistent migraines three days after acquiring a head injury on the job. After the provider assesses the patient, the final diagnosis is a concussion. Which of the following actions should the medical assistant take next?
Determine if a workman's compensation claim has been filed. Rationale: Whenever a patient claims a workplace injury, the health care provider should call the employer to see if a workman's compensation claim has been filed. If so, billing will first go through that claim. The other options listed in this scenario would be follow-up based on whether or not a workman's comp claim has been filed.
Which of the following is the most common means of transmission of Methicillin-Resistant Staphylococcus Aureus (MRSA)?
Direct contact with the skin of infected persons Rationale: Because SA can be on the surface of the skin, the most common way MRSA spreads from person to person is by direct contact. A much less common way it can spread is by touching surfaces such as railings, faucets, or handles that may be contaminated with MRSA.
Which type of medication is used to increase urinary output?
Diuretic Rationale: Diuretics are medications that act by promoting the excretion of excess fluid in the body which is eliminated through the kidneys. A vasopressor is used to raise blood pressure, an antiemetic is used to treat and prevent nausea and vomiting, and a cathartic increases the amount of defecation.
Which of the following medical office software applications uses an electronic signature? -Spreadsheets -EHR -Encoders -Scheduling
EHR Rationale: The use of Electronic Health Records (EHR) requires an electronic signature. Other office applications, such as spreadsheets, encoders, and scheduling programs don't require signatures.
Which of the following actions by the medical assistant is appropriate when interacting with a patient who is visually impaired?
Explain where things are positioned by referencing a clock image. Rationale: By providing general orientation to the environment, the visually impaired patient feels more comfortable. It is of utmost importance to maintain a visually impaired patient's dignity and independence in this type of setting. Guiding them physically takes away independence and could decrease their comfort level. Limiting communication or talking loudly is inappropriate.
When preparing a site with alcohol for venipuncture, the medical assistant should cleanse in which of the following motions?
From the inside out
The order reads cefaclor (Ceclor) 250 mg p.o. stat, then 150 mg q 2 h. How should the medical assistant interpret this medication order?
Give 250 milligrams of cefaclor (Ceclor) orally immediately, and then give 150 milligrams every 2 hours. Rationale: p.o.=oral (by mouth), stat=now (immediately), mg=milligrams, q=every
Employees of a major automobile manufacturer are provided health insurance under a master contract issued to their employer. Which of the following types of coverage does this reflect?
Group policy Rationale: The majority of people in the United States (approximately 60%) receive their health insurance through employer-sponsored group plans
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?
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).
A patient called the office complaining his hydromorphone prescription was not honored at the pharmacy. The patient stated, "The doctor gave me this prescription six weeks ago when I was in the office." The prescription was denied because it is a schedule
II drug. Rationale: This is a morphine derivate from an opium extract. Hydromorphone belongs to the group of medicines called narcotic analgesics (pain medicines). It acts on the central nervous system (CNS) to relieve pain. It is classified as a Schedule II drug with a high potential for abuse, therefore, written prescriptions must go to the pharmacy within 72 hours.
Which of the following ECG leads records the electrical activity of the inferior surface of the left ventricle and is closest to the heart?
Lead II Rationale: Lead II records tracings between the right arm and left leg. This is the lead recorded on a rhythm strip at the bottom of a 12 lead ECG.
Which of the following describes proper aseptic technique in the cleaning of the venipuncture site?
Let the alcohol air dry before inserting the needle.
A medical assistant posts damaging remarks on a social media site about a provider at the clinic where she is employed. She may be legally found guilty of which of the following?
Libel
The physician orders a PT/PTT. Which of the following evacuated tubes should the medical assistant select for collecting the specimen
Light blue Rationale: A light blue top on the tube means that the tube contains buffered sodium citrate, an additive that removes calcium to prevent blood from clotting. Therefore, this tube would be the one used for the PT/PTT test since those tests are done to see how well the blood clots. The light green tubes are used for STAT tests and will counteract the clotting tubes. Red tubes are for tests on hormones, and gray tubes are typically used for glucose testing and for testing blood alcohol content.
If a medical assistant has questions about disposing of outdated hazardous chemicals, where should the medical assistant look to find this information? -HIPAA -MSDS -CLIA -NIOSH
MSDS Rationale: A Material Safety Data Sheet (MSDS) is a hazardous chemical reference. The National Institute for Occupational Safety and Health (NIOSH) makes recommendations for preventing illness and injury acquired on the job.
A large open container of isopropyl alcohol is spilled on the floor in the clinic waiting area. The medical assistant should use which of the following resources for information about the chemical and any necessary procedure?
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 appropriate for the medical assistant to use an alcohol-based hand rub as the only method of hand hygiene after which of the following activities?
Measuring a patient's apical pulse
A Medicare patient presents to an outpatient hospital facility for a scheduled hysterectomy. To which Medicare plan should the facility submit the claim?
Medicare Part B Rationale: This claim should be submitted to Medicare Part B since it is an outpatient medical procedure. Medicare Part A basically covers inpatient care, but can expand to cover hospice and home health in a limited capacity. Medicare Part B is generally referred to as medical insurance that covers outpatient visits, services and supplies
The endocrinologist requested the patient to return to the outpatient clinic the next day for a glucose tolerance test. Which of the following preparations should the medical assistant instruct the patient to do the night before the test?
NPO after midnight. Rationale: Before a glucose tolerance test the patient needs to be NPO (nothing by mouth) after midnight the night before the test
Which term describes the failure to provide care that a prudent and reasonable professional with the same education would provide under similar circumstances?
Negligence Rationale: Negligence is the failure to provide adequate care to a patient, which in turn causes harm to that person. Beneficence is the act of doing good defamation is when a person's reputation is ruined by either libel or slander.
An incorrect dose of medication is delivered to a patient in the medical clinic. As a result, the patient experienced mild kidney damage. The responsible health care providers and/or clinic is at risk for which of the following?
Negligence Rationale: This is a case of negligence, a failure to practice within the standard of care. Defamation occurs when someone intentionally says or writes something false that causes harm to the person's reputation. Slander is a form of defamation that is heard/spoken. Libel is a form of defamation that is visible (written, produced, etc.).
Which of the following government agencies requires the medical office to develop an exposure control plan?
OSHA Rationale: Occupational Safety and Health Administration (OSHA) is the main Federal agency committed to enforcement of safety and health legislation.
A patient complains of nausea and vomiting, and has been unable to keep fluids down over the course of two days. A suppository has been ordered. Which of the following abbreviations is the correct route of administration?
PR Rationale: Common pharmaceutical abbreviations are as follows: PR = per rectum, IM = intramuscular SC = subcutaneous INH = isoniazid
Which part of Medicare covers office visits with a primary care provider?
Part B Rationale: A monthly premium and meeting an annual deductible are standard to qualify, after which an 80% reimbursement rate will take effect - the insured is responsible for the 20% coinsurance.
Which of the following is the most likely cause of the deposits not agreeing with the credits on the day sheet or the patient ledgers? -There are duplicate cards. -The bank made an error. -Cash is missing. -Payment is misplaced.
Payment is misplaced. Rationale: The first step of reconciliation is to first determine if a payment is misplaced. Then issues of duplication or misplaced monies can be addressed. Transactions involving a possible bank error would be the last thing to check before checking the medical office records.
Which of the following is likely considered outside the scope of practice for a medical assistant?
Perform CLIA high complexity tests
Which of the following resources should the medical assistant use to look up the side effects of (enoxaparin) Lovenox in the medical office?
Physician's Desk Reference (PDR) Rationale: The PDR (Physician's Desk Reference) is published annually, and is the most common drug reference book. It provides information about medications, their functions, side effects, contraindications, etc. The Healthcare Common Procedure Coding System (HCPCS) is a system of healthcare codes put in place to ensure insurance claims are handled correctly. A laboratory reference manual would contain information about laboratory tests, not medications. Current Procedural Terminology (CPT) codes are used to classify medical procedures and services, therefore these codes don't include information on medication side effects.
A patient presents to the urgent care office reporting a burn that occurred a few minutes ago from hot coffee. The left wrist is painful, red, swollen and has blisters. The medical assistant takes the patient directly to an exam room. Which of the following actions should the medical assistant take next?
Place the wrist under cool running water Rationale: Every burn should be evaluated before proceeding with treatment. This scenario describes the burn and symptoms in detail. The burn site should be placed under cool running water to both soothe and clean the area. The physician will then evaluate the burn and determine the course of treatment.
Which of the following actions by the medical assistant is correct when administering medication to a patient sublingually?
Placing the medication under the tongue
During a routine visit, a petite female patient becomes very distraught while discussing the recent death of her husband. She suddenly faints. Which of the following actions should the medical assistant take next? -Protect the patient from injury. -Activate EMS. -Notify the physician. -Draw blood for laboratory tests.
Protect the patient from injury. after making sure the patient is safe then you can notify the physician.
The medical assistant is assisting a physician with an I & D of a gangrenous abscess. In addition to mask and gloves, the medical assistant must wear which of the following personal protective equipment when performing this procedure?
Protective eyewear Rationale: I & D refers to incision and drainage. The staff should be protected from splashes and spurts to prevent transmission of bloodborne pathogens.
Which of the following indicates a medical office is compliant with the Americans with Disabilities Act (ADA)?
Providing hand rails in at least one restroom stall
When the patient's chart has been subpoenaed, which of the following types of information requires additional consent from the patient or a court order?
Psychiatric treatment Rationale: A HIPAA-covered health care provider or health plan may share protected health information if it has a court order. However, the provider or plan may only disclose the information specifically described in the order to protect the privacy of health information. A HIPAA-covered provider or plan may disclose information to a party issuing a subpoena only if the notification requirements of the Privacy Rule are met. Before responding to the subpoena, the provider or plan should receive evidence that there were reasonable efforts to: 1. Notify the person who is the subject of the information about the request, so the person has a chance to object to the disclosure, or 2. Seek a qualified protective order for the information from the court. However, there are many exceptions to this rule, such as disclosures for treatment, payment and healthcare operations, reporting certain types of injuries to law enforcement, disclosing information pursuant to a subpoena issued by a "judicial officer," and reporting abuse and neglect to an appropriate government agency. State laws also give legal protection to privileged information obtained through a provider-patient relationship (e.g. the traditional physician-patient privilege, counselor-client privilege), and to confidential information obtained by providers whose primary purpose is to provide services for the care, treatment, and rehabilitation of the mentally ill, developmentally disabled or substance abusers.
Which of the following is necessary before ordering or paying for medical office supplies?
Purchase order Rationale: A purchase order is required for authorization and expense documentation of transaction.
When measuring oxygen saturation on a child breathing room air, with normal color, and no signs of respiratory distress, the medical assistant obtains a reading of 79%. Which of the following actions should the medical assistant take next?
Reposition the finger probe Rationale: Oxygen saturation (O2 Sat or Pulse Ox) on a child with a structurally normal heart should be >92% . Patient movement, poor probe attachment, or nail polish can distort the sensor reading during monitoring. Always observe the child's condition first, and machine reading 2nd when troubleshooting. O2 saturation should be obtained and documented as part of a full set of vital signs for patients being evaluated for respiratory conditions.
Which of the following actions is an example of compliance with Quality Control (QC) guidelines for phlebotomy? -Run the daily control checks on urinalysis dipsticks. -Ensure supplies in venipuncture trays are no more than one month beyond the expiration date. -Ensure reusable supplies in venipuncture trays are recycled. -Run glucose meter controls between each patient sample.
Run the daily control checks on urinalysis dipsticks.
Which of the following is a likely complication from repeated phlebotomy procedures in the same area?
Sclerosed veins Rationale: Repeated punctures in a vein would cause hardening of the vessel tissue, known as sclerosis. Thrombosis refers to clot formation. Petechiae are tiny red or purple spots on the skin caused by broken capillaries. Varicose veins are caused by weakened valves and veins in the legs.
A patient with dyspnea comes in for an ECG. In which of the following positions should the patient be placed for the procedure? (pay atention to the fact that they have dysnea-trouble breathing-) -Supine -Semi Fowlers -Trendelenburg -Sims
Semi Fowlers Rationale: Dyspnea is a condition that causes a patient to be short of breath (SOB), so when the medical professional performs an ECG, the patient normally lays in a supine position. If the patient suffers from dyspnea it is difficult for them to lay flat so putting he/she in a semi Fowlers position will allow them to breath and be as close to the supine position as possible
Which of the following blood components are visible in a centrifuged, evacuated red top tube? (Select the two (2) correct answers.) -Plasma -Serum -Individual erythrocytes -Platelets -Coagulated blood (blood clot)
Serum, Coagulated blood (blood clot) Rationale: A centrifuged sample in a red top tube will have a liquid portion at the top and a solid portion on the bottom. Since the red top contains no anticoagulant, the blood will clot. This means the top liquid portion is serum and the bottom portion is the coagulated blood
A medical assistant is positioning a patient for sigmoidoscopy. Which of the following positions would be appropriate for the procedure?
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.
The medical assistant documented an IM injection as follows: 10/12/XX @ 1030, Rocephin 1 gram IM patient tolerated procedure well. Amy Ray, medical assistant. Which of the following necessary pieces of documentation is missing?
Site of administration Rationale: Anatomical site of injection should always be documented for reassessment of local and/or systemic reaction
While performing a Snellen visual acuity test, the patient misses two letters on the 20/70 line with his right eye. How should the medical assistant document this finding?
Snellen chart OD 20/70-2 Rationale: When documenting visual acuity with the Snellen chart, always start with 20. This represents 20 feet as the distance of the patient to the chart. The second number is the line that is read. A "-" represents letters missed.
Which of the following pieces of equipment should the medical assistant anticipate using when taking a patient's blood pressure? -Sphygmomanometer(BP cuff) -Otoscope -Speculum -Pulse oximeter
Sphygmomanometer Rationale: A sphygmomanometer is used to auscultate and measure blood pressure readings. An otoscope is used to examine the ear, a speculum is used to examine body cavities, and a pulse oximeter is used to see what a person's oxygen saturation is in the body
Which of the following insurance programs covers active duty military personnel?
TRICARE
The adult patient has a puncture wound on the sole of the right foot due to stepping on a nail in a construction area. Which of the following immunizations is particularly important for the medical assistant to ask about while taking the patient's history? -HepB -Td -PCV -DTaP
Td Rationale: Td = Tetanus booster recommended every 10 years. If a person has a deep or contaminated wound, a booster may be prescribed if it has been more than 5 years since the last dose. DTaP series is completed during the childhood immunization schedule. Adults should receive a one-time dose of Tdap if they have not received a previous dose. Tetanus is a neuromuscular disease, also known as lockjaw, preventable with immunization. Hep B is the vaccine for Hepatitis B. PCV is the vaccine for Pneumococcal disease.
Commitment to privacy, continuity of care, advance directives, and the authority to refuse treatment are granted according to which of the following?
The Patient's Bill of Rights
What is the importance of encouraging a patient diagnosed with bronchitis to maintain adequate fluid intake?
Thin secretions Rationale: Bronchitis is an inflammation of the bronchial tubes, which are in charge of taking air to the lungs. When they get inflamed, thick secretions build up in the bronchial tubes. Patients with bronchitis need to maintain adequate fluid intake in order to thin the secretions they have
Which of the following is the purpose of scheduling preadmission testing (PAT) prior to surgery?
To assess patients' health to make sure they can tolerate the proposed surgical procedure. Rationale: Testing is performed prior to a surgery as an assessment of the patient's health. It is used to measure whether or not the surgical procedure can be tolerated. It's a matter of risk versus benefit. If the preadmission testing shows that the patient is not "strong" enough ("healthy" enough) to tolerate the surgical procedure, it could be more harmful to proceed with the surgery than to delay or cancel it (since the surgery could do more harm than good).
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? -To determine the primary diagnosis -To ensure a secondary diagnosis is not listed on the claim form -To assign a two-digit modifier -To assign a V code
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.)
The medical assistant preps the median cubital vein for a venipuncture procedure. How should the medical assistant prep the patient's skin?
Use a circular motion, from the inside out.
When performing a 12-lead ECG, which of the following positions demonstrates correct lead placement?
V4 is placed left midclavicular 5th intercostal space Rationale: The precordial chest lead is positioned at the apex of the heart, where the apical pulse is auscultated and Point of Maximal Impulse (PMI) can be felt. V4 is placed on the left midclavicular 5th intercostal space, at the mitral valve (left ventricular) area.
A 6-month-old child is at the clinic for their well-child visit and routine vaccines. Which of the following is the preferred site for an intramuscular injection on this patient?
Vastus lateralis
Which of the following conditions may occur if a tourniquet is left in place on a patient's extremity for longer than 60 seconds?
Venous stasis Rationale: A tourniquet left in place for longer than 60 seconds predisposes the formation of blood clots due to slow blood flow (a.k.a. venous stasis)
Which pregnancy risk drug category indicates the greatest risk of fetal harm?
X Rationale: Medications are categorized to indicate risk of harm to fetus if taken during pregnancy or to nursing mothers. A system of classifying drugs according to their established risks for use during pregnancy includes the following: Category A: Controlled human studies have demonstrated no fetal risk. Category B: Animal studies indicate no fetal risk, but no human studies; or adverse effects in animals, but not in well—controlled human studies. Category C: No adequate human or animal studies; or adverse fetal effects in animal studies, but no available human data. Category D: Evidence of fetal risk, but benefits out-weigh risks. Category X: Evidence of fetal risk. It is thought that risks may outweigh any benefits.
A female patient has come in for an ECG following a mastectomy. ECG electrodes should be placed
as close to the surgery site as possible without touching the site. Rationale: If a female patient needing an ECG has had a mastectomy, the person performing the ECG should place the electrodes as close to the area they would normally be placed without touching the site of surgery. If that person were to place the electrodes three inches above or below the surgery site, the electrodes would be too far away from the correct placement and therefore could give false recordings.
Which of the following rhythms is shown in the strip above?
atrial flutter
The importance of accurate anatomic positioning of leads on a patient when performing an ECG is to
capture true cardiac activity.
A patient with diabetes has missed all scheduled appointments in the past 18 months. The physician requests that written notification be sent to the patient to make an appointment immediately. This letter should be sent -priority. -certified. -express. -standard.
certified. Rationale: The letter to the patient should be sent Certified so that the physician can see when the patient receives the letter. With Certified mail, the patient must sign for the letter when he/she receives it. This ensures that it was delivered to the correct person. Since the patient has diabetes, it is important for him/her to see a physician regularly to prevent the disease from getting worse. If a letter is sent Priority it will ship faster than general or first-class mail but would not be the best choice because the medical assistant needs to make sure that the patient received the letter about his/her upcoming appointment. Express mail is an international service that allows people to send mail from country to country and would not be needed in this case because the patient and physician are in the same country. Standard mail is not sent first-class and items typically sent by standard mail are newspapers, flyers, and magazines. This also would not be the best choice because the medical assistant would not have confirmation that the patient received the letter.
What abbreviation would a physician write on an order to "discontinue" a treatment or medication?
d/c DIC (Disseminated intravascular coagulation) indicates the formation of blood clots in the body following an injury/surgery, and can eventually lead to serious bleeding. D&C is an abbreviation for dilation and curettage, and is a procedure that removes tissue from inside of the uterus. Dx is an abbreviation commonly used for diagnosis.
The transfer of information such as patient eligibility, payment remittances, claims, claim status, authorizations and referrals are addressed under the HIPAA Administrative Simplification and Compliance Act as electronic
data interchange. Rationale: Data Interchange is defined as the automated transfer of data between a care provider and payer.
A medical assistant is reviewing a patient's encounter that is documented in the medical record prior to completing a CMS-1500 form. She notices that the physician upcoded the encounter. The medical office assistant has the ethical obligation to
debate the code. Rationale: I have to debate the code. I don't have the authority to just down code the visit on my own.
The medical assistant should instruct the patient obtaining a 24-hour urine collection to
discard the first morning sample. Rationale: When doing a 24-hour urine collection it is important the patient knows to discard the first morning sample. This allows the collection to begin with fresh urine to ensure the results of the test are not skewed. The sample should be refrigerated during the collection and all urine should be collected, not just urine excreted after meals. The patient should be instructed to collect all urine during the 24-hour period and not just to catch urine mid-stream.
A patient has refused to pay for a medical procedure that was performed six months ago. The medical procedure was not listed under the patient's schedule of benefits, and she is now fully responsible for all costs. Her account has now been turned over to a collection agency. This scenario is most likely an example of failure of the medical office assistant to properly
explain the non-coverage billing policies. Rationale: Making sure that the office has a policy in place to let your patients know what you expect of them and what they can expect of you. A well-crafted policy will prevent patients from being surprised about their financial obligation when they receive billing for your services.
Forced Vital Capacity is measured by instructing the patient to
forcefully breath air out and continue to exhale for at least 6 seconds. Rationale: Respiratory tests are performed to assess and/or monitor lung function. A spirometer measures how fast and how much air is pushed/forced out of the lungs
The medical assistant is collecting a urine sample on a patient to test for pregnancy. Which of the following is the correct CLIA-waived test?
hCG
Sterilized instruments should be stored
in a temperature controlled environment to prevent moisture accumulation
The physician has instructed the medical assistant to obtain a patient's temperature. Before placing the oral thermometer in the patient's mouth, it is important to ensure the accuracy of the reading by asking the patient if she has
recently ingested hot or cold food or beverages.
The main function of a centrifuge is to -freeze cells for transport. -determine the concentration of glucose. -magnify blood components. -separate cells from plasma.
separate cells from plasma. Rationale: A centrifuge is an essential laboratory instrument that rotates at varying speeds to separate blood components (i.e. separates cells from plasma or serum)
While a new patient is in the examination room with a physician who is explaining treatment options to the patient, the medical assistant is contacting the insurance carrier to discuss the patient's insurance coverage. This scenario is an example of obtaining? -a preauthorization for the patient. -a statement of probable cause. -a disclosure of benefits and eligibility for the patient. -verification of benefits and eligibility for the patient.
verification of benefits and eligibility for the patient. Rationale: It is important to verify what benefits and eligibility the patient has under the insurance policy