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CPSS Exam( 25 Sets) Questions with Verified Answers,100% CORRECT
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CPSS ophthalmology Exam 184 Questions with Verified Answers,100% CORRECT
CPSS ophthalmology Exam 184 Questions with Verified Answers OD - CORRECT ANSWER right eye OS - CORRECT ANSWER left eye OU - CORRECT ANSWER both ... [Show More] eyes QD - CORRECT ANSWER once a day BID - CORRECT ANSWER twice a day TID - CORRECT ANSWER three times a day QID - CORRECT ANSWER four times a day QHS - CORRECT ANSWER use at night QAM - CORRECT ANSWER use in the morning PRN - CORRECT ANSWER as needed CC - CORRECT ANSWER chief complaint GTT - CORRECT ANSWER drops UNG - CORRECT ANSWER ointment PO - CORRECT ANSWER by mouth NPO - CORRECT ANSWER nothing by mouth HPI - CORRECT ANSWER history of present illness STAT - CORRECT ANSWER urgent IOT/IOP - CORRECT ANSWER intraocular tension/ intraocular pressure RX - CORRECT ANSWER prescription what percentage of our message is contained in the words we use - CORRECT ANSWER 7% the three states of mind are - CORRECT ANSWER parent, child, adult contains recordings of authority that we heard as a child - CORRECT ANSWER parent state of mind contains recordings of feelings - CORRECT ANSWER child state of mind lets us choose how we act - CORRECT ANSWER adult state of mind in our adult state of mind we choose to ________, _________, or _______ a critical comment - CORRECT ANSWER accept, reject of modify describe osha's primary goal - CORRECT ANSWER protects employees in the work place what does osha stand for - CORRECT ANSWER occupational safety and health administration what does hipaa stand for - CORRECT ANSWER health insurance portability and accountability act is the privacy rule the first national regulation on medical privacy and health info management - CORRECT ANSWER yes an exempt employee is paid - CORRECT ANSWER salary a non-exempt employee is paid - CORRECT ANSWER an hourly wadge administration department - CORRECT ANSWER coordinates business function as well as staff oversight and management which part of the patient exam tests for gross measurement of peripheral vision , range of motion and function of eye muscles and evaluates size shape and reaction of pupils - CORRECT ANSWER external exam numerical value associated with the smallest objects a patient can see on a specific chart at a specific distance is called - CORRECT ANSWER visual acuity the lids, eyelashes, conjunctiva, cornea iris, lens and vitreous are evaluated during which portion of the exam - CORRECT ANSWER slit lamp examination when is a pt asked for their chief complaint and symptoms of their current problem - CORRECT ANSWER history the exam of the back of the eye - CORRECT ANSWER fundus exam portion of exam that determines best lens correction of the pt may result in a glasses prescription - CORRECT ANSWER refraction in order for the dr to see in the back of the eye the pt is given drops to make the pupil larger - CORRECT ANSWER dilation measurement documenting pt's current spectacle prescription is - CORRECT ANSWER lensometry intraocular pressure measurement - CORRECT ANSWER tonometry maps the curvature of the cornea - CORRECT ANSWER corneal topography evaluates the angle structures in the eye that allow for fluid transfer - CORRECT ANSWER gonioscopy allows for viewing of the appearance of retinal blood vesseles as dye injected into the pt's arm flows through the blood vessels - CORRECT ANSWER fluorescein angiography tests the pt's peripheral vision - CORRECT ANSWER visual field measures the quantity of tear secretion using a special paper strip - CORRECT ANSWER dry eye test (schirmers) measures the thickness of the cornea - CORRECT ANSWER pachymetry measures the length of the eye to assist in calculating the power of and intraocular lens to be used in cataract surgery - CORRECT ANSWER ultrasonography (biometry) tests a pt's potential for improvement in visual acuity with cataract surgery - CORRECT ANSWER potential acuity measure (pam) uses special magnification to see retinal detail and includes a color drawing of the detail and interpretation by the dr - CORRECT ANSWER extended ophtalmoscopy uses a pt's description of grid-lines on a chart to document distortions in near vision - CORRECT ANSWER amsler gird captures the appearance of the fibers of the optic nerve - CORRECT ANSWER nerve fiber analyzer inflammation of the conjunctiva often called "pink eye" - CORRECT ANSWER conjunctivitis progressive vision loss due to the damage of the optic nerve causing peripheral vision loss - CORRECT ANSWER glaucoma separation of the retina form the back of the eye - CORRECT ANSWER retinal detachment farsightedness - CORRECT ANSWER hyperopia nearsightedness - CORRECT ANSWER myopia irregular curvature of the cornea causing blurred vision - CORRECT ANSWER astigmatism clouding of the crystalline lens - CORRECT ANSWER cataract inflammation of the eyelid margins - CORRECT ANSWER belpharitis swelling in the eyelid caused by inflammation of one of the oil producing glands - CORRECT ANSWER chalazion abnormal growth of retinal blood vessels due to diabetes - CORRECT ANSWER diabetic retinopathy degeneration of the macula resulting in loss of central and reading vision - CORRECT ANSWER age related macular degeneration (armd) small particles or debris suspended in the vitreous causing shadows and shapes - CORRECT ANSWER floaters insufficient tear production - CORRECT ANSWER dry eye syndrome encounter forms are most commonly used to - CORRECT ANSWER record diagnosis and procedural codes an eyecare provider licensed to diagnose and treat diseases of the eye and to preform surgery - CORRECT ANSWER ophthalmologist an eyecare provider licensed to diagnose and treat diseases of the eye but unable to preform surgery - CORRECT ANSWER optometrist an eyecare professional licensed to fabricate and dispense eyeglasses is an - CORRECT ANSWER optician major surgeries are most commonly preformed in a - CORRECT ANSWER a certified surgical facility devices prescribed to correct refractive errors are - CORRECT ANSWER glasses and contacts common treatment for dry eyes - CORRECT ANSWER punctual occlusion instructions given for contact lenses are given by what staff - CORRECT ANSWER ancillary the ancillary testing room is used for - CORRECT ANSWER diagnostic testing (a-scan, b-scan ,and corneal topography) an auto refactor is used to - CORRECT ANSWER help determine eyeglasses prescription an a-scan is a piece of equipment used to - CORRECT ANSWER measure the length of the eye to assist in calculation the power of intraocular lens of cataract surgery the snellen acuity chart is used to - CORRECT ANSWER measure visual acuity using various sizes of letters visible to the normal eyes used to document abnormal defects in a pt's central peripheral vision - CORRECT ANSWER visual field lensometer is used to - CORRECT ANSWER measure pt's current spectacle prescription where do you assemble a pt's glasses - CORRECT ANSWER optical finishing lab a phaco instrument is used during what - CORRECT ANSWER cataract surgery PACU stands for what - CORRECT ANSWER post anesthesia care unit what laser is used to preform refractive surgery - CORRECT ANSWER excimer laser light enters the interior of the eye through the - CORRECT ANSWER pupil tissue that regulates the amount of light entering the eye - CORRECT ANSWER iris transparent curved tissue at the front of the eye - CORRECT ANSWER cornea sclera is also referred to as the - CORRECT ANSWER white of the eye the ciliary processes secrete fluid in the eye which is called - CORRECT ANSWER aqueous humor what are the three layers of tear film - CORRECT ANSWER mucin, watery, oily with age the lens becomes thick, hard, and non transparent causing impaired vision - CORRECT ANSWER cataract tissue located at the back of the eye and converts light to electric impulses that are carried to the brain - CORRECT ANSWER retina impaired drainage of the aqueous humor leads to a rise in iop and can damage the retinal nerves. what is this called - CORRECT ANSWER glaucoma this area of the retina provides the clearest and most detailed vision - CORRECT ANSWER macula superbills are used to - CORRECT ANSWER record diagnosis and procedural codes ICD-10 and CPT codes must correspond, because - CORRECT ANSWER payers will deny payments if diagnosis and procedure codes do not match coding of office visits is done by - CORRECT ANSWER provider or scribe incorrect use of CPT codes can result in - CORRECT ANSWER lost revenues and fines icd 10 (international classification of diseases) - CORRECT ANSWER used to classify and code all diagnoses, symptoms and procedures CPT (current procedural terminology) - CORRECT ANSWER used to report medical, surgical, and diagnostic procedures clean claim - CORRECT ANSWER has no obvious errors and can be processed quickly by insurance company without claim re-submission EOB - CORRECT ANSWER explanation of benefits what is used when compiling the daily balance sheet - CORRECT ANSWER lockbox receipts, mail receipts, and charge tickets the daily deposit includes - CORRECT ANSWER mail receipts daily backup tapes - CORRECT ANSWER used to protect data in case of a power failure or other damage to stored data EOB's should be - CORRECT ANSWER stored for future reference based on practice policy or local regulations direct remittance - CORRECT ANSWER check can be downloaded directly into the system and automatically posts payments required for claims processing - CORRECT ANSWER CPT,ICD-10 codes, signatures, and UPIN numbers medicare administrative contractors - CORRECT ANSWER reimbursement for physician services provided under medicare part b is paid for by the federal gov through contracts with different insurance companies provider enrollment, chain and ownership system - CORRECT ANSWER new doctors must enroll to see medicare patients national provider identifier - CORRECT ANSWER 10 digit number assigned to providers to be used for identification purposes when submitting services to medicare for payment before billing a medicare pt, the provider must have a pt authorization or assignment of benefits form signed by the pt to - CORRECT ANSWER inform medicare that the dr has the right to bill for covered services how often does medicare require patients to sign a patient authorization form - CORRECT ANSWER once per lifetime relative value units - CORRECT ANSWER medicare physician fee schedule database (MPFSD) includes fee calculations based on work expense, and malpractice expense which are used in determining payments to physicians deductible - CORRECT ANSWER amount a pt is financially responsible for before insurance provides payment ABN - CORRECT ANSWER must be signed when a provider believes that a normally covered service might not be covered under certain circumstances CMS-1500 - CORRECT ANSWER standard claim form used to submit provider services to medicare part b in order to be paid by medicare, claims must be filed by - CORRECT ANSWER 12 months (CCI) correct coding initiative bundling is used by providers to - CORRECT ANSWER identify codes that can be billed together on the same day local coverage determinations - CORRECT ANSWER provide documentation and billing guidelines for services rendered by providers medicare recovery audit contractors have the right to audit medical records for how long - CORRECT ANSWER three years office of inspector general (OIG) releases what annually - CORRECT ANSWER work plan what does excludes 1 note mean in ICD-10 - CORRECT ANSWER code excluded should never be used brackets - CORRECT ANSWER used in the alphabetic index to identify manifestation codes "family of codes" in CMS grace period guidence - CORRECT ANSWER any 3 character catagory sequelae - CORRECT ANSWER term used in ICD-10 to represent a consequence of a previous disease or injury max amount of characters that a ICD-10 code can contain - CORRECT ANSWER 7 when i excludes2 note appears in ICD-10, it means - CORRECT ANSWER the 2 codes can be reported together in ICD-10 what placeholder is used to allow for future expansion in codes that require seven digits - CORRECT ANSWER X biggest change in structure of ICD-10 that didn't exist in ICD-9 - CORRECT ANSWER laterality centers for medicare and medicaid services - CORRECT ANSWER responsible for implementation of ICD-10 and maintaining the codes in ICD-10 the eye codes are located in chapter____ which only includes eye and adnexa codes - CORRECT ANSWER 7 what dos did we start using ICD-10 codes - CORRECT ANSWER october 1st 2015 how is a glaucoma stage reported in ICD-10? - CORRECT ANSWER stage must be identified by a seventh character code world health organization - CORRECT ANSWER responsible for creating and publishing the ICD-10 codes in ICD-10, the tabular is a list of - CORRECT ANSWER codes in chronological order HIPAA stands for - CORRECT ANSWER health insurance portability and accountability act privacy officer - CORRECT ANSWER takes complaints regarding use of phi OSHA - CORRECT ANSWER occupational safety and health administration training on the revised hazard communication standard must begin and end by - CORRECT ANSWER december 1st 2013, and june 1st 2016 immunization is provided for employees with occupational exposure for what disease - CORRECT ANSWER hepatitis b ppe - CORRECT ANSWER personal protective equipment two new changes to hazard communication standard (HCS) are - CORRECT ANSWER Sds updates and label elements labels must include new info including - CORRECT ANSWER product identifier can be used to kill blood borne pathogens - CORRECT ANSWER bleach color used to identify biohazardous material - CORRECT ANSWER red pictograms used on labels must be - CORRECT ANSWER set in the shape of a SQUARE with a RED outline, BLACK symbol, and a WHITE background a spill kit contains - CORRECT ANSWER biohazard bag, absorbent pads, cleaning agents Exposure control plan (ECP) - CORRECT ANSWER written guidelines to protect employees against blood borne pathogens enforces compliance with the blood borne pathogens standard - CORRECT ANSWER OSHA complications of blunt trauma to the eye include - CORRECT ANSWER hyphema, glaucoma, and ecchymosis alkalis that can cause eye burns are - CORRECT ANSWER lye, concrete, and lawn fertilizer mucous discharge may represent - CORRECT ANSWER blepharitis, allergy, and bacterial infection orbital cellulitis - CORRECT ANSWER can result from a dental abscess, cause pain in eye movement, causes pt to feel ill most important condition to rule out in a case of painful lid swelling - CORRECT ANSWER orbital cellulitis common causes of lid twitching - CORRECT ANSWER lack of sleep, excess caffeine, dry eyes a subconjunctival hemorrhage can be caused by - CORRECT ANSWER trauma, cough or sneeze is a subconjunctival hemorrhage an emergency - CORRECT ANSWER no epiphora (excess tearing) is due to - CORRECT ANSWER dry eyes is epithelium hydrophobic - CORRECT ANSWER yes levator muscle - CORRECT ANSWER preforms primary lifting of upper lid structure of the eye that continues to grow throughout life - CORRECT ANSWER lens the junction of the cornea and sclera is the - CORRECT ANSWER limbus tarsal plate - CORRECT ANSWER gives structure and rigidity to the eyelid extraocular muscles that originate at the annulus of zinn - CORRECT ANSWER medial tectus, lateral tectus, superior oblique, inferior rectus CN II - CORRECT ANSWER cranial nerve responsible for afferent pupillary reflex the visual pathway begins at the - CORRECT ANSWER retina accommodation and aqueous production are a function of the - CORRECT ANSWER ciliary body the aqueous humor exits the anterior chamber through the drainage structure located in the - CORRECT ANSWER angle posterior chamber is located - CORRECT ANSWER between the iris and in front of the vitreous face obicularis - CORRECT ANSWER main depressor of the eyelids area susceptible to blunt trauma of the orbit is - CORRECT ANSWER orbital floor area in retina that represents the physiologic blind spot is - CORRECT ANSWER optic nerve the ciliary body, iris and choroid are part of what layer - CORRECT ANSWER vascular layer epithelium, endothelium, bowman's layer, and descements membrane are layers of the - CORRECT ANSWER cornea the eye consists of what layers - CORRECT ANSWER fibrous ,vascular , and nerve pseudophakia - CORRECT ANSWER diagnosis resulting from the removal of a cataract and the implantation of a intraocular lens pterygium - CORRECT ANSWER growth of fleshy tissue on the conjunctiva that may extend onto the cornea ptosis - CORRECT ANSWER droopy upper lid due to aging, gravity, or a weak muscle emmetropia - CORRECT ANSWER refractive condition that requires no lens correction dermatochalasis - CORRECT ANSWER excessive skin that may impair a person's field of vision corneal ulcer - CORRECT ANSWER a potentially sight threatening lesion on the surface of the cornea usually caused by infection or injury stereopsis test - CORRECT ANSWER screens for normal or abnormal depth perception in both eyes optical coherence tomography (OCT) - CORRECT ANSWER takes transpupillary images of the retina to assist in diagnosis and treatment of retinal diseases binocularity - CORRECT ANSWER tests parallelism and alignment of the eyes [Show Less]
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CPSS Exam 107 Questions with Verified Answers,100% CORRECT
CPSS Exam 107 Questions with Verified Answers Which of the following describes OSHA's (Occupational Safety and Health Administration's) primary goal - C... [Show More] ORRECT ANSWER protect employees in the workplace HIPAA is the acronym for which of the following? - CORRECT ANSWER Health insurance portability and accountability act The Privacy Rule is the first national regulation on medical privacy and health information management. - CORRECT ANSWER the first national regulation on medical privacy and health information management. Which of the following best describes the function of the Administration Department in the ophthalmology office? - CORRECT ANSWER Coordinates all business functions of the practice, as well as staff oversight and management. Which of the following functions are performed in the Business Office? - CORRECT ANSWER patient billing, patient check out, data entry Which part of the patient examination tests for gross measurement of peripheral vision, range of motion and function of eye muscles, and evaluates the size, shape, and reaction of the pupils? - CORRECT ANSWER external exam A numerical value associated with the smallest objects a patient can see on a specific chart at a specific distance is called - CORRECT ANSWER Visual Acuity The lids and eyelashes, the conjunctiva, the cornea, iris, lens and vitreous are evaluated during which portion of the eye exam? - CORRECT ANSWER Slit lamp examination The examination of the back of the eye is called the: - CORRECT ANSWER fundus examination The measurement documenting the patient's current spectacle prescription is called - CORRECT ANSWER lensometry The measurement of intraocular pressure is called - CORRECT ANSWER tonometry a. Amsler Grid - CORRECT ANSWER Uses a patient's description of gridlines on a chart to document distortions in near vision. b. Corneal Topography - CORRECT ANSWER Maps the curvature of the cornea. d. Extended Ophthalmoscopy - CORRECT ANSWER Uses special magnification to see retinal detail and includes a color drawing of the detail and interpretation by the physician. e. Fluorescein Angiography - CORRECT ANSWER Allows for viewing the appearance of retinal blood vessels as dye injected into the patient's arm flows through the blood vessels. g. Nerve Fiber Analyzer - CORRECT ANSWER Captures the appearance of the fibers of the optic nerve. h. Pachymetry - CORRECT ANSWER Measures the thickness of the cornea. j. Ultrasonography (biometry) - CORRECT ANSWER Measures the length of the eye to assist in calculating the power of an intraocular lens to be used in cataract surgery. a. Age-related macular degeneration (ARMD) - CORRECT ANSWER Degeneration of the macula resulting in loss of central and reading vision. h. Dry Eye Syndrome - CORRECT ANSWER . Insufficient tear production m. Pseudophakia - CORRECT ANSWER Diagnosis resulting from removal of cataract with implantation of intraocular lens. o. Secondary Membrane - CORRECT ANSWER Clouding of membrane of the lens after cataract surgery. Patient's charts are prepared - CORRECT ANSWER at the time the patient arrives for his/her appointment. Patient registration processes are normally completed: - CORRECT ANSWER upon check in Encounter forms are most commonly used to: - CORRECT ANSWER record the diagnosis and procedural codes Registration information should be: - CORRECT ANSWER Routinely reviewed for each patient upon arrival Payment receipts should be used: - CORRECT ANSWER To record all payments received from patients Accounts Receivable (A/R). - CORRECT ANSWER The balance due on services rendered by the practice The ancillary testing room is used for: - CORRECT ANSWER Diagnostic testing (A-Scan, B-Scan, and corneal topography) An auto refractor is used to; - CORRECT ANSWER c. Help determine the eyeglasses prescription. An A-Scan is a piece of ultrasound equipment used to - CORRECT ANSWER Measure the length of the eye to assist in calculating the power of an intraocular lens for cataract surgery The Snellen acuity chart is used to - CORRECT ANSWER Measure visual acuity using various sizes of letters visible to the normal eye A lensometer is used to - CORRECT ANSWER Measure the patient's current spectacle prescription A phaco instrument is used in what type of surgical procedure - CORRECT ANSWER Cataract surgery PACU is an abbreviation for - CORRECT ANSWER Post anesthesia care unit Refractive surgery services can be provided either - CORRECT ANSWER In office, separate center, or ambulatory Which of the following lasers is used to perform refractive surgery - CORRECT ANSWER Excimer Laser Light enters the interior of the eye - CORRECT ANSWER through the pupil. Which tissue regulates the amount of light entering the eye - CORRECT ANSWER Iris The ciliary processes secrete fluid in the eye - CORRECT ANSWER aqueous humor Which tissue is located at the back of the eye and converts light to electric impulses that are carried to the brain - CORRECT ANSWER retina provides the clearest and most detailed vision - CORRECT ANSWER macula EOBs are used by - CORRECT ANSWER Posting/Billing staff All checks received by mail should be processed within 24 hours of receipt - CORRECT ANSWER true Lockbox arrangements with banks are helpful to some practices in order to - CORRECT ANSWER Provide security for checks and rapid deposit of funds. Which of the following is not a process used by the practice in processing direct deposits from insurance companies, Medicare, and Medicaid? - CORRECT ANSWER Include the amounts from direct deposits in the daily deposit. an option provided by some practice management systems in which a Medicare check can be downloaded directly into the practice management system and automatically posts payments to specific patient accounts. - CORRECT ANSWER Direct remittance Reimbursement for physician services provided under Medicare Part B is paid for by the federal government through contracts with different insurance companies. What are those contracted entities called - CORRECT ANSWER Medicare Administrative Contractors In order for a new physician to see Medicare patients, the physician must first enroll in the Medicare program as a participating or nonparticipating provider. Medicare has an electronic enrollment system to assist providers in completing the enrollment forms more efficiently called the: - CORRECT ANSWER Provider Enrollment, Chain, and Ownership System The 10-digit number assigned to providers to be used for identification purposes when submitting services to Medicare for payment: is called what - CORRECT ANSWER National Provider Identifier Before billing a Medicare patient, the provider must have a Patient Authorization or Assignment of Benefits form signed by the patient to - CORRECT ANSWER Inform Medicare that the physician has the right to bill for covered services How often does Medicare require patients to sign a Patient Authorization form? - CORRECT ANSWER Once per lifetime The Medicare Physician Fee Schedule Database (MPFSD) includes fee calculations based on work expense, practice expense, and malpractice expense which are used in determining payments to physicians. Those figures are referred to as what? - CORRECT ANSWER Relative Value Units When billing Medicare, what is the definition of "deductible?" - CORRECT ANSWER The amount the patient is financially responsible for before Medicare provides payment. Medicare requires that patients be informed in advance when a provider believes that a normally covered service may not be covered under certain circumstances. The form which must be signed by the patient is called what? - CORRECT ANSWER ABN What is the standard claim form used to submit provider services to Medicare Part B? - CORRECT ANSWER CMS-1500 In order to be paid by Medicare, timely claims filing must occur within - CORRECT ANSWER 12 months. The Centers for Medicare and Medicaid Services (CMS), in conjunction with the National Correct Coding Institute, developed the Correct Coding Initiative (CCI) bundling edits which are used by Medicare providers to - CORRECT ANSWER Control improper coding of claims billed In a Medicare audit, which of the following patient statements would deem an office visit routine and not billable to Medicare? - CORRECT ANSWER I am here for my annual eye exam and glasses check When auditing medical records, Medicare auditors generally have no preference as to the method a physician uses for documenting a patient chart. - CORRECT ANSWER False Under Medicare's global surgical fee concept, most services performed following surgery are included in the global fee payment and not billable separately. A physician may, however, bill Medicare separately for - CORRECT ANSWER Diagnostic tests required to treat the patient. In order to treat patients effectively, a physician may have allied staff perform certain diagnostic tests. Before the test can be performed by the technician, what must be documented in the patient chart? - CORRECT ANSWER Order for the test Medicare payers publish medical policies on their individual websites that provide documentation and billing guidelines for services rendered by providers. These guidelines should be reviewed on a regular basis for updated information and are called what? - CORRECT ANSWER local Coverage Determinations Which of the following would CMS constitute as fraud? - CORRECT ANSWER Billing a more extensive service than actually performed What does the Office of Inspector General (OIG) release annually that identifies areas of focus for review and investigation they believe are the most vulnerable for possible fraud/abuse? - CORRECT ANSWER work plan HIPAA stands for - CORRECT ANSWER Health Insurance Portability and Accountability Act. The following disclosure requires signed permission from the individual whose PHI is being requested - CORRECT ANSWER Information requested by an attorney without a subpoena. Patient names on a sign-in form are considered an intentional breach of PHI - CORRECT ANSWER false Notice of Privacy Practices (NPP) must include which of the following information? - CORRECT ANSWER Description of how the entity discloses PHI. If an individual or staff member has a complaint regarding the use of PHI, the individual must speak with: - CORRECT ANSWER The Privacy Officer. Which of the following is NOT an Administrative Safeguard requirement - CORRECT ANSWER Developing a cost analysis of HIPAA requirements. Physical safeguards do NOT include which of the following? - CORRECT ANSWER A Posting PHI on a white board in the facility raining on the revised Hazard Communication Standard must begin by and end by which of the following dates? - CORRECT ANSWER Beginning December 1, 2013 and ending June 1, 2016 Immunization is provided for employees with occupational exposure for what disease? - CORRECT ANSWER Hepatitis B. What is PPE? - CORRECT ANSWER Personal Protective Equipment. The two new changes in the HCS are: - CORRECT ANSWER SDS and label elements. Labels must now include new information including: - CORRECT ANSWER Product identifier. The following color is used to identify biohazardous material: - CORRECT ANSWER Red Pictograms used on labels must be: - CORRECT ANSWER Set in the shape of a square with a red outline, black symbol, and white background. When referring to a theory of universal precautions for infection control: - CORRECT ANSWER All blood and other potentially infectious materials are handled as if they were known to be infectious. Spill kits contain all but one of the following: - CORRECT ANSWER Blanket. Which of the following is considered PPE? - CORRECT ANSWER Surgical mask. Complications of blunt trauma to the eye include all except: - CORRECT ANSWER Hyperopia All of the following are examples of alkalis that can cause eye burns, except - CORRECT ANSWER Battery acid. Patients complaining of discharge from their eyes in combination with an upper respiratory infection require evaluation for: - CORRECT ANSWER Adenovirus. The following statements about double vision are true except: - CORRECT ANSWER Binocular diplopia presents only when a patient has one eye open. All of the following can cause flashing lights, except - CORRECT ANSWER Uveitis. Mucous discharge may represent all of the following except: - CORRECT ANSWER Viral infection. The following are true of orbital cellulitis, except - CORRECT ANSWER It is more common than preseptal cellulitis. The following symptoms can be scheduled in the next available time slot except, - CORRECT ANSWER pain If a patient complains of a headache, the following associated symptoms may indicate an emergency, except: - CORRECT ANSWER Long-standing diplopia. Which of the following is hydrophobic? - CORRECT ANSWER Epithelium The structure of the eye that continues to grow throughout life is the - CORRECT ANSWER Lens The functions of the orbit are to provide protection, support, and attachment of the cranial nerves. - CORRECT ANSWER False The junction between the cornea and sclera is the - CORRECT ANSWER Limbus The extraocular muscle that does NOT originate at the annulus of Zinn is the _____ - CORRECT ANSWER Inferior oblique. The cranial nerve responsible for AFFERENT pupillary reflex is: - CORRECT ANSWER CN II. The Visual Pathway begins at the_____. - CORRECT ANSWER Retina Accommodation and aqueous production are a function of the: - CORRECT ANSWER Ciliary Body. The aqueous humor exits the anterior chamber through the drainage structure located in the _____. - CORRECT ANSWER Angle The structure which does NOT make up transparent ocular media is the - CORRECT ANSWER Iris The posterior chamber is: - CORRECT ANSWER Between the iris and in front of vitreous face The main depressor of the eyelids is: - CORRECT ANSWER Obicularis The area susceptible to blunt trauma of the orbit is: - CORRECT ANSWER orbital floor The area in the retina that represents the physiologic blind spot is: - CORRECT ANSWER optic nerve The temporal fibers of the optic nerve do not cross, while nasal fibers do cross at the optic chiasm. - CORRECT ANSWER True Which of the following is NOT a layer of the cornea? - CORRECT ANSWER Broadman's area. [Show Less]
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CPSS Exam 96 Questions with Verified Answers,100% CORRECT
CPSS Exam 96 Questions with Verified Answers Visual Acuity - CORRECT ANSWER the numerical value associated with the smallest objects the patient can see... [Show More] on specific eye charts at a specific distance. -cornerstone of the eye exam External Exam - CORRECT ANSWER Consists of 3 segments: -Confrontation Visual Field -ExtraOcular Motility -Pupil Evaluation Confrontation Visual Field (CVF) - CORRECT ANSWER Obtains a gross measurement of the patient's peripheral vision. It is useful in the detection of damage due to a stroke, glaucoma, and some retinal detachments. ExtraOcular Motility (EOM) - CORRECT ANSWER Measures the range of motion and the function of the six extraocular muscles. This testing helps to detect eyes that are misaligned or not working together properly. Pupil Evaluation - CORRECT ANSWER Evaluates pupils according to their size, shape, and reaction to light Lensometer - CORRECT ANSWER an instrument that is used to document the patient's current spectacle prescription. The readings identify not only the power of the lens but also the type of lens Refraction - CORRECT ANSWER This portion of the examination determines the best lens correction for eyes with refractive errors Tonometry - CORRECT ANSWER a measurement of intraocular pressure (IOP) application tonometry - CORRECT ANSWER measures the force needed to flatten part of the cornea. This type of procedure requires the administration of anesthetic drop Indentation tonometry - CORRECT ANSWER measures intraocular pressure by blowing a puff of compressed air at the cornea and measuring the amount of deflection produced. No anesthetic drop is needed for this procedure Slit Lamp Examination - CORRECT ANSWER -most frequently performed by the physician, but portions may be done by the ophthalmic technician. - focuses a narrow beam of light into the eye, and through magnification and light allows the physician to examine the lids and eyelashes, the conjunctiva, the cornea, iris, lens, vitreous, and fundus. Fundus Examination - CORRECT ANSWER The physician examines the retina (back of the eye) to determine the appearance of the optic nerve/disc, the macula, and the periphery Amsler Grid Test - CORRECT ANSWER Helps diagnose macular problems and is performed on patients with complaints of distortion, letters "jumping" when reading, or anyone with unexplained decrease in near vision. Patients describe the normal or abnormal appearance of gridlines on a chart. Color vision - CORRECT ANSWER Using a book of color vision plates or pages, this test screens for acquired and/or hereditary color visual defects Corneal topography - CORRECT ANSWER : Using a computerized and digital instrument, this test maps the curvature of the cornea and is useful in diagnosing corneal diseases such as keratoconus and astigmatism. This testing is often performed for contact lens fittings and preliminary evaluations for refractive surgery such as LASIK. Binocularity - CORRECT ANSWER Tests binocularity (parallelism) and alignment of the eyes Dry Eye Test - CORRECT ANSWER Measures the quantity of tear secretion using a special strip of paper placed under the lower lid for a specified time (often called a Schirmer test). Extended Opthalmoscopy - CORRECT ANSWER Test in which the physician uses special magnification to see retinal detail. Testing includes a color drawing of the detail seen, as well as interpretation by the physician. Flurescein Angiography - CORRECT ANSWER A technique for viewing the detail of the blood vessels of the retina. -Fluorescein dye is injected into the patient's arm after which time-lapse photos are taken to document the appearance of the retinal blood vessels as the dye passes through. This is important in the diagnosis of retinal disorders such as diabetic retinopathy, macular edema, etc Fundus Photography - CORRECT ANSWER Photographs the appearance of the optic discs, the macula, and anomalies of the retina Glare Test - Brightness Acuity Testing (B.A.T) - CORRECT ANSWER Determines the effects of glare on visual acuity, which is often needed to document medical necessity for cataract surgery Gonioscopy - CORRECT ANSWER A mirrored contact lens evaluation by the physician to examine the angle structures in the front portion of eye that allow for fluid outflow (primarily a screening test for glaucoma) Keratometry - CORRECT ANSWER Measures the curvature of a cornea. These measurements are frequently taken on patients who are being fitted for contact lenses, measured for intraocular lenses for cataract surgery, or who may have corneal problems. The results are called "K" readings. Nerve Fiber Analyzer (HRT, GDX) - CORRECT ANSWER This computerized, digital instrument captures the appearance of the nerve fibers of the optic nerve. This test is useful in the diagnosis and maintenance of glaucoma. Optical Coherence Tomography - CORRECT ANSWER Takes transpupillary images of the retina to assist in diagnosis and treatment of retinal diseases. Pachymetry - CORRECT ANSWER Measures the thickness of the cornea. This is used commonly in the diagnosis of glaucoma and corneal disease. Potential Acuity Measure (PAM) - CORRECT ANSWER Tests a patient's potential for improvement in visual acuity following cataract surgery. Stereopsis Test - CORRECT ANSWER Screens for normal or abnormal depth perception in both eyes Ultrasonography (biometry) - CORRECT ANSWER Uses the reflection or echo of sound waves to measure the length of the eye or to detect abnormalities in the eye. Visual Field (perimetry) - CORRECT ANSWER Used to test and document abnormal defects in a patient's central and peripheral vision. This test is most commonly used to diagnose and monitor glaucoma and other neurological eye problems. Agre related macular degeneration (AMD) - CORRECT ANSWER Degeneration of the macula, resulting in loss of central and reading vision. It affects older people. Astigmatism - CORRECT ANSWER Irregular curvature of the cornea causing blurred vision that normally can be corrected using a cylindrical lens. Blepharitis - CORRECT ANSWER Infection and inflammation of the eyelid margins, usually causing scaling and crustiness of the upper and lower lid margins Cataract - CORRECT ANSWER Clouding of the crystalline lens in the eye. Chalazion - CORRECT ANSWER Swelling in the eyelid caused by an inflammation of one of the oil producing glands in the upper and/or lower eyelid. Conjunctivitis - CORRECT ANSWER Inflammation of the conjunctiva (white of the eye), often called "pink eye." corneal abrasion - CORRECT ANSWER scratch on the cornea corneal ulcer - CORRECT ANSWER A potentially sight-threatening lesion on the surface of the cornea, usually caused by infection or injury. Dermatochalasis - CORRECT ANSWER Excessive eyelid skin that may impair a person's field of vision. Diabetic Retinopathy - CORRECT ANSWER A sight-threatening disease that results in the abnormal growth and leaking of retinal blood vessels due to diabetes. Dry Eye Syndrome - CORRECT ANSWER Dryness of the eye due to insufficient tear production causing scratchy, burning eyes. Emmetropia - CORRECT ANSWER Refractive condition of the eye that requires no lens correction. Floaters - CORRECT ANSWER Small particles or debris suspended in the vitreous, causing shadows or shapes seen by the patient Glaucoma - CORRECT ANSWER Progressive vision loss due to damage of the optic nerve, caused by higher than normal intraocular pressure. Hyperopia - CORRECT ANSWER farsightedness Keratitis - CORRECT ANSWER inflammation of the cornea Myopia - CORRECT ANSWER nearsightedness Presbyopia - CORRECT ANSWER A condition most commonly seen in people over age 40 who have lost the ability to focus at near and who need reading glasses (magnification). Pseudophakia - CORRECT ANSWER Diagnosis resulting from the removal of a cataract and the implantation of an intraocular lens (IOL). Pterygium - CORRECT ANSWER A growth of fleshy tissue on the conjunctiva that may extend onto the cornea. Ptosis - CORRECT ANSWER Droopy upper lid due to age, gravity, or a weak eye muscle. Retinal Detachment - CORRECT ANSWER Separation of the retina from the back of the eye; a potentially sightthreatening disorder. Secondary Membrane - CORRECT ANSWER Clouding of the membrane (lens capsule) of the lens after cataract surgery. This condition may be surgically treated with a laser. Subconjunctival Hemorrhage - CORRECT ANSWER Breaking of a blood vessel under the conjunctiva causing a "blood red" eye. Pre-test room - CORRECT ANSWER This area provides dedicated space to begin the initial testing for the eye exam Ancillary testing room - CORRECT ANSWER Many practices dedicate space for ancillary diagnostic tests such as A-Scan, B-Scan, corneal topography, etc. Having a specific area for these tests allows the practice to maintain a smooth flow of patients through the clinic area. Visual Field Room - CORRECT ANSWER Provides space and equipment for completing visual field examinations for patients Sub-waiting area - CORRECT ANSWER a dedicated waiting area for patients who have been given dilating drops for their exam Examination Lane - CORRECT ANSWER This is a room where patients are given a thorough eye exam Surgical Counselor's office - CORRECT ANSWER Patients who are being recommended for surgery will meet with a surgical counselor to schedule a date for surgery, review insurance reimbursement issues, and discuss pre-operative and post-operative procedures. auto refractor - CORRECT ANSWER A computerized instrument used to help determine the eyeglasses prescription Auto Keratometer - CORRECT ANSWER An instrument used to measure the curvature of the cornea. These measurements are frequently taken on patients who are being fitted for contact lenses, measured for intraocular lenses for cataract surgery, or who may have corneal problems. Corneal topographer - CORRECT ANSWER A computerized optical or digital instrument used to measure and map the curvature of the cornea. Direct ophthalmoscope - CORRECT ANSWER A hand-held instrument used at close range to view the inner structures of the eye. exopthalmometer - CORRECT ANSWER Instrument used to measure abnormal protrusion of the eye. Fundus Camera - CORRECT ANSWER Digital or analog camera designed to photograph the retina. Geneva Lens Clock - CORRECT ANSWER An instrument used to determine the base curve of a lens. Genio Lens - CORRECT ANSWER A mirrored lens used to examine the angle structures in the front portion of the eye that allow for fluid outflow (primarily a screening test for glaucoma) Indirect ophthamoscope - CORRECT ANSWER An instrument worn on the physician's head that allows viewing of the peripheral retina. Laser - CORRECT ANSWER Acronym for Light Amplification by Stimulated Emission of Radiation. Different types of lasers are used in several applications in ophthalmology. T Argon Laser - CORRECT ANSWER Laser in which the light source is argon gas excited by electricity, used in the treatment of diabetic retinopathy, macular degeneration, trabeculoplasty, and iridotomy. Nd:YAG laser - CORRECT ANSWER Neodymium:Yttrium Aluminum Garnet. A synthetic crystal used as a laser medium to produce 1064 nm light. The principal application of this laser in ophthalmology is for posterior capsulotomy and irridotomy. Maddox rod - CORRECT ANSWER A transparent rod used in testing visual fusion occluder - CORRECT ANSWER An opaque device used to cover the eye during an eye examination. opthalmodynamometer - CORRECT ANSWER An instrument used for measuring blood pressure in the central retinal artery by applying pressure to the sclera. Pachymeter - CORRECT ANSWER An instrument used to measure the thickness of the cornea. This is commonly used in the diagnosis of glaucoma and corneal disease. Perimeter (Visual Field) - CORRECT ANSWER An instrument used in visual field testing to document abnormal defects in a patient's central and peripheral vision. This test is most commonly used to diagnose and monitor glaucoma and other neurological eye problems. Phoropter - CORRECT ANSWER An instrument containing a battery of convex, concave and cylindrical lenses used to determine an eyeglass prescription. Potential Acuity Meter (PAM) - CORRECT ANSWER An instrument most frequently used to test the potential for improvement in visual acuity after cataract surgery. Prism Bar - CORRECT ANSWER A plastic bar containing a series of prisms used to test for diplopia (double vision). Retinoscope - CORRECT ANSWER An instrument used to objectively determine the refractive error of the eye. Slit Lamp - CORRECT ANSWER An instrument with two oculars (eyepieces) that allow the examiner to view ocular structures through an attached low-powered microscope Specular Microscope - CORRECT ANSWER An instrument used to view the corneal endothelium under high magnification. Tonometer - CORRECT ANSWER instrument used to measure intraocular pressure A-Scan - CORRECT ANSWER Used to measure the length of the eye to assist in the calculation of the power of an intraocular lens to be used in cataract surgery. B-Scan - CORRECT ANSWER Provides two dimensional reconstruction of the ocular and orbital tissues. It is also used to detect ocular tumors and retinal detachments. Salt pans - CORRECT ANSWER This heating element enables the optician to mold and adjust eyeglasses by applying heat to various parts of an eyeglass frame with the use of glass beads or salt Air Frame Warmer - CORRECT ANSWER Like a traditional frame warmer, this heating element will warm various parts of an eyeglass frame using warm air in place of salt or glass beads Pupilometer - CORRECT ANSWER An instrument used to measure a patient's binocular or monocular PD (pupillary distance) at various distances. Autoclave - CORRECT ANSWER This device is used to sterilize the surgical instruments before use in surgery. Phaco - CORRECT ANSWER A commonly used abbreviation for an instrument used during phacoemulsification (cataract) surgery. This instrument breaks the lens (cataract) into small pieces and aspirates the lens material out of the eye. LASIK - CORRECT ANSWER A procedure using a laser/lasers to reshape the cornea, often using wavefront technology to maximize results. Corneal Relaxing Incisions (CRI) - CORRECT ANSWER : A procedure in which incisions are made into the cornea to reduce astigmatism. This procedure is sometimes performed at the time of cataract surgery, but can also be completed in a physician office's minor procedure room Refractive Lense Exchange (RLE) - CORRECT ANSWER A procedure involving the removal of the eye's natural lens, either clear or cloudy (cataract), and the insertion of an intraocular lens. This lens may be monofocal, multifocal, or accommodative, depending on the patient's needs [Show Less]
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CPSS Exam 1|164 Questions with Verified Answers,100% CORRECT
CPSS Exam 1|164 Questions with Verified Answers Small bottle that contains the drug - CORRECT ANSWER Ampule Diameter of the needle - CORRECT ANSWER G... [Show More] auge Enlarged base by which a hollow needle may be attached to a device (as a syringe) - CORRECT ANSWER Hub Cylindrical container that holds liquids - CORRECT ANSWER Barrel A small container, usually with a closure, used especially for liquids - CORRECT ANSWER Vial What are the reasons to give an injection? - CORRECT ANSWER - if drug is poorly absorbed or degraded by GI system - if pt is uncooperative, unconscious, unable to take PO - used when localized therapy is desired - preferred when rapid & predictable drug response is desired in ER situations What is the needle size used for blood withdrawal? - CORRECT ANSWER 18 g What is the needle size used for IM injections? - CORRECT ANSWER 22g What is the needle size used for SubQ injections? - CORRECT ANSWER 25-27g What needle size is used for ID injections? - CORRECT ANSWER 26-27g What type of injection has the fastest rate of absorption? - CORRECT ANSWER IV > IM > SQ When are IM injections indicated? - CORRECT ANSWER - drugs are not easily absorbed PO - when you want an intermediate rate of onset & duration of action - when parenteral delivery is necessary What are the 3 main sites of IM injections? - CORRECT ANSWER - gluteal (upper outter quadrant) - deltoid (lateral & 3-4cm below the acromion) - vastus lateralis (antero-lateral, upper thigh) Which IM site is preferred in infants & kids under 3? - CORRECT ANSWER Vastus lateralis *painful due to fascia lata *lack of nerves and vessels Which IM site is preferred in kids over 2? - CORRECT ANSWER Gluteus maximus *higher risk of hitting siatic nerve in kids under 2 Which IM site is preferred in adults? - CORRECT ANSWER Deltoid *watch for radial nerve in kids What is an important technique to use when giving an IM injection? - CORRECT ANSWER Draw about 0.2ccs of air into syringe (air lock) Hold syringe like a dart at 90 degree angle Max amount injected is 3ccs *DO NOT MASSAGE- will break seal* What are the complications associated with IM injections? - CORRECT ANSWER - inject into vessel - inject into nerve - needle breaks off - sterile/septic abscess Which type of injection is used for drugs requiring slower absorption and longer duration of action? - CORRECT ANSWER SubQ *drugs must be soluble and potent in small concentrations What are the 3 common sites used for SC injections? - CORRECT ANSWER - upper outer arm - anterior thigh - lower abdomen What are the MC SC injections given? - CORRECT ANSWER Heparin & Insulin *refrigerate insulin *Do NOT aspirate or massage heparin injections How is insulin mixed? - CORRECT ANSWER Rolled between palms of hands - gently! What technique should be used when giving a SC injection? - CORRECT ANSWER Pinch SC tissue into roll with thumb & forefinger of non-dominant hand; inject at 45 degree angle Max amount 2ccs Which type of injection has little systemic affects and is mainly localized? - CORRECT ANSWER ID injections - TB & allergy testing What are the C/I to ID injections? - CORRECT ANSWER - dermatitis - cellulitis - previous positive TB test What are the most commonly used sites for ID injections? - CORRECT ANSWER Ventral forearm (TB) & back (allergy testing) *Rabies vaccine given ID in deltoid What technique should be used when giving an ID injection? - CORRECT ANSWER Move down 3-4 finger widths from the antecubital area Use 0.1ccs max Angle needle 10-15 degrees DO NOT ASPIRATE What are the absolute C/I for radial & brachial ABGs? - CORRECT ANSWER - no pulse/collateral circulation - cellulitis - aneurysm at puncture site - AV fistula or graft above puncture site What are the relative C/I for radial & brachial ABGs? - CORRECT ANSWER - chronic renal disease - arterial disease - bleeding disorders/ anticoagulant therapy What are the potential complications of ABGs? - CORRECT ANSWER - hemorrhage - thrombosis - transient arterial spasm - nerve damage - infections What artery is MC used for arterial puncture? - CORRECT ANSWER Radial artery Which artery runs along the lateral aspect of the volar forearm deep to the superficial fascia between the styloid process of the radius and the flexor carpi radialis tendon? - CORRECT ANSWER Radial artery Which artery is used if the radial artery is unavailable? - CORRECT ANSWER Brachial artery Which artery runs along the medial 1/3rd surface of the antecubital fossa and should be accessed above the antecubial crease? - CORRECT ANSWER Brachial artery Which artery is used only if the radial and brachial are not possible? Usually indicated when the pt is severely volume depleted or in shock? - CORRECT ANSWER Femoral artery Which artery lies midway between the ASIS and the pubic tubercle? - CORRECT ANSWER Femoral artery What are C/I to using the femoral artery? - CORRECT ANSWER - aortofemoral bypass graft - previous femoral artery surgery - leg ischemia - aneurysm of femoral artery What technique is used for femoral artery sampling? - CORRECT ANSWER Enter at steeper angle of 60-90 degrees Apply pressure for longer b/c inc risk of hematoma What is considered a positive Allen's test? - CORRECT ANSWER Color returns to hand within 15 seconds * over 6 seconds = delayed *over 15 seconds = abnormal What happens if too much heparin is left in the syringe? - CORRECT ANSWER Lowers the PCO2, bicarb & pH due to dilution of specimen What is the technique for drawing ABGs? - CORRECT ANSWER Hold syringe like a pencil Insert needle 45-60 degree angle *Obtain 2mL of arterial blood* Apply pressure for 5 mins- NOT the patient Why must air be quickly evacuated from the ABG collection? - CORRECT ANSWER Air will increase PaO2 & decrease PCO2 *gas bubble greater than 0.5-1% of volume of blood results in equilibrium between air & blood Why are ABGs placed in ice? - CORRECT ANSWER - avoid psudohypoxemia - allows more time to analyze specimen What are potential complications of ABGs? - CORRECT ANSWER - bruising - pain/tenderness - hemorrhage - decrease pulse due to arterial spasm - vessel trauma - vasovagal response - compression neuropathy - sepsis - ischemia or gangrene of hand or fingers What type of catheterization is performed on critically ill patients for continuous monitoring of arterial blood pressure as well as frequent blood gas sampling? - CORRECT ANSWER Radial artery catheterization What are the C/I to IV therapy? - CORRECT ANSWER - venipuncture should be avoided at the site of an active skin infection - IV lines should not be inserted distal to any site of thrombophlebitis - LE venipunctures should be avoided in elderly, pts with PVD & venous insufficiency What are the primary kind of IV needles we will use? - CORRECT ANSWER Over the catheter needles What type of needle is used for central monitoring and long term medication administration? - CORRECT ANSWER Inside the needle catheter Which type of IV fluid has a risk of causing edema, so should be avoided in HTN and CHF patients? - CORRECT ANSWER Isotonic - LR, NS Which type of IV fluid is helpful when pt is dehydrated, on dialysis, or in hyperglycemic conditions (DKA)? - CORRECT ANSWER Hypotonic- 0.45% NaCl, 2.5% Dextrose Which type of IV fluid is dangerous to use when the pt is dehydrated? - CORRECT ANSWER Hypertonic - D5, 0.45%NaCl, LR, D5%NS, blood products, and albumin Lactate is metabolized by the liver into? - CORRECT ANSWER Bicarbonate - buffers the blood if acidosis is present Which type of fluid is indicated for massive hemorrhage and resuscitation? - CORRECT ANSWER Lactated Ringer What is the ideal IV site in the hand? - CORRECT ANSWER Dorsal metacarpal veins What is the ideal IV site in the forearm? - CORRECT ANSWER Cephalic vein, Accessory Cephalic vein, & Median Cubital vein What is the rate of a micro/macro drip? - CORRECT ANSWER Microdrip - 60 drops/mL *good for peds* Macrodrip- 10-15 drops/mL *good for routine/rapid delivery* What is the formula for calculating flow rates? - CORRECT ANSWER (Volume mL) x (drip set) / (time in minutes) What are the complications of IV therapy? - CORRECT ANSWER Localized: - bruise, cellulitis, infiltration, extravasation, phlebitis Systemic: - sepsis, PE, air embolism, catheter fragment embolism, These complications can happen at insertion of needle if both walls of the vein are penetrated or at a later date if catheter moves and penetrates walls? - CORRECT ANSWER Infiltration or Extravasation (blistering) What areas should not be used for venipuncture? - CORRECT ANSWER - scars from burns & surgery - UE on the side of previous mastectomy - hematoma - IV/ blood transfusions on same arm - cannula/fistula/heparin lock - edematous extremities What type of antiseptic is used for blood cultures? - CORRECT ANSWER Povidone-iodine wipes What is the order of blood draw? - CORRECT ANSWER 1- blood culture tube (yellow black) 2- Non additive tube (red or STT) 3- coagulation tube (light blue) - NEVER DRAWN FIRST 4- Additive tubes (Heparin- Dark green; EDTA- lavender; oxalate/fluoride- light gray) What kind of symptoms should be avoided when performing a finger stick? - CORRECT ANSWER Avoid puncturing a finger that is cold, cyanotic, swollen, scarred or covered with rash What can be done to prevent a hematoma? - CORRECT ANSWER - puncture only top wall of vein - remove tourniquet before removing needle - use major superficial veins - apply pressure to site How many times must a sample be discarded before a specimen can be obtained for analysis using an indwelling catheter? - CORRECT ANSWER Discard a sample at least 3 times the volume of the line before a specimen is obtained for analysis What causes hemoconcentration (increased concentration of larger molecules & formed elements in blood)? - CORRECT ANSWER - prolonged tourniquet application (+2 mins) - massaging, squeezing, or probing site - long term IV therapy - sclerosed or occluded veins What effect may exercise have on pts blood sample? - CORRECT ANSWER increases: - CK - AST - LDH - platelet count What effect does stress have on pts blood sample? - CORRECT ANSWER Increases: - WBCs - adrenal hormone values (cortisol, catecholamines) - lactate (seen in hyperventilation/anxiety pts) What is the therapy for a red wound? - CORRECT ANSWER Keep site moist, clean and protected What is the therapy for a yellow wound? - CORRECT ANSWER Topical antimicrobial & application of prep to lift off pus, fibrin & necrotic tissue What is the therapy for a black wound? - CORRECT ANSWER Mechanical, surgical or chemical debridement to dissolve black necrotic tissue What is created when the anatomic integrity of the tissue is disrupted? - CORRECT ANSWER Wound What is the process whereby the integrity of the tissue is restored? - CORRECT ANSWER Healing How is an arterial ulcer diagnosed? - CORRECT ANSWER Noninvasive: ABI, US, transcutaneous oxygen pressure Arteriogram What medications are used to increase circulation to the area in question in arterial ulcers? - CORRECT ANSWER Pentoxifylline (Trental) Cilostazol (Pletal) What is the most common type of ulcer affecting the lower extremities? - CORRECT ANSWER Venous ulcers *medial malleolus *not too painful What is the treatment for venous ulcers? - CORRECT ANSWER Controlling edema Compression- typically 40mmHg (compression dressings, stockings, mechanical pumps) What are the 3 phases of wound healing? - CORRECT ANSWER Reaction (injury - 72 hrs) Regeneration (72 hrs - 3 weeks) Remodeling (3 weeks - 2 yrs) What phase consists of inflammation? - CORRECT ANSWER Reaction What phase consists of formation of granulation tissue, epithelialization & contraction? - CORRECT ANSWER Regeneration What phases consists of scar formation? - CORRECT ANSWER Remodeling What groups are high risk for wound healing? - CORRECT ANSWER Elderly Disabled Bedridden Head injuries Spinal injuries Nonblanchable erythema of INTACT skin? - CORRECT ANSWER Stage 1 pressure ulcer PARTIAL thickness skin loss involving epidermis, dermis, or both layers; presents clinically as an abrasion, blister or shallow crater? - CORRECT ANSWER Stage 2 pressure ulcer FULL thickness skin loss that extends down to, but not through, the underlying fascia; presents clinically as a deep crater with/without adjacent tissue? - CORRECT ANSWER Stage 3 pressure ulcer FULL thickness skin loss with extensive destruction, tissue necrosis, or damage to MUSCLE, bone, or supporting structures - CORRECT ANSWER Stage 4 pressure ulcers What is the Wagner Grading System for DM ulcers? - CORRECT ANSWER 1- superficial 2- ulcer extension 3- deep ulcer w/ abscess or osteomyelitis 4- gangrene to portion of forefoot 5- extensive gangrene of foot What are the different types of debridement? - CORRECT ANSWER autolytic mechanical chemical surgical What are the different ways to mechanically debride a wound (remove devitalized tissue, bacteria & proteolytic enzymes, and senescent cells)? - CORRECT ANSWER - pulse irrigation - vacuum assisted closure - sharp debridement What type of wound debridement is used to decrease fluid & bacterial burden, increase capillary ingrowth, and mechanically pull edges of wounds together? - CORRECT ANSWER Vacuum assisted closure device What are the clinical indications for enzymatic debridement? - CORRECT ANSWER - ideal for nonsurgical candidates or alternate care sites - break down eschar before sharp debridement - in conjunction with mechanical - infected wounds Most topical abx are compatible with enzymatic agents except? - CORRECT ANSWER Silver dressings What are the indications for non debridement? - CORRECT ANSWER - poor perfusion - pain control - exposed bone - hospice pts - dementia/unpredictable behavior - stable necrotic tissue - anticoagulant pt What are the final pathways to wound healing failure? - CORRECT ANSWER - Infection - Hypoxia (edema, radiation, scarring) - Cellular Failure (renal/liver failure, CA, nutrition, inflammation, steroids, vasculitis) - Trauma (pressure) What are the 4 types of topical dressings? - CORRECT ANSWER Passive dressing Mechanical dressings Dynamic dressing Anti-infective dressing What type of topical dressing is used for optimization of moist wound environment? - CORRECT ANSWER Passive dressings - hydrate & maintain moisture (Hydrogel) - absorb drainage (Alginate) - protect wound margins (zinc oxide) What type of dressing is used for mildly exuding wounds, clean wounds, & partial thickness wounds? - CORRECT ANSWER Hydrogel *absorbs 5xs its weight *cooling effect *facilitates autolytic debridement What are some examples of hydrogels? - CORRECT ANSWER Amorphous (SoloSite) Curasol What type of dressing is used for wounds with large amount of drainage? - CORRECT ANSWER Calcium Alginate *absorbs 30xs its weight *forms hydrophilic gel *maintains moist environment What type of dressing is used for highly exudative wound requiring a non-stick surface (e.g. venous stasis)? - CORRECT ANSWER Foam *absorbs 20xs its weight *non-adherent wound contact layer, hydrocellular foam, waterproof outer layer *allows for autolytic debridement & gaseous exchange Give an example of a foam? - CORRECT ANSWER Allevyn What type of topical dressing is used for pressure reduction or edema management? - CORRECT ANSWER Mechanical dressings - edema control (Profore) - fill dead space (VAC) -pressure reduction (Clinitron bed) What type of topical dressing is used for activation of wound environment? - CORRECT ANSWER Dynamic dressing - biological support (Apligraf) - remove nonvital tissue (Accuzyme) What activates endothelial cells & fibroblasts, stimulates vascular proliferation, migration, and new blood vessel formation & recruits smooth muscle cells and epricytes to stabilize newly formed vessels? - CORRECT ANSWER Platelet derived growth factors (pdGF) What modulates protease activity, keeps the growth factor active while bound, delivers growth factor back to wound over time & modifies hostile proteolytic environment of chronic wound? - CORRECT ANSWER Oxidized Regenerated Cellulose (ORC)/ Collagen What type of debridement is used for a wound requiring debridement of fibrinous exudate, other necrotic material or slough? - CORRECT ANSWER Enzymatic debridement *removes senescent fibroblasts - can't produce cytokines *removes necrotic tissue harboring bacteria Give an example of an enzymatic debridement application? - CORRECT ANSWER Accuzyme *apply directly to the wound Panafil What type of dressing is used to decrease bioburden? - CORRECT ANSWER Anti-infective dressings What type of dressing is indicated for venous ulcers or DM ulcers? - CORRECT ANSWER Acticoat (nanocrystalline silver coating) Wound with clean granular base; how to treat? - CORRECT ANSWER Protect & keep moist Ex- Hydrocolloid, Hydrogel, VAC device, secondary dressing, wet to damp saline Wound with crater; how to treat? - CORRECT ANSWER Fill the space with uniform contact Ex- Hydrogel, Alginate, Foam, hydrocolloid, VAC device, wet to damp saline Wound with necrotic/non-viable tissue; how to treat? - CORRECT ANSWER Debride and cleanse Ex- enzymatic dressing, hydrogel, calcium alginates, pulse irrigation, VAC device, hypertonic salts, wet to damp saline Wound with exudate; how to treat? - CORRECT ANSWER Absorb and contain Ex- Alginate, foam, VAC device, wet to damp saline Wound with sinus, tunnel, undermining; how to treat? - CORRECT ANSWER Prevent pre-mature closure, absorb exudate- treat with loose packing Ex- soak gauze w/ hydrogel; calcium alginate if high drainage, VAC device, wet to damp saline Wound with infection; how to treat? - CORRECT ANSWER Decrease local bacterial count Ex- pulse irrigation, long acting abx, antimicrobial, VAC device, wet to damp saline Which type of sutures pass through tissue easier & resists bacteria? - CORRECT ANSWER Monofilament strands Which type of sutures have greater strength and are easier handling and softer knots? - CORRECT ANSWER Multifilament strands List the absorbable synthetic sutures - CORRECT ANSWER Vicryl Monocryl PDS II Panacryl List the nonabsorbable synthetic sutures - CORRECT ANSWER Nylon Polyester Polypropylene (prolene) List the nonabsorbable organic sutures - CORRECT ANSWER Silk List the absorbable organic sutures - CORRECT ANSWER Plain gut & chromic gut Enzymatic degradation What's the most & least reactive absorbable suture? - CORRECT ANSWER Most- Fast gut Least- PDS II What's the most & least reactive non-absorbable suture? - CORRECT ANSWER Most- silk Least- prolene What are the stages of healing? - CORRECT ANSWER Inflammatory 0-7 - wound strength is minimal Proliferation 7-21 - rapid increase in wound strength Maturation 21+ - further CT remodeling What % of tensile strength is achieved by 2 weeks? - CORRECT ANSWER 25% Which type of organic absorbable suture is used for superficial skin closing? - CORRECT ANSWER Fast gut Which type of organic absorbable suture is used for superficial blood vessels? - CORRECT ANSWER Plain gut Which type of organic absorbable suture is used for oral mucosa or tongue? - CORRECT ANSWER Chromic gut What is the most common absorbable suture used? - CORRECT ANSWER Coated vicryl What is the fastest absorbing synthetic suture that is only used for superficial skin & mucosa? - CORRECT ANSWER Coated vicryl rapide What type of suture is used for SC areas with stress (joint surfaces)? - CORRECT ANSWER PDS II What type of suture is used for extended wound support, general soft tissue & orthopedics, tendons, ligaments, & used in pts with compromised wound healing (steroids, CA pts, obesity, malnourished)? - CORRECT ANSWER Panacryl What type of suture is used in areas such as the periocular area, lips, & other mucosal surfaces- loses strength when exposed to moisture? - CORRECT ANSWER Silk What type of suture is used in abdominal wall closures? - CORRECT ANSWER Steel What are the 2 types of needle points? - CORRECT ANSWER Taper point - soft, easy to penetrate skin Cutting point- tough, hard to penetrate skin Skin suture used for face, fingers, cosmetics? - CORRECT ANSWER 6-0 prolene Skin suture used everywhere, including dorsal of hand? - CORRECT ANSWER 5-0 ethilon Skin suture NOT used on face - CORRECT ANSWER 4-0 ethilon Most common SC closure, face? - CORRECT ANSWER 5-0 Vicryl Strong SC suture? - CORRECT ANSWER 4-0 Vicryl or PDS II What suture is used for tight spaces? - CORRECT ANSWER 5-0 vicryl What suture is used for intranasal & intraoral? - CORRECT ANSWER Intranasal - 5-0 chromic gut Intraoral - 4-0 chromic gut When should sutures be removed? - CORRECT ANSWER Eyelids- 3 days Face- 5 days Scalp - 7-10 days Trunk- 7-12 days UE - 7-14 days LE - 10-21 days What happens if wound edge is inverted? - CORRECT ANSWER Sunken scar will form What type of suture technique is most commonly used in skin closures? - CORRECT ANSWER Simple suture (simple interrupted) *most basic suture technique What type of buried suture technique is the closest to the surface than other buried sutures? - CORRECT ANSWER Intradermal suture *important to place knot on deep site of suture to prevent abscess formation What type of suture technique is continuous series of simple suture loops- knotted only at each end? - CORRECT ANSWER Simple running suture (baseball stitch) *can be diagonal or perpendicular to skin What type of suture technique assures a slightly greater independence or integrity of each loop? - CORRECT ANSWER Running locking suture What type of suture design adds an additional pass through the epidermis at a point close to wound edge on each site; strength determined by large pass while small pass is used to approximate edges? - CORRECT ANSWER Vertical mattress Involves making two sets of needles pass through the wound both in the same tissue plane at adjacent points. When is it most commonly used? - CORRECT ANSWER Horizontal mattress *classically used to secure seal around drain tube* What non suture wound closure method is used for scalp wounds b/c it causes minimal injury to hair follicles? Not for areas that bear weight? - CORRECT ANSWER Staples When closing with adhesive tape, what should be applied first to secure the tape? - CORRECT ANSWER Benzoin application first What is the type of tissue adhesive that is a cyanoacrylate? - CORRECT ANSWER Dermabond How close should sutures be placed to the wound edge & how far apart should they be? - CORRECT ANSWER 3-4 mm from wound edge 3-10 mm apart *face should be 2-3 mm from edge & 3-5 mm apart When should anesthesia be considered? - CORRECT ANSWER - any wound that decreases pt pain - assists clinician in performing a procedure If pt has an allergy to lidocaine, what should be used? - CORRECT ANSWER Ester type anesthetics (novocaine) or vice versa What kind of allergy is more common than allergies to amide anesthetics (lidocaine, mepivacaine, bupivacaine)? - CORRECT ANSWER Allergies to older ester solutions are more common (Procaine, Novacaine, Tetracaine) What is more painful to inject than lidocaine and is not as effective if repair will take longer than 30 mins? - CORRECT ANSWER Benadryl (1mg diluted with 4mL NS) What type of anesthetic is ideal for kids? - CORRECT ANSWER Topical Where should epi be avoided? - CORRECT ANSWER face, mucous membranes, digits, nose, penis, ears what's the most common local anesthetic? What is the Max amount given? - CORRECT ANSWER Lidocaine - NOT exceed 300mg What has the longest duration of action? - CORRECT ANSWER Bupivacaine (Marcaine) How can you decrease anesthetic pain? - CORRECT ANSWER Add 1mL of bicarbonate to 10mL of lidocaine 1% How do you clean a wound? - CORRECT ANSWER Use normal saline diluted with providone/iodine (betadine) 10:1 ratio [Show Less]
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CPSS Study Guide Exam 433 Questions with Verified Answers,100% CORRECT
CPSS Study Guide Exam 433 Questions with Verified Answers What does an Excludes1 note mean in ICD-10? - CORRECT ANSWER The code excluded should never be... [Show More] used. What is used at the end of an ICD-10 diagnosis code to indicate additional digits are required? - CORRECT ANSWER Dashes When coding services for eyelids, and the condition affects all four eyelids, separate codes must be assigned for all four eyelids. - CORRECT ANSWER False In the Alphabetic Index, ______ are used to identify manifestation codes. - CORRECT ANSWER Brackets In ICD-10, what is meant by a "family" of codes? - CORRECT ANSWER Any 3-character category The term used in ICD-10 to represent a consequence of a previous disease or injury is: - CORRECT ANSWER Sequela. What is the maximum number of characters that an ICD-10 code can contain? - CORRECT ANSWER 7 When an Excludes2 note appears in ICD-10, it means: - CORRECT ANSWER The two codes can be reported together. In ICD-10, a placeholder ______ is used to allow for future expansion in codes that require seven digits. - CORRECT ANSWER "X" What was the biggest change in the structure of ICD-10 that did not exist in ICD-9 codes? - CORRECT ANSWER Laterality What agency is responsible for oversight and compliance of ICD-10? - CORRECT ANSWER Centers for Medicare and Medicaid Services For ambulatory surgery coding, always select the diagnosis code from the preoperative diagnosis shown on the operative report. - CORRECT ANSWER False In ICD-10, the Diseases of Eye and Adnexa are included in Chapter _____. - CORRECT ANSWER 7 In ICD-10, the "A - Initial Encounter," "D - Subsequent Encounter," and "S - Sequela" are always shown as the _____ character. - CORRECT ANSWER 7th In ICD-10, the term "senile" cataract has been replaced with: - CORRECT ANSWER Age-related cataract . How is a glaucoma stage reported in ICD-10? - CORRECT ANSWER The stage must be identified by a seventh-character numeric code In ICD-10, diagnosis codes should be assigned based on the diagnosis shown in the fee slip. - CORRECT ANSWER False What group is responsible for creating and publishing the ICD-10 codes? - CORRECT ANSWER World Health Organization In ICD-10, the Tabular List is a list of: - CORRECT ANSWER Codes arranged in chronological order. The acronym "ICD" in ICD-10 stands for: - CORRECT ANSWER International Classification of Diseases In most cases, a patient's initial encounter with the practice is: - CORRECT ANSWER By telephone. Which of the following telephone techniques will help create a positive image for the practice? - CORRECT ANSWER Implementing a two-ring rule. Always make sure the phone is answered before the third ring. Acknowledging the caller by name. Minimizing customer hold time and frequently returning to reassure the caller that he/she has not been forgotten. If the recipient of a call is on the phone, it is best to alert the recipient that a call is holding, as the call may be expected. - CORRECT ANSWER True The basic components of effective telephone communication include which of the following: - CORRECT ANSWER Answering the telephone. Transferring calls.Placing calls on hold. If you call a patient and reach his/her voicemail, it is best to only leave your name and phone number - CORRECT ANSWER False Which of the following is most important to meet patient demands and be successful in today's highly competitive market? - CORRECT ANSWER Respond to patient questions, concerns, or complaints with a positive and professional attitude A neutral tone of voice may be perceived to indicate the person is bored, tired, indifferent, detached, or unenthusiastic - CORRECT ANSWER True Which of the following actions will help you portray a positive image on the telephone? - CORRECT ANSWER Focus on each caller with engaged listening. Use positive language and display kindness over the phone. Replace negative thoughts with positive solutions-oriented ones. It is best to use which of the following actions if you are on another call when the telephone rings: - CORRECT ANSWER Ask permission of the existing caller to be placed on hold while you answer the other telephone line. Which of the following are traits of successful telephone staff? - CORRECT ANSWER Putting a smile in one's voice. Being authentic and sincere with all callers The ciliary processes secrete fluid in the eye, which is called aqueous humor. - CORRECT ANSWER True With age, the lens becomes thick, hard, and non-transparent, causing impaired sight. What is this condition called? - CORRECT ANSWER Cataract An area of the retina known as the macula provides the clearest and most detailed vision. - CORRECT ANSWER True Light enters the interior of the eye through the pupil. - CORRECT ANSWER True Choose the three layers of the tear film. - CORRECT ANSWER Oily,Watery,Mucin Which tissue regulates the amount of light entering the eye? - CORRECT ANSWER Cornea Which tissue is located at the back of the eye and converts light to electric impulses, which are carried to the brain? - CORRECT ANSWER Retina Impaired drainage of the aqueous humor leads to a rise in intraocular pressure which can damage the retinal nerves. What is this condition called? - CORRECT ANSWER Glaucoma The sclera is also referred to as which of the following? - CORRECT ANSWER The white of the eye The following are all true about a subconjunctival hemorrhage except: - CORRECT ANSWER It usually results in loss of vision. The following is true of epiphora (excess tearing): - CORRECT ANSWER . It is typically due to dry eyes. The definition of "triage" is: - CORRECT ANSWER A system establishing the order in which to carry out acts of medical assistance in an emergency. The most important condition to rule out in a case of painful lid swelling is:The most important condition to rule out in a case of painful lid swelling is: - CORRECT ANSWER Orbital cellulitis. The following symptoms all warrant same-day evaluation except: - CORRECT ANSWER Itching In a penetrating injury to the eye: - CORRECT ANSWER Instruct the patient to leave the object in the eye. Complications of blunt trauma to the eye include all except: - CORRECT ANSWER Hyperopia All of the following can cause flashing lights, except: - CORRECT ANSWER Uveitis A "Droopy Eyelid" is not an emergency unless accompanied by: - CORRECT ANSWER Sudden vision loss. Diplopia. Pain. In a chemical splash injury, the first thing you should instruct the patient to do is: - CORRECT ANSWER . Immediately flush out the eye with water for 10-15 minutes. The following symptoms can be scheduled in the next available time slot except: - CORRECT ANSWER Pain The following are true of orbital cellulitis, except: - CORRECT ANSWER It is more common than preseptal cellulitis. If a patient complains of a headache, the following associated symptoms may indicate an emergency, except: - CORRECT ANSWER Long-standing diplopia Patients complaining of discharge from their eyes in combination with an upper respiratory infection require evaluation for: - CORRECT ANSWER Adenovirus Mucous discharge may represent all of the following except: - CORRECT ANSWER Viral infection. The most important condition to rule out in a case of painful lid swelling is: - CORRECT ANSWER Orbital cellulitis The following statements about double vision are true except: - CORRECT ANSWER Binocular diplopia presents only when a patient has one eye open. All of the following are examples of alkalis that can cause eye burns, except: - CORRECT ANSWER Battery Acid. The following is true of blepharospasm except: - CORRECT ANSWER . The patient can be considered legally blind due to eye damage in severe cases The following are all common causes of lid twitching except: - CORRECT ANSWER Hyperopia The posterior chamber is: - CORRECT ANSWER Behind the iris and in front of vitreous face. The eyeball consists of which of the following layers? - CORRECT ANSWER Fibrous layer,Vascular layer,Nerve layer The temporal fibers of the optic nerve do not cross, while nasal fibers do cross at the optic chiasm. - CORRECT ANSWER True The extraocular muscle that does NOT originate at the annulus of Zinn is the _____. - CORRECT ANSWER . Inferior oblique The structure of the eye that continues to grow throughout life is the _____. - CORRECT ANSWER Lens The aqueous humor exits the anterior chamber through the drainage structure located in the _____. - CORRECT ANSWER . Angle. Name the anatomical structure that gives shape and rigidity to the eyelid. - CORRECT ANSWER Tarsal plate The main depressor of the eyelids is: - CORRECT ANSWER Obicularis The Visual Pathway begins at the _____. - CORRECT ANSWER Retina The structure which does NOT make up transparent ocular media is the _____. - CORRECT ANSWER Iris. The area in the retina that represents the physiologic blind spot is: - CORRECT ANSWER Orbital floor Which of the following is NOT a layer of the cornea? - CORRECT ANSWER Broadman's area The cranial nerve responsible for AFFERENT pupillary reflex is: - CORRECT ANSWER CN II The vascular layer of the eye consists of the _____. - CORRECT ANSWER Ciliary body, Iris, Choroid. Accommodation and aqueous production are a function of the: - CORRECT ANSWER Ciliary Body The area susceptible to blunt trauma of the orbit is: - CORRECT ANSWER Orbital floor The primary lifting of the upper lid is performed by _____. - CORRECT ANSWER The levator muscle The junction between the cornea and sclera is the _____. - CORRECT ANSWER Limbus. The functions of the orbit are to provide protection, support, and attachment of the cranial nerves. - CORRECT ANSWER False Which of the following is hydrophobic? - CORRECT ANSWER Epithelium Which of the following statements are true? - CORRECT ANSWER The way you interact with others communicates your respect (or lack thereof) to them.Everyone who works in our office wants and deserves to have respect.a. The fewer interpersonal conflicts we have in our office, the more productive and happier we will be as a staff. You can say the same exact words and have two different meanings. What percent of our message is contained in the words we use? - CORRECT ANSWER 7% If a co-worker said to you, "Quit putting those charts on my part of the counter. You're always crowding my space!" which of the following would be a way of encouraging an Adult-to-Adult interaction? - CORRECT ANSWER I'm sorry, I didn't realize they were in your way. Where do you put the charts you are working on?" Which of the following would be the Adult response to the accusation, "I can't do my job, because you've never showed me how to enter new patients into the computer like you were supposed to." - CORRECT ANSWER "Let's spend a few minutes this afternoon, and I will train you how to do that." If a person seems to think they are superior to their co-workers, which life position are they most likely to have? - CORRECT ANSWER I'm not ok, you're ok Which of the following are reasons that the "I'm ok, you're ok" position is the most productive? - CORRECT ANSWER . It allows us to be in our Adult state of mind most of the time. It allows us to show respect for others.It allows us to give and receive positive strokes.It helps us interact positively with others. Which of the following describes the relationship between the concepts of Parent, Adult, and Child states of mind, strokes, and life positions? - CORRECT ANSWER The "I'm ok, you're ok" life position allows us to be in our Adult state of mind so that we can give and receive positive strokes and more accurately deal with negative strokes.The "I'm not ok, you're ok" life position tends to lead us to be in our Parent or Child mode and to give negative strokes to others. The three states of mind are: - CORRECT ANSWER Parent, Adult, Child Which of the following contain recordings of authoritative pronouncements that we heard as a child? - CORRECT ANSWER Our Parent state of mind Which of the following contain the recordings of the feelings we had as we experienced events in our life? - CORRECT ANSWER Our Child state of mind Which of the following allows us to choose how we - CORRECT ANSWER Our Adult state of mind In our Adult state of mind, we can decide whether to ______, ______ or _____ a critical comment aimed at us. - CORRECT ANSWER Accept, reject or modify If someone said "You're not the boss of me," which state of mind would they most likely be in? - CORRECT ANSWER The Child If you heard the following, which state of mind would be reflected? "You shouldn't just sit there waiting to be told what to do next. You need to quit being lazy and help us out." - CORRECT ANSWER The Parent For human beings, even strokes that are very negative are better than no strokes at all. - CORRECT ANSWER True OSHA Stands for - CORRECT ANSWER occupational safety and health administration what is the max amount of time a patient should be left on hold before someone check in with them - CORRECT ANSWER 10 sec cataract sx requires an overnight stay in a hospital - CORRECT ANSWER false bifocals lenses are - CORRECT ANSWER lenses with 2 different focal powers an ASC is an ambulatory sx center - CORRECT ANSWER true which of following equipment is not commonly used in a laser refractive procedures - CORRECT ANSWER phaco oculoplastics is an area of specialty for - CORRECT ANSWER ophthalmologist what is OSHA Primary goal - CORRECT ANSWER protects employees in work place the difficulty with triaging headaches is that in rare cases, a headache could indicate a life-threatening condition - CORRECT ANSWER true what common household products is used to kill blood-borne pathogens - CORRECT ANSWER bleach covered entities under HIPAA include - CORRECT ANSWER health care professionals, health care facilities medicare will reimburse practices for refractions - CORRECT ANSWER false which of the following is most likely used to help monitor glaucoma - CORRECT ANSWER visual field devices used to correct refractive errors are - CORRECT ANSWER glasses and contacts lenses the number of exemption each employee claims on his/her w-4 form helps determine how much_is withheld from each paycheck - CORRECT ANSWER federal tax which of the following actions help to portray a positive image on the telephone - CORRECT ANSWER all of the above in most states, a nonexempt employee is eligible for overtime pay for hours worked in excess of 40hrs per week - CORRECT ANSWER true the following symptoms can be scheduled in the next available time slot except - CORRECT ANSWER pain a patient desiring to have a change in glasses whose only complaint is difficulty with near vision should be scheduled - CORRECT ANSWER next available appt a patient with complaints of blurred vision for about three months should be scheduled - CORRECT ANSWER next available appt which government department enforces medicare rules and regulations - CORRECT ANSWER centers for medicare and medicaid services od - CORRECT ANSWER right bid - CORRECT ANSWER twice a day ha - CORRECT ANSWER headache QID - CORRECT ANSWER four times a day qd - CORRECT ANSWER once a day qhs - CORRECT ANSWER at night Pt - CORRECT ANSWER patient os - CORRECT ANSWER left eye R/O - CORRECT ANSWER rule out ou - CORRECT ANSWER both eyes an eye care professional licensed to fabricate and dispense eye glasses is an - CORRECT ANSWER optician a routine eye exam is likely to be covered under major medical insurance - CORRECT ANSWER false the world meaning to enlarge or cause to expand is - CORRECT ANSWER dilate the word meaning currently happening - CORRECT ANSWER occurring a physician and surgeon who specializes in treatment and surgery of the eye is an - CORRECT ANSWER ophthalmologist patient registration process are normally completed - CORRECT ANSWER upon check in in most cases the patients initial encounter with the practice is - CORRECT ANSWER by telephone The primary goal of the ophthalmic practice should be to: - CORRECT ANSWER Provide quality medical eye care for patients Which of the following are characteristics of a winning team? - CORRECT ANSWER All of the above A team is a group of people who work together in an ophthalmic practice. It is automatically a team because all of the team members are employed by the practice. - CORRECT ANSWER False Ethical treatment of patients depends on fair treatment of patients without regard to race, religion, financial status, sex, or ethnicity. - CORRECT ANSWER True The financial success of the practice depends on: - CORRECT ANSWER All of the above. Which of the following IS NOT a responsibility for a staff member in providing quality customer service? - CORRECT ANSWER Interrupt patients when they talk too long because the practice is running behind When dealing with unhappy patients, always apologize, even if you do not agree with their point of view. - CORRECT ANSWER True When communicating with patients, openly express your feelings, even if they are negative. - CORRECT ANSWER False Many patients change physicians because of dissatisfaction in their treatment by the physician and/or staff members. - CORRECT ANSWER True Which of the following are examples of excellent customer service? - CORRECT ANSWER Smile, make eye contact, and address patients by name. Be a good listener. Be courteous. The person at checkout never has to balance receipts collected to a patient payment log. This work is done by the data entry staff member who posts charges and payments. - CORRECT ANSWER False Superbills or encounter forms are most commonly used to: - CORRECT ANSWER Record diagnosis and procedural codes Patient receipts should be used: - CORRECT ANSWER To provide an immediate receipt for all patients. A "clean claim" expedites the payment process because it: - CORRECT ANSWER Has no obvious errors and can be processed quickly by the insurance company without claim resubmission. It is ideal for only one staff member to be responsible for all collection processes in the practice. - CORRECT ANSWER False In most practices the coding of office visits is done by: - CORRECT ANSWER The provider and/or scribe ICD-10 and CPT codes must correspond because: - CORRECT ANSWER Payers will deny payments if diagnosis and procedure codes do not match. The responsibilities of checkout DO NOT include which of the following? - CORRECT ANSWER Retrieving the patient's chart from storage ICD-10 codes are used to describe procedures and testing performed in the office. - CORRECT ANSWER False It is ideal for audits to take place after the claims have been submitted so that extra time and effort will not be required to correct them and, hopefully, the mistakes will not be recognized. - CORRECT ANSWER False When coding errors are identified, the auditor should: - CORRECT ANSWER Use the errors as a training opportunity to improve coding accuracy The staff member auditing charts focuses on which of the following areas - CORRECT ANSWER All of these End-of-the-day responsibilities for the data entry clerk include which of the following? - CORRECT ANSWER Balancing totals for payments posted into the practice management system with receipt totals and patient log amounts At the conclusion of each encounter, the patient should: - CORRECT ANSWER Stop at the checkout desk to determine payment status. Incorrect use of CPT codes can result in lost revenues and possible fines. - CORRECT ANSWER True The acronym "EOB" represents: - CORRECT ANSWER Explanation of benefits EOBs are used by: - CORRECT ANSWER Posting/Billing staff Which of the following information is used in compiling the daily balance sheet? - CORRECT ANSWER All of these When processing payments received from insurance companies via mail, it is important to: - CORRECT ANSWER All of these When checks are received and cannot be applied to a patient's account because of lack of information (unapplied cash), the practice: - CORRECT ANSWER Deposits the check in the "unapplied cash" account and calls the issuing agent of the check to identify the correct patient Direct remittance is an option provided by some practice management systems in which a Medicare check can be downloaded directly into the practice management system and automatically posts payments to specific patient accounts. - CORRECT ANSWER True The daily deposit includes which of the following? - CORRECT ANSWER Mail receipts In large practices, the posting of all payments usually is the responsibility of one person in the billing department. - CORRECT ANSWER False Maximizing practice collections is the responsibility of the entire staff. - CORRECT ANSWER True Which of the following is not a process used by the practice in processing direct deposits from insurance companies, Medicare, and Medicaid? - CORRECT ANSWER Include the amounts from direct deposits in the daily deposit All checks received by mail should be processed within 24 hours of receipt. - CORRECT ANSWER True Lockbox arrangements with banks are helpful to some practices in order to: - CORRECT ANSWER Provide security for checks and rapid deposit of funds EOBs should be: - CORRECT ANSWER Stored for future reference based on practice policy or local regulations Daily backup tapes are used to protect data in case of power failure or other damage to stored data. - CORRECT ANSWER True How many staff members are responsible for compiling all of the daily work that has been processed into a single balance sheet? - CORRECT ANSWER One staff member Which of the following forms is not usually requested during the registration process? - CORRECT ANSWER Patient's credit score In multi-physician practices, the appointment scheduler can schedule the patient for an appointment with any physician for any reason. - CORRECT ANSWER False Patient registration processes are normally completed: - CORRECT ANSWER Upon check-in. It is important to follow scheduling templates when scheduling patient appointments in order to: - CORRECT ANSWER Control the schedule so that patients are seen efficiently and in a timely manner. If the patient registers without noting a ZIP code, this most likely means: - CORRECT ANSWER Possible future delays in receiving payment from the patient if it is not obtained Registration information should be: - CORRECT ANSWER Routinely reviewed for each patient upon arrival If the patient arrives for an appointment without necessary insurance authorization: - CORRECT ANSWER An attempt is made to obtain the authorization, so that the patient can be seen. The appointment process is relevant to effective collections because: - CORRECT ANSWER Patients must be scheduled with the correct physician and for the correct reason. Scheduling patient appointments by documenting the appointment in a computerized practice management system offers the advantage of efficient integration with human resources. - CORRECT ANSWER False The patient's chart usually is prepared prior to the patient's visit. - CORRECT ANSWER True The patient registration form usually is completed upon arrival to the office and requests which of the following information? - CORRECT ANSWER All of the above When scheduling a patient for an appointment, which of the following data should be documented? - CORRECT ANSWER Patient's full address with ZIP code It is important to confirm patient appointments prior to the scheduled appointment in order to: - CORRECT ANSWER Limit the number of no-shows and last-minute cancellations Credit balances on accounts in which the patient cannot be located: - CORRECT ANSWER Must be forwarded to the state, subject to disposition as unclaimed property. Refunds due to Medicare/Medicaid should be: - CORRECT ANSWER Paid within 60 days of overpayment. Ideally, the patient and applicable payer should be billed for services: - CORRECT ANSWER As soon as possible In recent years, billing processes have become: - CORRECT ANSWER More reliant on automated processes. Within the practice information system, patient statements usually are divided by: - CORRECT ANSWER Alphabetical order of last names Cash management is a term referring to - CORRECT ANSWER Appropriate safekeeping of practice revenue. Electronic processing of claims greatly increases the speed of payment from third-party payers. - CORRECT ANSWER True Primary responsibility for effective policy implementation rests on: - CORRECT ANSWER The billing supervisor. When a practice receives checks for insufficient funds, the practice often adds bank processing fees to the amount owed by the patient. - CORRECT ANSWER True Unless unusual circumstances dictate otherwise, patients with outstanding accounts should receive a statement: - CORRECT ANSWER . Once per month. Which of the following information is required for claims processing? - CORRECT ANSWER . All of these Financial assessment of accounts receivable performance should be: - CORRECT ANSWER Measured monthly within the practice. [Show Less]
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CPSS midterm Exam 80 Questions with Verified Answers,100% CORRECT
CPSS midterm Exam 80 Questions with Verified Answers What are the indications for performing veni puncture? - CORRECT ANSWER a) Indications: for the e... [Show More] valuation and management of many different disease processes -when the quantity required for testing is > can be obtained by puncturing the skin with a lancing device. The primary purpose of phlebotomy is to obtain a sample of blood for Dx testing, and only rarely is phlebotomy utilized as a therapeutic modality what are the contraindications for performing venipuncture.? - CORRECT ANSWER b) Contraindications (relative bc other location can be selected): -skin infection, skin rashes, new tattoo -extensive scarring, phlebitis, sclerosed veins, -lymphedema (upper extremity on same side of mastectomy) -hematoma -IV cath distal to venipuncture site -arm w/ cannula or w/ vascular anomaly (AV fistula) Identify and describe the potential complications associated with venipuncture - CORRECT ANSWER a) Pain and discomfort b) Syncope c) Cellulitis and/or phlebitis d) Thrombosis e) Bruising f) Laceration of vein g) Hemorrhage/hematoma h) Prolonged bleeding in pts w/ coagulopathies or who are taking anticoagulants (not a contraindication) The pt should be advised that minor discomfort and discoloration at procedure site may be experienced for 48-72 hours after venipuncture 1) Describe the essential anatomy and physiology associated with the performance of venipuncture - CORRECT ANSWER a) Blood is 6-8% of total body weight, (serum= plasma -fibrinogen); main function is transport O2, nutrients, waste products, hormones, etc throughout body; also regulated body temp, fluids and acid-base balance; immune system response and coagulation b) 3 types of blood cells: RBC(erythrocytes), WBC (leukocytes), Platelets (thrombocytes) c) Cubital fossa (triangle on anterior aspect of elbow): cephalic and basilic veins (superficial) are prominent; median cubital vein crosses the bicipital aponeurosis -the site most frequently utilized for venipuncture. -The boundaries include imaginary line connecting medial and lateral epicondyles superiorly, pronator teres medially, and brachioradialis laterally. NOTE: The best veins for venipuncture, listed by order of preference, are as follows: 1. Median cubital vein, easily palpated, well anchored, least painful, least likely to bruise, and usually largest vein in the antecubital space. 2. Cephalic vein, large vein that is easily palpated, but poorly anchored; can be painful to pt 3. Basilic vein, easy to palpate, not well anchored, and very close to brachial artery and the median nerve 1) Identify the necessary materials and their proper use for performing venipuncture. - CORRECT ANSWER a) Gloves (At least 2 pairs of nonsterile gloves) b) Tourniquet (3⁄4 or 1 in for adults and 1⁄8 in for children. An adult or peds BP cuff may be utilized in place at mmHg >diastolic. Esp helpful in elderly to prevent excessive stress on the vein) c) Gauze pads d) Isopropyl alcohol pads e) Povidone-iodine (for blood cultures) f) Evacuated tubes g) Labels (prepare prior to procedure) h) Adhesive strips i) Sharps container, Biohazard waste container Venipuncture performed utilizing a Vacutainer requires the following materials: -Multisample needles (18 to 23 gauge) or butterfly infusion set (21, 23, or 25 gauge). -Vacutainer holder/barrel OR m) Single draw needle and syringe 1) Demonstrate the appropriate technique and sequence for performing venipuncture utilizing both a vacutainer system and a syringe - CORRECT ANSWER a) Check pt ID and orders b) Assemble equipment needed c) Wash hands d) Position pt (If possible, position in supine or recumbent position. If sitting up, extend arm straight down from shoulder to waist) e) Select vein (1. *median cubital vein, cephalic vein, basilic vein) [sense of touch should be refined by using palmar aspects of gloved finger pads] and apply tourniquet (3-4 in. above tourniquet site. Never leave on for >2 mins) f) Don gloves, secure vein by anchoring with finger, and clean skin (begin at venipuncture site and circle outward to a 2-in diameter) g) Stretch skin downward below anticipated venipuncture site w/ nondom hand to anchor vein. Insert needed into vein at 15-30° angle bevel side up and parallel to vein h) Move vacutainer down into barrel to puncture tube and fill until vacuum is exhausted (correct order of draw) i) For drawing into a syringe pull back gently on plunger, then transfer blood into vacutainer tubes what are Special Instructions for Blood Collection With a Syringe - CORRECT ANSWER Syringes may be used for venipuncture when the pt's veins are small or fragile and Vacutainer tubes may cause veins to collapse. Using a syringe w/ a 20- or 21-gauge needle or butterfly needle allows for greater control. The procedure follows same steps as for Vacutainer system except differs in the order of samples drawn, aspiration of blood into the syringe, and transfer of blood into the vacuum tubes. 1. make sure there is back flow in needle 2. pull back on the plunger and fill the syringe w/ desired amount of blood & release tourniquet 3. transfer blood in syringe to tubes by Attaching a Vacutainer blood transfer device to the syringe and proceed to engage and fill the evacuated tubes in the correct order. DONT USE THE PLUNGER TO FILL THE TUBES 1) Identify strategies for handling unsuccessful attempts at venipuncture - CORRECT ANSWER a) To find difficult veins: keep extremity below level of heart for a few mins, apply warm towel to promote vasodilation for no >2 mins, use BP cuff, rub/tap vein to promote vasodilation (before site is cleaned) b) If no blood is obtained, change position of needle carefully. Move it forward or backward, and consider adjusting the angle of the needle. Monitor for hematoma formation, stopping procedure if occurs & hold pressure for 10mins (15 min if on anticoags). c) If blood stops flowing into evacuated tube, vein may have collapsed. Resecure the tourniquet to increase venous filling. If this does not fix blood flow, remove needle, take care of puncture site, and redraw. d) Avoid leaving a tourniquet on for >2 mins.. e) When using a syringe, avoid drawing plunger back too forcefully. f) If venipuncture procedure is unsuccessful, do not attempt to repeat it at same site until healing has occurred. After 3 unsuccessful attempts, stop and ask for assistance. 1. Identify the anatomy associated with the insertion of a peripheral IV catheter - CORRECT ANSWER o Forearm is used if possible (Avoiding valves and bifurcations easier in lower arm) or dorsum of the hand offers good IV access o Assess bifurcations (visualize) and valves (palpate as knot-like lumps or tortuous areas) before IV placement o Commonly used: metacarpal, basilic, or cephalic veins -can use the foot in peds pts (bc good blood flow so no risk infection). Commonly used LE veins are the greater and lesser saphenous and medial marginal veins. what are indications for insertion of IV caths? - CORRECT ANSWER o Indications: fluid administration for illness, volume depletion, burns, blood loss, electrolyte disturbance, heat stroke, shock, trauma. -admin of Abx, chemotherapeutics, blood products -admin of Dx substances like dyes or contrast, -admin of nutritional fluids what are the contraindications for administration of IV caths? - CORRECT ANSWER o Contraindications: appropriate Tx can be given by less invasive route -extremities w/ significant burns, edema, injury, cellulitis or significant infection - no insertion distal to prior failed IV cath insertion attempt -avoid inserting distal to areas of preexisting phlebitis; -extremities w/ impaired circulation (mastectomy, axillary lymph node dissection, lymphedema, clot, PVD, venous insufficiency) -extremities w/ indwelling fistula consider if med is too caustic, hypertonic, a sclerosing agent, vasopressive agent or being given for >6 days; careful in pts w/ known bleeding risk 1. Identify common complications associated with IV catheter placement. - CORRECT ANSWER o Technique: -if no flash of blood cath probably not in vein, -flash of blood but can't advance catheter: vessel valve may be occluding cath --> remove & apply pressure -fluid not flowing freely: due to clot or kink --> remove & apply pressure o Local: -if fail to cannulate vein properly, may give med or fluid in surrounding tissue outside vessel -> pain, tissue irritation, and swelling. Certain meds can be caustic to adipose tissue & necrosis -minor bleeding -thrombophlebitis (can be minimized by avoiding trauma at time of insertion, securely taping cannula in place, and avoiding placing catheter near a joint line) -local site infection or cellulitis (use aseptic techniques and dont leave in place >72-96 hours) o Systemic: (RARE) -septicemia, bacteremia: MC if dont use aseptic technique -catheter embolization: results from distal portion of the cath end being shearing off by beveled end of needle. Can be avoided by not pulling catheter sheath back over needle once it has been threaded (advanced). -pulmonary emboli: w/ centrally placed peripheral lines -air emboli: if lines aren't properly flushed to remove air before connected to cath 1. Identify proper aftercare for an IV catheter insertion site. - CORRECT ANSWER o Instruct pt on signs of infection (discomfort, pain, redness, swelling) o Have pt notify caregiver immediately if experiencing signs o IV site should be changed every 96 hours to reduce likelihood of infection 1. Identify the material necessary to insert an IV catheter. - CORRECT ANSWER o Appropriate gauge IV catheter (over the needle catheters w/ safety devices are the MC used); size range is 24-14 gauge o Gloves and other PPE (eye protection) o IV fluid o Administration set (tubing w/ drip chamber that has been primed w/ IV fluid and has roller clamp flow regulator and standard connecting) o IV pole, Infusion pump o Antimicrobial cleanser o Tourniquet o Scissors o Tegaderm or other nonocclusive dressing o Gauze o Arm board (if needed) o Biohazard waste o Antiseptic ointment what consent must be obtained for inserting IV cath. - CORRECT ANSWER Verbal consent is sufficient. For the usage of intravenous catheters, the risk- benefit ratio and the indication for placing are considered to be common knowledge for a competent and alert patient. The patient is assumed to have consented if they extend the extremity to have the IV placed. Time should be taken to explain the indication, the pain involved the procedure, the expected time for the therapy and alternatives if available. what kind of needle is used for insertion of cath in infant? how about for blood transfusions? - CORRECT ANSWER A 24-gauge (small bore), 0.5-inch catheter is commonly used in a neonate or small infant. The delivery of blood products or trauma necessitates larger bore IV devices, such as 16 or 18 gauge describe the general procedure of insertion of IV cath (not objectives) - CORRECT ANSWER 1. Apply the tourniquet above the elbow (or ankle) both both arms (or feet). Choose most suitable vein 2. Palpate vein for stability and valves (a compressible, stable vein thats free of valves for 1 in is ideal). 3. Release tourniquet,turn on infusion pump, flush tubing w/ fluid, and ensure tubing is free of trapped air bubbles. 4. Apply tourniquet snuggly and well proxi- mal to the chosen site (less pressure on elderly sensitive skin) 5. Put on gloves and eye protection. 6. Allow vein to distend, place arm below heart 7. Cleanse site with approved aseptic cleanser (70% alcohol, tincture of iodine, an iodophor, or chlorhexidine gluconate). back-and-forth motion for a min of 30 secs and then allowed to dry. 8. W/ nondom hand, hold pt's hand (or foot) securely and use thumb to gently retract skin distal to insertion site 9. Puncture vein using direct or indirect entry -Direct (one step, used for larger veins): Hold assembly at 15-20 degrees above site and enter vein directly -Indirect (2 steps, used for smaller veins): hold assembly 15-20 degrees above site and 20 degrees lateral to vein, insert cath into skin, and then advance into vein. When vein is punctured, blood should appear in flash chamber. Once flash is seen, lower needle assembly to almost parallel w/ skin and thread the cath what is special care that should be considered for insertion of cath for peds or elderly? - CORRECT ANSWER The geriatric and pediatric populations are more likely to have smaller, more fragile veins, and fewer venous options may be present; thus, careful inspection of all options should be done before attempting IV placement. Avoid the LE in elderly or pt w/ vascular insufficiency. If blood products arent being given, use a smaller catheter, such as a 24 gauge. In geriatric may be equally difficult to start an IV in a very large vessel bc it may be sclerotic. Makes vein more difficult to puncture and catheter more difficult to thread. if <1 year of age, 24 gauge is the preferred cath size. In children, securing line is critical bc tend to be more active and remove the catheter. Describe the anatomy of the skin and underlying structures affecting the manner in which injections are administered. - CORRECT ANSWER -W/ ^ depth of needle penetration, systemic absorption of an injected agent is enhanced Below the epidermis is the dermis, which varies from 1-4 mm in thickness and is composed of connective tissue. The subcutaneous (adipose) layer lies directly beneath the dermis and above the muscles. This layer is composed of hair follicles, sebaceous glands, sweat glands, blood vessels that supply the dermis, and nerves of the autonomic nervous system. what does parenteral mean? - CORRECT ANSWER the administration of medical therapy is in a manner not involving the gastrointestinal or alimentary tract. -Specific routes of parenteral delivery include intradermal, subcutaneous, intramuscular, and intravenous what are the indications for injections? - CORRECT ANSWER injections are indicated for therapeutic treatment, Dx of medical conditions (i.e., allergen response, TB), and disease prevention (i.e., immunization). what are some risks/complications associated with injections? - CORRECT ANSWER unsafe injection practices may ^ risk of exposure to infectious dz such as HBV/HCV and HIV. Infection control is not limited to prevention of needlestick injuries. The CDC cited reinsertion of used needles into multidose vials or solution containers, such as saline bags and tubing, as a contributing factors. -Pain, burning, and erythema at injection site (to reduce pain: Ensure pt is relaxed, bc muscular contraction intensifies pain; allow antiseptic to dry completely before injection; gently massage area after injection) -Infection (reduced w/ proper aseptic technique) and abscesses from irritating solutions -Lipodystrophy (Pts administering multiple and repeated injections (i.e., insulin) may develop atrophy of subcutaneous fat, which may interfere w/ absorption. Rotation of injections sites can prevent atrophy) -Injury to surrounding structures such as nerves and arteries. Risk is ^ w/ IM injections. -Allergic reaction (including anaphylaxis) to injectant -Medical error what are important uses for: Intradermal Injections IM Injections subcutaneous injections - CORRECT ANSWER INTRADERMAL: Injected into the dermal layer of skin - Useful for conditions requiring skin testing, (TB and allergens) SUBCUTANEOUS -Useful for low-volume medication delivery (ex insulin or enoxaparin) and some vaccinations INTRAMUSCULAR (IM): Injected deep into musculature for distribution through the vasculature - Useful for higher volume medication delivery and some vaccinations what are potential contraindications for injections? - CORRECT ANSWER ■ Allergy to any component of injected substance (medication, preservative, etc.). When administering vaccines, ask pts about egg and or gelatin allergies. ■ Coagulopathy (esp for IM injections) ■ Pregnant pts should not be administered live virus vaccines (i.e., MMR, varicella, influenza vaccine). ■ Active infection at the injection site where is the optimal site for IM injections? for intradermal injections? for subcutaneous injections?q - CORRECT ANSWER • Intradermal: localized effect just beneath the epidermal skin layer; optimal site is ventral forearm 10cm from antecubital fossa (allergen testing may use lateral side of upper arm or upper back for ^ SA) • Subcutaneous: optimal absorption in adipose regions of lower abdomen, anterior or posterior thigh, upper buttocks, lateral lower back, and lateral upper extremities; rotate site to prevent lipodystrophy • Intramuscular: fastest/best absorption (bc contain BVs that transport med through CV system) -MCly use deltoid, ventrogluteal (lateral hip), and vastus lateralis (lateral thigh) -some injections are specifically manufactured to become activated w/in the muscle - to minimize injury, ensuring correct pt positioning, expose skin completely, and palpating landmarks where are the landmarks for IM common injection sites ? - CORRECT ANSWER Deltoid: Place 4 fingers across deltoid, w/ top finger lying along acromion process. Inject 2 to 3 fingers below the acromion process. *Risk for injury to radial and ulnar n. or brachial artery Ventrogluteal (Gluteus medius and minimus): Place heel of hand over greater trochanter, w/ thumb pointing toward groin and fingers toward head. Place index finger on anterosuperior iliac spine, extending the 3rd digit along iliac crest (a "V" is formed by first and third digits). Inject into center of the "V." **Advocated as 1st choice bc of distance from major nerves and blood vessels Vastus lateralis: Place hand above knee and then below greater trochanter of femur. The area between the hands is the vastus lateralis. Inject into middle 1/3 of the area. **Preferred choice by clinicians for infants & common in children/adults Dorsogluteal (Gluteus maximus): Draw an imaginary line btwn posterior superior iliac spine and greater trochanter of femur. Inject above and lateral to the imaginary line. Less reliable method: Divide butt into quadrants, inject into upper outer quadrant, 2-3 in below the iliac crest. *Most resources do not advocate routine administration in buttocks bc risk for sciatic n. and superior gluteal artery injury. 1) Recognize the importance of equipment preparation and proper technique when administering injections. - what are methods to ensure proper care? - CORRECT ANSWER -"rights of medication administration": -Right pt -right med (check med or vaccine label 3 times) -right dose, right time, right route, right site, -right documentation (A copy of a Vaccine Information Statement (VIS) required by law to be given to the pt and/or legal guardian for each dose) -Never administer meds from same syringe even if the needle itself was changed Before obtaining a verbal consent, inform the pt about the indication, benefits, and risks. Always verify allergies Inform pt about site of administration and potential sensations on needle insertion. (don't lie)• what is equipment needed for injections - CORRECT ANSWER Equipment: 2 or 3mL syringe, needle (according to route of admin and size of pt), injectable substance, alcohol pads, gloves, sharps container, gauze pad, bandage Size of needle: The larger the gauge, the smaller the diameter (26 gauge is thinner than a 20 gauge) Progressing from shorter length and thinner gauge -> longer length and larger gauge = intradermal, subQ, and IM needles. Commonly used sizes--> Intramuscular: 20 to 25 gauge, 1.5 inches Subcutaneous: 25 to 27 gauge, 3/8 to 5⁄8 inches Intradermal: 25 to 27 gauge, 0.5 to 5⁄8 inches -how are each of the following injection procedures done: *intradermal *subcutanous *IM - CORRECT ANSWER •Intradermal: after prepping site insert needle w/ bevel up at a 15° angle into upper layers of skin and inject slowly; wheal or bleb should appear (do not rub site/apply pressure) • Subcutaneous: after prepping site, bunch the skin w/ non dominate hand to pull subQ layer away from musculature and insert needle w/ bevel up at 45° angle into subQ layer, inject slowly and apply pressure w/gauze after needle removal •IM: after prepping site, ensure pt is relaxed, gently stretch skin pressing down slightly to reduce subcutaneous tissue and insert needle w/ a quick thrust at a 90° angle deep into muscle, apply pressure after needle withdrawal what is the recommended location for IM and SubQ injections in pediatric patients? - CORRECT ANSWER what are special ways for administering insulin? - CORRECT ANSWER Insulin preparations typically require that the vial be gently rolled in the palm of the hands to ensure proper distribution. Shaking the bottle can alter the potency. Pts need education on injection site rotation to limit lipodystrophy. Typically, sites such as the arms, abdomen, thighs, and buttocks provide effective absorption of insulin. Documentation and patient follow-up care after injections are : - CORRECT ANSWER The following documentation is required for any injected substance. -Name and manufacturer of agent, lot number, expiration date. Injection method (specific site, needle, route). Date, time, and person who administered injection. Vaccination Information Statement for vaccines **It is recommended to observe the pt for at least 15 mins after vaccination. Syncopal episodes may occur during or after a vaccination. Preceding sx- weakness, pallor, dizziness, palpitations, and diaphoresis. Adequate preparation includes having the pt seated or lying down during and after injection. *HCPs should report significant AEs after vaccination to the Vaccine Adverse Event Reporting System (VAERS) read the notes about how surgical knot tying procedures should be done on canvas - CORRECT ANSWER what are the advantages for plaster materials for casts? what are the advantages for fiberglass materials for casts? - CORRECT ANSWER PLASTER: easier to mold to an extremity, giving it an advantage when a snug and form-fitting cast is needed on an area w/ challenging contours, (ex. chubby, cone-shaped arm/legs of a toddler). Also absorbs ("wicks") underlying wound drainage, making it a desirable splinting material in trauma and postoperative settings. Although messy to apply, plaster is easily washed off with soap and water—making the wearing of gloves optional. Less expensive FIBERGLASS: The material of choice for majority of cast and splint applications, esp for weight-bearing ("walking") casts. its strength and flexibility, light weight, ease of application, and durability. Once hardened, it is fully water-resistant. Generates a much smaller exothermic reaction. Begins to harden in 3-4 mins and fully hardens in 1-2 hrs. Available in a wide variety of colors what are the disadvantages of using plaster materials for casts? [Show Less]
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CPSS Paracentesis,Thoracentesis,Chest Tube Questions with Verified Answers,100% CORRECT
CPSS Paracentesis,Thoracentesis,Chest Tube Questions with Verified Answers Indication for paracentesis - CORRECT ANSWER *new onset ascites* testing pre... [Show More] -existing fluid evaluation of patient with ascites who is deteriorating and/or signs of SBP therapeutic drainage of recurrent/refractory ascites Relative contraindications for paracentesis: _________ and DIC Overlying skin abnormalities like _______, engorged veins, or __________ - CORRECT ANSWER coagulopathies cellulitis abdominal wall hematoma More relative contraindications for paracentesis: Distended ____________ ________ - CORRECT ANSWER intra-abdominal organs Surgical scars ________ containers and or __________ cannisters are needed in paracentesis. - CORRECT ANSWER evacuated suction You can use IV catheters without retractable needles for paracentesis *DO NOT use IV catheters with ________ as they cannot be detached.* - CORRECT ANSWER safety mechanisms _______ needles are designed specifically for paracentesis and thoracentesis. They have plastic catheters over a metal needle and multiple side holes. - CORRECT ANSWER Centesis needles 2 types of paracentesis kits - CORRECT ANSWER 1) quick-tap 2) Saf-T centesis catheter T/F Paracentesis specific devices have been shown to remove larger volumes of ascites more rapidly and require fewer punctures than IV catheters - CORRECT ANSWER True When performing paracentesis, use the linea alba as a guideline. Avoid the __________. Lower areas are good because fluid travels down via gravity. - CORRECT ANSWER inferior epigastric arteries In ascites, _______ and _______ may be enlarged. Hollow organs may be distended. The intestines typically _______. - CORRECT ANSWER spleen and liver float If the bowel is adherent to parietal peritoneum, _________ is more common when performing paracentesis - CORRECT ANSWER injury What are the needle entry sites for paracentesis? - CORRECT ANSWER 1) Midline 2 cm below umbilicus at the linea alba 2) right or left lower quadrant 4-5 cm superior and medial to ASIS (LLQ is usually preferred) When inserting the needle in the RLQ/LLQ, insert the needle lateral to the _________ to avoid inferior epigastric arteries - CORRECT ANSWER rectus sheath _________ may be distended especially if patient is taking lactulose - CORRECT ANSWER Cecum If the paracentesis will be a large volume, ______ and monitor __________ - CORRECT ANSWER start an IV vitals Use ___________ to confirm entry site over fluid and not over structures - CORRECT ANSWER bedside ultrasound Like all anesthesia, use a _____ needle to place initial anesthesia then switch to _____ needle to anesthetize deeper tissue. Alternate _______ and ________ - CORRECT ANSWER 25 gauge 22 gauge aspirating injecting Once you insert the needle and attach the syringe. Rotate the catheter around the needle to break the ________ - CORRECT ANSWER factory seal When inserting needle during paracentesis, aspirate every ____ or so to check for inadvertent vascular placement or entry into peritoneal cavity. *DO NOT apply suction to minimize bowel injury and immediately stop advancing the needle if _________ fluid enters syringe.* - CORRECT ANSWER 5mm peritoneal Paracentesis Pearls: Use an ______ or 14-18 guage needle to create entry portal for paracentesis Use the _______ to reduce ascitic fluid leak - CORRECT ANSWER 11 blade z-track method Once fluid is removed, remove the catheter and apply firm, direct pressure for several minutes. Clenase the area and cover insertion site with ______ - CORRECT ANSWER sterile occlusive dressing Samples of fluid must be submitted. Albumin, protein goes in the ______ tube Cell count, differential goes in the _____ tube Gram stain, cytology goes in the ______ or _______ Aerobic or anaerobic cultures go in the _________ - CORRECT ANSWER red top tube purple top tube (has EDTA) syringe or red top tube blood culture bottles Monitor patients after ____________ for hypotension, circulatory dysfunction or instability. - CORRECT ANSWER large volume paracentesis > 5 L Complicated cascade that may occurs after large volume paracentesis > 5 L Increased plasma catecholamine and renin activity causes hypotension, electrolyte imbalance, hepatorenal syndrome, death Treat with IV albumin - CORRECT ANSWER post-paracentesis circulatory dysfunction Most common complication of paracentesis - CORRECT ANSWER persistent ascitic fluid leak z-track helps to prevent dermabond, skin affix used to treat Appearance of ascitic fluid: Translucent or clear yellow: ________ Cloudy/turbid: _______ Pink/blood tinged: __________ *Grossly bloody: ___________* Milky chylous: ___________- Brown: _________ - CORRECT ANSWER normal sterile infection mild trauma *malignancy/trauma* cirrhosis, lymphoma, thoracic duct injury hyperbilirubinemia, gall bladder or biliary perforation What is the serum ascites albumin gradient formula? SAAG > ________ = portal HTN if less than this it is another cause - CORRECT ANSWER serum albumin - ascites albumin > 1.1 Must draw serum albumin the same day as the _________. This doesn't need to be repeated after initial measurement. - CORRECT ANSWER paracentesis SAAG > 1.1 portal HTN is caused by what conditions? - CORRECT ANSWER cirrhosis alcoholic hepatitis cardiac ascites portal vein thrombosis budd-chiari liver mets SAAG < 1.1 is caused by what conditions? - CORRECT ANSWER peritoneal carcinomatosis tuberculous peritonitis pancreatic ascites biliary ascites nephrotic syndrome serositis What test can be performed if ascites is not caused by portal HTN? - CORRECT ANSWER carcinoembryonic antigen alkaline phosphatase amylase triglycerides cytology mycobacterial culture Carcinoembryonic antigen > _________ suggests perforation of a hollow viscus like colon cancer - CORRECT ANSWER 5 ng/mL Markedly high levels of amylase suggest ______ or perforation of hollow viscus - CORRECT ANSWER pancreatitis Total protein ______ LDH greater than the upper limits of normal Glucose _________ all suggest secondary peritonitis instead of SBP - CORRECT ANSWER > 1 g/dL < 50 mg/dL Spontaneous infection of ascitic fluid caused by translocation of intestinal bacteria into peritoneal cavity - CORRECT ANSWER SBP Ascitic fluid PMN count _________ is indicative of SBP - CORRECT ANSWER 250/ml Intra-abdominal infection from another source like appendicitis, cholecystitis, or diverticulititis - CORRECT ANSWER secondary peritonitis Ascitic fluid should be sent for ____ and ______ in all patients with possible infection. - CORRECT ANSWER gram stain culture **THORACENTESIS starts here** - CORRECT ANSWER Thoracentesis may be indicated for ______ or ________ purposes when draining pleural effusions. - CORRECT ANSWER therapeutic or diagnostic Transudative effusions - CORRECT ANSWER CHF Cirrhosis Exudative effusions - CORRECT ANSWER malignancy infection inflammation Relative Contraindications to Thoracentesis: inability of patient to cooperate overlying _______ mechanical ventilation ____________ coagulopathies, ________, bleeding disorders - CORRECT ANSWER skin infection hemodynamic/respiratory instability thrombocytopenia Lab Values for thoracentesis: INR _______ PTT typically ________ Platelets _________ is typically considered low risk - CORRECT ANSWER < 2 < 50 seconds > 50,000 Upright PA CXR can detect pleural effusions ________ and lateral CXR can detect smaller effusions __________ - CORRECT ANSWER > 200 mL > 50 mL Obtain a lateral decubitus if ultrasound is not available. If fluid is approximately ______ thick perform a simple thoracentesis. If it smaller or loculated it must be __________ - CORRECT ANSWER 1 cm ultrasound guided Arrow Clark Pleura-Seal Kit Safe-T centesis catheter drainage tray - CORRECT ANSWER used for thoracentesis Pleural cavity extends to _______ at posterior CVA. Inferior tip of scapula is at ________. Neurovascular bundles are located along the ______ of the ribs - CORRECT ANSWER 12th rib 7th rib inferior border Where is thoracentesis performed? - CORRECT ANSWER posteriorly with patient sitting upright midthoracic line ONE interspace below level of effusion but *never inferior to 9th rib* Thoracentesis can be performed via axillary approach *for those who can't sit up.* How is this done? - CORRECT ANSWER mid axillary-supine position posterior axillary-patient in lateral recumbent position with *effusion side down* Again NEVER inferior to 9th rib Do you need informed consent for thoracentesis? - CORRECT ANSWER yep JCAHO created a method to reduce errors during thoracentesis: 1) verify _______ 2) ____________ 3) take a time out to verify everything - CORRECT ANSWER patient with 2 identifiers mark the side of effusion Percuss the chest for transition of _______ and ______ and perform tactile fremitus for transition between normal and absent to determine the level of effusion - CORRECT ANSWER dullness tympany Needle will enter at least ________ below the top of the effusion going over the ________ of the rib to avoid the neurovascular bundles. *Always mark the site before!* - CORRECT ANSWER one interspace superior border Can a CXR determine the height of the effusion? - CORRECT ANSWER not reliably...it should not be used Use ultrasound to identify pleural effusions and entry site. Lung will appear _________ and pleural fluid will appear ______ - CORRECT ANSWER hyperechoic (bright) hypoechoic/anechoic (dark) When inserting needle, direct it to come in contact with the superior surface of the rib or _____ then gently _______ it over the surface of the rib - CORRECT ANSWER bone walk Needle advancement should be stopped once ________ enters syringe - CORRECT ANSWER pleural fluid Immediately place a finger over the catheter hub after the needle is removed to prevent _______ - CORRECT ANSWER air from entering pleural cavity When draining the stopcock is opened otherwise it should be closed immediately. Failure to do so may cause _______ - CORRECT ANSWER pneumothorax Never remove more than ________ of fluid at a time as you may cause re-expansion pneumonia - CORRECT ANSWER 1500 mL Time catheter removal with _________ - CORRECT ANSWER exhalation Traditionally ___________ was always performed after thoracentesis but this may not be necessary and is not mandatory. When should it be obtained: 1) __________ 2) chest pain, dyspnea, or hypoxemia 3) multiple _______ were required 4) patient is critically ill or on ________ - CORRECT ANSWER CXR apiration of air needle passes mechanical ventilation Rare- may occur after removal of large volumes of fluid Stretching and distension of pulmonary parenchyma causes pulmonary edema Dyspnea, tachycardia, and frothy sputum - CORRECT ANSWER re-expansion pulmonary edema Monitor pleural pressures during thoracocentesis. If ______ terminate the procedure as it may cause re-expansion pulmonary edema - CORRECT ANSWER < -20 mm Hg Caused by increased hydrostatic pressure in vascular space - CORRECT ANSWER Transudate (CHF, cirrhosis) Caused by increased capillary permeability or lymphatic obstruction - CORRECT ANSWER Exudate (infection, cancer, pneumonia) Think "exude" the nasty Light's Criteria compares pleural fluid protein and LDH and determines if fluid is ______ or not. Pleural protein to serum protein ratio > .5 Pleural LDH to serum LDH ratio > .6 Pleural fluid > 2/3 the upper limit of normal serum - CORRECT ANSWER exudate Quick, simple life saving procedure used to relief suspected tension pneumo - CORRECT ANSWER needle thoracostomy Needle thoracostomy requires subsequent _____ - CORRECT ANSWER tube thoracostomy (chest tube) Progressive accumulation of air in pleural space, increased ipsilateral pressure and collapse of lung Contralateral shift of mediastinum - CORRECT ANSWER tension pneumothorax Respiratory distress Chest pain Tachycardia Hypotension Diminished or absent lung sounds Hyperresonance (ipsilateral) Tracheal shift (contralateral) Jugular venous distension (increased CVP) - CORRECT ANSWER tension pneumothorax When is a needle thoracostomy indicated? - CORRECT ANSWER O2 < 92% Systolic BP < 90 Respiratory Rate < 10/min Decrease LOC High risk like mechanical ventilation Which indications of tension pneumo should have an xray first? - CORRECT ANSWER a patient on mechanical ventilation What are the contraindications to needle thoracostomy? - CORRECT ANSWER NONE-just be careful on those with coagulopathies What equipment is needed for needle thoracostomy? - CORRECT ANSWER skin cleansing agent *14-16 gauge* over the needle catheter (standard IV cath) 10 mL syringe Catheter selection Needle must be at least _________ - CORRECT ANSWER 5 cm or 2 in Where is a needle thoracostomy performed? - CORRECT ANSWER MCL 2nd intercostal space aka OVER superior surface of 3rd rib Advantages of midclavicular approach - CORRECT ANSWER air rises to anterior chest protects lung easy reach from head of bed easily monitored Disadvantages of midclavicular approach - CORRECT ANSWER chest wall thick subclavian vessels and internal mammary artery at risk Needle thoracostomy can also be done at the midaxillary line __________ inserting the needle over the superior aspect of the 5th or 6th rib. - CORRECT ANSWER 4th or 5th intercostal space Midaxillary approach is good for thin chest wall and is farther away from major vessels. The intercostal space are ______, there's more rib excursion, and increase risk for _________ - CORRECT ANSWER narrow Obtain written consent Place patient in supine position Supplemental O2 Cardiac monitor 2 large bore IVs Prep for chest tube Order portable CXR - CORRECT ANSWER prep for needle thoracostomy Needle is inserted ______ to skin in needle thoracostomy and advanced until a ________. - CORRECT ANSWER perpendicular rush of air or blood Tube thoracostomy indications: Evacuate abnormal accumulation of air or fluid via ________, hemothorax, or ______ Restore normal slight___________ - CORRECT ANSWER pneumothorax pleural effusion negative intrapleural pressure Sudden onset pleuritic chest pain Dyspnea Cough Restlessness/agitation Impending doom Hypotension Elevated CVP and PAOP symptoms that likely need ___________ - CORRECT ANSWER tube thoracostomy What are some signs a patient may need tube thoracostomy? - CORRECT ANSWER tachycardia hypotension dyspnea neck vein distension tracheal deviation diminished breath sound hyper-resonance subq emphysema pulsus paradoxus *may be totally normal exam* GOLD standard for diagnosis pneumothorax, pleural effusion, hemothorax - CORRECT ANSWER Thoracic CT On ultrasound the ____________ sign rules out pneumothorax - CORRECT ANSWER sliding lung sign Absence of peripheral lung marking Distinct line indicating edge of collaped lung Produces significant dyspnea in those with lung disease like COPD - CORRECT ANSWER pneumothorax What is often mistaken for pneumothorax? - CORRECT ANSWER bullae skin folds border of scapula 3 types of pneumothorax - CORRECT ANSWER 1) spontaneous 2) traumatic-open or close 3) tension NO underlying disease; typically tall thin male - CORRECT ANSWER primary spontaneous pneumo *these are clinically stable* Small primary spontaneous pneumo ________ Observe and repeat CXR every 3-6 hours Discharge if no progression F/U in _______ Readmit if unreliable f/u - CORRECT ANSWER < 3 cm apex to cupola 12-24 hours Large primary spontaneous pneumo ________ Possible ________ then observation Catheter/chest tube with valve or water-seal May discharge with valve and follow-up ______ if lung re-expanded - CORRECT ANSWER > 3 cm apex to cupola aspiration 24-48 hours Underlying disease caused pneumo - CORRECT ANSWER secondary spontaneous pneumo *clinically stable* Small stable PTX is hospitalized and observed or chest tube depending on progression. Large stable PTX is hospitalized and gets chest tube - CORRECT ANSWER ok An open traumatic pneumothorax may develop into _________ - CORRECT ANSWER tension pneumo Progressive accumulation of air in pleural space; life threatening On CXR: Mediastinal shift to contralateral side, flattened ipsilateral hemidiaphragm - CORRECT ANSWER tension pneumo Treatment for traumatic pneumo depends on: _______ age _______ bilateral pneumo - CORRECT ANSWER stability size of pneumo Fluid in chest cavity is seen as a *straight line without meniscus*; may occur after stab wound to chest - CORRECT ANSWER hemopneumothorax (air and blood) You need to determine if the patient is clinically stable. What vitals indicate that? RR- ________ HR- ________ O2 sats- ______ Normal BP Able to speak whole sentence with one breath - CORRECT ANSWER < 24 /min 60-120 bpm > 90% In a hemothorax, monitor the amount and rapidity of bleeding. 75% are managed with ____ and ______. Hemothorax > _________ needs early blood replacement - CORRECT ANSWER chest tube volume replacement 2000 mL Massive hemothorax (> 1000-1500 mL) Continued bleeding ___________ of hemothorax Persistent hemothorax __________ hemothorax Persistent or large air leak Inability to __________ are all indications for chest tube - CORRECT ANSWER increasing size clotted hemothorax fully expand lung *There are NO absolute contraindications to chest tubes*. Relative contraindications include the following: multiple _______ _______ scarring coagulopathy - CORRECT ANSWER pleural adhesions blebs Adult chest tube sizes - CORRECT ANSWER 8-42 french smaller tubes for small pneumo, larger for hemothorax, empyema Use the __________ chest tube possible when draining a suspected hemothorax. - CORRECT ANSWER largest (minimum 36 french) 2 Standard sites for chest tube insertion - CORRECT ANSWER 1) 2nd intercostal space, midclavicular line 2) 4th or 5th intercostal space midaxillary line Before inserting the chest tube, hold tube up to chest wall. Estimate the distance from _______ to _______. Ensure ALL _______ are within the pleural space. Mark maximum insertion length with clamp. - CORRECT ANSWER incision to apex holes Place the patient on oxygen. Head of the bed should elevated __________ and the ipsilateral arm should be restrained _______ before beginning the chest tube - CORRECT ANSWER 30-60 degrees overhead Anesthesia is first performed over the rib at the _______. Then advance needle slowly _______ of that rib while intermittently infiltrating and aspirating until pleura is breeched. - CORRECT ANSWER incision site over the top Use a __________ scapel and make a _________ incision 3-5 cm through skin and subcutaneous tissue - CORRECT ANSWER #10 transverse Once you open the tunnel with the kelly clamp, you must push into the pleural space. What signifies penetration into pleural space? - CORRECT ANSWER rush of air or fluid If the hole created is too large, ________ will leak and may lead to subcutaneous emphysema. - CORRECT ANSWER air The finger sweep method can be used to guide the chest tube into the pleural cavity. Do NOT ________ because the hole may be easily lost, especially in an obese patient. - CORRECT ANSWER remove your finger To insert the chest tube, grasp the tube with the ________. Chest tube should insert with little to no resistance. Direct the tube _______, _________, and _______. Insert the tube up to the marker clamp or the last hole clearly intrathoracic. - CORRECT ANSWER clamp posterior, medial, and superior The tube must be secured with an initial __________ then wrap the tails around the tube and tie. You may also perform ___________ on either side of the tube - CORRECT ANSWER stay suture horizontal mattress suture Apply occlusive dressing to the incision site. Wrap the base of the tube with ____________ dressings and two layers. Second layer is applied at a 90 degree angle to first. - CORRECT ANSWER petroleum impregnated This device alone is often sufficient to treat pneumothorax. May be used in outpatient setting. - CORRECT ANSWER Heimlich valve *not for hemothorax* Chest tubes are attached to drainage systems. They must remain below _____________ (at least 100 cm) - CORRECT ANSWER level of patient Bubbling in the drainage system indicates an air leak. Clamp the tube off at the insertion site. If the bubbling stops, the leak originates from ___________ the patient. - CORRECT ANSWER inside A *patient air leak* must be monitored at frequent intervals-every ________. Disconnect suction and observe. Assess and document degree of air leak using a Pleur-evac Air Leak Meter ________ is low and ______ is high - CORRECT ANSWER 4 hours 1 7 If you have a *system air leak*, find the origin by clamping every 8-12 inches, tighten all connections, and tape connections - CORRECT ANSWER ok Chest tube catheters may become clogged with mucus or blood, flush with ________ every 6-8 hrs if this happens - CORRECT ANSWER sterile saline Using an "over the wire" technique is more common these days The guidewire is passed through the needle over the rib into the pleural space then removed and the cathether is left. - CORRECT ANSWER seldinger technique The needle is advanced in a straight line. _____________ cannot be used. - CORRECT ANSWER tunneling approach Bleeding Injury to solid organs/nerves Subq emphysema Re-expansion pulmonary edema are all complications of chest tubes - CORRECT ANSWER ok To remove chest tube, place patient at ________. Cut sutures and ______ tube. Remove the tube when the patient is either ____________ . Repeat CXR in 6 hours - CORRECT ANSWER 45 degrees clamp inhaling or exhaling [Show Less]
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CPSS Centesis Exam 77 Questions with Verified Answers,100% CORRECT
CPSS Centesis Exam 77 Questions with Verified Answers What is the indication of a paracentesis? - CORRECT ANSWER ascites - new onset - therapeutic - ... [Show More] diagnostic What are the relative contraindications for a paracentesis? - CORRECT ANSWER Coagulopathy Overlying anatomical or infectious abnormalities Distended abdominal organs (i.e. ileus, megacolon) Surgical scars: May have attached bowel T/F: using an US is the standard of care for a paracentesis? - CORRECT ANSWER TRUE What is the best approach for a paracentesis? Why? - CORRECT ANSWER Lateral Bc when the pt is supine, the fluid will pool to the posterior wall and avoiding bowel perforation is easier. How should the pt be positioned for a paracentesis? - CORRECT ANSWER Pt supine and/or with head elevated to 10-30 degrees (pic on lecture says 30-45 degrees) What do you need to careful of when using the anterior approach for a paracentesis? - CORRECT ANSWER avoid the inferior epigastric arteries. T/F: For a paracentesis, it is considered a complete sterile technique, when the practitioner must be gowned up as well? - CORRECT ANSWER FALSE- Sterile technique but do not have to fully scrub in (don't have to fully gown in) When inserting the needle for a paracentesis, you want to pull the skin taught in what direction? - CORRECT ANSWER caudad (approx 1-2 cm) How will fluid on an US appear? - CORRECT ANSWER anechoic/hypoechoic (DARK) This is where the needle will go to drain! How can you recognize and locate the bowel in an US prior to performing a paracentesis? - CORRECT ANSWER Bowel will glisten (more than other tissue) and you will be able to see peristalsis. While inserting the needle for a paracentesis, how can you tell you're in the peritoneal cavity? - CORRECT ANSWER loss of resistance will be felt Paracentesis procedure: a. Hold syringe with (_) hand b. Rest (_) surface of (_) hand on patient's abdomen, and use (_) of this hand to steady shaft of needle c. Keep nondominant hand in this position during needle advancement and continue to hold the (_) - CORRECT ANSWER a. dominant b. dorsal; nondominant; thumb and index finger c. nondominant; shaft of needle What type of drainage tubing is used for a paracentesis? - CORRECT ANSWER High-pressure drainage tubing T/F: Want to insert the needle for a paracentesis into the wheal of the local anesthetic? - CORRECT ANSWER TRUE What should always be done after you advance the needle in for a paracentesis? - CORRECT ANSWER aspirate- want to do that after moving the needle every time until the fluid pocket is reached. T/F: When performing a paracentesis, you want to make sure to push the catheter all the way flush with the skin to ensure all fluid will be drained? - CORRECT ANSWER FALSE! Catheter does NOT have to be flush with skin, better to keep partially out than perforate the bowel or visceral organ What should be done after removing the catheter of the abdomen when doing a paracentesis? - CORRECT ANSWER apply firm, direct pressure to the site for several minutes What types of lab samples are commonly collected during a paracentesis? - CORRECT ANSWER Albumin, protein: exudative vs. transudative Cell count, differential Gram stain, cytology Aerobic & anaerobic cultures: blood culture What is the most common complication of a paracentesis? How can you fix this? - CORRECT ANSWER Ascitic fluid leak- apply dermabond or sutures Dermabond= best bc it provides a perfect seal. What types of circulatory dysfunction complications can occur with a paracentesis? - CORRECT ANSWER Critical HYPOtension Increased RAAS and catecholamine activity What is the indication for a thoracentesis? - CORRECT ANSWER pleural effusion Diagnostic Therapeutic (resp distress, CHF, cirrhosis, trauma, cancer) What are the relative contraindications of a thoracentesis? - CORRECT ANSWER Mechanical ventilation Overlying infection or anatomical abnormalities Respiratory instability Coagulopathy What is the best XR view for detecting effusions? - CORRECT ANSWER lateral chest (can detect smaller effusions >50mL) (upright PA chest- detect effusions >200 mL) A lateral chest XR can detect effusions >_____ - CORRECT ANSWER >50mL An upright PA chest XR can detect effusion >_____ - CORRECT ANSWER >200 What type of finding in a lateral chest XR supports the dx of a pleural effusion? - CORRECT ANSWER partial "blunting" of the CP angle Pleural cavity extends to (_) posteriorly - CORRECT ANSWER 12th rib What position does the pt need to be in for a thoracentesis? - CORRECT ANSWER Must be sitting up right Where will the needle be inserted for a thoracentesis? - CORRECT ANSWER Mid-thoracic line (medial edge of scapula) One interspace BELOW level of effusion detected with percussion/tactile fremitus For a thoracentesis, where should the needle NEVER be inserted? - CORRECT ANSWER NEVER inferior to the 9th rib The tip of the scapula is approx at what rib? - CORRECT ANSWER 7th How would you perform a thoracentesis if you have a pt that is unable to sit up? - CORRECT ANSWER Mid-axillary (need to use US assistance) In relation to the rib, where should the needle need to be inserted for a thoracentesis? Why? - CORRECT ANSWER Just above the inferior rib of the two ribs- in order to avoid the neurovascular bundle. How do you determine the level of effusion prior to performing a thoracentesis? - CORRECT ANSWER percuss- transition between dullness and resonance tactile fremitus- transition from normal to absent Per JCAHO, what needs to be done prior to any thoracentesis? - CORRECT ANSWER Verify the pt with 2 identifiers and review all relevant clinical data mark the side of the effusion (must be visible after drape has been applied) Take a "time-out" immediately before the procedure (verify the pt, the procedure, and the site are correct) How do you anesthetize the area you are going to perform a thoracentesis or a tube thoracostomy? - CORRECT ANSWER Direct needle until it comes in contact with the superior border of ribs (so it contacts the bone) Gently "walk" needle OVER rib (just superior to the rib in order to avoid the neurovascular bundle) Alternate aspirating and injecting anesthetic as advancing needle Sudden loss of resistance= in the cavity For a thoracentesis, you need to IMMEDIATELY stop advancing needle once (_) - CORRECT ANSWER pleural fluid enters the syringe After advancing catheter into place during a thoracentesis, you want to remove the needle and then what? Why? - CORRECT ANSWER Place finger over exposed catheter hub immediately after needle is removed to prevent air from entering pleural cavity When performing a thoracentesis, the stopcock should be (_) to patient at all times, except when actively draining fluid. Failure to do so may result in (_) - CORRECT ANSWER closed pneumothorax When performing a thoracentesis, you want to time the removal of the catheter with patient (inhalation/exhalation)? - CORRECT ANSWER *Exhalation* (to avoid the negative pressure pulling air into the area) T/F: you always need to get a chest XR post- thoracentesis? - CORRECT ANSWER FALSE When would it be indicated to get a chest XR post-thoracentesis procedure? - CORRECT ANSWER If air was aspirated Pt develops chest pain, dyspnea or hypoxemia If it is a critically ill pt If on a mechanical ventilation What is re-expansion pulmonary edema? - CORRECT ANSWER Stretching and distention of pulmonary parenchyma (alveoli) during re-expansion leads to increased pulmonary blood flow and alveolar-capillary membrane disruption, leading to pulmonary edema Why would a mini-catheter insertion (aka pleural pigtail catheter) be indicated over a tube thoracostomy? - CORRECT ANSWER When the pt has a constant pleural effusion (more of a permanent placement) What are the absolute contraindications for a tube thoracostomy? - CORRECT ANSWER NONE What is the most sensitive test for a pneumothorax? - CORRECT ANSWER CT (air will be pitch black) What kind of clamp is used for a tube thoracostomy? - CORRECT ANSWER Kelly clamps (Large clamps) What scissors are used for a tube thoracostomy? - CORRECT ANSWER Mayo scissors (large, curved) What indications would you want to make sure to use a larger tube size (minimal 36 Fr) for a tube thoracostomy? - CORRECT ANSWER a HTX or empyema T/F: For a tube thoracostomy, it is considered a complete sterile technique, when the practitioner must be gowned up as well? - CORRECT ANSWER TRUE- requires full scrub in! What is the most common location for a tube thoracostomy? - CORRECT ANSWER *5th intercostal space*, midaxillary line/nipple line (lateral to pectoralis muscle and breast tissue) Go to the *4th intercostal space* if you failed the 5th or you got a recurrent PTX) What is the other location that a tube thoracostomy can be place, but is only used if desperate! - CORRECT ANSWER second intercostal space, midclavicular line How do you measure the tube prior to performing a tube thoracostomy? - CORRECT ANSWER Estimate the distance between *incision to apex*. Ensure *ALL* holes within pleural space. Mark max insertion length with *clamp* T/F: tube location does not affect ability to drain? - CORRECT ANSWER TRUE How do you position the pt for a tube thoracostomy? - CORRECT ANSWER elevate head of bed to 30-60 degress restrain ipsilateral arm over head What do you ALWAYS want to ensure your pt has on before/during/after a tube thoracostomy? - CORRECT ANSWER Cardiac monitoring and pulse ox! T/F: Most patients are sedated for a tube thoracostomy? - CORRECT ANSWER True What medication do you want to give your pt prior to a tube thoracostomy since the pleura is VERY sensitive to pain? - CORRECT ANSWER Etomidate and a local anesthetic Why is Etomidate the best drug to give for a pt getting a tube thoracostomy? - CORRECT ANSWER bc it has the LEAST cardiopulmonary risk What are the steps for performing a tube thoracostomy? - CORRECT ANSWER Anesthetize region Make incision over 4th or 5th rib (anterior axillary line) Create tunnel with Kelly clamp Penetrate pleural space with Kelly clamp Finger sweep & maintain the tunnel with finger Insert chest tube Secure chest tube What size scalpel is used to make the incision for the tube thoracostomy? - CORRECT ANSWER No. 10 scalpel Where do you do the incision for a tube thoracostomy? - CORRECT ANSWER transverse incision 3-5 cm long (through skin and SQ tissue), over the 4th or 5th rib on the anterior axillary line (1-2 ribs below pleural entry point) How do you create a tunnel for a tube thoracostomy? - CORRECT ANSWER By using a long kelly clamp, bluntly dissect over TOP of rib. *Separate the tissue (YOU ARE NOT CUTTING)*. - Advance with clamp closed - Pull back with clamp spread When you are trying to do a tube thoracostomy, how will you know that you are in the pleural space? - CORRECT ANSWER "pop" will be felt when pleura is penetrated (may require significant force) rush of air of fluid will signify penetration into the pleural space as well. What do you use as a guide for the chest tube to ensure it's entry into pleural space? - CORRECT ANSWER your finger ** when preparing the tube to insert , make sure NOT to remove finger (bc hole can be easily lost) How should the tube be inserted for a tube thoracostomy? - CORRECT ANSWER Direct posterior, medial and superior should travel along the posterior thoracic wall Once inserting the chest tube during a tube thoracostomy, what shoudl you do in order to reduce likelihood of kinking? - CORRECT ANSWER rotate tube 360 degrees How far do you insert the chest tube? - CORRECT ANSWER up to the marker clamp OR when resistance felt T/F: you always need to get a chest XR post- tube thoracostomy placement? - CORRECT ANSWER TRUE *ALWAYS get a CHEST XR to confirm placement BEFORE securing tube!* How do you dress the tube/skin incision of a tube thoracostomy? - CORRECT ANSWER Wrap base of tube at skin incision with petroleum-impregnated dressing (Xeroform gauze) Then, place two layers of gauze sponges (Y-shaped cut centered)- the second layer will be placed at a 90 degree from the first layer The heimlich valve on the drainage system for a chest tube is only for (_) - CORRECT ANSWER pneumothorax! You start to notice that there may be a complication after placing a chest tube when monitoring the patient. What should be the first thing to check? - CORRECT ANSWER check the equipement first, there could be a damaged collection system/ air leaks What s/p tube thoracostomy complication typically occurs due to the surgical hole being made too large? - CORRECT ANSWER SQ emphysema Before pulling out the chest tube, what do you want to make sure to do first? - CORRECT ANSWER discontinue the suction maintain a water seal or clamp chest tube "clamping trail" What monitoring needs to be done after removing the chest tube? - CORRECT ANSWER repeat chest XR after 6-12 hours (looking for resolution of PTX, lungs are fully expanded and no evidence of air leak) When removing a chest tube, you want to have the pt do what? - CORRECT ANSWER Fully INHALE and do a valsalva maneuver Once the chest tube is pulled out, what do you want to do? - CORRECT ANSWER suture the wound and place OCCLUSIVE dressing on the wound to prevent air from escaping back into the pleural space. [Show Less]
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CPSS Instruments Exam 40 Questions with Verified Answers,100% CORRECT
CPSS Instruments Exam 40 Questions with Verified Answers Mixter Right Angle Clamp - CORRECT ANSWER Kelly Hemostatic Forceps curved & Straight - CORR... [Show More] ECT ANSWER Crile Hemostatic Forceps Curved & Straight - CORRECT ANSWER Mosquito Hemostatic Forceps Curved & Straight - CORRECT ANSWER Kocher (Oschner) Hemostatic Forceps - CORRECT ANSWER Allis Tissue Forceps - CORRECT ANSWER Vanderbilt clamp - CORRECT ANSWER Babcock Tissue (intestinal) holding forceps - CORRECT ANSWER Doyen Intestinal Forceps - CORRECT ANSWER Debakey Forceps AKA: pickups, sponge forceps - CORRECT ANSWER Rat-tooth (thumb) Tissue forceps - CORRECT ANSWER Brown-Adson (thumb) Tissue Forceps - CORRECT ANSWER Adson (thumb) tissue forceps - CORRECT ANSWER Russian Forceps - CORRECT ANSWER Weitlaner Retractor - CORRECT ANSWER Israel Retractor or "RAKE" - CORRECT ANSWER Amy-Navy (top) Farabeuf (bottom) retractors - CORRECT ANSWER S Retractor - CORRECT ANSWER Senn Retractors - CORRECT ANSWER Bookwalter Retractors - CORRECT ANSWER Balfour Abdominal Retractor with Blade - CORRECT ANSWER Surgeons Scalpel Blades & No. 3 handle - CORRECT ANSWER Mayo-Hegar Needle Holders - CORRECT ANSWER Webster Needle Holder - CORRECT ANSWER Mayo Dissecting Scissor Straight & Curved - CORRECT ANSWER Metzenbaum Scissors - CORRECT ANSWER Towel Clamps - CORRECT ANSWER Suture Scissors (blunt) - CORRECT ANSWER Kocher - CORRECT ANSWER Tonsil - CORRECT ANSWER kelly - CORRECT ANSWER Littauer Suture Scissors - CORRECT ANSWER Yankauer Suction Tip - CORRECT ANSWER Suction tubing with FRAZIER suction - CORRECT ANSWER Poole Suction Tip (tube) - CORRECT ANSWER Laparscopic port devices - CORRECT ANSWER Bovie Cautery & Power source - CORRECT ANSWER Jackson-Pratt Drain - CORRECT ANSWER Endo GIA - CORRECT ANSWER A) #11 blade: for draining abscess, shave biopsy B) #15- performing a biopsy, making incisions < 5, any incisions on the face C) #10- making incisions longer than 5cm, debriding wound - CORRECT ANSWER Label which number scalpel for A, B, C [Show Less]
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CPSS Midterm Exam 57 Questions with Verified Answers,100% CORRECT
CPSS Midterm Exam 57 Questions with Verified Answers Useful for allergens and TB testing - CORRECT ANSWER Intradermal Useful for medication deliver... [Show More] y like insulin or enoxaparin - CORRECT ANSWER Subcutaneous Useful for higher volume meds and some vaccines - CORRECT ANSWER Intramuscular a patient with a history of anaphylactic allergy to eggs is a contraindication for what vaccines? - CORRECT ANSWER influenza and yellow fever slow absorption rate which is effective to diagnose delayed type hypersensitivity (reactions dont develop until 24-48 hours) - CORRECT ANSWER Intradermal where does optimal absorption for subcutaneous occur? - CORRECT ANSWER lower abdomen, anterior/posterior thigh, upper buttocks, lateral back and lateral upper extremities fastest absorption route= deltoid, ventrogluteal, and vastis ateralis - CORRECT ANSWER IM What is the angle for intradermal injection? - CORRECT ANSWER 15 degrees what is the angle for subcutaneous injection? - CORRECT ANSWER 45 degree angle What is the angle for IM injection? - CORRECT ANSWER 90 degree easier to mold to an extremity, absorbs underlying wound drainage making it desirable splinting material for trauma/post op - CORRECT ANSWER Plaster popular because of strength, flexibility, light weight, ease of application, fully water resistant once hardened, much smaller exothermic reaction - CORRECT ANSWER fiberglass for fractures, a ___ replaces a ____ after acute swelling subsides - CORRECT ANSWER cast;splint pain out of proportion indicates what - CORRECT ANSWER compartment syndrome Tx for compartment syndrome - CORRECT ANSWER bivalving a cast (split cast down both sides to relieve pressure) Name some complications of casts - CORRECT ANSWER compartment syndrome, cast dermatitis, pressure sores, nerve injuries, DVT when casting an injured extremity the immobilization should include what? - CORRECT ANSWER the joints proximal and distal to the injured area Long term issues related to immobilization - CORRECT ANSWER frozen shoulder used for hand, distal radius, and distal forearm fractures - CORRECT ANSWER short arm cast used for fractures of the 4th and 5th phalanges and metacarpals - CORRECT ANSWER short arm gutter splint used for initial stabilization of humerus fracture - CORRECT ANSWER upper arm sugar tong if patient is given a sling, how many times should they remove is a day to perform elbow/shoulder ROM? - CORRECT ANSWER 3-4 times After casting a patient you should instruct them to return to check it in how many days? - CORRECT ANSWER 3-7 days For cast or splint immobilization of lower leg and ankle, the ankle must be strictly maintained at ___ degrees of ___ to avoid causing an equine gait that results from improper immobilization in a plantar-flexed position - CORRECT ANSWER 90 degrees of flexion What is the main advantage of a splint? - CORRECT ANSWER it allows for soft tissue swelling during acute phase of injury material of choice for majority of cast and splint applications, espcially for weight bearing - CORRECT ANSWER fiberglass should be the minimal number of precautions used when handling ALL patients regardless of their diagnosis or presumed infection status - CORRECT ANSWER standard precautions What secretions are covered and not covered with standard precautions? - CORRECT ANSWER Blood, semen, vaginal secretions, CSF, synovial fluid, pleural fluid, peritoneal fluid, pericardial fluid, and amniotic fluid Feces, nasal secretions, sputum, sweat, tears, urine, and vomit DO NOT APPLY unless they contain visible blood!!! What should be worn to avoid potential exposure to infectious agents transmitted by the airborne route? - CORRECT ANSWER N95 masks or higher respirators skin tension lines; Linear clefts in the skin that indicate the direction of orientation of the underlying collagen fibers - CORRECT ANSWER langer lines Why do we care about langer lines? - CORRECT ANSWER if the skin if disrupted parallel to long axis of fibers, wound would reapproximate; if wound crosses long axis fibers perpendicular they are disrupted in a manner that causes them to gape open What should you do for foreign bodies in wounds? - CORRECT ANSWER Foreign bodies may remain a source of repeated infections if not thoroughly removed through irrigation, exploration and extraction or debridement of devitalized and contaminated tissue wounds less than __ to ___ hours old are considered clean and eligible for primary closure with sutures - CORRECT ANSWER 6-8 hours All layers are closed, best chance for minimal scarring, usually performed for clean and clean-contaminated wounds - CORRECT ANSWER primary intention deep layers are closed, superficial are left open to granulate on their own from inside out -often leaves a wide scar and requires frequent wound care -prolonged process -reasons for use include excessive tissue loss and infection - CORRECT ANSWER secondary intention superficial layers are left open until reassessment on day 4 or 5 after initial closure - CORRECT ANSWER tertiary closure why do we let something heal in a tertiary way? - CORRECT ANSWER because its extremely contaminated Suture size for Scalp eyelid foot - CORRECT ANSWER SCALP → 5/0 AND 4/0 EYELID → 6/0 AND 7/0 FOOT → 4/0 AND 3/0 Some wounds can be closed within ___ ____ if the anatomic location is highly vascular (face, neck, scalp) - CORRECT ANSWER 24 hours When should we consider abx? - CORRECT ANSWER Wounds that are more than 12 hours old at initial presentation, especially on the hands Human or animal bites (including those caused by patients teeth) Crush wounds Heavily contaminated wounds Wounds involving relatively avascular areas, such as cartilage of ear Wounds involving joint spaces, tendon or bone Severe paronychia and felons Wounds in patients with hx of valvular heart disease Wounds in immunocompromised patients Where should you use absorbable sutures? - CORRECT ANSWER mucosal areas such as the oral cavity and tongue used for deeper wounds (scalp), eliminates dead space - CORRECT ANSWER vertical mattress useful when there is a flap of tissue or when tension of stitch is to be predominantly on one side - CORRECT ANSWER horizontal mattress used to close surgical incision or very clean wound - CORRECT ANSWER subcuticular why do use hair nets, foot covers, etc? - CORRECT ANSWER Complete sterilization of skin is not achievable; therefore utilization of appropriate barriers worn by providers and the use of cleansing agents on patients are essential for preventing infection why do we scrub even though we wear gloves? - CORRECT ANSWER Help minimize the number of microbes present in the OR and therefore prevent infection What are the two methods of surgical scrubbing? - CORRECT ANSWER 1. timed or anatomic scrub - 3-5 minutes; scrub with timers 2. counted or numbered scrub -allotted number of strokes for each body part -30 strokes for fingernails -20 strokes needed for each surface of the fingers, hands, wrists, arms, and elbows What is sterile and what is not? - CORRECT ANSWER The sterile field consists of the draped patient, scrubbed personnel, and the sterile surgical instruments If sterility of any person or item is in question → consider it contaminated and remove from sterile field promptly Gowns are considered sterile in front from shoulder to waist level; sleeves are considered sterile to 2 inches above the elbow Sterile property, including hands, instruments and the table are considered sterile above table or waist-height only Non-sterile personnel must remain at least 12 inches away from sterile field Remain facing sterile field when moving within or around the sterile field to avoid accidental contamination What is the MC reason to do a lumbar puncture? - CORRECT ANSWER Bacterial meningitis What else can lumbar punctures diagnose? - CORRECT ANSWER Meningitis, SAH, CNS TB, neurosyphilis, unusual viral infections, guillain-barre, MS, etc Contraindications to LP - CORRECT ANSWER Patients with signs/symptoms of increased intracranial pressure, esp. Suspected intracranial mass lesions, should have a CT scan before LP Coagulopathies & thrombocytopenia (hemophilia, leukemia, liver dz, anticoag therapy), local infections over site of LP, surface abnormalities, critical illness or medical instability AE and risks of LP - CORRECT ANSWER Postdural puncture headache (PDPH) is bilateral, generally occipital and has a throbbing or pressure quality Back discomfort, infection, nerve damage, herniation into foramen magnum where LP was performed, bleeding, intraspinal epidermoid tumors How long can a tourniquet safely stay on? - CORRECT ANSWER no longer than 2 minutes how long should you hold pressure on a wound post venipuncture? - CORRECT ANSWER Pressure should be applied for at least 3-4 minutes, until bleeding stops, or 5+ minutes if patient has been taking anticoagulants how long do we leave IVs in to reduce risk of infection? - CORRECT ANSWER 72-96 hours Contraindications to IV - CORRECT ANSWER Extremities with Significant burns, edema or injury Cellulitis or significant infection Impaired circulation (mastectomy, axillary lymph node dissection, lymphedema, clot, PVD, venous insufficiency) Indwelling fistula Insertion should not be performed distal to prior failed IV cath insertion attempts Insertion should be avoided distal to any area of preexisting phlebitis what is the most effective treatment for the postdural headache? - CORRECT ANSWER epidural blood patch [Show Less]
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CPSS Foley Exam 52 Questions with Verified Answers,100% CORRECT
CPSS Foley Exam 52 Questions with Verified Answers Bladder Cath: Hollow tube introduced through _________ through the _________ to the _______ - CO... [Show More] RRECT ANSWER urethral meatus urethra bladder Once catheter is inserted, urine moves through the bladder through catheter primarily by _________ - CORRECT ANSWER gravity flow Single lumen tube Inserted to drain bladder and then it is removed Aka "in and out cath" NO balloon - CORRECT ANSWER straight or intermittent catheter Catheter used for urinary retention that may be seen post op, spinal cord injury, BPH - CORRECT ANSWER straight or intermittent catheter Catheter that contains a second tube throughout its length that is connected to a balloon filled with *sterile water* - CORRECT ANSWER indwelling aka foley catheter Indwelling catheters have 2 ports: 1) _________ port 2) _________ port - CORRECT ANSWER balloon port urine drainage port When do you use an indwelling catether? - CORRECT ANSWER 1) monitor urinary output 2) facilitate urinary drainage (CVA, Alzheimer's spinal cord injury, etc) 3) bypass obstructive processes Indwelling catheters are designed to dwell in the ________ and are always ________. - CORRECT ANSWER bladder sterile Catheter capable of *continuous irrigation* Balloon is larger size about 30 mL Has 3 ports - CORRECT ANSWER 3 way foley catheter 3 ports of a 3 way foley catheter: 1) drains urine 2) _________ 3) instills _________ - CORRECT ANSWER inflates balloon instills sterile fluids When would you use a 3 way foley catheter? - CORRECT ANSWER as a traction device to control bleeding after prostate surgery *ALERT!* *Do not attach irrigation tubing to balloon inflation port on a 3 way catheter because this causes balloon ________* - CORRECT ANSWER rupture 3 way catheters allow for continuous bladder irrigation. What should you assess once in place? - CORRECT ANSWER assess for color of drainage in bag assess bladder for distention assess for clots document 2 bladder irrigation techniques: 1) closed-injecting solution or irrigating solution through a 3 way catheter 2) open-irrigating after separating ______ and _____; *increased risk of infection - CORRECT ANSWER catheter and bag Catheter with bend at distal tip that causes catheter to follow anterior surface of male urethra Insert with tip facing up - CORRECT ANSWER Coude catheter *french means elbowed* Which catheter would help facilitate insertion for a patient with BPH? - CORRECT ANSWER coude catheter S/P urethral surgery Suspected or known urethral trauma Pelvic fracture Inability to traverse the urethra into the urinary bladder for any reason are all ___________ for urinary catheterizations - CORRECT ANSWER contraindications Catheter Selection: Plastic -used for ______ Latex- used for up to ________ Silicone- used for ________ - CORRECT ANSWER in-out up to 2 weeks long term use What length catheter is used for females? Males? - CORRECT ANSWER 22 cm for females 40 cm for males Catheters are measured in french scale. 1 french = __________, so 3 french = _________ Sizing is determined by size of urethral canal and the size is printed on the port - CORRECT ANSWER .33 mm 1 mm in diameter What common catheter sizes are used in the following: Infants: ___________ Children: _________ Adults: _________ *Note: Men with BPH may need larger cath* - CORRECT ANSWER Infants 5-6 french children 8-10 french adults 14-16 french Balloon size is printed on the catheter port and ranges from _________ for a child to ________ for continuous bladder irrigation - CORRECT ANSWER 3 mL for a child 30 mL for CBI *always follow manufacturer recommendations* Are urinary catheters sterile procedures? - CORRECT ANSWER yep! Most common type of health care associated infection is a __________. If this occurs within a certain period of time during the hospital stay, insurance usually will not cover it. - CORRECT ANSWER UTI What patient position is used for most female urinary catheterizations? - CORRECT ANSWER dorsal recumbent-on back knees flexed, thigh relaxed (may also use lithotomy or sims position-lying on side) Found in the superior fornix of the vulva, anterior to vaginal opening and below clitoris - CORRECT ANSWER Urethral meatus Your nondominant hand will open the labia and should not let go once placed there as it is no longer ________! - CORRECT ANSWER sterile Wipe the urethral meatus in what order? - CORRECT ANSWER far near middle In females, advanced the catheter _______ until urine flows then advance it another _______ but never force it - CORRECT ANSWER 5-7.5 cm or 2-3 inches 2.5-5 cm or 1-2 inches Secure the catheter to the _______ allowing enough slack to prevent tension - CORRECT ANSWER inner thigh What patient position is used for male urinary catheterization? - CORRECT ANSWER flat supine The male urethra is longer and tortuous. It is normally curved but may be straightened by ___________ the penis. Lift the penis to a position perpendicular or _______ to the body and apply gentle ________ traction - CORRECT ANSWER elevating 90 degrees upward The narrowest position of the entire male urethra is the __________ - CORRECT ANSWER meatus Cleanse the urethral meatus using ________ beginning at the _____ and working outward in a spiral motion - CORRECT ANSWER circular strokes meatus In males, advance the catheter __________ or until urine flows. *Stop* if it is a straight catheter. If it is an indwelling catheter, *advance to the _________* - CORRECT ANSWER 17-22.5 cm or 7-9 inches Y-bifurcation Secure the catheter to the inner thigh and have the penis pointing ______. Be sure to replace the _______ if the patient is uncircumsized. - CORRECT ANSWER downward foreskin Drainage bag should always __________ to prevent urine from flowing back into bladder. Keep a watch for __________ in the tubing. - CORRECT ANSWER below the bladder obstruction When removing a foley cath, what should you do first? - CORRECT ANSWER remove the sterile water from the balloon or it won't come out! Sterile water should be removed from the balloon by _________ until the plunger stops moving and the original amount instilled has been removed. If there is any resistance when removing, try to remove more water from the balloon. - CORRECT ANSWER gravity NEVER _________ the balloon port as the fluid may not drain out fully. - CORRECT ANSWER cut If contamination occurs before or during catheter insertion procedure, start procedure over with a new catheter. - CORRECT ANSWER ok Are indwelling catheters recommended for long term use? - CORRECT ANSWER nope Always use the smallest size catheter possible to minimize trauma and promote drainage. Large catheters > 16 french might cause what? - CORRECT ANSWER 1) distend urethra and permanently damage and urethra and bladder neck 2) cause bladder spasms 3) cause leaking around the catheter Manufacturers no longer recommend testing _____________ as the balloon doesn't return to previous shape. - CORRECT ANSWER balloon inflation Complications of urinary catheters are ____________ or ___________; The patient would have the following symptoms: urgency to void fever, with or without chills nausea/vomiting anorexia malaise/irritability abdominal/flank pain cloudy urine (often with mucus visible) - CORRECT ANSWER UTI or pyelonephritis Injury to urethra Development of incontinence are more ___________ from urinary caths - CORRECT ANSWER complications *Draining > 500 mL to 1000 mL of urine at one time* is a hazard for the patient causing hypotension and changes in intraabdominal pressure. Know hospital policy but most only ______ ml at one time. - CORRECT ANSWER 500 mL Soft, rounded tip & one or two drainage eyelets on tip of side walls Catheter is hollow and distal end flared to facilitate urinary drainage Designed for one-time use, hence the term "in-and-out" catheter - CORRECT ANSWER straight or intermittent catheter What are the indications for a straight cath? - CORRECT ANSWER To obtain a sterile urine sample To decompress a distended bladder Relieve neurogenic bladder To deliver topical antineoplastic medications Relieve urinary retention Hospitals and nursing homes use __________ straight cath procedure due to high risk of nosocomial infections. Home settings may use ___________ - CORRECT ANSWER sterile technique clean technique (May reuse same catheter) External catheter Noninvasive Pliable condom-like sheath fits over penis to contain urine - CORRECT ANSWER Condom catheter Used to assist insertion of urinary catheter *Must set gender designation to obtain proper results* Can be done quickly and at patient bedside - CORRECT ANSWER handheld bladder scanner [Show Less]
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CPSS final review - part 2 my last will and testament 157 Questions & Verified Answers,100% CORRECT
CPSS final review - part 2 my last will and testament 157 Questions with Verified Answers No breath sounds on affected side + trachea shifted to non-a... [Show More] ffected side - CORRECT ANSWER tension pneumothorax What is the puncture site for an emergent chest needle thoracostomy for: Pediatric Adult - CORRECT ANSWER Pediatric: 2nd ICS midclavicular Adult: 5th ICS in anterior axillary line (to avoid the long thoracic nerve) What gauge angiocath is used for an emergent chest needle thoracostomy and where in the ICS do you insert the angiocath? If no air is noted when you insert the angiocath, what does this mean? Once catheter is secured into place, what do you do with the catheter? - CORRECT ANSWER 14 gauge angiocath over top of inferior rib perpendicular to skin no air = you have just created an open pneumothorax establish a water seal with the catheter If, after an emergent chest needle thoracostomy, the air collection reaccumulates, what do you do & with what equipment?? - CORRECT ANSWER Perform chest tube placement with 28-32 Fr. chest tube What is the purpose of a water seal with regards to a chest tube? - CORRECT ANSWER to provide a one way valve for air to escape & allows us to identify a leak in the system or pt What is the function of the three bottle collection system? What is the difference between the 3 bottle and a pleur-evac? How can you confirm suction is being provided to a pt using the pleur evac? How does an emerson pump differ from the above two systems? - CORRECT ANSWER provides a collection trap, water seal, and a bottle for regulation of suction (20cm of water pressure suction) pleur evac is the same system but contained in one unit. bubbles flowing in the suction control portion of pleur evac confirms suction emerson pump only has collection chamber and water seal. the pump itself provides the suction. suction system is not mutually exclusive with the collection & water seal. Drug assisted intubation or conscious sedation for chest tube placement: What meds are used and how can you reverse them? - CORRECT ANSWER Demerol Versed Demerol -> narcan (intranasal or rapid IV push) Versed -> Romazicon Pts with a chest tube will complain of side, shoulder, back pain that worsens with movement and inspiration. What should you encourage them to use? - CORRECT ANSWER tri-flow incentive spirometry (helps keeps lungs active throughout recovery & prevents pneumonia) Chest tube procedure: Identify what site? secure tube how? how do you check for placement? - CORRECT ANSWER find 5th ICS for adults secure with purse string suture CXR for placement. Complications of chest tube placement: how does damage to large vessels occur? what nerves could be damaged? don't drain > ___ cc at initial chest tube placement if treating an effusion. what is the max amt of cc you can drain before going to the OR? - CORRECT ANSWER damage to vessels occurs if trocar is used nerves often damaged include long thoracic or intercostal pulm edema: 1200 cc drainage max. > 1500 needs OR Assess daily pt progress with a chest tube how? Indications for chest tube removal? Technique to remove chest tube? Post op wound care? - CORRECT ANSWER daily CXR to remove -> pt stable and PTX resolved. drainage < 100cc/day positive pressure removal - pt blows against pursed lips w finger in mouth airtight dressing 24-48 hrs 7 P's of chest tube complications - CORRECT ANSWER Pain, pallor, pulselessness, paresthesia, paralysis, poikilothermia, or recreate pneumothorax A life-threatening hemopneumothorax in an adult requires immediate chest tube decompression through what intercostal site? a. 6th rib space, anterior axillary line b. 5th rib space, anterior to mid-axillary line c. 3rd rib space, mid-axillary line d. 1st rib space, mid axillary line e. 4th rib space, mid-clavicular line - CORRECT ANSWER b. 5th rib space, anterior to mid-axillary line Insert 28-32 size chest tube. Avoid long thoracic nerve. A life-threatening tension in an adult pneumothorax requires immediate chest tube decompression through what intercostal site? A.6th rib space, anterior axillary line B.5th rib space, above the 6th rib C.3rd rib space, mid-axillary line D.1st rib space, mid axillary line E.4th rib space, mid-clavicular line - CORRECT ANSWER B. fifth intercostal rib space anterior to mid-axillary line A life-threatening tension pneumothorax in a child requires immediate chest needle decompression through what intercostal site? A.6th rib space, anterior axillary line B.2nd rib space, mid-clavicular line C.3rd rib space, mid-axillary line D.1st rib space, mid axillary line E.4th rib space, mid- clavicular line - CORRECT ANSWER B. 2nd rib space, mid clavicular line Indications for thoracentesis? - CORRECT ANSWER -Effusion w/o secure clinical dx or small quantity -Diagnostic for those w/ abnormal amounts of fluid accumulation in the pleural space Preferred site: for thoracentesis vs for chest tube thoracostomy vs thoracentesis for pt on a ventilation - CORRECT ANSWER thoracentesis: 7-9th interspace midway between posterior axillary line and midline chest tube: 5th ICS anterior to mid axillary line on ventilator thoracentesis: 5th or 6th ICS at a site close to surface of bed What approach is best for thoracentesis? How should pt be positioned? - CORRECT ANSWER posterior approach pt straddling a chair, leaning forward What is the major and most common complication of thoracentesis? What are the 2 types? - CORRECT ANSWER pneumothorax benign PTX from introduction of air from outside. no tx needed accidental puncture of lung resulting in PTX. Observe w serial CXR. If a pt c/o shoulder pain during thoracentesis, what is your concern? - CORRECT ANSWER needle is piercing diaphragmatic pleura and site is too low. Include a description of what in your post-thoracentesis procedure note? Are tests routinely done following uncomplicated thoracentesis? - CORRECT ANSWER gross appearance of fluids red = bloody yellow = cholesterol milky white = chyle no tests needed if uncomplicated The primary concern in loculated effusions is??? When could you rely on PEx to select the site of loculation? Best method for thoracentesis site location if there is loculation? - CORRECT ANSWER selection of thoracentesis site use PEx if suspect empyema use U/S localization Is this a transudate or exudate: fluid/serum protein ratio > 0.5 fluid/serum LDH ratio > 0.6 fluid LDH > 2/3 upper limit of normal serum LDH - CORRECT ANSWER exudates have 1 or more of these characteristics (transudates have none!!) If LDH is the only abnormal, consider - CORRECT ANSWER parapneumonic effusion Protein in the thoracentesis fluid may confuse what possible pathologies? - CORRECT ANSWER CHF liver disease renal disease Protein is normally < 3g/dL, but may be 3-4g/dL in what cases? - CORRECT ANSWER if pt uses diuretics, or is chronic or recurrent Transudate fluid aspirated + fever > 101.5 24 - 48 hours after surgery = - CORRECT ANSWER atelectasis What are the main causes of transudates? - CORRECT ANSWER CHF, cirrhosis, peritoneal dialysis, urinothorax, nephrotic syndrome, atelectasis In the adult pt, what is the gold standard for emergent airway management? How often should you give breaths with this airway? - CORRECT ANSWER endotracheal intubation ventilate every 6 seconds (10 breaths/ min) Confirm accurate placement of ETT by checking what PEx? What is the preferred way to check placement? How do you know it's working? - CORRECT ANSWER 5 point auscultation - apices, axillary, stomach (for gurgling) preferred -> quantitative continuous waveform capnography. if yellow - working!! blue is bad. What is the most common incorrect placement of an ETT? What is the most lethal incorrect placement? - CORRECT ANSWER right mainstem bronchus - hear decreased breath sounds on the LEFT side lethal -> esophageal Anticipate vomiting in all pts by having what equipment available? How can you avoid hypoxia from suctioning? - CORRECT ANSWER yankeur suction at back of mouth oxygenate prior to suction & suction for < 10 seconds & suction only on the way OUT An unrestrained passenger/driver who sustained maxillofacial trauma gets what airway? - CORRECT ANSWER surgical cricothyroidotomy using #10 blade w surgical emergent tracheostomy tube placement How to tell if a pt is unstable? How to tx unstable pt? - CORRECT ANSWER CASH chest pain AMS SOB hypovolemic shock tx with VOMIT - vitals - O2 - monitor pulse ox & EKG - IV or IO fluids - Tx the pt H's and T's - CORRECT ANSWER H's Hypoxia Hypovolemia Hypo or Hyperkalemia H ion acidosis Hypothermia T's Tension pneumothorax Cardiac tamponade Toxins Thrombosis coronary MI Thrombosis Pulmonary DVT PE What is the most common cause of airway obstruction esp in the unconscious pt? What tool is used to remove foreign objects from airway? - CORRECT ANSWER the tongue remove FBs w magill forceps Do not use what technique to open the airway in pts with suspected c spine injury? Instead use what technique - CORRECT ANSWER do not use head tilt chin lift use jaw thrust What tool to maintain the airway can be used in conscious, semiconscious, or unconscious pts? How do you measure it? insert it how? - CORRECT ANSWER NPA or trumpet tip of nose to earlobe w diameter same size as pt's pinky insert it perpendicular to facial plane What tool can be used in unconscious pts w/o a gag reflex? How is it measured? - CORRECT ANSWER OPA angle of jaw to corner of mouth What tidal volume is needed using a bag valve mask to prevent over-inflation & gastric distention? - CORRECT ANSWER 500-600mL or 5-6mL/kg What definitive airway is used in spontaneously breathing drug OD in respiratory distress to secure an emergent airway? - CORRECT ANSWER nasotracheal For ETT placement: Which blade is curved vs straight? Hold these blades with what hand? The ETT is placed ____ cm above where? What is the max amt of time you can take to place it? What size tube? Avoid using what technique while placing? What is the best position to obtain direct alignment for placement through vocal cords? - CORRECT ANSWER McIntosh curved Miller straight Hold blades w left hand - place tip in vallecula 2.5cm above carina max of 30 seconds #8 ETT avoid using cricothyroid pressure use sniffing position for best alignment In an adult, to check proper ETT, the black line of proximal ETT will be at what level? - CORRECT ANSWER at the level of the corner of the mouth at 22 from vocal cords What can we do to achieve the maximal cellular o2 level? - CORRECT ANSWER 90-100% o2 at 12-15L per min by non rebreathing mask w/ oxygen reserve What % oxygen does each provide and at how many L/min: non rebreathing mask nasal cannula simple mask - CORRECT ANSWER nonrebreather: 90 -100% @ 12-15 L/min nasal cannula 24-40% @ 1-6L/min simple mask 40-60% @10-12 L/min What airway adjunct is used for pts with COPD, bronchitis, or emphysema who breathe by hypoxic drive? - CORRECT ANSWER venturi mask The criteria for when to intubate a pt is with a PaO2 of __%. - CORRECT ANSWER 88% AND clinical signs of respiratory distress 90mmHg PaO2 = ___ % O2 sat 60mmHg PaO2 = ___ % O2 sat - CORRECT ANSWER 90 mmHg = 100% 60 mmHg = 90% Laryngeal Mask Airway.... where does the cuff go over? Where is the king airway used? - CORRECT ANSWER LMA over hypopharynx king airway used by local EMS [Aseptic/sterile] is free from pathogenic microorganisms while [aseptic/sterile] is free from microorganisms. - CORRECT ANSWER aseptic - pathogenic microbes sterile - all microbes What is the method in which we maintain asepsis throughout the duration of a procedure? - CORRECT ANSWER sterile technique What are the guidelines to maintain sterility of an operating room? There must be enough space for what? What type of filter is used for ventilation in an OR? What does this filter filter out? - CORRECT ANSWER minimum 20 by 20 feet -space for gowning of team, for draping patient, to move around w/o contamination of sterile areas use HEPA filter - filters bacteria, fungi, viruses What face mask is considered a HEPA filter? - CORRECT ANSWER N95 UV lighting can be used in ORs and hospital rooms (and in new york subways) to do what? Which UV method is specifically used in ORs? - CORRECT ANSWER UV lighting disinfects for ORs -> UVGI (UV germicidal irradiation) On the pt, what is the primary source of infection and contamination & what is the key organism? How can pt clean themselves before surgery? How does staff prep skin if hairy? - CORRECT ANSWER pts skin and nares - staphylococci pt showers w hibiclens (antibacterial prep) electric clippers for hair on pt What is the most important method to decrease rate of infection in a surgical pt? - CORRECT ANSWER skin prep What antimicrobial preparation for intact skin is: broad-spectrum antimicrobial agent against fungi, viruses, gram + and - . sticky and stains chemical antiseptic that is bactericidal, bacteriostatic, and effective against fungi & viruses Which is the most common? - CORRECT ANSWER antimicrobial - iodophors (betadine) chemical antiseptic - hibiclens MC: depends on surgeon. betadine vs chloraprep Technique of skin preparation before incision how is betadine applied? do you wait before draping? vs how is chloraprep applied? do you wait before draping? - CORRECT ANSWER betadine: widening circles or rectangular motion. NO WAIT. chloraprep: apply back and forth motion. YES WAIT - flammable!!! What portion of the drape is considered unsterile? if hole is found in drape after placement, do what? If drape needs to be readjusted, do what? - CORRECT ANSWER below waist or table level if hole -> cover w 2nd drape or tegaderm readjusted -> don't. discard or cover w new drape What PPE do you need on before entering the operating room? - CORRECT ANSWER OR Scrubs, surgical masks, eye protection, surgical cap, shoe covers What are the general steps if using an alcohol scrub for your hands? - CORRECT ANSWER if using alcohol scrub, prewash hands and forearms w nonantimicrobial soap & dry them, then apply alcohol product. let dry fully before donning gloves How to hand scrub - first open your scrub brush packet. and place on top of sink. now what? - once washed, touch what? - what surfaces - how many strokes per surface - goal time - how to rinse? - CORRECT ANSWER wash hands w normal soap and water first 30-60 sec touch only ur brushie and your nail pick Alternate between left and right 5 fingers → 5 fingers hand → hand forearm → forearm 2" above elbow → 2" above elbow 10 strokes per surface 5 mins goal. 2 min 30 sec per extremity rinse w hands up up up so water drips down down down now go to OR What part of gown is considered sterile? - CORRECT ANSWER waist to xiphoid. forearms to 2 inches above elbows State whether a sterile gown is indicated or not: suturing minor lacs repairing a large wound cardiac catheterization joint aspiration invasive surgical procedures lumbar puncture - CORRECT ANSWER Yes: Repairing a large wound, cardiac catheterization, invasive surgical procedures No: minor lacerations, doing joint aspiration, or performing a lumbar puncture - only need sterile gloves for these Indicator gloves - worn on [top/bottom]? - what color? - what glove size? - CORRECT ANSWER worn on bottom - have blue or green indicator 1/2 size larger than actual glove size Doffing in the OR - CORRECT ANSWER 1. top pair of sterile gloves 2. gown and indicator gloves 3. remove shoe covers When out of OR in sub sterile area 4. goggle/face shield 5. mask/respirator 6. wash hands While self gloving, where should your hands be? - CORRECT ANSWER in your sleeves like a FREAK For assisted gloving, When putting hand in glove, go [straight down/in an angle]. Which glove first? For assisted gowning, spin towards or away from the person? - CORRECT ANSWER straight down to the floor right hand first spin away from the person When can you break scrub? What can you wear while rounding? - CORRECT ANSWER when surgeon says ok. - now u can go to PACU while rounding, can wear scrubs and lab coat. no other PPE In general, how is a laparoscopy performed? - CORRECT ANSWER ports are inserted into the abdomen which is then insufflated with CO2 gas. instruments can be put through the ports to do the procedure In general, how is robotic surgery performed? - CORRECT ANSWER 3D view with multiple instruments to control tips of instruments What is the biggest difference between laparoscopy and robotic surgery? - CORRECT ANSWER the instruments used - the tips of the instruments on robotics articulate so you can move the tips around like you would with your wrist while in laparoscopy, the instruments have straight tips doctor is at console What is the purpose of "the tower"? - CORRECT ANSWER a place to hold the HD monitor, CO2 insufflation unit, light source unit, digital video storage Cameras exist to fit in laparoscopic ports. What size lens would go into the 5mm port? the 10mm port? - CORRECT ANSWER 5mm lens in 5mm port 10mm lens in 10mm port Which angle provides a better view during laparoscopy if you are having a difficult time seeing something: 0 or 30 degrees? - CORRECT ANSWER 30 can give you a wider angle view What components of the laparoscopic camera must be assembled? - CORRECT ANSWER lens + light source together gray knob focuses blue knob zooms The light source of the camera must be set to what setting? At this point, what materials can the light source touch? - CORRECT ANSWER 100% - initially will be on standby do not let light source touch any material while on 100%!!! Before starting laparoscopic surgery, how must you prep the assembled camera? - CORRECT ANSWER perform white balance clean camera lens and port What are the 2 methods to clean the camera lens and port? - CORRECT ANSWER Defogger solution (fred) sprayed on green cushion & then dip tip of lens Camera cleaner (the house) - stick 10mm camera through the hole. 5mm camera you need to lock it up to become size of 5mm port The camera should be held with the buttons facing where? - CORRECT ANSWER towards the ceiling For laparoscopic surgery, you must try to use what size trocars? - CORRECT ANSWER as many 5mm as you can How is the introducer port introduced into the pt? The gas port should be [open/closed] before inserting into the pt. What must be done to the gas port while a surgeon is cauterizing? - CORRECT ANSWER introducer -> goes inside trocar and then inserted into pt gas port CLOSED before inserting into pt while cauterizing, open gas port to release steam & gas What do you do with insufflation tubing? - CORRECT ANSWER disc part gets thrown off the sterile field and attached to tower opposite side gets screwed into trocar w gas port then open valve to let CO2 flow into pt On the CO2 insufflation device what does the first number on the left mean? the middle number? What is the safe/average for each number? - CORRECT ANSWER left: CO2 volume going into pt - avg of 15mmHg. 18mmHg if large pt but can paralyze diaphragm middle: flow rate - 10-20 L/ min What suture, stitch, and # of stitches are used for each trocar incision: 5mm 8mm 10,11,12mm - CORRECT ANSWER 5mm: 4-0 monocryl simple interrupted buried intradermal stitch x1 8mm: 4-0 monocryl simple interrupted buried intradermal stitch x2 10,11,12mm: close fascia layer w figure 8 stitch. multiple interrupted or running intradermal w aberdeen knot to close incision How is mastosol used vs dermabond? - CORRECT ANSWER mastosol -> poured on side of incision, wait for it to dry then place steri strips dermabond - poured ONTO incision line & it dries w heat and light but incision needs to be dry. What suture type & stitch is used to close the facia layer? - CORRECT ANSWER figure 8 stitch using vicryl or ethibond Most laparoscopic procedures prefer [staples/sutures]. - CORRECT ANSWER buried sutures with skin glue or mastosol and steri strips Staples are used typically for what type of incision? What surgeries are exceptions to this? - CORRECT ANSWER larger incisions such as with a laparotomy avoid with hernia and thyroid procedures. do running subcuticular buried stitch in dermis then skin glue or mastosol + steri strips Skin sutures are usually used in what setting? - CORRECT ANSWER ET pts & anyone with a traumatic incision that has potential for infection What stitch is used to ligate blood vessels? - CORRECT ANSWER figure 8 - strangulates an artery or can use stick tie ligation or hand tie ligation What does each cautery setting mean: Yellow Blue - CORRECT ANSWER yellow - cuts using vibration blue - coagulates using burns During a laparoscopic cholecystectomy, pt typically has what ports - CORRECT ANSWER 4 ports - 3 5mm ports and 1 12mm port What is the purpose of the intra-operative cholangiogram? - CORRECT ANSWER To identify the common bile duct anatomy and any retained stones Thread catheter into the cystic duct and then insert dye into the biliary tree; serial x-rays Before you draw blood, what should you check about the pt? - CORRECT ANSWER Pt ID!!! Inpt: Full name & check armband. No armband = no draw. Outpt: name and verify DOB Equipment for phlebotomy: - what kind of gloves? - standard gauge needle? - clean skin how? - CORRECT ANSWER exam gloves 21-22 G needle clean skin w alcohol wipe (bactericidal) and LET FULLY DRY Leave the tourniquet on for a max of ___. Should pt pump the hand while tourniquet is on? What may occur if you leave the tourniquet on too long? What labs could be a sign that this has occurred? - CORRECT ANSWER tourniquet on for 1-2 mins do not pump hand hemoconcentration may occur causing hemolysis of the specimen Significant increases can be found in total protein, aspartate aminotransferase (AST), total lipids, cholesterol, iron For pHlebotomy - bevel faces.... What needles can you use? - CORRECT ANSWER UP butterfly needle or vacuum system (dual needle system) What info goes on the blood sample label - CORRECT ANSWER your initials date time of collection Patient's surname, first and middle Patient's ID number What additive does each tube contain based on cap color: Red Orange Yellow Green Light green Purple Light blue Black Grey - CORRECT ANSWER Red: no additive Orange: coagulant Yellow: coagulant and separation gel Green: Heparin sodium Light green: Heparin lithium Purple: EDTA anticoagulant Light blue: sodium citrate 1:9 Black: Sodium citrate 1:4 Grey: Potassium oxalate monohydrate and sodium fluoride If you see a red top what do you think? Which one do we use for our CBC? Which one do you use to draw lithium levels? Which one do you use for coags? If you see a light green top what do you think? Which color tube top is the most common? What tests? - CORRECT ANSWER type and screen or type and cross - red top CBC - purple top lithium - DARK green coags -> light blue cardiac enzymes - light green BMP & stat tests - most common - tiger top What additive does the gold tiger top have? mode of action uses - CORRECT ANSWER gel silica serum separator tube - gel at bottom to separate blood from serum on centrifuge chemistries -> BMP & stat tests what is the order of blood draw? - CORRECT ANSWER blood cultures coags type and cross/screen routine chemistry stat chemistry CBC, ESR type and cross/screen again lactic acid, glucose What arm do you start phlebotomy on? What is a contraindication to this? - CORRECT ANSWER start at non dom hand do not draw from non dom if pt is scheduled for AV fistula in that arm How do you palpate for a vein? What is the most common vein used for venous puncture? Where is this vein? What is an alternative for this vein? What part of the veins do you avoid? Which veins are last resort? - CORRECT ANSWER use index finger pad to feel vein bounce and roll median cubital vein - most common median cephalic vein is the alternate. avoid vein connections bc valves are often there last resort is foot vein Areas to be avoided when choosing a phlebotomy site - CORRECT ANSWER extensive scars UE on side of mastectomy hematomas IV therapy blood transfusion IV cannula/ AV fistula/ heparin lock edematous extremities / infections Phlebotomy procedure key points: *put on ur little glovies!!* - pt ARM position? - once in position, apply tourniquet WHERE to find a vein? - remove tourniquet and get set up. once done, apply tourniquet again. best vein to get? - once you've found the vein, clean it w alcohol wipe and wait how long? - get your needle ready. anchor vein with ___. - hold vacuutainer how? - CORRECT ANSWER arm hyperextended tourniquet 3-4 inches above puncture site best vein - median cubital (pinky side) wait 15-30 seconds for EtOH to dry hold vacutainer thumb on top, 2-3 fingers under More phlebotomy procedure points: - insert needle at what angle? once needle is in, pop the blood collection tube in - remove what first when the tube is halfway filled? then the? - put gauze over the site and remove ___ last. - apply pressure. mix the tubes. put on bandaid - CORRECT ANSWER needle at 15-30 degree angle remove TOURNIQUET FIRST then the TUBE gauze over site then remove the NEEDLE last. Can you puncture this vein: Lacks resilience, feels cord-like, and rolls easily - CORRECT ANSWER no - this vein is thrombosed What type of needle can you use if you don't have a steady hand? If blood doesn't flow as fast as others? if pts are difficult sticks or peds or scared? - CORRECT ANSWER butterfly needle How to treat vasovagal syncope? - CORRECT ANSWER bend them forward and bring their head between their knees or Lay them down on the floor and lift their legs up Avoid hematoma or blown vein how? - CORRECT ANSWER release tourniquet first then withdraw needle then apply firm pressure ___: Induration of a superficial vein +/- surrounding erythema How is it treated? - CORRECT ANSWER superficial thrombophlebitis - not a DVT!! tx w warm compress and NSAID What phlebotomy complication occurs in patients who are IV drug users, diabetics, immunocompromised, HIV, carriers of MRSA, pts in the hospital w IV in place? Tx? - CORRECT ANSWER cellulitis or abscesses give dicloxacillin if large and severe abscess w surrounding cellulitis. bactrim if healthy pt Elevated potassium on labs - first rule out... - CORRECT ANSWER hemolysis of specimen What precautions & PPE are required for phlebotomy? - CORRECT ANSWER universal/standard precautions exam gloves & lab coat or gown What type of line is this: located in periphery. single lumen. used for basic administration of IV meds and fluids. placed by RN - CORRECT ANSWER peripheral IV Where in the periphery can midline IVs be placed? The distal tip of the midline is where? How many lumens? How is it placed? - CORRECT ANSWER basilic, brachial, cephalic vein distal tip just proximal to axilla single or double lumen placed w US and seldinger's technique Where does a PICC line end vs midline? - CORRECT ANSWER PICC - IVC midline - axilla What is an A line? Check collateral circulation how? An A line can be connected to what monitoring? - CORRECT ANSWER peripheral line inserted into radial artery check circulation with Allen's test FloTrac to measure stroke volume and cardiac output What line gives info on volume status? - CORRECT ANSWER A line What is a central venous catheter? Where can it be placed? Where is the distal tip located? Why would you choose a CVC over a PIV? What measurements can be taken with CVCs? Other than meds & fluids, what can CVCs be used for? - CORRECT ANSWER long catheter placed into a large vein in neck (internal jugular), upper chest (subclavian), or groin (femoral) distal tip located within SVC near the right atrium CVC is more durable & less able to be displaced. Better able to deliver fluids & meds rapidly measure pressures, take frequent blood samples can be used for TPN, dialysis Where is the distal tip for: PICC lines Non tunneled catheters tunneled catheters***??? Implanted ports - CORRECT ANSWER PICC - at superior vena cava preferably at junction with right atrium (Cavoatrial junction) non tunneled - at superior vena cava tunneled - cavoatrial junction port - at SVC at cavoatrial junction How does a port differ from other central lines? How is it placed? - CORRECT ANSWER totally located under the skin placed under skin usually in upper chest by a surgeon Biggest complication with CVC placement? How to ensure this didn't happen? - CORRECT ANSWER collapsed lung/ pneumothorax verify placement with CXR Tunneled or non tunneled: short term use vs long term use accounts for most central line associated bloodstream infections vs lower rate of CLABSI - CORRECT ANSWER short & high CLABSI - nontunneled long & low CLABSI - tunneled Which CVC has the lowest risk of CLABSI? - CORRECT ANSWER Implantable port (note: PICC has a lower rate than nontunneled as well) Relative contraindications for CVCs? - CORRECT ANSWER infection at site of insertion coagulopathy newly inserted pacemaker wires Which internal jugular vein has a straight in-line course to right atrium? - CORRECT ANSWER Right IJ What is the preferred technique for CVC insertion? - CORRECT ANSWER seldinger technique - sterile US guidance with a catheter over a wire WHOOPS!!! You accidentally punctured an artery during CVC placement. What is the tx for each needle size: 22 G 18 G large bore introducer - CORRECT ANSWER 22G: no problem 18G: hematoma risk - hold pressure x 5min large bore: hold pressure x 30 min or surgical consult After CVC placement, always confirm venous access how? - CORRECT ANSWER check blood gas or.. hook up to fluid column & look at waveform - if BP of 5-10 = vein - if BP Of 100/60 = artery CVP = central venous pressure. What is a normal CVP range? CVP is more useful as trend or as an absolute value? What 2 main things can you assess with CVP? - CORRECT ANSWER 5-15mmHg note: CVP more useful as a trend!! CVP measures right ventricular filling pressure and right ventricular function (using starling's law can figure out LV function) You connect the transducer of the CVC to the CVP monitor. The pressure transducer has what reference point? - CORRECT ANSWER level of the heart Patients with CHF who have dysfunctional heart muscle would have what changes on the CVP? - CORRECT ANSWER abnormally high CVP due to a depressed cardiac function curve & a right-shifted venous function curve Pts w hypovolemia or sepsis (decreased venous tone) would have what changes on CVP? - CORRECT ANSWER abnormally LOW CVP due to left shifted venous function curve Explain what each wave means in CVP waveform: a wave c wave x descent v wave y descent - CORRECT ANSWER a wave: right atrial contraction - Occurs after the P wave on the ECG but before the first heart sound c wave: Right ventricular contraction -Caused by the bulging of the tricuspid valve into the atrium x descent: Downward movement of the ventricle and tricuspid valve during ventricular contraction - Atrial relaxation v wave: atrium fills against a closed tricuspid valve y descent: tricuspid valve opens and blood passively enters the ventricle What is swan ganz catheter? What does it help differentiate? - CORRECT ANSWER pulmonary artery catheter differentiates between the various mechanisms of shock - use in critically ill pts The tip of a swan ganz is where? - CORRECT ANSWER through right atrium -> rv -> pulmonary artery ____: the intensity and duration of pressure generated by the inspiratory muscles ____: interval between beginning of intake of air to when max tidal volume is reached - CORRECT ANSWER Pmus - intensity and duration of pressure inspiration time - intake of air to max TV What controls expiratory time (interval from beginning of inspiratory flow to beginning of next inspiration)? - CORRECT ANSWER medulla Mechanical ventilation replaces the actions of what muscles? - CORRECT ANSWER inspiratory & neural control of breathing What type of respiratory cycle is this: ventilator controls the entire inspiratory phase or totally replaces respiratory muscle effort and neural control - CORRECT ANSWER controlled cycle ex. volume cycled ventilation What type of respiratory cycle is this: ventilator only assists the inspiratory muscles that are active - CORRECT ANSWER assisted cycle What variables can be controlled during inspiration? - CORRECT ANSWER time flow volume or pressure Volume cycled ventilation vs Pressure cycled ventilation - CORRECT ANSWER Volume - cycle that ends when it reaches a predetermined tidal volume Pressure - a timed cycle During a volume controlled cycle (an example of controlled respiratory cycle), what determines how long expiration lasts? - CORRECT ANSWER PEEP - positive end expiratory pressure once alveolar pressure hits the PEEP value, expiration stops. cycle restarts A volume controlled cycle needs what predetermined value to work? How do you calculate this? - CORRECT ANSWER calculate Tidal volume 12mL by the ideal body weight What are the 3 basic ventilatory modes? - CORRECT ANSWER Assist/ control ventilation A/C Pressure support ventilation PSV Synchronized intermittent mandatory ventilation - a hybrid of the two What ventilatory mode is this: characterized by offering controlled and/or assisted cycles, depending on the settings programmed for the minimum respiratory rate (RR) delivered to the patient. - CORRECT ANSWER A/C mode What ventilatory mode would be used: immediately after tracheal intubation when the patient is sedated or under a neuromuscular blocker. - CORRECT ANSWER A/C - VCV What ventilatory mode is easier to determine respiratory mechanics? - CORRECT ANSWER A/C - VCV What ventilatory mode has alveolar pressure under greater control? - CORRECT ANSWER A/C - VCV What ventilatory mode is able to use a protective ventilation strategy for pts with ARDS? - CORRECT ANSWER A/C VCV uses low tidal volumes in pts with ARDS What ventilatory mode has ONLY assisted cycles? - CORRECT ANSWER PSV mode it is triggered by the pt. no mechanical triggers What ventilatory mode is used for pts that exhibit good recovery from an underlying disease and sedation is reversed? - CORRECT ANSWER PSV What ventilatory modes is typically used for weaning? - CORRECT ANSWER PSV mode [Show Less]
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CPSS EXAM #1 (POCUS PICS) 53 Questions with Verified Answers,100% CORRECT
CPSS EXAM #1 (POCUS PICS) 53 Questions with Verified Answers Small Bowel Obstruction (SBO) Interpretation: Anechoic (Black) lesions with thickened bo... [Show More] wel walls and posterior enhancement; suggestive of SBO - CORRECT ANSWER An US of the abdomen reveals the finding in the picture, what is the likely diagnosis? Benign Cyst Interpretation: Anechoic (black) lesion with posterior enhancement artifact (White patch after lesion) suggests that this cavity is fluid filled; suggestive of a cyst. - CORRECT ANSWER An US of the breast reveals the finding in the picture, what is the likely diagnosis? Posterior Enhancement Artifact (Acoustic Enhancement) NORMAL finding - CORRECT ANSWER What artifact is seen in the US? Posterior Shadowing Artifact (Acoustic Shadowing) NORMAL finding - CORRECT ANSWER What artifact is seen in the US? Edge Artifact NORMAL finding - CORRECT ANSWER What artifact is seen in the US? A-Lines (Reverberation artifact) NORMAL finding lungs - CORRECT ANSWER What artifact is seen in the US? Mirror Image Artifact (Reverberation artifact) NORMAL finding Liver - CORRECT ANSWER What artifact is seen in the US? Ringdown artifact (B-Lines) Note: These are the vertical hyperechoic lines noted in the US; indicates pulmonary edema - CORRECT ANSWER What artifact is seen in this US of the lungs? Normal US of kidney Renal capsule: Hyperechoic Renal pyramids: Anechoic/hypoechoic Collecting system (Pelvis): Hyperechoic - CORRECT ANSWER What is shown on this US of the kidneys? Mild to moderate hydronephrosis Renal sinus is not hyperechoic, but shows dilated anechoic regions. - CORRECT ANSWER What is shown on this US of the kidneys? Normal US of the bladder Bladder lining: Hyperechoic Internal bladder: Anechoic - CORRECT ANSWER What is shown on this US of the Bladder? Normal US of the uterus Note endometrial strip - CORRECT ANSWER What is shown on this longitudinal view of the uterus? Normal US of the uterus Note hyperechoic horizontal line that is representive of the endometrial strop - CORRECT ANSWER What is shown on this transverse view of the uterus? Intrauterine pregnancy! Fetal pole in a yolk sac; presence of this excludes ectopic pregnancy unless on IVF - CORRECT ANSWER What is shown on this longitudinal view of the uterus? Subxiphoid view Great to analyze for pericardial effusion or standstill - CORRECT ANSWER What view of the heart is shown in this US? Pericardial effusion - CORRECT ANSWER What is shown on this US - subxiphoid view of the heart? Parasternal Short Axis (PSAX) "doughnut view" Note: Abdominal marker should be at either 10 or 4 o'clock position - CORRECT ANSWER What view of the heart is shown in this US? Parasternal Long Axis (PSLAX) Note: Abdominal marker should be at either 10 or 4 o'clock position - CORRECT ANSWER What view of the heart is shown in this US? Apical 4 chamber view (A4C) Note: Place in left lateral decubitus position with marker at 3 or 9 oclock position; right side of heart is on left side of screen - CORRECT ANSWER What view of the heart is shown in this US? Normal variant longitudinal view of the gallbladder Phrygian Cap: Single fold at the fundus (Right of image) Hatmann's Pouch: Single fold at the neck (Left of image) - CORRECT ANSWER What 2 structures are shown in this US? Normal variation of gallbladder anatomy Hyper-echoic invaginations are gallbladder folds and are more susceptible to lodge gallstones - CORRECT ANSWER What is shown in this US? Gallstones Hyperechoic dependent masses with posterior shadowing; stones should move when rolling the pt - CORRECT ANSWER What is shown in this US? "Wall echo sign" suggesting gallbladders are completely full of gallstones - CORRECT ANSWER What is shown on these US? Gallbladder polyp Small isoechoic mass within the gallbladder lumen. May present with a visible stock. Immobile and without posterior shadowing. - CORRECT ANSWER What is shown on this transverse image of the gallbladder? Gallbladder wall thickness without gallstones (>3mm) Wall is less hyper-echoic with mixed echogenicity indicating wall edema - CORRECT ANSWER What is shown on this US? Gallbladder sludge Hypo-echoic mass that collects on the dependent aspect of the gallbladder lumen and moves slowly with position change - CORRECT ANSWER What is shown on this US? B-Lines (Ringdown artifacts) Indicative of pulmonary edema Note: Need 3-5 lines for pathological diagnosis - CORRECT ANSWER What is shown on this US of the lungs? Barcode sign All the hyper-echoic lines are static lung tissue, indicating a pneumothorax or Lack of lung sliding - CORRECT ANSWER What is shown on this US of the lungs? Note: The probe is in "M-mode" Lung point The point where the normal "Seashore sign"(Left of image) of the lung meets the "Barcode sign"(Right of image), identifying the exact location of the pneumothorax. Remember barcode sign = pneumothorax seashore sign = normal lung - CORRECT ANSWER What is shown on this US of the lungs? Note: The probe is in "M-mode" "Seashore sign" indicated NORMAL tissue - CORRECT ANSWER What is shown on this US of the lungs? Note: The probe is in "M-mode" Aortic dissection - CORRECT ANSWER What is shown on this US of the Aorta? Cellulitis "Cobblestone appearance" - CORRECT ANSWER What is shown on this US of the skin? Normal anatomy Largest anechoic circle on the right = basilic vein Two mixed echoic ("Honecombing") areas to the left of the basilic vein = median and ulnar nerve middle anechoic circle = Brachial artery Two anechoic circles surrounding breachial artery = Brachial veins - CORRECT ANSWER What is shown on this US of the skin? Necrotizing fasciitis -Mainly on patient presentation - Pain out of proportion to the area -Edematous anechoic areas found with hyperechoic collections which are air pockets from the bacteria Surgical emergency! - CORRECT ANSWER What is shown on this US of the skin? Abscess -Borders are not clear or round, so unlikely to be cyst -Internal hyperechoic regions that correlate with pus formation -Mixed echogenecity throughout entire region - CORRECT ANSWER What is shown on this US of the skin? Solid mass - likely a swanoma -Heterogenous echogenecity throughout region, all 1 density - CORRECT ANSWER What is shown on this US of the skin? Normal lymph node - CORRECT ANSWER What is shown on this US of the skin? Glass! looking underneath the foreign body, there is a reverberation artifact. so technically it could also be anything else that causes reverberation artifacts. - CORRECT ANSWER What could the foreign body be made of in this US? 1. Cornea 2. Anterior chamber 3. Cilary bodies 4. Lens 5. Vitreous chamber 6. Posterior wall (Retina, Choroid, Sclera) 7. Optic nerve 8. Periorbital fat 9. Optic disc - CORRECT ANSWER What are the anatomical structures associated with each number on this US of the eye? Periorbital abscess Located in the left upper corned of the image. - CORRECT ANSWER What is shown on this US of the eye? Periorbital cellulitis and Posterior abscess -Cobble-stoning in the upper portion of the image. -Abscess behind the orbit, distorting normal anatomy of the eye - CORRECT ANSWER What is shown on this US of the eye? Retinal detachment The retina is the white strand in the middle of the image... it shouldn't be there Note: can see this move in real time if you ask the patient to look in different directions - CORRECT ANSWER What is shown on this US of the eye? Retina detachment = "V" shaped form, following the optic nerve and anchored a the optic nerve sheath Choroid detachment = Not shape or form, does NOT follow optic nerve - CORRECT ANSWER How can we tell this image is a detached retina, as opposed to a choroid detachment? Parasternal short axis view (PSAX) Note: The mitral valve is visible here - CORRECT ANSWER What view is this of the heart? Apical 4 chamber view - CORRECT ANSWER What view is this of the heart? Subxiphoid view - CORRECT ANSWER What view is this of the heart? Parasternal Long axis view (PSLAX) - CORRECT ANSWER What view is this of the heart? B lines Indicates pulmonary edema - CORRECT ANSWER What is shown on this US of the lungs? Gallstones Posterior shadowing noted after hyperechoic areas - CORRECT ANSWER What is shown on this US of the gallbladder? "Wall echo sign" Indicates a gallbladder completely full with stones - CORRECT ANSWER What is shown on this US of the gallbladder? Actue cholecystitis -Thickened wall (>3mm) -Sludge present with gallstones -Pericholecystic fluid noted - CORRECT ANSWER What is shown on this US of the gallbladder? Enlarged prostate Note: left image is transverse, right is long - CORRECT ANSWER What is shown on this US of the bladder? Enlarged prostate Note: left image is transverse, right is long - CORRECT ANSWER What is shown on this US of the bladder? [Show Less]
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Ch 1: Performance Dimensions-CPSS 28 Questions with Verified Answers,100% CORRECT
Ch 1: Performance Dimensions-CPSS 28 Questions with Verified Answers In the context of sport and the high-performance unit (HPU), for something to be co... [Show More] nsidered information, it must have the potential to shift _________. a. thinking and decision making b. athlete performance outcomes c. HPU interactions d. culture - CORRECT ANSWER thinking and decision making The high-performance unit (HPU) comprises a. a group of muscle fibers innervated by a single alpha motor neuron b. the top 10% of athletes in a given monitoring session c. strength and conditioning professionals, physical therapists, nutritionists, and other specialists who support performance off the field d. the head coach, assistant coaches, and position-specific coaches who support performance on the field - CORRECT ANSWER c. strength and conditioning professionals, physical therapists, nutritionists, and other specialists who support performance off the field What is the correct order of the steps in assessing the flow of high-quality information? a. analyze, visualize, measure, and interpret b. measure, analyze, visualize, and interpret c. visualize, measure, interpret, and analyze d. interpret, measure, visualize, and analyze - CORRECT ANSWER b. measure, analyze, visualize, and interpret An emerging challenge for sport teams and organizations is a. a lack of portable devices on the market to measure relevant biometrics and performance outcome data b. declining interest in sport c. the slow pace of technological innovation in the wearable industry d. the difficulty of finding someone to manage multiple technologies while managing and interpreting the data they produce - CORRECT ANSWER d. the difficulty of finding someone to manage multiple technologies while managing and interpreting the data they produce Within the modern high-performance unit (HPU), the sport coach is responsible for a. implementing all details of the physical, technical, and tactical development of the athletes b. establishing the technical and tactical vision that forms the basis for how athletes will play the game c. working with athletes to ensure that they are developing the mental skills needed to consistently perform d. directing all aspects of athlete development and care - CORRECT ANSWER b. establishing the technical and tactical vision that forms the basis for how athletes will play the game The sport nutritionist or dietitian's primary role is to a. persuade athletes to adopt the latest dietary strategy that is suspected to improve health outcomes b. ensure that athletes support their physical development and daily energy needs with the right quantity and quality of calories c. collect food logs and check micronutrient levels d. implement strategies to ensure that athletes remain below a desired body fat percentage during the majority of the season - CORRECT ANSWER b. ensure that athletes support their physical development and daily energy needs with the right quantity and quality of calories According to the text, these members of the high-performance unit (HPU) comprise the medical collective and collaborate with the strength and conditioning professional to provide preventive and reactive injury reduction strategies. a. medical doctor, physical therapist, and athletic trainer b. medical doctor, nurse, and pharmacist c. chiropractor and athletic trainer d. physical therapist, massage therapist, and acupuncturist - CORRECT ANSWER a. medical doctor, physical therapist, and athletic trainer Because of the varied expertise of its members, the high-performance unit (HPU) is also known as a. a performance task force (PTF) because each person's primary focus should be on improving athletic performance b. an interdisciplinary team (IDT) because each person's discipline is both unique and interdependent with the other team members' c. the secondary team (ST) because all members are secondary to the head sport coach d. a peripheral specialist group (PSG) because each member's domain of expertise only indirectly influences performance - CORRECT ANSWER b. an interdisciplinary team (IDT) because each person's discipline is both unique and interdependent with the other team members' An interdisciplinary team (IDT) is a balance of both siloed and shared responsibilities. Which of the following is an example of an independent responsibility? a. a medical doctor advising a return-to-play protocol b. a physical therapist manipulating an athlete's hip joint c. an athletic trainer gathering session RPE data d. a strength and conditioning coach creating an injury prevention protocol - CORRECT ANSWER b. a physical therapist manipulating an athlete's hip joint An interdisciplinary team (IDT) is a balance of both siloed and shared responsibilities. Which of the following is an example of a dependent responsibility? a. a nutritionist analyzing food logs for micronutrient deficiencies b. a medical doctor performing a preseason physical exam c. a strength and conditioning coach prescribing intensity for a set of back squats d. an athletic trainer overseeing an athlete's return-to-play protocol - CORRECT ANSWER d. an athletic trainer overseeing an athlete's return-to-play protocol According to the text, "an established set of values and behaviors that align to a common vision and are upheld by all who enter the work environment" is known as a. a company ethos b. a mission statement c. a team slogan d. a shared mental model - CORRECT ANSWER d. a shared mental model The three components of an interdisciplinary team's (IDT) work environment that should be considered are a. people, process, and place b. vision, direction, and motivation c. instrumentation, finances, and organizational hierarchy d. principles, preparedness, and potential - CORRECT ANSWER a. people, process, and place According to the text, competence, clear communication, and the desire to learn are all desirable traits for a. the athletes b. the general manager c. the people in a successful IDT d. the referees, judges, and match officials - CORRECT ANSWER c. the people in a successful IDT Which of the following is not true of the process of an interdisciplinary team (IDT)? a. should be documented b. does not need to be documented c. should rely on scheduled meetings as well as organic communication d. describes how information influences decision making - CORRECT ANSWER b. does not need to be documented Within the context of an interdisciplinary team (IDT), "place" refers to a. the physical environment that each member works in b. the organizational structure c. the ranking of the sport team or organization among those in its conference or league d. the level of involvement that the IDT has in relation to the head coach - CORRECT ANSWER a. the physical environment that each member works in The decision-making process of an interdisciplinary team (IDT) should rely primarily on a. logic b. domain expertise c. expert opinion d. objective, data-driven insights - CORRECT ANSWER d. objective, data-driven insights The member of the interdisciplinary team (IDT) most equipped to handle interdisciplinary streams of domain-specific information is the a. head sport coach b. assistant sport coach c. team physician d. sport scientist - CORRECT ANSWER d. sport scientist The role of the sport scientist has progressed since 2010. What is the correct sequence for the actions that sport organizations have taken to fill the role of the sport scientist? i. convert a member of the IDT into a sport scientist ii. create a sport scientist position and go through an external hiring process iii. distribute the responsibilities of a sport scientist across the IDT a. i, ii, iii b. iii, ii, i c. iii, i, ii d. ii, iii, i - CORRECT ANSWER c. iii, i, ii The primary responsibility of a sport scientist is a. to make decisions on behalf of the interdisciplinary team (IDT) when they lack the proper information b. to connect the interdisciplinary team (IDT) to the right information at the right time so they can make better decisions c. to provide ongoing coach education services to the coaching staff d. to identify and invest organizational resources in valid and reliable sport technology - CORRECT ANSWER b. to connect the interdisciplinary team (IDT) to the right information at the right time so they can make better decisions A sport scientist has just been given grant money intended to fund innovative technology. After purchasing the technology, the sport scientist should a. work with members of the interdisciplinary team (IDT) in designing a process document that outlines how the technology will be used and integrated into the IDT's daily workflow b. evaluate the efficacy and utility of the technology c. lead an innovation group to determine whether the newly purchased technology will meet a need of the sport organization d. hand the technology over to the coaching staff without need for further interaction - CORRECT ANSWER a. work with members of the interdisciplinary team (IDT) in designing a process document that outlines how the technology will be used and integrated into the IDT's daily workflow The technology that acts as the sport science hub for most sport organizations is a. statistical software such as SPSS, JASP, or R b. a suite of inertial measurement unit (IMU) technology c. force instrumented devices d. the athlete management system (AMS) - CORRECT ANSWER d. the athlete management system (AMS) Technology that measures metrics associated with running distance, velocity, acceleration, and deceleration often uses a combination of _________ and _________ to triangulate an athlete's position. a. inertial measurement units (IMUs), force instrumented devices b. force instrumented devices, global positioning system (GPS) c. inertial measurement units (IMUs), global positioning system (GPS) d. inertial measurement units (IMUs), athlete management system (AMS) - CORRECT ANSWER c. inertial measurement units (IMUs), global positioning system (GPS) According to the text, which of the following is not true regarding options for data management? a. Microsoft Excel tends to be more flexible than athlete management systems (AMSs). b. Athlete management systems (AMSs) have virtually no limits to the amount of data storage but have limited flexibility. c. Statistical software, such as SPSS, R, or JASP, is an ideal option for day-to-day data management. d. Business intelligence software, such as Tableau or Power BI, is both flexible and powerful, making it an ideal candidate for data management. - CORRECT ANSWER c. Statistical software, such as SPSS, R, or JASP, is an ideal option for day-to-day data management. Regarding the mental model for data interpretation, what is known, or knowledge that is supported by evidence, falls into a. category 3 b. category 2 c. category 1 d. category 4 - CORRECT ANSWER c. category 1 Regarding the mental model for data interpretation, domains of knowledge that are known to exist but have no supporting evidence or experience fall into a. category 2 b. category 3 c. category 4 d. category 1 - CORRECT ANSWER b. category 3 Regarding the mental model for data interpretation, one of the primary roles of a sport scientist is to transform _________ into ________. a. categories 1 and 2 information, categories 3 and 4 information b. objective decision making, subjective decision making c. irrelevant information, relevant information d. unknown information, known information - CORRECT ANSWER unknown information, known information A sport scientist lacking in soft skills, such as organization, time management, prioritization, or communication, can make up for it with hard skills, such as technology and data analytics experience. a. True b. False - CORRECT ANSWER a. True The ability of a sport scientist to effectively calibrate messages to the intended IDT member is rooted in a. high emotional intelligence b. mental acuity c. a high intelligence quotient (IQ) d. the scientific rigor of the message - CORRECT ANSWER a. high emotional intelligence [Show Less]
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Child Protective Services Exam 1 |38 Questions with Verified Answers,100% CORRECT
Child Protective Services Exam 1 |38 Questions with Verified Answers A state agency established and defined by the Texas Family Code that investigates r... [Show More] eports of child abuse and neglect, provides services to children and families in their own homes, provides services to youth in foster care to make the transition into adulthood, and places children in adoptive homes - CORRECT ANSWER child protective services casework begins with an __________ of abuse or neglect - CORRECT ANSWER allegation texas family code section 261.101 (a) states that "a __________ having cause to believe that a child's physical or mental health or welfare has been adversely affected by abuse or neglect by any person shall __________ make a report" - CORRECT ANSWER child; immediately 1st step in the process of a CPS case: report is called into the __________ _________ _________ - CORRECT ANSWER child abuse hotline 2nd step in the process of a CPS case: statewide intake assigns a _________ and then to an __________ unit - CORRECT ANSWER priority; investigative what umbrella does CPS fall under? - CORRECT ANSWER texas health and human services commission how many agencies fall under CPS? - CORRECT ANSWER 3 what are the 3 agencies that fall under CPS? - CORRECT ANSWER investigations; family based safety services; conservatorship CPS intake priorities: acute cases - CORRECT ANSWER priority 1 CPS intake priorities: CPS responds within 72 hours of intake - CORRECT ANSWER priority 2 CPS intake priorities: case does not involve abuse or neglect or CPS does not have jurisdiction - CORRECT ANSWER no priority what is the decision to remove a child based on? - CORRECT ANSWER imminent danger to the child's life/limb who is required to report abuse and neglect? - CORRECT ANSWER everyone what is the failure of any person to report suspected child abuse or neglect charged with? - CORRECT ANSWER class b misdemeanor what does a class b misdemeanor result in? - CORRECT ANSWER jail time what region are we in? - CORRECT ANSWER region 3 how many cases does an average investigator have on their workload at a time? - CORRECT ANSWER 30 the alliance for children facilitates joint investigations between law enforcement and CPS by housing the __________ __________ - CORRECT ANSWER multidisciplinary team if the safety threat or danger against the child exists now, and CPS must move immediately to ensure the safety of the child, the threat is said to be __________ - CORRECT ANSWER present if the safety threat or danger against the child is very likely to be present due to various aspects, and CPS must plan for the child's safety in the very near future, the threat is said to be __________ - CORRECT ANSWER impending what are the three family decision making models to ensure families are involved in the protection of their children? - CORRECT ANSWER family team meetings; family group conferences; circle of support family group decision making: emergency meeting of available family members to address the immediate safety of a child - CORRECT ANSWER family team meetings family group decision making: meeting of extended family, friends, etc. to ensure the mitigation of risk to a child and develop a plan of service for the child and family - CORRECT ANSWER family group conferences family group decision making: meeting of extended family, friends, service providers, etc. to ensure the well being of a child about to age out of CPS care - CORRECT ANSWER circle of support what is the most important strength a family has? - CORRECT ANSWER capacity to protect its own children what are the two alternatives to removal? - CORRECT ANSWER parental child safety placement and family based safety services alternative to removal: parent agrees to voluntarily place their child(ten) in the care of a relative or family friend on a temporary basis - CORRECT ANSWER parental child safety placement alternative to removal: provides families with in home CPS monitoring and services - CORRECT ANSWER family based safety services a cps investigation must be closed and given a disposition within _____ days from the date of intake - CORRECT ANSWER 60 the burden of proof: 99.9% - CORRECT ANSWER beyond reasonable doubt the burden of proof: 75% - CORRECT ANSWER clear and convincing evidence the burden of proof: 51% - CORRECT ANSWER preponderance of the evidence the burden of proof: e.g. arrest - CORRECT ANSWER probable cause the burden of proof: e.g. emergency removal - CORRECT ANSWER reasonable suspicion what re the goals of CPS? - CORRECT ANSWER family reunification; permanent custody to relative/kin; termination of parental rights and adoption; foster care system in the case that a child is over 16, cps usually goes back and does a full case review to make sure they didn't miss anybody - CORRECT ANSWER permanency round table are cps workers armed or disarmed? - CORRECT ANSWER disarmed because cps workers are disarmed, what three things do they rely on for safety? - CORRECT ANSWER instincts; de escalation; law enforcement [Show Less]
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Certified Prevention Specialist CPS 184 Questions with Verified Answers,100% CORRECT
Certified Prevention Specialist CPS 184 Questions with Verified Answers Prevention strategies, activities, or approaches that have been shown through re... [Show More] search and evaluation to be effective in the prevention and/or delay of substance use or abuse. - CORRECT ANSWER Best Practices Data that already exists and that are maintained by an organization or entity. Typically, this refers to collected data repositories maintained by state agencies, such as Highway Patrol (for DUI accidents and fatalities), Health Services (for AOD related hospitalizations), and Treatment admissions for AOD substance use problems. - CORRECT ANSWER Archival Data The term "_______" refers to the various types and levels of resources that an individual, organization, or collaborative has at its disposal to meet the implementation demands of specific interventions. - CORRECT ANSWER Capacity A capacity building process through which a community of individuals, organizations, policy makers, or governmental representatives plans, carries out, and evaluates activities on a participating basis to improve health or other needs. It empowers individuals and groups to take some kind of action to facilitate change based on needs they have identified. Communities may initiate the process themselves or maybe motivated by outsiders to act. - CORRECT ANSWER Community Mobilization The formal names given to community mobilization types of efforts. All share a common theme: a group of individuals and/or agencies agreeing to work together for a common purpose. They may vary in formality, size, and composition. To be most effective, these community mobilizing efforts should have a membership that reflects the broader community. Cultural awareness and sensitivity are hallmarks of successful community mobilizing efforts. - CORRECT ANSWER Community Partnerships Collaboratives Coalitions The extent to which a community is adequately prepared to implement a substance abuse prevention program. The underlying premise of community readiness is change in AOD use cannot occur if there exists a high level of community denial about this problem. - CORRECT ANSWER Community Readiness This refers to an ability to interact effectively with individuals from different cultural backgrounds. It comprises of four components: 1) Awareness of one's cultural world view, 2) Attitudes towards cultural differences, 3) Knowledge and awareness of different cultural practices, beliefs and world views, and 4) Possessing cross-cultural skills. - CORRECT ANSWER Cultural Competence (Awareness) _____represents the "values, norms, and traditions that affect how individuals of a particular group perceived, think, interact, behave, and make judgment about the world." Chamberlain (2005). - CORRECT ANSWER Culture This term applies to replicating a program model or strategy. To have "_______," the program needs to be implemented with the same specifications of the original program. ______can be balanced with adaptation to meet local needs. - CORRECT ANSWER Fidelity Broad, future oriented action statements to be achieved by a program. Neither dates nor responsibilities are included. A program may have multiple (1 to 5), but not so many as to confuse staff and the general community. - CORRECT ANSWER Goal Statements Findings about effective prevention programs as identified through research. - CORRECT ANSWER Guiding Principles A planning tool that enables a group or its manager to identify, among other things, the strategies, best practices, guiding principles, and evaluation plan. This can contribute to the establishment of direction and clarity of vision for the implementation group. - CORRECT ANSWER Implementation Plan Those programs and strategies designed to target specific individuals at risk for substance abuse problems. - CORRECT ANSWER Indicated A variable that relates directly to some part of a program goal or objective. Positive change on an indicator is presumed to show progress in accomplishing the larger program objective. - CORRECT ANSWER Indicator An approach, since adopted by CSAP and the prevention field that: 1) view prevention as part of an overall continuum of services, concluding with treatment; 2) identifies three levels of prevention: universal, selected, and indicated that refers to populations at varying levels of risk involving substances which in turn dictates that level and type of prevention services appropriate for the level of risk evident in the various population groupings. - CORRECT ANSWER Institution of Medicine (IOM) Model Narrative or graphical depictions of processes in real life that communicate the underlying assumptions upon which an activity is expected to lead to a specific result. Logic models illustrate a sequence of cause-and-effect relationships - a systems approach to communicate the path toward a desired result. - CORRECT ANSWER Logic Model The broadcast statement of intent for an organization. They should be brief and to the point. They do not include dates or assign responsibility. There is only one mission statement for a program. - CORRECT ANSWER Mission Statement A systematic process for examining the current conditions and identifying the level of risk and protection within a community. It should also include the documentation of resources available in the community to address the problem areas. - CORRECT ANSWER Needs Assessment Statements that, minimally, have four main qualities that distinguish them from goals or mission statements. They are: 1) specific, 2) measurable, 3) achievable, and 4) timebound. - CORRECT ANSWER Objective Statements Used in the development of the logic model. They specify the expected results, short-term, intermediate, and long-term. They identify ways in which the participants in the prevention intervention could be expected to change by the conclusion of the service (e.g., change in behaviors, reduced consumption levels, etc.). - CORRECT ANSWER Outcome Benchmarks Refers to the type of substance, amount, and frequency of use. At times, the place/occasion of use is also noted. This information is typically picked up in individually administered surveys. - CORRECT ANSWER Patterns of Consumption As defined by SAMHSA, "A proactive process that empowers individuals and systems to meet the challenges of life events and transitions by creating and reinforcing conditions that promote healthy behaviors and lifestyles." - CORRECT ANSWER Prevention Information that is difficult to measure, count, or express in numerical terms and is therefore often presented in narrative forms. This type of research typically uses observation, interviewing, open ended responses, and document review to collect data. - CORRECT ANSWER Qualitative Data Information that is reported in numerical form such as substance use rates, number of people attending a program, or number of alcohol related deaths. The strength of this data is their use in testing hypotheses and determining the strength and direction of effects. - CORRECT ANSWER Quantitative Data In the public health model, this is the AOD substance of concern causing harm to the individual (e.g., tobacco, alcohol, other drug). This acts directly on the "host" (individual) and is influenced by the "environment" (community, culture, norms settings, politics, and values). - CORRECT ANSWER Agent This approach to substance abuse prevention is based on the assumption that involving high-risk youth in activities that are free of alcohol, tobacco, and other drugs will occupy their leisure time with pro-social activities and allow them to make friends with more social peers. These approaches fall into several broad categories: Athletic; Recreational Alternatives; Adventure Oriented; Cultural Specific Models; Aimed at High-Risk; Entrepreneurial; Community Service; Creative; Artistic; and Drop-in Centers. - CORRECT ANSWER Alternative Activities A widely used framework created by Search Institute, which includes relationships, opportunities, skills, values, and commitments children and adolescents need to grow up healthy, caring, and responsible. The research-based framework is organized into two types of assets. External assets refer to the support and opportunities that are provided by family, friends, organizations, and communities. The internal assets focus on the capacities, skills, and values that young people need to internalize as part of developing their character, identity, and life skills. - CORRECT ANSWER Asset Development Model Strategies that aim to enhance the ability of the community to more effectively provide prevention and treatment services for substance abuse. Services in this strategy include organizing, planning, and enhancing the efficiency and effectiveness of services implementation, interagency collaboration, coalition building, and networking. - CORRECT ANSWER Community-Based Processes The attitudes toward policies about drug use and crime that a community holds. They are communicated in a variety of ways: through laws and written policies; through informal social practices; and through the expectations that parents and other members of the community have of young people. - CORRECT ANSWER Community Norms CSAP Strategies - CORRECT ANSWER 1) Information Dissemination 2) Prevention Education 3) Alternative Activities 4) Problem Identification and Referral 5) Community-Based Processes 6) Environmental Approaches. Behavior by adolescents (younger than 18) that is antisocial or in violation of the law. - CORRECT ANSWER Delinquency In the public health model, what represents the broader context in which the "agent" interacts with the "host." In AOD planning, this would includes the community, culture, norms, laws and regulation that affect the distribution and availability of the "agent" (e.g., tobacco, alcohol, and other drugs). By changing the this it is expected that changes will occur with the "agent's" availability leading to reduced problems with the "host" (individual). - CORRECT ANSWER Environment Created by Search Institute, these are provided by the family, school, and community. They are Support: Family support, Positive family communication, Other adult relationships, Caring neighborhood/community, Caring school climate, and Parent involvement in school; Empowerment: Community values youth, Youth given useful roles, Youth volunteers in the community, and Safety; Boundaries and expectations: Family boundaries, School boundaries, Neighborhood/Community boundaries, Adult role models, Positive peer influence, and High expectations; and Constructive use of time: Creative and cultural activities, Youth programs, Religious community, and Time at home. - CORRECT ANSWER External Assets In the Public Health Model, who is the individual or person affected by the public health problem (e.g., the "agent"; for prevention - alcohol, tobacco and other drugs). - CORRECT ANSWER Host One of CSAP's Six Prevention Strategies that includes providing information about the nature and extent of drug use, abuse, and addiction and the effects on individuals, families, and communities. It also includes information about the availability of prevention services. A characteristic of this strategy is a one-way communication mechanism. - CORRECT ANSWER Information Dissemination Created by Search Institute, the values, commitments, competencies, and self-perceptions to be nurtured in every young person. They are: Commitment to learning: Achievement motivation, School engagement, Homework, Bonding to school, and Reading for pleasure; Positive values: Caring, Equality and social justice, Integrity, Honesty, Responsibility, and Restraint; Social skills: Planning and decision-making, Interpersonal skills, Cultural competence, Resistance skills, and Peaceful conflict resolution; Positive identity: Personal power, Self-esteem, Sense of purpose, and Positive view of personal future. - CORRECT ANSWER Internal Assets A behavior or belief that is commonly held by managing a community. It is often the focus of community-based prevention efforts (e.g., use of designated driver targeted a perception held by many, but not all, that drinking and driving was an acceptable behavior). - CORRECT ANSWER Norms A theory that empirically states that if certain conditions are present, a probable outcome may result. - CORRECT ANSWER Predictive Theory One of CSAP's Six Prevention Strategies that involves two-way communication, generally a facilitator/educator, and a group of learners (participants). Examples include classroom presentations, parenting and family management classes, and groups for children of substance abusers. - CORRECT ANSWER Prevention Education One of CSAP's Six Prevention Strategies that aims to identify those who have engaged in drug use in order to determine whether their behavior can be reversed through education (e.g., Student Assistance Programs [SAP]), or whether they need a referral for a chemical dependency assessment. Examples include DUI education programs or SAPs. - CORRECT ANSWER Problem Identification and Referral Factors, identified by Hawkins and Catalano, counter risks; the more protective factors are present, the less is the risk. Protective factors fall into three basic categories: individual characteristics, bonding, and healthy beliefs and clear standards. - CORRECT ANSWER Protective Factors This prevention model is based on the interaction of the "host" (individual or person), the "agent" (tobacco, alcohol or other drugs), and the "environment" (community setting, values, or policies). - CORRECT ANSWER Public Health Model of Prevention Factors shown to increase the likelihood of adolescent substance abuse, teenage pregnancy, school drop-out, youth violence, and delinquency. - CORRECT ANSWER Risk Factors Resilience is the ability of an individual to cope with or overcome the negative effects of "risk" factors or to "bounce-back" from a problem (e.g., substance abuse). - CORRECT ANSWER Resilience Werner et al. contend that these are factors that protect or buffer people against social problems or risk factors. There are three clusters of factors present in resilient youths: 1) positive dispositional attributes, 2) affectionate ties with an adult parental substance, and 3) having an external support system. - CORRECT ANSWER Resiliency Factors A strategy used to educate or communicate healthy behaviors as practiced by a majority of the public or selected group (e.g., rather than state 25% of high school seniors binge drink every month, a social norms approach would highlight the fact that 75% of our seniors do not engage in monthly binge drinking). - CORRECT ANSWER Social Norms Marketing Acts against a person or people that involve physical harm or the threat of physical harm. - CORRECT ANSWER Violence The Social Learning Theory was developed by: A) Erik Erikson. B) Abraham Maslow. C) Albert Bandura. D) David Hawkins and Richard Catalano. - CORRECT ANSWER C) Albert Bandura The CLOSEST description of the Asset Development Model is one that: A) Incorporates risk and protective factors. B) Was developed by the Search Institute and identifies 40 assets. C) Focuses only on resiliency factors. D) Identifies developmental tasks by various age groupings. - CORRECT ANSWER B) Was developed by the Search Institute and identifies 40 assets. Prevention strategy that provides information about the nature of drug use, abuse, addiction and the effects on individuals, families and communities. It also provides information of available prevention programs and services. The dissemination of information is characterized by one-way communication from the source to the audience, with limited contact between the two. - CORRECT ANSWER Information Dissemination A Youth Development Approach is best characterized as: A) Policies and procedures a youth program can do to promote youth development. B) A focus on protective factors. C) A focus on adolescent risk factors. D) Mentor relationships. - CORRECT ANSWER A) Policies and procedures a youth program can do to promote youth development. 1) Trust, which he linked to positive emotional relationships with caring adults 2) A strong sense of self-sufficiency 3) Ability to exercise initiative 4) Confidence in one's ability to master skills and navigate one's world 5) A well-formed sense of personal identity 6) A desire to be productive and contributing for future generations 7) The ability to experience true intimacy 8) A strong sense of personal integrity - CORRECT ANSWER Erikson's Stages of Development The Five Cs - CORRECT ANSWER 1) Competence, 2) Confidence, 3) Connection, 4) Character, and 5) Caring or Compassion SOS Structure - CORRECT ANSWER Services, Opportunities, and Supports Focuses on activities that nurture developmental assets rather than on reducing particular risks or preventing specific problems. - CORRECT ANSWER Youth Development Model The condition that builds resilience to buffer negative effects (e.g., poverty, drug-abusing environment) are called: A) Support Factors. B) Universal Factors. C) Resilient Factors. D) Protective Factors. - CORRECT ANSWER D) Protective Factors. Prevention strategy that involves two-way communication and is distinguished from merely disseminating information by the fact that it is based on an interaction between the educator and the participants. Activities under this strategy aim to affect critical life and social skills, including decision-making, refusal skills and critical analysis (e.g. of media messages). - CORRECT ANSWER Prevention Education Prevention strategy that provides for the participation of the target populations in activities that exclude drug use. The assumption is that because constructive and healthy activities offset the attraction to drugs, or otherwise meet the needs usually filled by drugs, then the population would avoid using drugs. - CORRECT ANSWER Alternative Activities Prevention strategy that aims to enhance the ability of the community to more effectively provide prevention and treatment services for drug abuse disorders. Activities in this strategy include organizing, planning, enhancing the efficiency and effectiveness of service implementation, building coalitions and networking. - CORRECT ANSWER Community-Based Processes Prevention that seeks to establish or change community standards, codes and attitudes, thereby influencing the incidence and Prevalence of drug abuse in the general population. - CORRECT ANSWER Environmental Approaches Prevention strategy that aims to identify those who have indulged in the illegal use of drugs in order to assess if their behavior can be reversed through education. It should be noted, however, that this strategy does not include any activity designed to determine if an individual is in need of treatment. - CORRECT ANSWER Problem Identification and Referral Examples of methods used for the strategy Problem Identification and Referral - CORRECT ANSWER 1) Driving-while-intoxicated Education Programs 2) Employee Assistance Programs 3) Student Assistance Programs 4) Teen Courts Examples of methods used for the strategy Environmental Approaches - CORRECT ANSWER 1) The Establishment and Review of Drug Policies in Schools 2) Technical assistance to communities to maximize local enforcement procedures governing the availability and distribution of drugs 3) The Review and Modification of Alcohol and Tobacco Advertising Practices 4) Product Pricing Strategies 5) Social Norms Strategies 6) Media Literacy Examples of methods used for the strategy Community-Based Processes - CORRECT ANSWER 1) Community and Volunteer Training (e.g. neighborhood action training, training of key people in the system) 2) Systematic Planning 3) Multi-Agency Coordination and Collaboration 4) Accessing Service and Funding 5) Community Team-Building Examples of methods used for the strategy Alternative Activities - CORRECT ANSWER 1) Drug-free Social and Recreational Activities 2) Drug-free Dances and Parties 3) Youth and Adult Leadership Activities 4) Community Drop-in Centers 5) Community Service Activities 6) Mentoring Programs Examples of methods used for the strategy Prevention Education - CORRECT ANSWER 1) Classroom and Small Group Sessions 2) Parenting and Family Management Classes 3) Peer Leader and Peer Helper Programs 4) Education Programs for Youth Groups 5) Groups for Children of Substance Abusers Examples of methods used for the strategy Dissemination of Information - CORRECT ANSWER 1) Clearinghouse and other information resource centers 2) Resource Directories 3) Media Campaigns 4)Brochures 5) Radio and Television Public Service Announcements 6) Speaking Engagements 7) Health Fairs Selective - CORRECT ANSWER Those programs and strategies designed to target specific groups at greater risk for AOD substance abuse problems (e.g. school dropouts, foster youths, incarcerated youths, children of alcoholics). Which of the following is NOT an example of a resiliency factor? A) Ability to obtain positive attention. B) Desire to achieve. C) Favorable community. D) Positive adult role models. - CORRECT ANSWER C) Favorable community. An example of an effective environmental approach to substance abuse prevention is: A) School-based curriculum highlighting community risks. B) Server intervention training. C) Program serving student drop-outs. D) Mass media campaign on meth addiction issues. - CORRECT ANSWER B) Server intervention training. Problem Identification and referral: A) Involves treatment options. B) Provides targeted educational options (e.g., DUI classes). C) Involves vulnerable populations. D) Focuses on resiliency factors. - CORRECT ANSWER B) Provides targeted educational options (e.g., DUI classes). Which of the following is NOT one of the broad six CSAP strategies? A) Alternative Activities. B) Community-Based Processes. C) Constructive Use of Time. D) Environmental Approaches. - CORRECT ANSWER C) Constructive Use of Time. Your needs assessment process identified a high-rate of alcohol consumption problems among adolescent females. You should: A) Consider a universal prevention approach. B) Consider a youth development approach. C) Consider a selective prevention approach. D) Implement an asset development approach. - CORRECT ANSWER C) Consider a selective prevention approach. [Show Less]
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CPS Exam 84 Questions with Verified Answers,100% CORRECT
CPS Exam 84 Questions with Verified Answers Safety Criteria - CORRECT ANSWER (1) Seriousness of behaviors/circumstances reflected by safety factors (2) ... [Show More] # of safety factors identifies (3)Degree of childs vulnerability(medical conditions?) and need for protections (4)Age of the child Safety Process - CORRECT ANSWER (1)Identify safety factors; look @ safety critetia (2)Decide if child is in dange or harm (3)Make decision.intervention Article 10 - CORRECT ANSWER Deals with Due process and how we get authority to intervene in parental rights; it stablishes procedures to help protect children from abuse and neglect. Provides due-process of law for determining when state, through family court may intervene against the wishes of a parent on behalf of a child so that the childs needs are properly met. Section 1012:Family Court Act - CORRECT ANSWER Person legally responsible for the child includes the child guardia or any other person responsible for the childs care @ the relevant time. Custodian may include any person continually or @ regular intervals found in the same household of the child when the conduct of such person causes or contribute to the abuse or neglect of the child.(parent, guardian, person over 18,doctor, daycare,fosterparent etc.) Indicate report - CORRECT ANSWER Some credible evidence exist of child abuse and maltreatment (when allegations are substantiated) Unfounded - CORRECT ANSWER No credible evidence of child abuse and maltreatment exist (when alligations are unsubstantiated) Abuse chld-(LEGAL) - CORRECT ANSWER Less than 18;person legally responsible i)inflict or allows to inflict upon child physical injury risk of death or SERIOUS protracted disfigurement or protracted imparement of physical or emotional health..ii)parent creats or allows to be created a SUBSTANTIAL risk of physical injury death other than accidental. iii)parent commits or allows to be commited a sex offense against child How to prove a Neglect case (legal) - CORRECT ANSWER (1)Parents failure to indicate minimum degree of care. (2)Causation;failure to exercise minimum degree of care has to CAUSE something. (3)Needs to cause imparement to a childs physical, mental or emotional conditions. **impairement is less then imminent danger, not the same thing** Medical Neglect 1012(f) - CORRECT ANSWER Means the parent fails to meet the childs basic minimal needs for medical care as outlined in NYS family court act 1012(f) medical includes dental, optometic and surgical care. IRI - CORRECT ANSWER Individual report involvement, It is any invlovement in prior cases by all individuals on the report, it provides case #s, dates, individual roles, DOB, and wether the report was indicated or unfounded Purpose of summarization - CORRECT ANSWER Demonstrate active listening, check understanding, clarify for the parent, highlight contradictions, MAKE TRANSITIONS, focus discussion, MAKE SURE BOTH ARE ON SAME PAGE, used as form of checking in. Reflection - CORRECT ANSWER Process of understandid anothers persons feelings, values,experiences,beliefs,need and self concept by listening to the words and feeling in the message and observing nonverbal cues. Why reflect? - CORRECT ANSWER To convey empathy and respect to build relationships, to stimulate parent awareness and responsibility, check accurate of communication, to uncover regular info,makes us focus on FEELINGS and CONTENT. Chronic neglect - CORRECT ANSWER History, patterns its categorized by the consisting failure of the parent to provide child with basic needs (indicators:neglect, failure to exercise minimum degree of care in reference to food, shelter,ed,med,or not providivg proper supervision guardancship,domestic violaence,substance use,mental health, living conditions,physical or sexual abuse,psycological abuse such as lack of empathy or unrealistic expectations) Allegations of inflicted injury*factors to consider* - CORRECT ANSWER Type of injury, location, shape, size, degree of fource needed to produce injury, childs level of development, old and new injuries, explanations, childs and parents, --development of child when looking @ force of injury, could the child had inflicted the injury him/herself? Core conditions - CORRECT ANSWER Respect, Empathy, Genuineness Investigation - CORRECT ANSWER to initiate investigation and assessment activities so that sufficient information can be gathered in order to assess whether or not the child is in immediate or impending danger of serious harm in order to assess whether or not the child is in immediate or impending danger of serious harm and if a safety intervention is needed immediately to provide for the safety of all the children. While conducting the investigation, CPS worker must decide... - CORRECT ANSWER 1)Is the child or children safe from immediate or impendind danger of serious harm? (2)Is the child or children at risk of abuse or maltreatment in the future? (3)was the child or children abused or maltreated? (4)How does CPS need to respond to protect the children now and reduce risk in the future? 5 phases of Critical Thinking (ODGET) - CORRECT ANSWER 1)Organize current Info. (2)Develop multiple hypothesis (3)Gather data in relation to hypothesis (4)Evaluate information,determine most resonable and make decision (5)Take action, continue to re-evaluate and make changes accordingly RAP - CORRECT ANSWER Purpose: to determine whether a child is at risk of future abuse or maltreatment. It is different from safety assessment in that it is focused on the likelyhood that a child will be abused or maltreated in the future. It includes the identification of risk elements present in a family. RAP is designed to help make informed decisions regarding whether to open a case for services. RAP is completed during the INVESTIGATION STAGE. (entered in connection and given a score) Pre-petition order to produce - CORRECT ANSWER before filing for article 10. CPS can request an order that the parent ot other person legally responsible for the child produce the child at a particular location which may inclide a CAC or to a particular person for an interview of the child or for observation of the condition of the child outside the presence of the parent or person responsible. (Before making this application, worker must have "resonable cause to suspect that a childs life or health may be in danger" based on the SCR reports and that the worker was not able to locate children, or denied access to thie child in the household and have informed the parents that worker can seek warrant if parents continue to deny access to the children pre-petition order of entry - CORRECT ANSWER requires that there is "probable cause to believe that an abused or neglected child may be found on the premisies" application must be based upon 3 criterias 1.from what we learned from SCR report 2.Worker has been denied access to the home and not able to evaluate childre. 3.Worker advised parent or guardian that ACS may consder getting court order to gain access to the home *Decisions ar emade without the parents having to come to court to argue against the granting of the order** Removals - CORRECT ANSWER Law requires that reasonable efforts be made to prevent or eliminate the need for the foster care placements, where appropriate. Must have CSC when conditions in the home indicate that the level of danger to the children has increased and a conference is needed to help decide if a protective removal is necessary or if any alternative safety plan can be developed. purpose of CSC is to make best safety decision for the child through in home options. Consent to Removal - CORRECT ANSWER CPS should ask parent consent to a temp. removal. If child is removed with the written consent of the parent or with a pre-petition court order, an article 10 petition must be filed within three court days. Parent must receive a 701b-701c notice of temporary removal. informing them of their right to a family court hearing and the date they should appear in court Court-order removal - CORRECT ANSWER if parent is absent or refuses to content to a temp. removal and there is not enough time to file article 10 petition allegin abuse and neglect . inform the parent of the intent to apply for an order of removal. Emergency removal - CORRECT ANSWER done without parental consent only in circumstances of IMMINENT danger to the childs life or healt and not enough time to apply for court order. In this case, article 10 petition must be filed as soon as possible but no later than the next cout day. worker is required to give parents/caretakes and schools hopsitals a written notice. parent must be informed of their right to apply to the family court for the return of the chid and right to legal counsel and how to contact their child.MUST COMMUNICATE TO REDUCE TRAUMA 4 ACS child welfare outcomes - CORRECT ANSWER 1)children are safe 2)families are streghtened 3) children and adolescents have permanency 4) children and adolescents needs are met Ethical Standards - CORRECT ANSWER 1)All parents are worthy of respect 2)confidentiality must be afforded to all parents 3)parents have rights 4)due process must be afforded to parents Core conditions - CORRECT ANSWER 1)Empathy 2)Genuineness 3)Respect Primary needs - CORRECT ANSWER Growth, Autonomy, Self-esteem, affiliation and love, Security, Survival Staging the professional helping relationship/managing authority - CORRECT ANSWER 1)Pre-engagement Anticipation of the other 2)Engagement 3)Reaching for Mutual undersanding 4)Taking action 5)Decision to continue Core principles - CORRECT ANSWER Protection, development permanency, cultural responsiveness, family foundation, partnerships, organizational competence, child welfare professionals Elements of change - CORRECT ANSWER present Discomfort, preferred future, Emotional security, efficacy, internalization of responsibility Categories of information gathering - CORRECT ANSWER Informal, Formal, Pubicly funded network/societal Convey: - CORRECT ANSWER Respect, empathy, genuiness, attending, listening, effective questioning, concreteness, reflection, summarization Condiions for sharing information - CORRECT ANSWER Need to know, authorization for parent, judge order, HIV providing care, treatment or supervision, police or HA office straight talk - CORRECT ANSWER treating people with respect when they need to hear something unpleasant Assesing parental functioning - CORRECT ANSWER Experience related to parenting, beliefs about parenting, willingness to parent and related needs, parental performance Reasonable efforts - CORRECT ANSWER Term used by agency refering to responsibilities required by federal law(reasonable efforts before placement) Eriksons Psychosocial stages of development - CORRECT ANSWER infancy:birth to 18 mnths-trust vs. mistrust Early childhool-18mnths to 3 yrs-autonomy vs. shame play age-3-5yrs initiative vs guilt school age-6-12 yrs industry vs inferiority adolescence-12yrs to 18yrs identity vs.role confusion young adulthood-18-35 intimacy and solidarity vs. isolation safe - CORRECT ANSWER a child is safe when there in no IMMEDIATE OR IMPENDING DANGER OF SERIOUS HARM to the childs life or health as a result of act of COMMISSION OR OMISSION by the childs parents and or caretaker RISK - CORRECT ANSWER The likely hood that a child may be abused or matreated in the FUTURE (RISK ELEMENTS/HIGH RISKS) maltreatment/neglect - CORRECT ANSWER A child under 18 who has had a serious physical injury inflicted upon him/her other than accidental means, whose physical, mental or emotional condition has a been impared or is in imminet danger of becoming impared as a result of the failure of his/her parent or other person legally responsible for his/her care to exercise minimum degree of care. underlying conditions - CORRECT ANSWER perception, beliefs, values, emotion, capability, self concept, experience,develpment,family system, culture contributing factors - CORRECT ANSWER mental illness, health status, substance use, domestic relations, developmental capacity, physical capacity, environment, other BEHAVIOR= - CORRECT ANSWER Needs+underlying conditions+contributing factors+strength. we need to asses parental behavior and make sure they dont interfere with meeting childs needs Types of clearances - CORRECT ANSWER public assistance (PA) suppemental security insurance (ssi) welfare managemnt systems (wms) domestic incidence report (DIR) ICWA - CORRECT ANSWER Indian child welfare act (1978), deals with perimancy, ASFA - CORRECT ANSWER Adoption and safe families actblocking, tagging, eliciting, joining Gatekeeping: - CORRECT ANSWER blocking, tagging, eliciting, joining, joining is used to assist in the process of engagement and relationship building with parents and children. it helps huminize the worker in the eyes of the family,creates bond, means having casual conversation "isnt all thus subway contructiong frustrating?it takes twice as long to get anywher im finding" IRT-Instant response team - CORRECT ANSWER deals with 1)Fatalities 2)sex abuse child under 13, sever abuse child under 11, felony sex abuse child under 18, 3)severe abuse and matreatment children 11017, sex abuse 11-17 analytical critical thinking - CORRECT ANSWER step by step conscious and logical process initiative critival thinking - CORRECT ANSWER using intuition-a way of thinking tat somehow poduces an snwer, solution or idea without the use of conscious and logical step by step process. critical thinking - CORRECT ANSWER step by step conscious logical prcess human beings use to obtain knowledge and discover the truth. componets are obervation, experience, reflection, reasoning and communication. non-cps characteristics - CORRECT ANSWER suicida child, substance using child, gang envolvement, criminal activity, unprotected-permicous sexual activity, family crisis, lost of promary care taker, reapperance of dangerous individual in household. in non-cps: we llok @ what the parent is doing or has done to adress the problem. IT IS SOMETHING BEYOND THE PARENTS BEHAVIOR. it lloks at the behavior of the childre, family and community members. WHEN THE PARENT HAS TRIED TO ADRESS PROBLEM IN THE PAST AND IT IS BEYOND THEIR CONTROL. INEFFECTIVE QUESTIONS - CORRECT ANSWER Form barriers to sharing information, building, maintaing relationsip or influence change. (ie. double questions, bombarding questions, Closed Questions - CORRECT ANSWER go straight to the point quick and simple (effective) open question - CORRECT ANSWER give us more info that allows us to move the investigation forward (effective) indirect question - CORRECT ANSWER a statement inviting response, implies but doesnt directly ask a questiong. this is useful when approaching a sensative topic ex.'"im wondering what youll do if gkenn gets out of jail" (effective) scaling question - CORRECT ANSWER ask parents to rank-order ir rate something . ex."on a scale of 1 to 10..." solution based question - CORRECT ANSWER seeks description of parents past efforts to solve or avoid proble (effective) ex. when you caught you bf hitting on your daughter, what did you do? circular question - CORRECT ANSWER focuses on the feedback and or support the parent has from significant other. ex. what does___say aout __? (effective) bombarding question - CORRECT ANSWER INEFFECTIVE contains series of questions, created an interrogation efffect Statement question - CORRECT ANSWER INEFFECTIVE expresses the questioners ideas or values or wishes ex:"dont you think.." loaded question - CORRECT ANSWER INEFFECTIVE contains blame or implies guilt for negative behavior. "ex. so did you buy condoms from the drug store or got them from your mom" informal information - CORRECT ANSWER immidiate family, extended family members,neighbores, and friends formal information - CORRECT ANSWER churches, religious organization, community orgaziations, social clubs, and places of employment soietll/publically funded information - CORRECT ANSWER systems, received public funds such as schools, social services, substance abuse services, police dept. etc. confidentiality - CORRECT ANSWER perservation of private information concerning the parent and child that is disclosed in the professional relationship xtacy law - CORRECT ANSWER says if a mandated sees the reporter he/she has to report it, cant tell another mandate reported to report it. done to avoide hearsay and get accurate info. ex. teacher cant tell guidance counselor to report something, if teacher sees it, teacher must report it. Critical thinking process in child protective services - CORRECT ANSWER phase 1: organize current info about case and yourself (Gather any current infor SCR repor and prior history; your awareness of your own values, beliefs and experiences as they relate to the current situation) phase 2: develop multiple hypother (formulate hypothesis for the information currently available to you) phase 3: gather data from multiple sources in relation to the current hypotheses (possibly creating new hypotheses) connect the data to info that exisist such as statements, repors, photos, interpretations of verbal and nonverbal behaviors) phase 4: evaluate the information including any hypothese related to abuse and maltreatment, determine most plausible and make decision base on it. (make decision base on quality of information required to make the decision) phase 5: take action bases on the decision, while continually re-evaluating and making changes (how is this action affecting everyone? did we miss anything? what needs to be corrected? if this action doesnt work what can we do differently?) critical thinking for child protecive specialist - CORRECT ANSWER phase 1: org. infor about case and yourself (seperate facts from judgement and speculation, diff between thinking critically and intuitively,recognize bias, personal opinion)phase 2: dev. multiple hypothesis (suspend judgement in abscence of sufficient evidence, use instict to created as many hypothesis as you can think of eliciting additional ones from other sources)phase 3:gather data from multiple sources(examine and followup insufficient info, inconsistenies,recognize limitation in your knowlege and draw upon available resources as neccesary, look for patterns rather than only examining singular facts)phase 4: evaluate info..(ask yourself, does the info i have provice sufficient, logical support for the decision? determine whether abuse or maltreatment has been taking place)phase 5: take action(continue to gather more data, formulate new hypotheses as needed in an ongoing cycle that continues until you are satisfied that the child welfare outcomes are achieved. evaluatning punishment - CORRECT ANSWER childs age, sex, physical and mental condition, capacity to understance correction, form of punishment, seriousness of injury to the child or the risk of serious injury,purpose of punishement, child behavior that requires correction,whether punishment is degrading or brutal,duration of punishment and if its protracted beyond childs endurance. what should we confrontation F-LISA - CORRECT ANSWER Facts and information-define as misinformation or lack of understanding that creates barriers or incongruencies L-Limitations, defined as the parents lack of resources or capability to successfully implement some or all the changes neccessary to achieve the child welfare outcomes I-Incongruencies defined as discrepencies between the parents words and actions or actions and actions S-Strengths-defined as the resources,capabilities,skills,talents,hopes,values,beliefs and competencies of the parent that could help solve problem A-capacity for Action defines as the parents ability to pursue tnew courses of action or attempt changes. When confronting - CORRECT ANSWER Only confrom behaviors not the persons motives, be specific and descriptive domestic violence - CORRECT ANSWER a pattern of intimidating and abusice tactice such as isolation,physical,psychological, threats,immigration,using children,sexual,economic,and emotional abuse. in DV coercive intimidating and abussive tactics are perpetrated by one person against an intimate partner with the goal of establishing and maintaining power and control over the survivor. Assessing chronic neglect - CORRECT ANSWER Id safety/risk Consider the effects of abu/mal recognize UL dynamics which may cause mal Interview all children Draw on knowledge n experience of source n collaterals Engaging families in Id services needed safety factors (19) - CORRECT ANSWER Prior history (p) Alcohol (p) Drugs(p) Phy/psy harm from DV (c) Med/mental/dev disability (p) History/present violence (p) Needs: food, shelter, medical/mental care, clothing control child's beh (p) Unwilling to supervise Repeated harm Unrealistic expectations Can't locate child or about to flee Sexual abuse Phy hazardous condition of home Child toxicology Dev delays n parents can't provide care Weapons Criminal activity No SF present determination - CORRECT ANSWER to evaluate all the information gathered from the investigation and concluded whether or not any child in the household has been or continues to be abused or maltreated. - to adress all the allegations in the report social service law and the family court act - CORRECT ANSWER provide the leagal authority for the department of social services to intervene in the lives of families when it appears that children are or likely will be in harms way because of something their caretake did or fail to do. section 1022 - CORRECT ANSWER removing a child before filing petition, allows judge to direct temporary removal of a child before filing a petition. conditions to do this is that child appears to suffer from abuse or neglect and immediate removal is necessary to avoid imminet danger to the child life or healt...parent will not or cant agree to consen to the 1021 and cps worker told parent that a removal order can still be mase..not enough time to file a petition or hold a hearing under 1027 of the FCA 1027-placement of a child - CORRECT ANSWER FCA stipulates that upon preliminarty hearing, if the court finds that removal is neccessary to avoid imminet risk t the childs life or health then it should remove the child and remand him/her to the local cps or place him or her in custedy of a relative or other suitable person. if child is not returned home within 3 days of a 1021 or 1022 action was implemented, a petition must be filed and a 1027 hearing is held. emergency removals - CORRECT ANSWER requieres that you make every reasonable effor to communicate immediatley with parents or guardians when there has been an emergency removal. requires that cps tried to get children bacj in home asap once safety is secured 1024 (removal notice) - CORRECT ANSWER workers are require to notify parents or persons legally responsible for the children of the removal and of their right to apply to the court for a return of the children. notice must be mailed within 24hrs of removal. even on a friday removal, doesn have to wai till next buisness dat, [Show Less]
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CPSS Vocabulary List L-O 22 Questions with Verified Answers,100% CORRECT
CPSS Vocabulary List L-O 22 Questions with Verified Answers languid (adj.) - CORRECT ANSWER sluggish from fatigue or weakness languid - CORRECT ANS... [Show More] WER In the summer months, the great heat makes people _____ and lazy. lavish 1. (adj.) - CORRECT ANSWER given without limits lavish - CORRECT ANSWER Because they had worked very hard, the performers appreciated the critic's _____ praise. lavish 2. (v.) - CORRECT ANSWER to give without limits lavished - CORRECT ANSWER Because the performers had worked hard, they deserved the praise that the critic _____ on them. lethargic (adj.) - CORRECT ANSWER in a state of sluggishness or apathy lethargic - CORRECT ANSWER When Jean Claude explained to his boss that he was _____ and didn't feel like working that day, the boss fired him. magnanimous (adj.) - CORRECT ANSWER noble, generous magnanimous - CORRECT ANSWER Although I had already broken most of her dishes, Jacqueline was _____ enough to continue letting me use them. maudlin (adj.) - CORRECT ANSWER weakly sentimental maudlin - CORRECT ANSWER Although many people enjoy romantic comedies, I usually find them _____ and shallow. nefarious (adj.) - CORRECT ANSWER heinously villainous nefarious - CORRECT ANSWER Although Dr. Meanman's _____ plot to melt the polar ice caps was terrifying, it was so impractical that nobody really worried about it. nominal (adj.) - CORRECT ANSWER trifling, insignificant nominal - CORRECT ANSWER Because he was moving the following week and needed to get rid of his furniture more than he needed money, Jordan sold everything for a _____ fee. nuance (n.) - CORRECT ANSWER a slight variation in meaning, tone, expression nuances - CORRECT ANSWER The _____ of the poem were not obvious to the casual reader, but the professor was able to point them out. obsolete (adj.) - CORRECT ANSWER no longer used, out of date obsolete - CORRECT ANSWER With the inventions of tape decks and CDs, which both have better sound and are easier to use, eight-track players are now entirely _____. opulent (adj.) - CORRECT ANSWER characterized by rich abundance verging on ostentation opulent - CORRECT ANSWER The _____ furnishings of the dictator's private compound contrasted harshly with the meager accommodations of her subjects. [Show Less]
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CPSS; Ophthalmic Facilities and Equipment | Basic Training Questions with Answers,100% CORRECT
CPSS; Ophthalmic Facilities and Equipment | Basic Training Questions with Answers After the initial patient registration process is complete, the patien... [Show More] t is asked to: - CORRECT ANSWER have a seat in the patient reception area The ancillary testing room is used for: - CORRECT ANSWER diagnostic testing (a-scans, b-scan, corneal topography) To start the exam, an ophthalmic assistant or technician performs pre-testing in preparation for the physician's eye exam. - CORRECT ANSWER true Once all clinical activities are done, the patient completes the check-out process, which includes: - CORRECT ANSWER scheduling the next appointment; payment for the eye exam An auto refractor is used to: - CORRECT ANSWER help determine eyeglass prescription An A-Scan is a piece of ultrasound equipment used to: - CORRECT ANSWER measure the length of the eye to assist in calculating the power of an intraocular lens for cataract surgery The Snellen acuity chart is used to: - CORRECT ANSWER measure visual acuity using various sizes of visible letters to the normal eye A visual field instrument is used to document abnormal defects in a patient's central peripheral vision. - CORRECT ANSWER true A lensometer is used to: - CORRECT ANSWER measure the patient's current spectacle prescription An optical finishing lab is a facility that is used to assemble patient's glasses. - CORRECT ANSWER true An ambulatory surgery center is an outpatient facility that provides the ability to perform all types of eye care surgery, regardless of the nature of the procedure. - CORRECT ANSWER false A phaco instrument is used in what type of surgical procedure: - CORRECT ANSWER cataract surgery PACU is an abbreviation for: - CORRECT ANSWER post-anesthesia care unit Refractive surgery services can be provided either in the doctor's office, in a separate refractive laser center, or in an ambulatory surgery center. - CORRECT ANSWER true Which of the following lasers is used to perform refractive surgery: - CORRECT ANSWER excimer laser [Show Less]
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CPSS; Anatomy of the Eye | Basic Training Questions with Answers,100% CORRECT
CPSS; Anatomy of the Eye | Basic Training Questions with Answers Light enters the eye through the pupil. - CORRECT ANSWER true Which tissue regulates... [Show More] the amount of light entering the eye? - CORRECT ANSWER iris What is the transparent, curved tissue in the front of the eye? - CORRECT ANSWER cornea The sclera is also referred to as which of the following: - CORRECT ANSWER the white of the eye The ciliary processes secrete fluid in the eye, which is called aqueous humor. - CORRECT ANSWER true Select the three layers of the tear film. - CORRECT ANSWER mucin, water, oil With age, the lens becomes thick, hard, and non-transparent, causing impaired sight. What is this condition called? - CORRECT ANSWER cataract Which tissue is located at the back of the eye and converts light to electric impulses that are carried to the brain? - CORRECT ANSWER retina Impaired drainage of the aqueous humor leads to a rise in pressure that can damage the retinal nerves. What is the name of this condition? - CORRECT ANSWER glaucoma An area of the retina known as the macula provides the clearest and most detailed vision. - CORRECT ANSWER true [Show Less]
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CPSS final Exam Questions with Verified Answers,100% CORRECT
CPSS final Exam Questions with Verified Answers What is RI Internationals Definition of recovery? - CORRECT ANSWER Recovery is remembering who you are a... [Show More] nd using your strengths to become all you were meant to be *fill in the blank* What are the 5 recovery pathways? (HINT: S.H.R.E.C) - CORRECT ANSWER Spirituality - Hope - Recovery Environment/culture - Empowerment - Choice what are some ways to blow off some steam ? - CORRECT ANSWER *physical activity* - walking - cleaning - calling a friend - *meditation* What are some ways people do for themselves to manage hearing voices? - CORRECT ANSWER Meditate - exercise Fill in the blank - " Peer support is about being an expert at not being an expert and that_______? - CORRECT ANSWER Takes Expertise what are the 6 Empowering interactions? - CORRECT ANSWER listening . validating strengths - reflective statements - relating with empathy - asking permission - open ended questions what is an example of "person first" language? - CORRECT ANSWER A) The autistic B) patient C) Client D) Ashley Fill in the blank - People push through trauma by__? - CORRECT ANSWER pushing through fear - recognizing & building strengths - building our resilience what are some socially based support program instrumental is helping people in recovery ? - CORRECT ANSWER 12 steps - Smart recovery - Celebrate recovery - S.O.S what are the stages of change? HINT : 6 - CORRECT ANSWER Pre contemplation - contemplation - preparation - Action - Maintenance - termenation fill in the blank - The fear will never go away as long as you continue to ____? - CORRECT ANSWER Grow name some coping skills a person can use to manage hearing voices? - CORRECT ANSWER Change of environment - reality check - music with headphones Fill in the blank - Work toward establishing ___________ that serve the persons needs & preferences. - CORRECT ANSWER mutually empowered relationships What do you do if a relative or friend asks you about information on the person you are providing services to? - CORRECT ANSWER I cannot confirm or deny without an ROI (release of info) [Show Less]
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CPSS; Maximizing Practice Collections: Patient Data Collection | Business Office,100% CORRECT
CPSS; Maximizing Practice Collections: Patient Data Collection | Business Office In most cases, the practice's initial encounter with a patient is: - ... [Show More] CORRECT ANSWER by telephone The appointment process is relevant to effective collections, because: - CORRECT ANSWER patients must be scheduled with the correct physician for the correct reason Patient registration processes are normally completed: - CORRECT ANSWER upon check-in Registration information should be: - CORRECT ANSWER routinely reviewed for each patient upon arrival If the patient registers without noting a ZIP code, this most likely means: - CORRECT ANSWER possible future delays in receiving payment from the patient if it is not obtained Superbills or encounter forms are most commonly used to: - CORRECT ANSWER record diagnosis and procedural codes In multi-physician practices, the appointment scheduler can schedule the patient for an appointment with any physician for any reason. - CORRECT ANSWER false When scheduling a patient for an appointment, which of the following data should be documented? - CORRECT ANSWER patient's full address with ZIP code The patient's chart usually is prepared prior to the patient's visit. - CORRECT ANSWER true If the patient arrives for an appointment without necessary insurance authorization, - CORRECT ANSWER an attempt is made to obtain the authorization so that the patient can be seen It is important to follow scheduling templates when scheduling patient appointments in order to: - CORRECT ANSWER control the schedule so that patients are seen efficiently and in a timely manner Most practices schedule patient appointments by documenting the appointment in a computerized practice management system. - CORRECT ANSWER true Which of the following forms is not usually requested during the registration process? - CORRECT ANSWER patient's credit score (insurance cards; driver's license; HIPAA consent) The patient registration form usually is completed upon arrival to the office and requests which of the following information? - CORRECT ANSWER Patient demographics (name, phone, address); insurance information; referral information) It is important to confirm patient appointments prior to the scheduled appointment in order to: - CORRECT ANSWER limit the number of no-shows and cancellations [Show Less]
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CPSS; Peer-to-Peer Relations for Staff Members | Basic Training Questions with Answers,100% CORRECT
CPSS; Peer-to-Peer Relations for Staff Members | Basic Training Questions with Answers Which of the following statements are true? - CORRECT ANSWER th... [Show More] e fewer interpersonal conflicts that we have in our office, the more productive and happy we will be as a staff; you can say the same words and have two different meanings; everyone who works in our office wants and deserves respect; the way you interact with other indicates your respect for them What percent of our message is contained in the words we use? - CORRECT ANSWER 7% The three states of mind are: - CORRECT ANSWER parent, adult, and child Which of the following contain recordings of authoritative pronouncements that we heard as a child? - CORRECT ANSWER our parent state of mind Which of the following contain the recordings of the feelings we had as we experienced events in our life? - CORRECT ANSWER our child state of mind Which of the following allows us to choose how we act? - CORRECT ANSWER our adult state of mind In our Adult state of mind, we can decide whether to ______, ______ or _____ a critical comment aimed at us. - CORRECT ANSWER accept; reject; or modify If someone said "You're not the boss of me," which state of mind would they most likely be in? - CORRECT ANSWER the child If you heard the following, which state of mind would be reflected? "You shouldn't just sit there waiting to be told what to do next. You need to quit being lazy and help us out." - CORRECT ANSWER the parent If a co-worker said to you, "Quit putting those charts on my part of the counter. You're always crowding my space!" which of the following would be a way of encouraging an Adult-to-Adult interaction? - CORRECT ANSWER "I'm sorry; I didn't realize those were in your way. Where do you put the charts that you are working on?" Which of the following would be the Adult response to the accusation, "I can't do my job, because you've never showed me how to enter new patients into the computer like you were supposed to." - CORRECT ANSWER "Let's spend a few minutes this afternoon, and I will train you how to do that." For human beings, even strokes that are very negative are better than no strokes at all. - CORRECT ANSWER true If a person seems to think they are superior to their co-workers, which life position are they most likely to have? - CORRECT ANSWER i'm not ok, you're ok Which of the following are reasons that the "I'm ok, you're ok" position is the most productive? - CORRECT ANSWER allows us to be in our adult state of mind most of the time; it allows us to show respect for others; it allows us to give and receive positive strokes; it helps us interact positively with others Which of the following describes the relationship between the concepts of Parent, Adult, and Child states of mind, strokes, and life posit - CORRECT ANSWER the "i'm ok, you're ok" life position allows us to be in our adult state of mind so that we can give and receive positive strokes and more accurately deal with negative strokes; the "i'm not ok, you're ok" life position tends to lead us to our parent or child state of mind and to give negative strokes to others [Show Less]
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CPSS; Maximizing Practice Collections: Processing Daily Work -Part 2 | Business Office,100% CORRECT
CPSS; Maximizing Practice Collections: Processing Daily Work - Part 2 | Business Office The acronym "EOB" represents: - CORRECT ANSWER explanation of ... [Show More] benefits EOBs are used by: - CORRECT ANSWER posting/billing staff Which of the following information is used in compiling the Daily Balance Sheet? - CORRECT ANSWER lockbox receipts; mail receipts; charge tickets The daily deposit includes which of the following? - CORRECT ANSWER mail receipts Daily backup tapes are used to protect data in case of power failure or other damage to stored data. - CORRECT ANSWER true Maximizing practice collections is the responsibility of the entire staff. - CORRECT ANSWER true EOBs should be: - CORRECT ANSWER stored for future reference based on practice policy or local regulations In large practices, the posting of all payments usually is the responsibility of one person in the billing department. - CORRECT ANSWER true When processing payments received from insurance companies via mail, it is important to: - CORRECT ANSWER data stamp checks/EOBs; stamp "for deposit only" on the back side of the check All checks received by mail should be processed within 24 hours of receipt. - CORRECT ANSWER true Lockbox arrangements with banks are helpful to some practices in order to: - CORRECT ANSWER provide security for checks and rapid deposit of funds Which of the following is not a process used by the practice in processing direct deposits from insurance companies, Medicare, and Medicaid? - CORRECT ANSWER include the amounts from direct deposits in the daily deposit (contact bank to determine date and amount of direct deposit; determine which insurance company is making the deposit; download EOBs from the internet so that payments can be applied to patient accounts) Direct remittance is an option provided by some practice management systems in which a Medicare check can be downloaded directly into the practice management system and automatically posts payments to specific patient accounts. - CORRECT ANSWER true When checks are received and cannot be applied to a patient's account because of lack of information (unapplied cash), the practice: - CORRECT ANSWER deposits the check into the "unapplied cash" account and calls the issuing agent of the check to identify the correct patient How many staff members are responsible for compiling all of the daily work that has been processed into a single balance sheet? - CORRECT ANSWER one staff member [Show Less]
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