Prepare for the NHA Certified Clinical Medical Assistant (CCMA) exam with this study guide. This covers clinical procedures, patient care, and administrative skills.
Q: Chief complaint CC
Answer: The reason a patient called for help. Also, the patient’s response to questions such as “What’s wrong?” or “What happened?”
Q: History of present illness HPI
Answer: Explains the chief complaint. A chronological description of the development of the patient’s present illness from the first sign or symptom or from the previous encounter to the present.
Q: Vital Signs
Answer: Temperature, pulse, respiration, and Blood pressure are all ___________ ___________.
Q: Normal oral temperature
Answer: 97.6F – 99.6F
Q: intermittent fever
Answer: Fever that alternates between elevated and normal or subnormal body temperatures.
Q: Remittent fever
Answer: fever in which temperature fluctuates greatly but never falls to the normal level.
Q: Continuous fever
Answer: A fever that remains constant above the baseline, does not fluctuate.
Q: 60-100 BPM
Answer: Normal pulse rate
Q: Respirations
Answer: Rate, rhythm, and depth are taken into account when measuring what?
Q: Systole
Answer: contraction of the heart
Q: Diastole
Answer: relaxation of the heart
Q: Anthropometric measurements
Answer: Measurement of height, (length rather than height is used in infants because they cannot stand.), weight, BMI, head circumference in infants, waist to hip, % of body fat.
Q: Inspection
Answer: General appearance, state of nutrition, body habits, symmetry, pasture and gait, speech.
Q: palpation
Answer: to examine by touch
Q: Percussion
Answer: physical examination method of tapping over the body to elicit vibrations and sounds to estimate the size, border, or fluid content of a cavity such as the chest.
Q: Ausculation
Answer: the act of listening to sounds arising within organs (as the lungs or heart) as an aid to diagnosis and treatment.
Q: OSHA
Answer: a government agency in the Department of Labor to maintain a safe and healthy work environment
Q: cardiopulmonary resuscitation
Answer: an emergency procedure for life support consisting of artificial respiration and manual external cardiac compression
Q: SHOCK
Answer: This is caused by inadequate blood flow to the heart and in turn to the rest of the body.
Q: Symptoms of shock
Answer: Pale, cold, clammy skinrapid, weak pulseincreased shallow breathingexpressionless face or staring eyes are all ____________ ___ _________.
Q: First aid for Shock
Answer: maintain open airway for the victim, call for assistance, keep victim lying down w/ head lower than rest of body; attempt to control bleeding or other cause of shock if known; keep victim warm until help arrives
Q: Portal of exit
Answer: Method in which a infectious agent leaves the reservoir. Ex: contact with body fluids such as blood or saliva.
Q: mode of transmission
Answer: contact, droplet, air, vehicles, or vectorborne
Q: Portal of entry
Answer: A pathway by which the causative agent enters the host. The area in which a microorganism enters the body. They may be cuts, lesions, injection sites, or natural body orifices.
Q: Susceptible host
Answer: An individual who has little resistance to an infectious agent.
Q: Disinfection
Answer: Process used to destroy microorganisms; destroys all pathogenic organisms except spores, can only be used on inanimate objects. Will not be used for invasive procedures, and will not be inserted into body orifices nor be used in sterile procedure.
Q: Chemical sterilization
Answer: Uses the same chemical used for disinfection, but exposure time is longer.
Q: Steam sterilization (Autoclave)
Answer: uses steam under pressure to obtain higher temperature (250-254F) with exposure time of 20-40 minutes depending on item being sterilized.
Q: hand washing
Answer: What is the most important means of preventing the spread of infection?
Q: hand antisepsis
Answer: the removal & destruction of transient microorganisms using antimicrobial soaps.
Q: PPE Personal protective equipment
Answer: mask, goggle, face shield, respirator
Q: Intradermal Injection
Answer: ID; 15 degrees no aspiration; used for TB test, allergy test, and local anesthetic
Q: Intramuscular Injection
Answer: IM; 90 degress with aspiration
Q: Subcutaneous Injection
Answer: SQ; 45 degress
Q: pericardium
Answer: protective sac enclosing the heart composed of two layers with fluid between
Q: Right atrium
Answer: The upper right chamber of the heart, where deoxygenated blood is received from the vena cava and then sent to the right ventricle.
Q: Right ventricle
Answer: the chamber on the right side of the heart that receives deoxygenated blood from the right atrium and pumps it into the pulmonary trunk
Q: Left atrium
Answer: the left upper chamber of the heart that receives oxygenated blood returning from the lungs via the right and left pulmonary veins.
Q: Left ventricle
Answer: the chamber on the left side of the heart that receives oxygenated blood from the left atrium and pumps it into the aorta
Q: Aorta
Answer: The largest artery of the body
Q: Pulmonary arteries
Answer: The only arteries in the body that carry deoxygenated blood.
Q: pulmonary veins
Answer: the only veins in the body that carry oxygenated blood.
Q: atrioventricular valves
Answer: Separate the atria and the ventricles. Right sided tricuspid, left sided mitral
Q: tricuspid valve
Answer: between right atrium and right ventricle
Q: mitral valve
Answer: between left atrium and left ventricle.
Q: Pulmonary valve
Answer: between right ventricle and pulmonary trunk.
Q: Aortic Valve
Answer: Between left ventricle and aorta
Q: depolarization
Answer: sodium rushes into neuron through membrane, potassium ruses out; results in a positive charge
Q: repolarization
Answer: when the K+ ions leave the inside of the axon, making the inside charge negative. Myocardial relaxation.
Q: SA NODE
Answer: the pace-maker of the heart; where the impulse conduction of the heart usually starts; located in the top of the right atrium just below superior vena cava
Q: AV node
Answer: Located at the posterior septal wall at the right atrium just above the tricuspid valve. There is a 1/10 second delay of electrical activity at this level to allow blood to flow from the atria to the ventricles.
Q: Lead I
Answer: Left arm is positive and right arm is negative (LA-RA)
Q: Lead II
Answer: Left leg is positive and right arm is negative (LL-RA)
Q: Lead III
Answer: Left leg is positive and left arm is negative (LL-LA)
Q: aVR
Answer: The right arm is positive and the other limbs are negative
Q: aVL
Answer: The left arm is positive and the other limbs are negative
Q: aVF
Answer: The left leg (or foot) is positive and the other limbs are negative
Q: V1
Answer: 4th intercostal space, right sternal border
Q: V2
Answer: 4th intercostal space, left sternal border
Q: V3
Answer: equidistant between v2 and v4
Q: V4
Answer: 5th intercostal space, on the left midclavicular line
Q: V5
Answer: 5th intercostal space at the anterior axillary line
Q: V6
Answer: 5th intercostal space, midaxillary line
Q: 1mm
Answer: 1 small square on eKG grid is equal to
Q: 5mm
Answer: 1 large square on EKG grid is equal to
Q: 1mv
Answer: 2 large squares on EKG grid is equal to
Q: .04 seconds or 40m seconds
Answer: 1 small square on eKG grid is equal to how much time?
Q: .2 seconds or 200m seconds
Answer: 1 large square on eKG grid is equal to how much time?
Q: 1 second or 1000 m seconds
Answer: 5 large squares on eKG grid is equal to how much time?
Q: 25mm per second
Answer: The running speed of an EKG is?
Q: Horizontal axis
Answer: What represents time on an EKG?
Q: Vertical axis
Answer: What represents amplitude on an EKG?
Q: P Wave
Answer: Deflection produced by Atrial depolarization. Normal range does not exceed 0.11s in duration or 2.55mm in height.
Q: T wave
Answer: Deflection produced by ventricular repolarization
Q: QRS complex
Answer: Ventricular depolarization
Q: Somatic tremors
Answer: Patients tremors or shaking the wires can produce jittery patterns on the EKG tracing.
Q: Wandering baseline
Answer: sweat or lotion on the patients skin or tension on the electrode wires can interfere with the signal going to the EKG apparatus causing the baseline of the tracing to move up and down on the EKG paper.
Q: 60-cycle interference
Answer: can produce deflections occurring at rapid rate that may mimic atrial flutter. this is caused by electrical appliances or apparatus being used nearby while the tracing is taken.
Q: broken recording
Answer: the stylus goes up and down trying to find the signal. tis can be caused by loose electrode or cables, or by frayed or broken wires
Q: arrhythmia
Answer: abnormal heart rhythms
Q: Ischemia
Answer: decreased blood flow to tissue caused by constriction or occlusion of a blood vessel can cause chest pain or angina
Q: Myocardial infarction
Answer: Death of myocardial cells
Q: PR segment
Answer: .16 mm/s; line from the end of the P wave to the onset of the QRS complex
Q: ST segment
Answer: From J point to the onset of the T wave; if elevated above base line could indicate myocardial infarction (STEMI)
Q: Beta Blockers
Answer: Reduce heart rate, blood pressure, myocardial oxygen consumption, effectively treat angina pectoris and hypertension. Contraindicated for cardiac stress test.
Q: 5-6 liters
Answer: The average adult has __ – ___ _______ of blood.
Q: 55%
Answer: How much of our blood is plasma?
Q: 45%
Answer: How much of our blood is made up of formed elements? RBC, WBC, Platelets
Q: 99%
Answer: ____ Of formed elements are Red Blood cells
Q: Erythrocytes
Answer: Oxygen carrying protein RBC’s
Q: 120 days
Answer: What is the normal lifespan of an RBC?
Q: 4.2-6.2 Million
Answer: How many RBC’s are the per microliter of blood?
Q: Thrombocytes
Answer: Platelets are irregularly shaped packets of cytoplasm formed in the bone marrow from megakaryocytes. Promote blood coagulation.
Q: 140,000-440,000
Answer: What is the average number of platelets per microliter of blood?
Q: Leukocytes
Answer: WBC that proves the body protection again infection.
Q: 5,000-10,000
Answer: What is the normail amount of Leukocytes for an adult per microliter?
Q: Leukocytosis
Answer: Increased WBC’s
Q: Leukopenia
Answer: Decreased WBC’s
Q: Neutrophils
Answer: These WBC’s are the most numerous and they comprise between 40-60%. of the WBC’s
Q: Lymphocytes
Answer: THe second most numerous WBC, comprise between 20-40% of the WBC’s
Q: Monocytes
Answer: Makes up 3-8% of WBC’s population they are the LARGEST WBC’s.
Q: Eosinophils
Answer: Represent 1-3% of WBC populations. fight antibody foreign materials.
Q: Basophils
Answer: Account for 0-1% of WBC’s in the blood. They carry histamines to be released in case of an allergic reaction.
Q: Hemostasis
Answer: The process by which blood vessels are repaired after injury. Prevents blood clot formation after venipuncture
Q: vascular stage, Platelet phase, coagulation phase, fibrinolysis
Answer: Name the four stages of Hemostasis.
Q: guage, needle
Answer: The smaller the needle ________ is the larger the diameter of the _______ is.
Q: needle adapters
Answer: Also known as hubs or needle holders; one end has a small opening that connects the needle, and the other end has a wide opening to hold the collection tube.
Q: Winged infusion sets
Answer: They are used for venipuncture on small veins such as those in the hand. The are also used for venipuncture in the elderly and pediatric patients.
Q: median cubital vein
Answer: The vein of choice because is it large and does not tend to move the the needle is inserted.
Q: Cephalic vein
Answer: The second choice for venipuncture. It is usually more difficult to locate and has a tendency to move, however, it is often the only vein that can be palpated in the obese patients.
Q: Basilic Vein
Answer: The third choice for venipunctures. It is the least firmly anchored and located near the brachial artery. If the needle is inserted too deep, this artery may be punctured.
Q: 3-4 inches above the venipuncture site
Answer: Where should the tourniquet be placed when performing venipuncture?
Q: 1. Blood cultures,2. light blue top tubes3. Serum (red or gray tubes)4. green top tubes5. lavender top tubes6. Gray top tubes.
Answer: What is the correct order of Draw?
Q: Fasting specimens
Answer: Glucose Tolerance Test; Patient must have fasted and refrained from strenuous exercise for 12 hours prior tot he drawing.
Q: 2 hour postprandial
Answer: This test is used to evaluate diabetes melitus. Fasting glucose level is compared with the level 2 hours after eating a full meal of ingesting a measured amount of glucose.
Q: Blood cultures
Answer: 8-10 mL; Are measured to detect the presence of microorganisms in the patient’s blood. Tests for septicemia.
Q: PKU
Answer: To test for mental retardation or brain damage.
Q: Cold Agglutinins
Answer: Red topper tubes, and must be kept warm.
Q: Chilled specimens
Answer: Arterial blood gasesammonialactic acidpyruvate,acthgastrinparathyroid
Q: Light sensitive specimens
Answer: Bilirubinbeta-caroteneVitamins A&B6porphyrins
Q: Infant dermal puncture
Answer: Use the lateral aspect of the heel (dorsal pedis lateralis), do not exceed more than 2.0mm.
Q: Older children & adult dermal puncture
Answer: Use the distal segment of the third and fourth finger of the non dominant hand. Go perpendicular to the lines of the fingerprint.
Q: Lavender Tubes
Answer: Contains EDTA. The tubes are used for CBC, RBC count, WBC & platelet count, WBC differential count, Hemoglobin and hemoaocrit determinations, ESR (erythrocyte sedimentation rater), Sickle Cell screening.
Q: Light blue tubes
Answer: Contains sodium citrate, which prevents coagulation, tube must be completely filled. Test for coagulation studies.
Q: Green top tubes
Answer: Chemistry tests. Heparin. tube should be inverted 8 times.
Q: Gray top tube
Answer: Fasting blood sugar, Glucose tolerance test, blood alcohol levels, lactic acid measurement. Potassium Oxalate/Sodium Fluoride
Q: Red/gray speckled or gold top tube
Answer: Serum Seperator Gel; Chemistry tests. Contain clot activators, glass particles, silica and celite. Must invert tubes 5 times.
Q: Red top tube
Answer: Serum chemistry test, serology tests, blood bank. This is a plain vacuum tube that contains no additives
Q: Yellow top tube
Answer: Sterile; Contains SUP sodium polyanetholesulfatonate; blood cultures; invert 8 times/
Q: At least once a day
Answer: How often should tests be checked for accuracy?
Q: Toxicology
Answer: Analyzes poison levels of drugs and poisons
Q: Blood type AB+
Answer: is Universal Recipient
Q: Blood type O+
Answer: Universal Donor
Q: ABGs
Answer: analysis of aterial blood to determine the adequacy of lung function in the exchange of gases; transport on ice
Q: Anuria
Answer: The absence of urine
Q: Hematuria
Answer: The presence of blood in the urine
Q: Polyuria
Answer: The passage of large volumes of urine
Q: First morning urine sample
Answer: The type of specimen that is most commonly used for routine analysis and HCG (pregnancy) test
Q: Mid-stream Specimen
Answer: A C&S specimen that is collected not at the beginning of end of voiding, but in the middle of urination.
Q: Clean-catch specimen
Answer: A C&S specimen that requires special cleaning of the external genitalia prior to collection.
Q: anuria
Answer: Little to no urine output.
Q: Hemoccult fecal occult test
Answer: Detect imperceptible blood in stool. The first and last portion of the stool after a bowel movement.
Q: Invasion of privacy
Answer: This is the release of medical records without the patient’s knowledge and permission.
Q: C&S stool specimen
Answer: specimen needs to be protected from contamination; instruct patients to avoid urinating while collecting the specimen
Q: nocturia
Answer: urination at night
Q: Appendix A
Answer: Section where special coding instructions are found
Q: peak flow meter
Answer: A take home device used to test respiratory function
Q: transdermal patches
Answer: A method of administering topical medication slowly and cosistently
Q: Hematemesis
Answer: vomit blood
Q: sigmoidoscope
Answer: An instrument used to view the sigmoid portion of the large intestine that is inserted rectally
Q: Apical pulse
Answer: A method of determining heart rate by placing the stethoscope over the apex of the heart; commonly used for infants
Q: Hypoglycemic emergency
Answer: A serious condition in which a patient’s blood sugar drops critically low; giving the patient orange juice is a common method used to restore appropriate blood sugar level
Q: POL testing
Answer: Physician office lab testing that is usually CLIA waved and can be performed by a medical assistant
Q: VDRL and TB
Answer: Communicable diseases in which the infected patient ‘s information can be released to an outside source
Q: Hemothorax
Answer: Blood in the chest cavitiy
Q: Nephrolithiasis
Answer: kidney stones
Q: sterilization
Answer: free of all microorganisms
Q: diaphoresis
Answer: profuse sweating
Q: Nosocomial infections
Answer: Infections derived from the patient staying in the hospital
Q: V codes
Answer: identify conditions other than a disease or injury, but are not necessarily a primary diagnosis