Certified Clinical Medical Assistant (CCMA)

Refrigerated medications must be stored at which of the following temperature ranges?

35 to 46 F

Which of the following must be included in a MAR?

Name of the medication, any allergies, name of the prescriber, dosage of medication

Which of the following is an advantage of electronic prescriptions?

Reduces the risk of prescriptions being lost, stolen, or altered

Where can you find an advanced directive in a patient’s medical record?

Administrative data

EMR vs EHR

EMR refers to an electronic version of a patient’s medical history used within a single organization. An EHR contains the patient’s EMR but can be incorporated across more than one healthcare organization

Computerized provider order entry (CPOE)

Process in which providers enter and send treatment instructions, including medications, laboratory, and radiology orders, via a computer application rather than paper, fax, or phone

Advantages of adding a CPOE with a CDSS?

Help prevent errors of medication ordering and suggest recommendations for medication dosage, routes of administration, and frequency.

Which of the following is a type of telehealth but not telemedicine?

Continuing education for a medical assistant

A medical assistant has just opened a new multidose vial of insulin to administer to a patient. The manufacturer’s expiration date is in 2 months and it is currently July 1st. Which of the following expiration dates should the assistant write on the vial.

July 29th. Multidose vials are good for 28 days after opening.

Which software automatically checks for medication errors and interactions?

Clinical decision support system (CDSS)

The patient asks if a controlled substance can be sent electronically to a specific pharmacy close to their house. Which of the following answers should the assistant give the patient?

Yes, as long as the pharmacy is using approved and certified software, the pharmacy must use software than has been approved through a third-party audit and certified to attest the software is DEA EPCS compliant

You need to prepare a patient for an colonoscopy. Which of the following positions should the patient be in?

Left lateral

A patient needs an administration of an influenza vaccine, what needle size, angle, and site should the medical assistant select for an intramuscular (IM) injection?

22-gauge, 90 angle, deltoid muscle

Steps for electronic prescription ordering in the EHR

1. Log into the EHR

2. Selecting patient from the list in the system

3. Entering the prescription into the EMR

4. Validating the order against the patient’s medical history, health insurance plan, and other information within the system

5. System sending the order to the pharmacy

Subcutaneous insulin injection, angle and tissue type?

45, adipose

Asepsis / Sterile technique

Techniques to eliminate pathogenic and other potentially harmful microbes related to invasive procedures

Sequence for creating a sterile field

1. Disinfect the Mayo stand

2. Place the packet on the Mayo stand

3. Open the flap farthest away from the MA

4. Pull both of the sides open

5. Open the flap closest to the MA

Suture Size

Measured by the gauge or diameter, stated in terms of “0”, the more 0s, the smaller the gauge. 0 is thicker or larger than 6-0.

Hypovolemic shock

Whe na patient loses an excessive amount of body fluids or blood, can result from internal or external hemorrhaging, prolonged vomiting or diarrhea, or severe dehydration

Sprain vs strain

Sprains are caused by a stretched or torn ligamanent, strain is a stretched or torn muscle or tendon

Arterial bleeding

Most severe and urgent type of bleeding, penetrating injury, blunt trauma, damage to organs or blood vessels. High pressure, spurting. Elevate site, tourniquet needed.

Venous bleeding

Produces a steady flow of dark red blood. Similar to an arterial bleed, the site of the wound should be covered with a clean cloth or gauze, pressure should be exerted on the wound, and the area should be elevated.

Capillaries

Smallest blood vessels, and bleeding is minimal. There will be a small and steady flow of blood from the site, but it will clot on its own within minutes.

3 Phases of wound healing

1. Inflammatory phase (3-4 days): pain, swelling, loss of function, blood clots formed

2. Proliferating phase (4-21 days): fibrin threads extend across the opening of the wound and pull edges together, cells multiply to repair the wound, scab form

3. Maturation phase (21 days-2 years): tissue cells strengthen and tightening forming a scar

Dehiscence

Partial or total separation of a wound's edges

Evisceration

Separation of wound edges and protrusion of abdominal organs

Burn Degrees

1. Superficial, sunburn

2. Breaks skin, severe sunburn, hot liquids or heat, blisters

3. Damage nerves and bones, fire, charred and white

4. Muscle and bone, no feeling nerves destroyed

Durable medical equipment (DME)

Includes medical devices and supplies that can be used repeatedly outside of a hospital.

Dialysis machines, CPAP, oxygen concentrators, ventilators, prosthesis, bed equipment, mobility aids, personal care aids

What is not considered DMEPOS?

compression leggings, incontinence pads, and ramps installed in the home are not considered DMEPOS

Centers for Medicare & Medicaid Services (CMS) established a list of items that are considered DMEPOS, called the Master List

submit the necessary forms and information to the Durable Medical Equipment Medicare Administrative Contractor (DME MAC) for review

Which of the following DMEPOS require prior authorization?

CPAP machines, power wheelchairs, pressure-reducing air mattresses

Which of the following is the proper technique for removing surgical staples?

To use the sterile staple remover, place the lower tip under the staple and squeeze the handle together until completely closed. This will bend the staple in the middle and pull the edges of the staple out of the skin.

Which of the following should the medical assistant identify when assigned to check the emergency kit or crash cart?

The emergency kit is in the same, accessible area

Which of the following medical emergency situations does a patient exhibit pale and clammy skin, rapid pulse, and respirations, and the patient appears weak and becomes unresponsibe with dilated pupils?

Shock

Which of the following is the purpose of submitting a prior authorization?

To request approval from the insurance company for coverage of an item before a claim is submitted

Medical asepsis

Clean technique that includes frequent hand hygiene, proper use of gloves, cleaning and sterilizing medical equipment, and sanitizing surfaces.

Varicella (chicken pox)

Direct or indirect contact from infected droplets or airborne secretions

Viral meningitis

Direct contact, respiratory secretions, and oral-fecal route

Bacterial meningitis

Direct contact and infected droplets from respiratory tract

Conjunctivitis (pinkeye)

Direct or indirect contact with eye discharge or discharge from upper respiratory tract of infected patient

Rhinovirus (common cold)

Direct or indirect contact from airborne or respiratory secretion droplets

Strep throat

Direct contact with infected individual, respiratory secretions

Pertussis (whooping cough)

Direct contact with respiratory secretion droplets

Influenza (flu)

Direct contact with respiratory secretion droplets

Viruses

• Rhinovirus

• Varicella

• HIV/AIDS

• Hepatitis

• Coronavirus

Bacteria

• E.Coli - UTI infections

• Vibrio cholerare - cholera

• Bordetella pertussis - whooping cough

Fungi

• Histoplasmosis - lung infection

• tinea pedis

• candida albicans - yeast infection

Parasites

• toxoplasmosis

• pinworm

• tapeworm

• scabies

• lice

• Lyme disease

Cycle of infection

1. infectious agent

2. reservoir/source

3. portal of exit

4. mode of transmission

5. portal of entry to host

6. susceptible host

Which of the following affects the chance of a patient becoming a host for disease transmission?

Age

Universal precautions

Precautions that apply when it is possible that one might come into contact with human blood, tissue, body fluids or secretions, regardless of the patients' infection status.

Standard precautions

Minimum infection prevention practices that apply to all patient care, regardless of known infection status

Infectious disease regulations category I

Tasks that have a chance of body fluids or blood spilling or splashing, or tasks that can cause exposure to blood or body fluids such as a minor surgical procedure

Infectious disease regulations category II

Tasks that do not usually involve chance of exposure, such as CPR; precautions must still be taken

Infectious disease regulations category III

Tasks that do not require any PPE, such as taking a patient’s vital signs

Three types of transmission-based precautions

1. contact precautions

2. droplet precautions

3. airborne precautions

Disinfection

The process of destroying pathogens or rendering them inactive on a surface or instruments

Minimum alcohol percentage in a sanitizer?

60%

When using soap and water, which of the following is the minimum amount of time that hands should be rubbed together?

Atleast 15 seconds

Sanitization

The cleaning process that reduces the number of micro-organisms to a safe level

is the cleaning process that is often the first step in assuring that medical equipment and instruments are as clean as possible

Helps to remove debris such as body fluids and blood that is present on the instruments and equipment

Ultrasonic or soaked in detergent and rinsed

Types of disinfectants

Alcohol: Intermediate

Chlorine (Chlorinated compounds): Low or Intermediate

Iodophores: Low

Phenols: Low or Intermediate

Quaternary ammonium (Quats): Low or Intermediate

Three levels of disinfectants

Low-Level: kills most bacteria and some viruses and fungi, exam tables and countertops, hydrogen peroxide

Intermediate-Level: kills bacteria and most viruses and fungi but not spores, instruments, isopropyl alcohol

High-Level: all microorganisms except a small number of bacterial spores, endoscopes, cidex OPA

What is mandatory on an SDS?

First aid measures, handling and storage, composition + ingredients

What temperature does an autoclave have to reach to sterilize?

250 - 270 F, RECOMMENDED TEMP IS 250

How long are sterilized items considered sterile?

30 days

What needs to be completed prior to sterilization?

Disinfection and sanitization

Biohazard waste bag

Items contaminated with blood/bodily fluids such as gloves, gauze, and dressi

Biohazard waste box

Items contaminated with blood/bodily fluids such as table covers and disposable gowns

Biohazard sharps container

Needles, lancets, and sharp objects

Engineering controls

Devices used to isolate or remove the bloodborne pathogen hazard from the workplace. 

Needles with safety devices, sharps disposable containers, and needle-less systems

Workplace controls

Practices in the workplace that reduce the chances of exposure by changing or mandating the way a task is performed. 

Handwashing procedures, disposal of sharps, and packaging lab specimens

Which of the following are when an exposure control plan should be reviewed with an employee?

Upon hire + annually

How long should an unwrapped item be sterilized in an autoclave?

20 minutes

When can a sterilized package be used?

If the package has been stored in a cool, dry area and does not show watermarks

How often should the exposure control plan be updated if there are no changes?

Annually

Which of the following is the first step a medical assistant should take after exposure to blood?

Wash the area with soap and water

OSHA regulations require employers to make which of the following vaccines available at no cost to healthcare workers?

Hepatitis B

Which of the following precautions should a medical assistant consider when a person is coughing or sneezing?

Droplet precautions

Which of the following is a common symptom of contracting an infectious disease?

Headache

When using chemical sterilization, how long does instruments need to be submerged to be considered sterilized?

8 hours

What is the goal of surgical asepsis?

To eliminate pathogenic micro-organisms

How long should the MA rub their hands vigorously with soap?

15 to 20 seconds

A healthcare worker is not feelign well and has a fever. In which of the following scenarios can the healthcare worker resume caring for patients?

After being fever-free for 24 hours without the help of fever-reducing medications

In which of the following scernarios should a medical assistant use medical aseptic techniques?

Washing hands prior to and after each patient encounter

Clinical laboratory improvement amendments (CLIA)

A 1988 amendment that regulates federal standards that apply to all clinical laboratory testing performed on humans in the United States

What must be included on a specimen container label?

Patient’s name, DOB, date and time of collection, MA initials

Human chorionic gonadotropic (hCG)

Hormone secreted by the placenta during pregnancy

Analytes

A substance or chemical that is being identified and measured

Excreted in the urine

Hemoglobin

O2 carying protein in blood, finger stick capillary puncture

Hematocrit spun

Helicobacter pylori

Type of bacteria that infects the digestive tract

Testing with whole blood

Mononucleosis

Contagious virus that is spread through saliva, also known as mono, most commonly caused by the Epstein-Barr virus

Capillary blood sample

Quantitiative blood test?

Glucose level - related to measuring the amount of something

Qualitiative blood test?

Influenza - Identifying or measuring by the quality of something rather than its quantity

Quality control

Included in quality assurance but is more specific; it is related to test reliability and accuracy while attempting to uncover errors and eliminate them.

Reviewing the expiration date of urine reagent strips

checking the temperature of the laboratory refrigerator and documenting it on a log

Quality assurance

comprehensive and relates to policies and procedures that must be implemented for the reliability of test results

policies related to rotating stock to put the newest containers in the back of the storage area is a quality assurance measure

The policy of checking the temperature and maintaining it between 2° C and 8° C (35° F and 46° F)

Which of the following category of tests is most often offered in a laboratory at a provider’s office?

Waived

Which of the following number of antiseptic wipes will be provided for a female patient when instructing them to obtain a clean catch, midstream urine specimen?

Three

How should the MA prepare a blood sample for transport to an outside lab?

Prepare it for transport in the proper container for that type of specimen, according to OSHA regulations. Place the container in a clear plastic bag with a zip closure and dual pockets, with the international biohazard label imprinted in red or orange. The requisition form should be placed in the outside pocket of the bag.

The laboratory courier cannot pick up the patient’s urine sample for another 4 hr. Which of the following methods will ensure specimen preservation?

Storing the urine in the refrigerator

Critical value

Laboratory results at such variance to the normal value range that a potentially life-threatening, pathophysiologic state is occurring. Action must be taken as soon as possible.