Nursing Fundamentals Quiz
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Questions and Answers

What is the correct reference range for blood glucose levels?

  • 100 to 130 mg/dL
  • 50 to 90 mg/dL
  • 80 to 120 mg/dL
  • 70 to 110 mg/dL (correct)

    • What is the proper timeframe for collecting a newborn screening card?

  • 36 to 48 hours after birth
  • 24 to 36 hours after birth
  • Within 12 to 24 hours after birth
  • Within 24 to 48 hours after birth (correct)

    • In which situation would an interrupted baseline likely occur?

  • Improper electrode placement
  • Patient movement during testing
  • Use of outdated equipment
  • Electrical disconnection or detached electrode (correct)

    • Which statement about the Weber test is accurate?

    <p>It determines if hearing is better in one ear.</p> Signup and view all the answers

    What process involves reviewing a patient's medical record to determine diagnostic and procedure codes for billing?

    <p>Abstracting</p> Signup and view all the answers

    How often should bone density screenings be performed for females aged 65 years and older?

    <p>Every 2 years</p> Signup and view all the answers

    Which vital sign order is correct for obtaining orthostatic vital signs?

    <p>Lying, sitting, then standing</p> Signup and view all the answers

    What is an example of a cultural difference in healthcare settings?

    <p>Inability to trust healthcare workers</p> Signup and view all the answers

    What is the maximum number of refills allowed for Schedule III medications?

    <p>5 refills</p> Signup and view all the answers

    What angle should a subcutaneous injection be administered at?

    <p>45°</p> Signup and view all the answers

    Which statement about absorbable sutures is correct?

    <p>They attach tissues beneath the skin.</p> Signup and view all the answers

    In which phase of wound healing do tissue cells strengthen and form a scar?

    <p>Maturation phase</p> Signup and view all the answers

    What is the correct order for donning personal protective equipment (PPE)?

    <p>Gown, mask, goggles, gloves</p> Signup and view all the answers

    What is a proper method for applying eye ointment?

    <p>Apply from the inner canthus to the outer canthus</p> Signup and view all the answers

    What is the expected heart rate range for a 6-year-old child?

    <p>75 to 120/min</p> Signup and view all the answers

    What gauge needle should be used for an intradermal injection?

    <p>25-gauge</p> Signup and view all the answers

    What condition should lead to a patient avoiding gluten?

    <p>Celiac disease</p> Signup and view all the answers

    What is the normal fasting glucose range?

    <p>70 to 100 mg/dL</p> Signup and view all the answers

    Which of the following is a characteristic of a comminuted fracture?

    <p>The bone results in multiple fragments</p> Signup and view all the answers

    What is the primary purpose of epinephrine in anesthetics?

    <p>To reduce bleeding</p> Signup and view all the answers

    What is the primary purpose of a permanent and easily removable suture?

    <p>Used on skin surfaces</p> Signup and view all the answers

    Which of the following statements about disinfection and sanitization is true?

    <p>Disinfection kills pathogenic organisms, while sanitization reduces microorganisms to a safe level.</p> Signup and view all the answers

    What is the key goal of patient-centered medical homes (PCMHs)?

    <p>To take into consideration a patient's preferences, culture, and health care needs.</p> Signup and view all the answers

    What is the normal range for total cholesterol in mg/dL?

    <p>130 to 200</p> Signup and view all the answers

    In the context of fire extinguishers, which type is appropriate for flammable liquids like grease?

    <p>Class B extinguishers</p> Signup and view all the answers

    Which of the following is NOT a requirement for sterilizing instruments?

    <p>Inverting EDTA tubes 8 to 10 times</p> Signup and view all the answers

    Which of the following accurately describes a preferred provider organization (PPO)?

    <p>Provides a network of contracted providers with discounted fees.</p> Signup and view all the answers

    At what age should annual mammograms begin for female patients?

    <p>40 years</p> Signup and view all the answers

    What is the primary purpose of a 24-hour urine collection?

    <p>For quantitative analysis of components like protein</p> Signup and view all the answers

    What do value-based plans focus on in healthcare reimbursement?

    <p>The quality of service and health outcomes of patients.</p> Signup and view all the answers

    Which of the following describes a normal tympanogram?

    <p>A peak on the graph</p> Signup and view all the answers

    What is the primary characteristic of capitation in managed care?

    <p>Providers receive payments based on the number of enrollees, regardless of service use.</p> Signup and view all the answers

    What adjustment should be made when administering ear drops to a child under the age of 3 years?

    <p>Position the child with the ear facing up and pull the earlobe down and back</p> Signup and view all the answers

    In a point of service (POS) plan, what notable flexibility do patients have?

    <p>Patients can self-refer to specialists without needing an assigned PCP.</p> Signup and view all the answers

    What should be done if a patient presents an unsatisfactory progress report?

    <p>Notify the provider immediately</p> Signup and view all the answers

    Which type of health information exchange (HIE) allows patients to control the usage of their health information?

    <p>Consumer-mediated exchange</p> Signup and view all the answers

    What does Part D of Medicare specifically cover?

    <p>Prescription drugs.</p> Signup and view all the answers

    Which gauge range is typically used for butterfly needles?

    <p>21 to 23-gauge</p> Signup and view all the answers

    Under HIPAA, which entities are defined as covered entities?

    <p>Health care clearinghouses and health insurance plans.</p> Signup and view all the answers

    What is characterized by a flat line on an EKG?

    <p>Ventricular fibrillation</p> Signup and view all the answers

    What is a major consequence of using outdated or incorrect diagnostic codes?

    <p>Reduced claim reimbursement</p> Signup and view all the answers

    How should the area be prepared before bandaging?

    <p>Clean and dry the area</p> Signup and view all the answers

    What is the general guideline for HbA1c levels to control diabetes?

    <p>Under 5.7%</p> Signup and view all the answers

    How should handwashing be performed effectively?

    <p>Rub hands together for 15 to 20 seconds</p> Signup and view all the answers

    What is the significance of a somatic tremor on an EKG?

    <p>Creates irregular spikes and artifacts</p> Signup and view all the answers

    What degree angle is typically used for administering an intramuscular injection?

    <p>90 degrees</p> Signup and view all the answers

    Which of the following amino acids cannot be produced by the body?

    <p>Essential amino acids</p> Signup and view all the answers

    How are all digestible carbohydrates ultimately processed in the body?

    <p>Converted into glucose</p> Signup and view all the answers

    Which type of fat is liquid at room temperature and considered healthier?

    <p>Unsaturated fats</p> Signup and view all the answers

    What is the primary role of Vitamin D in the human body?

    <p>Calcium absorption</p> Signup and view all the answers

    Which vitamin is primarily responsible for the health of the skin and night vision?

    <p>Vitamin A</p> Signup and view all the answers

    What is the main ingredient in aspirin that comes from natural sources?

    <p>Willow bark</p> Signup and view all the answers

    Which organelle is known as the powerhouse of the cell?

    <p>Mitochondria</p> Signup and view all the answers

    What condition results in a gradual decline in kidney function, requiring sodium and phosphorus restriction?

    <p>Chronic kidney disease (CKD)</p> Signup and view all the answers

    Which vitamin is associated with peripheral neuropathy if taken in excess?

    <p>Vitamin B6</p> Signup and view all the answers

    What is the function of the nuclear membrane?

    <p>Protects the genetic material</p> Signup and view all the answers

    What condition is characterized by an intolerance to gluten?

    <p>Celiac disease</p> Signup and view all the answers

    Which type of carbohydrates includes foods like pasta and rice?

    <p>Complex carbohydrates</p> Signup and view all the answers

    Which substance is known as a fatty acid byproduct and raises LDL cholesterol levels?

    <p>Trans fat</p> Signup and view all the answers

    Which set of medications is classified as anticholinergics and is used to relieve smooth muscle spasms?

    <p>Ipratropium, dicyclomine, hyoscyamine</p> Signup and view all the answers

    What is the main purpose of an anxiolytic medication?

    <p>To reduce anxiety symptoms</p> Signup and view all the answers

    Which of the following medications is categorized as a Schedule II controlled substance?

    <p>Oxycodone</p> Signup and view all the answers

    Which of the following is a contraindication for taking duloxetine?

    <p>Hepatitis</p> Signup and view all the answers

    What is the function of anticoagulants in medical treatment?

    <p>To prevent blood clotting</p> Signup and view all the answers

    Which of the following substances is known to have a high potential for abuse and is classified as a Schedule I drug?

    <p>LSD</p> Signup and view all the answers

    Which antihypertensive medication is known for blocking angiotensin II?

    <p>Lisinopril</p> Signup and view all the answers

    What is the primary use of proton pump inhibitors like esomeprazole?

    <p>To treat peptic ulcers and GERD</p> Signup and view all the answers

    Which of the following medications is included in the anti-migraine agents category?

    <p>Sumatriptan</p> Signup and view all the answers

    What is a common side effect of antidepressants that patients should be informed about?

    <p>Weight gain</p> Signup and view all the answers

    Which medications are used as oral hypoglycemics?

    <p>Metformin, glyburide, pioglitazone</p> Signup and view all the answers

    What type of medication is used primarily to treat influenza?

    <p>Antivirals</p> Signup and view all the answers

    What is the common route of administration for aerosols?

    <p>Inhalation</p> Signup and view all the answers

    Which medication is known for its use as an anti-inflammatory?

    <p>Aspirin</p> Signup and view all the answers

    What does a peak flow rating of 80% or better indicate about a patient's health condition?

    <p>Well-controlled condition</p> Signup and view all the answers

    What is the primary function of lysosomes within a cell?

    <p>Digest waste materials</p> Signup and view all the answers

    Which of the following is NOT a method for requesting referrals?

    <p>Through a clearinghouse</p> Signup and view all the answers

    Which type of bone is primarily flat or slightly curved and provides surface area?

    <p>Flat bones</p> Signup and view all the answers

    What is the primary role of interoperability in healthcare?

    <p>To provide timely access to patient health records</p> Signup and view all the answers

    During which psychosocial crisis do toddlers develop confidence in their abilities?

    <p>Autonomy vs. Shame and Doubt</p> Signup and view all the answers

    Which Medicare plan is responsible for covering durable medical equipment (DME) services?

    <p>Part B</p> Signup and view all the answers

    What is the key role of tendons in the musculoskeletal system?

    <p>Join muscles to bones</p> Signup and view all the answers

    What is the correct angle for inserting a needle during venipuncture?

    <p>15 degrees</p> Signup and view all the answers

    Which statement best describes the function of the Golgi apparatus in a cell?

    <p>Packages and ships proteins and lipids</p> Signup and view all the answers

    What instrument should be prepared for an orthopedic examination to measure joint range of motion?

    <p>Goniometer</p> Signup and view all the answers

    What action should a medical assistant take if they notice spots on surgical instruments?

    <p>Recognize it as mineral deposits</p> Signup and view all the answers

    Which term is used for the transformation of anxiety into a physical symptom with no identifiable cause?

    <p>Conversion</p> Signup and view all the answers

    What is the function of cilia in cellular structures?

    <p>Assist in moving substances along the cell surface</p> Signup and view all the answers

    Which type of pulse is characterized by an extremely strong and full feeling?

    <p>Bounding pulse</p> Signup and view all the answers

    Which billing method segments accounts based on the initial letter of the last name?

    <p>Cycle billing</p> Signup and view all the answers

    What is the primary difference between red and yellow bone marrow?

    <p>Red marrow produces blood cells, while yellow marrow stores fat</p> Signup and view all the answers

    What is NOT a recognized stage of grief?

    <p>Repression</p> Signup and view all the answers

    Which statement should a medical assistant avoid using when documenting in the electronic record, according to The Joint Commission's 'Do Not Use' list?

    <p>QD for 'daily'</p> Signup and view all the answers

    Which term refers to a patient displaying indifference and lack of interest?

    <p>Apathy</p> Signup and view all the answers

    Which type of connective tissue provides protection and form for organs?

    <p>Cartilage</p> Signup and view all the answers

    What is the most common method of identification as stressed by The Joint Commission?

    <p>Full name and date of birth</p> Signup and view all the answers

    Which medical abbreviation represents 'every day'?

    <p>q.d.</p> Signup and view all the answers

    What role do centrioles play in cell reproduction?

    <p>Distribute DNA to new cells</p> Signup and view all the answers

    Which response best defines the term 'sublimation' in psychology?

    <p>Rechanneling unacceptable urges into constructive activities</p> Signup and view all the answers

    What size of suture might be used for delicate areas such as the face and neck?

    <p>5-0 to 6-0</p> Signup and view all the answers

    Which factor qualifies an item as Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS)?

    <p>It must be used in the home.</p> Signup and view all the answers

    In which category would a CPR procedure be classified regarding PPE requirements?

    <p>Category II</p> Signup and view all the answers

    How often should an emergency kit be checked for readiness?

    <p>Once a month</p> Signup and view all the answers

    What impact does crossing the legs have on blood pressure readings?

    <p>It can increase systolic blood pressure by 2 to 8 mm Hg.</p> Signup and view all the answers

    What does a decrease in blood volume generally lead to?

    <p>A decrease in blood pressure.</p> Signup and view all the answers

    What is the primary purpose of sanitization in a clinical setting?

    <p>To reduce the number of microorganisms</p> Signup and view all the answers

    What is the correct body temperature for a newborn when measured axillary?

    <p>98.2°F</p> Signup and view all the answers

    What is an acceptable method for disposing of contaminated gauze?

    <p>Biohazard waste bag</p> Signup and view all the answers

    What is phase III of the Korotkoff sounds characterized by?

    <p>Sharp tapping sounds as blood surges.</p> Signup and view all the answers

    Which disinfectant is considered a high-level disinfectant?

    <p>Cidex OPA</p> Signup and view all the answers

    What is the recommended temperature for the autoclave during sterilization?

    <p>270°F</p> Signup and view all the answers

    How should you convert Celsius to Fahrenheit?

    <p>° F = (° C × 1.8) + 32</p> Signup and view all the answers

    What should you do with used or unsterile needles to prevent injury?

    <p>Dispose of them in a sharps waste container immediately.</p> Signup and view all the answers

    Which item might require prior authorization before being reimbursed under DMEPOS?

    <p>Power wheelchairs</p> Signup and view all the answers

    What is the primary indicator that sterilization has been successfully achieved in the autoclave?

    <p>Change of color on autoclave tape</p> Signup and view all the answers

    What range defines the normal pulse rate for school-age children?

    <p>75 to 118</p> Signup and view all the answers

    Which medication is primarily used for treating bradycardia?

    <p>Atropine</p> Signup and view all the answers

    What is the main purpose of the computerized provider order entry (CPOE) system?

    <p>To allow healthcare providers to enter orders electronically.</p> Signup and view all the answers

    What characteristic defines nonabsorbable sutures?

    <p>They remain in place to be removed after the incision heals.</p> Signup and view all the answers

    Which of the following is NOT considered a method of disinfection?

    <p>Washing with soap and water</p> Signup and view all the answers

    What score on the adult hearing test indicates hearing is within normal limits?

    <p>Below 25 decibels</p> Signup and view all the answers

    How should the auricle be positioned for administering ear drops to an adult?

    <p>Pulled outward and upward.</p> Signup and view all the answers

    For which condition is morphine primarily used?

    <p>Pain management</p> Signup and view all the answers

    The function of a clinical decision support system (CDSS) in a CPOE is primarily to:

    <p>Check for medication interactions and dosage errors.</p> Signup and view all the answers

    What is the primary characteristic of rales during auscultation?

    <p>Clicking, bubbling, or rattling sounds.</p> Signup and view all the answers

    What is the proper temperature range for storing refrigerated medications?

    <p>2˚ to 8˚C</p> Signup and view all the answers

    What effect does peripheral resistance have on blood pressure?

    <p>It increases blood pressure due to narrower blood vessel lumens.</p> Signup and view all the answers

    Study Notes

    Blood Glucose Levels

    • Reference range: 70 to 110 mg/dL

    Potassium Levels

    • Reference range: 3.5 to 5.1 mEq/L

    Hematocrit Levels

    • Male: 42% to 52%
    • Female: 36% to 45%

    Hemoglobin Levels

    • Male: 15 to 17 g/dL
    • Female: 12 to 16 g/dL

    Newborn Screening

    • Collection time frame: 24 to 48 hours after birth

    CPOE (Computerized Provider Order Entry)

    • Required for entering hospital orders

    Pap Test Specimen Collection

    • Method: Cytobrush

    EKG Baseline Issues

    • Wandering baseline: Poorly attached electrodes
    • Interrupted baseline: Electrical disconnection or detached electrode

    Ancillary Services

    • Provide diagnostic confirmation (e.g., pathology, radiology)

    Patient Ledger Adjustments

    • Post adjustments concurrently with payment postings

    Urine Specimen Handling

    • Send urine specimen and requisition to the lab on the same day
    • Record specimen temperature within 4 minutes of collection

    Weber Test Procedure

    • Instruct the patient to report if one ear hears the vibration louder.
    • Used to assess hearing lateralization

    Rinne Test Procedure

    • Place the tuning fork on the mastoid until the sound is no longer heard. Raise tuning fork.

    Cultural Differences

    • Patient distrust of healthcare workers can be a cultural difference

    Bandaging Procedure

    • Observe site for 5-10 seconds after bandaging to check for leakage

    Orthostatic Vital Signs

    • Order: Lying, sitting, then standing to take orthostatic vital signs

    Medical Billing Processes

    • Abstracting: Reviews medical records to determine billing codes.
    • Auditing: Checks claims for completeness.
    • Reviewing: Verifies correct diagnosis and procedure codes for reimbursement.

    Health Records

    • Complete medical history and physical examination = patient health record

    Cancer Screening Guidelines

    • Females (65+): Bone density screenings every 2 years.
    • Patients (55-80): Lung cancer screenings (based on criteria).
    • Patients (45-75): Colonoscopies every 3 years.
    • Males (50+): Prostate cancer screenings.

    Eye Ointment Application

    • Apply from inner to outer canthus (not above the eye)

    Specimen Labeling

    • Manually record time and initials on the specimen after venipuncture

    Child's Heart Rate

    • Expected range: 75 to 120 bpm (6-year-old child)

    Body Systems

    • Endocrine and nervous systems work together to maintain homeostasis

    Personal Protective Equipment (PPE)

    • Donning order: Gown, mask, goggles, gloves (CDC guidelines)

    Fracture Types

    • Comminuted fracture: Multiple bone fragments

    Anesthetic Use

    • Epinephrine use: Reduces bleeding and prolongs anesthetic effect (important for laceration repair)

    Injection Procedures

    • Intradermal: 25-gauge needle, 15° angle, anterior forearm (not for influenza)
    • Subcutaneous: 27-gauge needle, 45° angle, abdominal region (not for influenza)
    • Intramuscular: 18-gauge needle, 90° angle

    Medication Vials

    • Multidose vials: Good for 28 days after opening (unless manufacturer states otherwise)

    Eye Instillation

    • Patient instruction: Look towards ceiling while keeping both eyes open

    Insulin Injection

    • Subcutaneous insulin: 45° angle into adipose tissue

    Sterility Maintenance

    • Mayo stand: At least 12 inches from body to maintain sterility.
    • Sterile instrument packet: 1-inch edge is nonsterile

    Sutures

    • Absorbable: Attach tissues beneath the skin (5-0/6-0 for face/neck)
    • Nonabsorbable: Used on skin surfaces, easily removable (5-0/6-0 for face/neck)

    Wound Complications

    • Dehiscence: Wound edges separate
    • Evisceration: Wound edges separate, organs protrude

    Wound Healing Phases

    • Proliferative (3-21 days): Fibrin threads pull edges together
    • Maturation (21 days-2 years): Tissue strengthening, scar formation

    Colposcopy

    • Examine vagina and cervix following an abnormal Pap smear

    Staple Removal

    • Hold the staple remover's lower tip under the staple and squeeze handles together to bend and remove staples.

    Complete Blood Count (CBC) Ranges

    • White blood cell count: 4,500 to 11,000/mm³
    • Red blood cell count (Male): 4.5 to 5.9 million/mm³
    • Red blood cell count (Female): 4 to 5.5 million/mm³
    • Platelet count: 150,000 to 400,000/mm³
    • Granulocyte ratio: 50% to 70% (of all white blood cells)
    • MCV: 80 to 95
    • Hemoglobin (HGB):
      • Male: 13.5 to 17.5 g/dL
      • Female: 12 to 16 g/dL
    • Hematocrit (HCT)
      • Male: 41% to 53%
      • Female: 36% to 46%
    • Glucose (fasting): 70 to 100 mg/dL
    • Hemoglobin A1c: Below 5.7%
    • Total Cholesterol: 130 to 200 mg/dL
    • LDL: Less than 100 mg/dL
    • HDL: Greater than 60 mg/dL
    • Triglycerides: 40 to 150 mg/dL

    Hearing Tests

    • Adults with normal hearing can hear tones at 25 decibels.
    • Abnormal tympanograms appear as flat lines on a graph.

    Skin Testing

    • Discontinue antihistamines 3 days before skin testing.

    Medication Scheduling

    • Schedule II: No refills
    • Schedule III: 5 refills within 6 months
    • Schedule IV: 5 refills within 6 months
    • Schedule V: Yearly refills

    Medication Administration Routes

    • Lozenges: Oral administration

    Medication Terminology

    • Contraindication: Makes treatment inadvisable or dangerous
    • Adverse effect: Unintended, harmful effect
    • Adverse reaction: Unexpected, harmful, potentially dangerous or fatal effect
    • Side effect: Unintended, undesirable, but typically harmless

    Patient Care Models

    • PCMH: PCP coordinates patient care
    • Managed care: Umbrella term for plans that provide care for preset payments.
    • Home health: Specific types of care provided in the home

    Dietary Restrictions

    • Celiac disease: Avoid gluten
    • Chronic kidney disease: Limit phosphorus/potassium intake, sodium to < 2,300 mg/day

    Anorexia Signs

    • Significant (at least 15%) weight loss

    COPD Symptoms

    • Tachycardia
    • Weight gain
    • Orthopnea
    • Hypertension

    Patient Verification

    • Verify patient address at each visit

    Neurological Disorders

    • ALS: Lou Gehrig's disease
    • Transient ischemic attack: Mini-strokes
    • Trendelenburg position: Used in surgical and critical care (shock/hypotension)

    DMEPOS Items

    • CMS establishes a list of DMEPOS items on the Master List

    Infection Control

    • Healthcare worker must be fever-free for 24 hours without fever-reducing medications and facilities must train staff annually and on hiring.
    • Exposure control plans must be updated annually and when exposure procedures change.
    • Sterilization: Submerge instruments in chemical bath for 8 hours (closed lid)

    Handwashing Technique

    • Rub hands together vigorously for 15-20 seconds.

    Antiseptic/Disinfectant Use

    • Disinfection: Kills pathogenic organisms
    • Sanitization: Reduces microorganisms to safe levels

    Disinfection Levels

    • Low-level: Hydrogen peroxide
    • Intermediate-level: Isopropyl alcohol
    • High-level: Cidex OPA

    Autoclave Procedure

    • Recommended temperature: 250°-270°F
    • Unwrapped items: 20 minutes
    • Wrapped items: 30 minutes

    Sharps Disposal

    • Used/unsterile needles: Dispose in sharps container immediately.

    Specimen Handling/Storage

    • Serum specimens: Allow to clot 30 minutes before centrifuging
    • EDTA tubes: Invert 8-10 times
    • Serum separator gel: Tiger-top tubes
    • Clot activator: Red-top tubes
    • Lithium heparin: Green-top tubes

    Arrhythmias

    • Atrial fibrillation: Irregular rhythm, absence of P waves, narrow QRS complexes
    • Ventricular fibrillation: No discernable waves

    EKG Interference

    • 60-cycle interference: Regular spikes in tracing (caused by nearby electrical equipment)

    Eye Exam Color-Plate Test

    • Ishihara test: Identifies color deficiencies (red-green/blue-yellow most common)

    Cancer Screening (additional)

    • Cervical cancer screening (Pap test) for women (21-29) every 3 years.
    • Cervical cancer screening (Pap test) for women (30-65) every 3 years, or every 5 years with HPV test.

    Hearing Tests (cont)

    • Adults: Normal hearing thresholds below 25 decibels
    • Children: Normal hearing thresholds below 15 decibels

    Peak Flow Meter Use

    • 80% or better = well-controlled respiratory condition.

    Scheduling & Patient Encounters

    • Cluster scheduling: Groups patients with common medical needs
    • Encounter form (superbill): Includes visit reasons and actions performed.
    • Referrals: Requested in writing, by phone, or on third-party payer website

    Health Information Technology (IT)

    • Interoperability: Enables access to patient records for timely care.
    • Directed exchange: Sends and receives health information electronically.
    • Query-based exchange: Finds or requests information from other providers.
    • Consumer-mediated exchange: Patients control the use of their health information.

    Medicare/Medicaid/Insurance and Billing

    • CMS: Federal agency overseeing Medicare and Medicaid programs
    • Clearinghouses: Accept claim data, edit, and submit to third-party payers.
    • Cycle billing: Bills accounts in segments throughout the month.

    Medical Supplies

    • Par level: Appropriate stock levels determined by the health care team.

    Additional Patient Information to Record

    • Allergies, names and dosage of the medication, route, when it should be administered and the name of the prescriber ( MAR)

    Health Care Delivery Services

    • PCMH: PCP coordinates treatment for patients
    • Managed care: Insurers coordinate care.
    • Value-based insurance: Reimbursement depends on patient outcomes and service quality.
    • Capitation: Monthly payments to providers based on patient enrollment numbers.
    • HMOs: Provide coverage for health care services for a set fee and typically requires referral from a PCP.
    • PPO (Preferred Provider Organization): Network of physicians, etc., offering contracted/discounted health care. A PPO member doesn't need a PCP and can see any provider in their network or out-of-network.
    • POS (Point of Service): POS plans allow patient flexibility, with referrals to specialists without a PCP.
    • Fee-for-service models: Paid for services performed
    • Value-based models: Focused on value to the patient

    Types of Providers

    • GPs General practitioners

    Types of Health Care Services

    • Ancillary services
      • Urgent care
      • Lab service
      • Diagnostic imaging
      • Occupational therapy
      • Physical therapy
    • Complementary therapies:
      • Energy therapy
      • Chiropractic care
      • Dietary counseling
      • Acupuncture

    Medication Classification

    • Classification of medications
    • Analgesics
    • Antacids/Anti-ulcer
    • Antibiotics
    • Anticholinergics
    • Anticoagulants
    • Anticonvulsants
    • Antidepressants
    • Antidiarrheals
    • Antiemetics
    • Antifungals
    • Antihistamines
    • Antihypertensives
    • Anti-inflammatories
    • Antilipemics
    • Antimigraine agents
    • Anti-osteoporosis agents
    • Antipsychotics
    • Antipyretics
    • Skeletal/muscle relaxants
    • Antitussives/expectorants
    • Antivirals
    • Anxiolytics (anti-anxiety)
    • Bronchodilators
    • Contraceptives
    • Decongestants
    • Diuretics
    • Hormone replacement
    • Laxatives/stool softeners
    • Oral hypoglycemics
    • Sedative-hypnotics

    Controlled Substances

    • Schedule I: High potential for abuse (e.g., heroin, LSD, marijuana)
    • Schedule II: High potential for abuse (e.g., opioids, amphetamines)
    • Schedule III: Moderate to low potential for abuse (e.g., anabolic steroids, acetaminophen with codeine)
    • Schedule IV: Low potential for abuse (e.g., benzodiazepines, tramadol)
    • Schedule V: Limited quantities of narcotics (e.g., cough medicine with codeine)

    Medication Interactions/Contraindications

    • Medications toxic to the liver:
      • Acetaminophen
      • Phenytoin
      • Fluconazole
      • Bupropion
      • Penicillin
      • Erythromycin
      • Rifampin
      • Ritonavir
      • Lisinopril
      • Losartan
    • MAOIs (Monoamine Oxidase Inhibitors): Interact dangerously with tyramine-containing foods and other antidepressants.

    Medication Administration Forms

    • Elixirs
    • Emulsions
    • Foams
    • Liniments
    • Lozenges
    • Patches
    • Powders
    • Solutions
    • Sprays
    • Steam
    • Suppositories
    • Suspensions
    • Syrups
    • Tinctures

    Medication Administration/Storage

    • Check the medication and prescription before administering.
    • Check the medication and prescription when preparing.
    • Recheck medication before re-stocking bottle.
    • Liver and kidney function influence medication metabolism and excretion.
    • Medication dosages may need to be adjusted for infants and older adults.
    • Half-lives of medications must be known so medication is not given too late.
    • Store refrigerated medications between 2-8°C (35°F – 46°F)

    Medication Dosing Intervals

    • Half-lives help determine dosing intervals
    • Therapeutic level must be maintained to ensure medication effectiveness.

    Body Composition

    • Human body: 50-80% water.
    • Recommended daily water intake: 2 to 3 liters (64 to 96 fluid ounces)

    Amino Acids

    • Types of amino acids:
      • Essential: Body cannot produce
      • Nonessential: Body makes from essential amino acids
      • Conditional: Not usually essential, become essential during stress or illness

    Carbohydrates

    • Organic compounds made of carbon, oxygen, and hydrogen (sugars).
    • Types of carbohydrates:
      • Simple sugars
      • Complex carbohydrates
    • Digestion converts carbohydrates into glucose stored as glycogen.

    Fats (Lipids)

    • Use as energy source when glucose is low.
    • Types of fats:
      • Unsaturated (monounsaturated, polyunsaturated): Less dense, less likely to raise cholesterol.
      • Saturated: Solid at room temperature, raise LDL cholesterol.
      • Trans fat: Byproduct of hydrogenation, raises LDL cholesterol

    Vitamins

    • Body cannot produce/doesn't make enough of Vitamin D, A, and B3. So must be included in your diet.
    • Types of vitamins:
      • Fat-soluble: Vitamins A, D, E, K
      • Water-soluble: Vitamins B1, B2, B3, B6, folate, B12, pantothenic acid, biotin, C
    • Vitamin functions and potential toxicity

    Herbal Supplements

    • Examples of herbal supplements, their uses, and potential side effects (St. John's wort, black cohosh, melatonin, willow bark, glucosamine sulfate, ginkgo biloba)

    Chronic Kidney Disease (CKD)

    • CKD is a gradual decline in kidney function.
    • Diet restrictions for CKD: Limit sodium and phosphorus intake.

    Celiac Disease

    • Celiac disease: Autoimmune disorder, patients cannot consume gluten from wheat, barley, or rye.

    Cell Structure and Components

    • Plasma membrane: Separates internal cell components from the environment.
    • Cytoplasm: Gel-like fluid
    • Nucleus: Genetic material (DNA), regulates cell activity
    • Nuclear membrane: Surrounds and protects nucleus.
    • Nucleolus: Creates RNA and ribosomes
    • Mitochondria: Produces energy (ATP)
    • Ribosomes: Protein synthesis
    • Endoplasmic reticulum (rough and smooth): Transport and synthesis of materials
    • Golgi apparatus: Modifies and packages proteins/lipids
    • Lysosomes: Digestive sacs
    • Cytoskeleton: Maintains cell shape and structure.
    • Centrioles: Cell reproduction
    • Cilia: Movement of materials on cell surface
    • Flagella: Movement of the cell

    Anatomy and Physiology

    • Adult skeleton: Axial (80 bones) and appendicular (126 bones)
    • Ligaments: Connect bone to bone.
    • Tendons: Connect muscle to bone
    • Connective tissue/cartilage: Supports, protects, and forms tissues/organs
    • Types of bones: Long, short, flat, irregular, sesamoid.
    • Bone Marrow: Red(blood cell development), and Yellow.
    • Skeletal muscle: Voluntary muscle
    • Smooth muscle: Involuntary muscle

    Mental Health Conditions

    • Common mental health disorders -Apathy, Compensation, Conversion, Displacement, Intellectualization, Introjection, Reaction formation, Regression, Repression, Sublimation, Suppression.
    • Stages of grief: Denial, Anger, Bargaining, Depression, Acceptance

    Medical Record Verification

    • Verify name, address, and other identifiers to ensure accuracy.
    • Medication reconciliation: Matching current medications to the patient's medical record
    • Two methods of identification used to verify patient identity

    Vital Sign Measurement

    • Auscultation: Listening with a stethoscope
    • Blood pressure measurement: Correct cuff size, position, and patient posture
    • Factors affecting blood pressure results (e.g., arm position, leg crossing).
    • Peripheral resistance and blood volume effects on blood pressure
    • Pulse rates in different age groups (adolescents, children, toddlers, infants)

    Respiratory Assessment

    • Sounds: Rales (crackles), rhonchi (wheezing) - causes associated with conditions
    • Respiratory rates in different age groups

    Temperature Measurement

    • Temperature measurements in different age groups (newborns, 1 year, 6 to adult, older adults)
    • Measurement units
    • Conversions between Fahrenheit and Celsius

    Pulse Measurement

    • Pulse rate in different age groups

    Ear Drop Administration

    • Technique for administration to infants and children vs adults

    Injection Techniques

    • Subcutaneous injections (45°)
    • Intradermal injections (10-15°)

    Medication Storage Practices

    • Refrigerator and freezer maintenance( temperature needs to be checked daily and logged.)
    • Medications in different temperatures for storage

    Medication Administration Record (MAR)

    • Requirements for recording medication administration
    • Initialing or signing the MAR after administration.

    Electronic Prescription Transmission

    • State and federal regulations for e-prescribing.
    • DEA Electronic Prescription for Controlled Substances (EPCS)

    Specialty Pharmacy

    • Role and services provided.

    Computerized Provider Order Entry (CPOE)

    • Role and benefits of the electronic order entry system
    • Clinical decision support system (CDSS)

    Telehealth/Telemedicine

    • Scope of telehealth services, including non-clinical services
    • Use of draping materials and ensuring sterility.

    Sterile Field Techniques

    • Opening sterile packaging: Proper procedure for opening sterile packages.
    • Sterile field: Identifying sterile and non-sterile surfaces

    Sutures

    • Absorbable sutures: Used to attach tissues beneath the skin, generally reabsorb in 5-20 days
    • Nonabsorbable sutures: Used on skin surfaces (removed after healing, used for face/neck 5-0, 6-0 sutures. Heavier sutures for chest/abdomen)

    Wound Closure

    • Surgical staples: Close wounds under high tension (trunk, extremities, scalp)

    Medical Emergencies & Treatments

    • Emergencies kits: Checked regularly.
    • Epinephrine auto-injector: Anaphylactic shock
    • Naloxone: Opioid overdose
    • Morphine: Pain
    • Nitroglycerin: Chest pain
    • Albuterol: Breathing difficulty
    • Lidocaine: Local pain relief
    • Atropine: Bradycardia
    • Saline IV: Dehydration
    • Prochlorperazine: Nausea/vomiting

    Durable Medical Equipment (DME)

    • Items considered DMEPOS: Durable, home use, life expectancy is at least 3 years.
    • Prior authorization process for DMEPOS items.

    Disease Transmission

    • Chain of infection: Infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, susceptible host.
    • Exposure categorization: Tasks (minor procedures, CPR, vital signs, etc.)

    Instrument Cleaning and Sterilization

    • Procedures for sanitizing and disinfecting equipment.
    • Different disinfectant levels
    • Autoclave procedures: Temperatures and times for sterilization.

    Quality Control and Quality Assurance

    • Measures performed for proper lab and other health care services.

    Patient Assessment (additional)

    • Near and far vision screening: Use of Jaeger eye charts
    • Color deficiency test: Ishihara test

    ###Patient Registration and Scheduling

    • New Patient check-in forms: Contain patient's demographic information
    • Cluster scheduling: Grouping patients with similar medical needs.
    • Encounter forms/Superbills: Include reason for visit and actions performed.

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    Description

    Test your knowledge on essential nursing practices and protocols, including blood glucose levels, patient screenings, and wound care. This quiz covers critical topics like medication refills, personal protective equipment, and cultural differences in healthcare. Perfect for nursing students and professionals looking to refresh their skills.

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