NHA CCMA practice questions by exam domain

CCMA items are mostly short scenarios: a patient does or says something, and you choose what the medical assistant should do. The 17 questions below are quoted word for word from the free NHA CCMA exam prep course, which has 20 units, 159 chapters and 2,272 study cards, built on the 2022 NHA CCMA test plan. They are grouped by test-plan domain, in proportion to the weights in what is on the NHA CCMA exam, so you can see where you are weak. Commit to a letter before you read why. Encodr is a study aid, not clinical guidance; the provider, facility policy, state law and your training decide practice.

Domain 1: Foundational Knowledge and Basic Science (15 items)

1. A patient asks the MA whether her lab result is normal. The provider has not reviewed it yet. What should the MA do?

A) Say it looks normal against the reference range B) Read the value aloud and explain what it means C) Tell her to repeat the test if she feels worse D) Tell her the provider will review it with her

Answer: D. The MA records and reports results; the provider interprets them and discusses them with the patient.

2. A patient calls asking for a refill of a Schedule II opioid prescription. Which statement is accurate?

A) Schedule II prescriptions cannot be refilled B) It can be refilled up to 5 times in 6 months C) It can be refilled once within 30 days D) It can be refilled if the pharmacist agrees

Answer: A. Schedule II prescriptions cannot be refilled; the MA routes the request to the provider for a new prescription. The schedules are the same ones in DEA controlled substance schedules for the PTCE.

Domain 2: Anatomy and Physiology (8 items)

3. A patient points to pain in the right upper quadrant. Which organs lie in that quadrant?

A) Spleen and stomach B) Liver and gallbladder C) Appendix and cecum D) Bladder and pelvic organs

Answer: B. The liver and gallbladder lie in the right upper quadrant (right hypochondriac region).

Domain 3A: Patient Intake and Vitals (14 items)

4. A reading is 128/84. Under the ACC/AHA guideline, which category applies?

A) Elevated blood pressure B) Stage 1 hypertension C) Normal blood pressure D) Stage 2 hypertension

Answer: B. When the two numbers fall in different categories, use the higher one: 84 is in the 80-89 stage 1 band. All four categories: blood pressure categories explained.

Domain 3B: General Patient Care (28 items)

5. Minutes after an ordered vaccine, a patient reports throat tightness and begins to wheeze. What should the MA do first?

A) Give oral diphenhydramine and wait B) Have the patient walk to cool off C) Alert the provider and call 911 D) Book a follow-up visit for tomorrow

Answer: C. First response: alert the provider and call EMS, then epinephrine is given per provider order or standing order without delay. Who may give it depends on state law and office protocol.

6. Before injecting an ordered IM vaccine, should the MA aspirate?

A) Yes, for 5-10 seconds every time B) Yes, but only in the deltoid C) Only for subcutaneous vaccines D) No, CDC says it is not needed

Answer: D. The recommended sites have no large blood vessels, and aspiration may increase pain. Sites, angles and gauges: injection angles, needle gauges and sites.

7. A worker who was outdoors in the heat is now confused with slurred speech, and his skin is still sweaty. Which condition is most likely?

A) Heat exhaustion B) Heat cramps C) Heat stroke D) Heat syncope

Answer: C. Altered mental status separates heat stroke from heat exhaustion, and heat stroke patients can still be sweating heavily. It is a 911 emergency.

Domain 3C: Infection Control and Safety (15 items)

8. The medical assistant has just examined a patient with suspected C. difficile. Which hand hygiene method should be used?

A) Rub with alcohol sanitizer until dry B) Wash with soap and water C) Rub sanitizer in, then wipe with a towel D) Change gloves and skip hand hygiene

Answer: B. Spores must be physically washed off, so soap and water is used for C. difficile.

9. A patient with measles left the exam room an hour ago, yet the virus can still infect the next person who enters. Which mode of transmission explains this?

A) Droplet B) Direct contact C) Airborne D) Vectorborne

Answer: C. Airborne droplet nuclei stay suspended and travel far, so measles can linger after the patient leaves. The six links: the chain of infection and medical asepsis.

Domain 3D: Point of Care Testing and Laboratory Procedures (9 items)

10. An office changes the steps of a waived test to save time. Under CLIA, how is the modified test categorized?

A) Still waived B) Moderate complexity C) High complexity D) Provider-performed microscopy

Answer: C. A modified waived test becomes high complexity and can no longer be run under a Certificate of Waiver. More in CLIA-waived tests for medical assistants.

Domain 3E: Phlebotomy (12 items)

11. The provider orders a CBC, a PT/INR and a chemistry panel in a gold SST. In what order should the MA draw them with a straight needle?

A) Light blue, gold, lavender B) Lavender, light blue, gold C) Gold, light blue, lavender D) Light blue, lavender, gold

Answer: A. CLSI order: citrate, then serum, then EDTA. The full sequence is in the order of draw, explained, and the order of draw quiz drills it.

12. Which is the best way for the MA to identify a patient before a blood draw?

A) Say the patient's name and ask them to confirm it B) Check the room number against the requisition C) Ask the patient to state only a first name D) Have the patient state full name and birth date

Answer: D. Use two identifiers and ask an open question so the patient states the information, then match it to the requisition.

Domain 3F: EKG and Cardiovascular Testing (6 items)

13. The tracing suddenly looks like a chaotic ventricular rhythm, but the patient is alert, talking and has a normal pulse. What should the MA suspect first?

A) Artifact B) Ventricular fibrillation C) Asystole D) Atrial flutter

Answer: A. Always check the patient first. When an alarming strip does not match an alert patient with a normal pulse, suspect artifact, then check the connections and repeat the tracing. Artifact causes: 12-lead EKG electrode placement.

Domain 4: Patient Care Coordination and Education (12 items)

14. During teach-back, a patient describes the dosing schedule incorrectly. What should the MA do next?

A) Repeat the same words more loudly B) Explain it a different way, then recheck C) Chart the patient as noncompliant D) Hand over the leaflet and then end the visit

Answer: B. AHRQ: if teach-back shows a misunderstanding, explain again using a different approach and ask the patient to teach back again.

Domain 5: Administrative Assisting (12 items)

15. The allowed amount for a visit is $100, the deductible is met and coinsurance is 20%. What does the patient pay?

A) $0 B) $20 C) $80 D) $100

Answer: B. 20% of $100 is $20 for the patient; the plan pays $80.

Domain 6: Communication and Customer Service (12 items)

16. A Spanish-speaking patient arrives with her 10-year-old son, who offers to interpret. It is not an emergency. What should the MA do?

A) Let the son interpret since he is fluent B) Ask a bilingual coworker who has no training C) Use a qualified phone or video interpreter D) Ask the patient to return with an adult

Answer: C. 45 CFR 92.201 bars relying on a minor child except briefly in an imminent-threat emergency; telephone or video interpreter services are acceptable.

Domain 7: Medical Law and Ethics (7 items)

17. The provider refers a patient to a cardiologist, and the MA is asked to send the relevant records. What does HIPAA require first?

A) No authorization, since this is for treatment B) A signed authorization from the patient C) A court order naming the cardiologist D) Written approval from the office privacy officer

Answer: A. A covered entity may use and disclose PHI for treatment, payment and health care operations without the patient's authorization. More in HIPAA and patient consent for medical assistants.

What to do with your score

Count by domain. Two missed phlebotomy questions matter more than one missed anatomy question: phlebotomy is 12 scored items, anatomy is 8. Notice the pattern in the correct answers: verify the patient, follow the protocol, document, and route interpretation to the provider. The wrong options are usually the MA diagnosing, reassuring without basis, acting outside scope, or waiting.

Come back to the ones you missed in a few days, not tomorrow. Retrieving after a delay is the testing effect in practice, and a scheduler that spaces the misses is the point of spaced repetition. For where these fit in an 8-week run-up, see how to study for the NHA CCMA exam; for how the real exam reports by domain, see the CCMA passing score and score report, explained.

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