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NHA CCMA(Certification Study Guide) 2024 Questions
and Verified Answers
CC - Answer Chief Complaint Segment - Answer Line between two wave forms P-wave - Answer Atrial Depolarization How many 1mm boxes are in a 6 second Rythm strip? - Answer 30 one millimeter boxes The SA node represents which waveform on the ekg? - Answer Only the P-wave What is the reading you can get from the RR interval? - Answer Ventricular Pulse What is the primary stage of Hemolisis? - Answer Vascular phase and platelet phase together What is Electophoresis? - Answer Analyzation of the chemical components of blood e.g. hemoglobin, serum, urinem cerebrospinal fluid based on electrical charge. Positive testing for occult blood in a stool sample turn which color? - Answer Turns Blue on a positive test for occult blood in feces. The stages of Hemostasis: - Answer 1. Vascular 2. Platelet Phase 3. Coagulation Phase 4. Fibronolysis Blood Vessels - Answer Aorta, arteries, arterioles, capillaries, venues, veins, superior and inferior vena cavae. Outer connective tissue layer of a blood vessel - Answer Tunica adventitia Inner endothelial tissue layer of a blood vessel - Answer Tunica Intima The inner smooth layer of a blood vessel - Answer Tunica media The standards of right and wrong in a medical setting - Answer Code of Ethics What do you find in capillaries? - Answer A mixture of venous and arterial blood is found The average adult has how many liters of blood? - Answer 5-6 liters What is the percentage of water in blood? - Answer 92%
Percentage of plasma in blood - Answer 55% Percentage of Formed Elements in the blood - Answer 45% 99% of formed elements in blood - Answer RBC's or Erythrocytes Where you find Hemoglobin - Answer RBC's Where do all blood cells originate? - Answer Bone Marrow How many RBC's per microliter of blood - Answer 4.2-6.2 million What is the second most numerous WBC? - Answer Lymphocyte with 20-40% Their numbers increase in intracellular infections and TB - Answer Monocytes Their numbers increase in bacterial infections and often are first on scene - Answer Neutrophils These WBC's play an important role in viral infection as well as in immunity. - Answer Lymphocytes Number of leukocytes for average adult per micrometer - Answer 5000- 10000 Leukopenia - Answer Decrease in WBC's seen with viral infection and leukemia Comprises 3-8% of wbc or leukocytes - Answer Monocytes Largest in size of the leukocytes - Answer Monocytes Carries Histamine - Answer Basophil Injury to a blood vessel that causes it to constrict, slowing the clot of blood - Answer Cascular phase of hemostasis Preferred site for venipuncture - Answer Antecubital fossa Test used to evaluate the intrinsic pathway and monitor heparin therapy - Answer APTT also know as PTT Test used to evaluate the extrinsic pathway and also used to monitor warfarin therapy - Answer PT Fibrinolysis - Answer Breakdown and removal of a clot Converts the temorary platelet plug into a stable fibrin clot - Answer Coagulation phase
Common tests for the lifht blue sodium citrate tube - Answer Coagulation studies, PT (extrinsic, warfarin) APTT, PTT (intrinsic, heparin) TT, BT, FDP Common tests for the lavendar edta tube - Answer CBC, differential or diff., ESR, sickle cell screening Common tests for this color tube are chemistry tests performed on plasuma such as Ammonia, carboxyhemoglobin and STAT electrolytes - Answer Green top tube (heparin) Tests How long does it take for blood to clot by normal coagulation process in the red top tube? - Answer 30-60 mins The primary purpose is to provide reliable data about a patients health status by ensuring the accuracy of a test while detecting and eliminating error - Answer What is quality control Common test for the red topped tube - Answer Serum chemistry tests, serology tests, blood bank (glass only) Order of draw for cappilary specimens - Answer lavender first, then tubes with other additives, then tubes with out additives Antiseptic not used on a dermal puncture site - Answer Betadine (because it interferes with several tests like bilirubin, uric acid, phosphorus and potassium For which procedure would you warm the site for a minimum of 3-4 minutes to increase blood flow? - Answer dermal punctures (heel sticks) Which are the preferred sites for dermal punctures - Answer the distal segment of the third or fourth finger of the non-dominant hand heel sticks are performed on which patients? - Answer infants less than 1 year old Where on the foot is the dermal puncture made on patients less than a year old - Answer the medial and lateral areas of the plantar surface of the foot dermal puncture is made in - Answer the fleshy portion of the finger slightly to the side of the center perpendicular to the lines of the fingerprints What will occur if you puncture the heel too deep? more than 2 mm - Answer osteomyalitis What are the identification requirements for blood bank - Answer Pt's full name and DOB, hospital id # or ssn for outpatient, date and time of collection as well as the phlebotomist's initials
This section of the lab uses serum to analyze the presence - Answer Serology (immunology) Section When checking for hormones in urine when do you collect the urine sample - Answer first voiding in the morning Which urine specimen provides the clearest, most accurate results? - Answer Clean catch midstream specimen Which urine sample requires aseptic technique? - Answer Clean catch specimen Examination of urine consists of - Answer physical, chemical, microscopic Physical examination of urine consists of - Answer colume (adequate for testing, observing color and appearance, odor, specific gravity What amount of urine must you have to be sufficient for analysis? - Answer 25ml What is the normal range of specific gravity of random collection - Answer 1.005-1. normal range of specific gravity of urine in adults with normal diet and fluid intake - Answer 1.015-1. Microscopic examination of urine requires this amount - Answer 10-15ml Urine Specific gravity - Answer The ratio of weight of a given colume of urine to the weight of the same volume of distilled water at a constant temperature Glycosuria - Answer presence of glucose in the urine Symptoms of patients with diabetes mellitus - Answer glycosuria, polyuria, and thirst A urine pH of what is considered neutral? - Answer 7.0 pH the copper reaction test is used for what? - Answer screening for glucose in urine The presence of leukocytes in urine is an indicator for what? - Answer bacteruria or UTI Urine Screening for UCG or HCG - Answer Pregnancy Test HIPPA is for? - Answer Patient Confidentiality The four elements of Negligence - Answer Duty, duty of care, derelict= breach of duty of care, direct cause, damage
Explain blood pressure - Answer measurement of amount of force blood excertes on peripheral artery walls BP cuffs too short and narrow can give false reading of what? - Answer Hypertension Taking BP hearing two consecutive beats gives which reading - Answer Systolic Patient laying on back with knees flexed, soles of feet on bed - Answer Dorsal recumbant This position is used to promote drainage or ease of breathing - Answer Fowler's This position is used for examination of the pelvic organs - Answer Dorsal Lithotomy Prone position is used for - Answer used to examine back and spine patient lays on his/her stomach with head turned to one side for comfort - Answer prone position Patient in on left side with the right knee flexed against abdomen - Answer Sim's position Patients with leg injuries or arthritis can not assume this position - Answer Sim's position This position is usually used for taking rectal temperature - Answer Sim's position This position is usually used for rectal or vaginal examination - Answer Knee Chest This position is used for surgical procedures of pelvic abdomen and also for shock treatment - Answer Trendelenburg Never leave the patient alone in the room when he/she is in this position - Answer Knee Chest This position is used for surgical procedures of pelvic and abdomen and also for shock treatment - Answer Trendelenburg If skin or eyes come in contact with chemicals wash area with water for? - Answer 5 minutes MSDS - Answer Material Safety Data Sheet What are the symptoms of shock - Answer plale cold clammy skin, blank stare, rapid weak pulse, fast shallow breathing
First aid for shock - Answer Open airway, call assistance, position head lower, control bleed if any, keep warm Modes of transmission - Answer contact (direct or indirect) droplet, airborne, common vehicle, vector What is the least expensive and most available disinfectant for surfaces - Answer 1: bleach solution Define surgical asepsis - Answer All microbial life, pathogen and non pathogens are destroyed What is used at 250-254F, 15 pounds of pressure for 20- 40 minutes - Answer Autoclave Used for instruments that easily corrode - Answer dry heat sterilization What is the most important means of preventing the spread of infections? - Answer Handwashing PPE includes? - Answer mask, goggles, face shields, respirator What defines standard precautions? - Answer All patients are presumed to be infective for blood borne pathogens This is an infection control method designed to prevent direct contact with blood or other body fluids - Answer Standard precautions This replaces universal precautions and body substance isolation - Answer Standard precautions Don gloves, face shields if danger of splashing, dispose of all needles with out recappiong into the sharps container - Answer Standard Precautions This is the second tier of precautions used when patient is contagious - Answer Transmission based precautions Define contact precautions - Answer Reducing the risk of transmission of microorganisms direct or indirect Special air handling and ventilation are required to prevent - Answer Airborne diseases under Airborne Precautions This is an emerging and important problem in the health care field - Answer Latex Sensitivity
The av valves - Answer Tricuspid and Mitral (bicuspid ) valves The Semilunar valves - Answer Aortic and pulmonic Valve located between the left atrium and the left ventricle - Answer Mitral or bicuspid Valve lovated between the right ventricle and the pulmonary trunk - Answer pulmonic valve heart sounds produced by closure of the valves - Answer murmors caused by diseases of the valves or other structural abnormalities - Answer Murmors First heart sound due to the closure of the mitral and tricuspid valves - Answer S1 in the upper chambers or the atria S2 in the ventricles - Answer second heart sound due to the closure of the aortic and pulmonic valves arteries supplying the heart - Answer right and left coronary from the aorta Arteries supplying the heart - Answer right and left coronary from the aorta The ans or autonomic nervous system is subdvided into - Answer sympathetic and parasympathetic nervous system The SP or sympathetic nervous system affects - Answer both, the atria and the ventricles by increasing heart rate conduction and irritability The pns or parasympathetic nervous system affects - Answer atria only by decreasing heart rate, conduction and irritability Automaticity - Answer ability of the cardiac cells to initiate own electrical impulses without outside stimulation Excitability or irritability - Answer ability of cardiac cells to respond to external stimulus Contractility - Answer ability of cardiac cells to shorten (muscle contraction) in response to electrical stimulus Digitalis, dopamine, epinephrine - Answer Drugs that increase the contractility of the heart Results in myocardial relaxation - Answer repolarization
Consists of anterior, middle and posterior divisions that distribute electrical impulses by SA to AV node - Answer Internodal pathway This fires at 20-40 bpm - Answer Purkinje fibers limb leads consist of - Answer 3 bipolar and 3 augmented leads These record electrical potentials in the frontal plane - Answer Lead I, Lead II, Lead III and the chest leads On Lead III, which is the positive lead - Answer the left leg is positive Which limb is always the ground - Answer right leg Waveform - Answer movement away from the isoelectric line either positive or negative Interval - Answer waveform plus a segment Complex - Answer Several waveforms The normal P wave in standard and precordial leads does not exceed - Answer 0.11s in duration or 2.5 mm in height The vertical axis on the ekg paper measures - Answer Amplitude or voltage J (RST) junction - Answer point at which QRS complex ends and the ST segment begins ST segment - Answer from J point to the onset of the T wave Normal indication for a stress test - Answer Evaluation of a patient withchest pain and a normal ekg, arrythmia, monitoring a pt, with a recent MI The percentage of the target heart rate during a stress test that makes it valid - Answer 85% Hematocrite is made up of - Answer hemoglobin x 3 Define hematocrit - Answer The percentage by colume of packed red blood cells in a given sample of blood after centrifugation Opposite of anemia - Answer polycythemia When taking a pharmacologic stress test, it is concluded when - Answer 85% of the target rate is achieved
What is the most important task of a phlebotomist - Answer patient ID With the bevel upward insert the needle at which angle? - Answer 15-30 degrees Prandial - Answer Fasting What is important to do first after dermal puncture? - Answer Wipe away the first drop Timed specimens - Answer Hormone levels, blood levels of medications, monitor PT condition E.G. Hemoglobin level *internal bleeding ) While administering a OGTT it is important to take what with each sample - Answer Urine Sample When are OGTT scheduled to begin? - Answer 0700- 0900 7 - 9am The two hour postprandial test is used for? - Answer evaluation of diabetes mellitus The OGTT test is used for? - Answer Diagnosing diabetis mellitius and evaluating patients with frequent low blood sugar The 3 hour OGTT is used to test for - Answer To test for hyperglycemia The 5 hour OGTT is used for - Answer To test for hypoglycemia, for disorders of carbohydrate metaolism PKU - Answer Tests for babies and to detect phenylketouria, a genetic disease that causes mental retardation and brain damage Cold Agglutinins - Answer Antibodies produced in response to atypical pneumonia must be kept at 37c ABG, AMMONIA, lactic acid, pyruvate, parathyroid test handling - Answer Chilled in crushed ice and water mixture Billi - Answer Bile Which blood tests can NOT be done using dermal puncture - Answer ESR, BC You have the right to caring staff who believe your reports of pain - Answer Example of the patient bill of rights for pain management Method of taking pulse used on children and patient with irregular heartbeat - Answer Apical pulse Orthopenia - Answer Difficulty breathing when laying flat
Define Cheyne- Stokes - Answer Regular pattern of irregular breathing rate Medical Assistant role in the physical examination - Answer Room prep, patient prep, assisting the doctor Hazards - Answer Physical, chemical , biological This technique is not permitted in the lab - Answer Never draw a pipette by mouth Expresionless face and staring eyes are indications of - Answer Shock Agents are - Answer Any infective microorganisms, viruses,fungi, bacteria, and parasites Define common vehicle - Answer Water, food, drinking from the same glass, kissing What fires at 40-60 bpm - Answer AV junction, bundle of HIS Which are unipolar leads? - Answer aVR, aVL, aVF Whhich test is used to evaluate primary hemostasis - Answer Bleeding time test How long is the lifespan of a platelet? - Answer 9-12 days When the vaccutainer method can not be used you would use - Answer 10-12ml Syringes Which tube nmust be filled completely? - Answer Light Blue sodium citrate tube to maintain a ratio of 9:
