Safety, Compliance, and Coordinated Patient Care practice questions

Answer: C) After each patient use, before the next patient is connected

EKG lead wires and clips are noncritical items. When they are shared, CDC guidance says to clean and disinfect them before use on another patient, using low-level disinfection.

• AIncorrect. Equipment that looks clean can still carry pathogens. Shared noncritical equipment must be cleaned and disinfected before every use on another patient, not only when it is visibly soiled.
• BIncorrect. Cleaning only once per shift would let several patients share contaminated equipment in between, which allows cross-contamination.
• CCorrect. CDC says that when noncritical equipment must be shared, it should be cleaned and disinfected (low-level disinfection with an EPA-registered disinfectant) before use on another patient.
• DIncorrect. Under standard precautions, every patient is treated as potentially infectious. Shared equipment is disinfected between all patients, not only those on isolation precautions.

Answer: A) Chest pain

• ACorrect. These are signs of an adverse reaction.
• BIncorrect. This is expected with exercise.
• CIncorrect. This is expected.
• DIncorrect. This alone may not end the test.

Answer: A) It is safe; the electrodes only pick up the heart's own electrical signals, and nothing is sent into the body.

An EKG only records the heart's own electrical activity. It sends no electricity or radiation into the body and has no known risks, so it is safe throughout pregnancy.

• ACorrect. An EKG is a passive recording. The electrodes detect the heart's natural electrical activity, no electricity is sent through the body, and the test has no known risks, including during pregnancy.
• BIncorrect. An EKG sends no current into the body, so there is no trimester-based restriction. It is safe at any stage of pregnancy.
• CIncorrect. An EKG uses no radiation. It only records electrical signals, so there is no reason to delay an ordered test because of pregnancy.
• DIncorrect. No recording current is applied, and leaving off the chest leads would give an incomplete 12-lead EKG. The standard lead placement is used.

Answer: C) Inform the provider immediately and perform a 12-lead EKG without delay

Active chest pressure is a possible heart attack and needs urgent care. The technician should tell the provider immediately and get a 12-lead EKG right away instead of continuing routine workflow.

• AIncorrect. Ongoing chest pain may signal a heart attack. Leaving it in a note for later review delays care the patient may need urgently.
• BIncorrect. Ongoing chest pressure is a possible emergency. The patient should not be left unmonitored while waiting for the provider.
• CCorrect. Pressure-like chest pain that is still present may mean a heart attack. The provider must know at once, and a 12-lead EKG gives the information needed to decide on treatment.
• DIncorrect. Recommending medication is outside the technician's scope, and waiting could mask or delay treatment of a heart attack.

Answer: A) Prompt the coworker to clean their hands and follow facility policy for reporting the lapse

Hand hygiene is required immediately after glove removal. A technician who sees a lapse should prompt the coworker right away and follow facility reporting policy, not excuse it, delay, or go around proper channels.

• ACorrect. CDC calls for hand hygiene immediately after removing gloves. Addressing the lapse right away and using facility reporting channels protects patients.
• BIncorrect. Gloves do not replace hand hygiene. CDC specifically lists the moment right after glove removal as a time to clean hands.
• CIncorrect. Waiting leaves the next patient at risk now. A single lapse should be addressed when it happens.
• DIncorrect. This bypasses proper channels and does not fix the lapse. Raising it with the coworker and following facility policy are the appropriate steps.

Answer: B) Have the facility arrange a qualified sign language interpreter

For a non-emergency test, the facility must provide a qualified interpreter. ADA rules bar relying on a minor child to interpret and bar requiring the patient to bring their own interpreter.

• AIncorrect. Under ADA rules, a facility may not rely on a minor child to interpret except in an emergency with an imminent threat to safety or welfare when no interpreter is available. A routine EKG is not that situation.
• BCorrect. The facility must provide auxiliary aids and services, such as a qualified interpreter, so communication with the patient is effective.
• CIncorrect. ADA rules prohibit requiring a person with a disability to bring someone else to interpret. Providing the interpreter is the facility's responsibility.
• DIncorrect. For a patient whose primary language is ASL, this does not reliably achieve the effective communication the regulation requires for consent and instructions.

Answer: A) Offer a facemask and tissues, provide hand hygiene supplies, and encourage sitting away from others

Respiratory hygiene/cough etiquette means giving symptomatic patients a facemask and tissues, making hand hygiene supplies available, and seating them away from others when possible.

• ACorrect. CDC guidance says to give facemasks to patients with respiratory symptoms, make hand hygiene supplies available, provide tissues, and encourage symptomatic patients to sit as far from others as possible.
• BIncorrect. This may ease the patient's comfort, but it does nothing to contain respiratory secretions. Seating the patient near the busy reception area increases other people's exposure.
• CIncorrect. Coughing into bare hands contaminates the hands and surfaces. CDC guidance calls for a facemask or tissues, hand hygiene, and distance from others.
• DIncorrect. CDC recommends facemasks for anyone with signs or symptoms of a respiratory infection, such as a cough. A confirmed diagnosis is not required.

Answer: C) Those with external pacing wires or certain catheters

• AIncorrect. That doesn't increase risk.
• BIncorrect. Their risk is very low.
• CCorrect. Current can reach the heart directly.
• DIncorrect. That isn't the main concern.

Answer: A) Stop the test, steady the patient safely, and notify the provider right away

Dizziness or unsteadiness during exercise testing is a reason to stop the test early. The technician should stop safely, protect the patient from falling, and notify the provider.

• ACorrect. Dizziness is one of the symptoms that calls for stopping a stress test early. The patient must be protected from falling, and the provider must evaluate them.
• BIncorrect. Lowering the workload while continuing the test does not deal with a symptom that requires stopping. The provider needs to be told now.
• CIncorrect. Holding the rails does not make it safe to keep going while dizzy. The test should be stopped, not finished.
• DIncorrect. Dizziness is not a normal sign that the target is close. It is a symptom that calls for stopping the test early.

Answer: B) Withhold the test, notify the provider, and document the patient's refusal

A competent patient has the right to refuse an EKG. The technician respects the refusal, notifies the provider, and documents it.

• AIncorrect. A provider's order does not override a competent patient's refusal. Doing the test anyway violates the patient's right to refuse.
• BCorrect. A competent patient may refuse a test. The technician respects the decision, informs the ordering provider, and documents the refusal.
• CIncorrect. Substitute consent applies only when a patient cannot make decisions. A competent adult's own refusal stands.
• DIncorrect. The ordering provider must be told so they can address the patient's concerns or change the plan of care. Documenting alone is not enough.