Foundations
10%of exam
Anatomy + Physiology
5%of exam
Clinical Patient Care
56%of exam
Coordination + Education
8%of exam
Teach-BackReferralsPreventive CareFollow-Up
Admin Assisting
8%of exam
SchedulingEHRBillingClaims
Communication + Service
8%of exam
De-EscalationActive ListeningBarriersTeamwork
Law + Ethics
5%of exam
Quick Facts
- Exam
- NHA CCMA
- Items
- 150 scored + 30 pretest
- Time
- 3 hours
- Pass
- 390 scaled
- Scale
- 200-500
- Largest
- Clinical care 56%
- Renewal
- 2 years + 10 CE
Allergy vs Side Effect
Allergy
- Immune response
- Hives/anaphylaxis
Side effect
- Expected effect
- Nausea/drowsiness
Immune vs expected
Terminology
- Prefix
- Word beginning
- Suffix
- Word ending
- Root
- Core meaning
- A-
- Without
- Brady-
- Slow
- Tachy-
- Fast
- -itis
- Inflammation
- -ectomy
- Surgical removal
Pharmacology
- Indication
- Reason for drug
- Contraindication
- Reason to avoid
- Side effect
- Expected unwanted effect
- Adverse reaction
- Harmful response
- Allergy
- Immune reaction
- PRN
- As needed
- PO
- By mouth
- SL
- Under tongue
Body Systems
- Cardiac
- Heart pumping
- Respiratory
- Gas exchange
- Endocrine
- Hormone signaling
- GI
- Digestion
- Renal
- Fluid filtering
- Neuro
- Control signals
- Integumentary
- Skin barrier
- Musculoskeletal
- Movement support
Order Draw
Cultures, blue, red, green, lavender, gray.
SterileCitrateSerumHeparinEDTAFluoride
Asepsis vs Sterile
Asepsis
- Reduces microbes
- Routine clean care
Sterile
- No microbes
- Procedural field
Clean vs microbe-free
Clinical Picker
- New patient arrives→Verify identity
- Chest pain reported→Notify provider
- Bleeding after draw→Apply pressure
- Faint during draw→Stop and lower
- Fever with cough→Mask patient
- POCT control fails→Do not test
- EKG wandering baseline→Reduce movement
- Need sterile setup→Keep field dry
Vitals
- Temp
- Body heat
- Pulse
- Heart rate
- Respirations
- Breaths per minute
- BP
- Arterial pressure
- SpO2
- Oxygen saturation
- Pain
- Subjective scale
- BMI
- Weight-height ratio
- Orthostatic
- Position BP change
Medication Rights
Right patient, drug, dose, route, time.
PatientDrugDoseRouteTime
Systolic vs Diastolic
Systolic
- Top number
- Heart contracts
Diastolic
- Bottom number
- Heart relaxes
Pump vs rest
Infection Control
- Standard
- All patients
- Contact
- Gown and gloves
- Droplet
- Surgical mask
- Airborne
- N95 respirator
- Asepsis
- Reduce microbes
- Sterile field
- Microbe-free area
- Sharps
- Dispose immediately
- Exposure
- Wash, report, document
EKG Limbs
White right, smoke over fire.
RA whiteLA blackRL greenLL red
Phlebotomy
- Two IDs
- Name plus DOB
- Tourniquet
- One minute max
- Bevel
- Face up
- Angle
- 15-30 degrees
- Median cubital
- First choice
- Cephalic
- Second choice
- Basilic
- Last choice
- Label
- At bedside
Order of Draw
- Cultures
- Sterile first
- Light blue
- Citrate coag
- Red/SST
- Serum tests
- Green
- Heparin plasma
- Lavender
- EDTA hematology
- Gray
- Glucose/lactate
- Discard tube
- Butterfly before blue
- Invert tubes
- Gentle mixing
EKG
- RA
- Right arm
- LA
- Left arm
- RL
- Right leg ground
- LL
- Left leg
- V1
- Right fourth ICS
- V2
- Left fourth ICS
- V4
- Fifth ICS MCL
- Artifact
- False tracing
Patient Education
- Teach-back
- Patient repeats plan
- Health literacy
- Plain language
- Barrier
- Blocks understanding
- Referral
- Outside service link
- Follow-up
- Next care step
- Portal
- Electronic access
- Prevention
- Screening and vaccines
- Community resource
- Support service
Referral vs Prior Auth
Referral
- Provider direction
- Specialist access
Prior auth
- Payer approval
- Payment requirement
Provider vs payer
Admin Picker
- Wrong chart found→Stop documentation
- Missing referral→Contact payer
- Coding question→Ask biller
- Record request arrives→Check ROI
- Angry patient→Acknowledge concern
- Late provider→Update patient
- Interpreter needed→Use qualified interpreter
- Portal message urgent→Route immediately
Administration
- EHR
- Electronic chart
- Chief complaint
- Visit reason
- Demographics
- Patient identifiers
- Copay
- Patient portion
- Deductible
- Before insurance pays
- Prior auth
- Approval before service
- Referral
- Provider authorization
- Superbill
- Visit charge sheet
Communication
- Empathy
- Acknowledge feeling
- Reflection
- Restate meaning
- Open question
- Invites detail
- Closed question
- Specific answer
- Interpreter
- Qualified language help
- SBAR
- Structured handoff
- De-escalation
- Lower tension
- Boundary
- Professional limit
Law + Ethics
- HIPAA
- Protect PHI
- Consent
- Permission for care
- Scope
- Allowed duties
- Negligence
- Duty breach harm
- Incident report
- Internal event record
- Mandatory report
- Required legal alert
- ROI
- Release authorization
- Ethics
- Right conduct
Common Traps
Pretest Items
Still answer carefully ≠ Not identified
Tourniquet Time
One minute max ≠ Avoid hemoconcentration
HIPAA Minimum
Need-to-know only ≠ Curiosity is violation
Incident Reports
Internal document ≠ Not charted as filed
Scope Boundary
Assist provider ≠ Do not diagnose
EKG Artifact
Fix patient setup ≠ Do not interpret
Last Minute
- 1.Clinical care is 56%
- 2.Verify two identifiers first
- 3.Tourniquet: one minute max
- 4.Label specimens at bedside
- 5.HIPAA: minimum necessary
- 6.Consent treats; ROI discloses
- 7.Teach-back confirms understanding
- 8.Chest pain: notify provider
- 9.Sterile field stays dry
- 10.Pass standard is 390
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