Clinical Skills, Safety, and Technique
What to know
Clinical questions cover asepsis and infection control, vital signs, patient preparation and positioning, assisting with examinations, medication administration, injections, phlebotomy, electrocardiography, specimen collection, and emergency response. Know medical asepsis versus surgical asepsis, standard precautions, PPE sequence, and transmission-based precautions. For vital signs, understand normal ranges, proper cuff size, and factors that falsely elevate or lower readings. For medications, apply the rights (patient, drug, dose, route, time, documentation) and know common routes, sites, and needle gauges. For phlebotomy, know order of draw, vein selection, and sharps handling. For emergencies, know CPR/AED basics and anaphylaxis response.
Traps
Small blood pressure cuffs falsely raise readings; a cuff bladder should be about 80% of arm circumference and 40% of arm width. Needle gauge numbers run opposite to lumen size - a 25-gauge needle is thinner than a 21-gauge. Confusing clean with sterile technique or skipping the order of draw can cost points. Also watch for questions that ask what to do first: safety and ABCs come before documentation.
Worked example
A patient's arm circumference is 34 cm. Choose a cuff with a bladder length near 27 cm (about 80%) and width near 14 cm (about 40%). If only a smaller cuff is available, expect a falsely high reading and document the cuff size. Rule of thumb: when a reading seems inconsistent with the patient's condition, reassess technique, cuff size, and positioning before acting on the number.