Preparation Manual

Domain I—Academic Foundations

Competency 001—The teacher understands major trends in the history of health care and the impact of health care on society.

1. John Snow, M.D., traced the source of the London cholera epidemic of 1854 to a public water pump. When the pump handle was dismantled, the epidemic was brought under control. In recognition of his efforts, he is regarded as the founder of

1. the germ theory.
2. immunology.
3. sewage treatment engineering.
4. epidemiology.

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Option D is correct because Dr. Snow looked at the root cause of the cholera epidemic. Option A is incorrect because the germ theory explains the cause of disease. Option B is incorrect because immunology is the study of the body’s defense system. Option C is incorrect because Dr. Snow is not the founder of sewage treatment.

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The graphs are side by side. The graph on the left has a title of "Leading causes of death in low-income countries". The x axis is the number of deaths per 100,000 population starting a zero and increasing in multiples of 20 until 100 and the y axis is teh causes of death. The following is the data from top to bottom: Lower Respiratory Infections near 100, H I V/ AIDS inbetween 60 and 80, Diarrheal Diseases in between 60 and 80, Stroke near 60, Ischemic Heart Disease in between 40 and 60, but closer to 40. Malaria is near 40, Tuberculosis is in between 20 and 40, and Protien Energy Malnutrition is in between 20 and 40. The graph on the right has a title of "Leading Causes of Death in High-Income Countries". The x axis is deaths per 100,000 population starting at zero going up to 120 in multiples of 24 and the y axis is the causes of death. The following list is the data from top to bottom: Ischemic Heart Disease is at 120, H I V/ AIDS is near 72, Trachea Bronchus, Lung Cancers is just a little past 48, Lower Respiratory Infrections is 1 third in the middle of 24 and 48, Colon Rectal Cancer is a little past 24, Diabetes Mellitus is a little under 24, Hypertensive Heart Diesease is just a little under 24, and lastly breast cancer is in between 0 and 24.

2. Based on the graphs above, compared to individuals in high-income countries, individuals in low-income countries are more likely to die from

1. breast cancer.
2. colon cancer.
3. infectious diseases.
4. ischemic heart disease.

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Option C is correct because according to the graph, individuals in low-income countries are more likely to die from lower respiratory infections, diarrheal diseases, malaria, or tuberculosis. Option A is incorrect because individuals in low-income countries are less likely to die from breast cancer. Option B is incorrect because individuals in low-income countries are less likely to die from colon cancer. Option D is incorrect because individuals in low-income countries are less likely to die from ischemic heart disease.

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The pie chart is divided into 4 sections. The biggest portion is taken up by Medicare having an amount of 105 billion dollars. Medicaid comes in second at 36 billion dollars, third is Out-of-pocket at 34 billion dollars and fourth is Other at 26 billion dollars.

3. Based on the graph, treatment for a patient with Alzheimer’s disease in 2012 was primarily paid by

1. personal insurance plans.
2. government sources.
3. the patient.
4. the patient’s family.

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Option B is correct because care for a patient with Alzheimer’s disease in 2012 was primarily paid for by government sources. Option A is incorrect because care for a patient with Alzheimer’s disease in 2012 was not primarily paid by personal insurance plans. Option C is incorrect because care for a patient with Alzheimer’s disease in 2012 was not primarily paid by the patient. Option D is incorrect because care for a patient with Alzheimer’s disease in 2012 was not primarily paid by the patient’s family.

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4. Gregor Mendel discovered genetic inheritance patterns using

1. mice.
2. squash.
3. pumpkins.
4. garden peas.

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Option D is correct because Gregor Mendel experimented with pea plants. Option A is incorrect because Gregor Mendel did not experiment with mice. Option B is incorrect because Gregor Mendel did not experiment with squash. Option C is incorrect because Gregor Mendel did not experiment with pumpkins.

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Competency 002—The teacher applies academic skills to health science, understands scientific methods and the impact of scientific research on the health sciences, and organizes and communicates valid conclusions from experimental data.

5. A recent study by the Association of American Medical Colleges (AAMC) estimated that the United States will have a shortfall of more than 50,000 physicians by the year 2025. Based on the study’s finding, which of the following statements provides the most reasonable prediction?

1. Medical assistants will take the place of doctors in most cases.
2. Health care will proceed as it has, with higher numbers of patients served by fewer doctors.
3. Nurse practitioners will continue to grow in number and will have much more authority in the future.
4. Physician assistants will take the place of doctors in most areas of diagnosis and prescription.

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Option C is correct because the numbers of nurse practitioners are growing, with many states now granting them more independence, known as full practice authority. Option A is incorrect because medical assistants do not have the training or license to diagnose illness or prescribe medicines. Option B is incorrect because other health-care practitioners will have to take on more responsibility to meet the demand for increased need in health care. Option D is incorrect because even though the health-care workforce is underutilized, these workers cannot do the work of the doctor or nurse practitioner.

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The x axis represents Death by millions starting at 0 increasing in multiples of 2 until 8, the y axis has the leading causes. The following is a list of the data from top to bottom: Ischemic Heart Diesease is in the middle of 6 and 8, stroke is just a little over the 6 mark, lower respiratory infection is in between 2 and 4, C O P D is in between 2 and 4 a little under the amount of Lower Respiratory Infection. H I V/ AIDS is just a little under the 2 mark, and lastly Diabetes Mellitus is a little under the amount of H I V / AIDS in between 0 and 2.

6. Based on the graph, which of the following conditions causes the most deaths worldwide?

1. Ischemic heart disease
2. Stroke
3. Lower respiratory infection
4. Chronic obstructive pulmonary disease (COPD)

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Option A is correct because according to the graph, at approximately 7 million people, ischemic heart disease is the leading cause of death. Option B is incorrect because according to the graph, at approximately 6 million people, stroke is the second-leading cause of death worldwide. Options C and D are incorrect because at approximately 3 million people each, lower respiratory infection and COPD are the third- and fourth-leading causes of death of worldwide.

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7. Which of the following is a United States government report used to measure the effectiveness of health care in the United States?

1. World Health Report
2. National Healthcare Quality and Disparities Report
3. CDC Health Disparities & Inequalities Report (CHDIR)
4. National Health Insurer Report Card (NHIRC)

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Option B is correct because the National Healthcare Quality and Disparities Report reports on the quality of health care to all sectors of the population of the United States. Option A is incorrect because World Health Report is published by the World Health Organization (WHO) and combines an expert assessment of global health, including statistics relating to all countries, with a focus on a specific subject. Option C is incorrect because the Centers for Disease Control and Prevention’s Health Disparities & Inequalities Report (CHDIR) reports only on health care to minorities and groups with barriers to adequate care. Option D is incorrect because the National Health Insurer Report Card (NHIRC) is a report by the American Medical Association (AMA) concerning health insurance company ratings and expenses.

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Competency 003—The teacher understands medical terminology related to health care and uses it appropriately.

8. Which of the following terms best identifies the confusion, agitation, and aggressive behavior that individuals with dementia frequently experience in the late afternoon and early evening?

1. Circadian rhythm
2. Synucleinopathy
3. Sleep apnea
4. Sundown syndrome

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Option D is correct because sundown syndrome is often associated with Alzheimer’s disease and affects how an individual acts in the late afternoon or early evening. When an individual is sundowning, he or she may be confused, agitated, or aggressive. Option A is incorrect because circadian rhythm is the ability of the body to work within a 24-hour clock. Option B is incorrect because synucleinopathy is any degenerative disease of the central nervous system in which there is an excessive accumulation of protein in the neurons. Option C is incorrect because sleep apnea is a condition in which a person’s breathing is disrupted during sleep.

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9. The correct term for blood in the urine is

1. hematoma.
2. hemoglobin.
3. hemolysis.
4. hematuria.

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Option D is correct because hematuria is the presence of red blood cells in urine. Option A is incorrect because a hematoma is a localized collection of blood outside the blood vessels. Option B is incorrect because hemoglobin is the iron-containing oxygen-transport compound in the red blood cells of all vertebrates. Option C is incorrect because hemolysis is the rupturing of erythrocytes.

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10. Which of the following is the best definition for plagiocephaly?

1. Premature fusion of the coronal suture
2. Premature closure of the sagittal suture
3. A genetic bone-softening disease causing a malformation of the skull and facial bones
4. A condition caused by positional molding of the skull when infants are put to sleep on their backs

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Option D is correct because plagiocephaly is caused by positional molding of the skull when infants are put to sleep on their backs. Option A is incorrect because the coronal suture is a dense, fibrous connective tissue joint that separates the frontal and parietal bones of the skull. Option B is incorrect because the sagittal suture is a dense, fibrous connective tissue joint between the two parietal bones of the skull. Option C is incorrect because plagiocephaly is not a bone-softening disorder.

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Domain II—Medical Sciences

Competency 004—The teacher understands the anatomical structures of the human body and their relationship to the physiological functions and processes that maintain homeostasis.

11. Which of the following best explains why air from the atmosphere moves into the lungs?

1. Contraction of the diaphragm increases the pressure inside the lungs, forcing air from the atmosphere into the lungs.
2. An increase in thoracic volume creates a more negative pressure in the lungs than that of the atmosphere.
3. Wave-like contractions of the trachea pump air from the atmosphere into the lungs.
4. Muscles attached to alveoli cause each alveolus to expand and hold more air from the atmosphere.

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Option B is correct because an increase in thoracic volume creates a more negative pressure in the lungs than that of the atmosphere. Option A is incorrect because contraction of the diaphragm does not increase the pressure inside the lungs. Option C is incorrect because wave-like contractions of the trachea do not pump air from the atmosphere into the lungs. Option D is incorrect because muscles attached to alveoli do not cause each alveolus to expand.

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12. The cardinal gaze test shows that a patient’s right eye cannot track in the temporal direction. Which cranial nerve is most likely affected?

1. III
2. IV
3. VI
4. VII

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Option C is correct because damage in cranial nerve VI causes impairment in the lateral rectus muscles. Option A is incorrect because cranial nerve III does not innervate the lateral rectus muscles. Option B is incorrect because cranial nerve IV does not innervate the lateral rectus muscles. Option D is incorrect because cranial nerve VII does not innervate the lateral rectus muscles.

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13. Which THREE of the following are classified as micronutrients?

1. Vitamin A
2. Iron
3. Protein
4. Zinc

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Options A, B, and D are correct because micronutrients such as vitamins and minerals, including vitamin A, iron, and zinc, are nutrients that are required by organisms in small quantities to ensure normal function and good health. Option C is incorrect because protein, carbohydrates, and fat are macronutrients that are required in relatively large amounts for normal function and good health.

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Competency 005—The teacher understands the relationship between microorganisms and health and the role of microorganisms in infectious diseases.

14. Which of the following are the causative agents of bovine spongiform encephalopathy in cattle and Creutzfeldt-Jakob disease in humans?

1. Prions
2. Bacteria
3. Viruses
4. Fungi

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Option A is correct because bovine spongiform encephalopathy (BSE) and Creutzfeldt-Jakob disease result from infection by an agent called a prion. Option B is incorrect because bacteria cause diseases in cattle but not BSE or Creutzfeldt-Jakob disease. Option C is incorrect because viruses cause diseases in cattle but not BSE or Creutzfeldt-Jakob disease. Option D is incorrect because fungi cause diseases in cattle but not BSE or Creutzfeldt-Jakob disease.

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15. Which of the following antimicrobial agents interferes with bacterial cell wall synthesis?

1. Sulfonamide
2. Penicillin
3. Tetracycline
4. Erythromycin

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Option B is correct because penicillin inhibits the formation of cell walls in bacterial cells. Option A is incorrect because sulfonamide acts as a competitive inhibitor of the enzyme dihydropteroate synthase (DHPS). Option C is incorrect because tetracycline is a protein inhibitor. Option D is incorrect because erythromycin inhibits bacterial growth.

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16. In 1882, which of the following scientists discovered the causative organism for tuberculosis?

1. Robert Koch
2. Joseph Lister
3. Louis Pasteur
4. J. Hans D. Jensen

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Option A is correct because Robert Koch discovered the causative organism for tuberculosis. Option B is incorrect because Joseph Lister is the pioneer of antiseptic surgery. Option C is incorrect because Louis Pasteur discovered principles of vaccination, microbial fermentation, and pasteurization. Option D is incorrect because J. Hans D. Jensen was a physicist.

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17. Which of the following types of bacteria is completely dependent on oxygen for respiration?

1. Obligate anaerobe
2. Obligate aerobe
3. Aerotolerant anaerobe
4. Facultative anaerobe

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Option B is correct because obligate aerobes are completely dependent on oxygen for respiration. Option A is incorrect because obligate anaerobes are killed by normal atmospheric oxygen concentrations. Option C is incorrect because aerotolerant anaerobes grow poorly in the presence of oxygen. Option D is incorrect because facultative anaerobes survive both in the presence and in the absence of oxygen.

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Competency 006—The teacher understands the mechanisms of pathology, the process of pathogenesis, a variety of human diseases and the effects of disease prevention and control.

18. Which of the following are produced as part of the nonspecific immune response?

1. Neutrophils
2. Helper T cells
3. Cytotoxic T cells
4. B lymphocytes

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Option A is correct because neutrophils are the first nonspecific responders. Option B is incorrect because helper T cells help the activity of other immune cells and are a component of the specific immune response. Option C is incorrect because one of the functions of cytotoxic T cells is to kill cancer cells and they are a component of the specific immune response. Option D is incorrect because B lymphocytes make antibodies against antigens and they are a component of the specific immune response.

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19. Which of the following cellular components primarily acts as a protein catalyst in facilitating molecular rearrangements important for cell function?

1. An enzyme
2. A lysosome
3. Cytosol
4. A ribosome

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Option A is correct because an enzyme is a protein catalyst that speeds biochemical reactions by facilitating the molecular rearrangements that support cell function. Option B is incorrect because a lysosome is the digestive system in the cell that breaks down molecules into their base component digestive enzymes. Option C is incorrect because cytosol is the fluid in which organelles of the cell reside. Option D is incorrect because ribosomes are where ribonucleic acid (RNA) is translated into protein. This process is called protein synthesis.

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20. The time between the exposure to a pathogenic agent and the appearance of the first symptoms is the

1. lag period.
2. decline period.
3. incubation period.
4. prodromal period.

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Option C is correct because the incubation period is the time between the infection of an individual by a pathogen and the manifestation of the illness or disease it causes. Option A is incorrect because the lag period is the period of time between the introduction of a microorganism into a culture medium and the time it begins to increase exponentially. Option B is incorrect because the decline period describes the period where the symptoms are lessening. Option D is incorrect because the prodromal period is when symptoms first appear.

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Domain III—Occupational Knowledge

Competency 007—The teacher understands the aging process, including the sociological implications and psychological effects of aging.

21. The adverse effects of polypharmacy are much greater for people with which of the following?

1. Gastrointestinal problems
2. Skin conditions
3. Hearing impairments
4. Cardiovascular issues

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Option D is correct because people who are on medication for cardiovascular issues are at a greater risk for contraindication and falls. Option A is incorrect because gastrointestinal problems have nothing to do with the physiological effects of polypharmacy. Option B is incorrect because skin conditions and their medication generally do not contribute to side-effects of polypharmacy. Option C is incorrect because having a hearing impairment has nothing to do with the effects of polypharmacy.

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22. Which of the following lists contains three cognitive disorders commonly seen in the elderly?

1. Delirium, depression, dementia
2. Sensory impairments, pain, medication use
3. Cerebrovascular accidents, cancers, hypertension
4. Loss of hearing, loss of visual acuity, loss of coordination

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Option A is correct because delirium, depression, and dementia are cognitive disorders. Option B is incorrect because use of medicine is not a cognitive disorder. Option C is incorrect because cerebrovascular accidents, cancers, and hypertension are not cognitive disorders. Option D is incorrect because these are losses of senses, not losses of mental abilities and processes.

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23. Which of the following pharmacological drug-related issues is the leading cause of hospitalization and death in the elderly?

1. Adverse drug reactions
2. Alcohol abuse
3. Illicit drug use
4. Substitution of generic drugs for brand name drugs

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Option A is correct because of the pharmacological drug-related issues listed; adverse drug reactions are the leading cause of hospitalization and death in the elderly. Option B is incorrect because alcohol abuse is not the leading cause of hospitalization and death in the elderly. Option C is incorrect because illicit drug use is not the leading cause of hospitalization and death in the elderly. Option D is incorrect because the substitution of generic drugs for brand name drugs is not the leading cause of hospitalization and death in the elderly.

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Competency 008—The teacher understands foundations and therapeutic concepts of nutrition and social and cultural issues related to nutrition.

24. Which of the following would most likely be attributed to a diet that is high in processed foods, contains large amounts of trans fats, and is low in fiber?

1. Osteoporosis
2. Scurvy
3. Diabetes
4. Anemia

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Option C is correct because a diet that is high in processed foods, contains large amounts of trans fats, and is low in fiber leads to diabetes. Option A is incorrect because osteoporosis happens because of a lack of calcium in the diet. Option B is incorrect because a vitamin C deficiency causes scurvy. Option D is incorrect because an iron deficiency causes anemia.

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25. Information about which of the following is available on the Nutrition Facts label?

1. Total fats and cholesterol
2. Product ingredients and allergens
3. Net weight and company producing the product
4. Refrigeration status and expiration date

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Option A is correct because this information is available on the Nutrition Facts label. Option B is incorrect because allergens are not included on the Nutrition Facts label. Option C is incorrect because the company producing the product is not included on the Nutrition Facts label. Option D is incorrect because refrigeration status is not included on the Nutrition Facts label.

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26. Which of the following includes only substances needed to calculate the amount of carbohydrates on a food label?

1. Cholesterol and calories
2. Sodium and vitamins
3. Fat and protein
4. Fiber and sugars

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Option D is correct because these carbohydrates combined are used to calculate total carbohydrate on a food label. Option A is incorrect because cholesterol and calories are not the total carbohydrate on a food label. Option B is incorrect because sodium and vitamins are not carbohydrates. Option C is incorrect because fat and protein are not carbohydrates.

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27. Which of the following is an important clinical aspect of binge eating disorder?

1. Electrolyte imbalances
2. Use of laxatives or diuretics
3. Intense fear of gaining weight
4. Eating large amounts of food at one sitting

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Option D is correct because eating large amounts of food at one sitting is an important clinical aspect of binge eating disorder. Option A is incorrect because electrolyte imbalances are common to anorexia nervosa. Option B is incorrect because use of laxatives is usually associated with bulimia nervosa. Option C is incorrect because an intense fear of gaining weight is associated with anorexia nervosa.

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28. Which THREE of the following food items would most likely cause discomfort for a patient who suffers from severe ulcerative colitis (inflammatory bowel disease)?

1. Whole milk
2. Peppered steak
3. Potatoes
4. Fried fish

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Options A, B, and D are correct because dairy, meat and especially spicy meat, and fried fish can trigger flares. Option C is incorrect because potatoes are least likely to trigger flares.

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Competency 009—The teacher understands the concepts of and the technology used in pharmacology.

29. Which of the following methods of drug administration has the most immediate effect on the central nervous system?

1. Oral
2. Sublingual
3. Intravenous
4. Topical

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Option C is correct because intravenous (IV) drug use, in which the drug is injected directly into a vein and enters the bloodstream to reach the brain, has the most immediate effect on the central nervous system (CNS). Option A is incorrect because although oral administration is the most convenient, safest, and least expensive, it does not have the most immediate effect on the CNS. Option B is incorrect because sublingual administration involves placing a drug under the tongue to dissolve and be absorbed into the blood through the tissue there; it does not have the most immediate effect on the CNS. Option D is incorrect because topical administration involves medication that is applied to a particular place on or in the body; it does not have the most immediate effect on the CNS.

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30. A health science teacher shares a scenario in which an individual with a blood clot (deep vein thrombosis) is taking a blood-thinning medication. The teacher explains that the individual should not be asked to take aspirin primarily due to the risk of which of the following?

1. Relative contraindication
2. Absolute contraindication
3. Relative standards
4. Absolute standards

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Option A is correct because relative contraindication means that caution should be used when two drugs or procedures are used together. While the combination of a blood thinner and aspirin would not cause a life-threatening situation, there is some risk to the individual involved, but it is acceptable because the benefits outweigh the risk. Option B is incorrect because absolute contraindication means that event or substance could cause a life-threatening situation. The combination of a blood thinner and aspirin would not cause a life-threatening situation. Option C is incorrect because a relative standard is a norm-referenced standard that would not apply to a drug interaction. Option D is incorrect because an absolute standard is a norm-referenced standard that would not apply to a drug interaction.

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Competency 010—The teacher understands the concepts of, and social and cultural issues related to, mental health.

31. Which of the following is a symptom of the human body reacting to stress?

1. Healing of open wounds is slower
2. Hearing a ringing in the ears
3. Aching pain due to tense muscles
4. Having increased sexual desire or ability

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Option C is correct because aches, pains, and tense muscles are physical symptoms of stress. Option A is incorrect because slow healing of open wounds is not a result of stress but could indicate another serious medical condition. Option B is incorrect because ringing in the ears is not a physical symptom of stress but can indicate another medical condition. Option D is incorrect because increased sexual desire or ability is not a physical symptom of stress. A lack of sexual desire or ability is a physical symptom of stress.

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32. A 22-year-old patient shows a recent change in personality, has a distorted perception of reality, and experiences disorganized thinking and speech but does not have any other physical symptoms. The patient most likely displays symptoms of which of the following disorders?

1. Schizophrenia
2. Dissociative identity disorder
3. Major depressive disorder
4. Antisocial personality disorder

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Option A is correct because most people are diagnosed with schizophrenia in their late teens to early 30s. Someone with schizophrenia may have a recent change in personality, have difficulty distinguishing between what is real and what is imaginary, be unresponsive or withdrawn, and have difficulty expressing normal emotions in social situations. A medical or mental health professional may use these symptoms to diagnose a patient with schizophrenia. Option B is incorrect because dissociative identity disorder is when the patient has two or more distinct personalities that alternate with one another. Option C is incorrect because patients with major depressive disorder or clinical depression generally have low self-esteem, inescapable and ongoing low mood, and a loss of interest or pleasure in activities that were once enjoyable. Option D is incorrect because patients with antisocial personality disorder are impulsive, irresponsible, and callous, often acting out their conflicts and ignoring normal rules of social behavior.

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33. A patient in the ER experiences numbness and weakness in her right arm and slurred speech. After several hours, she recovers fully and has normal arm strength and speech patterns. Based on the symptoms the patient was experiencing, which of the following is the most likely diagnosis?

1. Stroke
2. Epileptic seizure
3. Cerebral aneurysm
4. Transient ischemic attack

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Option D is correct because these are symptoms of transient ischemic heart attack. Option A is incorrect because these are not symptoms of stroke because they only lasted for a few hours and the patient recovered fully. Option B is incorrect because these are not symptoms of epileptic seizure particularly because a seizure will not affect just one arm and speech only. Option C is incorrect because these are not symptoms of cerebral aneurysm, which typically is severe, and recovery will not be so quick.

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Competency 011—The teacher understands the fundamentals of wellness and disease prevention and the importance of preventive health behaviors.

34. Which of the following lifestyle choices is the largest contributor to death from preventable reasons in the United States?

1. Drinking alcohol in excess
2. Consuming a high-fat diet
3. Smoking cigarettes
4. Driving recklessly

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Option C is correct because cigarette smoking is the largest preventable contributor to death in the United States. Option A is incorrect because drinking alcohol causes fewer deaths per year than several other preventable contributors such as HIV, illegal drug use, vehicle accidents, and firearm accidents combined. Option B is incorrect because consuming a high-fat diet, in and of itself, is not a cause of preventable deaths in the United States. A high-fat diet is considered unhealthy when combined with a diet high in carbohydrates and sugar. Additionally, there are several fats that are considered healthy for bodily function and health. The type of fats consumed should also be evaluated. Option D is incorrect because motor vehicle accidents cause fewer deaths per year than several other preventable contributors such as HIV, illegal drug use, alcohol use, and firearm accidents combined.

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35. Which of the following levels of Maslow’s hierarchy of needs primarily deals with prestige and a feeling of accomplishment?

1. Self-actualization
2. Esteem needs
3. Belonging and love needs
4. Safety needs

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Option B is correct because Maslow’s level of esteem needs deals with psychological needs such as prestige and a feeling of accomplishment. Option A is incorrect because self-actualization refers to achieving one’s full potential, including creative activities. Option C is incorrect because belonging and love needs refer to intimate relationships and friends. Option D is incorrect because safety needs refer to basic needs, which include security and safety.

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Competency 012—The teacher understands the skills and roles of health care workers and the functions of the diagnostic, therapeutic, informational and environmental systems of health care.

36. One of a nurse’s functions is to understand the various ways to assist a patient with mobility difficulties. Which of the following pieces of equipment is used to allow the patient to pull his or her upper extremities to raise the trunk off the bed to assist in transferring the patient from the bed to a wheelchair?

1. Footboard
2. Trapeze bar
3. Transfer belt
4. Trochanter roll

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Option B is correct because trapeze bars are an important patient room accessory designed to help patients change positions while in bed, and aid in the transfer from bed to chairs with minimum attendant assistance. Option A is incorrect because footboards keep sheets and blankets from touching and rubbing a patients’ legs or feet, keep their feet in proper position while they are in bed, and help with air circulation but are not an aid for transferring patients from bed to wheelchair. Option C is incorrect because a transfer belt is secured around the waist to allow a nurse to grasp the gait belt to lift or move a weak patient, such as from a bed to a chair. Option D is incorrect because trochanter rolls are used to prevent a patient’s legs from turning outward.

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37. A 45-year-old patient has a respiratory rate of 25 breaths per minute and a pulse rate of 123 beats per minute. Which of the following terms correctly describes this condition?

1. Bradypnea and tachycardia
2. Tachypnea and tachycardia
3. Tachypnea and bradycardia
4. Bradypnea and bradycardia

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Option B is correct because it describes fast breathing rate and fast pulse rate. Option A is incorrect because it describes slow breathing rate and fast pulse rate. Option C is incorrect because it describes fast breathing rate and slow pulse rate. Option D is incorrect because it describes slow breathing rate and slow pulse rate.

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38. Which of the following is a key component of the Health Insurance Portability and Accountability Act (HIPAA)?

1. A patient can ask for an in-law’s health records.
2. A physician can give a patient’s health information to his or her employer.
3. A patient has the right to ask for and get a copy of his or her health records.
4. A physician can share private notes about a patient’s health care.

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Option C is correct because the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule gives a patient, with few exceptions, the right to inspect, review, and receive a copy of his or her medical records and billing records that are held by health plans and health care providers covered by the Privacy Rule. Option A is incorrect because a patient cannot ask for an in-law’s health records; the in-law must give permission. Option B is incorrect because a physician cannot give a patient’s health information to his or her employer. Option D is incorrect because a physician cannot share private notes about a patient’s health care with anyone.

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Competency 013—The teacher understands the importance of maintaining a safe environment and knows the roles of regulatory agencies, including safety policies, procedures and standard precautions, as they relate to health care workers and controlling the spread of infection.

39. Handling chemicals and hazardous materials involves following procedures for both general use and for specific chemical hazard groups. Which of the following handling procedures best describes a generic protocol to follow when handling chemicals?

1. Using safety rubber bottle carriers or nonbreakable bottles for the transport of strong acids and bases
2. Working with a peer in the laboratory and correctly labeling all used containers
3. Storing the smallest possible amounts of toxic chemicals in established areas
4. Ensuring that flammable liquids are stored only in containers that exceed one-quart capacity for purity

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Option B is correct because a general protocol for all situations is to ensure proper labeling of all chemicals, containers, and materials used in a laboratory. It is also best to work in a laboratory with another person when handling any chemicals. Option A is incorrect because using rubber carriers or nonbreakable bottles to transport chemicals is a specific protocol for handling corrosive materials. Option C is incorrect because using designated storage space for chemicals in the smallest amount possible is a specific protocol for handling toxins. Option D is incorrect because storing chemicals in glass containers and keeping the amount stored at less than a quart to maintain purity is a specific protocol for carcinogens and highly toxic chemicals.

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40. Which of the following elements of the cycle of infection primarily includes direct physical contact or contact with body fluids?

1. Infectious agent
2. Reservoir
3. Portal of exit
4. Transmission

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Option D is correct because transmission is how germs are spread, including physical contact with bodily fluids. Option A is incorrect because the infectious agent refers to actual germs that can cause illness. Option B is incorrect because the reservoir is where germs normally live and multiply. Option C is incorrect because the portal of exit is how germs leave the body.

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41. Which THREE of the following are recommended safety practices in the laboratory?

1. Tying back hair
2. Wearing goggles
3. Wearing open-toed shoes
4. Wearing protective mittens when handling hot containers

AnswerEnter to expand or collapse answer.Answer expanded

Options A, B, and D are correct because long dangling hair may be a laboratory hazard; one should always protect eyes and one should wear protective mittens when handling hot glassware. Option C is incorrect because open-toed shoes do not protect feet.

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Domain IV—Professional Responsibilities

Competency 014—The teacher communicates appropriately in medical environments and understands the importance of teaming and leadership skills and of developing partnerships within the health care community.

42. According to the National Institute of Health (NIH), one of the behaviors of a team member is to clearly communicate parameters of delegated responsibility, including decision-making authority and required actions or deadlines. This statement best describes which of the following behaviors?

1. Innovation
2. Adaptability
3. Collaboration
4. Accountability

AnswerEnter to expand or collapse answer.Answer expanded

Option D is correct because accountability can be described as clearly communicating parameters of delegated responsibility. Option A is incorrect because innovation can be described as exploring new ideas. Option B is incorrect because adaptability can be described as understanding changes in work tasks. Option C is incorrect because collaboration can be described as working together, especially in a joint intellectual effort.

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43. Which of the following lists correctly identifies the key characteristics that cohesive health care teams should exhibit?

1. Clear goals with measurable outcomes, effective communication, and informed knowledge of pharmacology
2. Training of all team members, effective communication, and a clear concept of chronic care
3. Effective communication, understanding of insurance premiums, and clear goals with measurable outcomes
4. Training of all team members, effective communication, and clear goals with measurable outcomes

AnswerEnter to expand or collapse answer.Answer expanded

Option D is correct because it describes three key characteristics that cohesive health care teams should exhibit. Option A is incorrect because an informed knowledge of pharmacology is not a key characteristic. Option B is incorrect because a clear concept of chronic care is not a key characteristic. Option C is incorrect because understanding of insurance premiums is not a key characteristic.

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44. According to the National Institutes of Health (NIH) job competencies, expected responsibilities of a team member are to explore new ideas, methodologies, different positions, and alternatives to reach good outcomes.

These responsibilities best describe which of the following?

1. Innovation
2. Adaptability
3. Collaboration
4. Accountability

AnswerEnter to expand or collapse answer.Answer expanded

Option A is correct because innovation is an NIH job competency that involves a team member exploring new ideas, methodologies, different positions, and alternatives to reach outcomes. Option B is incorrect because adaptability is an NIH job competency that involves a team member understanding changes in work tasks, situations, and environment as well as the basis for change. Option C is incorrect because collaboration is an NIH job competency that involves a team member maintaining positive and productive relationships and working with others to share information and achieve goals. Option D is incorrect because accountability is an NIH job competency that involves a team member accepting responsibility for positive and negative outcomes of work.

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Competency 015—The teacher prepares students for successful careers in the health care industry and understands the importance of lifelong learning and continuing professional development.

45. Which THREE of the following are personal characteristics health-care workers should display to be most effective in their profession?

1. Empathetic
2. Polite
3. Resourceful
4. A follower

AnswerEnter to expand or collapse answer.Answer expanded

Options A, B, and C are correct because a health-care worker must be empathetic, a health-care worker must be polite, and a health-care worker must be resourceful. Option D is incorrect because a health-care worker should not be a follower.

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46. Which THREE of the following provide professional development opportunities related to health care?

1. Donor agencies
2. Nongovernmental organizations
3. Academic institutions
4. Consumer organizations

AnswerEnter to expand or collapse answer.Answer expanded

Options B, C, and D are correct because non-governmental organizations may be involved in health care and provide professional development, academic institutions provide professional development, and consumer organizations related to health care also provide opportunities for professional development. Option A is incorrect because donor agencies do not have anything to do with health care.

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47. Which THREE of the following are advantages of participating in continuous professional development opportunities related to health care?

1. It encourages reflective practice.
2. It allows a person to acquire new skills for a safe and effective practice.
3. It allows a hospital administrator greater opportunity to transfer staff.
4. It provides different types of formal and informal learning opportunities and support.

AnswerEnter to expand or collapse answer.Answer expanded

Options A, B, and D are correct because continuing professional development is an essential component of successful health care systems. The systematic and ongoing provision of opportunities to engage in reflective practice, enhance or acquire new professional skills, knowledge, and attitudes, and participate in different types of formal and informal learning opportunities can lead to improved health care experiences and health outcomes for the community. Option C is incorrect because the goal of continuing professional development is to retain staff and increase their knowledge and skill set.

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Competency 016—The teacher understands the ethical and legal responsibilities of health care workers.

48. Which of the following did Congress pass in 1996 that mandated both privacy and security regulations in the health care industry?

1. The Health Insurance Portability and Accountability Act (HIPAA)
2. The Affordable Care Act (ACA)
3. The Wagner National Health Act (WNHA)
4. The McCarran-Ferguson Act (MFA)

AnswerEnter to expand or collapse answer.Answer expanded

Option A is correct because the HIPAA mandated privacy and security regulations. Option B is incorrect because the ACA gives people the flexibility to make informed choices about healthcare. Option C is incorrect because the WNHA gave general support for a national health program to be funded by federal grants. Option D is incorrect because the MFA exempts the insurance from corporations from most federal regulations.

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49. An increase in malpractice premiums would most likely influence which THREE of the following decisions by a physician?

1. Decisions about where to locate the medical practice
2. Degree of professional development
3. Selection of insurance company
4. Charge for treatments to patients

AnswerEnter to expand or collapse answer.Answer expanded

Options A, C, and D are correct because an increase in malpractice premiums would most likely influence a physician’s decisions about where to locate his or her medical practice, the choice of insurance companies, and what the physician would charge for treatments to patients. Option B is incorrect because an increase in malpractice premiums would most likely not influence a physician’s amount of professional development.

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50. Which of the following is necessary for a medical power of attorney or health care proxy to begin making health care choices for a patient?

1. The requirements depend on the particular laws of the state in which the patient resides.
2. At least one physician must determine that the patient is unable to communicate effectively or make health care decisions independently.
3. At least two physicians must determine that the patient is unable to communicate effectively or make health care decisions independently.
4. The physician and the family members must agree that the patient is unable to communicate effectively or make health care decisions independently.

AnswerEnter to expand or collapse answer.Answer expanded

Option A is correct because the laws for a medical power of attorney or health care proxy vary from state to state. It depends on the particular state laws where the patient resides as to how the law is applied. Options B and C are incorrect because although a doctor or psychologist or advanced practice nurse working with a doctor will generally make the determination if an individual is unable to communicate effectively or make health care decisions independently, the law varies from state to state. Option D is incorrect because the physician and family members do not have to agree that the patient is unable to communicate effectively or make health care decisions independently.

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