(RDA) Registered Dental Assistant Practice Test

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Understanding RDA expanded functions is one of the most important steps a registered dental assistant can take toward a more advanced, higher-paying career. The term "RDA meaning" in the dental field refers to a credentialed professional who has passed a state-approved examination and met specific education and clinical requirements. But beyond basic assisting duties, many states allow RDAs to perform additional clinical procedures โ€” known as expanded functions โ€” that go far beyond chairside support and instrument passing.

Understanding RDA expanded functions is one of the most important steps a registered dental assistant can take toward a more advanced, higher-paying career. The term "RDA meaning" in the dental field refers to a credentialed professional who has passed a state-approved examination and met specific education and clinical requirements. But beyond basic assisting duties, many states allow RDAs to perform additional clinical procedures โ€” known as expanded functions โ€” that go far beyond chairside support and instrument passing.

Expanded functions for a registered dental assistant typically include tasks such as placing and finishing dental restorations, applying sealants, taking preliminary impressions, performing coronal polishing, and placing rubber dams. These are procedures that require hands-on patient care, fine motor precision, and a thorough understanding of dental anatomy. Each state defines its own list of allowable expanded functions, which means an RDA practicing in California may be authorized to perform very different procedures than one licensed in Texas or New York.

The rda definition has evolved considerably over the past two decades. In the 1980s and 1990s, dental assistants were largely limited to supportive, non-intraoral duties. Today, the definition RDA encompasses a credential that can unlock a wide range of clinical responsibilities. This shift reflects a broader movement in healthcare toward expanding the roles of allied health professionals to improve patient access, reduce costs, and allow dentists to focus on more complex procedures requiring their advanced training.

To perform expanded functions legally, most states require RDAs to complete additional coursework or competency exams beyond the standard RDA credential. This may involve approved dental assisting programs, hands-on clinical training hours, and written or practical examinations administered by state dental boards. Some states require a separate EFDA (Expanded Function Dental Assistant) certificate or endorsement, while others fold these competencies into their standard RDA licensure pathway.

The stakes are high: performing expanded functions without proper authorization can result in disciplinary action, license revocation, and in some cases criminal charges. That is why understanding your specific state's laws and regulations is absolutely essential before you begin practicing any expanded function. The rda dental community strongly recommends that all assistants consult their state dental board's official guidelines and pursue only board-approved training programs to ensure full legal compliance.

For those preparing for the RDA examination, expanded functions content appears prominently on many state licensing exams. Knowing the clinical standards, infection control protocols, and patient communication requirements tied to these procedures is critical for exam success. You can explore rda expanded functions practice questions to get a feel for the types of clinical scenario questions that appear on state and national exams. Building this foundational knowledge now will serve you throughout your entire career.

This comprehensive guide covers everything you need to know about RDA expanded functions: what they are, which states allow them, how to get trained and certified, what to expect on competency exams, and how expanding your skill set can dramatically increase your earning potential and job satisfaction. Whether you are a student just entering the dental assisting field or an experienced assistant looking to advance, this article will give you the detailed roadmap you need to succeed.

RDA Expanded Functions by the Numbers

๐Ÿ†
40+
States Allow Expanded Functions
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$52K
Avg. Salary with Expanded Functions
๐Ÿ“š
120+
Required Training Hours
๐Ÿ“Š
15โ€“25%
Pay Increase Potential
๐ŸŽฏ
12+
Authorized Procedures
Test Your RDA Expanded Functions Knowledge

What Are RDA Expanded Functions?

๐Ÿฆท Restorative Procedures

Placing, carving, and finishing amalgam and composite restorations under dentist supervision. Includes matrix band placement, condensing material, and ensuring proper occlusion before final polish.

๐Ÿ›ก๏ธ Preventive Services

Applying pit-and-fissure sealants, fluoride treatments, and performing coronal polishing to remove extrinsic stains and plaque from tooth surfaces prior to examination.

๐Ÿ“‹ Impression & Fabrication

Taking preliminary alginate impressions for study models, fabricating custom trays, and pouring up models used in diagnosis, appliance fabrication, and treatment planning.

๐Ÿ”„ Isolation & Moisture Control

Placing and removing rubber dams to isolate teeth during restorative procedures, ensuring a dry field and protecting soft tissue from irrigants and materials.

โœ๏ธ Temporaries & Cementations

Fabricating and cementing temporary crowns and bridges, removing excess cement from restorations, and placing retraction cord for crown and bridge impressions.

The pathway to performing expanded functions as a registered dental assistant begins with understanding exactly what your state dental board authorizes and how it expects you to demonstrate competency. Most states have developed formal educational frameworks that require completion of an accredited dental assisting program, followed by a period of supervised clinical experience before any expanded function may be legally performed. The length and structure of this training varies widely โ€” from a focused 40-hour online and lab course to a full semester-long EFDA certificate program.

California, for example, has one of the most clearly defined expanded function frameworks in the country. The California Dental Board recognizes two levels of credentialing for expanded functions: the RDA (Registered Dental Assistant) and the RDAEF (Registered Dental Assistant in Extended Functions). The RDAEF credential allows practitioners to place and finish restorations, take impressions for crown and bridge work, and perform other intraoral tasks that even standard California RDAs are not permitted to do. To earn the RDAEF license, candidates must complete an approved program, accumulate supervised clinical hours, and pass both written and practical examinations.

In Pennsylvania, Texas, and Ohio, the framework differs. These states allow what they call Expanded Function Dental Assistants (EFDAs) to place tooth-colored restorations that have been prepared by the dentist. The EFDA must demonstrate competency through an approved course โ€” typically 90 to 200 hours of combined didactic and clinical training โ€” and pass a state or national competency examination. The Dental Assisting National Board (DANB) offers credentials that some states accept in place of or alongside their own licensure exams, including the Certified Restorative Functions Dental Assistant (CRFDA) credential.

Regardless of state, the common thread across all expanded function training programs is emphasis on infection control, patient safety, and documentation. Before learning any clinical skill, RDA students study the ethical and legal parameters of their practice, including the concept of direct versus indirect supervision. In most states, expanded functions must be performed under direct supervision, meaning the licensed dentist must be physically present in the office โ€” not just on call or reachable by phone โ€” while the expanded function is being performed.

Hands-on competency demonstrations are a universal requirement. Training programs use simulated dental mannequins (typodont heads) to teach and assess skills such as matrix placement, restoration finishing, and sealant application before students work on real patients. Clinical instructors evaluate technique, infection control compliance, patient communication, and documentation accuracy. Students are typically required to demonstrate each procedure multiple times with passing scores before moving on to supervised patient care.

After completing a program, many RDAs find that continuing education is required to maintain their expanded function authorization. States commonly require 2 to 8 hours of CE annually or biennially related to expanded functions, infection control updates, or emerging dental technologies. Staying current is not just a regulatory requirement โ€” it also makes you a more competitive candidate in the job market, since dental offices increasingly value assistants who can take on a broader clinical role with minimal additional supervision from the dentist.

The investment in expanded function training pays off quickly. According to national dental workforce surveys, RDAs with expanded function credentials earn 15 to 25 percent more than their non-credentialed counterparts. In some states, particularly those with robust EFDA frameworks, the pay gap can be even larger. The combination of additional clinical responsibility and the productivity boost that expanded functions provide to the dental practice means employers are willing โ€” and often eager โ€” to compensate credentialed assistants at a significantly higher rate.

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RDA Dental: Expanded Function Procedures by Category

๐Ÿ“‹ Restorative

Restorative expanded functions represent the most clinically advanced category available to RDAs and EFDAs. These include placing amalgam and composite restorations in teeth that the dentist has prepared, carving occlusal anatomy, and finishing and polishing the completed restoration. RDAs performing these tasks must demonstrate mastery of matrix band systems such as the Tofflemire retainer, proper condensation technique for amalgam, and layering protocols for light-cured composites to minimize shrinkage and ensure adequate polymerization depth.

Restoration placement also requires a solid understanding of occlusal anatomy โ€” knowing where centric stops should be, how to carve appropriate marginal ridges, and how to identify premature contacts using articulating paper. A poorly placed restoration that results in a high bite can cause significant patient discomfort and TMJ strain. Because the stakes are high, most states require multiple supervised competency demonstrations before an RDA is permitted to perform restorative functions independently on patients, even under the required dentist supervision.

๐Ÿ“‹ Preventive

Preventive expanded functions are among the most commonly authorized across U.S. states and are often the entry point for RDAs seeking to expand their scope of practice. Pit-and-fissure sealant application involves cleaning and etching the occlusal surfaces of premolars and molars, applying bonding agent, placing sealant material, light-curing, and checking the bite. Coronal polishing โ€” the removal of extrinsic stain and plaque using a rubber cup, prophy paste, and low-speed handpiece โ€” requires knowledge of which tooth surfaces to polish, which to avoid, and how to prevent damage to exposed root surfaces or newly erupted enamel.

Fluoride application, another common preventive expanded function, requires the RDA to understand different fluoride delivery systems: trays, varnishes, and professionally applied gels. Each system has specific indications based on patient age, caries risk, and fluoride history. Patient education is a key component of preventive visits, and RDAs performing these procedures are expected to counsel patients on brushing technique, diet modification, and the role of fluoride in remineralization โ€” adding a health coaching dimension to their clinical role.

๐Ÿ“‹ Prosthetic Support

Prosthetic support functions include taking final impressions for crown and bridge cases, fabricating and cementing temporary restorations, and removing excess cement from around permanent restorations. These tasks require precision, speed, and strong communication skills since patients often experience anxiety around crown preparations. The RDA must mix impression materials to the correct consistency within working time, seat the tray evenly, monitor the patient's airway and comfort, and remove the impression cleanly without distorting critical margin detail โ€” all while documenting each step in the patient record.

Temporary crown fabrication is another high-value expanded function that saves significant dentist chair time. Using prefabricated crown forms or bis-acryl composite, the RDA creates a temporary that protects the prepared tooth, maintains space, and preserves aesthetics until the permanent restoration returns from the lab. Proper temporization prevents post-preparation sensitivity, gingival migration, and opposing tooth movement. Many dental offices rely heavily on trained RDAs for this function, making it one of the most marketable expanded skills on the job market today.

Pursuing RDA Expanded Functions: Benefits and Challenges

Pros

  • Earn 15โ€“25% higher wages compared to non-credentialed dental assistants
  • Qualify for more job openings since many practices specifically recruit EFDA-certified candidates
  • Gain greater clinical autonomy and professional satisfaction in your daily role
  • Improve patient access to care by handling more procedures during each appointment
  • Build a foundation for future advancement into dental hygiene or office management
  • Expand your professional network through approved training programs and state board affiliations

Cons

  • Additional training costs range from $500 to $3,000 depending on program length and state
  • Time commitment of 40 to 200+ hours of coursework on top of regular work schedule
  • State regulations differ widely, meaning credentials may not transfer if you relocate
  • Performing any unauthorized expanded function risks license suspension or criminal charges
  • Ongoing CE requirements add annual time and financial obligations to maintain authorization
  • Not all dental offices compensate expanded function RDAs at a meaningfully higher rate
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RDA Expanded Functions Exam Preparation Checklist

Confirm your state's specific list of authorized expanded functions on the dental board website
Verify that your training program is approved by the state dental board before enrolling
Complete all required didactic (classroom) hours and document your attendance records
Log your supervised clinical hours using your program's official tracking forms
Practice each expanded function procedure at least 10 times on a typodont before patient care
Study infection control protocols specific to each expanded function you will be performing
Review direct versus indirect supervision requirements for each procedure in your state
Take at least three full-length RDA practice exams covering expanded function content
Submit your licensure or endorsement application to the state board well before your exam date
Confirm your CE requirements and schedule continuing education courses to maintain authorization
Direct Supervision Is Non-Negotiable for Most Expanded Functions

In the majority of U.S. states, performing expanded functions requires the supervising dentist to be physically present in the office โ€” not simply reachable by phone. Before performing any expanded function on a patient, always confirm that your dentist is on-site and that this visit qualifies as direct supervision under your state's dental practice act. Performing expanded functions under indirect or general supervision when direct supervision is legally required is a licensing violation that can end your career.

The career and salary benefits of earning expanded function credentials are substantial and well-documented in dental workforce research. According to data from the American Dental Association's Health Policy Institute, the average annual salary for a standard RDA in the United States hovers around $44,000 to $47,000. However, RDAs who hold expanded function endorsements or EFDA certificates routinely command salaries in the $52,000 to $62,000 range, with some metropolitan markets and specialty practices paying even more. This wage premium reflects the direct productivity value that expanded function RDAs bring to a dental practice.

When an expanded function RDA places a composite restoration or cements a temporary crown, the dentist is freed up to begin work in another operatory, conduct a new patient examination, or complete treatment planning. This simultaneous delegation โ€” known in practice management as "multi-room" or "expanded function" dentistry โ€” can increase a practice's daily production by 20 to 35 percent without adding a dentist to the payroll. Practice owners understand this productivity math intuitively, which is why many of them actively seek out and reward credentialed assistants.

For RDAs considering long-term career trajectories, expanded functions also serve as a stepping stone toward other advanced dental careers. Many dental hygiene schools give preferential admission consideration to applicants who have demonstrated clinical competency through expanded function experience. The fine motor skills, patient communication abilities, and clinical judgment developed through EFDA work translate directly to the expectations of dental hygiene programs. Some states even offer bridge programs that allow experienced EFDAs to complete dental hygiene licensure in an accelerated timeline.

Office management is another upward path. RDAs with expanded function experience who also develop skills in dental billing, scheduling software, and team leadership often transition into lead assistant, clinical coordinator, or office manager roles. These positions typically pay $55,000 to $75,000 or more depending on practice size and location. The combination of clinical credibility and administrative skill makes expanded function RDAs particularly valuable candidates for these leadership positions in multi-provider group practices and dental service organizations (DSOs).

Geographic factors play a significant role in salary outcomes as well. States like California, Washington, and New York โ€” which have robust expanded function frameworks and high costs of living โ€” tend to pay the highest wages. California RDAs with RDAEF credentials working in urban markets like Los Angeles, San Francisco, and San Diego can earn $65,000 to $80,000 annually. In contrast, rural markets in the Southeast or Midwest may offer lower base salaries but often compensate with lower cost of living and strong job stability due to dentist shortages in those regions.

Job security for expanded function RDAs is also notably strong. The U.S. Bureau of Labor Statistics projects 8 to 11 percent employment growth for dental assistants through 2033, faster than the average for all occupations. As the dental profession continues to face pressure to improve patient access and control overhead costs, the demand for clinical assistants who can legally perform a broader range of intraoral procedures will only grow. States that have not yet expanded their RDA scope of practice are under increasing legislative pressure to modernize their dental practice acts, which could open new opportunities in the near future.

Beyond raw compensation, expanded function RDAs consistently report higher job satisfaction scores in dental workforce surveys. When assistants are trusted with meaningful clinical responsibilities, given autonomy to exercise professional judgment, and recognized as contributors to patient outcomes rather than just instrument passers, their engagement and retention improve dramatically. Turnover is a costly problem for dental practices โ€” losing a trained EFDA can cost a practice $15,000 or more in recruiting and retraining costs โ€” so smart practice owners invest in the professional development of their expanded function staff.

Preparing for the RDA expanded functions examination requires a strategic, multi-layered approach that goes well beyond memorizing a list of procedures. The most successful candidates combine structured coursework with intensive hands-on practice, systematic review of dental anatomy and materials science, and repeated exposure to exam-style questions that mirror the clinical judgment scenarios you will face in the actual test. Starting your preparation early โ€” at least 8 to 12 weeks before your exam date โ€” gives you enough time to identify weak areas and address them without cramming.

Begin your preparation by obtaining a copy of your state dental board's candidate handbook or content outline for the expanded function examination. This document will tell you exactly which procedure categories are tested, the approximate weight of each section, and any reference materials that are officially endorsed by the board. Use this outline as your study roadmap, prioritizing sections that carry the highest exam weight. For most states, restorative procedures, infection control, and patient safety account for the largest share of expanded function exam content.

Dental materials is a subject area that many RDA candidates underestimate, but it is absolutely essential for expanded function competency. Understanding the chemistry and handling properties of composite resins, glass ionomer cements, zinc oxide eugenol, and cavity liners is not just academic โ€” it directly affects the quality of the restorations you place and the safety of your patients. Know the working times, setting times, and contraindications for each material class. Understand how temperature, humidity, and technique affect final material properties. These details appear regularly on expanded function competency exams.

Patient communication and documentation are two additional content areas that test-takers frequently overlook. Expanded function RDAs are expected to obtain informed consent before performing procedures, document their work accurately in the patient record, and communicate clearly with patients about post-procedure care and expectations. Exam questions in this domain often present clinical scenarios requiring you to identify the appropriate consent process, the correct method for documenting a restorative procedure, or the right response when a patient reports discomfort during treatment. Practice these scenarios as part of your exam preparation.

Radiographic interpretation supports expanded function decision-making in important ways. Before placing a restoration, an experienced EFDA evaluates preoperative radiographs to assess caries extent, root proximity, and existing restorative work that may influence material selection. While taking radiographs is a separate credentialed skill, interpreting them in the context of expanded function procedures is a testable competency. Review periapical and bitewing radiograph interpretation as part of your exam prep, focusing on identifying caries depth, assessing interproximal contacts, and recognizing endodontically treated teeth that may have altered restorative needs.

Practice examinations are the single most effective tool for RDA exam preparation, including for expanded function content. Working through realistic, case-based questions under timed conditions trains your brain to apply knowledge efficiently rather than simply recall it. After each practice session, review every question you answered incorrectly and trace the error back to a specific knowledge gap โ€” then go back to your study materials to close that gap before moving on. This iterative cycle of test, review, and reinforce is the fastest path to genuine exam readiness.

On exam day, manage your time carefully. Expanded function exams typically include 80 to 150 questions with a time limit of 2 to 3 hours. Pace yourself at roughly one minute per question, flagging difficult items for review rather than getting stuck. Read each question stem carefully, paying attention to qualifying words like "first," "most important," and "except," which can completely change the correct answer. Trust your preparation โ€” most expanded function exam failures result from test anxiety and poor time management, not a lack of clinical knowledge.

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Building strong practical skills for expanded function work requires consistent, deliberate practice long before you ever treat a real patient. The foundation of this skill development is typodont work โ€” practicing on simulated dental models that replicate real tooth anatomy and allow you to perform restorative procedures in a controlled, low-stakes environment. Most expanded function training programs require 20 to 40 hours of typodont work before students move to clinical patient care. Use every available typodont session to focus on a specific technique weakness, whether that is consistent matrix band adaptation, even composite layering, or smooth amalgam carving.

Seek out a mentor in your training program or clinical externship site who is an experienced expanded function practitioner. Watching a skilled EFDA work in real time โ€” observing their hand positioning, material management, time efficiency, and patient communication โ€” is invaluable learning that no textbook or video can fully replicate. Ask questions about their decision-making process, how they handle complications, and what they wish they had learned earlier in their training. The mentorship relationships you build during your expanded function training often become the professional network that supports your entire career.

Time management in the operatory is a skill that develops with experience, but you can accelerate its development by setting up simulated scenarios in practice sessions. Time yourself placing a two-surface composite restoration from setup to final polish. Track how long each step takes and identify where you are losing time. In a production dental practice, expanded function procedures are scheduled with tight appointment windows, and an RDA who can perform quality work efficiently is far more valuable than one who is technically proficient but slow. Efficiency and quality must develop together.

Infection control compliance during expanded function procedures is non-negotiable and is tested rigorously on competency exams. Every expanded function RDA must demonstrate proper personal protective equipment (PPE) use, surface disinfection protocols, instrument sterilization verification, and sharps handling procedures for every patient encounter. Develop the habit of mentally running through your infection control checklist before each procedure begins. In clinical examinations, evaluators are actively watching for PPE breaches, contamination events, and improper disposal practices โ€” these errors result in automatic competency failure in most programs.

Staying connected to the professional dental assisting community will serve you well throughout your career as an expanded function practitioner. Organizations like the American Dental Assistants Association (ADAA) and state dental assisting associations offer continuing education, certification support, advocacy resources, and networking opportunities that help RDAs stay current and connected. Many state associations also publish regular updates on dental practice act changes, which is the fastest way to stay informed when your scope of practice evolves due to legislative or regulatory changes in your state.

Finally, approach every patient interaction during expanded function procedures as an opportunity to build trust and demonstrate professionalism. Patients who are anxious about dental treatment respond remarkably well to calm, confident, and communicative dental assistants. Explain each step before you begin, check in frequently about patient comfort, and document any concerns the patient expresses.

When patients feel cared for by the entire dental team โ€” not just the dentist โ€” they are more likely to return for follow-up appointments, accept recommended treatment, and refer family and friends to the practice. Your expanded clinical role amplifies your impact on every patient you serve.

Remember that your journey toward expanded function mastery is an investment in yourself and in the patients who will benefit from your skills. The combination of rigorous training, ongoing professional development, and a commitment to evidence-based practice will position you as an indispensable member of any dental team. Whether you are just beginning your RDA career or looking to take your established practice to the next level, expanded functions offer one of the clearest and most rewarding pathways to professional growth in the entire dental assisting field.

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RDA Questions and Answers

What is the RDA meaning in the dental field?

RDA stands for Registered Dental Assistant, a credentialed dental professional who has passed a state-approved examination and met education and clinical requirements. The RDA definition goes beyond basic chairside assisting โ€” in many states, it encompasses the ability to perform expanded clinical functions such as placing restorations, applying sealants, and taking impressions under dentist supervision.

What are expanded functions for a registered dental assistant?

Expanded functions are intraoral clinical procedures that RDAs are authorized to perform in addition to standard chairside duties. These vary by state but commonly include placing and finishing amalgam and composite restorations, applying pit-and-fissure sealants, performing coronal polishing, taking preliminary impressions, fabricating temporary crowns, and placing rubber dams. Each state's dental practice act defines its specific list of authorized expanded functions.

Does every state allow RDA expanded functions?

Most U.S. states authorize some level of expanded functions for dental assistants, but the specific procedures, training requirements, and supervision standards differ significantly. States like California and Pennsylvania have detailed EFDA frameworks, while others allow only limited expanded duties. Always verify your state's current dental practice act through the state dental board's official website before performing any expanded function procedure.

How do I get certified for RDA expanded functions?

The process varies by state but typically involves completing an approved expanded function training program (40 to 200+ hours of didactic and clinical training), accumulating supervised patient care hours, and passing a written or practical competency examination. Some states issue a separate EFDA certificate or endorsement, while others fold expanded function authorization into the standard RDA licensure pathway. Contact your state dental board for specific requirements.

What is the difference between direct and indirect supervision for expanded functions?

Direct supervision requires the dentist to be physically present in the office while the expanded function is being performed and to have evaluated and diagnosed the patient beforehand. Indirect supervision means the dentist is available on call but not necessarily present. Most states require direct supervision for expanded function procedures, particularly restorative tasks. Performing expanded functions under the wrong supervision level is a licensing violation.

How much more do RDAs with expanded functions earn?

RDAs with expanded function credentials typically earn 15 to 25 percent more than those without. The national average for standard RDAs is approximately $44,000 to $47,000 per year, while credentialed EFDAs earn $52,000 to $62,000 or more depending on location and practice type. In high-cost markets like California, expanded function RDAs can earn $65,000 to $80,000 annually, reflecting the direct productivity value they bring to the dental practice.

What does the DANB CRFDA credential mean for expanded function RDAs?

The Certified Restorative Functions Dental Assistant (CRFDA) is a national credential offered by the Dental Assisting National Board (DANB) that validates competency in restorative expanded functions. Several states accept or recognize the CRFDA as part of their expanded function licensure pathway. Earning a nationally recognized credential like the CRFDA can also facilitate credential recognition when relocating to another state with compatible expanded function frameworks.

What is the rda definition difference between RDA and RDAEF in California?

In California, the RDA (Registered Dental Assistant) credential authorizes a range of chairside duties and some expanded functions. The RDAEF (Registered Dental Assistant in Extended Functions) is a higher-level credential that allows additional intraoral procedures such as placing restorations and taking crown and bridge impressions. The RDAEF requires completing an additional approved training program and passing both written and practical examinations beyond the standard RDA requirements.

How should I prepare for an RDA expanded functions competency exam?

Start preparation 8 to 12 weeks before your exam date using the state board's official content outline as your study roadmap. Prioritize high-weight content areas such as restorative procedures, dental materials, infection control, and patient documentation. Complete extensive typodont practice, take multiple full-length practice exams under timed conditions, and review every incorrect answer to identify and close knowledge gaps before exam day.

Can performing expanded functions without authorization affect my RDA license?

Yes โ€” performing expanded functions without proper state authorization is a serious violation of the dental practice act that can result in disciplinary action by the state dental board, license suspension or revocation, civil liability, and in some cases criminal charges depending on the state. Always confirm your specific authorized procedures with your state dental board and ensure you have completed all required training and credentialing before performing any expanded function on a patient.
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