According to OSHA guidelines for universal precautions, which of the following types of patients contact would require a medical assistant to wear gloves, a mask, a face shield, and protective apparel. Assisting a provider with the removal of a cyst Collection Procedure: LTD: Performing a Capillary Puncture Version 7 Performing a Capillary Puncture General Guidelines for a Capillary Puncture: Capillary punctures are ideal for small children when only a small volume of blood is needed. They are also advantageous in certain adult populations, such as: those with severe burns, obese patients, those with thrombotic tendencies, and for point-of-care testing when a small volume of blood is needed. Capillary puncture should not be used on patients who are extremely dehydrated or have poor peripheral circulation. Areas of fingers and heels that are cold, swollen, scarred or covered with a rash should be avoided. A warm compress or heel warmer should be used to warm fingers and heels that are cold, or if a capillary blood gas is being drawn, to increase the circulation of blood to the area. All approved lancets utilized at Akron Children’s are for single use and feature automatic retraction of the blade. Heel punctures are performed on infants less than 6 months of age, or on older premature infants who are the approximate size of a full-term 6 month old. For children over 6 months and adults, the finger is punctured. It may be necessary, on occasion, to perform a capillary puncture on the toe of a patient who is severely burned. Follow the same procedure as for performing a finger capillary puncture. Order of Draw for a Capillary Puncture: Proper collection of tubes when performing a capillary puncture is as follows: 1. Gas tubes (must warm the site before collecting the specimen) 2. Slides 3. EDTA - purple top tube 4. Heparin – light or dark green top tube 5. Serum – red top or amber tube with red top Procedure for Capillary Puncture of the Finger: The best site for a finger puncture is just off the center of the finger pad of the 3rd (middle) or 4th (ring) finger of the hand. The sides and the tip of the finger should be avoided. Select the proper approved lancet: The BD Microtainer Contact-Activated Lancet 1.5 mm (lavender) is used for glucometers and the BD Microtainer Contact-Activated Lancet 2.0 mm (blue) is used any time you need more than a drop or two of blood. Prepare the finger by cleaning it with a Chlorhexadine wipe. Allow it to air dry. Grasp the finger, and using a sterile lancet, press firmly against the finger to make a puncture. The first drop contains excess tissue fluid and must be wiped away. Collect the drops of blood into the collection device by gently massaging the finger. Avoid excessive pressure that may squeeze tissue fluid into the drop of blood or cause bruising. When full, cap and then gently invert the collection device 5-10 times to mix the blood. Hold a gauze pad over the puncture site for a short time to stop the bleeding. Dispose of the contaminated materials and lancet in the appropriate waste containers. Place a band-aid on the patient’s finger or have someone continue to hold gauze on the finger. (See “Use of Band-Aids in the Post Phlebotomy policy.) Label the specimens before leaving the patient’s bedside. Procedure for Capillary Puncture of the Heel: A heel puncture is performed on the lateral or medial plantar surface of the foot. The area of the arch should be avoided, as should the posterior curvature of the heel; a puncture in these areas could cause injury to the underlying bone. All babies in the neonatal unit must be warmed before performing a puncture. Begin by selecting the proper, approved lancet, such as: BD Microtainer Quikheel Lancet, 2.5 mm for full-term babies (green) BD Microtainer Quickheel Preemie Lancet, 1.75 mm for neonatal babies (purple) Unistick2 Neonatal 18G, 1.2mm Lancet for neonatal babies less than 1000g (blue) Prepare the heel by cleaning it with a Chlorhexadine wipe. Allow it to air dry. Grasp the foot, and using a sterile lancet, press firmly against the heel to make a puncture. The first drop contains excess tissue fluid and must be wiped away. Collect the drops of blood into the collection device by gently squeezing the foot. Avoid excessive pressure that may squeeze tissue fluid into the drop of blood or cause bruising. When full, cap and then gently invert the collection device 5-10 times to mix the blood. Hold a gauze pad over the puncture site for a couple of minutes to stop the bleeding, and then tie gauze around the foot. (See “Use of Band-Aids in this policy.) The chlorhexidine is a concern for the premature babies in NICU as it can be absorbed through the skin. For all NICU babies, once you have collected the blood, wipe off the area with a sterile saline wipe, to remove the chlorhexidine residue before tying a piece of gauze around the foot. Dispose of the contaminated materials and lancet in the appropriate waste containers. Label the specimens before leaving the patient’s bedside. References Ernst, Dennis J. “Pediatric Pointers.” Center for Phlebotomy Education, Inc. 2004-2008, edited for accuracy 1/08. Ernst, Dennis J. and Catherine Ernst. “Mastering Pediatric Phlebotomy.” Center for Phlebotomy Education, Inc. Adapted from Phlebotomy for Nurses and Nursing Personnel. HealthStar Press, Inc. 2001, updated 1/08. Kiechle, Frederick L. So You’re Going to Collect a Blood Specimen: An Introduction to Phlebotomy, 11th Edition. Northfield, IL: College of American Pathologists, 2005. NCCLS. Procedures and Devices for the Collection of Diagnostic Capillary Blood Specimens; Approved Standard—Sixth Edition. CLSI document H04-A6. Wayne, PA: Clinical and Laboratory Standards Institute; 2008. Proper Handling of an Uncooperative Patient in an Outpatient Setting – Akron Children’s Hospital
CCMA certification exam study guide part C.Send the specimen to the testing laboratory on the same day as the collection a medical assistant is collecting a urine specimen from a patient for a drug screening. which of the following actions should the assistant take to adhere to the chain of custody for this specimen? A medical assistant is preparing to collect a patient's temperature via the tympanic membrane. Which of the following locations should the system please the thermometer? Vigorously dry the patient's skin prior to electrode placement. When preparing a patient for Holter monitoring, which of the following actions should a medical assistant take? Immediately following a procedure. A medical assistant should complete documentation in a patient's medical record at which of the following times? Before the patient is tested. When should the code on glucose cuvettes be compared to the code on the glucometer? Which of the following terms should a medical assistant use to tell a provider that a patient is having discomfort and difficulty breathing? It is a medication that suppresses the cough reflex. A medical assistant is reviewing a provider's instructions as the patient is preparing to leave the office. The provider recommended that the patient purchased an over-the-counter antitussive, but the patient tells the assistant that she does not know wha Which of the following stages of the cardiac cycle on an EKG strip represents ventricular depolarization? a medical assistant is speaking with a patient who has seasonal allergies. which of the following healthcare providers should the assistant identify as being able to make diagnosis and initiate the necessary treatment? A medical assistant is use to the Snellen chart to test and adult patients visual acuity .The assistant should instruct the patient to stand which of the following distance away? A notification letter to a patient about surgery arrangements. which of the following types of written correspondence can be signed by a medical assistant? Place the zero mark of the measuring tape against the infant's forehead. A medical assistant is measuring the circumference of an infant's head. Which of the following actions should the assistant take? Ask the patient to raise his hand when he no longer hears any sound. A medical assistant is checking a patient's hearing using the Rinne test. Which of the following actions should the assistant take? A medical assistant is examining the skin on a patient's forearm where the patients reports developing a rash. The assistant notes the multiple solid elevations that are less than 0.5 (0.2in) in diameter. Which of the following terms should he use to docu List of medication with diagnosis A patient is entitled to which of the following medical records? Make sure the mid point of the patient's arm is at the level of the patient's upper arm. A medical assistant is measuring a patient's blood pressure with an aneroid sphygmomanometer and a stethoscope. Which of the following actions should the assistant make? A medical assistant is preparing to perform a capillary from an older adult patient who has poor circulation in his hands. Which of the following techniques should the assistant use to increase circulation at the collection site? Validate the patient's signature A medical assistant is witnessing a patient sign an informed consent form. Which of the following is the responsibility of the assistant I think as a witness? Which of the following terms describes the body's internal adaptation to change to keep body function in balance? Document the statement in the patient's chart A medical assistant in an acute care facility is checking in the patient who has a deep laceration. The patient tells the assistant that he cannot except blood transfusions due to his regular beliefs. Which of the following actions should the assistant ta A medical assistant is adding information to a patient computerized problem -oriented medical record (POMR). Into which of the following sections of the POMR should assistant enter the patient's health history and laboratory results? An MA is reviewing the laboratory results of the patient who has the Epstein-Barr virus. The assistant should verify identify that this micro-organism can cause which of the following conditions? Rainforest teaching about the frequency of the medication administration An MA is discussing information with the patient about a new medication that the provider prescribed. Which of the following actions should the assistant take? Explain the procedure to the child is simple steps Which of the following techniques should an MA used to put a 7-year old child at ease prior to administering in injection? A medical assistant is caring for a patient who has a body mass index (BMI) 23. This patient should be categorized as which of the following? Assisting a provider with the removal of the cyst According to OSHA guidelines for universal precautions, which of the following types of patients would require a medical assistant to wear gloves, a mask, and protective apparel? Current procedural terminology code a medical assistant is preparing a CMS-1500 insurance claim form for a patient who was treated for a burn injury. which of the following pieces of information is required on the form? A provider request a medical assistant to initiate a referral for a patient to a mental health facility. Which of the following pieces of information is required for the system to include in the initial referral? Insert the tip of the cannula into the patient's nostril Provider ask an MA to administer oxygen to a patient who is experiencing respiratory distress. Which of the following actions should the MA take when administering oxygen to the patient? The primary code in the CPT coding system consist of how many digits? An MA is preparing to draw venous blood samples. The assistant is required by OSHA regulations to wear which of the following pieces of PPE while performing this procedure? Which of the following information should the MA enter into the appointment calendar when scheduling a patient for a skin rash? Which of the following groups of EKG leads are bipolar? A patient arrives at a clinic with a bill for x-rays that were required due to an injury for workers patients place of employment. The patient has private insurance and is eligible for workers compensation. The assistant should recognize that which of the Paid in full by workers compensation An MA is assisting in the treatment of a patient who experienced a chemical. Which of the following steps should the assistant take? Remove any chemical - covered clothing A provider asked an MA to reinforce teaching with a patient about her new diagnosis. Which of the following actions should the assistant take? Document the patient's response to the teaching A medical assistant is reviewing discharge information with a patient who is postoperative following cryosurgery to the cervix. Which of the following statements should the assistant include? you may experience a watery discharge for up to 1 week after your procedure. Which of the following organs is located in the upper right quadrant of the abdomen? A provider is performing a routine rectal examination and a patient. Which of the following supplies should a medical assistant have available during examination? A medical system should recognize which of the following blood pressure readings as indicative of an adult a patient whose blood pressure level is classified as elevated? The parent of a child who has pinworms is asking a medical assistant for more information about his child condition. The assistant should begin by explaining the pinworms are which of the following types of micro - organisms? A medical assistant received a telephone call from a patient who seems anxious about the results of a test. How much of the following responses should the assistant make? I know you were concerned about your test results. We'll call you as soon as the results come in. During a routine venipuncture, The patient becomes Paul and diaphoretic. What condition is small select lead to occur in this patient? A medical assistant needs to remove all living micro organisms from a contaminated towel clamp. Which of the following methods should the system used to cleanse this instrument? The provider orders the medical assistant to prepare a tablespoon of medication for a patient. How many millimeters of medication should the assistant draw up? A medical assistant is asked to assist a provider with an orthopedic examination. Which of the following instruments sure the assistant prepare for the examination? A medical assistant receives a phone call from a parent of a child who has possibly ingested a household cleaner. Which of the following actions should the assistant take? Contact the local poison control center In medical system it has a request to collect a routine CBC for a healthy 10-month-old infant. Which of the following is the most appropriate collection site? When performing diagnostic coding, how many characters are used to provide the highest levels of specify with An ICD-10-CM code? In which of the following locations should a medical assistant place the electrode for lead V4? Fifth intercostal space, left midclavicular line. Which of the following types of appointments systems allows flexibility to allow for the most consistent patient flow? Which of the following actions should the medical assistant take to safeguard the patients protected health information? Log off the computers when not in use A medical assistant is disposing of the syringe and needle's she used to inject a seasonal influenza vaccine. Which of the following actions should the assistant take? Drop the syringe, needle first, into the biohazardous sharps containers A patient request a female provider to perform her examination due to a religious conviction. A female provider is not available. Which of the following is the appropriate response by the medical assistant? Assist the patient in locating a provider to accommodate the patient's needs America assistant is reporting a patient for that occurred in the front lobby of the clinic. What is the purpose of the system preparing an incident report? To avoid future reoccurrences A medical assistant is making a new sign in sheet for the patients who have appointments that day. Which of the following information should the sign in sheet include? A medical assistant is administering cough syrup to a patient. Which of the following actions should the assistant take? View the medication cup at eye level when pouring. In medical system in an outpatient facility is the purring a patient for a venipuncture. Which of the following actions should the system take two confirmed the patients identity? Ask the patient to state her full name and date of birth A medical assistant is preparing for a physical examination when he notices that the patient's eyes are moving back and forth in the consistent, involuntary manner. Which of the following terms should the assistant use when documenting this phone being in A medical assistant has a blood pressure cuff inflated and partially opened the valve to deflate as he listens with a stethoscope.When should he reach the diastolic pressure? When the tapping sound disappears Where should a medical systems play is the electrode for lead V5? On the left anterior axillary line, horizontal two V4 A medical assistant is drawing five blood collection tubes. When should the assistant release the tourniquet? Within one minute of application A medical assistant should follow chain of custody guidelines for which of the following types of laboratory results? In which of the following positions should the medical system in place and 18 month old patient when administering eardrops to the right ear? Right ear facing up with the earlobe pull down and back A medical assistant is collecting data for me patient who is experiencing his stroke. Which of the following many destinations shut the assistant expect to find? A medical assistant is using butterfly needle to obtain a blood sample from a vein in a patient's hand. Which of the following actions should the assistant take? A medical assistant receives a chemical splash in her eyes. Which of the following actions should the assistant take first? Flush the eyes out with tepid water A medical system is reviewing the medical history of a patient who regularly comes in contact with coal and Wood dust. The system should recognize that this patient is at increased risk for the developing which of the following disorders? The parents of a child that has pediculosis is asking a medical assistant for more information about her child's condition. The assistant should begin by explaining that pediculosis is which of the following types of infection? A medical assistant is reinforcing teaching with a patient about the self - administering insulin injections. Which of the following patient statement indicates an understanding of the teaching? I will roll the bottle between my hands before drying the medication The patient reports of getting a bill that includes services she did not receive. Which of the following actions should a medical assistant take to reconcile these charges? Review today's the counters to determine if another patient received the services A medical system is assisting a patient who is obese with insulin injection. Which of the following is the correct angle for the patients Injection? Which of the following should the medical assistant identify as the purpose of the category II code in procedural coding? Tracks provider performance measures A medical system discovers a garbage campfire has started in the break room of the medical office. According to the RACE acronym for emergency response call Mota which of the following actions should the assistant take? Evacuate Staff and patients from the immediate area When performing a first aid procedure to control bleeding of wound, which of the following actions should a medical assistant take? apply layers of sterile gauze The medical system is completing a progress note using the SOAP format. Which of the following patient information should the system include in the assessment section? Which of the following techniques shit the medical assistant use to confirm a patient understanding of insulin administration? Observe the patient as she performs a self - demonstration A medical assistant at a facility receives a call from a patient who is requesting the total cost of a surgical procedure. Which of the following is in the appropriate response by the assistant? Provide the patient with an estimate cost for the procedure A medical assistant is preparing a patient for a procedure to have a mole excised. Which of the following actions should the assistant take? Wipe the site with surgical soap and an anti-septic A medical assistant is talking with an older patient who sustained a foot fracture in the fall. She reports managing most tests at home well but has a difficulty navigating with her crutches and is currently home bound. To which of the following resources A medical assistant is monitoring a patient during a stress test. The patient becomes increasingly short of breath and tachycardic. Abnormalities appear in his EKG rhythm. Which of the following actions should the assistant take first? Discontinue the test. Which of the following is CLIE Dash waved laboratory test? Human chorionic gonadotropin (HCG) test Which of the following EKG already fax is caused by a disconnected electrode and results in the tracing going into the margins of the paper? A medical assistant is preparing 1g/kg of activated charcoal for a patient who is 171 lb. How many grams of charcoal shut the assistant prepare? A medical system is composing business correspondence using a simplified letter style. Which of the following features shit assistant use? A subject line in all capital letters A medical systems is preparing a patient for a physical examination and is helping the patient into the dorsal recumbent position. The system should identify that this position is described by which of the following? Laying face up, what legs bent and feet flat on the table A patient contact the facility to report a burn injury to her right arm. A medical system should identify which of the following pieces of information as necessary with screening for a possible emergency situation? The cost of the patients burn A medical system is transcribing a patient routine prescription for oxycodone. Which of the following methods should the assistant use to process the prescription? Provide the prescription in writing for the patient to take to the pharmacy A medical assistant is caring for a patient who has come in contact with the concrete debris. Upon inspection of the eye, the assistant sees debris On the surface of the sclera. Which of the following actions should the assistant take? Irrigate the ice starting at the inner canthus flowing to the outer canthus Which of the following laboratory values should a medical system immediately report to a patient provider? A medical assistant is reinforcing teaching with the patient who is going home after having extensive suturing to a laceration. Which of the following instructions shit assistant include? Be sure to call your provider if you have a fever over 100�F When assigning a CPT code, which of the following is the purpose of the modifier? Provide additional information or circumstances for a the procedure A medical assistant is administering an intramuscular immunization to a patient. Which of the following actions should the medical assistant take? Cleanse the site in a circular motion from the center outward Which of the following steps for a fingerstick should a medical assistant complete first? Confirm the correct identity of the patient The medical assistant is reviewing a Medicaid claim denial. The system determines that there are charges that exceed the usual, and reasonable fees. Which of the following actions should the medical assistant take? Adjust the patient's account to reflect no unpaid charges and write off the balance As a medical assistant is collecting a blood sample, the patient begins to faint. Which of the following actions should the medical assistant take to help ensure the patient safety? Position the patient flat on her back Which of the following actions should the medical assistant take to verify the quality of the Venipuncture supplies before beginning a blood draw? inspect the integrity of the needles seal In which of the following positions should a medical systems place a patient with obtaining a rectal temperature? A medical assistant Is collecting multiple blood samples from the patient. Which of the following vacuum tubes shit assistant who first? Which of the following methods is used to notify the provider of the denial of the claim by an insurance carrier? A medical assistant is preparing a patient for wearing a Holter monitor. Which of the following is your actions should the assistant include? You should avoid using an electric blanket during the monitor Patient arrives at the clinic with the tick bite or his leg. The provider ask a medical assistant to help remove the tick. Which of the following actions should the medical assistant take? Use tweezers to pull the tick away from the skin slowly A medical assistant is reinforcing teaching with the patient about lifestyle modifications to help regulate his hypertension. Which of the following statements by the patient indicates an understanding of the teaching? I only smoke a half a pack each day, so I'll just cut it out completely. Which of the following actions should the medical assistant take one performing aseptic hand washing? Turn off the faucet with a paper towel A medical assistant is measuring the vital signs of an adult patient. The assistant should identify which of the following blood pressure readings as primary hypertension? A medical system is preparing to apply to several abrasions on a patient's leg. Which of the following supplies should the medical system used to remove the medication from the jar. A medical assistant is preparing a patient for a physical examination . Which of the following steps should the assistant take first? Verified the patient identity A pharmacist calls the clinic to confirm an e-prescription Request to fill a patient's medication order.Which of the following actions should the assistant take? Verify the order with the provider prior to confirming the E-prescription A medical assistant is up serving a patient after administering an antibiotic injection. The patient develops an itchy rash with pinkish call mom raised lesions. Which of the following tons of shit this is the news with documenting this funding in the pat A medical assistant is obtaining information for a patient's medical history and physical examination. The patient reports intermitted episodes of ringing in his ears. Which of the following terms should the medical assistant use when documenting this fin A medical assistant is administering an intradermal injection For allergy testing. Which of the following actions should the assistant take? Locate the area two to three finger widths below the antecubital space. A medical assistant is preparing to use a glucometer to measure a patient's blood glucose level. Which of the following actions should the assistant take? Obtain a blood sample after inserting the test strip into the glucometer A medical assistant is preparing a patient who has intermittent peripheral cyanosis for an examination by the provider. The assistant should understand that healthy profusion of the hands and feet depends on adequate interaction between which of the follo Circulatory and respiratory Prior to a patient's follow-up appointment, which of the following information should the medical assistant report prior to the provider? Recent laboratory results A medical Assistant observes a provider failing to perform hand hygiene before beginning to remove sutures from a patient's hand. The patient's hand later becomes infected. The assistant should identify that which of the following legal torta has occurred When speaking with a patient who has moderate hearing loss and reads lips, which of the following actions should the assistant take to aid in communication with the patient? A medical assistant is reviewing the list of medications a patient reports currently taking. The assistant should recognize that which of the following medications is available in a sublingual form? A medical assistant is educating an older patient on wound care. Which of the following should the assistant do to ensure patient understanding? Have the patient repeat information A medical assistant is preparing a patient who has psoriasis to be examined by the provider. When inspecting the patient's skin lesions, the assistant should expect to observe which of the following characteristics? A medical assistant is checking a patient out of the clinic. In which of the following documents should the assistant locate information about provider referrals or follow-up appointments requests for the patient? Which of the following cell structures is the source of energy for a cell? Which of the following body systems should be evaluated for a diagnosis of pyloric stenosis? A medical assistant is explaining a venipuncture procedure to a patient. Which of the following statements should the assistant make? I'll be collecting a blood sample from you today. There will be a small stick in your arm. Which of the following routes for taking a patient's temperature is the most accurate? A medical assistant is preparing to sanitize contaminated equipment. Which of the following pieces of equipment can a medical assistant sanitize and reuse without needing to disinfect or sterilizing it. A patient at an urgent care facility reports that she vomited and saw blood in the vomitus. Which of the following terms should a medical assistant use to document the patient's report? Hematemesis When unloading an autoclave machine, a medical assistant notices spots on the instruments. The assistant should recognize that this is the result of which of the following? Mineral deposits from tapwater A pulse oximeter can register an artificially low oxygen saturation measurement for a patient who has which of the following conditions? A first-time patient is late arriving to the office which of the following should the medical assistant say first? hello welcome to our office A medical assistant is providing instructions to a patient on how to take an extended-release medication PO. Which of the following statements made by the patient indicates a need for further teaching? I can crush or chew the pill if it is too hard for me to swallow When informed consent is required for a procedure, which of the following steps should occur prior to the patient signing the form? The provider should review alternative procedures with the patient A medical assistant has requested a preauthorization for a patient's referral to a specialist. Which of the following is a reason for the claim submitted by the specialists to be denied? The service is provided after the expiration date Which of the following instructions should a medical assistant provide to a patient regarding transdermal patch use and care? Make sure to rotate patch placement to avoid skin irritation Patient loses consciousness, EKG ventricular fibrillation, what do you do Call for help and begin CPR A medical assistant is performing hand hygiene using an alcohol-based hand rub. The assistant should recognize that which of the following information about alcohol-based hand rubs is correct? Alcohol-based hand rub should not be applied to one hand then rubbed it between both hands At what time of the day will a patient's body temperature be at its lowest? A medical assistant is assisting with the examination of an older adult patient who has a curvature of the thoracic spine. Which of the following terms should the assistant use when documenting this finding in the patient's medical record? |
Which of the following actions should the MA take when performing a capillary puncture on a 10 month old patient?
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