DOH Allied Health Exam cheat sheet

Normal adult resting vital signs: oral temperature 36.5–37.5 °C (97.7–99.5 °F), pulse 60–100 beats/min, respirations 12–20 breaths/min, blood pressure <120/80 mmHg, SpO2 ≥95% on room air.

Orthostatic hypotension is a drop of ≥20 mmHg systolic or ≥10 mmHg diastolic within 3 minutes of standing from supine.

The 5 rights of medication administration are right patient, right drug, right dose, right route, and right time.

Standard precautions apply to all patients regardless of diagnosis; hand hygiene is performed before and after every patient contact.

When transferring a patient, keep the bed at the lowest position, lock wheels, and raise the side rail on the opposite side before moving the patient.

The head of bed should be elevated 30–45 degrees for patients receiving enteral tube feedings to reduce aspiration risk.

A patient in restraints requires reassessment at least every 15 minutes for circulation, skin integrity, and safety, with release and range-of-motion at least every 2 hours.

The Glasgow Coma Scale score ranges from 3 (deep coma) to 15 (fully alert); a score ≤8 indicates severe impairment and possible need for airway protection.

Anatomical position is standing upright, face forward, arms at the sides with palms facing forward, and feet flat on the floor.

The four primary tissue types are epithelial, connective, muscle, and nervous tissue.

The axial skeleton has 80 bones (skull, vertebral column, rib cage); the appendicular skeleton has 126 bones (limbs and girdles).

There are 206 bones in the adult human skeleton; an infant is born with about 270 bones that fuse during development.

The heart has four chambers: right atrium, right ventricle, left atrium, and left ventricle; the left ventricle has the thickest myocardium because it pumps to the systemic circulation.

The respiratory tract is divided into upper (nose, pharynx, larynx) and lower (trachea, bronchi, bronchioles, alveoli) portions; gas exchange occurs in the alveoli.

The nephron is the functional unit of the kidney, consisting of the glomerulus, Bowman's capsule, and renal tubules.

Cranial nerves I–XII: olfactory, optic, oculomotor, trochlear, trigeminal, abducens, facial, vestibulocochlear, glossopharyngeal, vagus, accessory, hypoglossal.

Cardiac output = heart rate × stroke volume; normal resting cardiac output is about 4–8 L/min.

Mean arterial pressure (MAP) ≈ diastolic pressure + one-third of the pulse pressure; a MAP ≥65 mmHg is generally needed for adequate organ perfusion.

Normal pH of arterial blood is 7.35–7.45; below 7.35 is acidosis and above 7.45 is alkalosis.

The renin-angiotensin-aldosterone system raises blood pressure by causing vasoconstriction and sodium/water retention.

Insulin lowers blood glucose by promoting cellular uptake; glucagon raises blood glucose by stimulating glycogenolysis and gluconeogenesis.

Inflammation is characterized by redness, heat, swelling, pain, and loss of function (rubor, calor, tumor, dolor, functio laesa).

Edema results from increased capillary hydrostatic pressure, decreased plasma oncotic pressure, increased capillary permeability, or lymphatic obstruction.

Shock is inadequate tissue perfusion; types include hypovolemic, cardiogenic, distributive (septic, anaphylactic, neurogenic), and obstructive.

The chain of infection has six links: infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, and susceptible host.

Hand hygiene with soap and water for at least 20 seconds is required when hands are visibly soiled or after contact with spore-forming organisms such as Clostridioides difficile.

Alcohol-based hand rub is preferred for routine hand hygiene when hands are not visibly soiled; apply enough product to cover all surfaces and rub until dry (about 20–30 seconds).

Personal protective equipment is removed in this order: gloves, goggles/face shield, gown, then mask/respirator; hand hygiene follows.

A surgical mask is worn for droplet precautions; an N95 or higher respirator is worn for airborne precautions (e.g., tuberculosis, measles, varicella).

Standard precautions apply to blood, all body fluids, secretions, excretions (except sweat), nonintact skin, and mucous membranes.

Transmission-based precautions: contact (e.g., MRSA, C. difficile), droplet (e.g., influenza, pertussis), airborne (e.g., TB, measles, varicella).

Sterile technique requires that sterile items contact only sterile items; a sterile field is considered contaminated if touched by a nonsterile object or if it becomes wet.

Common prefixes: brady- (slow), tachy- (fast), hyper- (above), hypo- (below), dys- (difficult/painful), poly- (many), a-/an- (without).

Common suffixes: -itis (inflammation), -ectomy (surgical removal), -ostomy (creating an opening), -otomy (incision), -algia (pain), -emia (blood condition), -uria (urine condition).

Root words identify the body part or system: cardi- (heart), nephr- (kidney), hepat- (liver), pulmon- (lung), gastr- (stomach), neur- (nerve).

The SOAP note format is Subjective, Objective, Assessment, Plan.

Documentation must be accurate, timely, complete, legible, and objective; late entries are labeled as such and never backdated.

Abbreviations to avoid in documentation include U (unit), IU (international unit), QD and QOD (daily/every other day), and trailing zeros (write 5 mg, not 5.0 mg).

HIPAA permits disclosure of protected health information for treatment, payment, and health care operations without patient authorization.

The medical record is a legal document; errors are corrected with a single line, the correction, initials, and date, never by erasure or correction fluid.

Therapeutic index = toxic dose / therapeutic dose; a narrow therapeutic index (e.g., warfarin, digoxin, lithium) requires close monitoring.

The six rights of medication administration: right patient, right drug, right dose, right route, right time, and right documentation.

Oral medications are absorbed primarily in the small intestine; first-pass metabolism in the liver reduces bioavailability of orally administered drugs.

Common antidotes: naloxone for opioids, flumazenil for benzodiazepines, acetylcysteine for acetaminophen, vitamin K for warfarin, protamine sulfate for heparin.

High-alert medications include insulin, heparin, opioids, and concentrated electrolytes; they require independent double-checks.

Never administer a medication prepared by another person; label all syringes and containers immediately after preparation.

Adverse drug reactions are classified as predictable (Type A, dose-dependent) or unpredictable (Type B, idiosyncratic or allergic).

Pregnancy risk categories have been replaced by the Pregnancy and Lactation Labeling Rule (PLLR), which uses narrative sections rather than letter grades.

Normal adult hemoglobin: men 13.5–17.5 g/dL, women 12.0–15.5 g/dL; hematocrit is roughly three times the hemoglobin value.

Normal adult white blood cell count is 4,500–11,000 cells/µL; neutrophils are the most abundant leukocyte.

Normal adult platelet count is 150,000–450,000/µL; thrombocytopenia increases bleeding risk.

Normal fasting blood glucose is 70–99 mg/dL; a fasting glucose ≥126 mg/dL on two occasions supports a diabetes diagnosis.

Normal adult serum potassium is 3.5–5.0 mEq/L; values outside this range can cause cardiac dysrhythmias.

Normal adult serum sodium is 135–145 mEq/L; normal serum calcium is 8.5–10.5 mg/dL.

A urinalysis positive for nitrites and leukocyte esterase suggests a urinary tract infection.

Therapeutic drug monitoring for vancomycin measures trough levels, typically drawn within 30 minutes before the next dose.

Autonomy respects the patient's right to make decisions; beneficence is acting in the patient's best interest; nonmaleficence is doing no harm; justice is fair treatment.

Informed consent requires capacity, voluntary decision-making, and disclosure of risks, benefits, and alternatives.

A living will states a patient's wishes about life-sustaining treatment; a durable power of attorney for health care designates a surrogate decision-maker.

Mandatory reporting includes suspected child abuse, elder abuse, and certain communicable diseases, as defined by state law.

Scope of practice defines the procedures and responsibilities a health care worker is legally permitted to perform under state licensure and employer policy.

A health care worker who observes an error must report it through the facility's incident reporting system; incident reports are not placed in the medical record.

Confidentiality is breached only when disclosure is required by law (e.g., reportable disease, court order) or necessary to prevent serious harm.

Negligence requires duty, breach of duty, causation, and damages; malpractice is professional negligence.

The Occupational Safety and Health Administration (OSHA) Bloodborne Pathogens Standard requires an exposure control plan, hepatitis B vaccination offer, and post-exposure evaluation.

Needles and sharps are placed in puncture-resistant, closable, leak-proof containers immediately after use; never recap by hand.

Safe patient handling programs use mechanical lifts and assistive devices to reduce musculoskeletal injuries from manual lifting.

Fire safety uses the RACE mnemonic: Rescue, Alarm, Contain, Extinguish/Evacuate.

The PASS technique for a fire extinguisher: Pull the pin, Aim at the base of the fire, Squeeze the handle, Sweep side to side.

A safety data sheet (SDS) provides hazard, handling, and first-aid information for every hazardous chemical in the workplace.

Wet floors require warning signs; spills are cleaned immediately to prevent falls.

Latex allergy precautions include using nonlatex gloves and avoiding latex-containing supplies for sensitized patients and staff.

The adult chain of survival: recognize and activate emergency response, early CPR, rapid defibrillation, advanced life support, and post-cardiac arrest care.

Adult CPR compression rate is 100–120 compressions per minute at a depth of at least 2 inches (5 cm) but not more than 2.4 inches (6 cm).

The compression-to-ventilation ratio for single-rescuer adult CPR is 30:2; for two-rescuer infant and child CPR, it is 15:2.

Defibrillation should be delivered as soon as an AED is available; resume compressions immediately after the shock.

Anaphylaxis is treated with intramuscular epinephrine (adult dose 0.3–0.5 mg of 1:1,000 solution) into the anterolateral thigh.

Signs of stroke can be remembered with BE-FAST: Balance, Eyes, Face drooping, Arm weakness, Speech difficulty, Time to call emergency services.

Hypoglycemia in a conscious patient is treated with 15 g of fast-acting carbohydrate, rechecked in 15 minutes (the 15-15 rule).

A choking adult who cannot speak or cough receives abdominal thrusts (Heimlich maneuver); an infant receives 5 back blows followed by 5 chest thrusts.

SBAR is a structured handoff tool: Situation, Background, Assessment, Recommendation.

Therapeutic communication uses open-ended questions, active listening, reflection, and clarification; it avoids false reassurance and why questions.

Teach-back confirms patient understanding by asking the patient to explain information in their own words.

Interprofessional collaboration requires role clarity, mutual respect, and shared decision-making among team members.

Conflict resolution uses 'I' statements, focuses on the problem rather than the person, and seeks a mutually acceptable solution.

Effective handoffs include the patient's current condition, recent changes, pending tests, and a clear plan of care.

Language barriers require a qualified medical interpreter; family members should not be used as interpreters for clinical discussions.

Documentation of communication includes the time, participants, content, and patient response to ensure continuity of care.