SCMA SCMA 2 — Questions and Answers
Question 1: A patient receiving a subcutaneous injection of insulin asks why the needle is inserted at a 45-degree angle. The correct response is:
- To reach the muscle layer for faster absorption
- To deposit the medication into subcutaneous fatty tissue (Correct answer)
- To avoid hitting a vein or artery
- To reduce the amount of medication needed
Correct answer: To deposit the medication into subcutaneous fatty tissue
A 45-degree angle (or 90 degrees in obese patients) ensures the needle reaches the subcutaneous fatty layer, where insulin is designed to be absorbed.
Question 2: Which laboratory value is most critical to monitor in a patient taking warfarin (Coumadin)?
- Complete blood count (CBC)
- Basic metabolic panel (BMP)
- Prothrombin time/INR (Correct answer)
- Hemoglobin A1c
Correct answer: Prothrombin time/INR
PT/INR measures the clotting time and is used to monitor warfarin therapy and adjust dosing to prevent bleeding or clotting complications.
Question 3: When performing a 12-lead ECG, lead V4 should be placed at which anatomical location?
- 4th intercostal space, right sternal border
- 5th intercostal space, midclavicular line (Correct answer)
- 5th intercostal space, anterior axillary line
- 4th intercostal space, left sternal border
Correct answer: 5th intercostal space, midclavicular line
V4 is placed at the 5th intercostal space at the midclavicular line on the left side of the chest.
Question 4: A medical assistant is preparing to administer a vaccine. The patient states they had a severe allergic reaction to a previous dose. The MA should:
- Administer the vaccine and observe the patient for 15 minutes
- Document the reaction and notify the provider before proceeding (Correct answer)
- Administer a reduced dose of the vaccine
- Reschedule the appointment for another day
Correct answer: Document the reaction and notify the provider before proceeding
A prior severe allergic reaction (anaphylaxis) to a vaccine is a contraindication; the provider must be notified before any dose is given.
Question 5: Which of the following is the correct order of blood draw tubes when using the evacuated tube system?
- Red, lavender, green, gray
- Lavender, red, green, gray
- Gold/yellow, blue, green, lavender
- Blue, gold, green, lavender, gray (Correct answer)
Correct answer: Blue, gold, green, lavender, gray
The correct order of draw (CLSI standard) is: blood culture, light blue (sodium citrate), gold/red, green, lavender (EDTA), then gray.
Question 6: A patient's blood pressure reads 148/94 mmHg. According to the ACC/AHA guidelines, this would be classified as:
- Normal
- Elevated
- Stage 1 hypertension
- Stage 2 hypertension (Correct answer)
Correct answer: Stage 2 hypertension
Stage 2 hypertension is defined as systolic ≥140 mmHg or diastolic ≥90 mmHg under the 2017 ACC/AHA guidelines.
Question 7: Which of the following personal protective equipment (PPE) is required when handling a blood specimen that may be splashed during processing?
- Gloves only
- Gloves and gown
- Gloves, gown, and face shield (Correct answer)
- Gloves and surgical mask only
Correct answer: Gloves, gown, and face shield
When splash risk exists, OSHA bloodborne pathogen standards require gloves, gown, and eye/face protection (face shield or goggles plus mask).
SCMA SCMA 2
A patient receiving a subcutaneous injection of insulin asks why the needle is inserted at a 45-degree angle.
The correct response is: