CMA Practice Test 5
Under which of these circumstances must patient records be released?
A court subpoena is the only one of these with which it is compulsory to comply; the other entities must obtain court orders if they wish to access patient records and the patient refuses access. Even in the case of a subpoena, it is best to check the legality of the order with legal staff or senior management before complying.
If a patient is faced with an upsetting diagnosis and starts to propose alternative diagnoses or treatments, they may be using which defense mechanism?
Intellectualization is a means of suppressing natural emotions and instead relying on the intellect to overcome a problem. Thus instead of allowing anger or grief to come out, a patient with a terminal diagnosis may become convinced s/he can find an intellectual solution to the problem.
All medical workers who will be exposed to blood or other bodily fluids in the course of their work should be given which vaccine?
Hepatitis B is one of the most common diseases for health workers to contract through patient contact. If you have not received the vaccination you should ask your physician for it immediately. The full course of three vaccinations should ensure lifelong immunity to hepatitis B, although it may be advisable to have your immunity checked at intervals to see if you need a booster shot.
Which two bones make up the structure of the lower leg?
The radius and the ulna make up the forearm and wrist. The metatarsals and tarsals are the bones in the foot. The femur and the patella make up the thigh and the kneecap. The sternum and clavicle are in the chest, therefore the only bone structures located in the lower leg are the tibia and fibula. Therefore, the correct answer is "Fibula & Tibia".
In the event of patient mortality with payment for treatment still outstanding, where the patient is uninsured, who is liable for the payment?
The financial liabilities of a deceased person fall to their estate. However, it must be appreciated that approaches for payment at a time of grieving may be regarded as insensitive and intrusive. Best practice is to approach the administrators of the patient's estate and negotiate payment through them, rather than directly approaching next of kin.
Every medical office should have…?
Every medical office should have its own safety manual based on OHSA legislation, detailing general safe practice and any office specific procedures. Make sure that you have access to this manual and that you know all the sections of it that apply to you.
When using a pain scale to take a patient history, nagging pain that doesn’t really impose on general life or activities should be categorized as…?
Pain scales are often used in patient histories, particularly for patients with chronic pain, but often they are not clearly defined or explained to the patient. Generally, no pain is zero, nagging pain which doesn't impose on general life is 1 to 3, moderate pain which affects daily activities is 4 to 6, severe pain which greatly restricts activity is 7 or 8 and excruciating pain which leaves the patient disabled, screaming and possibly delirious is 9 to 10.
What does a palliative drug do?
A palliative drug is one that relieves symptoms but does not treat them. Palliative drugs make patients more comfortable but do not help in treating their illness, and so they are often used in combination with curative drugs.
Every medical institution is required by the OHSA to have which of these?
All medical institutions are required by the OHSA to have an exposure control plan in the event of an outbreak of airborne, waterborne or blood-borne pathogens. Make sure you are familiar with this plan and with the role that you are expected to take on in the event of an emergency.
The autoimmune disease, multiple sclerosis is characterized by the degradation of what?
Multiple sclerosis targets the myelin sheath along the axon. The myelin sheath is degraded leading to slower neuron impulses as the action potential is unable to jump between the Nodes of Ranvier. Proteins, carbohydrates, and phospholipids are not directly affected by multiple sclerosis. Dendrites, the structures on the ends of the axons that receive incoming neural messages are also not directly targeted by multiple sclerosis. Therefore, the correct answer is "Myelin Sheath".
Patient details should be updated as necessary every…?
Best practice in recordkeeping is to check with the patient every time they visit the office that all their personal details (address, telephone number, email, next of kin etc.) are up-to-date. This should minimize the chance of important information going astray.
The final stage of human psychological development is often referred to as what?
Self acceptance is usually posited as coming after the age of 65, when a person has become happy with their place in life and no longer feels a need for self justification. Despite this often being the happiest stage of a person’s life, those who are self aware recognize and accept their approaching death.
Systolic and diastolic are terms used when referring to what?
Systolic blood pressure is the pressure of the blood as the heart beats, pushing out blood, and diastolic is the pressure between beats. It is measured in millimeters of mercury. The systolic pressure is always written first: normal blood pressure is around 120/80.
Occult blood is tested for using which procedure?
Occult literally means "hidden": the occult blood test looks for hidden blood in the stool which may be a sign of stomach problems. In order to make this test accurate it's very important that patients are clearly instructed on the correct way to collect the sample.
After a 24-hour urine specimen has been obtained, it should be…?
Urine decays when stored and this decay can influence test results. Therefore between reception of a sample and testing it should be kept refrigerated to avoid this.
Which organ does the pericardium surround?
From the Greek peri, around, and cardium, heart, the pericardium is the double layered sac around the heart. It protects the heart from infection, keeps it lubricated and stops it expanding too far.
The median effective dose of a drug is also known as…?
The median effective dose of a drug, or ED50, is the dosage that will be effective for 50% of the population. This is used as a benchmark when deciding on prescription strengths.
In putting a patient into the lithotomy position for examination, how should they be positioned?
The lithotomy position is used for examinations of the perineal area, as well as in childbirth. The patient should be lying on their back, with their heels above their hips – stirrups will often be used to achieve this position.
Which of these is the only element that is not a vital part of an appointment matrix?
The appointment matrix should display room availability, staff availability (and unavailability, e.g. holiday times) and should have built-in catch up times to make up for any overruns during the day. A well-run appointment matrix minimizes the chances of patients arriving and no doctor or room being available for them to be seen.
Which of these would not fall under the heading of medical malpractice?
Malpractice means to do harm through negligence or incompetence, not deliberately. A medical practitioner is judged to have committed malpractice if they do something, or don’t do something, a professional of their standing would reasonably be expected to do or not do. Causing deliberate harm is not malpractice and would be dealt with under applicable criminal law, e.g. assault.
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