Solution Manual For DHO Health Science, 9th Student Edition 9th Edition by Louise M Simmers, Karen S

Instructor’s Manual to Accompany

DHO Health Science 9th edition Louise Simmers, BSN, MEd, RN Karen Simmers-Nartker, BSN, RN Sharon Simmers-Kobelak, BBA

Australia • Brazil • Japan • Korea • Mexico • Singapore • Spain • United Kingdom • United States

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ii

Contents Preface CHAPTER 1

................................................................................................................ iv History and Trends of Health Care........................................................ 1 Suggested Answers to the End of Chapter Review Questions.................... 1 Suggested Answers to the Workbook Assignment....................................... 1

CHAPTER 2

Health Care Systems.............................................................................. 2 Suggested Answers to the End of Chapter Review Questions.................... 2 Suggested Answers to the Workbook Assignment........................................ 3

CHAPTER 3

Careers In Health Care........................................................................... 5 Suggested Answers to the End of Chapter Review Questions.................... 5 Suggested Answers to the Workbook Assignment........................................ 5

CHAPTER 4 Personal and Professional Qualities of a Health Care Team Member.... 7 Suggested Answers to the End of Chapter Review Questions.................... 7 Suggested Answers to the Workbook Assignment........................................ 8

CHAPTER 5

Legal and Ethical Responsibilities......................................................10 Suggested Answers to the End of Chapter Review Questions...................10 Suggested Answers to the Workbook Assignment.......................................11

CHAPTER 6

Medical Terminology.............................................................................13 Suggested Answers to the End of Chapter Review Questions...................13 Suggested Answers to the Workbook Assignments.....................................13

CHAPTER 7

Anatomy and Physiology......................................................................15 Suggested Answers to the End of Chapter Review Questions...................15 Suggested Answers to the Workbook Assignments.....................................17

CHAPTER 8

Human Growth and Development....................................................... 28 Suggested Answers to the End of Chapter Review Questions.................. 28 Suggested Answers to the Workbook Assignments.................................... 29

CHAPTER 9

Geriatric Care........................................................................................ 31 Suggested Answers to the End of Chapter Review Questions.................. 31 Suggested Answers to the Workbook Assignments.................................... 32

CHAPTER 10

Cultural Diversity.................................................................................. 34 Suggested Answers to the End of Chapter Review Questions.................. 34 Suggested Answers to the Workbook Assignment...................................... 35

CHAPTER 11

Nutrition and Diets............................................................................... 36 Suggested Answers to the End of Chapter Review Questions.................. 36 Suggested Answers to the Workbook Assignment...................................... 36

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iii CONTENTS

CHAPTER 12

Computers and Technology in Health Care....................................... 38 Suggested Answers to the End of Chapter Review Questions.................. 38 Suggested Answers to the Workbook Assignment...................................... 39

CHAPTER 13

Medical Math......................................................................................... 40 Suggested Answers to the End of Chapter Review Questions.................. 40 Suggested Answers to the Workbook Assignment...................................... 40

CHAPTER 14

Promotion of Safety............................................................................. 41 Suggested Answers to the End of Chapter Review Questions.................. 41 Suggested Answers to the Workbook Assignments.................................... 42

CHAPTER 15

Infection Control................................................................................... 44 Suggested Answers to the End of Chapter Review Questions.................. 44 Suggested Answers to the Workbook Assignments.................................... 45

CHAPTER 16

Vital Signs............................................................................................. 49 Suggested Answers to the End of Chapter Review Questions.................. 49 Suggested Answers to the Workbook Assignments.................................... 50

CHAPTER 17

First Aid................................................................................................. 59 Suggested Answers to the End of Chapter Review Questions.................. 59 Suggested Answers to the Workbook Assignments.................................... 60

CHAPTER 18

Preparing for the World of Work.......................................................... 65 Suggested Answers to the End of Chapter Review Questions.................. 65 Suggested Answers to the Workbook Assignments.................................... 65

CHAPTER 19

Dental Assistant Skills......................................................................... 71 Suggested Answers to the End of Chapter Review Questions.................. 71 Suggested Answers to the Workbook Assignments.................................... 72

CHAPTER 20

Laboratory Assistant Skills................................................................. 82 Suggested Answers to the End of Chapter Review Questions.................. 82 Suggested Answers to the Workbook Assignments.................................... 83

CHAPTER 21

Medical Assistant Skills....................................................................... 88 Suggested Answers to the End of Chapter Review Questions.................. 88 Suggested Answers to the Workbook Assignments.................................... 89

CHAPTER 22

Nurse Assistant Skills.......................................................................... 92 Suggested Answers to the End of Chapter Review Questions.................. 92 Suggested Answers to the Workbook Assignments.................................... 93

CHAPTER 23

Physical Therapy Skills.......................................................................105 Suggested Answers to the End of Chapter Review Questions.................105 Suggested Answers to the Workbook Assignments...................................106

CHAPTER 24

Business and Accounting Skills........................................................107 Suggested Answers to the End of Chapter Review Questions.................107 Suggested Answers to the Workbook Assignments...................................108

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iv

P r e face The text and workbook for DHO Health Science, 9th edition, were designed to provide beginning health ­science education (HSE) students with the basic knowledge and entry-level skills required for a wide variety of health care careers.

• The material will not replace the instructor, who is still an important element for student success. However, by using the material correctly, students can work more independently and master many skills at beginning levels of achievement. Students know what is expected of them as definite standards are set. Evaluations are objective, and quality of performance is stressed. In this Instructor’s Manual, suggested answers for the assignment sheets in the workbook are given, as well as suggested answers for the end of chapter review questions have been provided.

• Because regulations vary from state to state regarding procedures that can be performed by health science education (HSE) students, it is important for the HSE instructor to check specific state regulations. Stressing legal responsibilities to students is an important function of any HSE instructor.

• Always remember that an HSE instructor is providing a valuable service. The material in the text and workbook has been prepared to make an HSE instructor’s job a little easier. One hopes it will help many students become competent health care providers.

• A Teacher’s Resource Kit to Accompany DHO Health Science, 9th edition, is also available on the Instructor Companion Website. This kit provides a complete guide to implementing a health science education course. The kit contains instructional strategies and explains how to apply content to applied academics and the National Healthcare Standards. It also provides classroom management ideas, lesson plans, tests, classroom activities, leadership development ­activities, suggestions for Internet searches, visual aids, and lists of additional resources.

• An Instructor Companion Website to Accompany DHO Health Science, 9th edition, is also available from the publisher. It contains a Computerized Test Bank of over 1,800 questions that can be used to create ­quizzes and tests. Each question in the computerized test bank includes correlation mapping information to the National Healthcare Foundation and Skills Standards. A ­PowerPoint® Presentation with approximately 1,000 slides for use in classroom instruction, an Image Library with electronic versions of all of the visual aids for use in giving electronic presentations and creating ­customized assignments and worksheets, and an Animations Library with numerous multimedia animations providing narration and explanation of difficult to visualize anatomical and physiological processes for use in classroom presentations are also available for the instructor.

• We are offering the complete Health Science course online in our MindTap platform.

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INSTRUCTOR’S MANUAL 1

CHAPTER 1 HISTORY AND TRENDS OF HEALTH CARE SUGGESTED ANSWERS TO THE END OF CHAPTER REVIEW QUESTIONS 1. a. Hippocrates: created records that helped establish that disease is caused by natural causes, not by supernatural spirits and demons; author of the “Hippocratic Oath,” which established a strict code of ethics still used in some form by most schools of medicine today; stressed the importance of observation, diagnosis, and treatment b. Michelangelo or Leonardo da Vinci: used dissection to draw the human body more realistically and provided a better understanding of anatomy and physiology c. Anton van Leeuwenhoek: built microscopes that magnified greater than 200 times and identified tiny single-celled organisms now known as microorganisms; recorded microscopic observations on muscle fibers, blood vessels, and spermatozoa still used today d. Wilhelm Roentgen: discovered roentgenograms (X-rays) that allowed internal views of the body and aided in diagnosis of disease e. Sir Alexander Fleming: discovered penicillin, which led to the development of the many antibiotics in use today f. Ignaz Semmelweis: provided first attempt at decreasing infections during childbirth g. Joseph Lister: began the standards to prevent infections in surgical suites 2. (any 6 of the following) use diagnostic related groups (DRGs) to place a limit on the cost of care for patients with certain diagnoses on government insurance plans such as Medicare and Medicaid; replace fee-forservice compensation with value-based compensation or bundled payments; combine services to eliminate duplication of services; use outpatient services to allow patients to receive care without being admitted to hospitals or other care facilities; use mass or bulk purchasing and buy equipment and supplies in larger quantities at reduced prices; use computerized inventory to determine when supplies are needed to prevent overstocking and waste; provide early intervention and preventive services before acute or chronic disease occurs; practice energy conservation by monitoring the use of energy to control costs and conserve resources 3. (any 4 of the following) (Note: answers will vary as student identifies specific ways to conserve energy in a medical office; check their model or sketch to ascertain they have shown 4 of these methods.) proper management and disposal of waste, designing and building new energy-efficient facilities, maintaining heating/ cooling systems, using insulation and thermopane windows to prevent hot/cool air loss, repairing plumbing fixtures immediately to stop water loss, replacing energy-consuming light bulbs with energy-efficient bulbs, installing infrared sensors to turn water faucets on and off, using alternative forms of energy such as solar power, recycling 4. Answers will be individualized, but student must identify 2 CAM therapies and explain why they are beneficial and effective (see Table 1-8 for list of CAM therapies).

5. An outbreak of a disease that occurs over a wide geographic area and affects a high proportion of the population; (any 4 of the following) education to alert the population about ways to prevent the spread of the disease, increased vaccine research and production, stockpiling antiviral drugs so they are available, development of protective public health measures, international cooperation to limit the spread of lethal viruses 6. Answers will be individualized, but student must choose one of the biotechnological sciences, identify a ­potential bioethical concern, and state how the issue could be resolved.

SUGGESTED ANSWERS TO THE WORKBOOK ASSIGNMENT A. Matching 1. C 2. Q 3. N 4. L

5. V 6. U 7. M 8. I

9. D 10. E 11. A 12. G

13. S 14. B 15. O 16. R

17. P 18. H 19. W 20. T

B. Completion and Short Answer 1. supernatural spirits and demons 2. good diet, fresh air, cleanliness, exercise 3. Greek symbol associated with medicine and healing 4. prayer and divine intervention 5. (any 4 of the following) bubonic plague, smallpox, diphtheria, tuberculosis, typhoid, the plague, malaria

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2 INSTRUCTOR’S MANUAL

6. allowed physicians to view body organs and see the connections between different body systems; artists could draw the body accurately; provided a better understanding of anatomy and physiology 7. allowed physicians to see organisms too small to be seen by the human eye; provided the first observation of pathogenic organisms 8. plants and herbs 9. allowed physicians to listen to internal body sounds; by studying chest sounds, they could correlate them with diseases found on autopsy; René-Théophile-Hyacinthe Laënnec 10. (any 4 of the following) Florence Nightingale: began formal training for nurses; Elizabeth Blackwell: first female physician in the United States; Dorothea Dix: Superintendent of Female Nurses of the Army; Elizabeth Garrett Anderson: first female physician in Britain; Clara Barton: founded the American Red Cross 11. began the search for gene therapy to cure inherited diseases 12. computer technology 13. answers will be individualized; student must state a major advancement they would like to see and why they want the advancement 14. a. cost containment: trying to control the rising cost of health care, keeping health care at levels individuals can afford b. diagnostic related groups (DRGs): certain diagnoses classified in one payment group, done to control rising costs, leads to early release from hospitals and need for other facilities c. energy conservation: monitoring the use of energy to control costs and conserve resources d. home health care: providing care in the home, increasing because of early hospital release resulting from DRGs, desire of patients for care in home e. geriatric care: care of the elderly, increasing because of increase in life span and large number of people who are approaching this age group f. telemedicine: use of video, audio, and computer systems to provide medical and/or health care services g. wellness: state of being in optimum health, more awareness of good health and more stress on preventing or delaying disease h. complementary and alternative methods of health care: individuals seek other types of treatment for a variety of conditions, health care provider must respect person’s right to receive this care i. pandemics: outbreaks of a disease in a wide geographic area affecting a high proportion of the population are more likely to occur because society is global and individuals travel readily throughout the world, the mutation of viruses also increases the chances for diseases to spread rapidly j. biotechnologies: increased emphasis on newer sciences will potentially change the practice of medicine by creating specific individualized treatments based on a person’s genetic makeup 15. (any 4 of the following) complete a state-approved training program, pass a written and/or competency examination, continuing education, periodic evaluation of performance, retraining and/or retesting if the assistant does not work in a health care facility for more than 2 years 16. care that promotes physical, emotional, social, intellectual, and spiritual well-being 17. complementary therapies are used in conjunction with conventional medical therapies

alternative therapies are used in place of conventional medical therapies 18. each person is unique and may require different medical treatments and a variety of CAM therapies 19. (any 6 of the following) avian flu (H5N1), swine flu (H1N1), Ebola virus, hantavirus, severe acute respiratory syndrome (SARS) virus, monkeypox, Marburg virus, COVID-19 or coronavirus, or any microorganism that could potentially cause a pandemic 20. a. pharmacogenomics b. genomic or genetic testing c. stem cell research d. proteomics e. nanotechnology

CHAPTER 2 HEALTH CARE SYSTEMS SUGGESTED ANSWERS TO THE END OF CHAPTER REVIEW QUESTIONS 1. hospitals are classified as private or operated for profit, nonprofit, and government, depending on the sources of income received by the hospital; most charge a fee for services; grants and contributions help provide financial support, especially for nonprofit hospitals; government hospitals receive tax money from federal, state, and local governments © 2022 Cengage Learning, Inc. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

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INSTRUCTOR’S MANUAL 3

2. a. Centers for Disease Control and Prevention: concerned with causes, spread, and control of diseases in populations b. U.S. Food and Drug Administration: responsible for regulating food and drug products sold to the public c. National Institutes of Health: involved in research on disease and conducting scientific studies d. Occupational Safety and Health Administration: establishes and enforces standards that protect workers from job-related injuries and illnesses e. United States Department of Health and Human Services: deals with the health problems in the United States f. World Health Organization: compiles statistics and information on disease, publishes health information, and investigates and addresses serious health problems throughout the world g. Office of the National Coordinator for Health Information Technology: leads national efforts to build a private and secure nationwide health information exchange 3. identify and understand their respective position in a given facility’s organizational structure; know their lines of authority and understand who are the immediate supervisors in charge of their work 4. deductible: amount that must be paid by the patient for medical services before the health insurance policy begins to pay; co-insurance: requires that specific percentages of expenses are shared by the patient and insurance company; co-payment: specific amount of money a patient pays for a particular service; premium: a fee the individual pays to the health insurance company for insurance coverage; assignment of benefits: an agreement that assigns the benefits of health insurance to a physician of health care facility so they can collect payment directly from the insurance company 5. (any 3 of the following) study specific disease or group of diseases, provide funding to encourage research directed at curing or treating the disease, promote public education regarding information obtained through research, provide special services to victims of disease, provide treatment centers, supply information about community agencies that offer assistance 6. public health departments promote and protect public health; during pandemics or health threats, these agencies can recommend mandates like “shelter in place” and self-quarantine requirements; also provide specific services needed by the state or local community such as testing and immunization for disease control, inspections for environmental health and sanitation, collection of statistics and records related to health, health education, clinics for health care and prevention, and other services needed in a community; local health care services provide information on home care, recreation programs, meal and food assistance programs, transport, and other resources SUGGESTED ANSWERS TO THE WORKBOOK ASSIGNMENT 1. a. optical center, b. health maintenance, c. hospice, d. industrial health, e. school health, f. mental health, g. clinic, h. rehabilitation, i. hospital, j. medical office 2. a. long-term care facilities, b. emergency care services, c. mental health facilities, d. industrial health care centers, e. dental offices, f. laboratories, g. home health care agencies, h. rehabilitation facilities, i. genetic counseling facilities, j. pharmaceutical services 3. private or proprietary, religious, nonprofit or voluntary, government 4. residential care facilities: provide basic physical and emotional care for individuals who can no longer care for themselves extended care facilities: provide skilled nursing and rehabilitative care

independent living facilities: provide assistance with meals, housekeeping, laundry, transportation, and basic medical care to individuals who can care for themselves 5. (any 3 of the following) diagnosis, treatment, examinations, basic laboratory tests, minor surgery 6. (any 3 of the following) group of doctors who share a facility, surgical clinics, urgent care or emergency care clinics, rehabilitation clinics, substance abuse clinics, specialty clinics, outpatient or ambulatory clinics, health department clinics, medical center clinics 7. (any 3 of the following) nursing care, personal care, therapy, homemaking 8. care that provides support and comfort to allow a person to die with dignity 9. help patient with physical or mental disabilities obtain maximum self-care and function 10. (any 3 of the following) provide emergency care for accidents or sudden illness, perform tests for health conditions, promote health education, maintain safe and sanitary environment, counseling

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4 INSTRUCTOR’S MANUAL

11. World Health Organization, U.S. Department of Health and Human Services, National Institutes of Health, Occupational Safety and Health Administration, Agency for Health Care Policy and Research, Centers for Disease Control and Prevention 12. (any 4 of the following) testing and immunization for disease control, inspections for environmental health and sanitation, communicable disease control, collection of statistics and records, health education, clinics, distribution of information on resources that support people’s well-being 13. a. donations, membership fees, fundraisers, federal or state grants b. ensure that patients receive the safest, highest quality care in any health care setting c. (any 2 of the following) study disease, provide funding for research, promote public education, provide special services to victims of disease, provide treatment centers, supply information about other community agencies 14. shows a line of authority to indicate areas of responsibility and leads to efficient operation 15. a. premium: payment made to insurance company for health insurance coverage b. deductible: amount that must be paid by the patient for medical services before the policy begins to pay c. 75–25 percent co-insurance: company pays 75 percent and patient pays 25 percent of expense d. copayment: specific amount of money a patient pays for a particular service e. assignment of benefits: agreement that assigns benefits of insurance to health care provider so they can collect payment directly from the insurance company f. HMOs: health maintenance organizations g. PPOs: preferred provider organizations 16. a. (any of the following) monthly fee the same regardless of the amount of care, care directed toward preventive care, ready access to health examinations and early treatment b. required to use only HMO-affiliated health care providers 17. use a PPO that requires that specific hospitals or doctors be used 18. a. Medicare: almost all individuals over the age of 65, any person with a disability who has had Social Security benefits for at least 2 years, any person with end-stage renal disease b. Medicaid: individuals with low incomes, children who qualify for public assistance, individuals who are physically disabled or blind c. Children’s Health Insurance Program: uninsured children of working families who earn too little to afford private insurance but too much to be eligible for Medicaid d. Workers’ Compensation: workers who are injured on the job e. TRICARE: all active duty military personnel and their families, survivors of military personnel, retired members of the armed forces 19. developed because of rising cost of health care; principle is that all health care provided must have a purpose 20. fee-for-service compensation: doctors or health care providers are paid for each service rendered value-based compensation: doctors or health care providers are paid a certain amount for each diagnosis or disease 21. Health Insurance Portability and Accountability Act (HIPAA) 22. answers will be individualized; make sure student creates 3 examples that show how a facility or worker could be in violation of any of the 5 HIPAA regulations 23. c 24. (any 5 of the following) take an active role in maintaining good health, evaluate health care plans to choose a plan that will provide quality care at the most reasonable cost, research quality care and try to use providers who are highly rated, make informed decisions regarding health care and choose care based on your own values and beliefs, use health care benefits wisely and select the most reasonable type of care, make every effort to save money with in-network providers and generic medications, help prevent medical errors by questioning any care that does not seem appropriate

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INSTRUCTOR’S MANUAL 5

CHAPTER 3 CAREERS IN HEALTH CARE SUGGESTED ANSWERS TO THE END OF CHAPTER REVIEW QUESTIONS 1. secondary, or high school, education provides basic preparation for health careers and should include coverage of the sciences, social studies, English, and mathematics, keyboarding, computer applications, and accounting skills, and can prepare a student for immediate employment in many health care careers or for additional education after graduation; post–secondary education (after high school) can include training in a career/technical school, community college, university, or accredited online program, and provides training for health care careers that require education beyond the secondary level, such as an associate’s degree, bachelor’s degree, master’s degree, or doctorate degree 2. a. two-year course of study; any 3 careers such as dental hygienist, psychiatric/mental health t­echnician, dietetic technician, veterinary technician, health information technician, biomedical equipment technician b. four or more years of study; any 3 careers such as social worker/sociologist, dietitian, veterinary technologist, biotechnological engineer c. one or more years of work beyond a bachelor’s degree; any 3 careers such as psychologist, genetic counselor, physical therapist, epidemiologist, medical librarian d. two or more years of work beyond a bachelor’s or master’s degree; any 3 careers such as psychiatrist, physician, ophthalmologist, dentist, veterinarian, pharmacist 3. CEUs are continuing education units; required to renew licenses or maintain certification or registration in many states and to keep individuals informed on the latest research, trends, and changes to procedures, regulations, and other factors that may affect their day-to-day job duties 4. answers will be individualized; make sure student names 4 examples of careers in each of the National Health Standards clusters (refer to Table 3-2) 5. an individual who organizes, manages, and assumes the risk of a business; student must list 5 examples of entrepreneurs so answers will vary but may include dental laboratory technicians, dental hygienists, nurse practitioners, physical therapists, physician assistants, respiratory therapists, recreational therapist, physicians, dentists, chiropractors, and optometrists 6. answers will be individualized, but student must identify 3 schools that offer accredited programs in their chosen health care career 7. b, i, e, f, h, g, d, c, j, a SUGGESTED ANSWERS TO THE WORKBOOK ASSIGNMENT A. Matching 1. T 2. C 3. F 4. I 5. O

6. K 7. B 8. W 9. S 10. V

11. J 12. A 13. L 14. E 15. N

16. U 17. H 18. Q 19. R 20. G

21. D 22. M 23. P 24. X 25. Y

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6 INSTRUCTOR’S MANUAL

B. Health Care Career Search O R T H O D O N T I C S Z X E WP T V B P H Y S I C A L T H E R A P I S T X MN E C I D C X V E T E R I N A R I A N O P C MI D WQ T Y P X B N N A I C I N H C E T L A MI N A C E WI O N G H T S I G O L O N H C E T C I G O L O I D A R X B N MN I U T Y E MC T V U MK I J T V E P B I U N J X U T Y O P H Y E P I U O P T O ME T R I S T X V ME K E L P C V I E I T R O J K L I MU R O L O G I S T T X E MK U L I E R H WE S E S Q D X R L A A S E T S I E D V B N T U E S MO P I E T H I R O E V U I S E D P A R A ME D I C N X T L I E K T E R I L K E R N O E G R U S Y U R C E I D Z Q C WE A A T R G E U O C H I O I T L MI D I C A I N E A R O T C O D T H E R I P H I X E E O R T R H E P R I K I I S L O B O A T H L E T I C T R A I N E R E MU WT A I N C P I N C H I G R S O G P R N R T A N P A T H E R O R G Y N P E D O D O N T I C S N P E A D O S D O N O T P I E C S E O D E A N T I N A I T I T E I D S T N U R T H E A L T A I L Y U E R E S I P I R N A P T P R Y L R E C G Y N E C O L O G I S T R E A A WA R D C L E R K D X T I D O R N C A E L R A I T D P H Y S I C I A N E R N E U R O L O G I S T X Y Q R A P D I O R L A O Y G D MA I S H N S S E U R S E X O S T E O P A T H Y O S T I O P U A T R H Y X A R T O MP I U C MN E X Y Z WS C E N T R A L S U P P L Y S A N I T A T I J K A H O MC R O E E T A S T L S R E C B N R T S I C A MR A H P Y O G G R O S T I E P O U C I E T O B R N D MT I I WE A T H H E L P ME E D I A C I R T A I R E G R I G H MT O T N T O R R Y U I P R C C B O P H O ME H E A L T H C A R E T I E E S C H O H L R E J U I T O E T MT N C C I T O I P I X L Y O U S U R G I C A L T E C H N I C I A N F O N I U C N C S C X H P A MC H WQ R S P O R E C E P T R E C I F F O G N I T T I MD A X T I O A Y Z D E T E C L G I E R U N T O G E T H I E WA R D I A L Y S I S T E C H N I C I A N L MO ML R R I O P A R U R O B N I Z Y ME D I C A L L A B O R A T O R Y T E A C H U R N V O WE X A E L MN A S E T C X S O C I A L WO R K E R R I T WQ Y C V T S I N O I S U F R E P X P L O V I P K E N F E T H E R B I R T S I P A R E H T L A N O I T A E R C E R E A G L O Y R E T C I H I C A B X E N D O D O N T I C S H Y G I E N P A T H O L O G I S T V E T E R A MI X S MA L E L E C T R O C I H P A R G O L A H P E C N E O R T C E L E X E N C A R D G R A T H I C Copyright © Cengage Learning®. All Rights Reserved.

C. Completion and Short Answer 1. a.

Associate’s: complete a 2-year course of study at community college, technical school, or an accredited online program b. Bachelor’s: usually 4-year course of study at college, university, or an accredited online program c. Master’s: usually 1 or more years of study beyond a bachelor’s degree

Doctorate or Doctoral: two or more years beyond a bachelor’s or master’s degree 2. a. certification, b. licensure, c. registration 3. obtain additional hours of education in a specific health care career to renew a license or maintain a certificate 4. technician usually requires 2-year associate’s degree or 3–4 years of on-the-job training or special health science education; technologist usually requires at least 3–4 years of college in addition to work experience, usually bachelor’s degree and, at times, master’s degree 5. workers who can perform in a variety of health care positions; because of high cost of health care, smaller facilities or rural areas cannot afford to hire a specialist for every aspect of care 6. individual who organizes, manages, and assumes the risk of a business; (any 3 of the following) well motivated, self-confident, responsible, creative, independent

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INSTRUCTOR’S MANUAL 7

7. a. orthodontics, b. ophthalmologist, c. psychiatrist, d. oral surgeon, e. neurologist, f. gynecologist, g. urologist, h. family physician, i. periodontics, j. oncologist, k. cardiologist, l. gerontologist, m. pediatrician, n. obstetrician 8. a. dental hygienist, b. electroencephalographic technologist, c. radiologic technologist, d. emergency medical technician, e. health information (medical records) technician, f. medical coder, g. health care administrator, h. toxicologist, i. pharmacist, j. recreational therapist, k. optometrist, l. embalmer, m. epidemiologist, n. ­forensic science technician, o. medical interpreter/translator, p. genetic counselor, q. process technician 9. answers will be individualized; student must choose 3 health careers and include the duties of the careers, the educational requirements, and a brief explanation of why the careers were chosen 10. answers will be individualized; student must write a report on a specific health career and include a description of the career, specific job duties, educational requirements, employment outlook, average salaries, and at least 2 schools offering accredited programs; student must then summarize why they would be qualified for this career and how they would prepare now to enter it after graduation 11. (any 4 of the following) professional development; career information; influence legislation; assist with certification, registration, or licensure; financial support; code of ethics 12. a. diagnostic services standards, b. biotechnology research and development standards, c. support services standards, d. therapeutic services standards, e. health informatics standards

CHAPTER 4 PERSONAL AND PROFESSIONAL QUALITIES OF A HEALTH CARE TEAM MEMBER SUGGESTED ANSWERS TO THE END OF CHAPTER REVIEW QUESTIONS 1. answers will be individualized, but verbally Lucy is crying and non-verbally she is rubbing her head and holding her abdomen; relays message that she may have hurt her head and abdomen; many times non-verbal clues will provide more information about the situation than just the words that are spoken.

2. a. main motion b. lay on the table c. raise a question of privilege d. division of the assembly or house e. call for previous question f. point of order g. adjourn 3. answers will be individualized, but student should identify 1 major stress and 3 courses of action that can be taken while including the following steps of the problem-solving method in their answer: assess the situation to obtain all facts and opinions, try to identify the real stressor and why it is causing a reaction, list possible solutions, make a plan, act on your solution, evaluate the results, change the solution if necessary 4. used to ensure success in meeting established goals, allow an individual to record all activities and obligations, organize all information, become aware of conflicts, provide an organized schedule to follow, obtain self-satisfaction for achieving goals, decrease stress, and lead to quality time for rest and relaxation, a sense of being in control, a healthier lifestyle, and increased productivity; using time management decreases stress because individual is aware of what is needed to succeed and can try to avoid distractions or things that interfere with goals

© 2022 Cengage Learning, Inc. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

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SUGGESTED ANSWERS TO THE WORKBOOK ASSIGNMENT A. Crossword 1.

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Copyright © Cengage Learning®. All Rights Reserved.

B. Characteristic Profile Answers will be individualized; make sure student has defined at least 8 different characteristics in the description without using the actual words of the characteristics.

C. Completion and Short Answer 1. diet: provides body with materials for optimum health rest: provides energy and ability to deal with stress exercise: maintains circulation, improves muscle tone, enhances mental attitude, aids in weight control, and contributes to more restful sleep good posture: prevents fatigue and puts less stress on muscles avoid use of tobacco and drugs: prevents damage to body systems

preventative screenings: promote good health and prevent disease 2. (any 3 of the following) neat, well-fitting, clean, free from wrinkles, professional in appearance 3. follow standards established by place of employment 4. (any 3 of the following) fit well, provide good support, have low heels, avoid sandals or open-toe shoes, clean daily, clean/replace shoelaces frequently 5. (any 3 of the following) daily bath or shower, use of deodorant or antiperspirant, good oral hygiene, clean undergarments 6. avoid injuring patients, avoid transmitting germs, prevent torn or punctured gloves 7. hand cream or lotion 8. keep hair from touching patient, falling on a tray/equipment, or blocking necessary vision 9. watch; wedding ring; small, pierced earrings; medic alert bracelet or necklace 10. can interfere with patient care and detract from professional appearance

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11. detract from a professional appearance, are prohibited in many health care facilities 12. medical alert tattoo 13. (any 4 of the following) message must be clear, sender delivers message in a clear and concise manner, receiver must hear or receive message, receiver must understand message, avoid interruptions or distractions 14. a. not in terms patient can understand b. receiver may not be able to hear message c. distraction of radio interferes with message d. using slang or incorrect grammar e. shows lack of interest f. poor listening 15. paying attention to and making an effort to hear what the other person is saying 16. lets speaker know statements are being heard and allows speaker to clarify a message 17. facial expressions, body language, gestures, eye contact, touch 18. often conveys a message that is different from the verbal communication 19. physical and sensory disabilities, psychological attitudes and prejudice, cultural diversity 20. (any 4 of the following) use soft tone of voice, describe events, announce your presence, explain sounds or noises, use touch when appropriate 21. (any 4 of the following) allow patient to express fear or anger, encourage patient to talk about feelings, avoid arguing, remain calm, talk in a soft and nonthreatening tone of voice, provide quality care 22. values, beliefs, attitudes, and customs shared by a group of people and passed from one generation to the next 23. individual answers should include: a. check with immediate supervisor because patient may be allowed to leave article in place b. allow patient to express this belief and encourage patient to talk, do not preach your own religion c. continue with communication; patient may not feel comfortable with eye contact but still may be listening d. ask questions to see if he understands or get a translator to explain 24. (any 3 of the following) beliefs and practices regarding health and illness, language differences, eye contact, ways of dealing with terminal illness and/or severe disability, touch 25. subjective observations cannot be seen or felt, (any 2 examples) pain, itching, blurred vision; objective observations can be seen or measured, (any 2 examples) rash, bruise, elevated temperature 26. any unplanned or unintended event or situation which could have resulted in or did result in harm to a patient or that affects the health, safety, and welfare of others; reported so effective remediation can occur 27. Health Insurance Portability and Accountability Act; establishes standards for maintaining confidentiality of health care records 28. (any 5 of the following) provide a sense of belonging and self-worth, allow an individual to learn to trust and respect others and receive trust and respect in return, encourage participation in new ideas or activities, encourage personal growth, support ambitious career goals, increase self-confidence, offer safety and security, improve physical health by decreasing stress, provide support during tough times, share celebration of good times, make life more enjoyable 29. (any 5 of the following) maintain a positive attitude, be friendly and cooperate with others, assist others when they need help, listen to others, respect opinions of others, be open-minded and willing to compromise, avoid criticizing others, learn good communication skills, support and encourage others, perform duties to the best of your ability 30. many professionals with different levels of education, ideas, backgrounds, and interests working together for the benefit of the patient 31. a. democratic: encourages participation of all individuals in a group, listens to opinions of others, bases decisions on what is best for the group as a whole b. laissez-faire: believes in noninterference, has minimal rules or regulations, allows individuals to function independently, avoids making decisions until forced to do so c. autocratic: dictator, maintains total rule, makes all decisions, has difficulty delegating or sharing duties, expects others to follow directions at all times 32. answers will be individualized, but student must state which type of leader would be most effective in directing emergency room personnel; most common answer will be an autocratic leader who will take charge and give clear direction to provide care for all critically injured patients.

33. set of rules or guidelines that determine the conduct and order that is followed during a meeting

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34. a. raise a question of privilege b. call for a division of the assembly or house c. call for a point of order d. make a motion 35. body’s reaction to any stimulus that requires a person to adjust to a changing environment 36. psychiatric disorder that can occur in people who have experienced a traumatic event like a natural disaster, a terrorist act, a violent personal assault, a serious accident, or war/combat 37. stop: break out of stress response; breathe: take slow, deep breaths to relieve physical tension; reflect: think about the problem at hand and the cause of stress; choose: determine how you want to deal with the stress 38. answers will be individualized; evaluate student’s solutions to dealing with stress for a specific situation 39. short-term goals usually take days, weeks, or months to accomplish while long-term goals may take a period of years or a lifetime to accomplish; short-term goals are the smaller steps taken to reach long-term goals 40. (1) analyze and prioritize, (2) identify habits and preferences, (3) schedule tasks, (4) make a daily to-do list, (5) plan your work, (6) avoid distractions, (7) take credit for a job well done

CHAPTER 5 LEGAL AND ETHICAL RESPONSIBILITIES SUGGESTED ANSWERS TO THE END OF CHAPTER REVIEW QUESTIONS 1. implied consent or contracts are those obligations that are understood without verbally expressed terms

expressed consent or contracts are stated in distinct and clear language, either orally or in writing; answers for paragraph will be individualized, but student must explain why contracts are important and include information such as they are legally binding, give permission for care, explain all risks to patient, require that promises of care must be kept, and certain standards of care must be followed 2. medical law imposes legal implications that must be observed

medical ethics imposes moral obligations and a standard of conduct or code of behavior on what is right or wrong 3. this type of communication is not considered privileged communication and must be reported immediately per facility policy so correct action can be taken immediately 4. Health Insurance Portability and Accountability Act; (any 3 of the following) informs patients about how their health information is used; requires patients to sign a consent form before any health care provider can use the health information for diagnosis, treatment, billing insurance claims, or quality care assessments; allows a patient to sign an authorization form for the release of information that identifies the purpose or need for the information, the extent of the information that may be released, any limits on the release of information, the date of authorization, and the signature of the person authorized to give consent; provides patients with information on how to file a complaint against a health care provider who violates the privacy rule 5. (any 2 of the following) considered to be privileged communications, patient has right to obtain a copy of any information in record, can be used as legal records in a court of law, erasures are not allowed and errors must be corrected so original incorrect entry can still be seen, must be kept confidential, must be retained for legal amount of time required by law, should be shredded or burned when they are no longer required 6. answers will vary, but student must obtain and compare two different codes of ethics for health professions and describe scope of practice for each profession 7. Mr. Gonzales’ DNR order was for a terminal condition; a reaction to a laboratory dye is not terminal, so CPR should be started.

8. (any 6 of the following) free choice regarding physician, treatment, care, and participation in research; freedom from abuse and chemical or physical restraints; privacy and confidentiality of personal and clinical records; accommodation of needs and choice regarding activities, schedules, and health care; ability to voice grievances without fear of retaliation or discrimination; ability to organize and participate in family/resident groups and in social, religious, and community activities; receive information on medical benefits, medical records, survey results, deficiencies of the facility, and advocates including the ombudsman program; freedom to manage personal funds and use personal possessions; unlimited access to immediate family or relatives and to share a room with their spouse, if both are residents; remain in the facility and not be transferred or discharged except for medical reasons, the welfare of the resident or others, failure to pay, or if the facility either cannot meet the resident’s needs or ceases to operate

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9. (any 6 of the following) perform only procedures for which you are legally qualified and have the necessary training or you violate a patient’s rights by putting the patient at risk for injury or harm; use only approved methods while performing any procedure or charges of negligence or malpractice could occur; obtain proper authorization to be sure you are legally allowed to perform a procedure; identify the patient by checking the name band and stating the patient’s name clearly to avoid administering the wrong medication or treatment; explain a procedure and obtain the patient’s consent before performing any procedure to avoid charges of assault and battery; observe all safety precautions to avoid patient harm and identify safety hazards so they can be corrected or eliminated before injury occurs; keep all information confidential to avoid charges of invasion of privacy or defamation; think before you speak and do not reveal information unless you are permitted to do so or charges of invasion of privacy or defamation could occur; treat all patients equally or charges of discrimination or negligence could occur; do not accept any bribes or tips for the care you provide because it is illegal and unethical and violates the rights of patients who should receive the same quality of care as all other patients; report any errors immediately to your supervisor so corrective action can be taken or you could expose yourself and the facility to potential legal ramifications; behave professionally in dress, language, manners, and actions so you create a positive attitude and confidence in your ability SUGGESTED ANSWERS TO THE WORKBOOK ASSIGNMENT 1. a.

CONTRACT TORTS b.

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2. criminal law focuses on the wrongs against a person, property, or society

civil law focuses on the legal relationships between people and the protection of a person’s rights 3. answers will be individualized but make sure the student creates a situation that brings out the following information: a. malpractice: failure of a professional to use the degree of skill and learning commonly expected in a profession b. negligence: failure to give care that is normally expected c. assault and battery: threat or attempt to injure or unlawful touching of another person without consent d. invasion of privacy: unnecessarily exposing an individual or revealing personal information about an individual without consent e. false imprisonment: restraining an individual or restricting an individual’s freedom f. abuse: any care that results in physical harm, pain, or mental anguish g. defamation: false statements causing ridicule or damage 4. both refer to giving out incorrect information in error; slander is spoken, and libel is written 5. offer, acceptance, consideration 6. implied consent or contracts cause obligations without verbally expressed terms

expressed consent or contracts state obligations in distinct and clear language either orally or in writing 7. (any 3 of the following) minor, mentally incompetent persons, individuals under the influence of drugs that alter the mental state, semiconscious or unconscious persons 8. interpreter/translator must be provided 9. principal is responsible for the actions of an agent; principal may be held vicariously liable and required to compensate or pay people whom agent has injured

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10. all information given to health care personnel by a patient; written consent of the patient 11. (any 3 of the following) birth and death information; injuries caused by violence; drug abuse; communicable diseases; sexually transmitted diseases 12. health care provider; right to obtain a copy of any information in the record 13. cross out error with a single line so material is still readable, insert correct information, initial and date entry; on an EHR follow the directions for making corrections in the particular software being used or follow agency policy 14. (any 3 of the following) limit personnel with access, use iris scans or fingerprints to access records, use codes, require passwords, monitor and evaluate computer use 15. (any 3 of the following) higher patient safety with quick access to medical history and lab tests, better coordinated care across different health care facilities and across different specializations within those facilities, patient access to the Electronic Health Record (EHR), information for research and public health monitoring, reduction in health care costs due to the elimination of repeating the same tests in different facilities 16. Standards for Privacy of Individually Identifiable Health Information as a result of HIPAA 17. identify the purpose or need for the information, extent of the information that may be released, limits on the release of the information, date of the authorization, signature of the person authorized to give consent 18. scope of practice, federal laws, federal agencies, educational, professional, ethics, policy or procedure manual, legally 19. set of principles relating to what is morally right or wrong 20. a. report to immediate supervisor, b. report to immediate supervisor, c. refer question to dentist, d. report the signs to immediate supervisor or to individual responsible for reporting suspicions of abuse to proper authorities 21. factors of care that patients can expect to receive 22. (any 5 of the following) receive accurate, easily understood information and assistance in making informed health care decisions; a choice of health care providers that is sufficient to ensure access to appropriate highquality health care; access to emergency health services when and where the need arises; be able to fully participate in all decisions related to their health care; be represented by parents, guardians, family members, or other conservators if they are unable to fully participate in treatment decisions; considerate and respectful care; not be discriminated against in the delivery of health care services; be able to communicate with health care providers in confidence and have the confidentiality of their individually identifiable health care information protected; review and copy their own medical records and request amendments to their records; a fair and efficient process for resolving differences including a rigorous system of internal review and an independent system of external review 23. Omnibus Budget Reconciliation Act (OBRA) of 1987 24. answers will be individualized, but student must choose any 3 of the following rights under the PPACA and state why they are important: easy-to-understand summary of insurance benefits and coverage; coverage for essential health benefits; preventive care for specific procedures; coverage even if a pre-existing illness or condition exists; coverage to age 26 under a parent’s health plan; choose any available participating primary care provider as their doctor; receive care for emergency medical conditions at any emergency care facility; no annual or lifetime limits on health care benefits; no arbitrary withdrawal or cancelation of insurance coverage; be able to appeal any health plan decision; a review by an independent organization if a health insurance company denies payment for a claim or terminates insurance coverage; refund of a percentage of premiums if an insurance company does not spend at least 80 to 85 percent of premiums paid on health care 25. a. living will: allows an individual to state what measures should or should not be taken to prolong life when their condition is terminal b. durable power of attorney (POA): permits an individual to appoint another person to make decisions regarding health care when the individual is unable to make decisions 26. do not resuscitate order; means that CPR is not performed when the patient stops breathing 27. requires all health care facilities receiving federal aid to inform every adult of their right to make decisions concerning medical care, including the right to refuse treatment and right-to-die options 28. (any 3 of the following) check name band, state patient’s name clearly, repeat name, use scanner on bar code ID band, check photo ID if worn 29. a. state that you are not qualified or legally permitted to give injections b. check with immediate supervisor; do not take the temperature c. explain that you are not authorized to reveal the information and refer the wife to her husband’s doctor or your supervisor © 2022 Cengage Learning, Inc. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

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CHAPTER 6 MEDICAL TERMINOLOGY SUGGESTED ANSWERS TO THE END OF CHAPTER REVIEW QUESTIONS 1. a. false, b. true, c. false, d. false, e. true 2. ophthalmopathy, adenectomy, otoplasty, neurotripsy, neurectomy, cardiac, gastroenteritis, chirospasm, hypoglycemia 3. answers will vary, but student should choose 5 word roots related to a part of the body and add at least 3 different prefixes or suffixes; examples include arthr: arthritis, arthroscopy, arthroplasty; natal: prenatal, neonatal, postnatal; neur: neuralgia, neurologist, neurology; gast: gastritis, gastroenterology, gastroenteritis; stoma: stomatitis, stomatology, stomatologist 4. a. Robert J. Graves b. Jonas Salk c. Achilles, mythical Greek warrior 5. bid means twice a day and is from the prefix bi- (s), which means twice, double, or both

tid means three times a day and is from the prefix tri, which means three

qid means four times a day and is from the prefix quad- (rai, ri), which means four answers will vary but students must explain why it is easier to remember the 3 abbreviations when they are studied together 6. answers will vary, but student should list 20 abbreviations for diagnostic tests; examples include ABG, BE, Bl Wk, BP, BS, BUN, Bx or bx, CAT, CBC, CMP, C&S, CT, CXR, Diff, ECG or EKG, EEG, EMG, ESR, FBS, FBW, GA, GTT, hct, Hgb, IVP, KUB, LP, MRI, PAP, PKU, PTT, SGOT or SGPT, TSH, VDRL 7. a. -sclerosis, b. -otomy, c. dys-, d. -itis 8. answers will vary, but student must list 2 books/videos and 2 apps for learning medical terminology and evaluate the different methods of learning as presented in these sources SUGGESTED ANSWERS TO THE WORKBOOK ASSIGNMENTS CHAPTER 6:1 INTERPRETING WORD PARTS A. Identifying Word Parts 1. cutting into the skull 2. difficult urination 3. surgical removal of the uterus 4. blood poisoning 5. inflammation around the heart 6. white cell 7. inflammation of the gallbladder 8. rapid heart 9. nerve pain 10. excess of blood cells 11. slow heart

12. surgical removal of the stomach 13. inflammation of membranes covering the brain and spinal cord 14. new disease 15. person who studies the skin 16. instrument for examining the rectum 17. malignant tumor, cancer 18. instrument for recording electrical activity of the brain

19. softening of a bone 20. paralysis of lower half of the body 21. toxic or poison to blood vessels 22. enlarged extremities 23. study of the elderly, old age 24. difficult or painful eating or swallowing 25. swelling or tumor of water

B. Analyzing Words 1. tumor of a gland 2. inflammation of the prostate gland 3. study of the eye 4. surgical removal of the gallbladder 5. inflammation within the heart 6. inflammation of the stomach and intestine

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7. low blood sugar 8. poison blood 9. less than normal urine (output) 10. formation of cells 11. same kind or type 12. condition of hardening of the arteries 13. difficult or painful flow of menstruation 14. disease or abnormal condition of the vessels 15. sewing or suturing of the eyelid 16. inflammation of the urethra and bladder 17. condition of blackness in the lung 18. disease near a bone or joint 19. hernia of the fallopian tube and ovary 20. self-originating disease with a deficiency or decrease in the number of cells causing clot formation 21. seizure while sleeping 22. inflammation of a sweat gland 23. suture or sewing up of a rupture 24. condition of blueness of skin 25. surgical puncture to remove fluid from the thorax or chest CHAPTER 6:2 USING MEDICAL ABBREVIATIONS A. Identifying Abbreviations 1. discontinued, discharge 2. operating room 3. whenever necessary, as needed 4. before meals 5. immediately, at once 6. registered nurse 7. weight 8. chloride, chlorine 9. prescription, take, treatment 10. apical pulse 11. temperature 12. nothing by mouth 13. specimen 14. with 15. one-half 16. without B. Interpreting Orders 1. temperature, pulse, and respiration morning and afternoon 2. 2 drops twice a day 3. 1 cubic centimeter intramuscular 4. complaining of headache, give non-steroidal antiinflammatory drugs whenever necessary 5. check blood sugar four times a day before meals and hour of sleep (bedtime) 6. weight and height daily in morning (before noon) 7. bed rest with bathroom privileges only

17. patient, pint 18. blood pressure 19. respiration, rectal 20. sodium 21. Centers for Disease Control and Prevention 22. do not resuscitate 23. last menstrual period 24. methicillin-resistant Staphylococcus aureus 25. female 26. venipuncture, venous pressure 27. automated external defibrillation 28. Health Insurance Portability and Accountability Act 29. long-term care 30. body mass index

8. 1,000 milliliters normal saline intravenous 9. do electrocardiogram in coronary care unit 10. dissolve 2 teaspoons sodium chloride (salt) in 1 quart water 11. 1,000 cubic centimeters soap solution enema at hour of sleep (bedtime) 12. schedule blood laboratory in the morning (before noon) including complete blood count, blood urea nitrogen, comprehensive metabolic panel, and fasting blood sugar

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INSTRUCTOR’S MANUAL 15

13. dilute 1 tablet in 1 pint water 14. 1 capsule antibiotic by mouth after meals and hour of sleep (bedtime) 15. blood pressure is measured in millimeters of mercury 16. nothing by mouth before an operation 17. do ear, eye, nose, and throat exam in outpatient department 18. obstetrics-gynecology 19. 500 milligrams intramuscular at 8 in the morning (before noon) 20. vital signs immediately (at once) and every 2 hours 21. to physical therapy by wheelchair for range-ofmotion and activities of daily living twice a day 22. force fluids clear liquids to 240 milliliters every 2 hours

23. insert nasogastric tube for gastroesophageal reflux disease 24. diagnosis: chronic obstructive pulmonary disease, oxygen whenever necessary, intermittent positive pressure breathing twice a day every 12 hours 25. give the following directions: 2 capsules by mouth three times a day with food or milk 26. diagnosis: cerebral vascular accident, computerized tomography scan of the brain immediately (at once) 27. prescription: 20 milliliters potassium chloride intravenous 28. emergency medical technician is certified for advanced cardiac life support 29. normal saline intravenous to keep vein open 30. sequential compression device and passive range of motion after an operation

Note to Instructor: Use the abbreviation and word element lists to develop weekly tests. This provides the student with application of knowledge and provides a means of evaluation of this chapter.

CHAPTER 7 ANATOMY AND PHYSIOLOGY SUGGESTED ANSWERS TO THE END OF CHAPTER REVIEW QUESTIONS 1. congenital: acquired during development of the infant in the uterus and present at birth; (any 4 of the following) club foot, cleft lip, cleft palate, fetal alcohol syndrome, spina bifida, or any other congenital disease

inherited: transmitted from parents to child genetically; (any 4 of the following) color blindness, hemophilia, cystic fibrosis, Down syndrome, or any other inherited disease infectious: caused by a pathogenic organism; (any 4 of the following) common cold, hepatitis, meningitis, influenza, or any other infectious disease degenerative: caused by a deterioration of the function or structure of body tissues; (any 4 of the following) arteriosclerotic heart disease, chronic obstructive pulmonary disease, osteoarthritis, osteoporosis, or any other degenerative disease 2. answers will be individualized, but student must draw a sketch of the body, identify all body cavities and list the organs in each including cranial: brain; spinal: spinal cord; thoracic: esophagus, trachea, bronchi, lungs, heart, and large blood vessels; upper abdominal: stomach, small intestine, most of large intestine, appendix, liver, gallbladder, pancreas, and spleen; pelvic: urinary bladder, reproductive organs, and part of large intestine; orbital: eyes; nasal: nose structures; and buccal: mouth, teeth, and tongue; and create an overlay with the quadrants and organs in each including RUQ: liver, gallbladder, part of small and large intestine; LUQ: stomach, pancreas, spleen, part of large and small intestine; RLQ large and small intestine, appendix, reproductive organs, and part of urinary bladder; LLQ: small and large intestines, reproductive organs, and part of urinary bladder; See Figures 7-7 and 7-8 in text for comparison 3. (any 5 of the following) macule: flat, discolored lesion; papule: small, solid raised lesion; vesicle: small blister containing watery fluid; pustule: small elevation of the skin containing pus; crust: collection of dried serum and cellular debris; wheal: smooth, slightly elevated swollen area that is redder or paler than the surrounding skin; ulcer: open lesion of the skin or mucous membrane resulting in tissue loss; cyst: a closed sack or pouch containing soft or semisolid material 4. axial skeleton forms the main trunk of the body and is composed of the skull, spinal column, ribs, and breastbone; appendicular skeleton forms the extremities and is composed of the shoulder girdle, arm bones, pelvic girdle, and leg bones 5. involuntary muscle: acts on its own without conscious thought or control to produce movement; examples include cardiac muscle and visceral muscle

voluntary muscle: a person has conscious thought or control over the movement; an example is skeletal muscle © 2022 Cengage Learning, Inc. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

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6. sympathetic nervous system acts in times of emergency and prepares body to act by increasing heart rate, respiration, and blood pressure, and by slowing activity in digestive tract; parasympathetic nervous system takes over after an emergency to counteract the actions of the sympathetic nervous system by slowing heart rate, decreasing respiration, lowering blood pressure, and increasing activity in the digestive system; usually two systems work together to maintain homeostasis and control involuntary body functions at proper rates 7. etiology: blood flow to brain is impaired due to a blood clot or hemorrhage; signs and symptoms: loss of consciousness, weakness or paralysis on one side of the body, dizziness, dysphagia, visual disturbances, mental confusion, aphasia, incontinence; treatment: thrombolytics if blood clot is present, angioplasty if atherosclerosis is present, surgery to stop bleeding if hemorrhage is present, neuroprotective agents, and physical, occupational, and speech therapy as needed 8. cornea, aqueous humor, pupil, lens, vitreous humor, rods and cones in retina, optic nerve to occipital lobe of brain 9. ringing in the ears; Ménière’s disease 10. a. iron deficiency anemia: low hemoglobin due to inadequate amount of iron; aplastic anemia: poor or no formation of erythrocytes due to injury or destruction of bone marrow; pernicious anemia: formation of abnormal erythrocytes due to lack of intrinsic factor resulting in inadequate absorption of vitamin B12; sickle cell anemia: chronic inherited disease resulting in abnormal crescent-shaped erythrocytes that carry less oxygen, break easily, and block blood vessels b. congestive heart failure: heart muscles do not beat adequately to supply blood needs of the body c. aneurysm: ballooning out or saclike formation on wall of a blood vessel d. atherosclerosis: fatty plaques are deposited on the walls of the arteries, which reduces or eliminates blood flow e. myocardial infarction: a blockage in the coronary arteries cuts off the supply of blood to the heart causing ischemia, tissue injury, or tissue death 11. pick up lymph at tissues throughout the body and carry it to nodes where it is filtered and impurities are removed 12. any chronic lung disease that results in obstruction of the airways and limitation of air flow such as chronic asthma, chronic bronchitis, emphysema, and tuberculosis 13. secretes pancreatic juice which contains enzymes including amylase or amylopsin, which chemically digests sugars; trypsin or chymotrypsin, which chemically digests protein; and lipase or steapsin, which aids in the chemical breakdown of fats 14. a. oliguria: below normal amounts of urination b. polyuria: excessive urination c. nocturia: urination at night d. incontinence: involuntary urination e. pyuria: pus in the urine f. albuminuria: albumin, a blood protein, in the urine 15. pituitary gland in the brain because it produces many hormones that affect the function of other endocrine glands 16. answers will vary, but student must list 3 STIs and describe how symptoms are the same or different in males versus females; examples: AIDS: symptoms are the same in both males and females; Chlamydia: males experience burning when urinating and a mucoid discharge while females are frequently asymptomatic but may have a vaginal discharge; gonorrhea: males have a greenish-yellowish discharge, burning when urinating, sore throat, and swollen glands while females are frequently asymptomatic but may experience dysuria, pain in the lower abdomen, and greenish-yellowish discharge; herpes: symptoms are the same for both males and females and include a burning sensation, fluid-filled vesicles (blister-like sores) that rupture and form painful ulcers, and painful urination; pubic lice: symptoms are the same for both males and females and include an intense itching and redness of the perineal area; syphilis: symptoms are basically the same, but the symptom of the chancre sore usually appears on the penis of the male and in the vulva or on the cervix of the female; trichomoniasis: females usually have a large amount of a frothy, yellow-green, foul-smelling discharge while males are frequently asymptomatic but may experience urethral itching

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INSTRUCTOR’S MANUAL 17

SUGGESTED ANSWERS TO THE WORKBOOK ASSIGNMENTS CHAPTER 7:1 BASIC STRUCTURE OF THE HUMAN BODY 1. A. cell membrane: outer protective covering B. endoplasmic reticulum: transports materials in and out of nucleus; aids in synthesis and storage of protein C. nucleus: controls activities of cells D. nucleolus: reproduction of cell E. chromatin: forms chromosomes that contain genes F. cytoplasm: fluid containing water, food, and special materials; site for all chemical reactions in cell G. mitochondria: produce energy H. Golgi apparatus: produces, stores, and packages secretions for discharge from the cell I. lysosomes: contain digestive enzymes to digest and destroy old cells, bacteria, and foreign materials J. pinocytic vesicle: allows protein or fat to enter cell K. vacuole: pouchlike structure filled with watery substance, stored food, or waste products 2. anatomy, physiology, pathophysiology 3. a. congenital, b. infectious, c. degenerative, d. inherited 4. chemical, cellular, tissue, organ, organ system, organism 5. Atoms, Molecules, cells, homeostasis 6. (any 4 of the following) take in food and oxygen, produce heat and energy, move and adapt to the environment, eliminate wastes, perform specific functions, reproduce 7. a. filtration, b. diffusion, c. osmosis 8. strings of DNA nucleotides 9. mitosis; see Figure 7-2 in the textbook to evaluate the student’s sketch showing the process of mitosis 10. dehydration, edema 11. epithelial: covers surface of the body and lines body cavities connective: supporting fabric of organs and body parts nerve: controls and coordinates body activities by transmitting messages throughout the body muscle: produces power and movement 12. adipose 13. (any 3 of the following) store fat to provide energy, insulate the body, fill the area between tissue fibers, provide padding for body 14. bone tissue has calcium salts, nerves, and blood vessels 15. skeletal: provides movement of the body cardiac: causes the heart to beat visceral or smooth: forms walls of the respiratory, digestive, urinary tract, and blood vessels 16. organ, heart, stomach, lungs 17. answers will vary, but student may list any 10 of the following body systems and briefly state the function: integumentary: protects body from injury, infection, and dehydration, helps regulate body temperature, eliminates some wastes, produces vitamin D; skeletal: creates framework of body, protects internal organs, produces blood cells, acts as levers for muscles; muscular: produces movement, protects internal organs, produces body heat, maintains posture; nervous: coordinates and controls body activities; special senses: allow body to react to environment by providing sight, hearing, taste, smell, and balance; circulatory: carries oxygen and nutrients to body cells, carries waste products away from cells, helps produce cells to fight infection; lymphatic: carries some tissue fluid and wastes to blood, assists with fighting infection and body immunity; respiratory: breathes in oxygen and eliminates carbon dioxide; digestive: digests food physically and chemically, transports food, absorbs nutrients, eliminates waste; urinary: filters blood to maintain fluid and electrolyte balance in the body, produces and eliminates urine; endocrine: produces and secretes hormones to regulate body processes; reproductive: provides for reproduction of life

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CHAPTER 7:2 BODY PLANES, DIRECTIONS, AND CAVITIES 1. (1) E (2) O

(3) I (4) H

(5) Q (6) K

(7) L (8) C

(9) N (10) F

(11) J (12) B

(13) G (14) A

(15) M

2. A. dorsal, B. ventral, C. cranial, D. spinal, E. thoracic, F. abdominal, G. pelvic, H. orbital, I. nasal, J. buccal 3. a. cranial: brain b. spinal: spinal cord c. thoracic: esophagus, trachea, bronchi, lungs, heart, large blood vessels d. upper abdominal: stomach, small intestine, most of large intestine, appendix, liver, gallbladder, pancreas, spleen e. pelvic: urinary bladder, reproductive organs, last part of large intestines f. orbital: eyes g. nasal: nose structures h. buccal: teeth, tongue 4. right upper quadrant (RUQ), left upper quadrant (LUQ), right lower quadrant (RLQ), left lower quadrant (LLQ) 5. a. epigastric, b. right iliac/inguinal, c. left hypochondriac, d. umbilical, e. right lumbar, f. hypogastric or pelvic CHAPTER 7:3 INTEGUMENTARY SYSTEM 1. A. epidermis B. dermis C. subcutaneous fascia or hypodermis D. dermal papilla E. sweat pore F. hair shaft G. strata corneum H. strata germinativum I. sebaceous (oil) gland J. hair follicle K. nerve fiber L. sudoriferous (sweat) gland M. artery N. vein 2. areas on dermis that fit into ridges on the strata germinativum of the epidermis; form an individual’s unique fingerprints and footprints 3. sudoriferous; water, salts, body wastes 4. sebaceous; produce an oil that keeps skin and hair from becoming dry and brittle, help prevent infection 5. baldness or a loss of hair on the scalp 6. protection, sensory perception, body temperature regulation, storage, absorption, excretion, production 7. dilate: get larger; excess heat escapes through the skin constrict: get smaller; heat is retained in the body 8. a. erythema: reddish color, caused by burns or congestion of blood in the vessels b. jaundice: yellow discoloration, presence of bile in the blood caused by liver or gallbladder disease or diseases that involve destruction of red blood cells c. cyanosis: bluish discoloration, caused by insufficient oxygen and seen with heart, lung, and circulatory diseases 9. a. vesicles, b. papules, c. crusts or scabs, d. pustules, e. macules, f. wheals, g. ulcer, h. cyst 10. a. impetigo: contagious skin infection characterized by red lesions that ooze and form a yellowish-brown crust b. verrucae and warts: warts caused by the human papilloma virus c. dermatitis: inflammation of the skin d. acne vulgaris: inflammation of sebaceous glands e. athlete’s foot: contagious fungal infection that usually affects the feet f. psoriasis: chronic, noncontagious, inherited skin disease with red thick areas covered with white or silver scales g. ringworm: highly contagious fungal infection characterized by a flat or raised circular area with a healthy looking inner area surrounded by an itchy, scaly, or crusty outer ring © 2022 Cengage Learning, Inc. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

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INSTRUCTOR’S MANUAL 19

11. A: asymmetry or unequal halves B: border with ragged edges C: color which is different shades of brown, tan, or black D: diameter large or dark in color E: evolving or change in size, shape, color, or elevation 12. major concern because melanoma is a cancer that develops in the melanocytes of the epidermis that spreads rapidly and is the most dangerous skin cancer CHAPTER 7:4 SKELETAL SYSTEM 1. Answers to crossword puzzle 1.

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Copyright © Cengage Learning®. All Rights Reserved.

2. framework, protection, levers, produce blood cells, storage of calcium 3. way all blood cells are formed, develop, and mature into their final adult types; red bone marrow 4. frontal, two parietal, two temporal, occipital, ethmoid, sphenoid 5. seven cervical, twelve thoracic, five lumbar, sacrum, coccyx 6. true ribs attach to the sternum, false ribs attach with cartilage to the rib above, floating ribs have no attachment on the front of the body 7. xiphoid process 8. ilium, ischium, pubis 9. diarthrosis: freely movable; shoulder, hip, elbow, or knee amphiarthrosis: slightly movable; vertebrae and symphysis pubis synarthrosis: immovable; suture joints of cranium 10. connective tissue bands that hold bones together at joints 11. a. arthritis: group of diseases involving inflammation in the joints b. fractures: cracks or breaks in bone © 2022 Cengage Learning, Inc. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

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c. osteomyelitis: a bone inflammation usually caused by a pathogenic organism d. osteoporosis: disease in which bones become porous or soft and likely to fracture e. sprain: damage to ligaments in a joint f. bursitis: inflammation of small, fluid-filled sacs surrounding joints g. dislocation: bone is forcibly displaced from a joint h. scoliosis: side-to-side or lateral curvature of the spine 12. Answers to diagram of the skeleton Frontal Temporal Skull Zygomatic Maxilla

Parietal Occipital Temporal Mandible Clavicle

Sternum

Scapula Vertebral column

Thorax Ribs

Humerus Radius Ulna Ilium Sacrum Coccyx

Carpals Metacarpals Phalanges

Femur

Patella

Tibia

Fibula

Tarsals

Calcaneus

Metatarsals Phalanges (A) Anterior Copyright © Cengage Learning®. All Rights Reserved.

(B) Posterior

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INSTRUCTOR’S MANUAL 21

CHAPTER 7:5 MUSCULAR SYSTEM 1. a. excitability or irritability, b. extensibility, c. contractility, d. elasticity 2. cardiac: contract to circulate blood visceral or smooth: contract to cause movement in body systems and allow organs to expand as they fill and shrink when they empty skeletal: attach to bones and cause body movement 3. involuntary muscles: function without conscious thought or control voluntary muscles: person has control over their actions 4. voluntary movement, produce heat and energy, maintain posture, protect internal organs 5. tendon, fascia 6. a. flexion, b. circumduction, c. adduction, d. flexion, e. abduction, f. extension, g. extension, h. rotation, i. adduction, j. rotation, k. supination, l. plantar flexion 7. state of partial contraction or state of readiness to act 8. muscles waste away and shrink in size and lose strength, lack of use 9. severe tightening of a flexor muscle resulting in bending of a joint; foot, fingers, wrist, and knees 10. a. biceps brachii; b. sartorius; c. trapezius; d. intercostals; e. tibialis anterior; f. gluteus maximus, quadriceps femoris, and deltoid; g. rectus abdominis; h. pectoralis major; i. sternocleidomastoid; j. quadriceps femoris 11. a. muscle spasms: sudden, painful, involuntary contractions of muscles b. muscular dystrophy: group of inherited diseases that leads to a chronic progressive muscle atrophy c. myasthenia gravis: chronic condition in which nerve impulses are not transmitted properly to the muscles d. strain: overstretching or injury to a muscle and/or tendon e. fibromyalgia: chronic widespread musculoskeletal pain CHAPTER 7:6 NERVOUS SYSTEM 1.

S E T P A R A S Y MP A T H E T I C MI U B E MS D A V N E MR U R E N T H E C MR S E D T I C E I L W T X Q R Z D E I U T E L C I R T N E V X L O V D E S A I D I U L F L A N I P S O R B E R E C MME B R F G L O P Y D J O S E S H A R O L U O U I S E X R WT N A N H N I A MA R K A R E C E R E B R U MC A E R O E C E R E B E L L U MB R U MO S Y S T O MI T H L I S R I S C R A Z E N A N D I N A MN O T S N U R B E WA H Y I A MD O E I MG I D R O C L A N I P S O T B L U T Y G U E S R S H A V U N R I C T K E O X A C E N T R A L N E R V O U S S Y S T E MWO G N U L L D E U N D E R B L E O O D L Y MP H E R Y N S P L S B R A I N P I C I T E H T A P MY S N A L I C O U R D V N A T O P H Y S I O L E G E E R T S D N MI D D I O V E R S I O C C F E D I P A Y T I O N E L J E X A U T O N O MI C N E R V O U S S Y S T E MMH MC A S Y S T E MN Y O U F I N D T H E WO R D S I Copyright © Cengage Learning®. All Rights Reserved.

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2. neuron, nucleus, dendrites, axon, myelin sheath, impulse, insulates, maintains 3. space between axon of a neuron and dendrites of other neurons 4. a. ventricles: hollow spaces that contain cerebrospinal fluid b. cerebrum: reasoning, thought, memory, speaking, sensation, sight, hearing, and voluntary body movement c. midbrain: conducts impulses between brain parts, eye reflex actions d. pons: conducts messages to other parts of brain; reflex actions such as respiration, chewing, tasting, and production of saliva e. cerebellum: coordination of muscles, balance, and posture; muscle tone f. medulla oblongata: regulates heartbeat, respiration, swallowing, coughing, and blood pressure g. spinal cord: reflex actions, carries sensory and motor messages h. meninges: cover and protect brain and spinal cord 5. dura mater, arachnoid membrane, pia mater; cover and protect the brain and spinal cord 6. shock absorber to protect the brain and spinal cord; carries nutrients and helps remove metabolic products and wastes 7. somatic, autonomic, cranial nerves, spinal nerves 8. sympathetic: increases heart rate, respiration, and blood pressure; decreases activity in digestive tract parasympathetic: decreases heart rate, respiration, and blood pressure; increases activity in digestive tract 9. balanced state in the body 10. a. paraplegia: paralysis of the lower extremities b. encephalitis: inflammation of the brain usually caused by a virus, bacteria, or chemical agent c. hydrocephalus: excessive accumulation of cerebrospinal fluid in the ventricles d. concussion: traumatic brain injury usually caused by a blow to the head or a fall that affects brain function e. cerebrovascular accident: stroke; damage to the brain resulting from a blood clot or hemorrhage f. epilepsy: condition involving abnormal surges in electrical impulses in the brain resulting in seizures or convulsions g. cerebral palsy: disturbance in voluntary muscle action caused by brain damage h. Parkinson’s disease: chronic progressive condition involving degeneration of brain cells i. amyotrophic lateral sclerosis: chronic degenerative neuromuscular disease CHAPTER 7:7 SPECIAL SENSES 1. sensations, brain, interprets, responds, photoreceptors, nociceptors, chemoreceptors, thermoreceptors, mechanoreceptors 2. A. sclera: outermost tough connective tissue layer of the eye that helps protect the eye B. choroid: middle layer of the eye that nourishes the eye C. retina: innermost nerve-sensitive layer of the eye that picks up images and sends them to brain for interpretation D. conjunctiva: mucous membrane that covers and protects the eye E. cornea: allows light rays to enter the eye F. aqueous humor: maintains forward curvature of the eyeball and bends or refracts light rays G. iris: muscle that controls the size of the pupil H. pupil: hole in the choroid coat that allows light rays to enter I. lens: refracts light rays J. vitreous humor: maintains shape of the eyeball and refracts light rays 3. bony socket of skull, eyelids and eyelashes, lacrimal glands, conjunctiva 4. cornea, aqueous humor, pupil, lens, vitreous humor; vision is distorted or blurred 5. a. astigmatism, b. glaucoma, c. myopia, d. strabismus, e. cataract, f. conjunctivitis, g. presbyopia, h. macular degeneration 6. wax produced in the outer ear; protects the ear 7. tympanic membrane; vibrates when sound waves hit it and transmits waves to the middle ear 8. malleus, incus, stapes 9. tube between the middle ear and throat; equalizes air pressure on both sides of the tympanic membrane 10. a. vestibule: acts as an entrance to two other parts of the inner ear b. cochlea: contains the organ of Corti

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INSTRUCTOR’S MANUAL 23

c. organ of Corti: transmits sound impulses to the auditory nerve d. semicircular canals: send impulses that are interpreted as the sense of balance and equilibrium 11. otitis media, otosclerosis, conduction, sensory 12. sweet and salty at tip, sour at sides, and bitter at back of tongue 13. olfactory chemoreceptors 14. (any 4 of the following) pressure, heat, cold, touch, pain CHAPTER 7:8 CIRCULATORY SYSTEM 1. Answers to crossword puzzle 1.

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2. A. pericardium or epicardium B. myocardium C. endocardium D. septum or interventricular septum E. superior vena cava

F. inferior vena cava G. right atrium H. tricuspid valve I. right ventricle J. pulmonary semilunar valve K. pulmonary artery

L. pulmonary veins M. left atrium N. bicuspid or mitral valve O. left ventricle P. aortic semilunar valve Q. aorta

3. diastole: atria contract and push blood into the ventricles 4. systole: right ventricle pushes blood into the pulmonary artery so blood goes to the lungs; left ventricle pushes blood into the aorta so blood goes to all parts of the body 5. sinoatrial (SA) node, pathways in atria, atrioventricular (AV) node, bundle of His, right and left bundle branches, Purkinje fibers 6. abnormal heart rhythm; cardiac monitors and electrocardiogram 7. a. arteries, b. veins, c. capillaries, d. aorta, e. superior and inferior vena cava, f. capillaries, g. arterioles, h. venules, i. veins, j. arteries 8. oxygen, carbon dioxide, nutrients, metabolic waste products, heat, hormones

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9. (any 6 of the following) blood proteins (fibrinogen and prothrombin), nutrients (vitamins, carbohydrates, proteins), mineral salts or electrolytes (potassium, calcium, sodium), gases (carbon dioxide, oxygen), metabolic waste products, hormones, enzymes 10. erythrocytes: 4.5 to 6.0 million, carry oxygen and carbon dioxide leukocytes: 4,500 to 11,000, fight infection thrombocytes: 150,000 to 400,000, aid in the clotting process 11. hemoglobin and the amount of oxygen present 12. complex protein found on red blood cells; carries oxygen and carbon dioxide 13. a. neutrophils and/or monocytes, b. lymphocytes, c. eosinophils, d. basophils 14. a. aneurysm; b. anemias; c. varicose veins; d. atherosclerosis; e. hemophilia; f. hypertension; g. thrombophlebitis; h. myocardial infarction or heart attack; i. embolus; j. leukemia CHAPTER 7:9 LYMPHATIC SYSTEM AND IMMUNITY 1. thin watery fluid; composed of water, digested nutrients, salts, hormones, oxygen, carbon dioxide, lymphocytes, and metabolic wastes 2. lymphatic capillaries, lymph, lymphatic vessels, lymph nodes 3. valves in the lymph vessels 4. specialized lymphatic capillaries; pick up digested fats or lipids and transport them to the bloodstream 5. carbon, cancer cells, pathogens or germs, dead blood cells 6. lymphocytes, antibodies 7. right lymphatic duct: drains the right side of the head and neck, the right chest, and the right arm thoracic duct: drains the rest of the body 8. enlarged pouchlike structure at the start of the thoracic duct; serves as storage area for purified lymph and also receives chyle from the intestinal lacteals 9. bloodstream, right subclavian vein, left subclavian vein 10. palatine: on each side of the soft palate pharyngeal: in the nasopharynx on the upper part of the throat lingual: on the back of the tongue 11. (any 4 of the following) produces leukocytes, produces antibodies, destroys old erythrocytes, stores ­erythrocytes, destroys thrombocytes, filters some metabolites and wastes from tissues 12. mass of lymph tissue located in the center of the upper chest; atrophies or wastes away after puberty 13. active immunity: protection from a specific disease by contacting the actual disease of by obtaining a vaccine to allow antibodies to build up in the body

passive immunity: receiving antibodies to fight a specific disease via mother to newborn baby or by administration of antibody-containing blood products 14. a. adenitis, b. Hodgkin’s lymphoma, c. splenomegaly, d. tonsillitis, e. lymphangitis, f. lupus, g. acquired immune deficiency syndrome (AIDS), h. mononucleosis CHAPTER 7:10 RESPIRATORY SYSTEM 1. A. nasopharynx B. nasal cavity C. oropharynx D. laryngopharynx E. diaphragm F. epiglottis G. larynx H. trachea I. left lung J. right lung K. right and left bronchi or bronchus L. bronchiole M. alveolus or alveoli © 2022 Cengage Learning, Inc. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

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INSTRUCTOR’S MANUAL 25

N. alveolar duct O. alveolar sacs 2. warmed, filtered, moistened 3. tiny hairlike structures that filter inhaled air to trap dust and other particles in the mucus; they then help move the mucus to the esophagus so it can be swallowed 4. nasopharynx, oropharynx, laryngopharynx 5. air leaves the lungs, and the vocal cords in the larynx vibrate to produce sound; tongue and lips act on sound to produce speech 6. epiglottis 7. blood capillaries, oxygen, carbon dioxide, surfactant 8. the heart lies more to the left side of the chest 9. a. inspiration: diaphragm and intercostal muscles contract and enlarge the thoracic cavity; air rushes in through the air tubes to the alveoli b. expiration: diaphragm and intercostal muscles relax; air is forced out of the lungs and air passages 10. external respiration is the exchange of oxygen and carbon dioxide between the lungs and bloodstream internal respiration is the exchange of oxygen and carbon dioxide between the bloodstream and tissue cells 11. tissue cells use oxygen and nutrients to produce energy, water, and carbon dioxide 12. decreased amount of oxygen or increased amounts of carbon dioxide in the blood 13.

BRONCHITIS INFLUENZA SINUSITIS EMPHYSEMA EPISTAXIS TUBERCULOSIS ASTHMA RHINITIS COPD PLEURISY LARYNGITIS 14. continuous positive airway pressure; used to deliver pressure to keep the airway open on individuals who have sleep apnea 15. answers will be individualized, but student must name 4 possible diseases caused by smoking, such as bronchitis, COPD, emphysema, and lung cancer, and identify ways to quit smoking CHAPTER 7:11 DIGESTIVE SYSTEM 1. A. mouth or oral cavity B. salivary glands C. pharynx D. esophagus E. liver F. gallbladder

G. stomach H. pancreas I. duodenum J. jejunum K. ileum L. cecum

M. vermiform appendix N. ascending colon O. transverse colon P. descending colon Q. sigmoid colon R. rectum

2. physical: mechanical forces, such as chewing and muscle action, break the food into smaller components chemical: digestive enzymes break food down into simpler nutrients that can be used by the cells 3. ingestion: eating and drinking

digestion: breaking down food into nutrients

absorption: blood or lymph capillaries pick up digested nutrients

excretion: eliminating waste from the body 4. tastes food, aids with chewing and swallowing of food 5. chewing and grinding of food by the teeth 6. parotid, sublingual, submandibular, lubricates, moistens, salivary amylase, carbohydrates, starches, bolus 7. peristalsis

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8. (any 4 of the following) food converted to chyme; hydrochloric acid kills bacteria, helps in absorption of iron, and helps activate the enzyme pepsin; rennin digests milk in infants; lipase starts the chemical breakdown of fats; pepsin starts protein digestion 9. a. maltase: breaks down sugars into simpler forms b. sucrase: breaks down sugars into simpler forms c. peptidases: complete the digestion of proteins d. bile: emulsifies or physically breaks down fats e. pancreatic amylase or amylopsin: chemically breaks down sugars f. trypsin: chemically breaks down proteins g. lipase or steapsin: chemically breaks down fats 10. villi, blood capillaries, lacteals, digested nutrients, fats 11. (any 3 of the following) absorption of water and remaining nutrients, storage of indigestible materials, transportation of waste products, synthesis and absorption of some B-complex vitamins and vitamin K 12. ascending colon, transverse colon, descending colon, sigmoid colon 13. (any 5 of the following) secretes bile, stores sugar or glycogen, stores iron, stores vitamins, produces heparin, produces fibrinogen and prothrombin, produces cholesterol, detoxifies substances 14. stores and concentrates bile 15. pancreas; produces pancreatic juice with enzymes to digest food and produces insulin to regulate metabolism of carbohydrates 16. a. Crohn’s disease, b. diarrhea, c. cholelithiasis, d. cirrhosis, e. celiac disease, f. ulcerative colitis, g. gastroenteritis, h. hiatal hernia, i. gastroesophageal reflux disease 17. type A hepatitis is transmitted in food or water contaminated by the feces of an infected person; type B hepatitis is transmitted by body fluids including blood, serum, saliva, urine, semen, vaginal secretions, and breast milk; type C hepatitis also is transmitted through contact with blood or body fluids; health care providers can contact the virus through contaminated body fluids and must take precautions to prevent the spread of these diseases CHAPTER 7:12 URINARY SYSTEM 1. A. kidney B. renal cortex C. renal medulla

D. renal pelvis or basin E. ureter F. urinary bladder

G. urethra H. urinary or urethral meatus

2. a state of equilibrium, or constant state of natural balance in the internal environment of the body; regulates volume and composition of blood by filtering out waste products but reabsorbing components needed by the body and maintaining fluid balance and pH 3. nephrons, renal, glomerulus, water, mineral salts, glucose (sugar), metabolic products, Bowman’s capsule, convoluted tubule, reabsorbed, capillaries, glucose, mineral salts, water, wastes, urine 4. peristalsis; moves urine from the kidney to the bladder 5. series of folds on the walls of the bladder; allow bladder to expand to fill with urine 6. females: urethra shorter and carries only urine males: longer and carries both urine and semen 7. urea, uric acid, creatinine, mineral salts, various pigments 8. a. polyuria: excessive urination b. oliguria: below normal amounts of urination c. anuria: absence of urination d. hematuria: blood in the urine e. pyuria: pus in the urine f. nocturia: urination at night g. dysuria: painful urination h. retention: inability to empty the bladder i. incontinence: involuntary urination j. proteinuria: protein in the urine k. albuminuria: albumin (a blood protein) in the urine 9. pyelonephritis, cystitis, renal calculi, uremia, urinary tract infection 10. removal of waste products from the blood by a hemodialysis machine 11. (any 2 of the following) chromic glomerulonephritis, chronic renal failure, uremia © 2022 Cengage Learning, Inc. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

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CHAPTER 7:13 ENDOCRINE SYSTEM 1. substances produced and secreted by endocrine glands; chemical messengers; transported by the blood stream 2. (any 5 of the following) stimulate exocrine glands, stimulate endocrine glands, regulate growth and development, regulate metabolism, maintain fluid and chemical balance, control various sex processes 3. a. adrenal, b. ovaries, c. pituitary, d. thyroid, e. testes, f. parathyroids, g. pancreas 4. a. insulin, b. lactogenic or prolactin, c. somatotrophin, d. parathormone, e. testosterone, f. thyroxine, g. thyrotrophin, h. epinephrine or adrenalin, i. vasopressin, j. mineralocorticoids, k. estrogens, l. progesterone 5. 1. B 2. A 3. D 4. E 5. A 6. D 7. C 8. E 9. D 10. E 6. mass of tissue in the upper part of the chest; activates cells in the immune system in early life 7. placenta; expelled as the afterbirth 8. small structure located in the brain; produces melatonin, adrenoglomerulotropin, and serotonin 9. testes; ovaries 10. (any 6 of the following) hyperglycemia, polyuria, polydipsia, polyphagia, glycosuria, weight loss, fatigue, slow healing of skin infections, vision changes CHAPTER 7:14 REPRODUCTIVE SYSTEM 1. A. scrotum: sac suspended outside the body, contains the testes B. testes: produce sperm and the male hormone testosterone C. epididymis: stores sperm while they mature and become motile; also produces a fluid that becomes part of the semen D. ductus or vas deferens: passageway and temporary storage area for sperm E. seminal vesicle: produces thick yellow fluid that provides nourishment for the sperm F. ejaculatory duct: carries sperm and semen G. prostate gland: produces an alkaline secretion; contracts during ejaculation to empty the semen into the urethra H. urethra: carries urine from the bladder and semen from the reproductive tubes I. glans penis: enlarged structure at the distal end of the penis covered with the prepuce J. penis: male organ of copulation K. bulbourethral or Cowper’s gland: secretes mucus, which serves as a lubricant, and an alkaline fluid, which decreases the acidity of the urine residue in the urethra 2. the temperature is lower, which is ideal for the production of sperm 3. epididymis, seminal vesicles, prostate gland, Cowper’s gland 4. vas deferens 5. circumcision 6. early detection of cancer in the testes; monthly 7. A. ovary: produces the ovum and female hormones B. fimbriae: help move the ovum into the fallopian tube C. infundibulum (uterine) or fallopian tube: passageway for the ovum from the ovary to the uterus; also the area for fertilization D. fundus of uterus: top section where the fallopian tubes attach E. uterine cavity or body or interior of uterus: organ of menstruation, allows for the development of an infant, and aids in expulsion of the fetus during birth F. cervix of uterus or cervical canal: connects the uterus with the vagina G. vagina: passageway for menstrual flow, receives sperm, female organ of copulation, acts as the birth canal during delivery of an infant 8. union of the ovum with sperm to create a new life; takes place in the fallopian tube 9. peristalsis and cilia 10. sperm enters the ovum; sperm nucleus combines with the ovum nucleus to form a zygote, which now contains 23 chromosomes from each of the gametes and now has 23 pairs of chromosomes containing the DNA that carries the genetic code from each parent; zygote travels to uterus and is implanted in the endometrial lining where it develops into an embryo and then a fetus; placenta forms to provide nourishment; amniotic sac surrounds developing fetus to cushion and protect it 11. endometrium; deteriorates and causes bleeding known as menstruation 12. (any 3 of the following) passageway for the menstrual flow, receives the sperm and semen from the male, female organ of copulation, birth canal during delivery of the infant © 2022 Cengage Learning, Inc. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

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13. folds in the mucous membrane of the vagina; allow the vagina to enlarge during childbirth and intercourse 14. vulva, labia majora, enclose, protect, labia minora, clitoris 15. detect breast tumors early; every month, at the end of menstruation, or on a scheduled day of the month after menopause 16. Answers to crossword puzzle 1.

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CHAPTER 8 HUMAN GROWTH AND DEVELOPMENT SUGGESTED ANSWERS TO THE END OF CHAPTER REVIEW QUESTIONS 1. growth refers to the measurable physical changes that occur throughout a person’s life, such as height, weight, body shape, and head circumference; development refers to the changes in intellectual, mental, emotional, social, and functional skills that occur over time 2. answers will vary, but student must list the 5 stages of death and dying and describe the role of the health care team member in each stage; examples may include: denial: listen to the patient and try to provide support while allowing patient to express feelings without confirming or denying terminal illness; anger: recognize that anger is not a personal attack, provide understanding and support, listen, and make every attempt to respond to the patient’s demands quickly and with kindness; bargaining: be supportive and a good listener, whenever possible try to help patient meet their goals; depression: let patient know it is “OK” to be depressed, provide quiet understanding, support, and/or a simple touch, and allow patient to cry or express grief; acceptance: provide emotional support and presence, even if it just the touch of a hand 3. euthanasia occurs when a physician or other individual administers a lethal medication or uses another method to cause an individual’s death; assisted suicide occurs when a physician or authorized individual provides medications or a method by which an individual can end their own life but does not participate in causing the individual’s death 4. (any 2 of the following) offers palliative care that provides support and comfort; allows the patient to die with dignity and comfort; controls pain; offers psychological, spiritual, social, and financial counseling 5. signs: sudden changes in appetite and sleep habits, withdrawal, depression, moodiness, excessive fatigue or agitation, neglect of personal hygiene, alcohol or drug abuse, losing interest in hobbies and other aspects of life, preoccupation with death, injuring one’s body, giving away possessions, social withdrawal from family and friends; methods to prevent suicide: do not ignore signs, provide support and understanding, get psychological or psychiatric counseling © 2022 Cengage Learning, Inc. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

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6. must be aware of needs to provide more efficient and higher quality care that assists patients in meeting needs and to better understand both their own behavior and the behavior of others SUGGESTED ANSWERS TO THE WORKBOOK ASSIGNMENTS CHAPTER 8:1 LIFE STAGES 1. growth refers to measurable physical changes that occur throughout an individual’s life; development is more difficult to measure because it refers to changes in intellectual, mental, emotional, social, and functional skills that occur over time 2. a. physical: body growth, height and weight changes, muscle and nerve development, changes in body organs b. mental: intellectual development of mind; solve problems, make judgments, deal with situations c. emotional: feelings; dealing with love, hate, joy, fear, excitement, and other similar feelings d. social: interactions and relationships with others 3. a. a process by which a person’s mind takes in information from the environment b. process of changing cognitive ideas based on new information c. a balance with the environment 4. a. Moro, or startle; b. rooting; c. sucking; d. grasp 5. a. 2–4 months, b. 6–8 months, c. 12 months, d. 6 months, e. 4–6 months, f. 6 months, g. 12 months 6. a. 2–4 years, b. 4 years, c. 6 years, d. 1–2 years, e. 6 years, f. 6 years 7. children like routines; become stubborn, angry, and frustrated when changes occur 8. broad range of conditions that impairs the ability to communicate and interact; (any 4 of the following) avoiding eye contact; difficulty understanding other people’s feelings; delayed language development; persistent repetition of words or phrases; repetitive behaviors, such as flapping or rocking; resistance to changes in routine; intense reactions to sounds, smells, tastes, textures, light, and colors 9. loyalty, honesty, values, morals 10. development of sexual organs and secondary sexual characteristics 11. (any 3 of the following) feel uncertain, inadequate, and insecure; respond to peer group influences; changes in attitude and behavior; conflict with values previously established; worry about appearance, ability, and relationships with others 12. (any 4 of the following) anxiety or stress relief, peer pressure, escape from emotional or psychological problems, experimentation with feelings that chemicals produce, instant gratification, hereditary traits, cultural influences 13. (any 5 of the following) sudden changes in appetite and sleep habits; withdrawal, depression, and moodiness; excessive fatigue or agitation; neglect of personal hygiene; alcohol or drug abuse; losing interest in hobbies and other aspects of life; preoccupation with death; injuring one’s body; giving away possessions; social withdrawal from family and friends 14. no; individual is calling for help and needs support and understanding; otherwise, individual may commit suicide 15. 4-year-old: be sensitive to the child’s fears and anxiety when dealing with strangers, enlist the help of parents or guardians, use a calm but firm approach, establish rapport with the child, use play to alleviate fear, provide simple explanations to gain cooperation, allow the child to participate in care by providing one or two choices, reassure the child, encourage verbalization of fears, answer questions, allow the child to make choices such as what color cast to use to splint a fractured bone, praise the child for cooperating, make health education fun, and listen to the child’s requests and try to fulfill them

15-year-old: be aware of the many conflicts adolescents experience, be nonjudgmental to establish rapport while providing care, listen to the adolescent’s concerns, be sensitive to nonverbal behavior, involve them in decision making, answer questions as honestly and completely as possible, and provide education about hygiene, nutrition, developmental changes, sexually transmitted diseases, and substance abuse 16. (any 5 of the following) education, dealing with independence, making career choices, determining life styles, selecting marital partner, starting a family, establishing values 17. satisfaction: (any 3 of the following) job stability, financial success, end of child rearing, good health

stress: (any 3 of the following) loss of job, fear of aging, loss of youth and vitality, illness, marital problems, problems with children/aging parents

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18. (any 8 of the following) skin becomes dry, wrinkled, and thin; brown or yellow spots appear; hair becomes thin and loses luster; bones become more brittle and porous; cartilage in vertebrae thins; muscles lose tone and strength; hearing loss; decreased visual acuity; less tolerance to temperature; memory loss; circulation decreases; kidney and bladder are less efficient; breathing capacity decreases 19. no; some show changes much later because of better health and living conditions 20. (any 4 of the following) retirement, death of a spouse or friends, physical disabilities, financial problems, loss of independence, knowledge that life must end CHAPTER 8:2 DEATH AND DYING 1. disease that cannot be cured that will result in death 2. (any 3 of the following) pain, abandonment, loneliness, unknown, loved ones, unfinished work or dreams 3. should, some hope, not be left alone 4. 1. D 3. B 5. E 7. A–E 9. A and E 11. E 2. C 4. A 6. D 8. C 10. D 12. B 5. no; some may not progress through all stages, some may be in several stages at the same time, some may overlap 6. personal feelings, terms, fear, frustration, uncertainty 7. allow patient to die with dignity and comfort 8. (any 4 of the following) providing hospital equipment; offering psychological, spiritual, social, and financial counseling; personal care; free or less expensive pain medication; pain control; volunteer support; contact with family after the death of the patient 9. advance directives 10. answers will be individualized; make sure student explains why they do or do not believe in the “right to die” 11. euthanasia occurs when a physician or other individual administers a lethal medication or uses another method to cause an individual’s death; assisted suicide occurs when a physician or authorized individual provides medications or a method by which an individual can end their own life but does not participate in causing the individual’s death 12. (any 4 of the following) resident of the state where the law is in effect; mentally competent; have a terminal illness; consent of two doctors who have examined the individual; a written request for the lethal medication; a waiting period before the medication is dispensed 13. encourages people to make their end-of-life wishes known 14. answers will be individualized; make sure student names four rights from the Dying Person’s Bill of Rights and explains why those rights are the most important CHAPTER 8:3 HUMAN NEEDS 1. lower needs should be met before an individual can strive for higher needs 2. food, water, oxygen, elimination of waste materials, sleep, protection from temperature extremes 3. (any 3 of the following) new environment, change in routine, marital problems, loss of a job, injury or disease 4. fear for personal safety is more important than money and prestige 5. social acceptance, friendship, to be loved, accept and adapt, unknown situations 6. (any 3 of the following) friends are made, social contacts are established, acceptance by others is received, able to give and receive affection and love 7. people’s feelings concerning their masculine/feminine nature, abilities to give and receive love and affection, roles in reproduction of the species 8. married couples may share the same room 9. when others show respect, approval, and appreciation 10. people have obtained their full potential or they are what they want to be 11. motivated, satisfaction, tension

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12. answers will be individualized, but student must list 4 direct methods of meeting needs and explain how to reach goal of becoming a respiratory therapist; examples include:

hard work: work hard to get good grades to obtain a scholarship realistic goals: work as a respiratory therapy assistant to earn money for the education; consider a state college with a less expensive program evaluate situation: evaluate costs at other schools, obtain a job to help cover expenses, learn to budget and save money cooperate with others: live at home, share travel expenses with others, share books, find someone to sponsor education 13. unhealthy if used all of the time; healthy if aware of use and used to cope with certain situations 14. answers will be individualized, but student must create an example for each of the following defense mechanisms: a. rationalization: reasonable excuse or acceptable explanation for behavior b. projection: placing blame on someone else or circumstances c. displacement: transferring feelings about one person to someone else d. compensation: substitution of one goal for another goal e. daydreaming: escape to daydreaming, either good or bad f. repression: transfer of unacceptable or painful ideas, feelings, and thoughts into unconscious mind g. suppression: refusing to deal with unacceptable feelings or thoughts h. regression: retreating to a previous developmental level that provides more safety and security i. denial: disbelief of an event that is too frightening to cope with j. withdrawal: cease to communicate or remove self physically from a situation 15. answers will be individualized, but basic answer should include: a. anger caused by lack of food/drink, fear of test or illness b. let patient express anger, explain purpose of test and why it takes so long, make every attempt to make patient as comfortable as possible, provide encouragement and support

CHAPTER 9 GERIATRIC CARE SUGGESTED ANSWERS TO THE END OF CHAPTER REVIEW QUESTIONS 1. a. using mild soaps, bath oils, or moisturizing lotions; taking baths or showers two or three times a week with partial baths on other days; brushing the hair to help stimulate circulation and production of oil; keeping skin areas clean and free of infection; using sunscreen b. encouraging individual to exercise as much as physical condition permits; performing range-of-motion exercises to strengthen muscles; eating a diet rich in protein, calcium, and vitamins c. wearing a hearing aid to help resolve some hearing problems; keeping the hearing aid in good working condition by changing batteries, keeping the aid clean, and checking to make sure the individual wears it correctly; speaking slowly and clearly; facing individuals when talking to them; eliminating background noise d. serving attractive foods with a variety of textures and tastes to help stimulate the appetite; practicing good oral hygiene; repairing or replacing damaged teeth; creating a relaxed eating environment; avoiding dry, fried, and/or fatty foods because such foods are difficult to chew and digest; encouraging high-fiber and high-protein foods with different tastes and textures; using seasonings and herbs to improve taste e. avoiding excessive seasonings because they can cause indigestion; decreasing caloric intake because metabolism slows; increasing fluid intake to make swallowing easier, prevent constipation, and aid kidney function f. alternating activity with periods of rest to avoid dyspnea; avoiding strenuous exercise or overexertion; using proper body alignment and positioning to ease breathing difficulties; avoiding polluted air; breathing deeply and coughing at frequent intervals to help clear the lung passages and increase lung capacity; using oxygen if necessary 2. disease is any condition that interferes with the normal function of the body, such as COPD and diabetes disability is a physical or mental defect or handicap that interferes with normal functions, such as hearing impairments and visual defects 3. answers will vary, but student must list 4 factors that cause psychosocial changes in aging and provide 2 examples of how to help an individual adapt or cope with the change; examples include: retirement: finding a part-time or consultant job, becoming active in volunteer work, or joining a club or community center; social contacts decrease as more friends and relatives die: making new friends and establishing new social contacts through church or community groups, obtaining psychological help to learn how to cope with the devastating loss of a spouse or © 2022 Cengage Learning, Inc. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

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close relative; changes in living environments: allowing individuals to create their own “home” environments in long-term care facilities by having them bring their own furniture and personal items, moving to a warmer climate, or downsizing to help reduce the amount of maintenance work and living expenses; loss of independence: allowing individuals to make as many choices as possible, providing assistance as needed but encouraging them to do as much as possible, helping individuals learn how to cope with a disability; disease and disability: listening as individual tries to adjust to situation, providing supportive care, obtaining proper medical care 4. both acute and chronic dementia cause a loss of mental ability characterized by a decrease in intellectual ability, loss of memory, impaired judgment, personality change, and disorientation, but acute dementia is treatable while chronic dementia has permanent, irreversible damage to brain cells; acute dementia: (any 4 of the following) high fever, kidney infection, dehydration, hypoxia, drug toxicity, or other treatable conditions; chronic dementia; (any 4 of the following) cerebrovascular accidents, arteriosclerosis, atherosclerosis, Alzheimer’s disease, and TIAs 5. factors that can decrease the speed and degree of physical aging include good nutrition, economic status, social environment, easy access to medical care, exercise, genetics, and other similar factors; factors that can increase the speed of aging include limited access to medical care, poor nutrition, limited finances, bad genetics, chronic disease, obesity, smoking, drug use, and other similar factors 6. important to respect an individual’s cultural and religious beliefs because the beliefs often affect language, food habits, dress, work, leisure activities, and health care; shows a respect and acceptance of cultural and religious differences; allows patients to express their own feelings and thoughts 7. specially trained individual who works with the elderly and their families, health care providers, and other concerned individuals to improve the quality of care and quality of life; investigate and try to resolve complaints, suggest improvements for health care, monitor and enforce state and/or federal regulations, report problems to the correct agency, and provide education for individuals involved in the care of the elderly 8. critical for a health care provider to differentiate between myths and facts of aging in order to both recognize problems that do exist for the elderly and understand that the needs of the elderly vary according to many circumstances SUGGESTED ANSWERS TO THE WORKBOOK ASSIGNMENTS CHAPTER 9:1 MYTHS ON AGING 1. fact 2. myth; largest percentage remain mentally competent until they die 3. fact 4. fact 5. myth; financial situation of elderly varies just as financial situation of other age groups varies; less than 12 percent live at the poverty level 6. myth; most elderly individuals live with someone and/or associate frequently with friends and family members 7. myth; many people are employed and productive into their 70s and 80s 8. myth; “old” is not determined by the number of years lived as much as by how an individual thinks, feels, and behaves 9. fact 10. myth; many retired people enjoy full and active lives 11. myth; most elderly individuals are in general good health 12. fact CHAPTER 9:2 PHYSICAL CHANGES OF AGING 1. gradual, long period, rate, degree, Lifestyle, nutrition, economic, social, medical care, normal, adapt, cope 2. (any 4 of the following for each body system) a. integumentary: skin dry, less elastic, and fragile; itching; senile lentigines; lines and wrinkles develop; nails become thick, tough, and brittle; feeling cold b. musculoskeletal: muscles lose tone, volume, and strength; bones become brittle and more likely to fracture; joints become stiff, less flexible, and painful; rib cage becomes rigid; vertebrae compress; decreased

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muscle function and mobility; weakness; slower movement; sense of balance is less sure and falls occur easily c. circulatory: cardiac output decreases, blood vessels narrow and become less elastic, blood flow to brain and other organs may decrease, blood pressure may increase, weakness and dizziness, numbness in hands and/or feet, rapid heart rate d. respiratory: respiratory muscles weaker, rib cage more rigid, alveoli thinner and less elastic and exchange of gases decreases, bronchioles lose elasticity, changes in larynx cause higher-pitched and weaker voice, dyspnea, difficulty coughing up secretions e. nervous: progressive loss of brain cells; senses of taste, smell, vision, and hearing diminish; nerve endings less sensitive; decreased ability to respond to pain and stimuli; memory loss; decrease in peripheral and night vision; increased sensitivity to glare f. digestive: fewer digestive juices and enzymes produced, peristalsis decreases, teeth are lost, liver function reduced, dysphagia may develop, indigestion, increased flatulence and constipation, decreased taste sensation g. urinary: kidneys decrease in size and become less efficient, loss of ability to concentrate urine, ability of bladder to hold urine decreases, retention of urine occurs, nocturia and incontinence may occur h. endocrine: increased production of parathormone and thyroid-stimulating hormone, decreased production of other hormones, less efficient immune system, decreased basal metabolic rate, intolerance to glucose i. reproductive: decreased vaginal secretions, uterus sags downward, breasts sag, decreased production of sperm, sexual stimulation slower, testes get smaller and less firm, decreased seminal fluid 3. a. osteoporosis, b. arthritis, c. thrombus, d. emphysema, e. cataracts, f. glaucoma, g. dysphagia, h. incontinence, i. senile lentigines 4. a. use bath oils or moisturizing lotions, decrease daily baths b. set room temperature higher; use socks, sweaters, lap blankets, and layers of clothing c. avoid fluids in evening, rest during the day d. replace buttons with self-stick bands or strips e. install grab bars in bathroom and put stool in tub f. use two or three pillows, position in semi-Fowler’s, avoid polluted air g. serve foods with variety of textures and tastes, carefully use seasonings h. encourage shorter exercise periods, alternate rest and exercise i. talk slowly and clearly, face individual, avoid yelling, eliminate background noise j. make regular trips to bathroom, wear easy-to-remove clothing, use absorbent pads CHAPTER 9:3 PSYCHOSOCIAL CHANGES OF AGING 1. frustration, mental distress 2. (any 2 of the following) part-time or consultant job, volunteer work, community or club activities 3. lose social contacts, feel useless, experience financial difficulties 4. (any 2 of the following) children marry and move away, spouse dies, friends and relatives die 5. (any 2 of the following) make new friends, establish new social contacts, participate in church and community groups 6. (any 2 of the following) reverses roles between elderly individual and son or daughter; may put a strain on marriages and other relationships; financial problems may increase for everyone; if elderly person feels unwanted or useless, conflicts and tension may occur 7. feel a loss of independence and become frightened by lack of control over environment 8. (any 2 of the following) called “resident”; bring favorite pieces of furniture, pictures, television, and personal items; allow choice in arrangement of items 9. self-governance or the ability to decide for oneself by making choices and pursuing a course of action 10. physical disabilities, illness, decreased mental ability 11. encourage patient to do as much as possible and make choices, but provide for patient’s safety 12. disease is any condition that interferes with normal function of body; disability is a physical or mental defect or handicap that interferes with normal function 13. death, chronic illness, loss of function, pain 14. (any 2 of the following) listen as the person expresses fears, be patient and understanding, provide supportive care

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CHAPTER 9:4 CONFUSION AND DISORIENTATION IN THE ELDERLY 1. (any 6 of the following) talking incoherently, not knowing name or not recognizing others, wandering aimlessly, lacking awareness of time or place, displaying hostile and combative behavior, hallucinating, regressing in behavior, decreasing attention to personal hygiene, unable to respond to commands or follow instructions 2. (any 6 of the following) stress, depression, alcohol, chemicals, kidney disease, respiratory disease, liver disease, medications, poor nutrition, lack of fluid intake 3. a. cerebrovascular accident or stroke, b. arteriosclerosis, c. atherosclerosis 4. chronic dementia has permanent, irreversible damage to brain cells; delirium (acute dementia) has a treatable cause 5. a. middle, b. terminal, c. terminal, d. early, e. middle, f. terminal, g. early, h. middle, i. middle 6. safe, secure, routine, simple, noises, crowded, commotion, reality orientation 7. answers will vary; some examples are given a. hang large clock in room b. keep room well lit and curtains open, wear regular clothes in daytime, provide activities to keep patient active during day c. call by correct name d. correctly identify yourself frequently e. put picture of patient on their door f. make sure hearing aid is in good working order, talk slowly and clearly 8. a. T, b. T, c. T, d. F, e. F, f. T, g. F, h. F, i. T, j. T CHAPTER 9:5 MEETING THE NEEDS OF THE ELDERLY 1. physical, psychological, physical, psychosocial 2. language, food habits, dress, work, leisure activities, health care 3. spiritual beliefs, bias, spiritual beliefs 4. (any 3 of the following) allow patient to express feelings and thoughts, treat spiritual articles properly, enable a person to observe religious holidays or participate in spiritual services, honor requests for special foods, provide privacy during clergy visits 5. physical, verbal, psychological, sexual 6. verbal, physical, and psychological abuse; report it to your supervisor immediately 7. verbal, physical, and psychological abuse; report your observations to the physician immediately 8. want to protect abuser who may be family member or caretaker or believe they deserve abuse 9. ensure the elderly individual of “kind and considerate care” and provide for meeting individual needs 10. Ombudsman, investigate, resolve, improvements, monitor, enforce, problems, education

CHAPTER 10 CULTURAL DIVERSITY SUGGESTED ANSWERS TO THE END OF CHAPTER REVIEW QUESTIONS 1. culture is learned, culture is shared, culture is social in nature, culture is dynamic and constantly changing 2. (any 4 of the following) African American, Asian/Pacific American, European American, Hispanic American, Middle Eastern/Arabic American, Native American 3. answers will be individualized, but student must give an example of acculturation such as second- and thirdgeneration Americans adopting English as their main language and also some of the customs of the United States 4. nuclear family: consists of one or two parents and a child or children; extended family: includes the nuclear family plus grandparents, aunts, uncles, and cousins 5. culture is the values, beliefs, attitudes, languages, symbols, rituals, behaviors, and customs unique to a particular group of people and passed from one generation to the next; ethnicity is a classification of people based on national origin and/or culture; race is a classification of people based on physical or biological characteristics such as the color of skin, hair, and eyes, facial features, blood type, and bone structure 6. health care providers must have an awareness of a patient’s religious beliefs while caring for them because different religions have different beliefs about health care, personal care, and death and may require last rites or that family be present with a dying person; beliefs related to autopsy, organ donation, and life support may also vary depending on a person’s religion © 2022 Cengage Learning, Inc. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

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7. ask the patient about the meaning behind the bracelet and why it is important that she not take it off in order to learn more about the patient’s beliefs; then, consult with the immediate supervisor or the patient’s doctor on whether the patient can wear the bracelet 8. (any 6 of the following) listen to patients as they express their beliefs; appreciate differences in people; learn more about the cultural and ethnic groups that you see frequently; recognize and avoid bias, prejudice, and stereotyping; ask questions to determine a person’s beliefs; evaluate all information before forming an opinion; allow patients to practice and express their beliefs as much as possible; remember that you are not expected to adopt another’s beliefs, just accept and respect them; recognize and promote the patient’s positive interactions with family; be sensitive to how patients respond to eye contact, touch, and invasion of personal space; respect spirituality, religious beliefs, symbols, and rituals SUGGESTED ANSWERS TO THE WORKBOOK ASSIGNMENT 1. values, beliefs, attitudes, languages, symbols, rituals, behaviors, and customs unique to a particular group of people and passed from one generation to the next 2. learned, shared, social in nature, dynamic and constantly changing 3. ethnicity, race, cultural diversity 4. answers will be individualized, but student should state one of the following views: yes; cultural differences are recognized and respected no; cultural groups are forced to accept beliefs and behaviors of the dominant society 5. a. stereotype, b. bias, c. prejudice, d. stereotype, e. prejudice, f. bias 6. (any 6 of the following) know and be consciously aware of your own personal and professional values and beliefs; obtain as much information as possible about different ethnic/cultural groups; be sensitive to behaviors and practices different from your own; remember that you are not being pressured to adopt other beliefs but that you must respect them; develop friendships with a wide variety of people from different ethnic/ cultural groups; ask and encourage questions; evaluate all information before you form an opinion; be open about differences; avoid jokes that may offend; remember that mistakes happen 7. care that provides for the well-being of the whole person and meets physical, social, emotional, and mental needs 8. (any 5 of the following) family organization, language, personal space, touching, time orientation, eye contact, gestures, health care beliefs, spirituality, religion 9. a. patriarchal, b. nuclear, c. extended, d. matriarchal 10. past-oriented: may value tradition and be hesitant to try new procedures because they prefer to treat medical conditions the way they have always been treated; present-oriented: may not worry about the future and preventive health care measures; they will get treatment if they are ill, but then may ignore any follow-up when they recover; future-oriented: try to take preventive health care measures to ensure better health and may set long-term goals to maintain health 11. a. Asian b. Hispanic c. South African, Asian, and Native American d. Asian and Hispanic e. South African, Asian, Hispanic, Middle Eastern, and Native American f. South African, European, and Middle Eastern g. South African, European, Hispanic, Middle Eastern, Native American h. South African, Asian, European, Hispanic, Middle Eastern, and Native American i. Middle Eastern j. Asian, Hispanic, and Native American k. South African and European 12. no; spirituality is an individualized and personal set of beliefs and practices, while religion is an organized ­system of belief 13. some religions require last rites, and religious representatives must be notified when death is imminent 14. Christian Scientists and Jehovah’s Witnesses 15. monotheist, polytheist 16. atheist, agnostic

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17. (any 8 of the following) listen to patients as they express beliefs; learn to appreciate differences in people; learn about cultural and ethnic groups; recognize and avoid bias, prejudice, and stereotyping; ask questions to determine beliefs; evaluate all information before forming an opinion; allow patients to practice and express their beliefs; remember that you are not expected to adopt other’s beliefs, just accept and respect them; recognize and promote patients’ interactions with their families; be sensitive to patients’ response to eye contact, touch, and invasion of personal space; respect spirituality, religious beliefs, symbols, and rituals 18. answers will be individualized, but should contain information such as: a. try to find a translator (relative or other team member) or check to see if you have written instructions in patient’s language b. talk with physician to see if husband can be in the room c. talk with patient to find out significance of necklace; check with immediate supervisor or surgeon to see if necklace can be left on patient or taped in place to avoid being lost d. proceed at a slower pace; talk with patient and explain procedure while encouraging patient to relax; step back periodically to give patient “breathing room”; try to limit direct contact with patient as much as possible e. talk with patient and ask about daughter and family; find out if this is a usual routine; check with immediate supervisor to obtain permission for daughter to assist with bath

CHAPTER 11 NUTRITION AND DIETS SUGGESTED ANSWERS TO THE END OF CHAPTER REVIEW QUESTIONS 1. carbohydrates: provide heat and energy and supply fiber; lipids or fats: provide fatty acids, provide heat and energy, carry fat-soluble vitamins to body cells; proteins: build and repair body tissue, provide heat and energy, produce antibodies; vitamins: regulate body functions, build and repair body tissue; minerals: ­regulate body functions, build and repair body tissues; water: carries nutrients and wastes to and from body cells, ­regulates body functions 2. digestion is the process by which the body breaks down food into smaller parts, changes the food chemically, and moves the food through the digestive system; absorption is the process in which blood or lymph capillaries pick up the digested nutrients and carry them to body cells; metabolism is the process in which nutrients are used by the cells for building tissue, providing energy, and regulating various body functions 3. overweight is a body weight that is 10–20 percent greater than the average recommended weight for a person’s height, or a BMI from 25 to 29.9; obesity is excessive body weight 20 percent or more above the average recommended weight, or a BMI equal to or greater than 30; (any 6 of the following) hypertension, diabetes mellitus, coronary heart disease, high cholesterol, sleep apnea, osteoarthritis, gallbladder disease, stroke, and certain types of cancer such as colon or breast 4. answers will vary, but student should calculate the number of calories required to maintain their present weight by using the general guideline that a person should consume 15 calories per pound per day; student then calculates how to increase weight by 1 pound per week by adding 500 calories to the daily total; finally ­student should calculate how to lose 1 pound per week by subtracting 500 calories from the daily total 5. a. fat-restricted diet b. diabetic diet (carbohydrate-controlled diet) c. low-cholesterol diet for heart disease; sodium-restricted diet for hypertension or congestive heart failure d. bland diet e. high-protein diet f. low-fiber diet or liquid diet g. sodium-restrictred diet h. soft or pureed SUGGESTED ANSWERS TO THE WORKBOOK ASSIGNMENT A. Matching 1. N 2. I

3. K 4. D

5. E 6. O

7. G 8. A

9. B 10. Q

11. F 12. M

13. C 14. L

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B. Completion and Short Answer 1. (any 4 of the following) healthy appearance, well-developed body, good attitude, proper sleep and bowel habits, high energy level, enthusiasm, freedom from anxiety 2. osteoporosis 3. cellulose 4. (any 4 of the following) provide the most concentrated form of energy, provide insulation, cushion organs and bones, aid in absorption of fat-soluble vitamins, provide flavor 5. saturated are solid at room temperature, and polyunsaturated are soft or oily a. (any 4 of the following) meats, eggs, whole milk, cream, butter, cheese b. (any 3 of the following) vegetable oils, margarines, products made from vegetable oils, fish, peanuts 6. build and repair tissue, regulate body functions, produce energy and heat; complete proteins contain 9 essential amino acids, whereas incomplete proteins contain some of the 9 essential amino acids and any of the remaining 13 amino acids 7. water soluble, fat soluble 8. a. vitamin C, b. vitamin K, c. vitamin B12, d. vitamin D, e. riboflavin, f. vitamin A, g. vitamin E, h. pyridoxine (B6) 9. a. iron; b. potassium; c. calcium; d. iodine; e. calcium, phosphorus, and fluorine; f. magnesium and sodium; g. chlorine; h. zinc 10. digestion of food, makes up blood plasma, helps tissues absorb nutrients, moves waste material; six to eight glasses 11. digestion breaks down food into smaller parts and changes food chemically

absorption is the process where blood capillaries pick up digested nutrients 12. grains (breads, cereals, rice, and pasta), vegetables, fruits, dairy (milk, milk products, yogurt, and cheese), protein (meats, fish, poultry, dry beans, eggs, and nuts) 13. (any 5 of the following) sodium (salt) intake; saturated fats; trans-fatty acids; calories from solid fats and added sugars; refined grains; grains containing solid fats, added sugars, and sodium; alcohol 14. (any 5 of the following) serving size, number of servings in container, calories per serving, fat content, total carbohydrate, dietary fiber, total sugars, protein, vitamins, minerals 15. check with dietary department and obtain a substitute; note this fact in patient’s care plan so it does not happen again 16. calorie 17. (any 4 of the following) activity, age, size, sex, physical condition, climate 18. activity, caloric intake 19. calculation of calories will vary with student weight: weight should be multiplied by 15; 500; student subtracts 500 from daily calories; 500; student adds 500 to daily calories 20. measures weight in relation to height and correlates this with body fat; calculation of BMI will be individualized but ascertain that student’s graphic reading is accurate 21. underweight, overweight, obese 22. a. bulimarexia; b. anorexia nervosa; c. bulimia 23. answers will vary, but student choose 3 of the guidelines they believe are most important and explain why; examples may include: balance calories to manage weight; increase physical activity; reduce certain foods and food components; reduce daily sodium intake to less than 2,300 milligrams; consume less than 10 percent of calories from saturated fatty acids; consume less than 10 percent of calories from added sugars; increase certain foods and nutrients; limit red and processed meats; eat unsaturated fats in place of saturated fats; build healthy eating patterns 24. answers will be individualized, but student must choose one of the diets on Table 11-5 and provide reasons why the diet would be a healthy way to lose weight based on USDA Dietary Guidelines C. Menu Plans Answers will be individualized. Make sure basic requirements have been met. A sample menu is shown.

Breakfast: fruit, cereal, milk Lunch: fruit, meat/fish/poultry/beans, vegetable, 2 slices of bread, milk Dinner: salad, meat/fish/poultry/beans, vegetable, rice/potato/pasta, milk, dessert Snacks: raw vegetables, fruit, crackers, cereal © 2022 Cengage Learning, Inc. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

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D. Therapeutic Diets

Student may list any four of the foods that must be limited or avoided for each diet.

1. Soft: meat and shellfish with tough connective tissue, coarse cereals, spicy foods, rich desserts, fried foods, raw fruits and vegetables, nuts, coconut 2. Diabetic: candy, soft drinks, desserts, cookies, syrup, honey, condensed milk, chewing gum, jams and jellies 3. Low-calorie: butter, cream, whole milk, cream soups and gravies, sweet soft drinks, alcohol, salad dressings, fatty meats, candy, rich desserts 4. High-calorie: green salads, watermelon, fibrous fruits, fried foods, rich pastries, cheesecake 5. Low-cholesterol: beef, liver, pork, lamb, egg yolk, cream cheese, natural cheeses, whole milk, coconut and palm oil products, shellfish 6. Fat-restricted: cream, whole milk, cheese, fats, fatty meats, rich desserts, chocolate, fried foods, salad dressings, nuts, coconut 7. Sodium-restricted: salt added to food, smoked meats/fish, processed foods, pickles, sauerkraut, processed cheese, olives 8. Low-protein: meats, fish, milk, cheese, eggs 9. Bland: coarse foods, fried foods, highly seasoned foods, pastries, candies, raw fruits and vegetables, alcoholic and carbonated beverages, smoked and salted meats/fish, nuts, olives, avocados, coconut, whole-grain breads and cereals, coffee, tea 10. Low-fiber or low-residue: raw fruits and vegetables, whole-grain breads and cereals, nuts, seeds, beans, peas, coconut, fried foods

CHAPTER 12 COMPUTERS AND TECHNOLOGY IN HEALTH CARE SUGGESTED ANSWERS TO THE END OF CHAPTER REVIEW QUESTIONS 1. answers will be individualized, but student must list 6 health care personnel who use information systems; almost anyone in a health care career uses them 2. a. CT: permits physicians to see clear, cross-sectional views of both bone and body tissues and to find abnormalities, such as tumors or bleeding b. MRI: allows physicians to see blood moving through veins and arteries, to see a swollen joint shrink in response to medication, and to see the reaction of cancerous tumors to treatment c. PET: allows the physician to see an organ or bone from all sides similar to a model d. Ultrasonography: used to detect tumors; locate aneurysms and blood vessel abnormalities; examine the shape and size of internal organs; and during pregnancy, it is used to detect multiple pregnancies and to determine the size, position, sex, and even abnormalities of the fetus 3. a. key words: hypertension, culture, race b. search phrases: “hypertension and culture”; “hypertension and race” c. answers will be individualized, but student must state which search engine they will use and why d. answers will be individualized, but student must create a paragraph based on results of research 4. answers will be individualized, but student must list 3 ways to identify a reliable website; examples may include: using sites from governments, universities, and national organizations; using professional journal articles; author has proper education and credentials; date of publication is recent; references are reliable if listed; information can be documented by more than one search engine 5. answers will vary, but student must identify 5 ways to maintain confidentiality of patient information such as using access codes, special passwords, fingerprints, or iris identification; allowing only authorized team members access to the computer system; having only one dedicated computer to connect with the Internet and restricting connection on other computers; securing workstations and record storage areas; using encryption technology when transmitting information electronically; keeping passwords or access codes confidential; prohibiting others from reading information on computer screen; shredding discarded hard copies; never opening or downloading e-mails or files from an unknown party; following virus or firewall alert instructions 6. contingency backup plan is essential because, at times, computers must be shut down for reprogramming or adding new software; power or computer failures may shut down the system completely; a fire or environmental disaster may destroy the facility housing the computers

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SUGGESTED ANSWERS TO THE WORKBOOK ASSIGNMENT 1. (any 5 of the following) information systems, diagnostic testing, treatment, patient monitoring, educational tools, research, communication 2. ability to understand the basics of how the computer works and applications used in a field or profession 3. (any 5 of the following) check power connections; restart computer; refresh browser and check settings; shut down a program and restart it; exit by hitting control, alternate, and delete at the same time to get to the task manager and then restart computer; run a virus scan and remove any viruses or malware; delete programs that are not being used 4. an applied science used to promote the safety and well-being of a person by adapting the environment and using techniques to prevent injuries 5. (any 3 of the following) proper lighting, correct positioning of the computer keyboard and monitor, a chair that provides good support, proper posture 6. (any 5 of the following) word processing documents, compiling databases, creating and transferring electronic health records, scheduling, maintaining financial records, maintaining inventories and ordering supplies, developing spreadsheets 7. a national network that allows all health care agencies to readily transfer patient electronic health records (EHRs) between agencies; improve the speed, quality, and safety of patient care by providing health care personnel with quick access to a patient’s medical history 8. a secure online website established between a physician, health care facility, or other health care provider that the patient can access; (any 5 of the following) view medical history, treatments, and laboratory test results; request prescription refills; update insurance information; make payments; send messages to health care provider; view educational material; download and complete forms; schedule appointments 9. use access codes, special passwords, fingerprints, or iris identification to limit access to the information; allow only authorized personnel to have access to the system; keep access codes confidential 10. nuclear stress test: small amount of a radioactive substance is given intravenously, and a special camera is used to identify the rays emitted from the substance while the patient is at rest and then during exercise; Dobutamine or Adenosine stress test: a medication that stimulates the effect of exercise and increases the blood flow and heart rate is given to patients who cannot exercise 11. allows physician to see cross-sectional views of bone and body tissues and to find abnormalities, such as tumors or bleeding 12. uses high-frequency sound waves that bounce back as an echo when they hit different tissues and organs 13. (any 4 of the following) can be saved as an electronic file, less radiation so it is safer for patient, environmentally friendly because it eliminates need for X-ray film and developing solutions, storage of images is easier, images can be sent electronically to another dentist for a consultation, images can be enlarged and contrast can be enhanced to visualize dental disease 14. (any 6 of the following) lasers, robotic surgery, image-guided surgery, radiation therapy, computer-aided design, ultrasound, hearing assistive technology, automated drug dispensing systems 15. destroys the DNA or genetic structure of the cancer cells so they stop reproducing and die 16. constantly measure fetal heart rate and strength of the mother’s contractions to allow the team member to determine the progress of labor and approximate time of birth 17. electronic impedance tomography 18. data server that user connects with over the Internet that duplicates and stores data so it is always readily available and easily restored in case of computer failure or a natural disaster 19. each participant is given a phone number or identifying code so only invited participants can gain access 20. a database of the National Library of Medicine (NLM) that provides health care statistics and information 21. Networks, communication 22. process of creating and sending messages from one computer to another 23. (any 3 of the following) files created in word processing programs, insurance forms, financial data, radiographic images, photographs 24. a. telemedicine b. telepharmacies c. electronic medicine 25. organ transplants 26. not all data are accurate or current, and some sources do not have expertise in the area being researched © 2022 Cengage Learning, Inc. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

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27. a. ADDS: automated drug dispensing systems g. HIS: hospital information system b. CAD: computer-aided design h. IGS: image-guided surgery c. CAI: computer-assisted instruction i. MIS: medical information system d. CT: computerized tomography j. MRI: magnetic resonance imaging e. EHR: electronic health record k. PET: positron emission tomography f. HIE: health information exchange l. UPS: uninterrupted power supply 28. electrical surges, power outages, viruses, hackers 29. through downloading of information from the Internet, through opening of contaminated e-mails, through use of disks or flash drives that contain viruses 30. a protective program that limits the ability of other computers to access a computer 31. software that uses cryptography or the converting of data into a code of symbols; to protect digital information on computers and prevent unauthorized people from seeing the data if it is intercepted 32. (any 4 of the following) keep passwords confidential, prevent others from watching while keying a password, do not allow others to read the computer screen, clear the monitor before leaving the area, never open or download files or e-mails from an unknown party, follow the instructions if a virus or firewall alert occurs, shred discarded hard copies and printouts

CHAPTER 13 MEDICAL MATH SUGGESTED ANSWERS TO THE END OF CHAPTER REVIEW QUESTIONS 1. 420 mL 2. 13 lb, 5.9 kg 3. $97.50 4. $9.04 5. 52.5 tablets, dispense 53 tablets 6. 7½ hours 7. 6 seconds

8. 2,787.12 lymphocytes 9. 6.25 grams 10. 2 capsules 11. 8 ounces 12. 2,000 pairs of gloves 13. 2,500 liters 14. 3 ounces

15. 2 qt 16. 6:30 pm 17. 21.1°C 18. 82.4°F 19. Drawing with arm at 90-degree angle 20. 1.2 or 11 5 inch

SUGGESTED ANSWERS TO THE WORKBOOK ASSIGNMENT 1. (any 4 of the following) calculating medication dosages, taking height and weight readings, measuring intake and output, billing and housekeeping tasks, performing laboratory tests, mixing cleaning solutions (Note: student may have additional examples of applications of math principles.)

2. Whole numbers, Decimals, Fractions, Percentages, Ratios, Rounding 3. use rounding to get numbers that are easier to mentally compute, watch place values carefully, look at the size of the answer to see if it makes sense, be careful about placing decimal points 4. a. 2,001 c. 85,044 e. 3,432 g. 37 b. 6,042 d. 9,668 f. 342,468 h. 18 5. a. 93.713 c. 28.762 e. 153.94379 g. 53.4 b. 5,509.559 d. 88.792 f. 0.0034875 h. 162 6. a. 13 8 c. 9 16 e. 2 9 g. 1 1 20 b. 24 9 40 d. 9 5 12 f. 69 3 4 h. 5 7. a. 91.5% b. 42.9% c. 11.5 d. 28,150 8. a. 9,840 b. 700 c. 1,000 9. a. 3 tablets b. 1.5 or 1½ aspirins c. 160 milligrams d. 112.5 milliliters 10. a. LV c. DXCV e. MMCCCLXVII b. CIX d. DCCLXXXVIII 11. a. 12 c. 44 e. 3,533 b. 219 d. 692 12. injecting medications, describing joint movement, indicating bed positions (Note: student may have other examples.)

13. identify an equivalent between the two systems, set up a proportion so unit measurements on each side of the equation are the same, use x for the unknown value being calculated, cross multiply, solve for x, verify that the answer is reasonable © 2022 Cengage Learning, Inc. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

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14. a. 25 c. 15 b. 1¼ d. 180 15. a. 1.7°C b. 22.2°C 16. a. 86°F b. 143.6°F 17. time designations using the 24-hour clock 18. a. 1300 c. 1200 b. 0200 d. 0300 19. $2,208 20. 70 capsules 21. 24½ oz 22. 14.7 mg 23. 30 ounces of formula, 90 ounces of water 24. 4,411 25. $241.49 26. 2 to 1 or 2:1 27. 797.5 g 28. 240 mL 29. 1947 30. 36.1°C to 37.8°C 31. a. $2,546.96 b. 80% 32. 7 mL 33. 10.5 g 34. a. 10 mL b. no; 2030 is the correct time

e. f. c. c.

55 60 37.6°C 59°F

e. 2035 f. 0505

d. 39.4°C d. 78.1°F g. 2348 h. 2400

CHAPTER 14 PROMOTION OF SAFETY SUGGESTED ANSWERS TO THE END OF CHAPTER REVIEW QUESTIONS 1. muscles work best when used correctly; correct use of muscles makes lifting, pulling, and pushing easier; prevents unnecessary fatigue and strain, and saves energy; prevents injury to self and others 2. (any 3 of the following) maintain a broad base of support, bend from hips and knees and keep your back straight, use strongest muscles to do job, use the weight of your body to help push or pull an object, carry heavy objects close to the body, avoid twisting your body, avoid bending for long periods, get help if patient or object is too heavy 3. remain calm but stop using the machine and turn it off; report the incident to your immediate supervisor right away; use a lockout tag system if that is your facility’s policy; if an electrical fire starts and the fire is small, confined to one area, and your safety is not endangered, determine what type of fire extinguisher should be used and extinguish the fire 4. (any 4 of the following) read SDSs before using any hazardous chemical solutions; check the NFPA code on a chemical to determine the specific hazards associated with the chemical; never use solutions from bottles that are not labeled; read the labels of solution bottles at least three times during use to be sure you have the ­correct solution; do mix any solutions together unless instructed to do so by your immediate supervisor or you can verify that they are compatible; avoid contact with your eyes and skin; avoid inhaling fumes displaced by a solution; use only as directed; store all chemical solutions in a locked cabinet or closet following the ­manufacturer’s recommendations; dispose of chemical solutions according to the instructions provided on the SDS for the solution; if you spill a solution, immediately report the incident to your supervisor 5. (any 3 of the following) obtain correct authorization, knock on the door, provide privacy by closing the door and/or pulling the curtain, introduce yourself, identify the patient by stating the patient’s name and/or checking the armband, explain the procedure so the patient knows what you are going to do, obtain the patient’s consent, wash hands

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6. (any 5 of the following) make sure the patient is in a comfortable position; elevate the side rails, if indicated; make sure the bed is at the lowest level to the floor; lock the wheels on the bed to prevent movement; place the call signal and other supplies, such as fresh water and tissues, within easy reach of the patient; open the privacy curtains if they were closed; leave the area neat and clean; make sure no safety hazards are present; wash hands 7. oxygen, fuel, heat 8. (any 5 of the following) post a “No Smoking—Oxygen in Use” sign; remove all smoking materials, candles, lighters, and matches from the room; do not empty ashtrays into trash cans or plastic bags; extinguish matches, cigarettes, and any other flammable items completely; avoid the use of electrically operated equipment whenever possible; do not use flammable liquids such as alcohol, nail polish, and oils; avoid static electricity by using cotton blankets, sheets, and gowns 9. PASS stands for: Pull the pin, Aim the extinguisher at the near edge and bottom of the fire, Squeeze the handle to discharge the extinguisher, Sweep the extinguisher from side to side at the base of the fire 10. answers will be individualized, but student must describe the school’s active shooter plan SUGGESTED ANSWERS TO THE WORKBOOK ASSIGNMENTS CHAPTER 14:1 USING BODY MECHANICS 1. way in which the body moves and maintains balance by the most efficient use of all of its parts 2. muscles work best when used correctly; correct use of muscles makes pushing, pulling, and lifting easier; prevents unnecessary fatigue and strain; saves energy; prevents injury to self and others 3. (any 4 of the following) stand straight, stomach muscles pulled in, shoulders relaxed and pulled back, weight balanced equally on each foot and aligned with the shoulder, chest and chin held up 4. Diagram 1: maintain broad base of support, use strongest muscles, use weight of your body to help push Diagram 2: maintain broad base of support, use strongest muscles, stand close and carry heavy objects close to body Diagram 3: maintain broad base of support, bend from hips and knees, use strongest muscles CHAPTER 14:2 PREVENTING ACCIDENTS AND INJURIES 1. Occupational Safety and Health Administration, to establish and enforce standards for the workplace 2. (any 8 of the following) product identification information, hazards of the chemical, ingredients, first aid measures for exposure, fire-fighting measures, correct clean up procedure for spills, handling and proper storage, maximum exposure limits, required personal protective equipment, physical properties of chemical, stability and reactivity hazards, health effects of exposure, environmental impact, proper disposal method, correct transporting of chemical, other regulations on the chemical, when SDS was prepared or revised 3. health, fire, reactivity, or other specific hazards of the chemical 4. (any 6 of the following) blood, blood components, urine, stool, semen, vaginal secretions, cerebrospinal fluid, saliva, mucus 5. hepatitis B, hepatitis C, acquired immune deficiency syndrome (AIDS) 6. ergonomics 7. (any 5 of the following) radiation, radioactive iodine, radioactive seeds, antineoplastic drugs, nitrous oxide, mercury, biohazard wastes (Note: student may identify other environmental hazards.)

8. radioactive wastes are placed in sealed container and sent to disposal site; wastes are stored for a minimum of 10 half-lives and then monitored for amount of residual activity; when radioactivity is safe, wastes are discarded in secure government approved location 9. heavy silver element that can evaporate and create a toxic vapor that can poison the central nervous system in humans and contaminate water supplies 10. (any 5 of the following) read Safety Data Sheets (SDSs) before using any hazardous chemical solutions; make sure all solution bottles are labeled; read the labels at least three times to make sure you have the ­correct ­solution; do not mix any solutions together unless instructed to do so by the instructor or i­mmediate ­supervisor; some solutions can be poisonous—avoid contact with your eyes and skin; avoid inhaling any fumes displaced by a solution; store all chemical solutions in a locked cabinet or closet; dispose of solutions according to instructions provided on the SDS; if you spill any solutions, immediately report the incident to the instructor or immediate supervisor © 2022 Cengage Learning, Inc. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

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11. (any 4 of the following) keep equipment in proper location at all times; dry hands thoroughly before handling any electrical equipment; do not operate any equipment until instructed on how to use it; read and follow the operating instructions for all major pieces of equipment; do not operate any equipment if the instructor is not in the room; report any damaged or malfunctioning equipment immediately; do not use frayed or damaged electrical cords; if any equipment breaks, immediately report the incident to the instructor or immediate supervisor; observe all safety precautions when handling any equipment 12. (any 4 of the following) do not perform any procedure unless instructed to do so; provide privacy for all patients; identify your patient; explain the procedure to the patient; never perform a procedure on a patient if they refuse; observe the patient closely during any procedure; check the area frequently for safety hazards; observe all safety checkpoints before leaving a patient 13. (any 2 of the following) knock on the door, speak to the patient and identify yourself before going behind privacy curtains, close door and/or draw curtains before beginning a procedure 14. (any 2 of the following) check identification wrist band, ask the patient to state their name, repeat name twice, check name on record or bed 15. (any 5 of the following) leave patient in comfortable position, elevate siderails if indicated, lower bed to lowest level, lock the bed wheels, place the call signal in reach, open privacy curtains, leave area neat and clean 16. before and after any procedure, anytime they become contaminated 17. when instructed to do so and in situations that might result in possible eye injury 18. a. report the cut to the instructor immediately b. inform the instructor; do not attempt to remove the particle or rub the eye c. report the malfunctioning equipment immediately d. report the spilled acid to the instructor e. do not use the cord; report it immediately CHAPTER 14:3 OBSERVING FIRE SAFETY 1. oxygen, fuel, heat 2. (any 4 of the following) unattended cooking fires, misuse of electricity, defects in heating systems and portable heaters, smoking and matches, candles, spontaneous ignition, improper rubbish disposal, children playing with matches and lighters, arson 3. (any 3 of the following) obey all “No Smoking” signs, extinguish matches and cigarettes completely, dispose of all waste materials in correct containers, check all electrical equipment for damaged cords or improper grounding, store flammable materials in proper containers, do not allow clutter to accumulate, observe special precautions when oxygen is in use 4. answer depends on school’s location of fire alarm box 5. answers depend on location and kind of extinguisher 6. A: combustibles, such as wood, paper, cloth, and plastics B: flammable or combustible liquids, such as gasoline, oil, paint, grease, and cooking fat C: electrical fires, such as fuse boxes, appliances, wiring, and electrical outlets D: burning or combustible metals K: burning cooking materials, such as fats, grease and oils, and appliances in commercial cooking sites 7. a. Class A, b. Class C, c. Class K, d. Class B and C, e. Class A, B, and C 8. carbon dioxide and dry chemical 9. R: Rescue anyone in immediate danger

A: Activate the alarm

C: Contain the fire

E: Extinguish the fire or evacuate the area 10. (any 3 of the following) post “No Smoking—Oxygen in Use” sign; remove all smoking materials, candles, ­lighters, and matches from the room; avoid use of electrically operated equipment; do not use flammable ­liquids; avoid static electricity 11. (any 3 of the following) run and escape if possible, hide out of sight of the shooter if escape is not possible, try to protect patients by moving them to a secure location, silence any electronic devices, text 911 or put a sign in the window, stay in place until law enforcement arrives 12. legally

© 2022 Cengage Learning, Inc. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

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CHAPTER 14 SAFETY EXAMINATION 1. A 7. B 13. D 19. True 25. False 2. B 8. C 14. True 20. True 26. False 3. A 9. B 15. False 21. False 27. True 4. A 10. B 16. True 22. False 28. True 5. D 11. A 17. True 23. True 29. False 6. C 12. C 18. True 24. True 30. True 31. a. Class A Combustibles: paper, cloth, plastic, wood b. Class B Flammable or combustible liquids: gasoline, oil, paints, grease, fats c. Class C Electrical: fuse boxes, appliances, wiring, electrical outlets d. Class D Burning or combustible metals e. Class K Burning cooking materials and appliances in commercial cooking sites 32. (any 3 rules for preventing fires are acceptable) obey all “No Smoking” signs, extinguish matches and cigarettes, dispose of waste materials in correct containers, check all electrical equipment before use, store flammable materials in proper containers, do not allow clutter to accumulate 33. Occupational Safety and Health Administration; to establish and enforce standards for the workplace 34. check Safety Data Sheet (SDS) 35. hepatitis B, hepatitis C, acquired immune deficiency syndrome (AIDS)

CHAPTER 15 INFECTION CONTROL SUGGESTED ANSWERS TO THE END OF CHAPTER REVIEW QUESTIONS 1. antiseptics: prevent or inhibit the growth of pathogenic organisms but are not effective against spores and viruses; can usually be used on the skin disinfection: destroys or kills pathogenic organisms but is not always effective against spores and viruses; can irritate or damage the skin and are mainly used on objects, not people sterilization: destroys all microorganisms, both pathogenic and nonpathogenic, including spores and viruses 2. before touching a patient, before a clean or aseptic procedure, after body fluid exposure, after touching a patient, after touching the patient’s surroundings 3. gloves: whenever contact with blood, body fluids, secretions, excretions, mucous membranes, tissue specimens, or nonintact skin is possible; when handling or cleaning any contaminated items or surfaces; when performing any invasive procedure; when performing venipuncture or blood tests

gowns: during any procedure that may cause splashing or spraying of blood, body fluids, secretions, or excretions masks and protective eyewear or face shields: during procedures that may produce splashes or sprays of blood, body fluids, secretions, or excretions 4. ultrasonic cleaning: just cleans articles; it is not sterilization because spores and viruses remain on the articles chemicals: a form of disinfection; a few chemicals will kill spores and viruses, but these chemicals frequently require that instruments be submerged in the chemical for 10 or more hours autoclave: most efficient method of sterilization; it will destroy all microorganisms, both pathogenic and nonpathogenic, including spores and viruses 5. drop technique: used for gauze pads, dressings, and small items; mitten technique: used for bowls, drapes, linen, and other similar items; transfer forceps: used for cotton balls, small items, or articles that cannot be removed by the drop or mitten techniques 6. the outside of the gloves after they have been used 7. airborne precautions: patient must be placed in an airborne infection isolation room, and the door should be kept closed; air in the room must be discharged to outdoor air or filtered before being circulated to other areas; each person who enters the room must wear respiratory protection such as an N95, P100, or HEPA mask; people susceptible to measles or chickenpox should not enter the room; the patient should not be moved from the room droplet precautions: patient should be placed in a private room or otherwise maintain a distance of at least 3 feet from other patients or visitors; masks must be worn when entering the room; if transport or movement of the patient is essential, the patient must wear a surgical mask contact precautions: patient should be placed in a private room or, if a private room is not available, in a room with a patient who has an active infection caused by the same organism; gloves must be worn when entering © 2022 Cengage Learning, Inc. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

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the room; gloves must be changed after having contact with any material that may contain high concentrations of the microorganism, such as wound drainage or fecal material; gloves must be removed before leaving the room, and hands must be washed with an antimicrobial agent; a gown must be worn in the room; movement and transport of the patient from the room should be for essential purposes only; the room and items in it must receive daily cleaning and disinfection as needed; patient-care equipment (bedside commode, stethoscope, thermometer) should be left in the room and used only for this patient 8. intense and repeated training must be done to ensure that correct PPE is used; proper order and procedure for donning and doffing of PPE must be followed; a trained team member must supervise the donning and doffing of PPE; PPE must cover all of the skin, head, neck, body, and feet; powered air-purifying respirator (PAPR) or N95 respirator must be worn at all times; double gloves should be worn when in direct contact with the patient; separate room or area should be designated for the donning and doffing of the PPE SUGGESTED ANSWERS TO THE WORKBOOK ASSIGNMENTS CHAPTER 15:1 UNDERSTANDING THE PRINCIPLES OF INFECTION CONTROL 1. Answers to crossword puzzle 1.

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Copyright © Cengage Learning®. All Rights Reserved.

2. nonpathogens are microorganisms that are beneficial in maintaining certain body processes

pathogens are microorganisms that cause infection and disease 3. a. bacilli b. vibrio c. streptococci d. spirilla e. staphylococci 4. a. methicillin-resistant Staphylococcus aureus, b. Vancomycin-resistant Enterococcus faecalis, c. multidrugresistant Acinetobacter baumannii, d. carbapenem-resistant enterobacteriaceae, e. extended spectrum beta lactamase © 2022 Cengage Learning, Inc. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

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46 INSTRUCTOR’S MANUAL

5. a. viruses, b. rickettsiae, c. protozoa, d. fungi, e. rickettsiae, f. bacteria, g. viruses, h. fungi 6. a. West Nile virus (WNV) b. H5N1 virus c. severe acute respiratory syndrome (SARS) virus and coronavirus (COVID-19) d. monkeypox hantavirus e. filoviruses such as Ebola and Marburg f. human immunodeficiency virus (HIV) g. hepatitis B (HBV) and hepatitis C (HCV) h. H1N1 virus 7. multicellular parasitic organisms commonly called worms or flukes 8. must provide vaccination at no cost to any team member with exposure to blood or body secretions 9. (any 3 of the following) warm environment, darkness, source of food and moisture, some need oxygen 10. (any 2 of the following) produce poisons called toxins, cause allergic reaction, attack and destroy living cells 11. endogenous originates within the body, exogenous originates outside the body 12. staphylococcus, pseudomonas, enterococci 13. establish infection-control programs 14. vaccine stimulates the immune system to produce antibodies against the disease similar to the antibodies produced when a person has the disease 15. a. mode of transmission and portal of exit b. portal of entry c. susceptible host d. reservoir or source and mode of transmission e. mode of transmission and source or reservoir f. infectious agent 16. (any 4 of the following) handwashing, good personal hygiene, using disposable gloves, proper cleaning of instruments and equipment, thorough cleaning of the environment 17. a. antisepsis: prevents or inhibits growth of pathogenic organisms but not effective against spores and viruses b. disinfection: destroys or kills pathogenic organisms but not always effective against spores and viruses c. sterilization: destroys all microorganisms, both pathogenic and nonpathogenic, including spores and viruses CHAPTER 15:2 BIOTERRORISM A. Matching 1. D 2. C 3. A 4. B

5. F 6. C 7. E 8. F

9. A 10. D 11. B 12. E

13. A 14. C

B. Completion and Short Answer 1. use of microorganisms or biologic agents as weapons to infect humans, animals, or plants 2. inexpensive and readily available; spread through air or contaminated food and water; survives sunlight, drying, and heat; causes death or severe disability and public panic; easily transmitted; difficult to prevent and/or treat 3. development of a comprehensive plan against bioterrorism 4. (any 5 of the following) community-based surveillance to detect early indications of an attack; notification of public when high-risk situation detected; strict infection-control measures and public education about measures; funding for studying pathogens, developing vaccines, researching treatments, and determining preventive actions; strict guidelines for purchasing and transporting pathogens; mass immunization; increased protection of food and water supplies; training personnel to properly diagnose and treat infectious diseases; establishing emergency management policies; criminal investigation of threats; improving ability of health care facilities to deal with an attack; improving communication so information can be transmitted quickly 5. military, first responders, police, fire department and health care personnel; answers will be individualized, but student should explain why this is important 6. so information can be transmitted quickly and efficiently 7. answers will be individualized; make sure student states why health care providers are or are not prepared for a bioterrorism attack © 2022 Cengage Learning, Inc. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

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CHAPTER 15:3 WASHING HANDS 1. method followed to prevent the spread of germs or pathogens 2. washing hands prevents spread of pathogens from one person to another, protects health care provider from disease and illness 3. (any 6 of the following) when you arrive and immediately before leaving facility; before and after patient contact; before moving from a contaminated body site to a clean body site during patient care; any time hands become contaminated; before applying and immediately after removing gloves; any time gloves are torn or punctured; before and after handling any specimen; after contact with soiled or contaminated linen; after picking up any item from the floor; after personal use of the bathroom; after you cough, sneeze, or use a tissue; before and after any contact with your mouth or mucous membrane 4. aids in removal of germs 5. fingers are pointed downward to prevent flow of water up forearm 6. warm water is used; hot water damages skin, and cold water does not create good lather 7. prevents contamination of hands from germs on faucet 8. palms, top or back of hands, between fingers 9. brush or blunt edge of orange stick 10. long or artificial nails can harbor organisms, increase the spread of infection, and puncture or tear gloves 11. a. antiseptic hand rub or waterless handwashing b. antiseptic handwashing using an antimicrobial soap and water c. regular handwashing using plain soap and water d. antiseptic handwashing using an antimicrobial soap and water 12. alcohol to provide antisepsis and a moisturizer to prevent drying of the skin 13. until they are dry, usually at least 20 seconds 14. six to ten times CHAPTER 15:4 OBSERVING STANDARD PRECAUTIONS 1. hepatitis B virus, hepatitis C virus, human immunodeficiency virus (HIV) 2. Occupational Safety and Health Administration (OSHA) 3. (any 4 of the following) gloves, gowns, lab coats, masks, face shields 4. no; federal law prohibits eating and drinking in any area potentially contaminated by blood or body fluids 5. provide a confidential medical evaluation and follow-up 6. identify and use effective and safe medical devices, incorporate changes in annual update of Exposure C ­ ontrol Plan, solicit input from nonmanagerial employees who are responsible for direct patient care, maintain a sharp’s injury log 7. in any situation where health care provider might contact blood, body fluids, secretions, excretions, mucous membranes, nonintact skin, and/or tissue or cell specimens 8. whenever contact with blood, body fluids, secretions, excretions, mucous membranes, or nonintact skin is possible; handling any contaminated items or surfaces; performing invasive procedures; performing venipuncture or blood tests 9. during any procedure likely to cause splashing of blood, body fluids, secretions, or excretions 10. (any 3 of the following) irrigation of wounds, suctioning, dental procedures, delivery of a baby, surgical procedures 11. anytime they become moist or wet 12. left uncapped and placed in leakproof, puncture-resistant sharps container 13. put on gloves, wipe area with disposable cleaning cloth and a disinfectant solution 14. eliminate need for mouth-to-mouth resuscitation 15. infectious waste or biohazard material bag 16. report it immediately CHAPTER 15:5 STERILIZING WITH AN AUTOCLAVE 1. steam, pressure, gas, microorganisms, pathogenic, nonpathogenic, spores, viruses 2. prepared properly, washed thoroughly and rinsed © 2022 Cengage Learning, Inc. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

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3. (any 3 of the following) muslin, autoclave paper, special plastic or paper bags, autoclave containers 4. to ensure that an article has been sterilized 5. (any 2 of the following) tape, sensitive marks, capsules 6. (any 3 of the following) space between all pieces; packages placed on side, not flat; jars, basins, and cans placed on sides; no articles in contact with side, door, or top of the autoclave 7. different articles require different pressure, temperature, and/or time 8. check directions provided with autoclave 9. wet surfaces permit rapid infiltration of organisms 10. clean, dustproof areas 11. 30 days 12. rewrap and autoclave the item 13. 320°F to 350°F (160°C to 177°C) 14. 60 minutes 15. instruments that corrode, items destroyed by moisture CHAPTER 15:6 USING CHEMICALS FOR DISINFECTION 1. spores, viruses, chemical disinfection, sterilization 2. (any 3 of the following) instruments that do not penetrate body tissue, dental instruments, percussion ­hammers, scissors, thermometers 3. (any 2 of the following) particles or debris contaminate chemical, soap reduces effectiveness, water dilutes 4. (any 5 of the following) 90 percent isopropyl alcohol, formaldehyde–alcohol, 2 percent phenolic germicide, 10 percent bleach (sodium hypochlorite) solution, glutaraldehyde, iodophor, Lysol, Cidex, benzalkonium (Zephiran) 5. some must be diluted or mixed, obtain recommended time 6. prevent formation of rust; no; can cause a chemical reaction with some solutions and reduce effectiveness 7. ensures that all parts of article are disinfected 8. tight-fitting lid 9. drawer or dust-free closet 10. some after one use, any time contamination occurs or dirt is present, follow manufacturer’s instructions CHAPTER 15:7 CLEANING WITH AN ULTRASONIC UNIT 1. sound 2. bubbles strike article being cleaned, explode, and drive solution onto the article 3. no; does not remove spores or viruses 4. some solutions must be diluted, some can only be used on specific materials 5. toxic, can cause skin irritation 6. general all-purpose cleanser 7. bottoms should be below level of solution in the permanent tank 8. brush off most of the dirt or particles 9. pearls, pasted stones 10. discard and replace 11. drain by side valve, wipe with damp cloth or disinfectant 12. check cleaning chart CHAPTER 15:8 USING STERILE TECHNIQUES 1. sterile: free from all organisms, including spores and viruses

contaminated: organisms and pathogens are present 2. hold out in front of body and above waist 3. two-inch border around the sterile field © 2022 Cengage Learning, Inc. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

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4. drop: drop from wrapper onto sterile field

mitten: loose ends grasped to form mitten for handling transfer forceps: use to grasp article and place on sterile field 5. organisms and pathogens travel quickly through a wet surface 6. discard and start over 7. inside (side against skin) 8. sterile tray is open and you are ready to do procedure 9. away from body and above waist 10. start over CHAPTER 15:9 MAINTAINING TRANSMISSION-BASED PRECAUTIONS 1. method or technique of caring for patients who have communicable disease 2. epidemic affects a large number of people at the same time

pandemic affects a wide geographic area and most of the population 3. standard precautions are used on all patients; transmission-based isolation techniques provide extra protection against specific diseases or pathogens to prevent their spread 4. disease caused by a pathogenic organism that can be easily transmitted to others 5. direct contact with patients; contact with dirty linen, equipment, and/or supplies; contact with blood, body fluids, secretions, and excretions 6. infectious agent, way organism is transmitted, whether pathogen is antibiotic-resistant 7. contaminated: items that contain disease-producing organisms 8. clean: items that do not contain disease-producing organisms and have minimal chance of spreading the disease (6) B 9. (1) A (11) A, B, C (7) A (12) C (2) C (13) A (3) D (8) A, C (9) A (4) B (14) A, B, C (10) B (5) A, B, C, D 10. Centers for Disease Control and Prevention (CDC) 11. (any 4 of the following) intense training for donning and doffing of PPE; trained team member must supervise donning and doffing of PPE; PPE must cover all of the skin, head, neck, body, and feet; powered air-purifying respirator (PAPR) or N95 respirator must be worn at all times; double gloves must be worn when in direct ­contact with patient; diligent hand hygiene is essential; separate room or area should be designated for ­donning and doffing of PPE 12. method used to protect patients from organisms in environment 13. (any 2 of the following) depressed immune system, severely burned, patients receiving chemotherapy or radiation treatment, immune system failed 14. room cleaned and disinfected; wear clean or sterile gowns, gloves, and masks; equipment and supplies are clean, disinfected, or sterile; filters are used to purify air

CHAPTER 16 VITAL SIGNS SUGGESTED ANSWERS TO THE END OF CHAPTER REVIEW QUESTIONS 1. 0.2 or two-tenths of a degree 2. pain is an unpleasant sensation that is perceived in the nervous system when illness or injury occurs; can be assessed by asking patient to rate level of pain using a scale of 0 to 10 or a series of faces ranging from happy to very sad; important to remember that pain is what the person says it is because that is how the person is perceiving it 3. a. oral or tympanic: 97.6°F–99.6°F b. rectal or temporal: 98.6°F–100.6°F c. axillary or groin: 96.6°F–98.6°F d. pulse: general range of 60–100 beats per minute; adult men: 60–70 beats per minute; adult women: 65–80 beats per minute e. respiration: 12–20 breaths per minute © 2022 Cengage Learning, Inc. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

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4. rate, rhythm, volume 5. easier to count a rapid pulse; frequently ordered for patients with irregular heartbeats, hardening of the arteries, or weak or rapid radial pulses which are difficult to feel; typically taken on children and infants because they have very rapid pulse counts 6. 24 7. a. bradycardia: a pulse rate under 60 beats per minute b. arrhythmia: an irregular or abnormal rhythm, usually caused by a defect in the electrical conduction pattern of the heart c. dyspnea: difficult or labored breathing d. tachypnea: rapid, shallow respiratory rate above 25 respirations per minute e. rales: bubbling, crackling, or noisy sounds caused by fluids or mucus in the air passages 8. systolic pressure: occurs in the walls of the arteries when the left ventricle of the heart is contracting and pushing blood into the arteries; normal range is between 100 and 120 mm Hg diastolic pressure: the constant pressure in the walls of the arteries when the left ventricle of the heart is at rest, or between contractions; normal range is between 60 and 80 mm Hg 9. 44 10. hypertension: high blood pressure; stage 1: pressures are 130 to 139 mm Hg systolic or 80 to 89 mm Hg diastolic; stage 2: pressures are greater than 140 mm Hg systolic or 90 mm Hg diastolic; common causes include stress, anxiety, obesity, high salt intake, aging, kidney disease, thyroid deficiency, and vascular conditions such as arteriosclerosis hypotension: low blood pressure; pressures are less than 90 mm Hg systolic or 60 mm Hg diastolic; common causes include heart failure, dehydration, depression, severe burns, hemorrhage, and shock SUGGESTED ANSWERS TO THE WORKBOOK ASSIGNMENTS CHAPTER 16:1 MEASURING AND RECORDING VITAL SIGNS 1. Answers to crossword puzzle 1.

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2. temperature, pulse, respiration, blood pressure, pain 3. often the first indication of a disease or an abnormality 4. (any 4 of the following) orally, rectally, axillary, aurally (tympanic), temporally, surface of skin 5. pressure of the blood felt against the wall of an artery as the heart contracts (or beats); rate, rhythm, volume © 2022 Cengage Learning, Inc. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

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6. count or rate, rhythm, character 7. systolic, diastolic 8. an unpleasant sensation that is perceived in the nervous system when illness or injury occurs 9. ask patient to rate level of pain on a scale of 1 to 10 10. assess pain frequently because it is often the first sign of a problem 11. (any 3 of the following) illness, hardening of the arteries, weak or rapid radial pulse, doctor’s order, infants and children 12. report it to your supervisor immediately 13. ask another individual to check the patient 14. a. 60°C e. 30°C i. 37.6°C b. 21.1°C f. 40.6°C j. 23.9°C c. 10°C g. 58.9°C d. 3.3°C h. 95.6°C 15. a. 89.6°F e. 32°F i. 211.6°F b. 129.2°F f. 161.6°F j. 115°F c. 46.4°F g. 78.8°F d. 195.8°F h. 177.8°F CHAPTER 16:2 MEASURING AND RECORDING TEMPERATURE 1. balance between heat lost and heat produced in the body 2. individual differences, time of day, parts of the body 3. 97°F (36.1°C), 100°F (37.8°C) 4. 98.6°F (37°C), 97.6°F (36.5°C), 99.6°F (37.5°C) 5. 99.6°F (37.6°C), 98.6°F (37°C), 100.6°F (38.1°C) 6. 97.6°F (36.4°C), 96.6°F (36°C), 98.6°F (37°C) 7. rectal or temporal: internal temperature; it measures the temperature inside the body 8. axillary or groin; external temperature because it only measures temperature outside the body so it is not as accurate 9. temperature recorded in ear or auditory canal 10. measures thermal infrared energy radiating from tympanic membrane, or eardrum 11. measures the blood temperature in the temporal artery 12. hypothermia is low body temperature below 95°F (35°C)

hyperthermia is high body temperature above 104°F (40°C) 13. rectal thermometer has a short, stubby, rounded bulb and a red tip while oral thermometer has a long slender bulb and blue tip 14. place disposable cover over probe 15. forehead covered with hair, a wig, or a hat; forehead lying on pillow; profuse perspiration 16. use light wavelength technology to measure thermal energy radiating from the skin 17. special chemical dots or strips change color when exposed to specific temperatures 18. eating, drinking, or smoking can alter temperature in mouth 19. 30 minutes 20. Answers to reading a thermometer A

94

8

B

C

6

8

7

94

DE

F

G H

100 6

28

100 4

4

1 3

9

5

2

6

J

I

46

6

88

110 10

10

2

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21. A. 95 B. 964 C. 98

D. 1002 E. 1008 F. 102

G. 1034 H. 1042 I. 1054

J. 1088

CHAPTER 16:3 MEASURING AND RECORDING PULSE 1. pressure of the blood felt against the wall of an artery as the heart beats and rests 2. (a) A. temporal B. carotid C. brachial D. radial E. femoral F. popliteal

G. dorsalis pedis or pedal

H. posterior tibial (b) Circle radial pulse D. 3. rate, rhythm, volume 4. a. 60 to 100 b. 70 to 100 c. 80 to 110 d. 100 to 160 5. (any 3 of the following) exercise, stimulant drugs, excitement, fever, dehydration, shock, nervous tension 6. (any 3 of the following) sleep, depressant drugs, heart disease, coma, physical training 7. bradycardia, tachycardia, arrhythmia 8. oxygen level of blood and pulse rate 9. 95 to 100 percent oxygen 10. deficiency of oxygen reaching the tissues CHAPTER 16:4 MEASURING AND RECORDING RESPIRATIONS 1. the process involving taking in of oxygen and expelling of carbon dioxide by the lungs and respiratory tract 2. inspiration, expiration 3. a. 12–20 breaths per minute; b. 16–30 breaths per minute; c. 30–50 breaths per minute 4. (any 4 of the following) deep, shallow, labored, difficult, moist, stertorous 5. regular, irregular 6. a. dyspnea: difficult or labored respirations (breathing) b. apnea: absence of respirations, usually a temporary period of no respirations c. Cheyne-Stokes: abnormal breathing pattern characterized by periods of dyspnea followed by periods of apnea d. rales: bubbling, crackling, or noisy sounds caused by fluids or mucus in the air passages e. tachypnea: respiratory rate above 25 respirations per minute f. bradypnea: respiratory rate below 10 respirations per minute g. wheezing: difficult breathing with high-pitched whistling or sighing sounds during expiration h. cyanosis: a dusky, bluish discoloration of the skin, lips, and/or nail beds as a result of decreased oxygen and increased carbon dioxide in the bloodstream 7. if patient is aware, they can alter the rate of breathing 8. leave hand in position on radial pulse, but count respirations

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CHAPTER 16:5 GRAPHING TPR Assignment Sheet #1

146 lbs

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54 INSTRUCTOR’S MANUAL

Assignment Sheet #2

126 lbs

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Assignment Sheet #3

238 lbs

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Assignment Sheet #4

200 lbs

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Assignment Sheet #5

DAVE IMHOFF

206 lbs

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CHAPTER 16:6 MEASURING AND RECORDING APICAL PULSE 1. a pulse count taken at the apex of the heart with a stethoscope 2. (any 2 of the following) irregular heartbeats, hardening of the arteries, weak radial pulse, rapid radial pulse 3. infants and children have very rapid radial pulses 4. sounds are caused by the closing of the heart valves as blood flows through the chambers of the heart 5. report to your supervisor immediately 6. heart contractions are not strong enough to produce a pulse sensation at the radial site 7. a. 24, b. 46, c. none or 0 8. wipe earpieces and bell/diaphragm with a disinfectant such as alcohol CHAPTER 16:7 MEASURING AND RECORDING BLOOD PRESSURE Assignment Sheet #1 1. the measurement of the pressure that the blood exerts on the walls of the arteries during the various stages of activity in the heart 2. pressure that occurs in the walls of the arteries when the heart is contracting and pushing blood into the arteries 3. constant pressure that is present in the walls of the arteries when the heart is at rest, or between contractions 4. below 120 mm Hg, below 80 mm Hg 5. 64 6. 30 to 50 mm Hg 7. a pressure between 120 and 129 mm Hg systolic or between 80 and 89 mm Hg diastolic; a warning that high blood pressure will develop unless a person commits to proper nutrition and a regular exercise program to help avoid developing hypertension 8. 130–139 mm Hg, 80–89 mm Hg, 140 mm Hg, 90 mm Hg 9. stress triggers the body to produce a surge of hormones that temporarily increase the blood pressure by causing the heart to beat faster and the blood vessels to narrow 10. blood pressure is measured at a systolic over 180 mm Hg and/or a diastolic over 120 mm Hg, which can damage blood vessels and cause a cardiovascular accident (CVA) or stroke; immediate medication changes and possible immediate hospitalization if there are signs of organ damage 11. most individuals do not have any signs or symptoms of the disease 12. (any 3 of the following) heart failure, dehydration, depression, severe burns, hemorrhage, shock 13. a sudden drop in both systolic and diastolic pressure when an individual moves from a lying to a sitting or standing position; inability of blood vessels to compensate quickly to the change in position 14. (any 3 of the following) excitement, anxiety, nervous tension, eating, stimulant drugs, exercise, smoking 15. (any 3 of the following) rest or sleep, depressant drugs, shock, excessive loss of blood, fasting 16. mercury sphygmomanometers can cause a mercury spill and contamination 17. a. 128/92, 188/84, 136/76, 210/118 b. normal: 136/76 c. abnormal: 128/92, 188/84, 210/118 18. cuffs that are too wide or too narrow give inaccurate readings Assignment Sheet #2 1. 298 6. 258 2. 288 7. 248 3. 280 8. 242 4. 274 9. 232 5. 268 10. 226

11. 216 12. 210 13. 204 14. 192 15. 186

16. 176 17. 166 18. 160 19. 150 20. 146

21. 140 22. 132 23. 128 24. 120 25. 114

26. 106 27. 98 28. 94 29. 86 30. 74

31. 68 32. 60 33. 54 34. 48 35. 38

Assignment Sheet #3 1. 20 5. 62 2. 34 6. 76 3. 42 7. 82 4. 52 8. 90

9. 98 10. 104 11. 116 12. 130

13. 134 14. 142 15. 150 16. 158

17. 170 18. 178 19. 186 20. 198

21. 208 22. 222 23. 236 24. 244

25. 260 26. 276

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CHAPTER 17 FIRST AID SUGGESTED ANSWERS TO THE END OF CHAPTER REVIEW QUESTIONS 1. (any of the following) check for responsiveness, activate EMS, check pulse and breathing simultaneously, if no pulse or breathing start chest compressions 2. check the scene and move victim only if necessary; check for consciousness, a pulse, and breathing; call EMS if necessary; provide care to victim; check for and control severe bleeding 3. remain calm and call EMS; control the bleeding by applying direct pressure to the affected area using a thick dressing or sterile gauze; elevate the affected hand above the heart to allow gravity to aid in stopping the blood flow from the wound; continue to maintain direct pressure and elevation and apply a pressure bandage to hold the dressings in place; a. wrap the fingertip in a cool, moist dressing and place it in a plastic bag that should be kept cool or placed in ice water in case it can be reattached; b. shock; c. call EMS, monitor breathing and pulse, position to improve circulation, cover with blanket but avoid overheating, avoid giving victim anything to eat or drink 4. remain calm and check for breathing and consciousness; begin CPR if the victim is not breathing, and then call EMS; if the victim is breathing, position the victim on his side so fluids can drain from the mouth; call a poison control center or physician and obtain medical help immediately; save the bottle of aspirin and any vomitus; calculate or estimate the number of aspirin tablets that might have been taken; observe for and treat signs of anaphylactic shock; a. save the bottle so the dosage and amount taken can be determined; b. a hypersensitive or allergic reaction to a substance such as a medication 5. move patient out of sun, flush areas with superficial burns with cool water, apply sterile dressings to forehead, do not break any blisters, if more than 15 percent of body is burned obtain medical care; a. calculating percentage of body surface burned; b. (any 4 of the following) sunburn, contact with hot objects or steam, exposure of skin to acid or alkali, sunlamp, contact with fire, boiling liquids, electricity 6. remain calm and shout for someone to call EMS or, if you have a cell phone, immediately call EMS; move the victim to a shady or cool area; remove any excess clothing; try to cool your friend’s body temperature by putting cool water and/or ice bags on the skin, soaking a towel with cool water and sponging the skin, or putting them in a tub of cool water; watch for and treat any signs of shock or difficulty in breathing ; a. victim is unconscious; b. heat cramps, heat exhaustion, heat stroke 7. move victim to warm area, remove wet clothing, slowly warm victim by wrapping in blankets and/or putting on dry clothing, cover the head with a warm cap to retain body heat, if victim is conscious give warm nonalcoholic and noncaffeinated liquids by mouth, put feet in warm water until normal color and/or feeling returns, avoid warming victim to quickly, obtain medical help as needed; a. condition in which body temperature is less than 95°F (35°C); b. rubbing may cause gangrene or death of tissue 8. maintain respirations, treat for shock if needed, use splints to immobilize the arm in the position in which it is found, obtain medical help; a. immobilize to keep the broken bone from moving and causing additional injury; b. boards, shop rags and cloths, cardboard from boxes 9. remain calm and position the victim comfortably on his back, but raise the head and shoulders slightly to aid breathing; encourage the victim to relax and stay calm; call EMS immediately; give the victim an aspirin if possible; constantly monitor breathing and consciousness; if the pulse stops, begin CPR; reassure the victim until help arrives; place enough blankets on the victim to prevent chilling; a. call EMS immediately; b. victim must be on a firm flat surface to perform CPR 10. shout for help and immediately contact EMS; tell the victim to remove any glasses or contact lenses; if the solution splashed into the eye was acidic or alkali and could burn the eye, locate the emergency eye wash station in the lab or sink and flush the eyes and face with large amounts of water for at least 15–30 minutes, or until medical help arrives; tell the victim to hold the eyelids open and start flushing the eye with water at the inner corner of the eye, allowing the water to run over the surface of the eye to the outside; remove any clothing, shoes, socks, or jewelry that contain the chemical to minimize the area injured; if objects are embedded in the eye and will not flush out, cover both eyes with a sterile dressing and obtain medical help quickly; watch the victim for signs of shock and treat for shock if necessary; a. rubbing or wiping the shards of material can cause them to be embedded deeper into the eye tissue 11. remain calm and avoid panic; call EMS immediately and provide as much detail about the scene as possible; make sure it is safe for you to approach the vehicle, and if it is safe, decide if either victim is in danger by being near the fire; if either victim needs to be moved, do so as quickly and carefully as possible; if it is not safe for you to approach the car, allow professionals to handle the situation; after removing the victims, immediately check for breathing and consciousness; provide care as needed until EMS arrives; a. fire at rear of car, small child in infant seat, driver’s broken arm and level of consciousness; b. small child, driver, fire

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SUGGESTED ANSWERS TO THE WORKBOOK ASSIGNMENTS CHAPTER 17:1 PROVIDING FIRST AID 1. the immediate care that is given to the victim of an accident or illness to minimize the effect of the injury or illness until experts can take over 2. life, death, recovery, permanent disability 3. (any 3 of the following) type of injury or illness, environment, others present, equipment or supplies available, availability of medical help 4. (any 3 of the following) listen for unusual sounds, look for unusual sights, note any odors, watch for unusual appearance or behavior 5. call for medical help and allow professionals to take over 6. whether victim is conscious 7. victim can be injured more severely by improper movement 8. (any 5 of the following) situation, actions taken, exact location, telephone number, assistance required, number of people involved, condition of victim(s) 9. do not proceed with care; if possible, have someone witness refusal of care; call EMS and allow professionals to take over if a life-threatening emergency exists 10. method of prioritizing treatment 11. (any 6 of the following) no pulse; no breathing; difficult breathing; severe bleeding; persistent pain in the chest or abdomen; vomiting or passing blood; poisoning; head, neck, or spine injuries; open chest or abdominal wounds; shock; severe partial-thickness and all full-thickness burns 12. (any 4 of the following) victim, others present, items noted at scene, emergency medical identification, empty medicine containers, bottles of chemicals or solutions 13. present a confident, calm attitude 14. maintain confidentiality and protect victim’s right to privacy 15. injury, qualified CHAPTER 17:2 PERFORMING CARDIOPULMONARY RESUSCITATION 1. cardiopulmonary resuscitation 2. C: circulation; A: airway; B: breathing; D: defibrillation 3. clinical death occurs when the heart stops beating and the victim stops breathing

biological death is death of cells 4. 4–6 minutes after clinical death 5. head tilt/chin lift method, jaw-thrust maneuver 6. automated external defibrillators; AED determines heart rhythms and sends audible or visual warning telling operator to push “shock” button 7. if any other rescuers are touching the victim when the shock is administered, they could receive severe injuries and even go into cardiac arrest 8. whether the victim is conscious or check for responsiveness 9. a. call fast, b. call first, c. call first, d. call fast, e. call fast 10. pulse, breathing 11. carotid 12. avoid pressure on the xiphoid process 13. 30, 2, 100 to 120, 5, 2, 5 14. 30:2 15. feel for a carotid pulse while chest compressions are administered 16. nose, mouth, lower half of the sternum, one-third the depth of the chest or approximately 11 2 inches (4 cm), 100 to 120, 30, 2, 30:2, 15, 2 17. 100 to 120, lower half of the sternum, one-third the depth of the chest or approximately 2 inches (5 cm), 30:2 18. remain calm and encourage victim to cough hard

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19. give five back blows, give five chest thrusts, check the mouth and sweep with a finger only if the object is seen 20. victim recovers, qualified medical help arrives, physician orders you to discontinue attempt, rescuer becomes physically exhausted, scene becomes unsafe, you are given a legally valid do not resuscitate (DNR) order CHAPTER 17:3 PROVIDING FIRST AID FOR BLEEDING AND WOUNDS 1. an open wound has a break in skin or mucous membrane, and a closed wound does not 2. bleeding, infection 3. a. abrasion, b. incision, c. laceration, d. puncture, e. avulsion, f. amputation 4. a. spurts from wound, heavy blood loss, bright red in color; b. slower, steadier, dark red or maroon, constant but easier to control; c. oozes from wound, less red than arterial, clots easily 5. (1) direct pressure, (2) elevation, (3) pressure bandage, (4) tourniquet in extreme emergencies 6. gloves, plastic wrap 7. effective, life-threatening, medical help, instructed 8. (any 4 of the following) wash hands, wear gloves, use sterile gauze with soap and water to wash wound, ­discard wipe after one use, wipe in outward direction when cleaning wound, rinse wound with cool water and pat dry, apply sterile dressing or bandage 9. (any 5 of the following) swelling, heat, redness, pain, fever, pus, red streaks leading from the wound 10. obtain medical advice regarding protection with tetanus shot 11. by a physician 12. (any 6 of the following) pain; tenderness; swelling; deformity; cold, clammy skin; rapid, weak pulse; a drop in blood pressure; uncontrolled restlessness; excessive thirst; vomited blood; blood in urine or feces 13. (any 4 of the following) get medical help, check breathing, treat for shock, avoid unnecessary movement, avoid giving any fluids or food to the victim 14. shock 15. calm, medical CHAPTER 17:4 PROVIDING FIRST AID FOR SHOCK 1. a clinical set of signs and various symptoms that are associated with an inadequate supply of blood to body organs 2. brain, heart 3. (any 6 of the following) hemorrhage; excessive pain; infection; heart attack; stroke; poisoning by chemicals, drugs, or gases; lack of oxygen; psychological trauma; dehydration from burns, vomiting, or diarrhea 4. a. septic, b. cardiogenic, c. hemorrhagic, d. anaphylactic, e. psychogenic, f. metabolic 5. (any 10 of the following) skin pale or cyanotic; skin cool; excessive perspiration (diaphoresis); wet, clammy skin; rapid, weak pulse; rapid, shallow respirations; irregular respirations; low blood pressure; weak; confused; loss of consciousness; anxiety and restlessness; excessive thirst; nausea and/or vomiting; blurred vision; sunken or vacant expression in eyes; dilated pupils 6. cause of shock, circulation, adequate oxygen, body temperature 7. a. do not move b. lying on side c. raise victim’s head and shoulders d. lying flat with feet raised approximately 12 inches 8. remove some blankets to avoid overheating the victim CHAPTER 17:5 PROVIDING FIRST AID FOR POISONING 1. ingestion (swallowing), inhalation, skin contact with harmful substances, injection (bite or sting) 2. type, injury, contact 3. on the side; so fluids can drain from the mouth 4. call poison control center, physician, or EMS

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5. name of poison, how much was taken, when poisoning occurred 6. save a sample of the vomited material 7. tickle the back of the victim’s throat, give warm salt water 8. to bind the poison so it is not absorbed into the body 9. (any 4 of the following) unconscious victims, victims who swallow an acid or alkali, victims who swallow petroleum products, victims who are convulsing, victims with burns on lips and mouth 10. remove the victim from the area if a quick rescue can be achieved without inhaling the gas 11. use large amounts of water to dilute the substance and remove it from the skin 12. (any 5 of the following) redness and swelling at site, itching, hives, pain, swelling of the throat, difficult or labored breathing, dizziness, change in level of consciousness CHAPTER 17:6 PROVIDING FIRST AID FOR BURNS 1. an injury caused by fire, heat, chemical agents, radiation, and/or electricity 2. superficial: red, mild swelling, pain partial-thickness: blister (or vesicle), skin red or mottled, surface appears wet, swelling, painful full-thickness: white or charred appearance, severe pain or painless 3. source of heat, skin area, burn, pain, shock, infection 4. (any 5 of the following) burns on more than 15 percent of surface of adult (10 percent in child); burns affect face or respiratory tract; victim is having difficulty breathing; burns cover more than one body part; victim has partial-thickness burn and is under 5 or over 60 years of age; burns result from chemicals, explosions, or electricity; all full-thickness burns 5. flush area with large amounts of cool water and apply dry, sterile, non-stick dressing when pain subsides 6. prevent infection 7. do not break or open them 8. call for medical help immediately and cover with thick sterile dressings 9. flush with large amounts of water for 15–30 minutes or until medical help arrives 10. loss of body fluids (dehydration) occurs quickly CHAPTER 17:7 PROVIDING FIRST AID FOR HEAT EXPOSURE 1. chemical imbalance that can eventually lead to death 2. muscle pains and spasms resulting from loss of fluids and electrolytes 3. firm pressure to cramped muscle, small sips of water, victim should rest and move to cool area 4. (any 6 of the following) pale and clammy skin, diaphoresis, fatigue (or tiredness), weakness, headache, muscle cramps, nausea and/or vomiting, dizziness and/or fainting, normal body temperature or just slightly elevated 5. (any 3 of the following) moving victim to cooler area; loosening or removing excessive clothing; applying cool, wet cloths; lying victim down with feet elevated 12 inches; giving small sips of water; obtaining medical help as needed 6. heat exhaustion: approximately normal or just slightly elevated; heat stroke: elevated to 105°F or above 7. (any 3 of the following) high body temperature; red, hot, dry skin; rapid pulse; loss of consciousness 8. convulsions, death 9. (any 3 of the following) place in tub of cool water; sponge skin with cool water; place ice or cold packs on victim’s wrists, ankles, and in axillary and groin area; watch for shock; obtain medical help 10. avoid abnormally warm or hot temperatures for several days, drink sufficient amounts of water and/or electrolyte solutions CHAPTER 17:8 PROVIDING FIRST AID FOR COLD EXPOSURE 1. wind velocity, amount of humidity, length of exposure 2. (any 5 of the following) shivering, numbness, weakness, drowsiness, low body temperature, poor coordination, confusion, loss of consciousness

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3. (any 3 of the following) move to warm area, remove wet clothing, warm victim slowly, wrap in blankets or put on dry clothing, cover head with cap to retain body heat, give warm liquids 4. freezing of the tissue fluids with damage to the skin and underlying tissues 5. (any 4 of the following) pale glossy skin, white or grayish-yellow color, blisters, skin cold to touch, numbness, pain that subsides 6. (any 4 of the following) fingers, toes, ears, nose, cheeks 7. 100°F–104°F or 37.8°C–40°C 8. rubbing may cause gangrene 9. avoid opening or breaking blisters 10. prevent them from rubbing and causing further injury CHAPTER 17:9 PROVIDING FIRST AID FOR BONE AND JOINT INJURIES 1. a. fracture: break in the bone b. dislocation: bone end displaced from a joint or moved out of its normal position c. sprain: injury to tissues surrounding a joint d. strain: overstretching of a muscle 2. closed fracture has no open wound on the skin; open fracture involves an open wound on the skin 3. (any 6 of the following) deformities, loss of motion, limited motion, pain and tenderness, swelling, discoloration, bone ends protruding through the skin, hearing bone break or snap, grating sensation, abnormal motion 4. respirations, shock, moving, injury 5. (any 4 of the following) deformity, limited or abnormal motion, swelling, discoloration, pain and tenderness, shortening or lengthening of affected arm or leg 6. can lead to additional injury to nerves, blood vessels, and other tissues 7. swelling, pain, discoloration, impaired motion 8. (any 3 of the following) cold application, elevate affected part, rest, elastic bandage for support, RICE (rest, ice, compression, elevation) 9. cold reduces swelling; warm relaxes the muscles 10. (any 6 of the following) commercial splints; inflatable, or air, splints; padded boards; cardboard; newspapers; blankets; pillows; boards 11. (any 3 of the following) long enough to immobilize joint above and below injured area, padded, tied in place, applied so they do not apply pressure to injury 12. make an indentation mark by applying slight pressure with the thumb 13. fracture of femur or thigh bone 14. promote circulation, prevent swelling (or edema), decrease pain 15. (any 4 of the following) temperature, color, swelling (or edema), amount of pain, color return on nail beds, numbness or tingling 16. immediately loosen the ties holding the splint in place 17. permanent damage resulting in paralysis can occur 18. only definite diagnosis of a closed fracture is an X-ray CHAPTER 17:10 PROVIDING FIRST AID FOR SPECIFIC INJURIES 1. vision loss, medical help, eye specialist 2. pull upper lid down over lower lid; raise upper eyelid and use sterile gauze to remove object or gently flush eye with water 3. apply dry sterile dressing and obtain medical help 4. make no attempt to remove it, apply dressings loosely or use a paper cup with a hole in the bottom to support it, keep victim lying flat, obtain medical help 5. wrap it in gauze moistened with cool sterile water or normal saline, put the gauze-wrapped tissue in a plastic bag, and send it to the medical facility with the victim

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6. lying on the injured side with head and shoulders elevated slightly to allow fluid to drain 7. (any 6 of the following) clear or blood-tinged cerebrospinal fluid, loss of consciousness, headache, disturbances in vision, pupils unequal in size, paralysis of muscles, disturbances in speech, convulsions, nausea and/or vomiting 8. (any 4 of the following) keep victim lying flat, treat for shock, watch breathing, allow cerebrospinal fluid to flow, avoid giving any fluids, note length of time victim is unconscious 9. (any 3 of the following) injuries to nose, change in altitudes, strenuous activity, high blood pressure, rupture of blood vessels after a cold 10. sitting position with head leaning slightly forward 11. no, leave wound exposed to air; if bleeding, use a nonocclusive dressing so air can still go in and out of wound 12. on injured side with head and chest elevated slightly 13. immobilize it in place, do not remove it, position the victim comfortably, maintain respiration, obtain medical help 14. (any 4 of the following) pain and tenderness, visibility of protruding organs or open wounds, nausea and/or vomiting, rigidity of abdominal muscles, symptoms of shock 15. flat on the back with a pillow or rolled blanket under the knees to bend the knees slightly, elevate the head and shoulders slightly to aid breathing 16. cover with a large sterile dressing moistened with sterile water or normal saline, make no attempt to replace organs 17. (any 4 of the following) control severe bleeding, treat for shock, do not remove any penetrating or inserted objects, save any torn tissue, apply cold applications, obtain medical help 18. wrap it in gauze moistened with sterile water or sterile normal saline, put it in a plastic bag, keep it moist and cold, send it to medical facility with victim CHAPTER 17:11 PROVIDING FIRST AID FOR SUDDEN ILLNESS 1. information from the victim, medical alert bracelets or necklaces, medical information cards 2. (any 4 of the following) painful pressure under sternum; pain radiating to shoulders, arms, neck, and jaw; intense shortness of breath; pale or cyanotic skin; weak and apprehensive; nausea and/or vomiting; diaphoresis; loss of consciousness 3. (any 3 of the following) encourage victim to relax, position in comfortable position, obtain medical help, provide treatment for shock, avoid unnecessary stress and movement, reassure victim constantly 4. (any 6 of the following) numbness, paralysis, pupils of eyes unequal in size, mental confusion, sudden severe headache, loss of balance or coordination, slurred speech or difficulty speaking, nausea and/or vomiting, difficulty breathing and swallowing, loss of consciousness, one side of face drooping, unable to lift or hold up one arm 5. (any 3 of the following) maintain respirations, lie victim flat or on side, avoid any fluids by mouth, obtain medical help as quickly as possible, reassure victim, avoid unnecessary stress or movement 6. if stroke is caused by a blood clot, treatment with thrombolytic drugs can be given in the first 3 hours 7. lying down or sitting in a chair with head at level of knees 8. (any 3 of the following) lie victim flat, elevate legs and feet if no neck or spine injury is suspected, loosen tight clothing, maintain open airway, wash face with cool water, check for injuries, get victim up slowly after recovery 9. violent involuntary contraction of muscles 10. self-injury 11. no, can cause injury to your fingers and/or damage victim’s teeth or gums 12. force causes the contractions to become more severe 13. diabetic coma, insulin shock 14. (any 6 of the following) confusion, weakness, dizziness, nausea and/or vomiting, rapid deep respirations, dry and flushed skin, sweet or fruity odor to the breath, loss of consciousness 15. obtain medical assistance as soon as possible 16. (any 6 of the following) muscle weakness, mental confusion, restlessness or anxiety, diaphoresis, pale and moist skin, hunger pangs, palpitations, coma, convulsions

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INSTRUCTOR’S MANUAL 65

17. give victim some form of sugar 18. ask the patient “Have you eaten today?” and “Have you taken your insulin?”

CHAPTER 17:12 APPLYING DRESSINGS AND BANDAGES 1. sterile covering placed over a wound or an injured part 2. (any 3 of the following) control bleeding, absorb blood and secretions, prevent infection, ease pain 3. fibers contaminate the wound 4. materials used to hold dressings in place, secure splints, and support and protect body parts 5. bleeding, movement of the dressing, circulation 6. roller gauze, triangular, elastic 7. (any 3 of the following) sling, bandage for head/scalp, bandage for large body part, secure splints or dressings 8. they can cut off or constrict circulation if applied too tightly or stretched during application 9. (any 4 of the following) swelling, pale or cyanotic (blue) color, coldness, numbness or tingling, poor return of color to nail beds 10. loosen bandage immediately

CHAPTER 18 PREPARING FOR THE WORLD OF WORK SUGGESTED ANSWERS TO THE END OF CHAPTER REVIEW QUESTIONS 1. purpose is to obtain an interview; used to create a good impression so that the employer will be interested in interviewing and hiring you; should accompany all resumes.

2. personal identification: name, address, telephone number, and e-mail address; employment objective, job desired, or career goal: title of the position for which you are applying; educational background: starting with the highest level of education, list the names and addresses of your high school or post-secondary schools, and any special courses or majors if they relate to the job position; work or employment experience: starting with the most recent position and working backward, list previous positions of employment with the name and address of the employer, dates employed, your job title, and a brief description of duties; skills: list special knowledge, computer, and work skills; other activities: list organizations of which you are a member, offices held, community service, special awards received, volunteer work, hobbies, special interests, and other similar facts; credentials: note any credentials or certifications/registrations obtained 3. (any 6 of the following) fill out each item neatly and completely; do not leave any areas blank; be sure addresses include zip codes and all other required information; watch spelling and punctuation, and use spell check when completing an application on a computer; complete the form in the manner requested (on a computer or handwritten); use a black pen if printing; if the application is not available electronically, scan the application into a computer word program, key in all information, check for accuracy, and then print the completed application form; make sure all information is legible; do not write in spaces that state “office use only” or “do not write below this line”; be sure all information is correct and truthful; proofread your completed application; if references are requested, be sure to include all information such as title, address, telephone number, and e-mail address 4. a. $608 c. $18.24 e. $46.51 b. $91.20 d. $3.04 f. $449.01 SUGGESTED ANSWERS TO THE WORKBOOK ASSIGNMENTS CHAPTER 18:1 DEVELOPING JOB-KEEPING SKILLS 1. externship 2. internship 3. (any 3 of the following) access your strengths and weaknesses to help determine which type of job you would be best suited for; if you have completed an externship or internship, use those experiences to help determine what positions you would excel in; determine the type of job you would like, hours you are available to work, location or area where you would like to work, potential health care agencies you would like, and positions you are qualified to hold; develop a positive attitude—be proud of what you have accomplished; do a job search;

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66 INSTRUCTOR’S MANUAL

prepare a letter of application and résumé; complete all information for your portfolio; prepare for a job interview 4. (any 10 of the following) poor written grammar, poor spelling, poor communication, poor speech, poor math skills, lack of respect for work, lack of self-initiative, poor personal appearance, not accepting responsibility, excessive tardiness, poor attendance, inability to accept criticism 5. questions and problems can be resolved in a quick and efficient manner if the correct person is consulted 6. evaluate individual answers: answer should include three job-keeping skills with at least two reasons why student feels competent in each of the skills 7. evaluate individual answers: answer should include three job-keeping skills and at least two ways to improve competency in each of these skills 8. (any 3 of the following) you have been offered another job with better hours, more pay, better benefits, more educational and advancement opportunities, or better job security; you have been offered a position that allows you to use more of your education and skills, or is in a specialized area that you are interested in; personal reasons, such as marriage, moving, illness, or pregnancy 9. (any 3 of the following) always give notice—usually at least one pay period or a minimum of 2 weeks, make sure the first person you tell is your supervisor or the person in charge, be positive about your reasons for leaving and emphasize how your current position has benefited you, work to the best of your ability until your resignation date, make sure you complete all open assignments, leave detailed progress reports for your supervisor and fellow team members, offer to train your replacement 10. letter of resignation 11. (any 3 of the following) stay positive, no matter how difficult; don’t blame others; look for the reason within yourself and learn from experience; accept responsibility for whatever caused you to be fired; do not criticize the health care facility to others or make any statements or express any opinions that you may later regret; ask the employer if a letter of resignation would be accepted instead of being fired and, if the employer agrees, be sure to thank them 12. you may need to contact them for consultations, recommendations, advice, and help; a network of professionals is helpful as you advance in your career CHAPTER 18:2 WRITING A COVER LETTER AND PREPARING A RÉSUMÉ 1. to obtain an interview 2. computer printed, neat, complete, form, spelling, punctuation 3. a. paragraph 1: states purpose for writing and position you are applying for b. paragraph 2: states why you believe you are qualified c. paragraph 3: résumé is included d. paragraph 4: close with a request for an interview, reference as to how employer can contact you 4. record of information about an individual; a thorough yet concise summary of education, skills, accomplishments, and work experience 5. a. personal identification: name, address, telephone number, e-mail address b. employment objective: title of position you are applying for c. educational background: name and address of school, any special training or courses d. work or employment experience: name and address of employers, job title, dates employed, and brief description of duties e. skills: special knowledge, computer, and work skills f. other activities: organizations, offices held, volunteer work, special interests, hobbies, awards g. credentials: any kind of credential, certification, and/or licensure 6. no; references should be printed on a separate sheet of paper and given to the employer during the job interview 7. incorrect information can cost you a job 8. standard business envelope that matches the paper or a 9 × 12 inch envelope to eliminate the need to fold the letter and résumé 9. professional way to highlight your knowledge, abilities, and skills as you prepare for employment or extended education

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INSTRUCTOR’S MANUAL 67

10. (any 5 of the following) introductory letter, résumé, skill list and competency level, letter(s) of recommendation, copies of work-based learning evaluations and documentation of hours, credentials, sample projects, documentation of mastering job-keeping skills, leadership and organization abilities 11. a national organization that developed a framework that describes the skills, knowledge, and expertise students must master in order to succeed in work and life 12. evaluate individual answers: student should choose two categories in the Partnership for 21st Century Skills (core subjects and 21st century themes; learning and innovation skills; information, media, and technology skills; or life and career skills) and explain how the skills have been mastered CHAPTER 18:3 COMPLETING JOB APPLICATION FORMS 1. to collect specific information 2. (any 3 of the following) note areas where information is to be placed; read instructions on how to complete form; note whether it should be written, printed, or computer printed; check all required information 3. NA or none 4. errors will not impress the potential employer 5. black ink, scan, key, accuracy, print 6. material can be checked and verified and a simple half-truth can cost you a job 7. leave it blank; employers judge how well you follow directions 8. obtain their permission 9. ensures that you have necessary information with you 10. (any 3 of the following) completeness of information, spelling, proper answers to questions, errors CHAPTER 18:4 PARTICIPATING IN A JOB INTERVIEW 1. (any 2 of the following) allows employer to evaluate you in person, allows employer to obtain additional information, lets employer ascertain whether you meet the job qualifications, tells you about the position in more detail 2. (any 2 of the following) wallet card or mobile device with wallet card information saved on it, résumé, completed application 3. (any 4 of the following) conservative dress, clothes fit well, clothes clean and pressed, hair neat, nails clean, teeth clean, effective antiperspirant males: suit or coat and tie or dress shirt and slacks, clean-shaven or well-maintained facial hair females: suit, dress, skirt, dress pants, nails—no bright polish, avoid too much makeup 4. 5–10 minutes early 5. turn them off 6. (any 8 of the following) greet interviewer by name, remain standing until interviewer asks you to sit, use correct grammar, speak slowly and clearly, be polite, maintain eye contact, answer questions thoroughly, do not smoke or eat candy or chew gum, watch posture and sit straight, smile—avoid giggling, be yourself, be enthusiastic, listen closely, watch awkward habits, do not discuss personal problems or criticize former employers, answer questions truthfully, think before you respond, be proud of yourself, do not immediately ask about salary/fringe benefits/insurance, thank employer 7. send follow-up note, letter, or e-mail to thank employer for interview 8. evaluate individual answers a. why they are qualified b. what are their strengths or strong points c. polite but firm refusal to answer the question d. three most important features of a job e. what they hope to accomplish in next 2 years

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68 INSTRUCTOR’S MANUAL

CHAPTER 18:5 DETERMINING NET INCOME Assign each student a different hourly wage. Then check the answers on this assignment using the following chart.

Percentages used are stated. You may have to change figures depending on tax percentages, which vary.

Hourly Wage

40-Hour Week

Federal 15%

State 2%

City 1%

F.I.C.A 7.65%

Net Week

Net Month

9.25

370.00

55.50

7.40

3.70

28.31

275.10

1,100.38

9.30

372.00

55.80

7.44

3.72

28.46

276.58

1,106.33

9.35

374.00

56.10

7.48

3.74

28.61

278.07

1,112.28

9.40

376.00

56.40

7.52

3.76

28.76

279.56

1,118.22

9.45

378.00

56.70

7.56

3.78

28.92

281.04

1,124.17

9.50

380.00

57.00

7.60

3.80

29.07

282.53

1,130.12

9.55

382.00

57.30

7.64

3.82

29.22

284.02

1,136.07

9.60

384.00

57.60

7.68

3.84

29.38

285.50

1,142.02

9.65

386.00

57.90

7.72

3.86

29.53

286.99

1,147.96

9.70

388.00

58.20

7.76

3.88

29.68

288.48

1,153.91

9.75

390.00

58.50

7.80

3.90

29.84

289.97

1,159.86

9.80

392.00

58.80

7.84

3.92

29.99

291.45

1,165.81

9.85

394.00

59.10

7.88

3.94

30.14

292.94

1,171.76

9.90

396.00

59.40

7.92

3.96

30.29

294.43

1,177.70

9.95

398.00

59.70

7.96

3.98

30.45

295.91

1,183.65

10.00

400.00

60.00

8.00

4.00

30.60

297.40

1,189.60

10.05

402.00

60.30

8.04

4.02

30.75

298.89

1,195.55

10.10

404.00

60.60

8.08

4.04

30.91

300.37

1,201.50

10.15

406.00

60.90

8.12

4.06

31.06

301.86

1,207.44

10.20

408.00

61.20

8.16

4.08

31.21

303.35

1,213.39

10.25

410.00

61.50

8.20

4.10

31.37

304.84

1,219.34

10.30

412.00

61.80

8.24

4.12

31.52

306.32

1,225.29

10.35

414.00

62.10

8.28

4.14

31.67

307.81

1,231.24

10.40

416.00

62.40

8.32

4.16

31.82

309.30

1,237.18

10.45

418.00

62.70

8.36

4.18

31.98

310.78

1,243.13

10.50

420.00

63.00

8.40

4.20

32.13

312.27

1,249.08

10.55

422.00

63.30

8.44

4.22

32.28

313.76

1,255.03

10.60

424.00

63.60

8.48

4.24

32.44

315.24

1,260.98

10.65

426.00

63.90

8.52

4.26

32.59

316.73

1,266.92

10.70

428.00

64.20

8.56

4.28

32.74

318.22

1,272.87

10.75

430.00

64.50

8.60

4.30

32.90

319.71

1,278.82

10.80

432.00

64.80

8.64

4.32

33.05

321.19

1,284.77

10.85

434.00

65.10

8.68

4.34

33.20

322.68

1,290.72

10.90

436.00

65.40

8.72

4.36

33.35

324.17

1,296.66

10.95

438.00

65.70

8.76

4.38

33.51

325.65

1,302.61

11.00

440.00

66.00

8.80

4.40

33.66

327.14

1,308.56

11.05

442.00

66.30

8.84

4.42

33.81

328.63

1,314.51

11.10

444.00

66.60

8.88

4.44

33.97

330.11

1,320.46

11.15

446.00

66.90

8.92

4.46

34.12

331.60

1,326.40

11.20

448.00

67.20

8.96

4.48

34.27

333.09

1,332.35

11.25

450.00

67.50

9.00

4.50

34.43

334.58

1,338.30

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INSTRUCTOR’S MANUAL 69

Hourly Wage

40-Hour Week

Federal 15%

State 2%

City 1%

F.I.C.A 7.65%

Net Week

Net Month

11.30

452.00

67.80

9.04

4.52

34.58

336.06

1,344.25

11.35

454.00

68.10

9.08

4.54

34.73

337.55

1,350.20

11.40

456.00

68.40

9.12

4.56

34.88

339.04

1,356.14

11.45

458.00

68.70

9.16

4.58

35.04

340.52

1,362.09

11.50

460.00

69.00

9.20

4.60

35.19

342.01

1,368.04

11.55

462.00

69.30

9.24

4.62

35.34

343.50

1,373.99

11.60

464.00

69.60

9.28

4.64

35.50

344.98

1,379.94

11.65

466.00

69.90

9.32

4.66

35.65

346.47

1,385.88

11.70

468.00

70.20

9.36

4.68

35.80

347.96

1,391.83

11.75

470.00

70.50

9.40

4.70

35.96

349.45

1397.78

11.80

472.00

70.80

9.44

4.72

36.11

350.93

1,403.73

11.85

474.00

71.10

9.48

4.74

36.26

352.42

1,409.68

11.90

476.00

71.40

9.52

4.76

36.41

353.91

1,415.62

11.95

478.00

71.70

9.56

4.78

36.57

355.39

1,421.57

12.00

480.00

72.00

9.60

4.80

36.72

356.88

1,427.52

12.05

482.00

72.30

9.64

4.82

36.87

358.37

1,433.47

12.10

484.00

72.60

9.68

4.84

37.03

359.85

1,439.42

12.15

486.00

72.90

9.72

4.86

37.18

361.34

1,445.36

12.20

488.00

73.20

9.76

4.88

37.33

362.83

1,451.31

12.25

490.00

73.50

9.80

4.90

37.49

364.32

1,457.26

12.30

492.00

73.80

9.84

4.92

37.64

365.80

1,463.21

12.35

494.00

74.10

9.88

4.94

37.79

367.29

1,469.16

12.40

496.00

74.40

9.92

4.96

37.94

368.78

1,475.10

12.45

498.00

74.70

9.96

4.98

38.10

370.26

1,481.05

12.50

500.00

75.00

10.00

5.00

38.25

371.75

1,487.00

12.55

502.00

75.30

10.04

5.02

38.40

373.24

1,492.95

12.60

504.00

75.60

10.08

5.04

38.56

374.72

1,498.90

12.65

506.00

75.90

10.12

5.06

38.71

376.21

1,504.84

12.70

508.00

76.20

10.16

5.08

38.86

377.70

1,510.79

12.75

510.00

76.50

10.20

5.10

39.02

379.19

1,516.74

12.80

512.00

76.80

10.24

5.12

39.17

380.67

1,522.69

12.85

514.00

77.10

10.28

5.14

39.32

382.16

1,528.64

12.90

516.00

77.40

10.32

5.16

39.47

383.65

1,534.58

12.95

518.00

77.70

10.36

5.18

39.63

385.13

1,540.53

13.00

520.00

78.00

10.40

5.20

39.78

386.62

1,546.48

13.05

522.00

78.30

10.44

5.22

39.93

388.11

1,552.43

13.10

524.00

78.60

10.48

5.24

40.09

389.59

1,558.38

13.15

526.00

78.90

10.52

5.26

40.24

391.08

1,564.32

13.20

528.00

79.20

10.56

5.28

40.39

392.57

1,570.27

13.25

530.00

79.50

10.60

5.30

40.55

394.06

1,576.22

13.30

532.00

79.80

10.64

5.32

40.70

395.54

1,582.17

13.35

534.00

80.10

10.68

5.34

40.85

397.03

1,588.12

13.40

536.00

80.40

10.72

5.36

41.00

398.52

1,594.06

13.45

538.00

80.70

10.76

5.38

41.16

400.00

1,600.01

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70 INSTRUCTOR’S MANUAL

Hourly Wage

40-Hour Week

Federal 15%

State 2%

City 1%

F.I.C.A 7.65%

Net Week

Net Month

13.50

540.00

81.00

10.80

5.40

41.31

401.49

1,605.96

13.55

542.00

81.30

10.84

5.42

41.46

402.98

1,611.91

13.60

544.00

81.60

10.88

5.44

41.62

404.46

1,617.86

13.65

546.00

81.90

10.92

5.46

41.77

405.95

1,623.80

13.70

548.00

82.20

10.96

5.48

41.92

407.44

1,629.75

13.75

550.00

82.50

11.00

5.50

42.08

408.93

1,635.70

13.80

552.00

82.80

11.04

5.52

42.23

410.41

1,641.65

13.85

554.00

83.10

11.08

5.54

42.38

411.90

1,647.60

13.90

556.00

83.40

11.12

5.56

42.53

413.39

1,653.54

13.95

558.00

83.70

11.16

5.58

42.69

414.87

1,659.49

14.00

560.00

84.00

11.20

5.60

42.84

416.36

1,665.44

14.05

562.00

84.30

11.24

5.62

42.99

417.85

1,671.39

14.10

564.00

84.60

11.28

5.64

43.15

419.33

1,677.34

14.15

566.00

84.90

11.32

5.66

43.30

420.82

1,683.28

14.20

568.00

85.20

11.36

5.68

43.45

422.31

1,689.23

14.25

570.00

85.50

11.40

5.70

43.61

423.80

1,695.18

14.30

572.00

85.80

11.44

5.72

43.76

425.28

1,701.13

14.35

574.00

86.10

11.48

5.74

43.91

426.77

1,707.08

14.40

576.00

86.40

11.52

5.76

44.06

428.26

1,713.02

14.45

578.00

86.70

11.56

5.78

44.22

429.74

1,718.97

14.50

580.00

87.00

11.60

5.80

44.37

431.23

1,724.92

14.55

582.00

87.30

11.64

5.82

44.52

432.72

1,730.87

14.60

584.00

87.60

11.68

5.84

44.68

434.20

1,736.82

14.65

586.00

87.90

11.72

5.86

44.83

435.69

1,742.76

14.70

588.00

88.20

11.76

5.88

44.98

437.18

1,748.71

14.75

590.00

88.50

11.80

5.90

45.14

438.67

1,754.66

14.80

592.00

88.80

11.84

5.92

45.29

440.15

1,760.61

14.85

594.00

89.10

11.88

5.94

45.44

441.64

1,766.56

14.90

596.00

89.40

11.92

5.96

45.59

443.13

1,772.50

14.95

598.00

89.70

11.96

5.98

45.75

444.61

1,778.45

15.00

600.00

90.00

12.00

6.00

45.90

446.10

1,784.40

15.05

602.00

90.30

12.04

6.02

46.05

447.59

1,790.35

15.10

604.00

90.60

12.08

6.04

46.21

449.07

1,796.30

15.15

606.00

90.90

12.12

6.06

46.36

450.56

1,802.24

15.20

608.00

91.20

12.16

6.08

46.51

452.05

1,808.19

15.25

610.00

91.50

12.20

6.10

46.67

453.54

1,814.14

15.30

612.00

91.80

12.24

6.12

46.82

455.02

1,820.09

15.35

614.00

92.10

12.28

6.14

46.97

456.51

1,826.04

15.40

616.00

92.40

12.32

6.16

47.12

458.00

1,831.98

15.45

618.00

92.70

12.36

6.18

47.28

459.48

1,837.93

15.50

620.00

93.00

12.40

6.20

47.43

460.97

1,843.88

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INSTRUCTOR’S MANUAL 71

CHAPTER 18:6 CALCULATING A BUDGET Grade this assignment on an individual basis. Make sure student uses realistic amounts in each category. Check total amounts. Make sure expenses equal net monthly income.

CHAPTER 19 DENTAL ASSISTANT SKILLS SUGGESTED ANSWERS TO THE END OF CHAPTER REVIEW QUESTIONS 1. answers will be individualized, but student must draw a diagram of the tooth, label the 4 sections (crown, root, cervix, and apex), 4 tissues (enamel, cementum, dentin, and pulp), and structures of the periodontium (alveolar process, periodontal ligament, and gingiva); refer to Figure 19-2 2. crown surfaces of the anterior teeth: labial, lingual, incisal, mesial, distal crown surfaces of the posterior teeth: buccal, lingual, occlusal, mesial, distal line angles of anterior teeth: linguoincisal, labioincisal, mesiolabial, mesioincisal, mesiolingual, distolingual, distoincisal, distolabial line angles of posterior teeth: mesioocclusal, mesiolingual, mesiobuccal, distoocclusal, distolingual, distobuccal, linguoocclusal, buccoocclusal point angles of anterior teeth: mesiolinguoincisal, mesiolabioincisal, distolabioincisal, distolinguoincisal point angles of posterior teeth: mesiolinguoocclusal, mesiobuccoocclusal, distobuccoocclusal, distolinguoocclusal 3. a. 8 (Universal/National) and 11 (FDI System) b. 15 (Universal/National) and 27 (FDI System) c. 22 (Universal/National) and 33 (FDI System) d. 28 (Universal/National) and 44 (FDI System) 4. a. dental chair: wipe the headrest, armrest, and any other contaminated area with a disinfectant, then respray, leave in place for the required time, and wipe again; cover headrest and/or top of the chair with a plastic disposable cover, which is discarded and replaced with a clean one after each patient; most manufacturers recommend frequent, thorough cleaning with special upholstery cleaners or mild soap solutions b. dental light: prior to a procedure, place protective barriers, such as plastic wrap, aluminum foil, or commercial covers, on the handles and switches of the light; barriers must be removed and replaced with clean barriers after each patient; all parts that are touched must be disinfected after each patient; most manufacturers recommend the use of a mild detergent and a soft cloth to clean the light shield and prevent the formation of scratches; at least once a week, all moving parts on the light should be lubricated with a general, all-purpose oil c. tri-flow or air-water syringe: put protective barrier covers on the syringe handle and tubing prior to each patient examination; after each use, run the air-water syringe for at least 30 seconds to flush out the unit; discard plastic disposable tips in an infectious-waste container; clean and autoclave metal tips and replace with a sterile tip after each patient; wipe the syringe and tubing with a disinfectant after each patient d. low-speed handpiece: after each patient, scrub handpieces thoroughly to remove debris, rinse, dry, and sterilize or disinfect with a chemical germicide; wipe all tubings with a disinfectant; clean burs with a bur brush and then sterilize following manufacturer’s recommendations; follow the manufacturer’s instructions regarding the type of lubrication and method of application to lubricate the handpiece 5. a. prophylactic and oral examination: mouth mirror; cotton pliers; explorer; scalers; a periodontal probe for an adult; prophylactic cups, paste, and brushes; fluoride-treatment supplies b. amalgam restoration: mouth mirror, cotton pliers, explorer, spoons, hatchet, gingival margin trimmer, amalgam carriers, condenser-pluggers, carvers (Hollenback and/or cleoid discoid), burnisher, plastic filling instruments, matrix retainer and band c. composite restoration: explorer, mouth mirror, cotton pliers, spoons, hoes or hatchets, plastic filling instruments, composite instruments, matrix band d. surgical extraction: explorer, mouth mirror, cotton pliers, extracting forceps, root elevators, root-tip picks, periosteal elevators, Rongeur forceps, lancets, bone chisel and mallet, needle holder with suture materials 6. general anesthesia: renders a patient unconscious

analgesia or sedation: causes loss of ability to feel pain, but not loss of consciousness; usually given by having the patient inhale a mixture of nitrous oxide and oxygen gases, which causes the patient to feel pleasantly relaxed but remain awake and able to cooperate

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72 INSTRUCTOR’S MANUAL

local anesthesia: administered by injecting an anesthetic into the area where loss of sensation is desired; decreases or eliminates the sensation of pain in the specific area but has no effect on the patient’s level of consciousness topical anesthesia: applied to the mucous membrane to desensitize the area where another anesthetic is to be injected 7. varnish: used to cover, line, or seal exposed tooth tissue, such as dentin base: material that is placed over the pulpal area of a tooth to reduce irritation and thermal (heat) shock cement: used to permanently seal inlays, orthodontic appliances, crowns, and bridges in place; as a temporary filling; or as a base for restorations when sedation is necessary temporary: used as a restorative material for a short time and only until permanent restoration can be done 8. student draws a diagram of the 14 periapical films for a full-mouth series of radiographs and identifies the teeth; see Figures 19-77 and 19-80 SUGGESTED ANSWERS TO THE WORKBOOK ASSIGNMENTS CHAPTER 19:1 IDENTIFYING THE STRUCTURES AND TISSUES OF A TOOTH 1. A. crown H. cemento-enamel junction B. cervix or cemento-enamel junction I. free gingiva C. root J. alveolar process D. apex with apical foramen K. cementum E. enamel L. pulp canal F. dentin M. periodontal ligament G. pulp in pulp chamber 2. 20 3. 6 months of age 4. (any 2 of the following) maintain proper spacing, mastication, speech 5. 5–6 years of age 6. 32 7. mixed 8. a. dentin f. enamel b. apical foramen g. cementum c. pulp h. root d. cervix or cemento-enamel junction i. pulp e. crown j. enamel 9. periodontium 10. (1) D (2) A (3) D (4) C (5) A (6) D (7) B (8) D (9) B and C

(10) D

CHAPTER 19:2 IDENTIFYING THE TEETH A. Labeling 1. primary, or deciduous, teeth: see Figure 19-3A 2. permanent, or succedaneous, teeth: see Figure 19-3B B. Matching 1. B 2. A

3. C 4. D

5. B 6. A, D

7. C 8. B

9. B 10. D

11. C 12. A

C. Completion and Short Answer 1. maintain correct spacing for permanent teeth 2. transverse, or horizontal, plane 3. midsagittal, median, midline

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INSTRUCTOR’S MANUAL 73

CHAPTER 19:3 IDENTIFYING TEETH USING THE UNIVERSAL/NATIONAL NUMBERING SYSTEM AND THE FEDERATION DENTAIRE INTERNATIONAL (FDI) SYSTEM 1. primary teeth labeled by Universal/National Numbering System: teeth labeled from A–T; see Figure 19-4 2. A max. rt. 2nd molar H G max. lft. lateral incisor S K mand. lft. 2nd molar N P mand. rt. central incisor B T mand. rt. 2nd molar R I max. lft. 1st molar O C max. rt. cuspid D E max. rt. central incisor L M mand. lft. cuspid F Q mand. rt. lateral incisor J 3. d-3 max. rt. cuspid d-14 mand. lft. lateral incisor d-19 mand. rt. 1st molar d-6 max. lft. central incisor d-8 max. lft. cuspid d-11 mand. lft. 2nd molar 4. permanent teeth labeled by Universal/National Numbering System: teeth labeled from 1–32, see Figure 19-4 5. 1 max. rt. 3rd molar 7 8 max. rt. central incisor 29 15 max. lft. 2nd molar 19 20 mand. lft. 2nd bicuspid 24 28 mand. rt. 1st bicuspid 11 32 mand. rt. 3rd molar 6 16 max. lft. 3rd molar 18 4 max. rt. 2nd bicuspid 13 23 mand. lft. lateral incisor 26 17 mand. lft. 3rd molar 21 12 max. lft. 1st bicuspid 9 30 mand. rt.1st molar 31 3 max. rt. 1st molar 22 25 mand. rt. central incisor 2 10 max. lft. lateral incisor 27 5 max. rt. 1st bicuspid 14 6. diagram divided into 4 quadrants and labeled; primary teeth labeled according to Federation Dentaire International (FDI) System; see Figure 19-5 7. 51 max. rt. central incisor 55 74 mand. lft. 1st molar 73 63 max. lft. cuspid 81 85 mand. rt. 2nd molar 62 82 mand. rt. lateral incisor 84 53 max. rt. cuspid 61 72 mand. lft. lateral incisor 75 65 max. lft. 2nd molar 52 54 max. rt. 1st molar 83 71 mand. lft. central incisor 64 8. diagram divided into 4 quadrants and labeled; permanent teeth labeled according to Federation Dentaire International (FDI) System; see Figure 19-5

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9. 11 max. rt. central incisor 23 max. lft. cuspid 28 max. lft. 3rd molar 47 mand. rt. 2nd molar 35 mand. lft. 2nd bicuspid 22 max. lft. lateral incisor 15 max. rt. 2nd bicuspid 43 mand. rt. cuspid 18 max. rt. 3rd molar 41 mand. rt. central incisor 24 max. lft. 1st bicuspid 36 mand. lft. 1st molar 14 max. rt. 1st bicuspid 33 mand. lft. cuspid 42 mand. rt. lateral incisor 38 mand. lft. 3rd molar

12 45 37 21 46 32 13 26 44 31 16 25 34 48 17 27

CHAPTER 19:4 IDENTIFYING THE SURFACES OF THE TEETH A. 1.

2.

3.

4.

5.

6.

incisal distal lingual medial labial mesiolingual

I D Li M La MLi

7.

8.

9.

10.

11.

12.

mesioincisal distoincisal linguoincisal distolingual mesiolinguoincisal distolinguoincisal

MI DI LiI DLi MLiI DLiI

B. 1.

2.

3.

4.

5.

6.

7.

8.

9.

buccal occlusal mesial distal lingual mesiobuccal buccoocclusal distobuccal distoocclusal

B O M D Li MB BO DB DO

10.

11.

12.

13.

14.

15.

16.

17.

distolingual linguoocclusal mesiolingual mesioocclusal mesiobuccoocclusal distobuccoocclusal distolinguoocclusal mesiolinguoocclusal

DLi LiO MLi MO MBO DBO DLiO MLiO

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INSTRUCTOR’S MANUAL 75

CHAPTER 19:5 CHARTING CONDITIONS OF THE TEETH Assignment Sheet #1 Following charted on dental card: 1/20/— Ex, FMXR, Pro, and FI 1/23/— 2 AM to O 8 Comp to MLaI, Dycal 3/10/— BWXR–4

11 RCT 5/3/— 12 AM to MOD 5/20/— 17 Ext 6/2/— 23 Comp to DLinI 7/12/— Ex, Pro, Al. Imp. Mandibular 7/30/— 4 Am to B 8/15/— 30 Cr-Gold

RCT

RIGHT

1

2

32

3 31

4 30

5 29

6 28

7 27

8

9

10

26 25 24 23

11

22

12 21

13

20

14

15

16

LEFT

19

18

17

13

J

Copyright © Cengage Learning®. All Rights Reserved.

POSTERIOR 1

2

3

ANTERIOR

POSTERIOR

4

5

6

7

8

9

10

RCT 11 12

A

B

C

D

E

F

G

H

14

15

16

MAXILLARY

RIGHT

I

LINGUAL

LEFT

T

S

R

Q

P

O

N

M

L

K

29

28

27

26

25

24

23

22

21

20

MANDIBULAR

32

31

30

POSTERIOR

ANTERIOR

19

18

17

POSTERIOR

Copyright © Cengage Learning®. All Rights Reserved. © 2022 Cengage Learning, Inc. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

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76 INSTRUCTOR’S MANUAL

Assignment Sheet #2 Following charted on dental card: 1/1/— Ex, FMXR 1/23/— 20 AM to MO 1/30/— 3 AM to MOD 2/3/— 11 RCT 6/2/— Ex, BWXR, Pro 7/4/— 8 Comp to MLinI, Dycal 8/9/— 6 RB Imp. 8/20/— 6 Cr-Porcelain 2/11/— Ex, Pro, BWXR–4 3/8/— 22 AM to Lin 4/6/— 31 AM to MO 4/28/— 24 Comp to Lin RCT

RIGHT

1

2

32

3 31

4 30

5 29

6 28

7 27

8

9

26 25 24 23

10

11

22

12 21

20

13

14 19

15 18

16

LEFT

17

Copyright © Cengage Learning®. All Rights Reserved.

POSTERIOR 1

2

3

ANTERIOR

POSTERIOR

4

5

6

7

8

9

10

RCT 11

A

B

C

D

E

F

G

H

12

13

I

J

14

15

16

MAXILLARY

RIGHT

LINGUAL

LEFT

T

S

R

Q

P

O

N

M

L

K

29

28

27

26

25

24

23

22

21

20

MANDIBULAR

32

31

30

POSTERIOR

ANTERIOR

19

18

17

POSTERIOR

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INSTRUCTOR’S MANUAL 77

Assignment Sheet #3 Following charted on dental card: 5/7/— FMXR, PRO, Ex 6/1/— 20 AM to DO, I.R.M. 6/15/— 17 Ext. 7/2/— 6 R.B. Imp. 7/20/— 6 Cr. Porc.

10/1/— Ex, PRO, BWXR–4 10/15/— 11 Comp to LaI 10/22/— 13 AM to DO 11/3/— 4 AM to DB 3/3/— EX, FMXR, PRO 3/20/— 22 Comp to Lin, Dycal 4/2/— 29 AM to MO, IRM 4/15/— 25 RCT 5/3/— 30 AM on O

RIGHT

1

2

32

3 31

4 30

5 29

6 28

7 27

8

9

26 25 24 23

10

11

22

12

21

13

20

14 19

15

16

18

LEFT

17

RCT Copyright © Cengage Learning®. All Rights Reserved.

1

2

3

ANTERIOR

POSTERIOR

4

5

6

7

8

9

10

11

12

13

A

B

C

D

E

F

G

H

I

J

14

15

16

MAXILLARY

RIGHT

LINGUAL

LEFT

T

S

R

Q

P

O

N

M

L

K

29

28

27

26

25 RCT

24

23

22

21

20

MANDIBULAR

32

31

30

POSTERIOR

ANTERIOR

19

18

POSTERIOR

17

Copyright © Cengage Learning®. All Rights Reserved.

POSTERIOR

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78 INSTRUCTOR’S MANUAL

CHAPTER 19:6 OPERATING AND MAINTAINING DENTAL EQUIPMENT 1. blood, saliva, body fluids, Standard precautions, Protective, disinfect, sterilize, gloves, disinfected 2. a. dental light: illuminates oral cavity b. dental chair: positions the patient c. air compressor: provides air pressure to run handpieces d. oral-evacuation system: removes particles and liquid from oral cavity e. air-water syringe: provides air, water, or a combination f. saliva ejector: provides low-volume suction to remove saliva and other fluids from the mouth g. high-velocity evacuator: removes particles, debris, and large amounts of liquid from oral cavity h. low-speed handpiece: does carries removal and fine finishing work i. high-speed handpiece: does cutting and preparation of the tooth during dental procedures j. prophylaxis angle: holds polishing cups, disks, and brushes that are used to clean the teeth or polish a restoration 3. 30–50 inches; prevents formation of scratches on light shield 4. doctor and assistant can position themselves close to patient; prevent movement while patient is getting in or out of the chair 5. 100, 120 6. read and follow the manufacturer’s recommendations 7. catches large particles; empty particles into paper towel and then wash, rinse, and dry trap; prevent growth of organisms and development of unpleasant odors 8. plastic disposable tip is discarded; metal tip is removed and sterilized, replaced with a sterile tip 9. remove barrier, disinfect, draw disinfecting solution through tubing 10. to trap large particles drawn into the evacuator 11. to prevent sticking 12. contra-angle: cutting and polishing; prophylaxis angle: clean the teeth or polishing restorations 13. scrubbed thoroughly, rinsed, dried, and sterilized 14. read the specific manufacturer’s instructions for the equipment

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INSTRUCTOR’S MANUAL 79

CHAPTER 19:7 IDENTIFYING DENTAL INSTRUMENTS AND PREPARING DENTAL TRAYS 1. set up for particular patient or preset by procedure 2. proper sequence, order of use 3. a. prophylactic or oral examination tray: basic examination and cleaning of the teeth b. amalgam restoration tray: amalgam restorative procedure c. composite restoration tray: placement of composite or anterior restorative d. surgical extraction tray: removing or extracting teeth 4. a. blade, b. nib, c. point, d. shank, e. shaft 5. Answers to crossword puzzle 1

f

l

o s

2

s 4 5 6 7 o a m a l g a m a m pt 8 m c u r i 10 11 12 9 p r r t a x 14 13 15 16 h o l l e n b a c k c a r v e r 17 o r a o u a a u l 18 g y n t e r b r 20 19 t d o r g y n s 3

21

b e d d

32

b a n d e n 37

v

40

e e x

t

l p 45 o t

46

a m a l g

i

a s m e r a c t

p 44

28

33

22

r 36

h y g i

a

e

r p r

n i

23

s p o o a 27 w a s h

25

c o n

42

i o n d u b 26 p e d s 29 i b l 31 i s u

e r b c

24

t

u

t r e

e r o s

c 35 o t t i p p i i f 38 39 d e n t i s t 41 p o 43 n g f o r c e p s 34

i

t

l

n

30

b l

w c

k

a t i

47

s c a l e r r n s i 48 49 50 e e n t e c n o 52 51 r r r a s s i s t a n t Copyright © Cengage Learning®. All Rights Reserved.

CHAPTER 19:8 POSITIONING A PATIENT IN THE DENTAL CHAIR 1. supine, lying down 2. allows the dentist and assistant closer access to the oral cavity 3. to a height that will allow the dentist to be seated comfortably by the chair with the patient’s head above the doctor’s lap 4. when patient gets in chair, when patient gets out of chair 5. allow the patient time to adjust to the change in position; avoid dizziness, discomfort, and fear 6. unexpected movements can frighten the patient 7. protect the patient’s clothing 8. plastic side; plastic prevents moisture from soaking through to patient’s clothing 9. protects the patient’s eyes from sprays and fluids that may be present during a dental procedure 10. 30–50 inches, illuminates the mouth, shine in the patient’s eyes

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80 INSTRUCTOR’S MANUAL

CHAPTER 19:9 DEMONSTRATING BRUSHING AND FLOSSING TECHNIQUES 1. prevent decay or carious lesions, remove plaque, prevent halitosis or bad breath 2. all patients, slowly, clearly, repeat, stress 3. 45-degree angle, vibrating 4. chewing or biting, facial, lingual, one side, other side 5. side surfaces (interproximal surfaces) 6. soft bristled; will not injure gum or gingival tissue 7. when bristles are frayed or worn 8. to clean teeth and provide pleasant taste 9. aids in preventing decay 10. waxed and unwaxed; whichever type doctor prefers CHAPTER 19:10 TAKING IMPRESSIONS AND POURING MODELS 1. negative reproduction of a tooth, several teeth, or the dental arch 2. to form model of area for restorative treatment 3. alginate, polysulfide, or silicones (polysiloxane or polyvinylsiloxane) 4. advantages: (any 3 of the following) simple and economical to use, setting time controlled by water temperature, adequate strength, adequate reproduction, can be used for impressions of the teeth and/or tissue, easily cleaned disadvantages: not good for final impressions or fine detail, changes in dimension, tears or breaks easily 5. not as subject to dimension changes, good for fine detail 6. (any 3 of the following) easy cleanup, not affected by fluids in the oral cavity, highly accurate impression, retains shape and size for long period, odor-free and has a pleasant taste 7. positive reproduction of arches or teeth 8. construction of dentures, partials, or other prosthetics; making orthodontic appliances, mouth guards, and custom trays 9. plaster, stone 10. stronger, more regular and uniform model 11. moisture contamination leads to defective models or casts 12. stir and spatulate carefully, place mix on vibrator CHAPTER 19:11 MAKING CUSTOM TRAYS 1. impression trays that are made to fit a particular patient 2. preliminary impression and model 3. base, custom tray, fitted perfectly 4. curing; causes material to become pliable so it can be fitted to the contour of the preliminary model 5. self-curing resins set in a short period of time; light-curing resins do not set, or become hard, until they are exposed to a light in a special curing oven 6. plastic- or wax-lined disposable paper cup and tongue blades 7. coat with petroleum jelly 8. they can be vacuum-formed to make a custom tray CHAPTER 19:12 MAINTAINING AND LOADING AN ANESTHETIC ASPIRATING SYRINGE 1. sensation of feeling pain has been decreased or eliminated 2. decrease pain or discomfort caused by injection; to mucous membranes as spray, liquid, gel, or ointment 3. block: near main nerve trunk, mandibular infiltration/field: terminal nerve branches of teeth, maxillary or anterior mandibular 4. lidocaine or Xylocaine

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5. (any 2 of the following) decrease size of blood vessels, prolong effect, reduce bleeding; epinephrine 6. a. glass: no cracks or chips; b. date: do not use if expiration date has passed; c. solution: clear in color; d. rubber plunger: basically level with or just slightly below top; e. bubbles: small bubbles only; f. aluminum cap: clean, no rust 7. use sterile pad moistened with 70-percent ethyl alcohol or 91-percent isopropyl alcohol; disinfectant passes through rubber diaphragm and contaminates solution 8. be sure needle has not penetrated a blood vessel 9. (A) needle adaptor, (B) barrel, (C) guide bearing, (D) spring, (E) piston with harpoon, (F) finger grip, and (G) thumb ring 10. wash, rinse, sterilize in autoclave 11. take apart, check parts, replace worn or defective parts, lubricate threaded joints 12. (any 2 of the following) compensates for different tissue densities and determines exact amount of anesthesia needed; anesthesia delivered ahead of needle to numb site of insertion; anesthesia can be directed to exact area where it is needed; decreases collateral numbness of tongue, lips, and other facial tissues 13. it is more expensive 14. leakproof puncture-resistant sharps box; bent; broken; recapped CHAPTER 19:13 MIXING DENTAL CEMENTS AND BASES 1. a. liner: material used to cover, seal, or line exposed tooth tissue; example: varnish b. base: protective material placed over pulpal area of tooth to reduce irritation and thermal shock; examples: calcium hydroxide, zinc oxide eugenol, zinc phosphate, carboxylate c. cement: material used to seal inlays, orthodontic appliances, crowns, bridges in place; examples: zinc phosphate, carboxylates d. temporary: material used as a restorative for a short time; example: zinc oxide eugenol 2. (any 2 of the following for each) varnish: Copal, Copalite, Varnal, Handi-Liner; zinc oxide eugenol: I.R.M., Cavitec; calcium hydroxide: Dycal, Hypocal, Dropsin; carboxylates: Durelon, Hybond, Tylock-Plus 3. no; interferes with setting reaction of the materials 4. no; it is water soluble 5. thermally protective base, cement for gold restorations 6. improper techniques can lead to a poor base or cement and shorten life of restoration 7. read manufacturer’s directions 8. contamination of a container can destroy the entire contents CHAPTER 19:14 PREPARING RESTORATIVE MATERIALS—AMALGAM AND COMPOSITE 1. process of replacing a diseased portion of a tooth or lost tooth by artificial means 2. a hollow space in the tooth after dentist removes decayed and damaged tooth tissue 3. silver, tin, copper, zinc 4. mercury 5. (any 3 of the following) wear personal protective equipment (PPE); store in well-sealed, unbreakable container; clean up spills immediately; discard mercury-contaminated items in a sealed polyethylene bag 6. submerged in a tightly sealed, unbreakable jar containing sulfur water, glycerin, or mineral oil 7. formation of a new alloy called dental amalgam that is formed when amalgam alloy is mixed with mercury 8. mixing process used to combine mercury with amalgam alloy 9. improved appearance, increased strength, ability to withstand chemical actions caused by mouth fluids 10. when material is exposed to curing light 11. wear light-filtering glasses or use light-filtering paddles 12. etching roughens surface so composite will adhere and bond more securely to tooth tissue; bonding agent helps composite adhere to tooth

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CHAPTER 19:15 DENTAL RADIOGRAPHS (X-RAYS) 1. (any 4 of the following) locate carious lesions or dental decay; reveal tooth abscesses, cysts, or tumors; find cracks or damage in existing restorations; reveal bone loss from periodontal (gum) disease; determine if sufficient bone is present for dental implants; plan orthodontic treatments required to straighten teeth; check the condition of crowns and root canal treatments; calculate placement of bridges or dentures.

2. an electronic pad or sensor is positioned in the mouth, and beams of radiation are directed toward the sensor, which allows a computer to pick up an electronic image and display it on a screen; eliminates need for X-ray film and developing process and decreases individual’s exposure to radiation 3. compare current image with previous image and see anything that has changed or is new 4. radiolucent; pulp; caries; radiopaque; enamel; dentin; metallic restorations 5. 14 to 20; aids in proper diagnosis and treatment planning 6. a. bite-wings, b. periapical, c. panoramic 7. facial (buccal or labial) 8. lingual (tongue) 9. a. maxillary films; b. maxillary cuspids; c. maxillary molars; d. maxillary central incisors; e. mandibular lateral incisors; f. mandibular molars; g. bite-wings 10. lead apron to protect abdomen, thyroid collar to protect thyroid, operator stands behind barrier

CHAPTER 20 LABORATORY ASSISTANT SKILLS SUGGESTED ANSWERS TO THE END OF CHAPTER REVIEW QUESTIONS 1. resistant: if the organisms grow up to the edge of a particular disk, the organism is resistant to the antibiotic, and the antibiotic would not work against the organism to help cure the disease; sensitive: if the organisms do not grow close to the disk, the organisms are sensitive to the antibiotic, and the antibiotic would work against the organism and aid in the curing of the disease 2. (any 6 of the following) edema; cyanosis; scars; sores; calluses; rashes; color; avoid using the thumb, index finger, or pinkie finger 3. erythrocyte count: actually counts the total number of erythrocytes in a volume of blood; hematocrit: measures the volume of packed red blood cells, or erythrocytes, in the blood or the percentage of RBCs per volume of blood; hemoglobin: used to determine the oxygen-carrying capacity of the blood by measuring the amount of hemoglobin present 4. a. microhematocrit: 36–46 percent for women; 40–55 percent for men; 51–61 percent for infants; children 1 year old, 32–38 percent; children 6 years old, 34–42 percent b. hemoglobin: average range is 12–18 grams, males average 13–18 grams, females average 12–16 grams, newborns average 16–23 grams, and children 1–10 years of age average 10–14 grams of hemoglobin per 100 milliliters of blood c. erythrocyte count: 4.5–6.0 million per cubic millimeter of blood for males and 4.0–5.5 million per cubic millimeter of blood for females d. leukocyte count: 4,500–11,000 per cubic millimeter of blood e. erythrocyte sedimentation rate: normal values for the Wintrobe method are 0–20 millimeters per hour (mm/hr) for adult women and 0–9 mm/hr for adult men; normal values for the Westergren method are 0–20 mm/hr for adult women younger than 50 years, 0–30 mm/hr for women 50 years or older, 0–15 mm/hr for adult men younger than 50 years, and 0–20 mm/hr for men 50 years or older f. specific gravity of urine: 1.005–1.030 with most specimens ranging between 1.010 and 1.025 5. (any 5 of the following) store in a dry, cool, dark area because the strips are sensitive to light, heat, and moisture; close the bottle immediately after use; do not touch or handle any of the chemical-reactant pads on the strip because chemicals and moisture on the skin can lead to an inaccurate test, and many of the chemicals on the strip are poisonous and can burn or injure the skin; never use strips after the expiration date because inaccurate test results will occur; make sure patients who use reagent strips in their homes understand the importance of correct storage and handling of reagent strips; caution the patient against storing the strips in a bathroom, on windowsills, or close to sources of heat; store strips out of the reach of children 6. physical examination: consists of observing and recording color, odor, transparency, and specific gravity chemical examination: checks pH, protein, glucose, ketones, acetones, bilirubin, urobilinogen, phenylalanine, and blood microscopic examination: examines formed or solid elements in the urine, such as cells, casts, crystals, and amorphous deposits © 2022 Cengage Learning, Inc. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

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7. hands must be washed frequently and thoroughly; gloves must be worn; protective clothing, such as lab coats, lab aprons, or disposable gowns, must be worn; if splashing of specimens, such as blood or urine, is possible, a mask or face shield and protective eyewear must be worn; any lab counter or contaminated area must be wiped immediately with a disinfectant solution; any blood spills must be wiped up immediately with a disinfectant solution; all contaminated disposable materials or supplies and any remaining samples or specimens must be placed in an infectious waste bag prior to being disposed of as infectious waste according to legal requirements; any sharps, such as lancets or needles, must be placed in a leakproof puncture-resistant sharps box; sharps should not be bent, broken, or recapped; urine should be discarded in a toilet, but if it is poured down a sink, the sink must be flushed with water and wiped with a disinfectant SUGGESTED ANSWERS TO THE WORKBOOK ASSIGNMENTS CHAPTER 20:1 OPERATING THE MICROSCOPE A. Labeling 1. eyepiece(s) 2. body tube 3. arm 4. coarse adjustment 5. fine adjustment 6. base 7. illuminating light 8. condenser and iris diaphragm 9. stage with side clips 10. objectives 11. revolving nosepiece B. Completion and Short Answer 1. electron beams 2. to detect antibodies and specific organisms 3. crack slide and/or damage objective 4. adjust iris diaphragm 5. other materials scratch delicate glass 6. to bring the slide into rough focus 7. to get a precise and clear image 8. to concentrate light so object can be seen 9. a. 40, b. 100, c. 400 10. a. 80, b. 200, c. 800 11. covered with a dust cover or stored in a dust-free closet CHAPTER 20:2 OBTAINING AND HANDLING CULTURES 1. to identify the causative agent of a disease 2. to prevent contamination from other sources 3. special solid medium that provides both nourishment and moisture for the organism 4. a. resistant: antibiotic would not work against the organism b. sensitive: antibiotic would work against the organism 5. doctor can determine which antibiotic or medication to give the patient for the disease or infection 6. slide is held over a source of heat for a very brief period of time; heat causes organisms to stick to the slide 7. a. gentian violet or crystal violet: primary stain, stains gram-positive organisms; 1 minute b. iodine: sets the primary dye or makes it adhere to the organisms on the slide; 30 to 60 seconds c. ethyl alcohol or acetone-alcohol: removes gentian violet from gram-negative organisms; until solution running off the slide is no longer purple in color d. safranin: counterstain, stains gram-negative organisms; 30–60 seconds © 2022 Cengage Learning, Inc. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

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8. to provide another method for identifying organisms 9. gram-positive: streptococcus, staphylococcus; gram-negative: Escherichia coli (E. coli), Acinetobacter 10. to identify organisms quickly so effective antibiotics can be started immediately 11. require that a positive and negative control test be done at the same time as the patient’s test 12. gloves, lab coat or apron, mask or face shield, protective eyewear CHAPTER 20:3 PUNCTURING THE SKIN TO OBTAIN CAPILLARY BLOOD 1. skin puncture, venipuncture, arterial puncture 2. in some states, health science education students are not permitted to perform procedures that involve obtaining blood 3. clean skin with alcohol, use sterile lancet, cover puncture with sterile gauze 4. (any 5 of the following) do not use thumb, index finger, or pinkie finger; check edema; check calluses; check scars; check rashes; check sores; make sure skin is warm and pink; do not use if cyanotic 5. 2–4 mm 6. across, right angles 7. contaminated with alcohol, perspiration, excess tissue fluid, and other substances; these substances can dilute the blood and cause inaccurate blood tests 8. until the blood flow ceases 9. diseases can be transmitted by improper handling of blood samples 10. place in a leakproof, puncture-resistant sharps box CHAPTER 20:4 PERFORMING A MICROHEMATOCRIT 1. a blood test that measures the volume of packed red blood cells in the blood 2. oxygen, carbon dioxide, 4.5–6.0 million per cubic millimeter of blood for males and 4.0–5.5 million per cubic millimeter of blood for females 3. requires less blood, done in a shorter period of time than other methods for determining hematocrit 4. red blood cells, buffy coat (white blood cells and platelets), plasma 5. fighting infections; 4,500–11,000 per cubic millimeters of blood; 8,000 6. to prevent the blood from clotting 7. to prevent the blood from running out of the tube during centrifuging 8. 46.5 percent 9. a. 36–46 percent; b. 40–55 percent c. 51–61 percent; d. 34–42 percent 10. anemia, severe bleeding 11. polycythemia, dehydration, burns 12. test is used to diagnose disease, false results can lead to improper diagnosis and care 13. repeat the test 14. the physician or other authorized individual CHAPTER 20:5 MEASURING HEMOGLOBIN 1. substance found in red blood cells 2. to carry oxygen and carbon dioxide 3. the oxygen-carrying capacity of blood or grams of hemoglobin per 100 mL of blood 4. special instrument that measures the hemoglobin content in blood 5. destroying red blood cells; hemoglobin is released into the solution surrounding the cells 6. blood changes in appearance from cloudy to clear (or transparent) 7. a. 13–18 grams, b. 12–16 grams, c. 16–23 grams, d. 10–14 grams 8. anemia; polycythemia 9. repeat the test 10. the physician or other authorized individual © 2022 Cengage Learning, Inc. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

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CHAPTER 20:6 PREPARING AND STAINING A BLOOD FILM OR SMEAR 1. a spreader is used to spread a small drop of blood into a thin layer on a slide 2. 100, total, type, percentage 3. it is an aid in making a diagnosis because certain types of white blood cells increase after specific infections 4. form, structure, relative number, erythrocytes, leukocytes, platelets, shapes 5. certain types of leukemia 6. contaminants will interfere with and even distort the appearance of the cells 7. alcohol 8. stains cells, fixes smear 9. fixative, 1 second, staining, 1 second, four to five, manufacturer’s 10. faster, requires less than 1 minute to complete CHAPTER 20:7 TESTING FOR BLOOD TYPES 1. antigens 2. a. type A, b. type AB, c. type O, d. type B, e. type Rh positive, f. type Rh negative 3. a. hemolyze: red blood cells dissolve and go into solution, releasing hemoglobin b. agglutinate: red blood cells clump together 4. typing and crossmatch 5. typing determines the ABO and Rh factors; crossmatch checks for other incompatibilities 6. test to check for antibodies, done to avoid incompatible reaction 7. when woman is Rh negative and fetus is Rh positive 8. a. type AB positive b. type O positive c. type A negative d. type B positive CHAPTER 20:8 PERFORMING AN ERYTHROCYTE SEDIMENTATION RATE 1. distance that red blood cells fall or settle in a specific period of time 2. an anticoagulant (oxalate or sequestrene), to prevent clotting of blood 3. measurement is taken at the point where the clear plasma line is noted above the settled RBCs 4. to hold the tube in an exact vertical position 5. place on a counter free of vibrations; not exposed to a heating/cooling vent or direct sunlight 6. 20-minute interval, 1-hour interval 7. Westergren system: completely closed system that eliminates the manual transfer of blood that can result in leakage, overfilling, and spraying from the transfer pipette 8. a. 0–20 mm/hr b. 0–9 mm/hr c. 0–20 mm/hr for adult females younger than 50 years and 0–30 mm/hr for females older than 50 d. 0–15 mm/hr for adult males younger than 50 years and 0–20 mm/hr for males older than 50 9. (any 5 of the following) infections, carcinoma (or cancer), leukemia, rheumatic fever, rheumatoid arthritis, viral hepatitis, pregnant or menstruating female 10. (any 4 of the following) polycythemia, certain types of heart disease, congestive heart failure, severe liver disease, sickle-cell anemia CHAPTER 20:9 MEASURING BLOOD-SUGAR (GLUCOSE) LEVEL 1. glucose, insulin, bloodstream, kidneys, urine 2. a. hyperglycemia: high blood sugar b. glycosuria: excess amounts of sugar in the urine c. hypoglycemia: low blood sugar

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3. patient has nothing to eat or drink for 8–12 hours, venipuncture is done, serum level of glucose is checked 4. 70–100 mg/deciliter of blood 5. how well a person metabolizes a calculated amount of glucose 6. fasting blood-sugar test measures the current level of glucose in the blood

glycohemoglobin test measures the average blood sugar level for the previous 2 to 3 months 7. (any 4 of the following) increased accuracy, can be done at any time, detects both low and high glucose levels, better regulation of insulin dosage, improved control of diabetes 8. strips of plastic with chemical-reagent pads 9. color change 10. compare color to color chart on bottle, place in glucose meter for reading 11. strips are very sensitive to heat, light, and moisture 12. dark, dry, and cool area but not refrigerated 13. chemicals and moisture on the skin can cause inaccurate results; chemicals can burn or injure the skin 14. time and procedure methods vary with different strips 15. lens paper or water can be used to clean screen, disinfectant can be put on areas unless prohibited by manufacturer 16. (any 2 of the following) do not require drops of blood and eliminate need for finger punctures, individual can check blood glucose levels frequently with minimal effort, alerts quickly to high or low levels CHAPTER 20:10 TESTING URINE 1. 1000–2000; increased amount: polyuria; decreased amount: oliguria; no formation: anuria 2. straw yellow to amber; pale: dilute; clear red: hemoglobin or RBC destruction; cloudy red: RBCs present (hematuria); yellow or beer-brown: bilirubin or bile pigment 3. clear; (any 3 of the following) pus, mucus, white blood cells, old specimen 4. faintly aromatic; ammonia: old specimen; fruity or sweet: acetone or ketones or diabetes; foul or putrid: bacteria or infection 5. 5.0–8.0, mildly acid 6. 1.005–1.030; high: (any 3 of the following) diabetes mellitus, concentrated urine, low fluid intake, dehydration; low: (any 3 of the following) renal disease, diluted urine, high fluid intake, diuretic medications 7. (any 8 of the following) glucose: diabetes; albumin: kidney disease; acetones-ketones: starvation, diabetes, mellitus, high-fat diet; blood: kidney disease, infection; pus: infection; bacteria: infection; RBCs: kidney disease, bleeding in urinary tract; WBCs: infection if large amount; bilirubin: liver disease, bile duct obstruction, hepatitis; urobilinogen: liver disease or destruction of red blood cells (hemolytic diseases) 8. physical, chemical, microscopic 9. color, odor, transparency, specific gravity 10. (any 6 of the following) pH, protein, glucose, ketone, bilirubin, urobilinogen, blood 11. to spin out solid particles and form urinary sediment 12. within 1 hour after it is collected 13. (any 4 of the following) wash hands frequently; wear gloves; if splashing is possible, wear a mask or face shield, protective eyewear, and protective clothing; wipe any contaminated areas with a disinfectant; discard specimen container in an infectious waste container 14. pour down toilet; if poured down sink, flush the sink with water and wipe with a disinfectant CHAPTER 20:11 USING REAGENT STRIPS TO TEST URINE 1. by the kidney as part of urine 2. firm plastic strips with small pads containing chemical reactants 3. chemicals react with reactant on strip and produce a color change 4. store in dry, cool, dark area; keep moisture-absorbent pad in the bottle; close bottle immediately after use 5. contact with skin can lead to an inaccurate test, chemicals can burn or injure the skin 6. chemical reactants are effective only for a certain period of time; no, inaccurate test results will occur © 2022 Cengage Learning, Inc. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

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7. (any 3 of the following) diet, medications, kidney disease, starvation, diabetes mellitus 8. a. protein: kidney disease b. glucose: diabetes mellitus c. ketones (acetones): diabetes, starvation, fasting, dieting, high-fat diet, metabolic disorders d. blood: injury, infection, or disease in kidneys and/or urinary tract e. bilirubin: liver disease such as hepatitis or bile duct obstruction f. urobilinogen: heart, spleen, liver, or hemolytic disease g. phenylalanine: phenylketonuria (PKU) 9. (any 3 strips for each substance) a. pH: Bili-Labstix, Combistix, Labstix, Multistix b. glucose: Bili-Labstix, Clinistix, Combistix, Diastix, Keto-Diastix, Labstix, Multistix, Uristix c. protein: Albustix, Bili-Labstix, Combistix, Labstix, Multistix, Uristix d. ketones: Bili-Labstix, Keto-Diastix, Ketostix, Labstix, Multistix e. blood: Bili-Labstix, Hemastix, Labstix, Multistix 10. lists substances to be tested, gives correct time interval for reading each reaction 11. to make sure strips produce accurate results; urine control solution with predetermined results is tested, and measurements must match predetermined range 12. it is more accurate than the human eye 13. fresh urine specimen 14. within 1 hour after collection; results are more accurate CHAPTER 20:12 MEASURING SPECIFIC GRAVITY 1. weight of urine compared with the weight of an equal amount of distilled water 2. 1.005–1.030 with most specimens ranging between 1.010 and 1.025 3. (any 3 of the following) excessive fluid intake, kidney disease in which kidneys cannot concentrate urine, diuretic medications, diabetes insipidus 4. (any 3 of the following) low fluid intake, dehydration, excessive fluid loss, kidney disease, diabetes mellitus 5. a. 1.001 b. 1.005 c. 1.008 d. 1.012 e. 1.015 f. 1.019 g. 1.024 h. 1.029 i. 1.034 j. 1.038 6. one drop, ocular, eyepiece, accuracy, strips, solutions CHAPTER 20:13 PREPARING URINE FOR MICROSCOPIC EXAMINATION 1. to examine the solid materials (urinary sediment) suspended in the urine 2. fresh, early-morning, first-voided specimen is more concentrated and more likely to contain abnormal substances 3. certain substances disintegrate rapidly in warm specimens 4. kept cold 5. spins urine, causing solid material to settle to the bottom 6. sediment 7. cover slip will float; empty space under cover slip 8. drying occurs quickly, which can result in distortions in the shape and size of substances present 9. per low-power field, per high-power field 10. CLIA-waived, moderately complex, legally qualified

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CHAPTER 21 MEDICAL ASSISTANT SKILLS SUGGESTED ANSWERS TO THE END OF CHAPTER REVIEW QUESTIONS 1. used to determine whether a patient is overweight or underweight; provide necessary information in performing and evaluating certain laboratory tests and in calculating dosages of certain medications; aid in detecting problems with growth and development 2. answers will be individualized, but student must identify 6 exam positions and list at least 2 types of treatments or examinations for each position; horizontal recumbent (supine): examination or treatment of the anterior part of the body, breast examination during a gynecological examination, examine the chest or abdomen during a general physical examination; prone: examination or treatment of the back or spine; Sims’ (left lateral): simple rectal and sigmoidoscopic examinations, enemas, rectal temperatures, rectal treatments; knee–chest: rectal examinations such as a sigmoidoscopic examination; Fowler’s: facilitate breathing, relieve distress, encourage drainage, examine the head, neck, and chest; lithotomy: vaginal examinations, Pap tests, urinary catheterization, cystoscopic examinations, surgery of the pelvic area; dorsal recumbent: vaginal examinations, Pap tests, urinary catheterization, cystoscopic examinations, surgery of the pelvic area; Trendelenburg: increase circulation to the head and brain, treat circulatory shock, surgery on pelvic organs, pelvic treatments; jackknife (proctologic): rectal surgery, rectal examinations, back surgery, back treatments 3. Snellen chart tests only for defects in distant vision or for nearsightedness (myopia); Jaeger card is used to test for defects in close vision known as farsightedness (hyperopia); Ishihara plate checks for defects in color vision, or color blindness 4. a. OU: oculus uterque, or each eye; both eyes b. OS: oculus sinister, or left eye c. OD: oculus dexter, or right eye d. myopia: nearsightedness, defect in distant vision e. hyperopia: farsightedness, defect in close vision 5. a. EENT: examines the ears, eyes, nose, throat, and mouth; tests include: screen for visual acuity with a ­Snellen chart, Jaeger card, and/or Ishihara plate; check size of pupils and reaction of eyes to light; obtain cultures from nose, mouth, or throat; test hearing acuity; check bone conduction of sound b. gynecological: examines the female reproductive organs including the vagina, cervix, and other pelvic organs, as well as the breasts; tests include: check breasts for lumps or defects, order a mammogram, perform a Pap test to detect cancer of the cervix or reproductive organs, obtain a culture to check for infection or STIs c. general physical: all areas of the body are examined; tests include: perform blood and urine tests, take an electrocardiogram (ECG), test visual acuity, check hearing and bone conduction, check reflex reactions, check nerve response, test for fecal occult blood 6. (any 5 standard precautions) wash hands frequently; wear gloves; if splashing or contact with blood, urine, secretions, excretions, or other body fluids is possible, wear a gown, mask or face shield, and eye protection; clean and/or sterilize all instruments and equipment after use; wipe contaminated areas with a disinfectant; place contaminated disposable supplies in an infectious waste bag prior to being disposed of according to legal requirements; put sharp objects and needles in a sharps container immediately after use 7. a hemostat is a special group of curved or straight instruments, usually striated at the end, that are used to compress (clamp) blood vessels to stop bleeding or grasp tissue; a needle holder is a special instrument that also has striations, but it is used to hold or support the needle while sutures are being inserted 8. (students must list 12 ECG leads and state the location of the electrodes standard or limb leads: 1 (right arm and left arm), 2 (right arm and left leg), and 3 (left arm and left leg); a­ ugmented voltage leads : aVR (right arm with left arm and left leg), aVL (left arm with right arm and left leg), and aVF (left leg with right arm and left arm); chest leads : V1 (chest lead 1 with left arm and right arm and left leg), V2 (chest lead 2 with left arm and right arm and left leg), V3 (chest lead 3 with left arm and right arm and left leg), V4 (chest lead 4 with left arm and right arm and left leg), V5 (chest lead 5 with left arm and right arm and left leg), and V6 (chest lead 6 with left arm and right arm and left leg) 9. right medication, right dose, right patient, right time, right method or mode of administration, right documentation

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SUGGESTED ANSWERS TO THE WORKBOOK ASSIGNMENTS CHAPTER 21:1 MEASURING/RECORDING HEIGHT AND WEIGHT 1. to determine if a patient is overweight or underweight 2. allows a physician to check the child’s growth and compare it to the average percentiles of other children of the same age 3. hydrocephalus, microencephaly 4. to determine the progression of chronic obstructive pulmonary diseases (COPDs) such as emphysema 5. (any 4 of the following) use the same scale each day, make sure the scale is balanced, weigh the patient at the same time each day, weigh the patient early in the morning before any food or liquids have been consumed, make sure the patient is wearing the same amount of clothing each day, ask the patient to void or empty the bladder 6. answer will be individualized; student should tell the patient that the physician will determine whether weight is excessive 7. 154 pounds 8. 60 kilometers 9. 44 inches 10. 195 centimeters 11. A. 2 E. 6¾ I. 12¼ M. 18 B. 3¼ F. 8½ J. 13¾ N. 19¼ C. 4¼ G. 10¼ K. 15½ O. 20½ D. 6 H. 11 L. 16¾ E. 56¾ I. 212¼ M. 268 12. A. 52 B. 53¼ F. 208½ J. 213¾ N. 269¼ C. 54¼ G. 210¼ K. 265½ O. 270½ D. 56 H. 211 L. 266¾ 13. A. 47½ E. 43 I. 38¼ M. 54½ B. 46½ F. 41¾ J. 37¼ N. 74¼ C. 45½ G. 40½ K. 71 D. 44¼ H. 39¾ L. 68¾ 14. A. 4 ft E. 5 ft 2 in I. 1 ft 6 in M. 5 ft 1¾ in B. 4 ft 6 in F. 5 ft 8 in J. 6 ft 6 in N. 4 ft 7¼ in C. 3 ft 3 in G. 6 ft 2 in K. 3 ft 6½ in O. 6 ft 1½ in D. 4 ft 10 in H. 2 ft 6 in L. 4 ft 6¼ in 15. A. 1¾ D. 33⁄8 G. 6½ J. 9 B. 2¼ E. 4 H. 75⁄8 K. 107⁄8 7 C. 2 ⁄8 F. 5¼ I. 8¼ L. 117⁄8 16. A. 12 oz D. 2 lb G. 3 lb 4 oz J. 4 lb 10 oz B. 1 lb 2 oz E. 2 lb 5 oz H. 3 lb 14 oz K. 4 lb 15 oz C. 1 lb 8 oz F. 2 lb 11 oz I. 4 lb 6 oz L. 5 lb 3 oz 17. A. 1/8 E. 5/8 I. 2¼ M. 12¾ B. 1/4 F. 3/4 J. 6½ N. 1115⁄16 3 C. 3/8 G. 7/8 K. 8 ⁄16 O. 155⁄8 7 D. 1/2 H. 1 L. 10 ⁄16 CHAPTER 21:2 POSITIONING A PATIENT A. Matching 1. C 2. H 3. E, H 4. D

5. B 6. B 7. G 8. H

9. A, F 10. I, F 11. I 12. G

13. C 14. C 15. B 16. F

17. H 18. E 19. D, E, H 20. B, C

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B. Completion and Short Answer 1. obtain instruction or read manufacturer’s instructions 2. (any 2 of the following) close door to room, draw curtains, drape or cover patient CHAPTER 21:3 SCREENING FOR VISION PROBLEMS 1. ability to perceive and comprehend the sense of sight 2. natural daylight with no direct sunlight 3. pictures, letter E, alphabet 4. heights, 20, 20 5. distance the patient is from the chart 6. height of the characters the patient can read 7. 50, 20, 50 8. myopia or nearsightedness 9. Jaeger system 10. Ishihara method 11. patient is asked to identify number printed in colored dots against a background of colored dots 12. OD: oculus dexter, or right eye OS: oculus sinister, or left eye OU: oculus uterque, or each eye; both eyes 13. defect in distant vision, or nearsightedness 14. defect in close vision, or farsightedness 15. instrument for checking the eye 16. tonometer CHAPTER 21:4 ASSISTING WITH PHYSICAL EXAMINATIONS 1. a. EENT: eye, ear, nose, and throat b. GYN: breasts, vagina, cervix, pelvic organs of female c. general: all areas of the body 2. to detect cancer of the cervix or reproductive organs 3. a. palpation, b. percussion, c. observation, d. auscultation 4. so bladder is empty and internal organs can be felt 5. (any 5 of the following) height/weight, vital signs, vision screening, audiometric screening, blood tests, electrocardiogram 6. a. ophthalmoscope: examine eye; b. otoscope: examine ear; c. tuning fork: test hearing acuity; d. stethoscope: ­listen to internal body sounds; e. percussion (reflex) hammer: test tendon reflexes; f. cervical spatula (Ayer blade): obtain or scrape cells from cervix; g. rectal speculum: examine rectum; h. sigmoidoscope: examine sigmoid colon 7. to alleviate fears and reassure patient 8. (any 3 of the following) wash hands frequently, wear gloves if contact with blood or body fluids is likely, wear personal protective equipment (PPE) if splashing/spraying is likely, disinfect or sterilize any contaminated instruments or equipment CHAPTER 21:5 ASSISTING WITH MINOR SURGERY AND SUTURE REMOVAL 1. (any 3 of the following) removal of warts, cysts, tumors, growths, or foreign objects; performing biopsies of skin growths or tumors; suturing wounds; incision and drainage of body areas 2. removal of stitches 3. to prevent infection and maintain sterility 4. a. incise, or cut, skin and tissues b. cut tissues c. compress, or clamp, blood vessels to stop bleeding or grasp tissue © 2022 Cengage Learning, Inc. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

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d. grasp tissue e. hold or draw back the lips or sides of a wound or an incision f. hold or support the needle while sutures are inserted g. remove splinters and other foreign objects from the skin and/or tissues h. attach surgical drapes to each other or clamp onto tissue that has been dissected 5. cleansing the surgical site with an antiseptic soap and, at times, shaving excessive hair 6. suture scissors, thumb forceps 7. to insert under suture material so stitch can be cut and removed 8. to numb the surgical site and decrease pain 9. description of the procedure, alternative treatments, possible complications and/or risks of the surgery 10. refer questions to physician 11. place in special container immediately, label, send to laboratory 12. standard precautions CHAPTER 21:6 RECORDING AND MOUNTING AN ELECTROCARDIOGRAM 1. sinoatrial (SA) node, atria, atrioventricular (AV) node, bundle of His, right and left bundle branches, Purkinje fibers 2. a. P wave: impulse originates in SA node and travels through atria, atrial depolarization b. QRS wave: impulse moves through AV node, bundle of His, bundle branches, and Purkinje fibers, ventricular depolarization c. T wave: repolarization of the ventricles, period of recovery when ventricles relax 3. one 4. to determine which parts of the heart are diseased or malfunctioning 5. 12 6. RA: right arm; LL: left leg; RL: right leg; LA: left arm 7. a. 1 (I), 2 (II), 3 (III) b. aVR, aVL, aVF c. V1, V2, V3, V4, V5, V6 8. a. V6, b. V3, c. V1, d. V5, e. V2, f. V4 9. a single-channel ECG produces a narrow strip of paper showing one lead at a time; a multiple-channel ECG produces a full sheet of paper with all 12 leads 10. one millivolt electrical input should cause the standard to raise 10 millimeters 11. a. complexes large: set sensitivity at 1 2 b. standard 8 blocks high: adjust standard control c. complexes tiny: set sensitivity at 2 d. complexes fast and close together: use run 50 12. 10, 2 13. 1, 25 14. nervous tension can interfere with an accurate reading: (any 2 of the following) stress that test is not painful or uncomfortable, position patient comfortably, reassure patient CHAPTER 21:7 WORKING WITH MEDICATIONS 1. no, only legally authorized individuals may administer medications 2. (any 3 of the following) aqueous suspension, suspension, syrup, tincture 3. (any 3 of the following) capsule, pill, tablet, troche (or lozenge), enteric-coated 4. (any 3 of the following) ointments, pastes, creams, suppositories 5. a. oral: by mouth; b. rectal: into rectum; c. subcutaneous: injected into layer of tissue just under the skin; d. intramuscular: injected into a muscle; e. intravenous: injected into a vein; f. topical: applied directly to the top of the skin; g. sublingual: given under the tongue 6. (any 3 of the following) Physician’s Desk Reference (PDR), National Institutes of Health Medline Plus, FDA drug site at www.drugs.com/fda, medication packet inserts

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7. (any 6 of the following) action of drug, use of drug, availability or how supplied, dosage, administration methods and precautions, adverse effects, contraindications, cautions for use, interactions 8. right medication, right dose or amount, right patient, right time, right method of administration, right documentation 9. three; when taking bottle from shelf, while pouring, when replacing bottle 10. safe, cool, dry area; out of reach of children 11. never use it, throw it out 12. follow agency policy and federal and state laws; if the policies/laws call for destruction of the medications, discard in prescription drug drop boxes at specific pharmacies or law enforcement agencies so drugs can be destroyed following recommendations of the FDA and EPA; record all information according to agency policy 13. return to pharmacy as required by law, complete all required documentation 14. Emtet-500, Panmycin, Sumycin 15. a. (any 5 of the following) Antara , Fenoglide , Lipofen , Lofibra , TriCor , Triglide b. hypertriglyceridema c. high blood levels of triglycerides 16. a. fexofenadine hydrochloride b. non-sedating antihistamine c. 60 milligrams by mouth twice a day d. management of allergies including allergic rhinitis 17. a. Zocor b. 5 mg, 10 mg, 20 mg, 40 mg, 80 mg c. treatment of hypercholesterolemia, hyperlipidemia, hyperlipoproteinemia, and hypertriglyceridemia d. 10 to 20 mg by mouth once daily in the evening e. no, it is contraindicated 18. a. tetracycline class derived from oxytetracycline b. used to treat acne vulgaris, non-gonococcal urethritis and cervicitis, and exacerbations of bronchitis in patients with COPD c. 100 mg by mouth every 12 hours on day one and then 100 mg by mouth once daily d. (any 6 of the following) enterocolitis, odynophagia, pancreatitis, esophageal ulceration, hepatic failure, exanthematous pustulosis, hemolytic anemia, azotemia, papilledema, increased intracranial pressure

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CHAPTER 22 NURSE ASSISTANT SKILLS SUGGESTED ANSWERS TO THE END OF CHAPTER REVIEW QUESTIONS 1. (any 6 of the following) obtain orders from your immediate supervisor or check orders to obtain permission for the procedure; wash hands; assemble equipment and prepare the room for admission; greet and identify the patient; introduce yourself; ask the family or visitors to wait in the lobby while you complete the admission process; provide for privacy by closing the door and pulling the curtain; ask the patient to change into a gown or pajamas; position the patient comfortably in the bed or in a chair; complete the admission form; measure and record vital signs; weigh and measure the patient; complete a personal inventory list; complete a valuables list and secure valuables correctly; obtain a routine urine specimen if ordered; orient the patient to the facility by explaining how to use the call signal, mealtimes and menu selections, visiting hours, activities or services available, and so forth 2. closed bed: made following the discharge of a patient and after terminal cleaning of the unit; open bed: fanfolding the top sheets on a closed bed to “welcome” a new patient or for patients who are ambulatory or out of bed for short periods of time; occupied bed: made while the patient is in the bed 3. bathing, back care, perineal care, oral hygiene, hair care, nail care, shaving 4. a hollow tube, usually made of soft rubber or plastic, that is inserted into the bladder to drain the urine when a patient is unable to urinate 5. routine urine specimen: most common specimen, used for a variety of laboratory tests such as urinalysis; clean-catch (midstream) specimen: urine specimen that is free from contamination and collected in a sterile specimen container, first the genital area is cleansed thoroughly with a mild antiseptic solution, the patient then voids a few drops of urine into the bedpan or toilet bowl, a sterile container is used to catch the urine that follows, and the last few drops of urine are discarded so that only the middle, or midstream, urine is collected; sterile specimen: obtained via catheterization of the patient, using a sterile specimen container to collect urine © 2022 Cengage Learning, Inc. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

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directly from the sterile tube of the catheter so no external contamination is present; 24-hour urine specimen: requires that all urine produced by the patient during a 24-hour period be saved and is usually used to check kidney function and components such as protein, creatinine, urobilinogen, hormones, and calcium 6. to determine if blood is present in the stool 7. a. colostomy: an opening, called a stoma, is created in the abdominal wall to allow waste such as urine or stool to be expelled through the opening b. pressure ulcer: a bedsore or ulcer caused by prolonged pressure on an area of the body that interferes with circulation c. edema: swelling or excessive accumulation of fluid in the tissues d. nasogastic tube: a tube that is inserted through the nose, down the esophagus, and into the stomach e. dysphagia: difficult swallowing f. compression sleeves: hose connected to a pump that constantly inflates and deflates the hose to mimic the action of leg muscles on blood vessels 8. (any 4 of the following) all patient or resident behavior that may necessitate the use of restraints must be documented; alternatives must be tried and carefully documented; a physician must write an order for the restraint, and the order must state the type of restraint, the reason for its use, the length of time it can be used, and where or when it can be used; the least restrictive device must always be used first; restraints must be checked frequently after they are applied; if any signs of poor circulation are noted, the restraint must be removed immediately; all restraints must be removed every 2 hours for at least 10 minutes; skin care must be provided to the skin under the restraint 9. (any 5 of the following for preoperative care) operative permit must be signed by the patient or next of kin; laboratory tests such as blood tests, urine tests, chest or other radiographs, EEG, or special tests as ordered by the physician must be completed; enemas or vaginal irrigations as ordered by the physician must be administered; baths may be given to remove microorganisms; vital signs are taken and recorded; patient is NPO and allowed nothing by mouth for 8–12 hours before surgery; all of the patient’s valuables should be placed in a hospital safe or with security to prevent loss; artificial parts, including dentures, contact lenses or glasses, artificial arms or legs, and hearing aids, are removed; cosmetics, including nail polish, makeup, wigs, and hair pins, are removed; all clothing is removed and the patient is placed in a hospital gown; prior to surgery, the patient’s name band is checked for accuracy; patient should void immediately before being brought to the operating room (any 5 of the following for postoperative care) vital signs are taken and recorded; dressings must be checked frequently; IV flow rate and injection site must be checked by an authorized individual; patient’s level of pain must be assessed in order to determine the level and type of pain relief provided; observations related to restlessness, color and temperature of skin, nausea and/or vomiting, and so forth, should be noted and reported; patient’s position must be changed when possible; most patients need to be encouraged to cough and deep breathe; drainage tubes should be checked frequently to ensure they are functioning properly 10. mask: used most frequently by rescue personnel because it provides the highest concentration of oxygen cannula: consists of two small, curved, plastic tubes, which are placed one in each nostril; more comfortable and convenient method of administering oxygen tent: surrounds the patient with a high concentration of oxygen and is often used for small children or restless patients who are not able to cooperate well with other methods 11. (any 5 of the following) wash hands frequently; wear gloves any time there is a risk of contamination or exposure to blood, body fluids, secretions, or excretions; wear personal protective equipment (PPE), including a gown, a mask and protective eyewear, or a face shield, any time there is a risk of contamination or exposure to blood, body fluids, secretions, or excretions; any health care providers with cuts, sores, or dermatitis on their hands must wear gloves for all patient contact; dispose of all sharp objects, including razors and needles, in the appropriate sharps container; sterilize or discard equipment according to agency policy; wipe any areas contaminated with body fluids, blood, secretions, or excretions with a disinfectant; discard contaminated wastes in infectious waste containers; observe standard precautions while cleaning up spills of contaminated liquids; put contaminated linen in special infectious waste linen bags SUGGESTED ANSWERS TO THE WORKBOOK ASSIGNMENTS CHAPTER 22:1 ADMITTING, TRANSFERRING, AND DISCHARGING PATIENTS 1. anxiety, fear 2. (any 3 of the following) be courteous, supportive, and kind; provide clear instructions on how to operate equipment; explain the routine schedule; do not hurry or rush the patient; allow patient to ask questions and express concerns © 2022 Cengage Learning, Inc. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

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3. relative or person responsible for patient 4. (any 3 of the following) place in safe or with security, description of valuables put on valuable’s envelope, money left in wallet counted and recorded, both the health care provider and patient should check items and sign envelope, receipt for valuables given to patient 5. (any 6 of the following) operate call signal, operate bed controls, operate television, use telephone, visiting hours, location of lounges, smoking regulations, availability of services, times for meals, other rules or routines 6. change in patient’s condition, request made by patient 7. (any 2 of the following) clothing, personal items, equipment, medications 8. written physician’s order 9. report immediately to your supervisor 10. to ensure that all procedures are followed 11. answers will be individualized: check the admission form to ascertain that information is complete CHAPTER 22:2 POSITIONING, TURNING, MOVING, AND TRANSFERRING PATIENTS 1. positioning the patient in such a way that all body parts are in proper relation to each other to maintain correct body posture 2. (any 2 of the following) fatigue, pressure ulcers, contractures 3. two; (any 3 of the following) provides exercise for muscles, stimulates circulation, decreases pulmonary congestion, prevents pressure ulcers and contractures, provides comfort 4. tightening, or shortening, of the muscles usually caused by a lack of movement or usage of the muscle 5. bedsore, or pressure sore, caused by prolonged pressure on an area of the body that interferes with circulation 6. stage I: red or blue-gray discoloration on intact skin stage II: abrasions, bruises, and open sores develop stage III: deep open crater forms stage IV: damage extends into muscle, tendon, and bone tissue 7. (any 5 of the following) providing good skin care; using moisturizing lotions on dry skin; prompt cleaning of urine and feces from the skin; massaging in a circular motion around a reddened area; frequent turning; positioning to avoid pressure on irritated areas; keeping linen clean, dry, and free from wrinkles; applying protectors of sheepskin, lamb’s wool, or foam to bony prominences 8. applies negative pressure to draw wound edges together and remove exudate and infectious materials; also reduces edema and promotes perfusion by forcing the flow of fluid in the area 9. at start, after patient is in dangling position, at end 10. to determine how well patient tolerates procedure 11. (any 5 of the following) change in pulse rate, change in blood pressure, change in respirations, color, weakness, dizziness, increased perspiration, discomfort 12. approval, orders, immediate supervisor, Never CHAPTER 22:3 BEDMAKING 1. wrinkles cause discomfort and can lead to pressure ulcers 2. mitered corners hold linen firmly in place 3. to welcome patient, for ambulatory patient 4. occupied bed is made while patient is in bed; closed bed is made after patient is discharged 5. a bed cradle will prevent bed linen from touching parts of the body 6. (any 5 of the following) leg injury, blood clot, burns, skin ulcers, leg/foot surgery, circulatory disease, fractures 7. half sheets that extend from the patient’s shoulders to the knees; to protect the mattress 8. roll it while removing it from the bed; hold it away from your body and uniform; place it in a linen hamper, cart, or bag immediately 9. saves time and energy 10. open end is away from the door; looks neater, protects against germs that enter from the hall

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CHAPTER 22:4 ADMINISTERING PERSONAL HYGIENE 1. (any 6 of the following) bath, back care, perineal care, oral hygiene, hair care, nail care, shaving, shower, tub bath 2. patient is confined to bed and health care provider bathes all parts of the body 3. only the face, hands, arms, back, and perineal area are bathed; patient washes parts they are able to wash, and the health care provider washes rest of the body 4. (any 3 of the following) prevents disease, prevents caries, stimulates the appetite, provides comfort, prevents halitosis 5. unconscious or semiconscious patient 6. (any 3 of the following) stimulates circulation to scalp, helps remove tangles or knots, removes dirt and/or lint, helps keep the hair shiny and attractive 7. nails harbor dirt and can lead to infection, rough or sharp nails can cause injury 8. nail clippers, scissors, straight across, tips 9. injuries to the feet are prone to infection and slow to heal 10. safety razors or electric razors; patient’s personal preference 11. stimulates circulation, prevents pressure ulcers, leads to relaxation and comfort 12. remove sleeve from unaffected arm first, then from injured arm or arm with IV 13. (any 5 of the following) sores, cuts, injuries, rash, color, swelling (or edema), dyspnea, vertigo, unusual weakness, diaphoresis, extreme pallor, lethargy 14. a. erythema: redness, b. cyanosis: blue color, c. jaundice: yellow color, d. vertigo: dizziness, e. dyspnea: difficulty breathing, f. diaphoresis: excessive perspiration (or sweating), g. lethargy: excessive drowsiness or sluggishness 15. (any 3 of the following) wash hands frequently, wear gloves if contact with blood or body fluids is possible, wear gowns if contamination of uniform or clothing is likely, wear a mask or a face shield and protective eyewear if droplets of blood or body fluids are present 16. (any 3 of the following) knock on door and pause before entering, close door, pull the curtain, avoid exposing patient during procedure 17. answers will be individualized but should include: a. report rash immediately b. report to supervisor and obtain an order for shampooing c. explain reason for electric razor; if Mr. Mollica refuses shave, check with supervisor d. leave the gown in place and report this to the supervisor immediately e. turn him back over and call for your supervisor CHAPTER 22:5 MEASURING AND RECORDING INTAKE AND OUTPUT A. Measuring Instructor: Set up a station with measuring devices listed on the assignment sheet so students can practice measuring with metric units. Measurements will vary slightly, but answers should be close to those listed.

1. 5 mL 2. 4 oz 3. 12 or 14 oz 4. 8 oz 5. 11 oz or 12 oz 15 mL 120 mL 360 or 420 mL 240 mL 330 mL or 360 mL 6. 1 cup 7. 32 oz 8.

8 oz 4 cup 240 mL 2 pints 1 quart 1,000 mL

16 cups 9.

8 pints 4 quarts 128 oz 4,000 mL

2 cups 10. 450 gtts 1 pint 2 tbsp 16 oz 1 oz 500 mL 30 mL

B. Completion and Short Answer 1. a. natural balance in the body b. swelling due to excessive fluid retained by the body c. excessive fluid lost from the body

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2. nasogastric: nose through esophagus to stomach; orogastric: mouth to esophagus to stomach; gastrostomy: surgically implanted through abdominal skin into the stomach 3. (any 3 of the following) head elevated at a 30- to 45-degree angle during feeding and 30 to 60 minutes after the feeding; make sure there are no kinks or bends in the tubing; use extreme caution when turning or positioning the patient to avoid dislodging the tubing; provide frequent oral hygiene; notify the nurse if the alarm sounds, the solution is not flowing, or the solution container is low or empty 4. (any 3 of the following) liquid bowel movements, emesis, urine, drainage from tubings 5. on a flat solid surface and read at eye level 6. millimeters (mL) 7. females should be asked to use a bedpan or special urine collector on the toilet; males should be asked to used a urinal; both should be told not to discard toilet tissue in the specimen 8. (any 4 of the following) wear gloves; wash hands frequently; if splashing is possible, wear a gown, mask or face shield, and eye protection; measuring graduate should be used for only one specific patient; any contaminated areas should be wiped with a disinfectant

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CHAPTER 22:5 RECORDING INTAKE AND OUTPUT Assignment Sheet #1

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Assignment Sheet #2

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Assignment Sheet #5

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CHAPTER 22:6 FEEDING A PATIENT 1. offer bedpan or urinal, wash hands and face, position in sitting position, provide oral hygiene if desired, clear overbed table, remove unpleasant objects 2. explain this fact to the patient 3. check with immediate supervisor or dietitian 4. check with immediate supervisor or dietitian to see if a substitute can be provided 5. (any 3 of the following) name, room number, type of diet, food on the tray 6. compare plate of food to a clock and tell patient the location of each item, arrange utensils conveniently 7. place small amount on your wrist 8. (any 3 of the following) alternate liquids and solids; use straws for liquids; offer only small bites of food at a time; hold utensils at right angle to mouth; encourage patient to eat as much as possible; provide relaxed, unhurried atmosphere; give patient sufficient time to chew 9. keep a record of nutritional intake 10. (any 2 of the following) feed small quantities, allow patient time to chew and swallow, provide liquids to keep mouth moist CHAPTER 22:7 ASSISTING WITH A BEDPAN/URINAL 1. emptying of the bladder; discharge of waste through rectum 2. death would be the result 3. fracture or orthopedic, standard bedpan 4. (any 2 of the following) close door, close privacy curtain, close window curtain 5. (any 3 of the following) frequency, amount, appearance, abnormalities 6. intake and output, measured, recorded 7. report it immediately, save a specimen 8. sensitive, privacy, comfortable, immediately 9. (any 5 of the following) wash hands frequently, wear gloves, wear a mask or face shield and eye protection if splashing/spraying is possible, disinfect bedpan or urinal after use, use bedpan or urinal for one patient and sterilize before using for another patient, wipe contaminated areas with disinfectants, never place bedpan on overbed table or bedside stand, use a one-glove technique while carrying bedpan 10. protect environmental surfaces from contamination with substances on gloved hands CHAPTER 22:8 PROVIDING CATHETER AND URINARY-DRAINAGE UNIT CARE 1. catheters 2. balloon, sterile water, the catheter in place 3. (any 6 of the following) connection between catheter and unit is secure; tubing is free from kinks or bends; drainage bag is below level of bladder; urine is flowing freely; catheter is secured to leg; drainage unit is emptied frequently; drainage bag is attached to bed frame; no loops of drainage tube are below bag; drainage tube in bag is above level of urine; any patient complaints of burning, pain, irritation, or tenderness in the urethral area 4. backflow of urine into bladder, could cause infection 5. use special urine collection area on tubing if available or disconnect catheter from unit 6. to prevent infection 7. to keep urinary meatus clean and free of secretions to help prevent bladder and kidney infections 8. (any 3 of the following) amount, color, type, presence of other substances, abnormal observations 9. report immediately 10. to develop voluntary control of urination and prevent incontinence CHAPTER 22:9 PROVIDING OSTOMY CARE 1. surgical procedure in which an opening called a stoma is created in the abdominal wall 2. (any 4 of the following) tumors and/or cancer, birth defects, ulcerative colitis, bowel obstructions, injuries © 2022 Cengage Learning, Inc. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

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3. a. ureterostomy, b. colostomy, c. ileostomy 4. ascending colostomy: stool is more liquid; sigmoid colostomy: stool is similar to normal stool; water and other substances have been reabsorbed when stool reaches sigmoid colon 5. leakage, odor, irritation of the skin surrounding the stoma 6. prevent irritation from the removal of the pouch; (any 3 of the following) wafers, creams, lotions, powders, liquid films 7. allow patient to express feelings and verbalize fears, provide understanding and support 8. bright to dark red in color with wet appearance 9. a. low hemoglobin level b. dehydration c. interference with blood supply 10. amount, color, type of discharge CHAPTER 22:10 COLLECTING STOOL/URINE SPECIMENS 1. urine is more concentrated and may reveal more abnormalities, acid pH preserves any cells present 2. 120; send amount available 3. refrigerate specimen 4. to obtain specimen free from contamination 5. female: front-to-back motion, external lips, then internal lips, then center male: circular motion from meatus down 6. sterile container and lid 7. catheterize patient 8. it was produced before the start of the test 9. chemicals, cold storage 10. to keep at body temperature; most accurate if it is examined within 30 minutes 11. blood from areas of the intestinal tract is present in the stool 12. to avoid contamination from spills CHAPTER 22:11 APPLYING RESTRAINTS 1. protective devices that limit a patient’s movements 2. behavior must be documented; alternatives must be tried; physician must write order; least restrictive device must be used first 3. (any 3 of the following) type of restraint, reason for its use, length of time it can be used, where or when it can be used 4. (any 4 of the following) severe behavioral or cognitive issues, irrational or confused, danger to self, skin conditions, paralysis or limited muscular coordination 5. (any 4 of the following) straps or belts: hold patient in stretcher or wheelchair limb: limit movement of arms or legs hand mitts: applied to hands to prevent patient from scratching or injuring skin or pulling out tubes and lines jacket: prevent patient from sitting up, rolling, or getting out of bed or wheelchair geriatric chair: prevent patient from falling out of chair or getting up unassisted 6. slip two to three fingers between the restraint and the skin 7. (any 5 of the following) paleness, cyanosis, cold skin, edema, weak or absent pulse, poor return of pink color after nail beds are blanched, complaints of pain/numbness/tingling 8. two, ten, repositioned, range-of-motion, skin 9. physical and mental frustration; impaired circulation; pressure ulcers; loss of muscle tone, joint stiffness, and discomfort from immobility; respiratory, or breathing, problems 10. whether the risk of potential injury to the patient or others is greater than the risk of complications from the use of restraints © 2022 Cengage Learning, Inc. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

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CHAPTER 22:12 ADMINISTERING PREOPERATIVE AND POSTOPERATIVE CARE 1. preoperative, operative (peri-op), postoperative 2. (any 10 of the following) operative permit signed, laboratory tests, enemas, vaginal irrigations, baths, skin preparation, vital signs, NPO, valuables secured, prosthetics removed, cosmetics removed, clothing removed, check name band, voiding, surgical checklist 3. remove as many microorganisms as possible to prevent infection 4. tape or tie to the finger 5. it is a cleanser that removes bacteria from the skin to prevent infection in and around the surgical site 6. a. general: given by mask or IV, patient unconscious b. local: injected into area around op site, stops sensation c. spinal: injected into spinal column, loss of sensation in all areas below injection 7. nausea and/or vomiting 8. vital signs equipment, IV stand, emesis basin, tissues, special equipment 9. (any 6 of the following) check vital signs; check dressings; check IV; assess level of pain; observe restlessness, color of skin, nausea and/or vomiting, temperature of skin; change position; cough and breathe deeply; check drainage tubes 10. analgesic or pain medication injection into an intravenous line by an analgesic pump; patient can push button when feeling pain to obtain immediate relief 11. (any 3 of the following) tubes not draining, tubes clamped, drainage solution changes or seems unusual, tube not connected to a drainage source, unusual observations 12. (any 4 of the following) provide support and relief from pain, hold dressings in place, provide support for engorged breasts, limit motion, apply pressure to specific body parts 13. support veins of legs and increase circulation 14. special adhesive strips that are applied when dressings must be changed frequently; to prevent the need to remove and reapply adhesive tape during each dressing change 15. negative pressure wound therapy; used on open incisions and wounds to drain exudate and promote healing CHAPTER 22:13 ADMINISTERING OXYGEN 1. some states prohibit administration of oxygen by a health care assistant 2. deficiency of oxygen 3. (any 3 of the following) cyanosis, rapid and shallow respirations, rapid pulse, restlessness, anxiety 4. mask: 6–10 liters per minute; cannula: 2–6 liters per minute; tent: 10–12 liters per minute 5. a device that removes impurities and other gases from room air to concentrate oxygen in the unit; provides low liter flows of oxygen 6. oxygen is drying and can damage or irritate mucous membranes 7. (any 4 of the following) avoid smoking, avoid open flames, place warning labels on door or tanks, avoid electrically operated equipment, do not use flammable liquids, use cotton blankets, inspect area frequently 8. level of oxygen in arterial blood 9. (any 3 of the following) quality of respirations, mouth and nose care, rate of flow, water in humidifier, check safety precautions 10. respiratory therapy department CHAPTER 22:14 GIVING POSTMORTEM CARE 1. care given to the body immediately after death 2. grief, loss, crying, embarrassed, emotions, support 3. (any 4 of the following) position naturally with limbs straight, raise head of bed 30 degrees, return dentures to mouth, keep bed linen neat and clean, remove extra equipment from unit, provide privacy 4. rights, dignity, respect, Privacy 5. (any 6 of the following) shroud or body bag, gown, chin strap, pads, gauze squares, ties, two or three tags, safety pins

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6. remove from body, list on valuable’s list, place in safe or with security, tape wedding ring and note on chart 7. tape in place and note on chart 8. nurse or other authorized person

CHAPTER 23 PHYSICAL THERAPY SKILLS SUGGESTED ANSWERS TO THE END OF CHAPTER REVIEW QUESTIONS 1. active ROM exercises: performed by patients who are able to move each joint without assistance active assistive ROM exercises: the patient actively moves the joints but receives assistance to complete the entire ROM passive ROM exercises: another person moves each joint for a patient who is not able to exercise

resistive ROM exercises: joint movements are performed against resistance provided by the therapist 2. (any 8 of the following) abduction: moving a part away from the midline of the body adduction: moving a part toward the midline of the body flexion: bending a body part extension: straightening a body part hyperextension: excessive straightening of a body part rotation: moving a body part around its own axis circumduction: moving in a circle at a joint, or moving one end of a body part in a circle while the other end remains stationary pronation: turning a body part downward supination: turning a body part upward opposition: touching each of the fingers with the tip of the thumb

inversion: turning a body part inward eversion: turning a body part outward dorsiflexion: bending backward plantar flexion: bending forward radial deviation: moving toward the thumb side of the hand ulnar deviation: moving toward the little finger side of the hand 3. patient should wear walking shoes that fit well and provide good support; shoes should have low, broad heels and nonskid soles; crutches should be positioned 4–6 inches in front of and 2–4 inches to the side of the patient’s foot; the length of axillary crutches should be adjusted so that there are 11 2 to 2 inches or two or three fingers’ width between the armpit and axillary bar of the crutch; the handpieces of axillary or forearm crutches should be adjusted so that each elbow is flexed at a 25- to 30-degree angle 4. do not try to hold the patient in an upright position; use your body to brace the patient; keep your back straight, bend from the hips and knees, and maintain a broad base of support; keep a firm hold on the transfer belt; ease the patient to the floor as slowly as possible; protect the patient’s head and neck, and prevent the head from striking the floor; stay with the patient and call for help 5. two-point gait: the patient is taught to move the cane and affected leg together, and then move the unaffected leg three-point gait: the patient is taught to move the cane, then the affected or involved leg, and finally the unaffected leg 6. moist heat applications: warm and wet against the skin, are more penetrating, and are more effective in relieving pain in deeper tissues than are dry heat applications; (any 2 of the following) Sitz bath, hot soaks, compresses, hydrocollator packs, paraffin wax treatments dry heat applications: warm and dry against the skin; (any 2 of the following) warm-water bags, heating pads, thermal blankets, gel packs, aquamatic pads or aquathermia pads, heat lamps 7. a. vasodilation: the blood vessels in the area become larger (dilated); more blood comes to the area to stimulate healing b. vasoconstriction: the blood vessels become smaller (constricted); less blood comes to the area, which helps to decrease swelling; also has a numbing effect, which decreases local pain © 2022 Cengage Learning, Inc. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

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8. (any 5 of the following) check the physician’s order to confirm the type of application, duration of treatment, temperature, and area of application; patient should be asked to remove all metal objects in the treated area before a heat or cold application is administered; patient must be checked frequently; note the color and temperature of the skin, amount of pain and bleeding, effect on circulation, and other signs and symptoms; the rubber or plastic should never come in contact with the skin; cover all rubber or plastic applications with a towel or special cloth; pay special attention to infants, young children, and elderly patients because their skin is less resistant and burns or injuries can occur rapidly; observe standard precautions if any contact with blood, body fluids, secretions, or excretions is possible; if abnormal symptoms are noted, discontinue the application and notify the immediate supervisor SUGGESTED ANSWERS TO THE WORKBOOK ASSIGNMENTS CHAPTER 23:1 PERFORMING RANGE-OF-MOTION (ROM) EXERCISES A. Completion and Short Answer 1. activities of daily living; (any 3 of the following) cooking, cleaning, dressing, shaving, brushing hair 2. to maintain health of musculoskeletal system 3. physical therapist, nurse, health care assistant, other authorized person 4. (any 6 of the following) contractures, atrophy of muscles, poor circulation, pressure ulcers, mineral loss, brittle bones that fracture easily, renal calculi, poor appetite, constipation, urinary infections, respiratory problems, hypostatic pneumonia 5. a. active: patient moves each joint without assistance b. active assistive: patient moves each joint but receives assistance to complete the ROM c. passive: another person moves each joint for a patient who is not able to exercise d. resistive: exercises performed against resistance provided by a therapist 6. physical therapists, registered nurses, head, neck, hip, knee 7. part above and below joint being exercised 8. three to five times or as ordered 9. stop the exercise and report to immediate supervisor 10. expose only area being exercised, close door and/or pull the curtain B. Matching 1. G 2. L 3. M 4. E 5. B

6. C 7. H 8. F 9. P 10. O

11. I 12. K 13. A 14. N 15. A

16. G 17. F 18. H 19. D 20. J

CHAPTER 23:2 AMBULATING PATIENTS WHO USE TRANSFER (GAIT) BELTS, CRUTCHES, CANES, OR WALKERS 1. (any 5 of the following) specific nature and location of patient’s complaint; how they were injured; the severity of pain; if they can bear weight or move the injured part; notice any instability, problems with joint motion, numbness, and/or weakness; any history of previous injuries 2. (any 4 of the following) rest, cold application, supportive bandage, referral for X-ray imaging, medical care, assistive devices 3. underhand grasp; more secure, and hands are less likely to slip off the belt 4. a. axillary crutches; b. platform crutches; c. forearm or Lofstrand crutches 5. 1–1½ inches; 4–6 inches; 2–4 inches; 11 2 to 2 inches or two to three fingers’ width; 25–30 degrees 6. four-point, two-point, swing-to, swing-through 7. three-point, swing-to, swing-through 8. can injure axillary blood vessels and nerves 9. unaffected (good) side 10. 6, 8, top of femur at the hip joint, 25- to 3011. the walker may move away from the patient causing the patient to fall

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12. patient must be strong enough to hold themselves upright while leaning on a walker 13. top of femur at the hip joint, 25- to 3014. to prevent slipping 15. dangerous and easy to upset the walker while using a sliding technique 16. keep a firm hold on the transfer belt, use your body to brace the patient, ease the patient to the floor as slowly as possible while protecting the patient’s head and neck, stay with the patient and call for help CHAPTER 23:3 ADMINISTERING HEAT/COLD APPLICATIONS 1. use of cold for treatment 2. use of heat for treatment 3. vasodilation; blood vessels become larger, and more blood comes to area 4. vasoconstriction; blood vessels become smaller, and less blood comes to area 5. (any 3 of the following) relieve pain, reduce swelling, reduce inflammation, reduce body temperature, control bleeding 6. (any 3 of the following) relieve pain, increase drainage from an infected area, stimulate healing, increase circulation, combat infection, relieve muscle spasms, increase muscle mobility before exercise 7. a. moist cold: applications wet and cold against skin; (any 2 of the following) cold compresses, packs, soaks b. dry cold: applications dry but cold against skin; (any 2 of the following) ice bags, ice collars, hypothermia blankets, gel packs c. moist heat: applications wet and warm against skin; (any 2 of the following) Sitz baths, hot soaks, compresses, hydrocollator packs, paraffin wax treatment d. dry heat: applications dry and warm against skin; (any 2 of the following) warm-water bags, heating pads, thermal blankets, gel packs, aquamatic pads or aquathermia pads, heat lamps 8. to provide warm, moist heat to perineal and rectal areas 9. gel-filled packs warmed in a water bath 10. chronic joint disease (arthritis), ROM exercises 11. to prevent the spread of infection 12. a control unit on the aquathermia pad maintains a constant preset temperature of the water 13. physician’s 14. health care assistants are not allowed to administer heat or cold applications in some states and agencies 15. (any 3 of the following) color and temperature of skin, pain, bleeding, circulation 16. metal readily conducts heat or cold and can cause injury to the skin

CHAPTER 24 BUSINESS AND ACCOUNTING SKILLS SUGGESTED ANSWERS TO THE END OF CHAPTER REVIEW QUESTIONS 1. answers will be individualized, but student must list 5 rules for filing records alphabetically and create 1 example for each rule; (any 5 of the following) divide names into units and index the units in the correct order for filing: Edward H. Franklin would be indexed and filed as Franklin, Edward H. names of organizations and businesses are usually filed in the same order as they are written: American ­Medical Association would be filed with American as the first indexing unit, Medical as the second indexing unit, and so on words such as of, and, at, the, on a, and an are not counted as indexing units, but the word is placed next to the word to which it belongs, and in parentheses: A Medical Supply Business of Oklahoma would be indexed as Medical [A], Supply, Business [of ], Oklahoma strict alphabetical order is followed after a name or company is indexed: Steinhaus comes before Steinhouse; Riley appears before Smith because R comes before S nothing comes before something: Rumsen, F. comes before Rumsen, Francis prefixes are treated as parts of names: MacDonald is filed before Macintyre hyphenated names are each considered one unit: Billings-Jones would be filed before Billingsworth

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titles or degrees are usually used as the last indexing unit if names are identical: James Robert Jones, DDS would be indexed as Jones, James, Robert, DDS and would be filed before Jones, James, Robert, MD terms of seniority such as Jr or II are used as the last indexing unit: Michael R. Smith, II is indexed as Smith, Michael R., II numerical seniority terms are filed before alphabetical terms if names are identical: Polinski, John, II would be filed before Polinski, John, Jr if names begin with numbers, the number becomes the first indexing unit and is filed in numeric order before any letters: 3rd Street Clinic is indexed as 3rd, Street, Clinic and filed before Second, Avenue, Pharmacy 2. 00038, 0325, 0566, 03251, 08532, 008553, 0008564, 081000 3. electronic mail: use a secured Internet connection that includes a strong encryption program, a firewall, and/ or password protection; require patients to sign an authorization form before any information can be sent cellular phones: never discuss confidential patient information because other people can hear the cellular signal by using scanners fax machines: use password protection or an encryption code if possible, have written authorization from the patient before records are faxed, never fax financial information, fax only to machines located in secure locations, use a cover sheet that contains a confidentiality statement, use a patient reference number instead of the patient’s name, contact the receiver before sending the material so they will be ready to receive it, confirm with the receiver that the material was transmitted correctly, mail the records or send them by messenger if in doubt 4. answers will be individualized, but student must list 5 sections on a medical history form and briefly describe the type of information in each section; (any 5 of the following) general statistical data: patient name, address, birth date, e-mail address, phone number family history: information on the patient’s immediate family members (blood relatives) related to cancer, heart disease, allergies, and other genetic diseases; causes of death for deceased family members patient’s medical history: past illnesses, treatments, operations, accidents, physical defects, allergies, childhood diseases, and so forth

personal/social history: information about the patient’s diet, sleep, exercise routines, and personal habits such as smoking and alcohol use present illness or ailment: exact description of the signs and symptoms the patient is currently experiencing physical examination or Review of Systems (ROS): physician performs an examination of all body systems and records both positive and negative findings diagnosis, prognosis, treatment: information on name of current condition, expected outcome, and any treatment provided 5. block style: all parts of the letter are aligned starting at the left margin of the paper modified-block style: certain parts of the letter (date, complimentary closing, signature, and keyed signature) are aligned at the center line of the paper, and the remaining parts are aligned at the left margin of the paper 6. ICD code: numerical and alpha coding system for diagnoses CPT code: numerical codes used for procedures and services NPI number: a 10-digit number used to identify physicians and required by Medicare 7. $417.05 SUGGESTED ANSWERS TO THE WORKBOOK ASSIGNMENTS CHAPTER 24:1 FILING RECORDS Assignment Sheet #1 1. systematic or orderly arrangement of papers, cards, or other materials so they are readily available for future reference 2. locate material quickly, store safely and protect as legal records 3. a. in alphabetical order following same rules used in telephone book b. in numerical order after assigning each record a number c. according to location, either cities, states, or countries d. by subject or topic that the record pertains to

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4. the Health Insurance Portability and Accountability Act (HIPAA) prohibits placing identifiable information such as Social Security numbers on the outside of a patient’s chart; helps prevent identify theft if an unauthorized person should happen to see the chart 5. to avoid misplaced or lost records 6. on index cards in a separate file, on colored paper placed in a file folder 7. folders are marked with series of colors in addition to name to provide a second means of verifying placement 8. different color chart stands out immediately 9. durable, quality, conveniently, fireproof, locks, packed tightly in drawers or shelves 10. active: currently being used; inactive: patient has not been seen for a number of years; closed: patient has died, transferred to another physician or facility, or a file that is no longer required 11. shredded or burned 12. in an external hard drive, secure cloud, or off-site server

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Assignment Sheet #2 1. Group 1: Indexing Order Brown, Mary K. Smith, June J. Stanton, Betty M. Thomas, Jesse Tom Bell, Arlet Ann James, C. M. Jones, Mary S.

Filing Order Bell, Arlet Ann Brown, Mary K. James, C.M. Jones, Mary S. Smith, June J. Stanton, Betty M. Thomas, Jesse Tom

Group 2: Indexing Order Barr, A. Barr, David B., Jr. Barr, Bruce Arnold Barr, B.D. Barr, Bruce A. Barr, Arnold Barr, David B., Sr. Barr, Bruce

Filing Order Barr, A. Barr, Arnold Barr, B.D. Barr, Bruce Barr, Bruce A. Barr, Bruce Arnold Barr, David B., Jr. Barr, David B., Sr.

Group 3: Indexing Order Macerow, Cynthia O’Rouge, Michael M. MacDanner, Camelia McDavis, Carol O’Brian, Carl M. DuBarry, Mary Macer, Charles M. McDowell, Clair C. Mack, Christopher C. Ducan, Mary D. Mt. John, Mack M. Mount-Smith, Jean

Filing Order DuBarry, Mary Ducan, Mary D. MacDanner, Camelia Macer, Charles M. Macerow, Cynthia Mack, Christopher C. McDavis, Carol McDowell, Clair C. Mount-Smith, Jean Mt. John, Mack M. O’Brian, Carl M. O’Rouge, Michael M.

Group 4: Indexing Order Kirk, Carl, Sr. Kirk, Carol Kirk, Carl, Jr. Kirk, C. Kirk, Harry, RN Krirk, Genevieve Krickey, Roger Mounts, Michael McKirk, Lanna Mt. Kirk, Mike Kirk, Harry, MD Kirk, Harry, DDS

Filing Order Kirk, C. Kirk, Carl, Jr. Kirk, Carl, Sr. Kirk, Carol Kirk, Harry, DDS Kirk, Harry, MD Kirk, Harry, RN Krickey, Roger Krirk, Genevieve McKirk, Lanna Mounts, Michael Mt. Kirk, Mike

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2. 00034 3.

0039 0086 249 00250 288 00289 456 588 0987 5678 9870

System 1 02-34-88 04-66-88 06-76-88 22-43-88 24-32-88 45-34-88 52-45-88 55-34-88 62-62-88 62-66-88

System 2 00-94-90 03-94-90 05-65-90 06-82-90 07-77-90 08-99-90 34-33-90 43-42-90 45-33-90 70-67-90

Assignment Sheet #3 1. Group 1: Indexing Order

Sainer, Judy St. John, Stacy Stacy, John S. Stadler, Jill St. Clair, Joseph Scott, Michael Scanlon, Lois Scodova, Bob Set, Frederick C. Sanborn, Mike M. Stanton, John Sanborn, Mike

Filing Order Sainer, Judy Sanborn, Mike Sanborn, Mike M. Scanlon, Lois Scodova, Bob Scott, Michael Set, Frederick C. Stacy, John S. Stadler, Jill Stanton, John St. Clair, Joseph St. John, Stacy

Group 2: Indexing Order Russ, Henry Rush, Tom E., Jr. Rush, Rupert C. Rusk, Herbert Russ, Henry C. Rush, Orville D. Rush, Tom D., Sr. Rusell, Robert A. Russell, Barbara D. Rush, Tom Dean, Jr. Rurals, Michael Rusiska, Brent T. Russell, Bonnie F. Russel, Kenneth K. Ruster, Lennie L. Rustert, Mabel M. Rusher, Florence C. O’Rush, Connie S. Russell-Brown, Mary

Filing Order O’Rush, Connie S. Rurals, Michael Rusell, Robert A. Rush, Orville D. Rush, Rupert C. Rush, Tom D., Sr. Rush, Tom E., Jr. Rush, Tom Dean, Jr. Rusher, Florence C. Rusiska, Brent T. Rusk, Herbert Russ, Henry Russ, Henry C. Russel, Kenneth K. Russell, Barbara D. Russell, Bonnie F. Russell-Brown, Mary Ruster, Lennie L. Rustert, Mabel M.

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Group 3: Indexing Order Third, Street, Ambulance, Supplies EMS, Supply, Corporation 4th, Street, Medical, Supplies Smith, Mike, DDS American, Medical, Association American, Nurses, Association A., M., Albian, Company Dr., John’s, Foot, Pads Smith, Mike, MD Smith, Mike, A., ATR Company (The), Medical (For), Supplies M., A., Smith, Pharmacy Smith, Medical, Equipment, Miami (of ), Florida 2nd, Avenue, Pharmacy

Filing Order 2nd, Avenue, Pharmacy 4th, Street, Medical, Supplies A., M., Albian, Company American, Medical, Association American, Nurses, Association Company (The), Medical (for), Supplies Dr., John’s, Foot, Pads EMS, Supply, Corporation M., A., Smith, Pharmacy Smith, Medical, Equipment, Miami (of ), Florida Smith, Mike, DDS Smith, Mike, MD Smith, Mike, A., ATR Third, Street, Ambulance, Supplies

2. 0005 3. System 1 008 0002-65 50 0020-65 0058 0033-65 0062 0324-65 080 0333-65 082 2435-65 0085 3245-65 00088 3333-65 555 3425-65 00555 4328-65 0567 0582 0850 05820 005821 5822 85200

System 2 0002-77 0020-77 0200-77 3891-77 4004-77 4328-77 4657-77 5682-77 5862-77 5865-77

CHAPTER 24:2 USING THE TELEPHONE 1. (any 4 of the following) pleasant, low-pitched, clear, distinct, no monotone or indifferent tone 2. promptly, smile 3. (any 5 of the following) name of caller, telephone number, message, date, time of call, action taken, initials 4. answers will be individualized but should be similar to the following: a. Hello, Dr.___’s office, Ms. ___speaking b. May I have your name please? c. May I tell Dr.___why you are calling?

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d. Would you please repeat your name? e. The doctor is not available at present. f. Would you please repeat that? g. The doctor will not take calls unless I tell him/her who is calling. h. If you will leave your name and telephone number, I will give the doctor the message. i. Thank you for calling. Good-bye. j. The doctor is busy at present. May I have your telephone number so he/she can call you back?

5. avoid disturbing the doctor for calls that can be handled by another team member in the office 6. name of caller, purpose of call 7. process of evaluating the situation and prioritizing treatment 8. if you hang up first, you might miss something the caller wanted to say 9. secure online website established by a physician, health care facility, or other health provider; (any 4 of the following) access electronic health record, request prescriptions, request or verify an appointment, view laboratory reports, ask a question 10. to allow a large number of telephone calls to be answered at the same time 11. allows the caller to talk to an operator who can transfer the call to the appropriate person, contact the individual and ask them to call the patient, or record a message 12. allow two-way communication in almost any location, individual does not have to use another telephone to respond 13. other people can hear the cellular signal by using a scanner 14. yes; if sent on a secure Internet network; no, if sent on an insecure Internet network because it can be intercepted and read by others 15. (any 4 of the following) have patient’s written authorization, fax only to machines in secure locations, use a cover sheet that contains a confidentiality statement, use a patient reference number instead of the patient’s name, mail records or send with messenger if in doubt 16. answers will be individualized, but examples of messages follow: a. Dr. Jones Mrs. Smith 522-5409 Daughter Melinda has fever of 102°. No other symptoms.

Can bring in until 4 pm or call in prescription b. Dr. Jones Dr. Peterson See below Has findings on Mrs. Complaint 1–4 pm at office 528-0991 4–6 pm at hospital 524-2118 ext. 34 after 7 pm at home 756-6677 c. Dr. Jones John Cauffwell, Ace Medical (442) 560-4560 ext. 110 ECG paper 524 no longer available. New substitute 529 more expensive. Both equal quality. Can locate old stock or send new paper d. Dr. Jones Hospital—Mrs. Efficient—Ward 5B 524-2118, ext. 5566 Johnny Pothman vomited bright red blood at 9:40 AM CALL STAT e. review messages to be sure information is concise, words are spelled correctly, and information is printed clearly f. #1 would be d; #2, a; #3, b; #4, c

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CHAPTER 24:3 SCHEDULING APPOINTMENTS Assignment Sheet #1

MONDAY 8:00 8:15 8:30 8:45 9:00 9:15 9:30 9:45 10:00 10:15 10:30 10:45 11:00 11:15 11:30 11:45 12:00 12:15 12:30 12:45 1:00 1:15 1:30 1:45 2:00 2:15 2:30 2:45 3:00 3:15 3:30 3:45 4:00 4:15 4:30

East, Maddie—shot—756-1824

Bjore, Carol—589-2897 wart removal foot Wang, Sue Lee—laryngitis—524-9293 Conery, Tami—797-6116 ingrown toenail Haumesser, Lisa—ear inf.—522-7723 Frey, Chris—524-8713 growth—rt. arm

(lunch) Shade, Frieda—522-8680 Ron, Bob, Juan—immun.

Sanchez, Jose—X-ray arm—589-3156 Hephner, Robert—Allergy sh.—589-8152 Hillborn, Debbie—589-0302 children—colds Gathee, Amondi—797-5433 physical Koppert, Debbie—522-5564 stomach

TUESDAY 8:00 8:15 8:30 8:45 9:00 9:15 9:30 9:45 10:00 10:15 10:30 10:45 11:00 11:15 11:30 11:45 12:00 12:15 12:30 12:45 1:00 1:15 1:30 1:45 2:00 2:15 2:30 2:45 3:00 3:15 3:30 3:45 4:00 4:15 4:30

Wilfong, Beth—Pap—522-0689 Hockensmith, Sue—524-9964 allergy tests Staup, Kim cold—522-2321 Figerino, Sophia—physical—756-1184

Diaz, Jayden—797-2418 physical

(lunch)

Medical Board Meeting

Gonzales, Maria—589-2008 physical Yoder, Fabian—589-0020 X-ray chest

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Assignment Sheet #2 WEDNESDAY 8:00 8:15 8:30 8:45 9:00 9:15 9:30 9:45 10:00 10:15 10:30 10:45 11:00 11:15 11:30 11:45 12:00 12:15 12:30 12:45 1:00 1:15 1:30 1:45 2:00 2:15 2:30 2:45 3:00 3:15 3:30 3:45 4:00 4:15 4:30

Maldanado, Sienna—589-7191

wart removal

Hernandez, Liliana—burn arm—522-1948 Gross, Cindy —525-1149 physical Rodriguez, Tina—knee—886-7022 (lunch) Dental Appointment

Goldsmith, Lisa—inf. diarh.—524-8750 Albanese, Jody—laryn.—589-6151 Secrist, Bonnie—589-4265 nose surgery Martinez, Isabel—Pap—522-5048 Wadley, Mary—pain elbow—756-6346 Paradiso, Chloe—stomach—756-6632

THURSDAY 8:00 8:15 8:30 8:45 9:00 9:15 9:30 9:45 10:00 10:15 10:30 10:45 11:00 11:15 11:30 11:45 12:00 12:15 12:30 12:45 1:00 1:15 1:30 1:45 2:00 2:15 2:30 2:45 3:00 3:15 3:30 3:45 4:00 4:15 4:30

Neptune, Rose—tetanus—526-3678 Stimson, Tara—Pap—524-3107 Nelson, Belinda—Bl. test—756-8032 McKevitt, Erin—VDRL—589-3626 Crupper, Cheryl—524-6505 physical Hagedorn, Cindy—756-7487 physical Ortiz, Jessica—589-4746 triplets—checkup (lunch) Chang, Brandon—522-1190 physical Cantrell, Kim—all. shot—886-2108 Pifer, Janet —529-5209 physical Troupe, Polly—BP—gastr.—886-4885 Taylor, Cindy—OR—toenail—747-7501 Yoder, Levi—headaches—747-4858 Kihara, Tyronne—BP—524-1652 Kelser, Brenda—BP—589-5289

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CHAPTER 24:4 COMPLETING MEDICAL RECORDS AND FORMS 1. statistical data sheets, medical history records 2. (any 5 of the following) patient’s name, address, telephone, cell phone number, e-mail address, marital status, gender, birthdate, place of employment, person responsible for account, insurance company, person referring 3. confidential, written consent, stored in a secure locked area 4. a. general statistical data: name, address, age b. family history: diseases and conditions of patient’s blood relatives; if family member dies, record cause of death and age at time of death c. past history: illnesses and treatments patient has had d. personal history: patient’s marital status and personal habits e. present illness or ailment: exact description of signs and symptoms patient is currently experiencing 5. a. S: single; b. M: married; c. W: widowed; d. D: divorced; e. O: negative or none; f. l&w: living and well; g. NA: not applicable; h. d: died 6. review the completed statistical data sheet and medical history form to ascertain that student has completed all sections correctly CHAPTER 24:5 COMPOSING BUSINESS LETTERS 1. a. collection: encourages patient to pay an account that is due b. appointment: informs patient of scheduled appointment c. recall: reminds patient to return for periodic examination d. consultation: requests another doctor to examine patient e. inquiry: seeks information 2. a. heading or letterhead, b. inside address, c. salutation, d. complimentary close, e. body, f. reference initials 3. a. paragraph 1: state why letter is being written b. paragraph 2: list main facts c. paragraph 3: sign off or give final reminder 4. block style: all parts of letter are aligned at left margin modified-block style: heading, complimentary close, and printed names begin at center with remainder of letter at left margin 5. date line, heading or computerized template if letterhead is not available, complimentary close, keyed signature 6. a. Rose Toussaint, DDS; b. Dr. Toussaint 7. person dictating and person preparing the letter 8. a. OH, b. UT, c. AK, d. ID, e. WA, f. KY, g. MO, h. VA CHAPTER 24:6 COMPLETING INSURANCE FORMS 1. statistical data sheet or in a computer database 2. the coverage may have changed 3. (any 2 of the following) correct type of form, patient has completed any required parts, patient has signed forms in correct area, insured has signed forms if patient is a dependent 4. written release signed by patient and insured to provide information to insurance company; used when insurance forms are completed on computer and claims are filed electronically 5. insured 6. a universal form required for any government-sponsored health care claims and accepted by all major insurance companies 7. International Classification of Diseases Clinical Modifications (ICD-CM) 8. identification of the disease or condition 9. in the order of importance 10. 3 to 7 digits; to code a diagnosis to the highest level of specificity 11. bronchus

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12. Current Procedural Terminology (CPT) 13. five 14. to further explain or change the meaning of a code 15. by a dash 16. a. diagnostic x-rays, b. medical care, c. diagnostic laboratory, d. surgery 17. letter, letters, all, abbreviations 18. Physician’s National Provider Identifier number,10 digit number inserted in box 33 of CMS-1500 form 19. “Signature on file,” authorization to release information and assignment of benefits form must be completed 20. a. inpatient hospital, b. home, c. nursing home, d. outpatient hospital CHAPTER 24:7 MAINTAINING A BOOKKEEPING SYSTEM Assignment Sheet #1 1. a. day sheet or daily journal: daily record of all patients seen, charges incurred, and payments received b. statement-receipt record: record of past balances, charges, payment received, current balance, and sometimes appointment date c. charge slip: charges for services rendered d. ledger card: total financial record 2. one copy can be mailed in place of or attached to an insurance form and thus eliminates the need for a separate insurance form 3. copies can be made and mailed to the patient 4. previous balance, charges, payment 5. a series of records are being recorded with one writing 6. line out neatly or void entire statement 7. received on account 8. amount charged by health care provider, negotiated or allowed amount according to the contract, amount the insurance company pays, amount of money the patient owes 9. a. an adjustment of $140 will be credited to the patient’s account b. $48 10. (any 4 of the following) name of patient, address, person responsible for account, family members in account, insurance information 11. to preserve information in case of computer failure 12. $45 Assignment Sheet #2

5/1/— Joan Exam-PRO 5/1/— Mike ENDO 5/1/— Mary AM 5/1/— Jane AR 5/1/— Joe EXT 5/1/— John DENTURE 5/1/— John ROA

Chg. 149.00 365.00 165.00 145.00 325.00 590.00 ___

Pay 50.00 90.00 ___ 95.00 100.00 150.00 540.00

CurB 99.00 275.00 264.00 325.00 489.00 929.00 389.00

PrevB 00.00 00.00 99.00 275.00 264.00 489.00 929.00

John Smith Mike Mendez John Smith Mike Mendez John Smith John Smith John Smith

Total Deposit: $150.00 cash, $875.00 checks, $1,025.00 total

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Assignment Sheet #3

5/2/— Jane Exam-PRO 5/2/— Mike AM 5/2/— Nellie AR 5/2/— Joe DENTURE 5/2/— Mary ENDO 5/2/— Brad Exam 5/2/— Joe ROA 5/2/— Mike ROA

Chg. 172.00 213.00 148.00 1,825.00 297.00 169.00 ___ ___

Pay ___ 85.00 210.00 850.00 125.00 68.00 1,556.38 529.00

CurB 497.00 625.00 563.00 1,364.00 1,536.00 1,637.00 80.62 34.00

PrevB 325.00 497.00 625.00 389.00 1,364.00 1,536.00 1,637.00 563.00

Mike Mendez Mike Mendez Mike Mendez John Smith John Smith John Smith John Smith Mike Mendez

Total Deposit: $278.00 cash, $3,145.38 checks, $3,423.38 total CHAPTER 24:8 WRITING CHECKS, DEPOSIT SLIPS, AND RECEIPTS Assignment Sheet #1 1. financial transactions 2. check, receipt 3. a. payee: person who receives payment b. originator or maker: person writing check or issuing payment c. endorsement: signature of the payee on the back of the check 4. so they cannot be altered or changed 5. (any 4 of the following) correct amount, same amount on both lines, correct individual or agency as payee, accurate date, check signed by patient 6. to prevent anyone from cashing the check if it is stolen 7. after the person takes it to the bank 8. receipt, proof, accurate, legible, ink 9. to prevent loss or theft 10. $133.00, $1.18 Assignment Sheet #2 Problems 1 and 2

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Problem 3

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Problem 4 (a–c) 4. a.

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4. b.

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4. c.

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Problem 5

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Problem 6

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Problem 7

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Problem 8

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Problem 9

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Problem 10

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Problem 11

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Assignment Sheet #3 Problems 1 and 2

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Problem 3

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Problem 4

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Problem 5 (a–d) 5. a.

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5. b.

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5. c.

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5. d.

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Problem 6

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Problem 7

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Problem 8

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Problem 9

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