NHA Patient Care Technician (CPCT) — All Questions

A technician finishes a round of vital signs and observations at 1500. Which finding should be reported to the nurse right away rather than saved for the end-of-shift report?

• a.A patient reports new shortness of breath while at rest✓
• b.A patient's blood pressure reads 134/86 mm Hg on a second check
• c.A patient walked half of the hallway instead of the whole hall
• d.A patient's oral temperature is 99.1°F at rest

New shortness of breath at rest is a change in condition that the nurse has to assess now, because the causes range from anxiety to a pulmonary embolus and the technician cannot tell them apart. A reading of 134/86 mm Hg is stage 1 hypertension under the 2017 ACC/AHA categories, which begin stage 1 at 130-139 systolic or 80-89 diastolic; it is abnormal and must be recorded and passed on, but it is not an emergency on its own. An oral temperature of 99.1°F sits inside the usual range of about 97.6-99.6°F. A shortened walk is documented and reported at the end of the shift.

For several shifts a technician has seen the same coworker leave call lights ringing while patients wait for help. The technician has already raised it with the coworker directly and nothing has changed. What should the technician do next?

• a.Report the pattern to the charge nurse or supervisor✓
• b.Write a note about each unanswered light in the patients' charts
• c.Ask the other technicians whether they have noticed the same thing
• d.Answer those call lights herself and let the matter drop

A direct conversation is the right first move and it has been tried, so the next step in the chain of command is the person responsible for the assignment and for the patients who are waiting. The patient record documents that patient's care, not a coworker's performance, and putting staffing complaints in it exposes the chart in ways that help no one. Polling other technicians spreads the story sideways to people with no authority to correct it. Quietly covering the lights protects the coworker, hides the pattern from the one person who can fix it, and leaves the next patient waiting.

A patient who speaks limited English is being prepared for a procedure, and his 12-year-old daughter offers to interpret for him. What should the technician do?

• a.Ask the supervisor whether the daughter may interpret today
• b.Let the daughter interpret, since she knows his history
• c.Use simple English and hand gestures with the patient
• d.Arrange a qualified interpreter through the facility✓

Facility policy and federal language-access requirements expect a trained interpreter, in person or by phone or video, because clinical terms have to survive translation, the patient's information stays confidential, and a child is not made responsible for delivering frightening news to a parent. A minor who is fluent is still not qualified, and she may soften or edit what she hears. Routing the question through the supervisor delays care and cannot turn an untrained child into a qualified interpreter. Gestures and simple English cannot carry what a patient needs to know before a procedure.

A technician is walking a patient who is blind from her room to the shower room down the hall. What is the correct technique?

• a.Take hold of her upper arm and steer her from behind down the hall
• b.Speak loudly as they walk so that she can follow his voice
• c.Push her in a wheelchair because the hallway is crowded
• d.Offer his arm for her to hold and walk half a step ahead of her✓

In sighted-guide technique the patient holds the technician's arm just above the elbow and follows about half a step behind, so she feels every turn, slope, and stop through his arm before she reaches it. Taking her arm and pushing her from behind reverses that: she gets no advance warning and loses control of her own pace. Volume is not the barrier, and shouting at a blind patient in a hallway is undignified and announces her business to everyone. Putting an ambulatory patient in a wheelchair for the staff's convenience takes away mobility she has and did not ask to give up.