NHA CCMA Practice Questions and Answers

Answer: A. The appointment is scheduled for the morning to accommodate fasting requirements

Patients usually fast 8 to 12 hours before a fasting draw, and an early morning slot lets most of that fast happen overnight. An end-of-day slot forces the patient to skip food all day, raising the chance they eat and void the test. A lunch-hour time has the same problem and is chosen for lab convenience, not the patient. Fasting does matter, since recent meals raise glucose and triglycerides.

Source: NHA CCMA Test Plan 2022 — Section 5: Administrative Assisting

Answer: D. Compile clinical documentation and submit the prior authorization request

The assistant gathers the order, diagnosis codes, and supporting chart notes, submits the authorization request to the payer, and tracks it until a decision arrives. Scheduling without approval invites a denied claim. Telling the patient to pay first and seek reimbursement shifts cost unfairly when authorization is available. A physician order alone does not satisfy the insurer's prior authorization requirement, and the assistant does not perform the scan.

Source: NHA CCMA Test Plan 2022 — Section 5: Administrative Assisting

Answer: C. Wave scheduling

Wave scheduling books several patients at the start of each hour and sees them in order of arrival, which absorbs no-shows and visits of different lengths. Strict single-booking gives each patient a separate slot, the opposite of shared start times. Inpatient bed rotation concerns hospital bed assignment, not outpatient appointments. Surgical block release frees unused operating room time and has nothing to do with clinic arrival times.

Source: NHA CCMA Test Plan 2022 — Section 5: Administrative Assisting

Answer: C. ICD-10-CM codes

ICD-10-CM codes report the diagnosis, the reason the patient was seen, on a claim. HCPCS Level II codes cover supplies, equipment, ambulance services and certain drugs, not diagnoses. CPT codes describe the procedures and services the provider performed. DRGs group inpatient hospital stays for payment and are not used to code office visit diagnoses.

Source: NHA CCMA Test Plan 2022 — Section 5: Administrative Assisting

Answer: C. Use a certified medical interpreter rather than a family member

Medical interpreters who are certified in healthcare interpreting should be used for patients with limited English proficiency. Family members, especially children, should not be used as interpreters due to potential accuracy issues, emotional burden, and HIPAA concerns. Speaking louder does not improve comprehension. Written instructions alone may not be effective if the patient has limited literacy in their primary language.

Source: NHA CCMA Test Plan 2022 — Section 6: Communication and Customer Service

Answer: B. Identifying the office, yourself, and asking how you may help

Proper phone etiquette means naming the office, giving your own name, and asking how you can help. The caller then knows they reached the right place and who is speaking. Promising a diagnosis before triage is outside a medical assistant's scope and could mislead the caller. Staying silent until the caller speaks leaves them unsure whether anyone answered. Eating loudly sounds unprofessional and makes messages harder to hear and record accurately.

Source: NHA CCMA Test Plan 2022 — Section 6: Communication and Customer Service

Answer: C. What brings you in today?

"What brings you in today?" is open-ended because the patient has to answer in their own words, often revealing the chief complaint and details the assistant would not think to ask. Asking about a penicillin allergy invites only yes or no. "Do you have pain: yes or no?" limits the answer even more directly. Asking whether a birthday is in June is closed and also only confirms one detail.

Source: NHA CCMA Test Plan 2022 — Section 6: Communication and Customer Service

Answer: B. Staying calm, listening fully, then offering solutions

Staying calm, listening fully, and then offering solutions helps de-escalate an angry patient. Feeling heard lowers the tension, and the patient is then more open to problem solving. Raising your voice escalates the conflict and can make the patient feel threatened. Walking away silently while the patient is talking feels dismissive and usually increases anger. Arguing over who is right turns the problem into a contest instead of resolving it.

Source: NHA CCMA Test Plan 2022 — Section 6: Communication and Customer Service

Answer: D. Verify the patient's identity and check the medical record for refill status

Before any refill request moves forward, the assistant confirms the caller's identity with two identifiers and reviews the chart for the current order, remaining refills, and recent visits. Sending the patient to the emergency department is unnecessary for a routine refill. Saying insulin can never be refilled by phone is false; providers authorize refills that way regularly. Calling in a refill without provider approval exceeds the assistant's scope.

Source: NHA CCMA Test Plan 2022 — Section 4: Patient Care Coordination and Education

Answer: D. Asking the patient to restate instructions in their own words

Teach-back means asking the patient to repeat the instructions in their own words. It shows the assistant what the patient actually understood, so gaps can be fixed before the patient leaves. Lecturing without pauses gives no chance to check understanding. A graded exam feels like a test of the patient instead of a check on how well the teaching worked. A pamphlet with no discussion assumes the patient can read and apply it alone, which many cannot.

Source: NHA CCMA Test Plan 2022 — Section 4: Patient Care Coordination and Education

Answer: C. Colonoscopy at guideline intervals

For average-risk adults, colorectal screening starts at 45, and colonoscopy at the recommended interval is a standard choice because it can find and remove polyps. A monthly chest x-ray targets the lungs and would add needless radiation. A throat culture checks for strep infection and tells nothing about the colon. A weekly EKG records heart rhythm and plays no role in cancer screening.

Source: NHA CCMA Test Plan 2022 — Section 4: Patient Care Coordination and Education

Answer: B. Verifying insurance, booking the specialist, and sending records

Verifying insurance, booking the specialist, and sending records are the medical assistant's part of a referral. Ordering surgery is a provider decision, and skipping insurance approval can leave the patient with an unpaid bill. Diagnosing a condition is outside the assistant's scope of practice. Canceling all follow-up care once the referral is made leaves the primary provider unable to track the patient's progress.

Source: NHA CCMA Test Plan 2022 — Section 4: Patient Care Coordination and Education

Answer: B. A patient's name combined with their diagnosis

Protected health information under HIPAA includes any individually identifiable health information, such as a patient's name linked to their diagnosis, treatment, or payment information. Employment contracts, general clinic services, and published research do not contain individually identifiable patient data and are not considered PHI.

Source: NHA CCMA Test Plan 2022 — Section 7: Medical Law and Ethics

Answer: D. Informed consent with risks, benefits, and alternatives explained

Before a surgical procedure, the provider must obtain informed consent: the patient hears what will be done, its risks, its benefits, and the alternatives, then agrees, usually in writing. Booking an appointment shows only implied consent, which covers simple acts like taking a blood pressure, not an incision. The medical assistant may witness the signature but cannot be the one who explains and obtains consent. Office surgery is still surgery, so saying no consent is needed is false.

Source: NHA CCMA Test Plan 2022 — Section 7: Medical Law and Ethics

Answer: B. Durable power of attorney for health care

A durable power of attorney for health care is an advance directive in which the patient names an agent to make medical decisions if the patient can no longer decide. A vendor invoice is a business bill for supplies. A hospital parking permit only controls where a car may be left. A gym membership form is a contract with a fitness club and gives no one any legal authority over medical care.

Source: NHA CCMA Test Plan 2022 — Section 7: Medical Law and Ethics

Answer: D. Suspected child or elder abuse observed in clinic

Suspected abuse of a child or elder must be reported under state mandatory reporting laws, even without proof. A missed appointment is handled with a reminder call and a chart note, not a report to authorities. A billing or coverage dispute is an administrative matter for the billing office. Complaints about the wait time are customer service concerns, not signs of harm.

Source: NHA CCMA Test Plan 2022 — Section 7: Medical Law and Ethics

Answer: C. 95% to 100%

SpO2 in a healthy person normally reads 95% to 100%, so the patient's 94% is just below normal and should be reported. A 90% to 95% range would label mildly low values as normal. Values of 85% to 90% indicate hypoxemia that may need oxygen. Readings of 80% to 85% are severely low and call for urgent provider attention.

Source: NHA CCMA Test Plan 2022 — Section 3A: Patient Intake and Vitals

Answer: B. A systolic drop of 20 mmHg or more when moving from lying to standing

Orthostatic hypotension is a fall in systolic pressure of at least 20 mmHg, or diastolic of at least 10 mmHg, within 3 minutes of standing from lying down. Unchanged pressures are a normal response. A diastolic rise is not a drop and does not meet the definition. A small heart-rate change of 5 beats per minute does not by itself define the condition, which is based on blood pressure.

Source: NHA CCMA Test Plan 2022 — Section 3A: Patient Intake and Vitals

Answer: D. Ventrogluteal site of the hip

The ventrogluteal site on the hip is preferred for adult IM injections because the gluteus medius there is thick and the site has no major nerves or blood vessels. Inner forearm skin is used for shallow intradermal tests such as the TB skin test, not for deep muscle injections. The dorsal hand has thin skin and veins, so it suits venipuncture or IV access instead. The eyelid is never an injection site.

Source: NHA CCMA Test Plan 2022 — Section 3A: Patient Intake and Vitals

Answer: B. Temp 98.6F, pulse 76, respirations 16, BP 118/76

Temperature 98.6 F, pulse 76, respirations 16, and blood pressure 118/76 all fall within normal adult ranges. A temperature of 104 F with pulse 150 and respirations 40 shows high fever with a fast heart rate and rapid breathing. A pulse of 30 with confusion is severe bradycardia with signs the brain is not getting enough blood. A pressure of 220/140 with chest pain is a hypertensive emergency that needs immediate care.

Source: NHA CCMA Test Plan 2022 — Section 3A: Patient Intake and Vitals

Answer: C. Body temperature (37°C or 98.6°F)

Irrigation solution should be warmed to body temperature (37°C or 98.6°F) to prevent stimulating the vestibular system, which could cause vertigo, nausea, or nystagmus. Cold or hot solutions can cause dizziness and discomfort. Room temperature solutions may also cause some vestibular stimulation, though less than extreme temperatures.

Source: NHA CCMA Test Plan 2022 — Section 3B: General Patient Care

Answer: A. Semi-Fowler's position with the head of the bed at 45 degrees

Semi-Fowler's position, with the head of the bed raised to about 45 degrees, is correct. Raising the upper body lets the diaphragm drop and the lungs expand, so breathing takes less effort. Prone position puts the patient face down, pressing on the chest of someone already short of breath. Flat supine with the legs raised pushes abdominal organs up against the diaphragm. Trendelenburg tips the head below the feet, which shifts even more weight onto the diaphragm and makes breathing harder.

Source: NHA CCMA Test Plan 2022 — Section 3B: General Patient Care

Answer: D. 10 to 15 degrees with the bevel up

An intradermal injection goes in at 10 to 15 degrees with the bevel up, placing a small amount just under the epidermis to raise a wheal, as in a TB skin test. A 45-degree angle reaches subcutaneous tissue, which is too deep. An angle of 180 degrees would lay the needle flat along the skin, so it could not enter the dermis. A 90-degree angle is for intramuscular injections and would bypass the dermis entirely.

Source: NHA CCMA Test Plan 2022 — Section 3B: General Patient Care

Answer: B. 45 to 90 degrees depending on tissue

Subcutaneous injections go in at 45 to 90 degrees, depending on how much fatty tissue the patient has and the needle length. An angle of 180 degrees is not a real injection angle; it would lay the needle flat along the skin. Zero degrees likewise means no penetration at all. A 10 degree angle into the dermis is the intradermal technique used for TB skin tests, not a subcutaneous dose.

Source: NHA CCMA Test Plan 2022 — Section 3B: General Patient Care

Answer: A. At least 20 seconds

CDC guidance is to lather and scrub all hand surfaces for at least 20 seconds when washing with soap and water, which is required whenever hands are visibly soiled. Five or 10 seconds is too short for friction to remove dirt and transient organisms. Thirty seconds is acceptable practice but is not the stated minimum, so it does not answer what the guideline requires.

Source: NHA CCMA Test Plan 2022 — Section 3C: Infection Control and Safety

Answer: A. Gloves, then goggles or face shield, then gown, then mask last

The correct order is gloves, then goggles or face shield, then gown, then mask last. Gloves are the most contaminated item, so they come off first, and the mask comes off last because it sits over the nose and mouth. Taking the gown off first means reaching around with dirty gloves still on. Removing the mask first brings contaminated gloves to the face. Pulling off gloves and mask together has the same problem, since gloved hands touch the mask straps.

Source: NHA CCMA Test Plan 2022 — Section 3C: Infection Control and Safety

Answer: B. Blood culture, sodium citrate, SST, EDTA

Blood cultures come first to protect sterility, then the light-blue sodium citrate tube, then the serum tube (SST), then EDTA, following the CLSI sequence. Putting SST before citrate risks clot activator carryover that shortens coagulation times. Starting with EDTA carries the chelating additive into later tubes and can falsely lower calcium or alter clotting results. Drawing SST first and blood cultures last also exposes the culture bottle to contamination.

Source: NHA CCMA Test Plan 2022 — Section 3E: Phlebotomy

Answer: A. No longer than one minute

A tourniquet should stay on for no more than one minute. Longer pressure pools blood in the arm, causing hemoconcentration that falsely raises values such as potassium, protein, and cell counts. Five minutes is five times the limit and also makes the patient uncomfortable. Tubes are labeled after the needle is out, so leaving the band on until then means it stays on far too long, and keeping it on for the whole visit could injure nerves and skin.

Source: NHA CCMA Test Plan 2022 — Section 3E: Phlebotomy

Answer: D. Positive leukocyte esterase with positive nitrites

Positive leukocyte esterase plus positive nitrites is the classic dipstick pattern for a UTI: white cells release the esterase, and many urinary bacteria convert nitrate to nitrite. Pale yellow urine without odor is a normal appearance. Negative protein with a normal pH says nothing about bacteria or white cells. Very low specific gravity simply means dilute urine, often from high fluid intake, not infection.

Source: NHA CCMA Test Plan 2022 — Section 3D: Point of Care Testing

Answer: A. Control results, reagent expiration, and meter calibration

Before running a waived glucose test, confirm that control results are in range, the strips or reagents have not expired, and the meter has been calibrated or coded as the manufacturer directs. Any one of these problems can give a false reading. The patient's favorite color and room number tell you nothing about whether the test works. The TV volume and room temperature of the waiting area, and the assistant's lunch schedule, have no effect on the accuracy of the result.

Source: NHA CCMA Test Plan 2022 — Section 3D: Point of Care Testing

Answer: D. Fourth intercostal space, right sternal border

V1 sits in the fourth intercostal space just right of the sternum. The fourth intercostal space at the left sternal border is V2, its mirror partner. Fifth intercostal space at the midclavicular line marks V4. Fifth intercostal space at the anterior axillary line is the V5 position, level with V4.

Source: NHA CCMA Test Plan 2022 — Section 3F: EKG and Cardiovascular Testing

Answer: C. Wandering baseline with muscle tremor artifact

When the patient moves, talks, or shivers, the tracing shows a wandering baseline and jagged muscle tremor artifact, so helping the patient lie still and relax fixes it. A flat calibration signal is the standard square pulse the machine prints, not a sign of movement. Clean complexes on a steady baseline show that the patient was still. A disconnected lead produces a flat line in that lead, which is a hookup problem, not motion.

Source: NHA CCMA Test Plan 2022 — Section 3F: EKG and Cardiovascular Testing

Answer: B. Hypo-

Hypo- means below, under, or deficient, as in hypotension and hypodermic. Epi- means upon or over, as in epidermis, the outer skin layer. Peri- means around, as in pericardium, the sac surrounding the heart. Hyper- is the opposite of hypo- and means above or excessive, as in hyperglycemia.

Source: NHA CCMA Test Plan 2022 — Section 1: Foundational Knowledge and Basic Science

Answer: B. Commission on Accreditation of Allied Health Education Programs (CAAHEP)

CAAHEP accredits medical assisting programs, along with many other allied health programs, and holds CHEA recognition. The NBME writes the USMLE licensing exams for physicians and accredits no schools. The AMA is a physician membership organization that sets policy, not an accrediting agency for these programs. The AHA represents hospitals and health systems in advocacy.

Source: NHA CCMA Test Plan 2022 — Section 1: Foundational Knowledge and Basic Science

Answer: D. 30 mL

One US fluid ounce holds about 30 mL (29.57 mL exactly), the figure used when measuring liquid doses and charting intake. A thousand milliliters is one liter, roughly 33 ounces. Five hundred milliliters is about 17 ounces, a typical water bottle. Five milliliters equals one teaspoon, so mixing it up with an ounce would cause a sixfold dosing error.

Source: NHA CCMA Test Plan 2022 — Section 1: Foundational Knowledge and Basic Science

Answer: D. Nothing by mouth

NPO stands for the Latin nil per os, meaning nothing by mouth, an order often given before surgery or certain tests. New patient only is a made-up expansion with no clinical use. Normal pulse observation is not what the abbreviation stands for. Night shift personnel is also invented; reading NPO that way could lead staff to feed a patient who must keep an empty stomach.

Source: NHA CCMA Test Plan 2022 — Section 1: Foundational Knowledge and Basic Science

Answer: C. Right ventricle

The right ventricle receives deoxygenated blood from the right atrium and pumps it through the pulmonary valve into the pulmonary arteries, which carry it to the lungs for oxygenation. The right atrium receives deoxygenated blood from the body. The left ventricle pumps oxygenated blood to the body. The left atrium receives oxygenated blood from the lungs.

Source: NHA CCMA Test Plan 2022 — Section 2: Anatomy and Physiology

Answer: C. Sagittal plane

The sagittal plane runs vertically from front to back and splits the body into right and left parts; the midsagittal plane makes the two halves equal. A transverse plane is horizontal and separates upper from lower portions. An oblique plane cuts at a slant, so it does not give a clean right and left division. The coronal plane, also called frontal, divides the body into front and back sections rather than sides.

Source: NHA CCMA Test Plan 2022 — Section 2: Anatomy and Physiology

Answer: B. Beta cells of the pancreatic islets

Insulin is made by the beta cells in the islets of Langerhans in the pancreas. Intestinal villi absorb nutrients and do not secrete insulin. The alveoli are the air sacs of the lungs where oxygen and carbon dioxide are exchanged. The glomeruli are kidney capillary clusters that filter blood to begin urine formation.

Source: NHA CCMA Test Plan 2022 — Section 2: Anatomy and Physiology

Answer: B. Medial toward the center

Medial means toward the midline of the body; the nose is medial to the eyes. Cephalic refers to the head end of the body, not the midline. Lateral is the opposite of medial and means away from the midline. Proximal describes a point on a limb closer to where it attaches to the trunk.

Source: NHA CCMA Test Plan 2022 — Section 2: Anatomy and Physiology