NHA CCMA Comprehensive Review

These flashcards cover the major concepts, definitions, procedures, and values from the NHA CCMA study notes, including phlebotomy, ECG interpretation, vital signs, infection control, laboratory testing, medical law, and pharmacology. Use them to quiz yourself on key facts for the CCMA exam.

What does the abbreviation CC stand for in medical documentation?

Chief Complaint

In ECG terminology, what is a segment?

The line between two waveforms

What cardiac activity is represented by the P-wave on an ECG?

Atrial depolarization

How many 1-mm boxes appear in a 6-second ECG rhythm strip?

30 one-millimeter boxes

Which waveform on the ECG reflects SA-node activity?

Only the P-wave

What can be determined from the R-R interval on an ECG?

Ventricular pulse (heart rate)

Which phases make up the primary stage of hemostasis?

Vascular phase and platelet phase together

What is electrophoresis used for?

Analyzing chemical components of blood or body fluids based on electrical charge

A positive occult-blood stool test turns what color?

Blue

List the four stages of hemostasis in order.

1) Vascular 2) Platelet Phase 3) Coagulation Phase 4) Fibrinolysis

Name the major types of blood vessels from the heart outward and back.

Aorta → arteries → arterioles → capillaries → venules → veins → superior & inferior vena cavae

What is the outer connective-tissue layer of a blood vessel called?

Tunica adventitia

What is the inner endothelial layer of a blood vessel called?

Tunica intima

What is the middle smooth-muscle layer of a blood vessel?

Tunica media

Which document outlines standards of right and wrong in medicine?

Code of Ethics

What type of blood is found in capillaries?

A mixture of arterial and venous blood

How many liters of blood does the average adult have?

5–6 liters

What percentage of blood is water?

92 %

What percentage of whole blood is plasma?

55 %

What percentage of whole blood is formed elements?

45 %

What cell type makes up 99 % of formed elements?

Red blood cells (erythrocytes)

Where is hemoglobin located?

Inside red blood cells

Where do all blood cells originate?

Bone marrow

Normal RBC count per microliter of blood?

4.2–6.2 million

Which WBC is second most numerous?

Lymphocyte (20–40 %)

Which leukocyte count rises in intracellular infections and tuberculosis?

Monocytes

Which leukocytes increase first in bacterial infections?

Neutrophils

Which WBCs play a key role in viral infections and immunity?

Lymphocytes

Normal adult leukocyte count per microliter?

5 000–10 000

What term describes decreased WBCs as seen in viral infection and leukemia?

Leukopenia

What percentage of leukocytes are monocytes?

3–8 %

Which leukocyte is the largest in size?

Monocyte

Which WBC carries histamine?

Basophil

What hemostatic phase involves vessel constriction?

Vascular phase

Preferred site for venipuncture?

Antecubital fossa

Which test evaluates the intrinsic pathway and heparin therapy?

APTT (or PTT)

Which test evaluates the extrinsic pathway and warfarin therapy?

PT

What is fibrinolysis?

Breakdown and removal of a clot

Which phase converts the platelet plug to a stable fibrin clot?

Coagulation phase

Second-choice vein for venipuncture, often palpable in obese patients?

Cephalic vein

Most common antiseptic for phlebotomy skin prep?

70 % isopropyl alcohol

Common needle length for venipuncture?

1 inch (up to 1.5 inches)

Needles smaller than which gauge risk hemolysis?

Smaller than 23 gauge

Average gauge for routine blood draw needles?

21–22 gauge

Name the three core skills of a phlebotomist.

Social, clerical, technical

Give two analytical errors that can occur during blood collection.

Extended tourniquet time, wrong order of draw (others acceptable)

Give one analytical error that can occur before blood collection.

Patient misidentification (others acceptable)

Give one analytical error that can occur after blood collection.

Failure to separate serum from cells (glycolysis)

What is a fistula in vascular access?

Permanent surgical connection between an artery and a vein; never used for venipuncture

Define edema.

Accumulation of fluid in tissue

Define thrombophlebitis.

Inflammation of a vein with clot formation

What is hemoconcentration?

Increase in proportion of formed elements due to prolonged tourniquet (>2 min)

Consequence of insufficient pressure after needle withdrawal?

Thrombus formation or hematoma

List common additives in green-top tubes.

Heparin (sodium, lithium, or ammonium)

Why aren't green-top tubes used for hematology differentials?

Heparin interferes with Wright-stained blood films

Name a common test for light-blue (sodium-citrate) tubes.

Coagulation studies such as PT or APTT

Name a common test for lavender (EDTA) tubes.

CBC or ESR

State a common chemistry test done in green-top tubes.

Ammonia level (others: carboxyhemoglobin, STAT electrolytes)

How long does blood in a red-top tube clot normally?

30–60 minutes

What is the primary purpose of quality control in the lab?

Ensure accuracy of tests while detecting and eliminating error

Give one common test for a red-top tube.

Serum chemistry tests (others: serology, blood bank if glass)

What is the correct order of draw for capillary specimens?

Lavender first, then other additive tubes, then non-additive tubes

Which antiseptic is avoided on dermal puncture sites?

Betadine (povidone-iodine)

Why warm a dermal puncture site 3–4 minutes?

Increase blood flow

Preferred fingers for adult dermal puncture?

Distal segment of third or fourth finger of non-dominant hand

Heel sticks are performed on what age group?

Infants less than one year

Where on the infant foot is a heel stick performed?

Medial or lateral plantar surface

What depth causes risk of osteomyelitis in heel sticks?

2 mm

List the identification items required for blood bank samples.

Patient’s full name, DOB, ID/SS #, date/time, phlebotomist initials

Which lab section uses serum to detect antibodies?

Serology (Immunology)

When testing hormones in urine, which sample is collected?

First-voided morning urine

Which urine specimen gives the clearest results?

Clean-catch midstream

Which urine collection requires aseptic technique?

Clean-catch specimen

Name the three parts of urine examination.

Physical, chemical, microscopic

List two observations in physical urine exam.

Color and specific gravity (others: volume, appearance, odor)

Minimum urine volume sufficient for analysis?

25 mL

Normal specific-gravity range for random urine?

1.005–1.030

Normal specific gravity for adults with normal intake?

1.015–1.025

Volume needed for microscopic urine exam?

10–15 mL

Define urine specific gravity.

Ratio of weight of urine to equal volume of distilled water at constant temperature

What is glycosuria?

Presence of glucose in urine

List two classic symptoms of diabetes mellitus.

Polyuria and thirst (plus glycosuria)

What urine pH is considered neutral?

pH 7.0

Copper-reduction urine test screens for what?

Glucose

Leukocytes in urine usually indicate what?

Bacteriuria or urinary-tract infection

Urine UCG/HCG testing is for what condition?

Pregnancy

What federal law protects patient confidentiality?

HIPAA

Name the four elements of negligence.

Duty, derelict (breach), direct cause, damages

Define tort.

Wrongful act leading to injury of another

Defamation of character in writing is called what?

Libel

What constitutes battery in medical law?

Unprivileged touching of another person

Releasing medical records without consent is?

Invasion of privacy

What law protects volunteers rendering emergency aid?

Good Samaritan Law

Which brain region regulates body temperature?

Hypothalamus

List the four vital functions necessary for life.

Heart function, blood pressure, respiration, temperature

Normal rectal temperature range (°C)?

37.0–38.1 °C

Normal oral temperature range (°F)?

97.6–99.6 °F

Normal axillary temperature range (°C)?

35.9–37.0 °C

Normal tympanic temperature reading in °F and °C?

98.6 °F or 37 °C

Define intermittent fever.

Fever that returns to or below baseline, then rises again