Download CNT TEST QUESTIONS WITH 100% ACCURATE ANSWERS and more Exams Public Health in PDF only on Docsity!
CNT TEST QUESTIONS WITH 100% ACCURATE
ANSWERS
AE (adverse effects) of acupuncture - Accurate answers site bleeding, superficial hematoma, needle site pain less frequently: fainting, tiredness, aggravation, broken needle rare but serious (SAEs): pneumothorax, injury to organs, traumatic tissue injury Critical and recommended procedures to reduce risks and AE of acupuncture - Accurate answers 1. be aware of vascular anatomy
- mild pressure after needle removal
- identify points that lie over or next to major vessels
- palpate vessels, muscles, bones, ec. before preparing site for insertion
- apply caution with those who take blood thinners
- allow alcohol to dry before needling
- place first-time patient in supine position with knees slightly elevated for 1st acupuncture treatment
- inform patients they should eat 1-2 hours before treatment
- limit needle manipulation during 1st treatment until the patient's response to acupuncture has been established
- identify recommended depth of insertion for points and utilize proper stimulation techniques
- obtain medical history regarding lung function, disease, and history of smoking
- Assess physique of patient (if thinner, don't go deep)
- 10-20mm is safe needling for the lung area
- needle at oblique angle on thoracic body
- do not cup over needles on the thorax in the area of the lungs
- limit vertical manipulation over abdomen
- CNT! including hand washing
- wear gloves to protect broken skin of practitioner
- do not needle into skin lesions
- immediately isolate used sharps into sharps container
- inspect needles for defects in manufacturing before use
- never insert needle to the handle and use only single-use needles AE (adverse effects) of moxa - Accurate answers bruising, burns, cellulitis, allergies Critical and recommended procedures to reduce risks and AE of moxa - Accurate answers 1. protect skin from falling ashes
- caution in diabetics and those with neural injury who cannot feel pain as well
- take care of any burns immediately with cool water and sterile gauze
- remain in room at all times
- do not use on face, hairline, or sensitive areas
- monitor skin temperature
- refer to western doctor if needed
- have proper ventilation in room (air filter unit recommended) AE (adverse effects) of cupping - Accurate answers burns (fire cupping), skin reactions including fluid blisters, hyperpigmentation, petechia, and ecchymosis, pneumothorax (needle cups), nodules, scarring, anemia and enlarged heart (excessive wet cupping), infections Critical and recommended procedures to reduce risks and AE of cupping - Accurate answers 1. take careful patient history (diabetes, neuropathies, etc.)
- do not place burning material at the rim of the cup (deepest part only)
- remove burning material before applying cup to patient's skin
- Use PPEs (gloves, eyewear)
- apply cups to clean skin only
- CNT, hand washing, clean field
- do not cup over lesions, rashes, skin breaks
- remove cup slowly so blood or OPIM does not splash
- clean and sterilize cups
- Screen patients for keloid scarring or a history of psoriasis, as well as hemophilia and von willebrand's disease AE (adverse effects) of heat lamps - Accurate answers burns, infections, fire Critical and recommended procedures to reduce risks and AE of heat lamps - Accurate answers 1. monitor carefully and check for defects of lamp before use
- do not use on infants, children, incapacitated persons, or sleeping or unconscious persons
- do not use over sensitive skin or persons having poor blood circulation AE (adverse effects) of electro acupuncture - Accurate answers There are no common adverse effects associated with EA. cardiac effects and electrical injury are uncommon AEs Critical and recommended procedures to reduce risks and AE of electro acupuncture - Accurate answers 1. do not use silver needles
- do not allow muscles to contract
- avoid certain areas of body (anterior triangle of neck, posterior cervical area, crossing the spine, crossing the heart)
- do not use with those who have implanted medical devices
- always turn up amperage on EA machine slowly and ask for feedback; turn off before removing needles
- level of stimulus should never approach sensation of pain
- prevent moisture or water from coming in contact with patient treatment table
- do not use a damaged machine or when wires are not in good condition The surface of the skin to the spinal cord or roots of spinal nerves range from - Accurate answers 25-45mm Can you needle Du22 in an infant - Accurate answers No
Implement safety practices to prevent needles being left in patient - Accurate answers 1. count needles before and after Identify variations of CNT protocol for office setting, hospital or multi-disciplinary setting, public health setting, travel setting - Accurate answers office setting (see CNT flashcard) Travel - use hard-sided container or plastic large case with tight closure that is puncture proof, seal items in one large ziplock bag and appropriate separate ziplock bags within it (20 needles, 20 cotton balls, 5 2x2 in. gauze pads, one pair of gloves, 30+ 70% alcohol prep pads)... non-clean items should be in two separate gallon ziplock bags (one for trash bag and one for sharps container)... hemostat or tweezers and hand sanitizer do not go in ziplock bags NO BIG DIFFERENCE - always wash hands, establish clean field, use single-use sterile needles, follow safety and standard precautions, dispose of used needles immediately into sharps container that is nearby, use new paper for each patient on treatment table, wear gloves around broken skin, treat all as though they are infectious Best practice protocols for acupuncture needling - Accurate answers Best practice protocols for moxa - Accurate answers wash hands, check for patient comfort and skin reactions, take patient history, remain in room at all times, shield patient skin from falling ash, avoid moxa on hairline or face, have proper ventilation, chart any burns, utilize air filter if possible, have fire extinguisher available, do not put moxa in trashcan!, use hemostat or tweezers to remove moxa cones, have ashtray nearby, always light away from patient's skin for indirect moxa, use herbal insulation to area being heated, when 2/3 of moxa is burnt, remove from patient into ashtray *make sure all used moxa sticks are contained in an appropriate extinguisher for no less than 1 hour after use Best practice protocols for cupping - Accurate answers follow standard precautions, cleanfield, and hand sanitation guidelines, do not apply 48 hours before or 24 hours after chemo., cup over clean skin only, take patient medical history, screen for keloid scarring and skin lesions, use PPE, use sterile lancets for wet cupping and discard into sharps container, allow vacuum to be compromised slowly when removing cup, clean all materials with soap and water and disinfectant before using again, use safe needle depth, cup children only with parent present, place burning material into deepest part of cup, wear gloves during wet cupping *retain cups for 2-10 mins Best practice protocols for bleeding - Accurate answers USE PPE (gloves), lancing devices are single-use, take medical history and watch for bleeding disorders, do not bleed active skin lesion, recommended to use eye protection Best practice protocols for heat lamps - Accurate answers check for lamp defects, check area to be treated for skin lesions, move clothing and combustible materials away from area being heated, lamp
head is at least 12 inches from area being heated for no more than 10-15 minutes, never leave immediate area, check area once every 5 minutes to make sure skin does not burn, unplug after use Best practice protocols for plum blossom/seven-star/cutaneous needling - Accurate answers clean field, hand sanitation, skin prep, PPE, clean area being treated, use sterile items, dispose in sharps container after use, do not be too forceful or flinging hammer around *hammer is raised 1-2 inches above skin Use hand sanitizer that contains at least ___% alcohol - Accurate answers 60 Standard precautions are: - Accurate answers "...all blood, body fluids, secretions, excretions except sweat, non-intact skin, and mucous membranes may contain transmissible infectious agents." It includes hand washing, use of gloves, gown, mask, eye protection, or face shield and safe injection practices. Blood borne infections - Accurate answers Hepatitis, HIV Airborne infections - Accurate answers Specific infections associated with acupuncture and related techniques - Accurate answers Autogenous infections - Accurate answers Created when a pathogen is already present in a person and is moved to another location within the body where it is considered a pathogen Cross infections - Accurate answers Infections caused by pathogens acquired from another person or by the environment Hep A signs and symptoms - Accurate answers abrupt onset; abdominal discomfort, loss of appetite, fatigue, nausea, dark urine, jaundice (usually <2 months) Methods to prevent Hep A - Accurate answers hand-washing, vaccine, hygiene Public safety measures for Hep A - Accurate answers personal hygiene, proper sanitation, hand- washing Hep A transmission - Accurate answers fecal contaminated food and water, blood, sex Hep A incubation period - Accurate answers 15-50 days (28 average) Hep A sequelae - Accurate answers cannot become re-infected after infection heals Hep A vaccine? - Accurate answers yes How long Hep A lasts on common surfaces - Accurate answers months unless heated above 185 degrees
Hep D signs and symptoms - Accurate answers *Requires concurrent Hep B infection for development of disease severe hepatitis OR transform a mild or asymptomatic chronic HBV into a more severe disease process, causing increased scarring of the liver Methods to prevent spread of Hep D - Accurate answers Hep B vaccine, clean needle, safe sex Public safety measures for Hep D - Accurate answers Hep B vaccine Hep E signs and symptoms - Accurate answers *Rarely seen in US sudden onset of fever, malaise, nausea, anorexia, possible jaundice, can lead to death in pregnant women Methods to prevent spread of Hep E - Accurate answers don't drink contaminated drinking water, clean kitchen practices Public safety measures for Hep E - Accurate answers clean food and drinking water HIV signs and symptoms - Accurate answers (can be asymptomatic) fever, malaise, body aches, maculopapular rash, lymphadenopathy, headache, fever, night sweats, rapid/unexplained weight loss, chronic diarrhea, persistent cough, flat or raised pigmented lesions on the skin ranging in color from pink, red, brown or blue Methods to prevent spread of HIV - Accurate answers Standard precautions! (use barriers) Public safety measures for HIV - Accurate answers safe sex, safe needle use, safe healthcare practices HIV transmission - Accurate answers blood to blood contact, contaminated needles (drugs) HIV incubation period - Accurate answers 8-10 years , developing into AIDs for some HIV chronic active infection state - Accurate answers Chronic - can turn into AIDS and immunodeficiency diseases such as pneumocystitis carinii pneumonia (leading cause of death), Kaposi's sarcoma, esophageal candidiasis, cytomegalovirus. HIV vaccine? - Accurate answers no - protease inhibitors and other drugs to ease symptoms How long HIV lasts on common surfaces - Accurate answers dies within minutes Herpes simplex virus signs and symptoms - Accurate answers recurring legions, itching, pain, tingling at site of infection Methods to prevent HSV spreading - Accurate answers standard precautions, disinfect surfaces daily
Public safety measures for HSV - Accurate answers awareness of when the virus is shedding, abstaining from sex or direct contact at that time HSV transmission - Accurate answers saliva, skin to skin, direct contact with infected mucosal regions, ingestion, parenteral injection, droplet exposure of mucous membranes, inhalation of aerosolized materials HSV incubation period - Accurate answers 2-12 days HSV chronic active infection state - Accurate answers gets milder over time HSV vaccine? - Accurate answers no How long HSV will last on common surfaces - Accurate answers a few hours Signs and symptoms of staph and strep - Accurate answers staph: red, painful skin infections, abscesses, bacteremia, necrotizing fasciitis (staph) strep: sore throat, fever, chills, malaise, swollen lymph nodes Public safety measures for staph and strep and Methods to prevent spread of staph and strep - Accurate answers hand washing, barrier protections, proper disposal of sharps, avoid contact with draining wounds or inflamed skin, avoid acupuncture in those areas, use clean needle technique, disinfect!, refer patients to appropriate physician when needed Transmission of staph and strep - Accurate answers staph: skin to skin strep: mucus from nose or throat of person who is infected or contact with infected wounds or sores on skin Incubation period of staph and strep - Accurate answers strep: 1-4 days staph/MRSA: ~3 days Vaccine for staph and strep? - Accurate answers No How long staph and strep will live on common surfaces - Accurate answers staph/MRSA 90 days strep? MRSA transmission - Accurate answers skin to skin contact MRSA incubation period - Accurate answers a few days TB signs and symptoms - Accurate answers coughing, sneezing, weight loss, fever, night sweats, loss of appetite, chest pain, bloody sputum
- Rub hands vigorously for 10-20 seconds, thoroughly
- Rinse hands well with water
- Dry thoroughly with a clean, disposable towel
- Use towel to turn off faucet Options when soap and water are not available - Accurate answers alcohol-based hand sanitizer, antiseptic towels Transient hand flora - Accurate answers Temporary skin flora that colonize the skin - bacteria, fungi, viruses (handwashing aims to reduce these) Resident hand flora - Accurate answers Consists of microorganisms residing under the superficial cells of the stratum corneum and on the surface of the skin Has protective function to prevent colonization of skin by pathogenic organisms Recommendations for AOM practitioner health and hygiene - Accurate answers Don't OR remove rings when hand washing, yearly physical examination, wear clean/washable/disposable protective clothing while performing treatments, closed-toe shoes, hand washing, refrain from treating patients when actively ill Proper uses of PPEs - Accurate answers ensure they are disposed of properly, ensure they are available for free use of employees, use proper fitting gloves (not to tight or too lose), use gloves when touching blood or OPIM, do not wear the same gloves for more than one patient (disposable!), remove gloves properly to prevent hand contamination use goggles if there may be splash or sprays of blood, lab coats should be worn to protect the skin from splatter and spills (with chemicals or biologicals) Glove use (when is it required?) - Accurate answers when blood or OPIM is present during a healthcare procedure or performing procedures on areas of mucus membranes Critical elements of cleaning and disinfecting AOM practice locations - Accurate answers 1. Written schedule for cleaning and decontamination
- Regular cleaning
- A sink with hot and cold running water must be located near or in treatment rooms with liquid hand soap and disposable paper towels
- Written notice of maintenance of biohazardous materials available
- Towel, cloth, gown, covering of any kind that has come into contact with patient skin should be cleaned
- Treatment table tops, shelves, and working surfaces should have a smooth, impervious surface, be in good repair, and cleaned with suitable disinfectant at least once a day Classifications of disinfectants - Accurate answers Sterilant - germicide used to actually sterilize, toxic, not used in regular office cleaning High-level, intermediate and low-level disinfectants
Items: critical - enter vascular system or any sterile internal part of the body semi-critical - touch mucus membranes and non-intact skin non-critical - touch intact skin Commonly used disinfectants - Accurate answers chlorine and chlorine compounds, glutaraldehyde, hydrogen peroxide, idophors, phenol, Who approves use of disinfectants for healthcare offices and procedures? - Accurate answers Antimicrobials Division, Office of Pesticides Program, EPA Monitoring and labeling disinfectants - Accurate answers All disinfectants should be handled according to manufacturer's instructions and labeled if they are not in their original bottle (including the day it was mixed and its concentration) Identify steps for surface disinfection - Accurate answers Clean with soap and water first, soak in FDA-cleared disinfectant for time indicated for re-usable equipment Recognize instrument disinfection techniques - Accurate answers Cups used for wet cupping or gua sha spoons used on non-intact skin: wash, autoclave OR soak in high-level disinfectant Needles, 7 star hammers, lancets, press tacks, ear seeds - NOT reusable cups or gua sha spoons on intact skin require intermediate-level disinfectant BP cuff, stethoscope can be cleaned with soap and water and then low or intermediate disinfecting agent Best practices when dealing with blood/OPIM/bodily fluid spills - Accurate answers Use PPE appropriate for the area, wash area with soap and water first, disinfect contamination blood/OPIM spills using EPA-registered commercial hypochlorite solution and follow manufacturer's labels for spills and the amount of blood present, If the spill contains large amounts of blood, clean visible matter with disposable absorbent material and discard contaminated material in labeled biohazard waste container Needlestick protocol - Accurate answers wash needlestick location with soap and water, flush splashes to nose, mouth, or skin with water, irrigate eyes with clean water, saline, or sterile irrigants, seek medical advice by a liscenced physician as soon as possible Sharps disposal legal requirements and where to get state-specific info - Accurate answers 1. Labeled with biohazard symbol or be color-coded red.
- Do not overfill container
- Place in secondary container if leakage is possible
- Re-usable containers may not be opened, emptied, cleaned manually or use in an manner that would put someone at risk of injury
- Secure duct tape over the lid to close and secure sharps container
- Easily accessible to employees Contact local health department or OSHA office for state specific details.
*must create a "Hazardous Communication Plan" regarding policies on chemical exposures, labeling, safety, training information, etc.
- Must have policies in place and training for moxa, heat lamps, electro-acupuncture, or any other electrical equipment
- Written plan must be implemented to identify and handle biohazardous waste and employees must be trained who work in areas where biohazardous waste is kept
- must be kept in red, impermeable plastic bags and sealed
- stored away from traffic flow and accessible to only authorized personnel
- waste removed by medical waste disposal company
- items not soaked in blood or OPIM can be placed in regular waste basket
- provide patients with sharps container to return to you if they are using press tacks
- Safety in practice environment:
- All floors, passages, stairs shall be of sound construction and properly maintained, kept from obstruction and any substance likely to cause someone to slip
- Substantial handrail and adequate lighting for every staircase
- Adequate lighting in all office spaces
- All structures and equipment must be regularly inspected and maintained
- Electrical installations should be in accordance with code
- Floors should be easily cleaned
- All modifications of the clinic should be done in a manner that all construction and plumbing, and wiring met codes and be done in a competent and safe manner
- All fire extinguishers, fire sprinkler systems, and other fire safety equipment should be maintained according to manufacturer's instructions and local fire regulations
- Handwashing facilities, sharps containers, biohazard containers, and a HIPAA and confidentiality - Accurate answers HIPAA includes the confidentiality provisions which apply to many health providers. The HIPAA Security Rule establishes national standards to protect a patient's personally identifiable information. HIPPA requirements for practitioner offices, standards, training, updates, legal documentation requirements - Accurate answers 1. Most clinical practitioners must develop and provide individuals with a notice of their privacy practices (NOPP); includes individual's rights, how they can complain to their practitioner, whom they can contact further about the privacy policy, how a practitioner may disclose protected health info about an individual
Informed consent - Accurate answers All diagnostic and medical procedures require the consent of the patient or their legal representative (children, mentally ill) Patient's must understand: The diagnosis, the nature and purpose of the proposed treatment, the probable risks or consequences of the treatment (that the practitioner has knowledge of), reasonable treatment alternatives, prognosis without treatment Consent must be signed, showing the procedure was the one consented to, address the nature of the procedure, alternatives, risks, consequences, and demonstrate patient understanding of these concerns, and the patient must fill in the date on which the form was signed. Oral consent is as binding as written consent, but harder to prove in court. Basic understanding of requirement of communicable diseases and abuse - Accurate answers Requirement for practitioner offices, standards, legal documentation, where to find info appropriate to practice location regarding diseases and abuse - Accurate answers For a spill of blood or OPIM:
- Evacuate personnel from immediate area
- Block off area
- Don 2 sets of utility gloves 4.. Surround spill with paper towels
- Put absorbent material on spill
- If glass in involved, remove glass with forceps or tweezers, or use a broom and dustpan
- Dispose of absorbent material in hazard waste trash (double bag)
- Change gloves if contaminated
- Clean area with detergent and water
- Disinfect are with EPA approve disinfectant appropriate for the surface
- Wash hands are removing gloves First AID kit should be available for employee use, as well as a list of emergency numbers for fire, ambulance, and poison control directly next to the phone. Have a plan or policy in place for mental health issues and suicide. Record- keeping - Accurate answers - Records should be kept for all patient visits and treatments performed
- Should be complete, accurate, up-to-date report of medical history, conditions, and treatment of each patient
- Complete in black ink, never erased or illegible; draw line through text in question and initial change before updating information
- Protect files against theft, fire, or water damage with policies in place Antimicrobial agent - Accurate answers Any agent that kills or suppresses the growth of microorganisms
OPIM - Accurate answers Other potentially infectious material - all body fluids where it may be difficult to differentiate between contaminated and non-contaminated fluids Personal Protective equipment (PPE) - Accurate answers Specialized clothing or equipment worn by an employee for protection against a hazard. General work clothes not intended to function as protection against a hazard are not considered PPE. Sanitizer - Accurate answers Agent that reduces the number of bacterial contaminants to safe levels as judged by public health requirements, that is commonly used with substances applied to inanimate objects. According to the protocol for the official sanitizer test, a sanitizer is a chemical that kills 99.999% of the specific test bacteria in 30 seconds under the conditions of the test Standard Practice - Accurate answers Often synonymous with "customary practice." It is the legal term that is commonly defined as what a minimally competent healthcare provider in the same field would do in the same situation, with the same resources. Standard Precautions - Accurate answers A set of basic infection prevention practices intended to prevent transmission of infectious diseases from one person to another. Sterilization - Accurate answers A validated process used to render a product free of all forms of viable microorganisms. In a sterilization process, the presence of microorganisms on any individual item can be expressed in terms of probability. Although this probability can be reduced to a very low number, it can never be reduced to zero.
