CSLB General Building (B) — All Questions

A patient care technician counts a resting adult patient's radial pulse and gets 78 beats per minute. How should this finding be classified?

• a.Bradycardia requiring immediate provider notification
• b.Tachycardia requiring immediate provider notification
• c.Within the normal adult range of 60-100 beats per minute✓
• d.Below normal, indicating possible shock

The normal resting heart rate for an adult is 60 to 100 beats per minute, so 78 bpm is normal. Bradycardia is a rate below 60 bpm and tachycardia is a rate above 100 bpm. No urgent notification is needed for a normal reading.

What is the normal respiratory rate range for a resting adult?

• a.6 to 10 breaths per minute
• b.12 to 20 breaths per minute✓
• c.24 to 30 breaths per minute
• d.30 to 40 breaths per minute

A normal adult resting respiratory rate is 12 to 20 breaths per minute. Rates below 12 indicate bradypnea and rates above 20 indicate tachypnea. Count respirations for a full minute for the most accurate result when the rate is irregular.

According to widely accepted guidelines, a normal adult blood pressure reading is closest to which value?

• a.Less than 120/80 mmHg✓
• b.140/90 mmHg
• c.160/100 mmHg
• d.90/50 mmHg

A normal adult blood pressure is a systolic reading below 120 mmHg and a diastolic reading below 80 mmHg. Readings of 130/80 mmHg or higher are classified as hypertension. Consistently low readings such as 90/50 may indicate hypotension.

A technician takes an oral temperature and records 98.6°F. Which statement about this reading is correct?

• a.It indicates a low-grade fever
• b.It is below normal and suggests hypothermia
• c.Oral temperature is always 1 degree higher than rectal
• d.It is the accepted normal average oral body temperature✓

98.6°F (37°C) is the accepted average normal oral body temperature. Rectal temperatures typically run about 1°F higher than oral, and axillary temperatures run about 1°F lower. A fever is generally defined as an oral temperature of 100.4°F or higher.

A technician is checking a patient for orthostatic hypotension. After measuring blood pressure while the patient is lying down, what is the correct next step?

• a.Measure the pulse only, not the pressure
• b.Have the patient stand or sit and re-measure blood pressure and pulse✓
• c.Give the patient fluids before any further readings
• d.Wait 30 minutes before the next reading

Orthostatic (postural) vital signs are taken by measuring blood pressure and pulse in the lying position, then again after the patient sits or stands. A drop of 20 mmHg systolic or 10 mmHg diastolic, or a rise in pulse of 20 bpm, suggests orthostatic hypotension. Guard the patient against falling during the position change.

A pulse oximeter reads 97% on room air for a stable adult. How should the technician interpret this value?

• a.Critically low, apply oxygen immediately
• b.Abnormally high, remove the sensor
• c.Within the normal range of 95-100%✓
• d.Normal only for patients receiving oxygen

A normal oxygen saturation (SpO2) for a healthy adult on room air is 95% to 100%. Readings below 90% generally indicate hypoxemia and require prompt attention. Cold fingers, nail polish, and poor perfusion can produce falsely low readings.

A patient with difficulty breathing is most likely to be positioned in which way to ease respiration?

• a.High-Fowler's position with the head of the bed raised 60-90 degrees✓
• b.Flat supine with no pillow
• c.Prone with the face turned to the side
• d.Trendelenburg with the head lower than the feet

High-Fowler's position raises the head of the bed 60 to 90 degrees, which allows the diaphragm to drop and the lungs to expand, easing breathing. Lying flat or in Trendelenburg increases pressure on the diaphragm and worsens dyspnea. Semi-Fowler's (30-45 degrees) is a milder alternative.

Before transferring a weak but weight-bearing patient from bed to a wheelchair, the technician applies a gait belt. Where should the belt be positioned?

• a.Loosely around the neck
• b.High under the armpits
• c.Snugly around the patient's waist over clothing✓
• d.Around the patient's thighs

A gait belt (transfer belt) is applied snugly around the patient's waist over clothing so the technician can grasp it and control the transfer. It should never be placed under the arms or around the neck, which can cause injury. The technician grasps the belt with an underhand grip during the transfer.

A technician is assisting a patient to ambulate with a cane. On which side should the patient hold the cane?

• a.On the weaker side
• b.In whichever hand feels comfortable
• c.Directly in front of the body
• d.On the stronger side, opposite the weak leg✓

A cane is held on the strong side of the body, opposite the affected or weaker leg. The cane and the weak leg move forward together, providing support to the injured side. This creates a wider, more stable base of support during walking.

When providing oral care to an unconscious patient, which action best prevents aspiration?

• a.Pour a full cup of water into the mouth to rinse
• b.Position the patient in a side-lying position with the head turned to the side✓
• c.Lay the patient flat on the back during care
• d.Use large amounts of toothpaste and foam

An unconscious patient cannot protect the airway, so oral care is given with the patient in a side-lying position with the head turned to the side. This allows fluids to drain out of the mouth rather than pooling in the throat. Use only small amounts of moisture and suction as needed to prevent aspiration.

When performing perineal care on a female patient, in which direction should the technician cleanse?

• a.From front to back, away from the urethra✓
• b.From back to front, toward the urethra
• c.In a circular scrubbing motion
• d.From side to side repeatedly with the same cloth

Perineal care on a female patient is performed front to back, moving away from the urethra toward the rectum. This prevents transferring bacteria from the anal area to the urethra, reducing the risk of urinary tract infection. A clean section of the washcloth is used with each stroke.

A technician is measuring fluid intake and output (I&O). Which of the following is counted as output?

• a.Gelatin eaten at lunch
• b.Water consumed with medications
• c.Intravenous fluids infused
• d.Urine and emesis (vomit)✓

Output includes measurable fluids leaving the body such as urine, emesis, liquid stool, and wound drainage. Intake includes oral fluids, IV fluids, and foods that are liquid at room temperature like gelatin and ice cream. Accurate I&O helps monitor a patient's fluid balance.

A patient drank 240 mL of juice, 120 mL of water, and a 180 mL cup of broth. What is the total recorded intake?

• a.360 mL
• b.420 mL
• c.540 mL✓
• d.600 mL

Adding the fluids: 240 + 120 + 180 = 540 mL. Broth is a liquid and is counted as intake. Accurate addition of all consumed fluids is essential for reliable I&O documentation.

To reduce the risk of catheter-associated urinary tract infection, how should the technician position the urinary drainage bag?

• a.On the bed next to the patient
• b.Below the level of the bladder at all times✓
• c.Hooked to the upper side rail
• d.At the same height as the bladder

The urinary drainage bag is kept below the level of the bladder so urine flows down and away by gravity, preventing backflow into the bladder. The bag should never touch the floor or be raised above the bladder. Keeping the tubing free of kinks also promotes proper drainage.

A bedbound patient is at risk for pressure injuries. How often should the technician typically reposition the patient?

• a.Once per shift
• b.Every 6 hours
• c.At least every 2 hours✓
• d.Only when the patient asks

Repositioning an immobile patient at least every 2 hours relieves prolonged pressure over bony prominences and helps prevent pressure injuries. A turning schedule and pressure-relieving surfaces support skin integrity. Frequently at-risk areas include the sacrum, heels, and hips.

A technician notices an area of intact skin over the sacrum that is reddened and does not blanch (turn white) when pressed. This finding is most consistent with which stage of pressure injury?

• a.Stage 1✓
• b.Stage 3
• c.Stage 4
• d.Unstageable

A Stage 1 pressure injury is intact skin with non-blanchable redness, usually over a bony prominence. In darker skin, it may appear as a change in color or temperature rather than redness. It should be reported and pressure relieved immediately to prevent progression.

While assisting with a dressing change, a technician observes that the patient's wound has increased redness, warmth, swelling, and yellow-green drainage with odor. What is the most appropriate action?

• a.Cover it and say nothing since drainage is expected
• b.Cleanse the wound with alcohol independently
• c.Apply a heating pad to the area
• d.Report the findings to the nurse, as they suggest possible infection✓

Increased redness, warmth, swelling, purulent (yellow-green) drainage, and odor are classic signs of a wound infection. The technician should report these observations promptly to the nurse for assessment. Wound assessment and treatment decisions are outside the technician's scope of practice.

Restorative care focuses primarily on which goal for the patient?

• a.Completing all tasks for the patient to save time
• b.Helping the patient regain and maintain the highest possible level of independence✓
• c.Keeping the patient in bed to prevent injury
• d.Discouraging self-care to avoid fatigue

Restorative care promotes the patient's independence and self-care by encouraging them to do as much as they safely can. The goal is to restore or maintain function, mobility, and dignity. Doing everything for a capable patient promotes dependence and deconditioning.

A technician performs passive range-of-motion (ROM) exercises on a patient who cannot move a joint independently. What defines this type of exercise?

• a.The patient moves the joint without any help
• b.The joint is moved rapidly past the point of resistance
• c.The technician moves the joint for the patient through its normal range✓
• d.Weights are added to increase resistance

Passive ROM is performed by the technician moving the patient's joint through its normal range because the patient cannot do so independently. The movements are slow, gentle, and stopped at the point of pain or resistance. Passive ROM helps prevent contractures and maintains joint mobility.

When feeding a patient who has had a stroke with left-sided weakness, which action promotes safe swallowing?

• a.Place food on the stronger (right) side of the mouth and keep the patient sitting upright✓
• b.Feed rapidly to finish before the patient tires
• c.Have the patient lie flat while eating
• d.Tilt the head back to help food go down

Placing food on the unaffected (stronger) side of the mouth and keeping the patient upright at 90 degrees reduces pocketing of food and lowers aspiration risk. The patient should be given time to chew and swallow, and the chin should be slightly tucked, not tilted back. Tilting the head back opens the airway and increases aspiration risk.

Before assisting a patient into a tub bath, what is the safest water temperature range?

• a.About 120-130°F (very warm)
• b.About 100-105°F (comfortably warm)✓
• c.About 80-85°F (cool)
• d.Whatever temperature the patient prefers, without checking

Bath water should be about 100 to 105°F, comfortably warm but not hot enough to burn fragile skin. The technician should always check the temperature with a thermometer or the inner wrist before the patient enters. Older adults and those with reduced sensation are especially vulnerable to scald burns.

When making an occupied bed, which action best protects the technician's back and the patient's safety?

• a.Lower the bed to its lowest position and bend at the waist
• b.Keep the far side rail down while turning the patient
• c.Work alone regardless of the patient's size
• d.Raise the bed to hip height and keep the far side rail up while turning the patient✓

Raising the bed to hip height lets the technician work without bending the back, using proper body mechanics. Keeping the far side rail up while turning the patient prevents the patient from rolling off the bed. The bed is returned to its lowest position when care is complete.

Where is the apical pulse best auscultated with a stethoscope?

• a.Over the carotid artery in the neck
• b.At the wrist on the thumb side
• c.At the fifth intercostal space, left midclavicular line✓
• d.At the antecubital fossa of the arm

The apical pulse is heard over the apex of the heart, located at the fifth intercostal space at the left midclavicular line. It is counted for a full 60 seconds and is the most accurate site for patients with irregular rhythms. The carotid and radial sites are palpated, not auscultated for apical rate.

A technician palpates a patient's radial pulse and notes it is regular. For how long may the pulse be counted, and what is done with the result?

• a.Count for 30 seconds and multiply by 2✓
• b.Count for 10 seconds and multiply by 4
• c.Count for 15 seconds and multiply by 3
• d.Estimate without counting

A regular radial pulse may be counted for 30 seconds and multiplied by 2 to obtain the rate per minute. If the pulse is irregular, it must be counted for a full 60 seconds for accuracy. The radial pulse is palpated with the fingertips, never the thumb, which has its own pulse.

A patient states they feel dizzy and unsteady while walking in the hallway. What should the technician do first?

• a.Tell the patient to keep walking to the room
• b.Ease the patient to the floor or a nearby chair and stay with them✓
• c.Leave to get the nurse immediately
• d.Have the patient bend forward and keep moving

If a patient becomes dizzy or begins to fall, the technician should ease them to the floor or into a nearby chair using the gait belt while protecting the head, then stay with the patient and call for help. Attempting to hold the patient fully upright risks injury to both. Never leave an unsteady patient unattended.

The Sims' position is most commonly used for which purpose?

• a.Feeding a patient a meal
• b.Measuring blood pressure
• c.Promoting lung expansion
• d.Administering an enema or rectal care✓

Sims' position is a left side-lying position with the upper knee flexed toward the chest, used for enemas, rectal examinations, and rectal care. It provides access to the rectal area and follows the natural curve of the colon. Proper support with pillows keeps the patient comfortable and safe.

A patient lying flat on the back facing upward is in which position?

• a.Supine✓
• b.Prone
• c.Lateral
• d.Fowler's

Supine is lying flat on the back facing upward. Prone is lying on the abdomen facing downward, and lateral is side-lying. Knowing standard positioning terms ensures clear communication and correct patient care.

When a patient is in the lateral (side-lying) position, which bony areas require padding to prevent pressure injuries?

• a.The sacrum and heels
• b.The back of the head only
• c.The hip (greater trochanter), shoulder, and ankles✓
• d.The abdomen and chest

In the lateral position, pressure concentrates on the hip (greater trochanter), shoulder, ear, and ankles, so these areas need padding and protection. The sacrum and heels are more at risk in the supine position. Pillows placed between the knees and behind the back maintain alignment and offload pressure.

A patient with dysphagia (difficulty swallowing) is about to eat. Which position best reduces the risk of aspiration during and after the meal?

• a.Reclined at 30 degrees
• b.Upright at 90 degrees, remaining upright for at least 30 minutes after eating✓
• c.Flat on the back
• d.Lying on the left side

A patient with dysphagia should sit fully upright at 90 degrees to eat and remain upright for at least 30 minutes afterward. This uses gravity to help food and fluids pass safely and prevents reflux and aspiration. Thickened liquids and small bites may also be ordered by the care team.

A patient drank 4 ounces of water. How many milliliters should the technician record, knowing that 1 ounce equals approximately 30 mL?

• a.40 mL
• b.60 mL
• c.90 mL
• d.120 mL✓

Multiplying 4 ounces by 30 mL per ounce gives 120 mL. Converting household measures to milliliters ensures consistent I&O documentation. One ounce is roughly 30 mL, one cup (8 oz) is about 240 mL.

A patient's chart states 'NPO after midnight' for a scheduled procedure. In the morning the patient asks for water. What should the technician do?

• a.Withhold food and fluids and explain the patient is NPO, then notify the nurse of the request✓
• b.Give a small glass of water since it is only water
• c.Offer ice chips freely
• d.Provide a full breakfast

NPO means nothing by mouth, so the patient must not receive food or fluids, including water and ice chips, until cleared. The technician should explain the reason kindly and inform the nurse of the patient's request. Giving fluids could force cancellation of the procedure or cause aspiration during anesthesia.

A patient reports constipation. Which intervention, within the technician's role, generally supports normal bowel elimination?

• a.Restricting all fluids
• b.Encouraging prolonged bed rest
• c.Encouraging fluids, fiber-rich foods, and activity as allowed✓
• d.Discouraging any movement

Adequate fluid intake, fiber-rich foods, and physical activity promote normal bowel function and help relieve constipation. Immobility and dehydration worsen constipation. Any laxatives or enemas require an order and are given per facility policy.

To obtain the most accurate and consistent daily weight for a patient, the technician should weigh them:

• a.At different times each day after meals
• b.At the same time each day, ideally before breakfast, wearing similar clothing✓
• c.Only when the patient feels bloated
• d.Immediately after the patient drinks fluids

Daily weights should be taken at the same time each day, usually in the morning before breakfast, using the same scale and similar clothing. This consistency makes changes meaningful for tracking fluid balance and nutritional status. The patient should void before weighing when possible.

Before ambulating a patient who has been on bed rest, the technician has the patient sit on the edge of the bed and dangle the legs for a few minutes. What is the main purpose of dangling?

• a.To allow the body to adjust and prevent dizziness from orthostatic hypotension✓
• b.To measure the patient's height
• c.To warm the patient's feet
• d.To count the respiratory rate

Dangling lets the patient sit upright with the legs over the side of the bed so the cardiovascular system can adjust to the upright position. This helps prevent orthostatic hypotension and dizziness that can cause a fall. The technician assesses for lightheadedness before assisting the patient to stand.

According to CDC guidance, which practice is considered the single most effective way to prevent the spread of infection in healthcare settings?

• a.Wearing gloves at all times
• b.Using a face mask during all care
• c.Performing proper hand hygiene✓
• d.Wearing a gown for every patient

Hand hygiene is recognized by the CDC as the single most effective measure to prevent the spread of healthcare-associated infections. It should be performed before and after patient contact, after glove removal, and after touching contaminated surfaces. Gloves and gowns supplement, but never replace, hand hygiene.CDC

A technician has cared for a patient with Clostridioides difficile (C. diff), whose spores are not killed by alcohol. What is the correct hand hygiene method after this care?

• a.Alcohol-based hand rub only
• b.No hand hygiene is needed if gloves were worn
• c.A quick water rinse
• d.Wash hands with soap and running water✓

C. diff spores are resistant to alcohol-based hand rubs, so hands must be washed with soap and running water to physically remove them. The friction and rinsing action mechanically removes spores that alcohol cannot destroy. Alcohol rubs are appropriate for most other organisms when hands are not visibly soiled.CDC

Standard precautions are applied to which patients?

• a.All patients, regardless of diagnosis or infection status✓
• b.Only patients known to have an infection
• c.Only patients in isolation rooms
• d.Only patients who are bleeding

Standard precautions are used for the care of all patients at all times, treating blood and body fluids as potentially infectious. They include hand hygiene, appropriate PPE, and safe handling of sharps and contaminated equipment. Transmission-based precautions are added for specific known or suspected infections.CDC

A patient is placed on contact precautions for a multidrug-resistant organism. What PPE should the technician don before entering the room to provide direct care?

• a.N95 respirator only
• b.Gown and gloves✓
• c.Surgical mask and goggles only
• d.No PPE is required

Contact precautions require a gown and gloves for direct patient contact or contact with the patient's environment. This prevents transfer of organisms spread by touch, such as MRSA and VRE. Dedicated or disposable equipment is also used and cleaned between patients.CDC

Droplet precautions are used for organisms spread by respiratory droplets. How far do these large droplets typically travel?

• a.Up to 20 feet
• b.Through a building's ventilation system
• c.About 3 to 6 feet✓
• d.They do not travel through the air at all

Large respiratory droplets generally travel about 3 to 6 feet before falling, so droplet precautions require a surgical mask when within this distance of the patient. Examples include influenza and pertussis. Unlike airborne particles, droplets do not remain suspended in the air over long distances.CDC

A technician must enter the room of a patient with active pulmonary tuberculosis, which spreads by airborne transmission. Which respiratory protection is required?

• a.A standard surgical mask
• b.No mask if staying near the door
• c.A cloth face covering
• d.A fit-tested N95 respirator or higher✓

Airborne precautions for tuberculosis require a fit-tested N95 respirator or higher-level respirator because the tiny particles remain suspended in the air. The patient is placed in an airborne infection isolation (negative pressure) room with the door kept closed. A standard surgical mask does not filter these small airborne particles.CDC

What is the correct sequence for donning (putting on) personal protective equipment?

• a.Gown, mask/respirator, goggles/face shield, gloves✓
• b.Gloves, gown, mask, goggles
• c.Mask, gloves, gown, goggles
• d.Goggles, gloves, gown, mask

The correct donning order is gown first, then mask or respirator, then goggles or face shield, and finally gloves. Gloves are put on last so they cover the cuffs of the gown. Following this sequence ensures each item is properly positioned for protection.CDC

When doffing (removing) PPE after patient care, which item is generally removed first?

• a.The mask or respirator
• b.The gloves✓
• c.The goggles before anything else
• d.The gown before the gloves

Gloves are removed first during doffing because they are the most contaminated item. The typical order is gloves, then goggles or face shield, then gown, and finally the mask or respirator, which is removed last outside the room. Hand hygiene is performed immediately after removing all PPE.CDC

Under the OSHA Bloodborne Pathogens Standard, what is the correct way to handle a contaminated needle after use?

• a.Recap it by hand and set it aside
• b.Bend the needle before disposal
• c.Do not recap it, and dispose of it immediately in a puncture-resistant sharps container✓
• d.Place it in the regular trash

OSHA's Bloodborne Pathogens Standard prohibits recapping needles by hand and requires immediate disposal of contaminated sharps into a labeled, puncture-resistant, leak-proof sharps container. This prevents needlestick injuries and exposure to bloodborne pathogens such as HIV and hepatitis B. Bending or breaking needles is also prohibited.OSHA 29 CFR 1910.1030

A sharps container is about three-quarters full. What is the appropriate action?

• a.Push the contents down to make more room
• b.Continue filling it until it overflows
• c.Empty it into the regular trash and reuse it
• d.Close and replace it before it becomes overfilled✓

Sharps containers should be replaced when they reach the fill line, generally about two-thirds to three-quarters full, and never overfilled. Overfilling increases the risk of needlestick injury when adding or removing items. Containers must never be emptied by hand or reused, per OSHA requirements.OSHA 29 CFR 1910.1030

Using proper body mechanics, how should a technician lift a heavy object from the floor?

• a.Bend at the knees and hips, keep the back straight, and lift with the leg muscles✓
• b.Bend at the waist and lift with the back
• c.Keep the legs straight and twist while lifting
• d.Hold the object away from the body while lifting

Proper lifting means bending at the knees and hips with a straight back and lifting using the strong leg muscles rather than the back. The object is held close to the body, and the feet are shoulder-width apart for a stable base. Twisting while lifting should be avoided to prevent back injury; turn the whole body instead.

A technician enters a room and finds a patient's call light out of reach and the bed in a high position. Which action reduces this patient's fall risk?

• a.Leave the bed high for easier care access
• b.Lower the bed to its lowest position and place the call light within reach✓
• c.Remove the non-slip footwear
• d.Keep the room dimly lit at all times

Keeping the bed in the lowest position and the call light within reach are basic fall-prevention measures. Other measures include non-slip footwear, adequate lighting, clear pathways, and responding promptly to call lights. A safe environment reduces the chance of falls and injury.

During a fire, the acronym RACE guides the response. What does RACE stand for?

• a.Run, Alert, Contain, Escape
• b.Rescue, Alarm, Confine, Evacuate in reverse order
• c.Rescue, Alarm, Contain, Extinguish✓
• d.Report, Assist, Cover, Exit

RACE stands for Rescue anyone in immediate danger, Alarm by activating the fire alarm and calling for help, Confine the fire by closing doors, and Extinguish the fire if small and safe or Evacuate. Following RACE provides an organized response that protects patients and staff. Staff should know the location of alarms and extinguishers.

When using a fire extinguisher, the acronym PASS is followed. What does PASS stand for?

• a.Point, Alarm, Squeeze, Stop
• b.Pull, Alert, Spray, Signal
• c.Push, Aim, Slide, Sweep
• d.Pull, Aim, Squeeze, Sweep✓

PASS stands for Pull the pin, Aim at the base of the fire, Squeeze the handle, and Sweep from side to side. Aiming at the base rather than the flames targets the fuel source. This technique should be used only on small, contained fires when it is safe to do so.

A technician finds a patient unresponsive and not breathing. After ensuring scene safety, what is the immediate priority action?

• a.Call for help/activate the emergency response system and begin CPR if trained✓
• b.Leave to document the finding
• c.Offer the patient water
• d.Wait 10 minutes to see if the patient recovers

For an unresponsive, non-breathing patient, the technician should immediately activate the emergency response system (call a code or 911) and begin CPR if trained and within scope. Early activation and high-quality chest compressions improve survival. Delaying care reduces the chance of a good outcome.

A confused patient keeps trying to climb out of bed. According to safe practice, restraints should be:

• a.Applied immediately for any confused patient
• b.Used only as a last resort after less restrictive alternatives fail, with an order✓
• c.Applied whenever staffing is low
• d.Tied to the movable side rail for quick release

Restraints are a last resort used only after less restrictive alternatives (such as bed alarms, closer observation, and frequent toileting) have failed, and they require a provider's order. They are never used for staff convenience or discipline. Restraints must be tied to the non-movable part of the bed frame with a quick-release knot.

A patient is in a physical restraint. How often should the technician typically check the patient and release the restraint for circulation, toileting, and repositioning?

• a.Once per shift
• b.Every 4 hours
• c.At least every 2 hours (or per facility policy), with frequent monitoring✓
• d.Only at the end of the day

A restrained patient must be monitored frequently, with the restraint typically released at least every 2 hours for repositioning, range of motion, toileting, and skin and circulation checks. Continuous monitoring guards against injury, impaired circulation, and skin breakdown. Documentation of checks and the patient's response is required.

When removing a contaminated isolation gown, which part is considered the most contaminated and should not touch the technician's clothing?

• a.The inside back of the gown
• b.The neck ties
• c.The inner sleeves
• d.The front and sleeves of the gown✓

The front and sleeves of an isolation gown are considered the most contaminated areas and must not touch the technician's uniform during removal. The gown is unfastened at the neck and waist, then peeled away and rolled inward so the contaminated surface is contained. Hand hygiene is performed immediately after removal.CDC

According to the standard order of draw, which specimen is collected first when a blood culture is ordered along with other tests?

• a.Blood culture (sterile) tubes/bottles✓
• b.Light blue (sodium citrate) tube
• c.Lavender (EDTA) tube
• d.Red (no additive) tube

Blood cultures are always drawn first to maintain sterility and prevent contamination that could cause false results. The standard order of draw then proceeds to light blue, then serum tubes, then green, lavender, and gray. Following the correct order prevents additive carryover between tubes.

In the CLSI order of draw, which tube is collected immediately after blood culture bottles?

• a.Lavender (EDTA) tube
• b.Light blue (sodium citrate) tube✓
• c.Gray (sodium fluoride) tube
• d.Green (heparin) tube

The light blue sodium citrate tube for coagulation studies is drawn immediately after blood cultures. Drawing it early minimizes contamination from other additives that could affect clotting results. The order then continues with serum tubes, green, lavender, and gray.

A lavender-top (purple) tube is required for a complete blood count (CBC). Which additive does it contain?

• a.Sodium fluoride
• b.Sodium citrate
• c.EDTA✓
• d.Sodium heparin

The lavender-top tube contains EDTA, an anticoagulant that binds calcium and preserves the shape of blood cells, making it ideal for hematology tests such as the CBC. It must be gently inverted several times after collection to mix the additive. Clots form if it is not mixed, invalidating the sample.

A green-top tube is used for many chemistry (plasma) tests. Which additive does it contain?

• a.EDTA
• b.Sodium citrate
• c.Silica clot activator
• d.Heparin✓

The green-top tube contains heparin (sodium, lithium, or ammonium), an anticoagulant that inhibits thrombin to prevent clotting for plasma chemistry tests. It is inverted several times to mix. Choosing the correct additive tube ensures the specimen is suitable for the ordered test.

A gray-top tube containing sodium fluoride is most appropriate for which test?

• a.Glucose or lactate levels✓
• b.Complete blood count
• c.Coagulation studies (PT/INR)
• d.Blood typing

The gray-top tube contains sodium fluoride, an antiglycolytic agent that preserves glucose by preventing cells from metabolizing it, making it ideal for glucose and lactate testing. Potassium oxalate is often included as an anticoagulant. It is drawn last in the standard order of draw.

A plain red-top tube (no additive or with clot activator only) is typically used to collect which specimen type?

• a.Whole blood with anticoagulant
• b.Serum, after the blood clots✓
• c.Plasma requiring immediate anticoagulation
• d.A sterile blood culture

A plain red-top tube has no anticoagulant, so the blood is allowed to clot and then centrifuged to yield serum. Serum is used for many chemistry, serology, and blood bank tests. Because it contains no additive, a plain red tube does not require inversion to mix, though clot-activator tubes are inverted.

At what angle should the needle be inserted during a routine venipuncture?

• a.45 to 60 degrees
• b.Straight down at 90 degrees
• c.15 to 30 degrees, bevel up✓
• d.Parallel to the skin at 5 degrees

The needle is inserted at a 15 to 30 degree angle with the bevel facing up during venipuncture. A shallow angle follows the path of the vein and reduces the risk of passing through it. Too steep an angle can puncture the back wall of the vein.

To avoid hemoconcentration and inaccurate results, a tourniquet should not remain in place longer than:

• a.5 minutes
• b.4 minutes
• c.3 minutes
• d.1 minute✓

A tourniquet should be left on for no longer than 1 minute to prevent hemoconcentration, which can falsely elevate certain results such as potassium and protein. If more time is needed to find a vein, the tourniquet is released and reapplied after two minutes. It is loosened as soon as blood flow is established.

Which vein is generally the preferred first choice for routine venipuncture in the antecubital area?

• a.Median cubital vein✓
• b.Basilic vein
• c.Cephalic vein of the wrist
• d.A vein on the underside of the wrist

The median cubital vein is usually the first choice for venipuncture because it is large, well-anchored, and located away from major nerves and arteries. The cephalic vein is a second choice, and the basilic vein is used with caution due to its proximity to the brachial artery and nerves. Veins on the underside of the wrist are avoided due to injury risk.

When performing a capillary (heel) puncture on an infant, which area of the heel should be used?

• a.The center of the heel
• b.The medial or lateral (side) plantar surface of the heel✓
• c.The back curve of the heel
• d.The arch of the foot

Infant heel sticks are performed on the medial or lateral plantar (bottom) surface of the heel to avoid the bone, which lies close to the surface at the center and back of the heel. Puncturing over the bone can cause injury or infection. The puncture depth is also limited to protect the calcaneus.

The order of draw for capillary (skin puncture) collection differs from venipuncture. Which specimen is generally collected first from a capillary stick?

• a.Serum tubes
• b.Chemistry tubes
• c.Blood gases, then EDTA (hematology) tubes, then other additive and serum tubes✓
• d.Coagulation tubes

In capillary collection, blood gases are collected first, followed by EDTA (hematology) tubes, then other additive tubes, and serum last. EDTA is collected early to ensure an adequate, well-mixed hematology sample before the drop begins to clot. This order differs from venous draws, where the light blue coagulation tube comes early.

Immediately after filling an additive tube, what must the technician do to properly handle the specimen?

• a.Shake it vigorously to speed mixing
• b.Place it on ice regardless of the test
• c.Centrifuge it immediately at the bedside
• d.Gently invert it the recommended number of times to mix the additive✓

Additive tubes must be gently inverted the recommended number of times immediately after collection to mix the blood with the additive and prevent clotting or clumping. Vigorous shaking can cause hemolysis, which ruins the sample. The number of inversions varies by tube type and manufacturer.

A technician receives a report that a specimen was hemolyzed. Which action during collection most likely caused the hemolysis?

• a.Vigorously shaking the tube after collection✓
• b.Gently inverting the tube five times
• c.Filling the tube completely
• d.Using an appropriately sized needle

Vigorous shaking of a tube ruptures red blood cells and causes hemolysis, which can falsely elevate results such as potassium. Other causes include using too small a needle, drawing too forcefully, or leaving the tourniquet on too long. Proper gentle mixing and technique prevent hemolysis.

A serum separator tube (SST), often gold or tiger-topped, contains which components?

• a.An anticoagulant to prevent clotting
• b.A clot activator and a gel separator✓
• c.Sodium fluoride to preserve glucose
• d.EDTA for hematology testing

An SST contains a clot activator to speed clotting and a thixotropic gel that forms a barrier between serum and cells after centrifugation. This yields a clean serum sample for many chemistry and serology tests. It is inverted five times after collection and allowed to clot before spinning.

A test requires a fasting specimen. A patient scheduled for a fasting glucose reports eating breakfast an hour ago. What should the technician do?

• a.Draw the specimen anyway without comment
• b.Tell the patient to fast for one more hour, then draw
• c.Notify the nurse or provider and document that the patient was not fasting before proceeding✓
• d.Cancel the test permanently

Fasting typically requires no food or caloric intake for 8 to 12 hours, and eating invalidates a fasting result. The technician should notify the nurse or provider and document the patient's non-fasting status so an informed decision can be made about rescheduling. Accurate reporting protects the reliability of the result.

When should specimen tubes be labeled during the blood collection process?

• a.Before the patient arrives
• b.The next day during charting
• c.Only if the specimen looks abnormal
• d.At the bedside immediately after collection, in the patient's presence✓

Tubes are labeled at the bedside immediately after collection while still with the patient, after verifying identity with two identifiers. Labeling on the spot prevents mislabeling and misidentification, a serious safety error. The label includes the patient's name, identifiers, date, time, and collector's initials.

When placing precordial (chest) leads for a 12-lead EKG, where is lead V1 positioned?

• a.Fourth intercostal space at the right sternal border✓
• b.Fourth intercostal space at the left sternal border
• c.Fifth intercostal space at the midclavicular line
• d.Fifth intercostal space at the anterior axillary line

Lead V1 is placed in the fourth intercostal space at the right sternal border. Accurate placement of V1 is critical because the other chest leads are positioned relative to it. Misplacement produces inaccurate waveforms and can lead to misinterpretation.

Where is lead V2 placed during a 12-lead EKG?

• a.Fourth intercostal space at the right sternal border
• b.Fourth intercostal space at the left sternal border✓
• c.Fifth intercostal space at the midclavicular line
• d.Fifth intercostal space at the midaxillary line

Lead V2 is placed in the fourth intercostal space at the left sternal border, directly across from V1. V1 and V2 straddle the sternum in the same intercostal space. Correct placement ensures reliable recording of the heart's electrical activity.

Lead V4 of a 12-lead EKG is correctly positioned at:

• a.The fourth intercostal space at the right sternal border
• b.The fourth intercostal space at the left sternal border
• c.The fifth intercostal space at the left midclavicular line✓
• d.The left midaxillary line level with V4

Lead V4 is placed in the fifth intercostal space at the left midclavicular line. V4 is generally positioned before V3, and V3 is placed midway between V2 and V4. Correct V4 placement anchors the horizontal plane of the remaining chest leads.

When applying limb electrodes for a 12-lead EKG, where should they generally be placed?

• a.On the chest near the heart
• b.Over bony areas like the wrist bone and ankle bone
• c.On the fingertips and toes
• d.On fleshy, muscular areas of the arms and legs, avoiding bony prominences✓

Limb electrodes are placed on fleshy areas of the arms and legs, avoiding bony prominences and large muscles to reduce artifact. They are positioned symmetrically on both sides for accuracy. Placing electrodes over bone or on the torso can distort the tracing.

A monitored patient has a regular rhythm with a rate of 76, a P wave before each QRS, and normal intervals. This rhythm is best described as:

• a.Normal sinus rhythm✓
• b.Sinus bradycardia
• c.Atrial fibrillation
• d.Ventricular tachycardia

Normal sinus rhythm has a regular rate of 60 to 100 beats per minute with a P wave preceding each QRS complex and normal intervals. A rate of 76 with these features is normal. Recognizing normal rhythm helps the technician identify deviations quickly.

A cardiac monitor shows a regular rhythm with a P wave before each QRS at a rate of 48 beats per minute. This is best described as:

• a.Normal sinus rhythm
• b.Sinus bradycardia✓
• c.Sinus tachycardia
• d.Atrial fibrillation

Sinus bradycardia is a regular sinus rhythm with a rate below 60 beats per minute, so a rate of 48 with normal P waves fits. It may be normal in athletes or during sleep but can cause symptoms if the rate is too slow. Symptomatic bradycardia should be reported to the nurse promptly.

A monitored patient's rhythm is regular with a normal-appearing complex and P waves, at a rate of 120 beats per minute. This is best described as:

• a.Sinus bradycardia
• b.Normal sinus rhythm
• c.Sinus tachycardia✓
• d.Asystole

Sinus tachycardia is a regular sinus rhythm with a rate above 100 beats per minute, so 120 with normal P waves fits. It can result from fever, pain, anxiety, dehydration, or exertion. The underlying cause should be identified and reported as appropriate.

An EKG tracing shows fuzzy, erratic spikes in the baseline caused by the patient shivering. What is the most likely cause of this artifact?

• a.A loose electrode
• b.60-cycle electrical interference
• c.Wandering baseline from breathing
• d.Somatic (muscle) tremor artifact✓

Somatic tremor artifact is caused by muscle movement such as shivering, tremors, or tension, producing fuzzy, erratic spikes on the tracing. Warming the patient and helping them relax can reduce it. Distinguishing artifact from true rhythm prevents misinterpretation.

An EKG shows a baseline that gradually drifts up and down across the tracing. This wandering baseline is most often caused by:

• a.Patient movement, respiration, or loose/dirty electrodes✓
• b.A normal heart rhythm
• c.Sixty-cycle interference from equipment
• d.Ventricular fibrillation

A wandering baseline is a slow up-and-down drift usually caused by patient movement or respiration, or by loose or poorly attached electrodes and dried gel. Ensuring good skin prep and secure electrode contact corrects it. Recognizing it as artifact prevents mistaking it for a rhythm abnormality.

A tracing shows a uniform, thick, fuzzy line with small regular spikes about 60 times per second. This artifact is most consistent with:

• a.Somatic tremor
• b.Sixty-cycle (AC) electrical interference✓
• c.Wandering baseline
• d.Normal sinus rhythm

Sixty-cycle interference (AC interference) produces a uniform series of small, regular spikes from nearby electrical equipment or improper grounding. Unplugging non-essential electrical devices and checking cables and grounding can reduce it. It is distinguished from muscle tremor, which is irregular.

An EKG shows an irregularly irregular rhythm with no clearly identifiable P waves. This is most consistent with:

• a.Normal sinus rhythm
• b.Sinus bradycardia
• c.Atrial fibrillation✓
• d.First-degree heart block

Atrial fibrillation appears as an irregularly irregular rhythm with no discernible P waves, replaced by a chaotic, wavy baseline. It results from disorganized electrical activity in the atria. The technician should document the finding and notify the nurse, especially if the rate is rapid or the patient is symptomatic.

A cardiac monitor suddenly shows a flat line and the patient is unresponsive with no pulse. After confirming the patient and checking leads, what does this rhythm represent and what is the priority?

• a.Normal rhythm; continue monitoring
• b.Artifact; ignore it
• c.Sinus bradycardia; recheck in an hour
• d.Asystole; call for emergency help and begin CPR✓

A flat line with an unresponsive, pulseless patient represents asystole, a life-threatening emergency. The technician should quickly confirm the patient is truly pulseless (and that it is not a lead disconnection), then activate the emergency response and begin CPR if trained. Rapid recognition and response are critical to survival.

Lead V6 of a 12-lead EKG is placed at:

• a.The fifth intercostal space at the left midaxillary line, level with V4 and V5✓
• b.The fourth intercostal space at the right sternal border
• c.The second intercostal space at the sternum
• d.The left midclavicular line at the fourth intercostal space

Lead V6 is placed at the fifth intercostal space at the left midaxillary line, horizontally level with V4 and V5. V5 sits between V4 and V6 at the anterior axillary line. Keeping V4, V5, and V6 on the same horizontal level ensures an accurate lateral view of the heart.

To obtain a clear EKG tracing, how should the technician prepare the skin before applying electrodes?

• a.Apply electrodes over lotion for better adhesion
• b.Clean the site, and if needed clip excess hair and lightly abrade dry skin so electrodes adhere well✓
• c.Place electrodes directly over thick chest hair
• d.Wet the skin thoroughly before applying electrodes

Good skin preparation includes cleaning the site, clipping excess hair where electrodes will go, and lightly abrading dry or oily skin so electrodes make solid contact. Lotions and oils prevent proper adhesion and cause artifact. Secure electrode contact produces a clean, interpretable tracing.

A visitor asks a technician to confirm whether their neighbor is a patient and what condition they have. What is the correct response under HIPAA?

• a.Confirm the room number so they can visit
• b.Share the diagnosis since they are neighbors
• c.Politely decline to share any patient information and refer the request to appropriate staff✓
• d.Give general details but not the exact diagnosis

HIPAA protects patients' health information, and technicians may not disclose whether someone is a patient or their condition to unauthorized individuals. The technician should politely decline and direct the person to the nurse or facility policy for handling such requests. Even confirming a patient's presence can be a privacy violation.HIPAA

A competent patient refuses a bath that the technician planned to give. What is the appropriate response respecting patient rights?

• a.Give the bath anyway because it is scheduled
• b.Tell the patient they have no choice
• c.Wait until the patient is asleep and proceed
• d.Respect the patient's right to refuse, explain the benefits, and report the refusal✓

Patients have the right to refuse care, and forcing care against a competent patient's wishes can constitute battery. The technician should respect the refusal, provide education about the benefits, and document and report it to the nurse. The patient's autonomy and dignity must be honored.

Which of the following is an example of objective data that a technician would document?

• a.A blood pressure reading of 128/82 mmHg✓
• b.The patient's statement 'I feel nauseous'
• c.A report of a headache described by the patient
• d.The patient saying they slept poorly

Objective data are measurable, observable facts such as a blood pressure reading, temperature, or visible wound drainage. Subjective data are what the patient reports, such as pain, nausea, or feelings. Documentation should clearly distinguish measured findings from patient statements.

A technician makes an error while charting on a paper record. What is the correct way to correct it?

• a.Erase the mistake completely
• b.Draw a single line through the error, write 'error' with initials and date, and enter the correct information✓
• c.Use correction fluid to cover it
• d.Scribble it out so it cannot be read

A charting error on paper is corrected by drawing a single line through it so the original remains legible, then labeling it as an error with the initials and date, and writing the correct entry. Erasing, using correction fluid, or obscuring an entry raises legal and integrity concerns. Accurate, transparent records are a legal document.

A patient's family member asks the technician to adjust the dose of the patient's IV medication because the patient seems uncomfortable. What is the appropriate action within scope of practice?

• a.Adjust the IV rate as requested
• b.Tell the family it is fine to change it themselves
• c.Explain this is outside the technician's scope and notify the nurse promptly✓
• d.Turn off the IV pump to be safe

Adjusting medications or IV rates is outside a patient care technician's scope of practice and must be handled by a licensed nurse. The technician should acknowledge the concern, explain the limitation, and promptly report it to the nurse. Working within scope protects patient safety and follows legal boundaries.

A patient appears anxious before a procedure. Which response by the technician is an example of therapeutic communication?

• a.'Don't worry, everything will be fine.'
• b.'There's no reason to be nervous.'
• c.Changing the subject to avoid the topic
• d.'You seem worried. Would you like to tell me what's concerning you?'✓

Therapeutic communication uses open-ended questions and reflection to encourage the patient to express feelings, such as acknowledging the worry and inviting them to share. False reassurance and dismissing concerns block communication and can make the patient feel unheard. Active listening builds trust and helps identify the patient's needs.

A patient from a different cultural background declines to make direct eye contact and prefers a family member present during care. How should the technician respond with cultural competence?

• a.Respect the patient's cultural preferences and adapt care accordingly✓
• b.Insist the patient make eye contact
• c.Ask the family member to leave
• d.Assume the patient is being uncooperative

Cultural competence means respecting and adapting to patients' cultural beliefs and practices, such as preferences about eye contact or family involvement. Avoiding eye contact may be a sign of respect in some cultures, not disinterest. Providing individualized, respectful care improves trust and outcomes.

Who is responsible for obtaining a patient's informed consent for a medical procedure?

• a.The patient care technician
• b.The provider (physician or licensed practitioner) performing the procedure✓
• c.The receptionist at check-in
• d.Any staff member available

Informed consent is the responsibility of the provider performing the procedure, who explains the risks, benefits, and alternatives. The technician does not obtain consent but may witness a signature or reinforce that questions be directed to the provider. Ensuring true informed consent protects patient autonomy and legal rights.

A patient has an advance directive on file. What does this document primarily do?

• a.Authorizes the technician to make all care decisions
• b.Guarantees the patient will refuse all treatment
• c.States the patient's wishes for medical care if they become unable to communicate them✓
• d.Replaces the need for provider orders

An advance directive documents a patient's wishes for medical treatment and may name a healthcare proxy for situations when the patient cannot speak for themselves. It guides the care team in honoring the patient's preferences. It supports patient autonomy and should be respected and accessible to the team.

A technician monitoring telemetry notices a patient's rhythm has changed to a fast, abnormal pattern and the patient reports chest discomfort. What is the appropriate action?

• a.Wait until the end of the shift to report it
• b.Silence the alarm and take no action
• c.Document it only, without telling anyone
• d.Notify the nurse immediately and stay alert to the patient's condition✓

A telemetry technician who observes a significant rhythm change with symptoms must notify the nurse or provider immediately so timely intervention can occur. Silencing alarms or delaying reporting endangers the patient. The technician monitors and communicates changes but does not diagnose or treat.

When entering patient data into the electronic health record, which practice best supports accuracy and safety?

• a.Verify patient identifiers and enter data promptly and correctly, reviewing before saving✓
• b.Enter data from memory hours later
• c.Use another staff member's login for convenience
• d.Round values however seems easiest

Accurate data entry requires verifying the correct patient with two identifiers, recording values precisely and promptly, and reviewing entries before saving. Charting from memory and estimating values introduce errors that can harm patients. Each user must use their own login to maintain accountability and security.

A technician fails to raise the side rails as ordered, and the patient falls and is injured. This failure to provide reasonable care that a prudent technician would provide is an example of:

• a.Assault
• b.Negligence✓
• c.Slander
• d.Defamation

Negligence is the failure to provide the standard of care that a reasonably prudent person would provide, resulting in harm to the patient. Following orders and safety measures such as raising ordered side rails is part of that standard. Documentation and adherence to policy help prevent negligence and protect both patient and technician.

A technician overhears coworkers discussing a celebrity patient's diagnosis in the cafeteria. What is the ethical and legal concern here?

• a.There is no concern since staff can discuss patients anywhere
• b.It is acceptable because the patient is famous
• c.It breaches patient confidentiality and HIPAA to discuss protected information in a public area✓
• d.It is only a problem if a visitor complains

Discussing a patient's protected health information in a public place like a cafeteria breaches confidentiality and violates HIPAA, regardless of the patient's fame. Patient information should be shared only with those involved in the patient's care and in private settings. Maintaining confidentiality is both an ethical duty and a legal requirement.HIPAA

A technician notices unexplained bruises and signs that suggest a vulnerable patient may be abused. What is the appropriate action?

• a.Ignore it unless the patient complains
• b.Confront the suspected abuser directly
• c.Wait to see if more bruises appear
• d.Report the observations to the nurse or supervisor per facility policy as a mandated reporter✓

Healthcare workers are typically mandated reporters and must report suspected abuse or neglect through the proper channels, usually the nurse or supervisor per facility policy. The technician reports objective observations rather than investigating or confronting anyone. Timely reporting protects vulnerable patients from harm.

When communicating with a patient who is hard of hearing but does not use sign language, which technique is most helpful?

• a.Face the patient, speak clearly at a normal-to-slightly-slower pace, and reduce background noise✓
• b.Shout loudly into the patient's ear
• c.Cover your mouth while speaking
• d.Speak quickly to save time

For a patient who is hard of hearing, the technician should face the patient so they can see the lips, speak clearly at a moderate pace, and minimize background noise. Shouting distorts speech and covering the mouth prevents lip reading. Ensuring hearing aids are in place and using written communication as needed also help.

A technician is unsure whether a task assigned to them is within their scope. What is the appropriate first step following the chain of command?

• a.Perform the task and hope it is allowed
• b.Clarify with the supervising nurse before performing the task✓
• c.Refuse and say nothing to anyone
• d.Ask a visitor for advice

When uncertain about scope or an assignment, the technician should follow the chain of command and clarify with the supervising nurse before acting. Performing a task outside one's scope endangers the patient and the technician's license or certification. Seeking clarification demonstrates professional accountability and patient safety awareness.

Under the HIPAA 'minimum necessary' principle, how should a technician access and share patient information?

• a.Access all records freely for curiosity
• b.Share full records with anyone who asks
• c.Access and share only the information needed to perform the specific job task✓
• d.Post updates on social media to keep family informed

The HIPAA minimum necessary standard requires that staff access and share only the protected health information needed to accomplish a specific task. Browsing records out of curiosity or oversharing violates this principle. Limiting access protects patient privacy and reduces the risk of breaches.HIPAA

After a patient falls, in addition to notifying the nurse, the technician should complete which document?

• a.A social media post
• b.A personal note to keep at home
• c.Nothing, since the nurse handles it
• d.An incident (occurrence) report documenting the facts objectively✓

An incident or occurrence report is completed after an event such as a fall to objectively document the facts, actions taken, and the patient's condition. It is a factual record used for quality improvement and risk management, not for blame. The report is kept separate from the medical record and completed promptly per policy.