NCCT Practice Test 5
This is a timed quiz. You will be given 60 seconds per question. Are you ready?
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.
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.
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.
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.
In your medical office, staff are issued with iPads in order to access patient information during consultations etc. It's vital that they have…?
All peripheral devices should be as well protected as the main computer, i.e. through passwords and other security measures. With tablet computers, which can easily be forgotten and left in places accessible to non-authorized personnel, it is particularly important to make sure that they will automatically close when not in use and that a password is needed to reopen them.
Which of these is an external barrier to good communication?
The environment in which a discussion occurs can have a significant impact on its success. In a noisy environment misunderstandings can easily occur, especially if the patient is hard of hearing. If you see that a patient is struggling to understand, consider taking them to a quieter environment.
When only a small amount of blood is needed, a capillary puncture may be used. Which of these is the best site for this in a healthy adult?
Using a capillary puncture when only a small amount of blood is needed is advantageous, especially for obese patients, those who may have bleeding problems, people who may have severe burns, etc. The fingers are generally the best site for this type of blood draw, though the toes may also be used. Remember to use the correct lancet and wipe away the first drop of blood as it will contain excessive tissue fluid.
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.
A person who issues a legal suit against a medical professional is known as what?
A person entering a legal complaint is known as the plaintiff. The person against whom the complaint is made is the defendant. All parties in a court case are known as the litigants, and an appellant is a person who appeals to a higher court to have the judgment of a lower court overturned.
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.
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.
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 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.
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.
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.
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.
The first step when removing sutures is to do what?
Before removing any suture the wound should be cleaned with antiseptic. This should remove any encrusted blood or loosened scar tissue, which could not only cause unnecessary pain to the patient during removal but might increase the risk of infection.
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.
When performing a venipuncture, where should the collecting syringe/tube be held in relation to the puncture site?
It is undesirable for collected blood to flow back into the vein. To ensure that this does not happen always hold the collecting tube below the puncture so that gravity can assist you in ensuring this does not happen.