Medical Assisting Scope of Practice

Unlicensed individuals who perform non-invasive routine technical support services under the supervision of a licensed physician and surgeon, podiatrist, physician assistant, nurse practitioner, or nurse midwife in a medical office or clinic setting without the need of receiving a certification

Medical assistants

The licensed practitioner must be physically present in the treatment facility during the MA’s performance of technical procedures

Supervision

A specific written order prepared by the supervising physician, podiatrist, physician assistant, nurse practitioner, or nurse midwife authorizing the procedures to be performed on a patient , which shall be placed in the patient’s medical record

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or

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A standing order prepared by the supervising licensed practitioner authorizing the procedures to be performed, the duration of which shall be consistent with accepted medical practice

Specific authorization

Certified by a medical assistant certifying organization approved by the Board 

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Holds a credential to teach in a medical assistant training program at a community college

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OR

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Authorized to teach medical assistants in a private postsecondary institution accredited by an accreditation agency recognized by the United States Department of Health or approved by the Bureau for Private Postsecondary Education

Qualified medical assistant

True or false?

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An MA can perform application and removal of bandages and dressings.

True

True or false?

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An MA can perform suture removal.

True

True or false?

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An MA can perform ear lavage.

True

True or false?

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An MA can prepare patients for examinations.

True

True or false?

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An MA can shave and disinfect treatment sites.

True

True or false?

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An MA can hand patients properly-labeled and pre-packaged prescription drugs (including controlled substances) that have been ordered by the licensed practitioner.

False; controlled substances are not allowed

An MA __cannot__ receive training from which supervisor?

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A. Licensed physician

B. Podiatrist

C. Registered nurse

D. Licensed vocational nurse

E. Physician assistant

F. Qualified medical assistant

G. None of the above

G. None of the above; all of them can give MAs training.

Where can an MA be trained?

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A. Postsecondary or adult education program in a public school authorized by the Department of Education 

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B. Community college program provided for in the Education Code 

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C. Postsecondary institution accredited or approved by the Bureau for Private Postsecondary and Vocational Education in the Department of Consumer Affairs

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D. All of the above

D. All of the above

True or false?

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Medication administrations, skin tests, and blood draws are procedures that require minimum training.

True

True or false?

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Any procedure within the MA’s scope of practice that involves using a needle requires minimum training.

True; this includes skin tests, blood draws and medication administration involving injections

At least how many hours are required in minimum training for each of the following procedures?

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* Administering injections
* Performing skin tests
* Venipuncture and skin puncture for the purpose of withdrawing blood
* Administering medication by inhalation

10 hours

At least how many of each of the following procedures is required to be practiced under minimum training?

* Intradermal injections
* Subcutaneous injections
* Intramuscular injections
* Skin tests
* Venipunctures
* Skin punctures

10 each

To inject, handle, or provide medications to a patient __after__ a physician or other appropriate licensed person has __verified the correct medication and dosage.__

Medication administration by medical assistants

Can MAs administer injections of scheduled drugs?

Yes, if trained appropriately

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When trained appropriately and supervised, MAs can administer injections of __scheduled drugs__ under what 2 following conditions?

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* Licensed person must __verify__ the correct medication and dosage
* __IM, ID, or SQ__ injections only

True or false?

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MAs __never__ handle administration of anesthetic agents.

True

True or false?

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An MA can start or disconnect IVs.

False- invasive and outside scope of practice

True or false?

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An MA can administer injections or medication into an IV.

False- Invasive and outside scope of practice

An MA can perform nasal smears under what condition?

If the procedure is __limited__ to the opening of the nasal cavity

This procedure involves pricking the finger in order to collect a sample of blood.

Finger stick/capillary puncture

Can an MA do “finger sticks“?

Yes, if proper training was received

True or false?

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An MA can perform throat swabs for a throat culture.

True, if proper training was received

True or false?

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An MA is responsible for taking the patient’s vitals.

True

List the patient’s vitals.

Height, weight, blood pressure, temperature, pulse, respiration, oxygen saturation

An MA can give __narcotic__ injection under what 4 conditions?

* The licensed person has __verified__ the correct medication and dosage
* __Licensed person__ is on the premises
* The __injection__ being given is IM, SQ, or ID
* __Not__ an anesthetic

Can an MA be allowed access to the keys of the narcotic medication cabinet?

Depends on the supervising physician/podiatrist

Why can’t MAs chart pupillary responses?

This procedure is known as an assessment which requires interpretation.

True or false?

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An MA cannot read, interpret, or diagnose symptoms or test results.

True- We can make __observations__ of symptoms but can’t actually do any sort of diagnosis or interpretation

Why can’t MAs insert urine catheters?

It is considered invasive and out of the scope of practice.

Why can’t MAs perform an independent telephone triage?

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MAs are not legally authorized to interpret data or diagnose symptoms.

True or false?

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MAs can inject collagen.

False

True or false?

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MAs can use lasers to remove air, wrinkles, scars, moles, or other blemishes.

False

True or false?

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MAs can administer chemotherapy and/or monitor patients.

False

True or false?

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Medical assistants can apply orthopedic splints in emergency situations, such as splints in a physician’s office.

False

True or false?

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MAs can remove casts, splints, and other external devices.

True

Although MAs cannot interpret the results of skin tests, what can they do instead?

Measure and describe the test reaction and record it in the patient’s chart.

Under what 2 conditions can MAs be supervised by an NP, nurse midwife, or PA when the physician and/or surgeon is not on site?

* __Written instructions__ from the supervising physician/surgeon __to be followed by the MA__ in regards to a performance of tasks or supportive services when they are not on site.

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* Done at their discretion and in __consultation__ with the NP, certified nurse midwife, or PA

What 3 conditions must be met to allow an MA to call in refills to a pharmacy?

* Under __direct supervision__ of the physician or podiatrist
* Refills must be __exact__ and have no changes in dosage levels
* Refill must be __documented__ in the patient’s chart as a standing order, patient specific

If the prescription has any changes or there is a new prescription, can an MA call in refills to a pharmacy?

No

When can an MA perform a hearing test?

Under direct supervision of a licensed physician/surgeon/podiatrist

What 3 conditions must be met for an MA to administer flu shots and other vaccines?

* Received appropriate __training__
* The licensed person has __verified__ the correct medication and dosage
* The __supervising practitioner is present__ in the facility

An MA can hand patients prescription medications, how should they be labeled and packaged?

* Right medication
* Patient’s name
* Drug dosage

What 3 conditions must be met in order for a packaged medication to be handed over to patients by the MA?

* Pre-labeled and prepackaged
* Patient’s name and right medication
* Medication dosage
* The prescriber provided consultation and ordered it

What 2 conditions must be met for an MA to lawfully perform spirometry pulmonary function testing?

* Received proper __training__
* The test is a __usual and customary__ part of the medical practice where the MA is employed