A medical assistant should recognize that which of the following procedures is usually performed by a registered nurse?
Administering IV medication
Performing a heel stick on an infant
Drawing blood for a glucose tolerance test
Performing venipuncture with a winged collection device
The Correct Answer is A
A. Administering IV medication: Administering intravenous (IV) medication is typically within the scope of practice for registered nurses (RNs) due to the complexity and need for careful monitoring.
B. Performing a heel stick on an infant: This procedure is often performed by medical assistants, especially in a pediatric setting, as it is part of routine blood collection practices.
C. Drawing blood for a glucose tolerance test: Medical assistants are usually trained to perform blood draws, including for glucose tolerance tests.
D. Performing venipuncture with a winged collection device: Medical assistants are generally trained to perform venipunctures, including using winged collection devices (butterfly needles)
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Correct Answer is B
Explanation
A. Perform orthostatic blood pressure. Orthostatic blood pressure measurements are used to assess changes in blood pressure when a patient moves from lying down to standing, not in response to emotional upset.
B. Recheck the blood pressure after a few minutes. This is the correct action, as the initial elevated reading could be due to the patient's emotional state. Waiting a few minutes and rechecking can provide a more accurate reading.
C. Measure blood pressure at the wrist. Wrist blood pressure readings are less accurate than those taken at the upper arm and are not recommended in this scenario.
D. Use the palpatory method for blood pressure. The palpatory method is used when auscultation is difficult, but it does not address the issue of an elevated reading due to emotional upset.
Correct Answer is A
Explanation
A. Deflate the cuff slowly until the last sound is heard. The diastolic reading is determined when the last sound (Korotkoff sound) is heard as the cuff is deflated.
B. Listen for the first sound through the stethoscope: The first sound corresponds to the systolic reading, not the diastolic.
C. Document the reading when the gauge needle jumps: The gauge needle jump is not a reliable indicator of blood pressure readings.
D. Inflate the cuff to at least 180 mm Hg, deflate the cuff slowly, and listen for the first sound: Inflating to 180 mm Hg is unnecessary and might cause discomfort; also, the first sound is the systolic reading, not the diastolic.