DHA Allied Health Exam cheat sheet

Six aims of quality (IOM/NAM): safe, effective, patient-centered, timely, efficient, equitable.

Error taxonomy: near miss = no harm reached patient; adverse event = harm occurred; sentinel event = unexpected death or serious permanent harm.

Universal Protocol for invasive procedures has three elements: pre-procedure verification, site marking, and time-out immediately before starting.

Speak-up/chain of command: any team member who perceives a threat to safety may escalate up the chain until the concern is resolved.

Two-patient identifiers (name plus date of birth or medical record number) are required before every specimen collection, medication, or procedure.

RCA is retrospective and systems-focused, asking what failed and why; FMEA is prospective, scoring failure modes by severity x occurrence x detectability.

Fall risk tools (e.g., Morse, Hendrich) trigger bed in lowest position, brakes locked, call light within reach, and non-skid footwear.

Pressure injury staging: Stage 1 = intact skin with non-blanchable erythema; Stage 2 = partial-thickness loss; Stage 3 = full-thickness; Stage 4 = exposed bone, tendon, or muscle.

Chain of infection: infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, susceptible host; breaking any link prevents transmission.

Standard precautions apply to all patients regardless of diagnosis and include hand hygiene, gloves, gown, mask/eye protection, and safe sharps handling.

Hand hygiene moments (WHO 5): before patient contact, before aseptic task, after body fluid exposure risk, after patient contact, after touching patient surroundings.

Alcohol-based rub is preferred for routine hand hygiene when hands are not visibly soiled; soap and water is required for C. difficile, norovirus, and visible soiling.

Transmission-based precautions: contact (gown/gloves, e.g., MRSA, C. difficile), droplet (mask, e.g., influenza, pertussis), airborne (N95 plus negative-pressure room, e.g., TB, measles, varicella).

Do not recap, bend, or break needles; dispose immediately in a puncture-resistant sharps container filled no more than three-quarters full.

Sterile field rule: items below waist level or outside the field edge are contaminated; any item contacting a non-sterile surface is discarded.

Needle-stick/post-exposure: wash the site with soap and water, report immediately, and initiate source testing and post-exposure prophylaxis evaluation per protocol.

Four core principles: autonomy (respect patient choice), beneficence (act for benefit), nonmaleficence (avoid harm), justice (fair allocation and access).

Informed consent requires capacity, voluntariness, disclosure of risks/benefits/alternatives, and comprehension; it is documented before the procedure.

Scope of practice is defined by licensure law, facility policy, and demonstrated competence; performing outside it is a regulatory violation even if the task is easy.

Confidentiality is breached only by authorized consent, legal mandate (reportable diseases, suspected abuse), or imminent harm to self or others.

Mandatory reporting typically covers suspected child/elder abuse, certain communicable diseases, and impaired or unsafe practitioners.

A living will or advance directive documents wishes; a durable power of attorney for health care designates a surrogate decision-maker.

Ethical dilemma resolution sequence: identify the problem, gather facts, consider options and stakeholders, apply principles, decide, act, and evaluate.

Personal health information may be accessed only on a need-to-know basis for care delivery; curiosity-driven access is a privacy violation.

Vital sign thresholds in adults: respiratory rate 12-20/min, heart rate 60-100/min, systolic BP 90-120 mmHg, temperature 36.5-37.5 C, SpO2 95-100% on room air.

Blood pressure cuff bladder should encircle about 80% of arm circumference and 40% of arm length; cuff too small falsely elevates the reading.

Pulse oximetry is unreliable with poor perfusion, motion artifact, nail polish, or carbon monoxide exposure (falsely normal or high).

Specimen labeling is done at the bedside in the presence of the patient; unlabeled or mislabeled specimens are rejected and recollected.

Venipuncture order of draw: blood cultures, sodium citrate (light blue), serum (red/gold), heparin (green), EDTA (lavender), oxalate/fluoride (gray).

Orthostatic hypotension is a drop of at least 20 mmHg systolic or 10 mmHg diastolic within three minutes of standing from supine.

Therapeutic communication techniques: open-ended questions, reflection, clarification, and silence; avoid false reassurance and 'why' questions.

Documentation must be contemporaneous, objective, factual, and signed with name and credential; late entries are labeled as such and never altered.

Anatomical position: standing erect, face forward, arms at sides with palms forward, feet flat and parallel.

Body planes: sagittal divides left/right, coronal (frontal) divides anterior/posterior, transverse divides superior/inferior.

Directional terms: proximal nearer the trunk, distal farther; medial toward midline, lateral away; superficial near surface, deep internal.

Four abdominopelvic quadrants: RUQ (liver, gallbladder), LUQ (stomach, spleen), RLQ (appendix, cecum), LLQ (sigmoid colon).

Cardiac conduction sequence: SA node, AV node, bundle of His, bundle branches, Purkinje fibers; SA node intrinsic rate 60-100/min.

Normal blood pH 7.35-7.45; bicarbonate 22-26 mEq/L; PaCO2 35-45 mmHg; PaO2 80-100 mmHg.

Skeletal muscle contraction follows the sliding filament model: calcium binds troponin, tropomyosin shifts, actin and myosin cross-bridge using ATP.

Kidney nephron: glomerular filtration in the glomerulus, reabsorption in the proximal tubule, and concentration in the loop of Henle and collecting duct.

SBAR handoff: Situation, Background, Assessment, Recommendation; delivered in that order for concise, structured transfer of information.

Closed-loop communication: sender gives a directive, receiver repeats it back, sender confirms accuracy; used for critical orders and high-risk tasks.

Teach-back is the validated method to confirm patient understanding: the patient explains the information in their own words.

Health literacy best practice: plain language at roughly a fifth- to sixth-grade reading level, chunked information, and avoidance of jargon.

Interpreter use is required for limited-English-proficiency patients; family members, especially minors, should not serve as medical interpreters.

Documentation elements: date and time, objective findings, interventions performed, patient response, and signature with credential.

SOAP note format: Subjective, Objective, Assessment, Plan; each section is distinct and cannot substitute for another.

Conflict in teams is addressed directly and privately using 'I' statements and focusing on the behavior, not the person, then escalated if unresolved.

Six aims of quality (IOM/NAM): safe, effective, patient-centered, timely, efficient, equitable.

Error taxonomy: near miss = no harm reached patient; adverse event = harm occurred; sentinel event = unexpected death or serious permanent harm.

Universal Protocol for invasive procedures has three elements: pre-procedure verification, site marking, and time-out immediately before starting.

Speak-up/chain of command: any team member who perceives a threat to safety may escalate up the chain until the concern is resolved.

Two-patient identifiers (name plus date of birth or medical record number) are required before every specimen collection, medication, or procedure.

RCA is retrospective and systems-focused, asking what failed and why; FMEA is prospective, scoring failure modes by severity x occurrence x detectability.

Fall risk tools (e.g., Morse, Hendrich) trigger bed in lowest position, brakes locked, call light within reach, and non-skid footwear.

Pressure injury staging: Stage 1 = intact skin with non-blanchable erythema; Stage 2 = partial-thickness loss; Stage 3 = full-thickness; Stage 4 = exposed bone, tendon, or muscle.

Chain of infection: infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, susceptible host; breaking any link prevents transmission.

Standard precautions apply to all patients regardless of diagnosis and include hand hygiene, gloves, gown, mask/eye protection, and safe sharps handling.

Hand hygiene moments (WHO 5): before patient contact, before aseptic task, after body fluid exposure risk, after patient contact, after touching patient surroundings.

Alcohol-based rub is preferred for routine hand hygiene when hands are not visibly soiled; soap and water is required for C. difficile, norovirus, and visible soiling.

Transmission-based precautions: contact (gown/gloves, e.g., MRSA, C. difficile), droplet (mask, e.g., influenza, pertussis), airborne (N95 plus negative-pressure room, e.g., TB, measles, varicella).

Do not recap, bend, or break needles; dispose immediately in a puncture-resistant sharps container filled no more than three-quarters full.

Sterile field rule: items below waist level or outside the field edge are contaminated; any item contacting a non-sterile surface is discarded.

Needle-stick/post-exposure: wash the site with soap and water, report immediately, and initiate source testing and post-exposure prophylaxis evaluation per protocol.

Four core principles: autonomy (respect patient choice), beneficence (act for benefit), nonmaleficence (avoid harm), justice (fair allocation and access).

Informed consent requires capacity, voluntariness, disclosure of risks/benefits/alternatives, and comprehension; it is documented before the procedure.

Scope of practice is defined by licensure law, facility policy, and demonstrated competence; performing outside it is a regulatory violation even if the task is easy.

Confidentiality is breached only by authorized consent, legal mandate (reportable diseases, suspected abuse), or imminent harm to self or others.

Mandatory reporting typically covers suspected child/elder abuse, certain communicable diseases, and impaired or unsafe practitioners.

A living will or advance directive documents wishes; a durable power of attorney for health care designates a surrogate decision-maker.

Ethical dilemma resolution sequence: identify the problem, gather facts, consider options and stakeholders, apply principles, decide, act, and evaluate.

Personal health information may be accessed only on a need-to-know basis for care delivery; curiosity-driven access is a privacy violation.

Vital sign thresholds in adults: respiratory rate 12-20/min, heart rate 60-100/min, systolic BP 90-120 mmHg, temperature 36.5-37.5 C, SpO2 95-100% on room air.

Blood pressure cuff bladder should encircle about 80% of arm circumference and 40% of arm length; cuff too small falsely elevates the reading.

Pulse oximetry is unreliable with poor perfusion, motion artifact, nail polish, or carbon monoxide exposure (falsely normal or high).

Specimen labeling is done at the bedside in the presence of the patient; unlabeled or mislabeled specimens are rejected and recollected.

Venipuncture order of draw: blood cultures, sodium citrate (light blue), serum (red/gold), heparin (green), EDTA (lavender), oxalate/fluoride (gray).

Orthostatic hypotension is a drop of at least 20 mmHg systolic or 10 mmHg diastolic within three minutes of standing from supine.

Therapeutic communication techniques: open-ended questions, reflection, clarification, and silence; avoid false reassurance and 'why' questions.

Documentation must be contemporaneous, objective, factual, and signed with name and credential; late entries are labeled as such and never altered.

Anatomical position: standing erect, face forward, arms at sides with palms forward, feet flat and parallel.

Body planes: sagittal divides left/right, coronal (frontal) divides anterior/posterior, transverse divides superior/inferior.

Directional terms: proximal nearer the trunk, distal farther; medial toward midline, lateral away; superficial near surface, deep internal.

Four abdominopelvic quadrants: RUQ (liver, gallbladder), LUQ (stomach, spleen), RLQ (appendix, cecum), LLQ (sigmoid colon).

Cardiac conduction sequence: SA node, AV node, bundle of His, bundle branches, Purkinje fibers; SA node intrinsic rate 60-100/min.

Normal blood pH 7.35-7.45; bicarbonate 22-26 mEq/L; PaCO2 35-45 mmHg; PaO2 80-100 mmHg.

Skeletal muscle contraction follows the sliding filament model: calcium binds troponin, tropomyosin shifts, actin and myosin cross-bridge using ATP.

Kidney nephron: glomerular filtration in the glomerulus, reabsorption in the proximal tubule, and concentration in the loop of Henle and collecting duct.

SBAR handoff: Situation, Background, Assessment, Recommendation; delivered in that order for concise, structured transfer of information.

Closed-loop communication: sender gives a directive, receiver repeats it back, sender confirms accuracy; used for critical orders and high-risk tasks.

Teach-back is the validated method to confirm patient understanding: the patient explains the information in their own words.

Health literacy best practice: plain language at roughly a fifth- to sixth-grade reading level, chunked information, and avoidance of jargon.

Interpreter use is required for limited-English-proficiency patients; family members, especially minors, should not serve as medical interpreters.

Documentation elements: date and time, objective findings, interventions performed, patient response, and signature with credential.

SOAP note format: Subjective, Objective, Assessment, Plan; each section is distinct and cannot substitute for another.

Conflict in teams is addressed directly and privately using 'I' statements and focusing on the behavior, not the person, then escalated if unresolved.