Policies / Procedures
Emergency
A Day in Clinic
CHAM
Critical Thinking
100
On the new Medicaid travel vouchers, if a provider has not issued an escort, what should you put in/on the escort section?
a large X
100
How often should the AED be checked (powered on and off and expiration dates reviewed)?
weekly
100
Which reflects the proper way to store immunizations and medications in Fridge A?
a) immunizations must be on the top shelf
b) medications must be on the top shelf
c) all injectable meds and imms must be stored on the same shelf
d) immunizations and meds must be stored on different shelves
e) Darlene Huntington doesn't care, so neither do you.
d) immunizations and meds must be stored on different shelves
100
You are documenting the length of a laceration in your note in Athena. What units of measure are acceptable now that CHAM has switched to metric?
a) inches or centimeters
b) inches or millimeters
c) centimeters only
d) millimeters or centimeters
d) millimeters or centimeters
Inches are considered a Standard unit of measurement and are no longer being used in the CHAM. Centimeters and millimeters, along with mL are all units within in the metric system.
100
Which of the following are abnormal vital signs that you would want to make sure to discuss with your medical traffic provider?
a) BP of 136/88 in a 45 yo
b) respirations of 42 in a 6 month old
c) SPO2 = 94% in a 4 yo
d) oral temp of 99.2 in a 9 yo
c) SPO2 = 94% in a 4 year old
200
Per TCC Policy No 30-3332, in what time period should a health aide have his/her note finished and closed?
by the end of day when possible; but at most within 2 business days
200
When performing an EKG, in what space should the V1 and V2 leads be placed?
a) between 2nd and 3rd rib (2nd intercostal space)
b) between the 3rd and 4th rib (3rd intercostal space)
c) between the 4th and 5th rib (4th intercostal space)
d) at the nipple line
e) it doesn't matter, just slap those suckers on because its an EMERGENCY
c) between the 4th and 5th rib (4th intercostal space)
200
How long is a tuberculin vial (used for placing PPDs) good for once opened?
30 days
200
You are deciding how much amoxicillin to dose for a child who has acute otitis media. The CHAM is now in metric. The child weighs 25 lbs. Approximately how many kilograms does the child weigh?
Approximately 12 kg
Divide 25lbs by 2.2
= 11.363 kg
200
A state trooper presents to your clinic to follow up on the physical assault of a 32 yo male that you saw at your clinic last night. The trooper asks you for a copy of your note as the victim is pressing charges. How do you proceed?
a) call the patient and ask for permission to release the note
b) print the note - it is acceptable to provide notes to law enforcement
c) refer the trooper to the TCC HIMS department
d) tell the trooper that you can speak to him about the case, but can't print out the visit note
e) tell the trooper he should call Crystal Stordahl
c) refer the trooper to the TCC HIMS department
300
A patient's record can be shared with which of the following entities WITHOUT a release of information?
a) Providence Medical Center
b) VPSO
c) Alaska State Troopers
d) BCBS Insurance Company
e) Judge/Magistrate
a) Providence Medical Center
via "continuity of care" guidelines
300
You are called to the scene of a patient who was thrown to the ground in a snowmachine vs car accident. The scene is safe and you are assessing the patients level of consciousness. His eyes are closed and he is not moving. He does not respond to you loudly calling his name. He groans when you do a sternal rub. On the AVPU scale what would you rate his level of consciousness?
P - patient responds to painful stimuli
300
A 36 yo AN female with Medicaid insurance presents to the clinic following a laceration injury to her leg. The wound was "dirty." You check VacTrak and her last tdap was 15 years ago. She is agreeable to having her tdap updated today. From what funding source do you offer the patient her tdap (state/private)? And what do you document under VFC Status in Athena?
a) state supply - Boostrix tdap - VFC Eligible - Medicaid/Medicaid Managed Care
b) state supply - Boostrix tdap - Not VFC Eligible
b) private supply - Adacel tdap - VFC Eligible - Medicaid/Medicaid Managed Care
d) private supply - Adacel tdap - Not VFC Eligible
d) private supply - Adacel tdap - Not VFC Eligible
300
Per the CHAM, at what age do you routinely start checking a child's blood pressure when you take vitals?
age 3
300
A 16 yo patient presents to your clinic complaining of left ear pain and drainage that has been worsening over the past week. What is your assessment based on the exam pictures below?
Left Acute Otitis Externa
400
An unaccompanied 13 yo female presents to your clinic with complaints of vaginal discharge and concerns that she may have gotten an STD from her 14 yo boyfriend. She reports that her parents do not know that she is sexually active. The parents are also unaware that she is here at the clinic. How do you proceed?
a) Call her parent. You are unable to see her without parental consent.
b) See the patient, but only if she is emancipated.
c) See the patient, and keep visit and results completely confidential from parents.
d) Tell the patient to go talk to her parents and retrieve a note of consent.
e) Call OCS to report concerns of child abuse.
c) See the patient, and keep visit and results completely confidential from parents.
In the state of Alaska, regardless of the age of the patient, if the visit is pertaining to reproductive health (birth control, pregnancy) or STIs, the visit/results must be kept confidential. OCS would be called only if concerns of abuse.
400
A 67 yo female presents with a weird sensation in her chest that is hard for her to describe. She feels short of breath, but is not having chest pain. When you listen to her heart - you hear this:
When you palpate her radial pulse, this also seems different.
The cham tells you to get an EKG.
How would you describe her heart sounds to the med traffic provider?
Abnormal Rhythm - Irregularly Irregular - Atrial Fibrillation
400
All of the following are correct Lab QC statements aside from which one?
a) urine clinitek QCs are performed weekly and with the opening of a new box
b) urine HCG QCs are performed monthly and with the opening of a new box
c) hemoccult FOB QCs are performed monthly and with opening of a new box
d) hemocue QCs are performed monthly and with opening of a new box
e) rapid strep swab QCs are performed monthly and with opening of a new box
e) rapid strep swab QCs are performed monthly and with opening of a new box
FALSE -
Rapid strep swab QCs are performed only with the opening of a new box
400
An anatomic term that means away from the center of the body; the radial pulse is found __________ to the elbow.
distal
400
You are weathered in waiting on an air medevac with a 42 yo patient who wrecked his ATV an hour ago. He is awake, alert, and denies any complaints other than having a bit of a belly ache where the handlebars hit his stomach in the crash. His vitals are stable. All of the following are appropriate management interventions except?
a) Keep patient NPO.
b) Check O2 and IV flow rates every 15 minutes.
c) Keep patient and approved family members aware of updates in the care plan.
d) Record a set of Vital Signs and LOC on Emergency flow sheet every 60 minutes.
e) Check any equipment on patient (IV lines, traction splint) every 30 minutes to make sure they are still operating properly.
d) Record a set of Vital Signs and LOC on Emergency flow sheet every 60 minutes.
500
In which of the following cases are you a mandated reporter?
a) a 24 yo female who was physically beaten by her husband
b) a 55 yo male who was assaulted by a friend
c) a 5 yo with a few scratches and bruises on his legs
d) a 73 yo male who reports to you that his daughter takes all of his social security check and he has little food to eat
e) a frail elder with a sliver
d) a 73 yo male who reports to you that his daughter takes all of his social security check and he has little food to eat
500
Per the CHAM, in 2 rescuer Child or Infant CPR, what ratio of compressions to breaths should you perform?
15:2
500
Per TCC Policy, at what volume must you refill O2 tanks?
a) < 1000 psi
b) < 500 psi
c) < 100 psi
d) < 50 psi
e) when its empty and your patient's lips turn blue
b) < 500 psi (pounds per square inch)
500
All of the following are high risk health conditions except for:
a) a 50 yo female who was last treated with radiation 6 months ago for breast cancer
b) a patient with diabetes who has a laceration
c) a 1 yo old who's mother reports he was hospitalized for RSV when he was 3 months old
d) a 2 yo with CPT-1 Deficiency
e) a 65 yo male who takes prednisone 20 mg on a daily basis for arthritis
f) pregnant female who c/o ankle pain after rolling her L ankle
a) a 50 yo female who was last treated with radiation 6 months ago for breast cancer
500
A trauma patient has the following vitals: 90/50, P 158, R20, T98.6, O2 = 99%. What condition must you be concerned for?
Shock