Written to NHA's CCMA test plan
- Foundational Knowledge and Basic Science 10%
- Anatomy and Physiology 5.3%
- Clinical Patient Care 56%
- Patient Care Coordination and Education 8%
- Administrative Assisting 8%
- Communication and Customer Service 8%
- Medical Law and Ethics 4.7%
Free · 2026 · 56% of the NHA CCMA CCMA Clinical Patient Care practice questions
Clinical Patient Care is 56% of the NHA CCMA. Answer 10 questions (6 on Clinical Patient Care) and see your score by domain, with every answer explained. Free, no sign-up.
A provider orders a CBC, a plasma chemistry panel and a serum test on an adult. Because the patient's veins are poor, the medical assistant collects all three by fingerstick into microcollection tubes: lavender (EDTA), green (lithium heparin) and red (serum). In what order should the tubes be filled?
Tap an answer, or press A to D
Intake and vital signs, exam room procedures, infection control, point-of-care testing, phlebotomy and EKG. More than half the exam.
What the NHA CCMA exam tests in Clinical Patient Care
- 3A Patient intake and vitals (14 of 84 items): patient identifiers; medical/surgical/family/social history; screenings (tobacco, alcohol, HIV, depression/anxiety, mini-mental state); BP methods, normal/abnormal values and common errors; orthostatics; pulse sites and rhythms; respiratory rate and abnormal patterns; pulse oximetry; temperature sites and ranges; pain scale; LMP; factors affecting vitals; conversions (height, weight, temperature); height/weight/BMI/circumference; pediatric measurements and growth charts
- 3B General patient care (28 of 84 items): exam room prep; sterile field and sterile technique; positioning and draping; instruments and supplies for general and specialty exams; pre/post-procedure instruction; immunization schedules, registries and adverse-event reporting; allergies and anaphylaxis response; oral and injectable dosage calculations; non-parenteral and parenteral (non-IV) administration, needle angle/gauge/length and injection sites; injection and medication logs; eye and ear irrigation and medications; suture and staple removal; wound types, care and infection signs; minor surgery assisting; emergencies (diabetic shock, heat stroke, choking, syncope, seizure), crash cart, CPR/BLS/AED; prescription and refill rules and e-prescribing; prior authorization; DME ordering; EHR/EMR use and CPOE; telehealth visits
- 3C Infection control and safety (15 of 84 items): pathogens and microorganisms; chain of infection and transmission; CDC guidance and reporting; OSHA bloodborne pathogens standard and exposure control plan; standard and universal precautions; PPE donning/doffing; hand hygiene and alcohol rubs; sanitization vs disinfection vs sterilization (autoclave); medical vs surgical asepsis; order of cleaning; Safety Data Sheets and chemical cautions; biohazard and sharps disposal; post-exposure steps and eyewash; equipment and temperature logs
- 3D Point-of-care testing and lab procedures (9 of 84 items): non-blood specimen collection (urine, stool, cultures, sputum); CLIA-waived testing and regulations; internal and external quality control; normal vs abnormal results; requisition contents; specimen labeling, handling, transport and chain of custody; pre- and post-analytical errors; vision and hearing tests; scratch and intradermal allergy testing; spirometry and peak flow
- 3E Phlebotomy (12 of 84 items): blood components (whole blood, serum, plasma); patient prep (fasting, medications, basal state, positioning); special patient needs and restraints; site selection and contraindications; tube types, additives, inversions and fill ratios; order of draw for venipuncture and for capillary microtubes; evacuated tube, syringe and butterfly methods; needle insertion and removal; bandaging and allergies; special collections (timed, drug levels, blood cultures, fasting); centrifuging and aliquoting; light/temperature-sensitive handling; labeling, processing and transport to reference labs; critical values
- 3F EKG and cardiovascular testing (6 of 84 items): patient prep, positioning and draping; limb and chest (12-lead) electrode placement; minimizing and recognizing artifacts (somatic tremor, wandering baseline, 60-cycle interference); supplies and calibration; waveforms, intervals and segments; recognizing abnormal or emergent rhythms vs artifact; signs of distress during testing; Holter, event monitor and stress test assisting; transmitting results
High-yield clinical patient care facts
- 3A Intake: identify every patient with 2 identifiers (full name + DOB), never by room number. Take the chief complaint in the patient's own words. History: medical, surgical, family (heredity), social (tobacco, alcohol, drugs, occupation, sexual history), medications including OTC and supplements, and allergies with the reaction.
- 3A Screenings: tobacco use (pack-years = packs per day x years), alcohol (AUDIT-C), depression (PHQ-2/PHQ-9), anxiety (GAD-7), HIV, cognition (Mini-Mental State Exam or Mini-Cog), fall risk. Record the first day of the LMP.
- 3A BP technique: patient seated 5 min, back supported, feet flat, legs uncrossed, bare arm supported at heart level. No caffeine, exercise or smoking for 30 min. The cuff bladder should cover about 80% of arm circumference.
- 3A BP method: palpate to estimate systolic, then inflate 20-30 mmHg above it to avoid missing an auscultatory gap. Deflate 2-3 mmHg/s. Systolic = first Korotkoff sound (phase I); diastolic = when sounds disappear (phase V).
- 3A Orthostatic vitals: measure lying, then sitting, then standing (about 1 and 3 min). Positive = systolic drop of 20 mmHg or more, or diastolic drop of 10 mmHg or more. Guard against falls.
- 3A Respirations: count without the patient knowing (keep fingers on the pulse) for 30 s x 2, or a full 60 s if irregular. 1 respiration = 1 inhale + 1 exhale.
| Measure | Normal |
|---|---|
| Oral temperature | about 97.6-99.6 °F (36.4-37.5 °C); rectal and tympanic about 1 °F higher, axillary about 1 °F lower |
| Pulse | 60-100 bpm |
| Respirations | 12-20/min |
| SpO2 | 95-100% |
| Blood pressure | under 120/80 |
The full CCMA High-Yield Cram Sheet comes with full prep.
Common clinical patient care traps
- Cuff too small reads high; too large reads low.
- Rectal and tympanic run higher than oral; axillary runs lower.
- Adult ear: pinna up and back; child under 3: down and back (same for tympanic temperature and ear drops).
- Orthostatic sequence is lying, then sitting, then standing.
- Count respirations without telling the patient.
- Intradermal angle is 10-15° (not 45°); TB test is read by induration, not redness.
- Infant IM site is the vastus lateralis, not the deltoid or dorsogluteal.
- A higher gauge number means a thinner needle.
Free CCMA clinical patient care practice questions
Question 1
A patient arrives with a three-week productive cough, night sweats, and weight loss, and the provider suspects pulmonary tuberculosis. Which respiratory protection should the medical assistant wear when entering the patient's room?
- AA fit-tested N95 respirator
- BA standard surgical face mask
- CA face shield with no mask
- DA gown and gloves with no mask
Show answer and explanation
Answer: A. TB spreads by airborne droplet nuclei, so airborne precautions require a fit-tested N95 or higher-level respirator for staff.
Why not B: A surgical mask is used for droplet precautions, as with influenza. It does not filter airborne TB particles adequately for staff.
Why not C: A face shield protects against splashes only. It provides no filtration of inhaled particles.
Why not D: A gown and gloves are contact precautions. They do not protect against an airborne pathogen.
Remember: Suspected TB, measles, and varicella need airborne precautions, with a fit-tested N95 respirator for staff and a surgical mask on the patient.
Question 2
After a minor skin procedure, a medical assistant collects reusable hemostats and scissors that have dried blood in the hinges. The instruments are due to be autoclaved. What should the medical assistant do first?
- AWipe the instruments with an alcohol pad and return them to the procedure drawer
- BWrap the instruments in autoclave paper and run them through a sterilization cycle immediately
- CDiscard the instruments in the sharps container because they contacted blood
- DWear utility gloves, scrub the instruments with detergent and a brush to remove all debris, then rinse and dry them
Show answer and explanation
Answer: D. Sanitization, which means removing visible debris, must come first. Disinfection or sterilization can only work on clean surfaces.
Why not A: Alcohol does not remove dried debris and does not sterilize. Critical instruments must be sterilized before reuse.
Why not B: Dried blood and debris shield microorganisms from steam, so instruments must be cleaned before they are sterilized.
Why not C: Reusable instruments are cleaned and reprocessed, not discarded. Sharps containers are for disposable sharps.
Remember: Always sanitize (physically clean) instruments before disinfecting or sterilizing them, because debris prevents the sterilant from reaching microorganisms.
Question 3
A patient tells the medical assistant she had a left mastectomy with lymph node removal 3 years ago. Both arms have visible antecubital veins, and there are no other restrictions. Which site is most appropriate for venipuncture?
- ALeft hand dorsal veins, to avoid the antecubital area
- BRight median cubital vein
- CLeft median cubital vein, because the surgery has healed
- DLeft basilic vein, using a butterfly needle
Show answer and explanation
Answer: B. Use the arm opposite the mastectomy. The median cubital vein is the first choice because it is large, well anchored and less painful.
Why not A: Any site on the arm of the mastectomy side is restricted, not only the antecubital area.
Why not C: The risk of lymphedema and infection on the affected side persists after healing, so that arm should be avoided without a provider's order.
Why not D: A smaller needle does not remove the lymphedema risk on the affected side, and the basilic vein is near the brachial artery and a nerve.
Remember: Avoid drawing blood on the side of a mastectomy and use the opposite arm, starting with the median cubital vein.
Question 4
A reference laboratory calls the clinic to report a critical potassium result of 6.9 mEq/L for a patient seen that morning. What is the medical assistant's best action?
- ACall the patient right away and tell them to go to the emergency department
- BFile the result in the EHR for the provider to review at the end of the day
- CWrite down the result, read it back to the caller, and notify the provider immediately
- DAsk the lab to fax the result and wait for the paper copy before acting
Show answer and explanation
Answer: C. Reading back confirms accuracy, and the provider must be told at once so they can act. The call and notification are then documented.
Why not A: Interpreting results and directing treatment is the provider's role. The MA must not give clinical advice on their own.
Why not B: Critical values may be life-threatening. They cannot wait for routine end-of-day review.
Why not D: Waiting for a faxed copy delays urgent care. Verbal critical results are confirmed by read-back and acted on immediately.
Remember: Critical values are read back to confirm, reported to the provider immediately, and documented with time and names.
Question 5
At the start of the day, a medical assistant checks the vaccine refrigerator and the log shows a current reading of 11°C (52°F). What is the most appropriate action?
- ADiscard all vaccines in the unit immediately and reorder stock
- BMove the vaccines to the freezer until the refrigerator cools down
- CLabel the vaccines "Do Not Use," store them at proper temperature, and notify the vaccine coordinator
- DLower the thermostat setting and continue giving vaccines as usual
Show answer and explanation
Answer: C. The safe range is 2–8°C (36–46°F). Out-of-range vaccines are quarantined and labeled, kept refrigerated, and the excursion is documented and reported so the manufacturer or immunization program can determine viability.
Why not A: CDC advises against discarding vaccines before the manufacturer or immunization program confirms whether they are still usable.
Why not B: Freezing can destroy many refrigerated vaccines. Moving them to the freezer turns a warm excursion into a cold one.
Why not D: Adjusting the unit does not resolve possible vaccine damage. Using the vaccines without consultation risks giving ineffective doses.
Remember: Keep refrigerated vaccines at 2–8°C (36–46°F); after an excursion, quarantine them as "Do Not Use," document it, and get guidance before discarding or using them.
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