Clinical Medical Procedures
57.6%of exam
Law and Ethics
16%of exam
ScopeConsentPrivacySafety
Pharmacology and Medical Knowledge
14.4%of exam
MedicationsCalculationsTerminologyBody Systems
Medical Administrative Duties
12%of exam
SchedulingCodingInsuranceTechnology
Quick Facts
- Credential
- NCCT NCMA
- Items
- 150 total
- Scored
- 125 items
- Pretest
- 25 unscored
- Time
- 3 hours
- Format
- 92% standard, 8% alternative
- Pass
- 575 scaled
- Scale
- 200–720
- NCCT Fee
- $119
- Site Fee
- May apply separately
- Delivery
- Computer-based
- Results
- Immediately after exam
- Renewal
- Annual recertification
- First Retake
- Wait 30 days
Order of Draw
Cultures, blue, serum, green, lavender, gray.
CulturesBlueSerumGreenLavenderGray
Disinfection vs Sterilization
Disinfection
- Inanimate surfaces
- Not all spores
Sterilization
- Critical instruments
- All microbial life
Surface control vs complete destruction
Safety Response Picker
- Patient becomes unresponsive→Activate emergency response
- Patient begins fainting→Stop and protect patient
- Medication reaction suspected→Stop and notify provider
- Needlestick occurs→Wash and report immediately
- Chemical exposure occurs→Follow SDS guidance
- Fire is discovered→Begin RACE protocol
- Isolation type unclear→Confirm before entry
- Scope is unclear→Stop and escalate
Official Blueprint
- Clinical
- 72 scored items
- Law and ethics
- 20 scored items
- Pharmacology
- 18 scored items
- Administration
- 15 scored items
- Infection control
- 15 clinical items
- Patient care
- 32 clinical items
- Phlebotomy
- 15 clinical items
- ECG
- 10 clinical items
- Pretest items
- 25 unscored items
- Alternative items
- Drag, select, hotspot
Fire RACE
Rescue, alarm, contain, extinguish or evacuate.
RescueAlarmContainExtinguishEvacuate
Subjective vs Objective
Subjective
- Patient reports
- Pain or nausea
Objective
- Measured findings
- Vitals or tests
Stated vs measured
Specimen Response Picker
- Identity cannot be confirmed→Do not collect
- Label is incorrect→Recollect per policy
- Hematoma develops→Stop and apply pressure
- Blood flow stops→Assess needle position
- Citrate tube underfilled→Recollect per policy
- Specimen is rejected→Correct and recollect
- Patient begins fainting→Stop and protect patient
- Sterile site contaminated→Prepare site again
Infection and Safety
- Standard precautions
- Use for every patient
- Contact precautions
- Prevent contact transmission
- Droplet precautions
- Mask per protocol
- Airborne precautions
- Respirator and special room
- Visibly soiled hands
- Wash with soap and water
- Clean hands
- Before and after care
- Disinfection
- Treats inanimate surfaces
- Sterilization
- Destroys all microbial life
- After needle use
- Activate safety; discard without recapping
- Sharps container
- Puncture resistant
- Needlestick
- Wash and report immediately
- Chemical exposure
- Follow SDS directions
ECG Troubleshooting
- Baseline wanders→Check electrode adhesion
- Tracing looks shaky→Reduce patient movement
- Regular interference appears→Remove electrical sources
- Lead is missing→Check cable connection
- Skin is oily→Clean and dry skin
- Hair prevents contact→Clip per policy
- Patient cannot lie flat→Adjust and document position
- Abnormal tracing appears→Notify appropriate clinician
Patient Intake and Care
- Patient identity
- Use two identifiers
- Chief complaint
- Use patient words
- Medication list
- Review and reconcile per protocol
- Allergy check
- Verify before treatment
- Pain
- Patient-reported data
- Blood pressure
- Use correct cuff
- Pulse
- Rate, rhythm, strength
- Respirations
- Rate, rhythm, effort
- BMI
- Screening measure
- Abnormal finding
- Report promptly
- Snellen chart
- Distance visual acuity
- Teach-back
- Patient explains instructions
Procedures and POCT
- Supine
- Face up
- Prone
- Face down
- Fowler position
- Head elevated
- Sims position
- Left side, knee flexed
- Lithotomy
- Pelvic examination
- Sterile field
- Protect from contamination
- Wound drainage
- Document amount and character
- Suture removal
- Requires authorized order
- CLIA-waived test
- Simple low-risk testing
- Quality control
- Validate testing system
- Invalid control
- Stop patient testing
- Specimen label
- Apply in patient's presence
Phlebotomy
- Median cubital
- Common first choice
- Cephalic vein
- Common alternate site
- Basilic vein
- Use added caution
- Site antisepsis
- Let site dry
- Needle bevel
- Faces upward
- Tourniquet
- Release before needle removal
- No blood flow
- Assess needle position
- Hematoma
- Stop and apply pressure
- Syncope
- Stop and protect patient
- Tube mixing
- Invert gently
- Blood cultures
- Collect first
- Light blue
- Coagulation tests
- Serum tube
- Before green tube
- Green tube
- Heparin additive
- Lavender tube
- EDTA additive
- Gray tube
- Glycolysis inhibitor
- Adult capillary
- Middle or ring finger
- Infant capillary
- Medial or lateral heel
ECG Setup and Artifacts
- Twelve-lead ECG
- Uses ten electrodes
- V1
- Fourth interspace, right sternal
- V2
- Fourth interspace, left sternal
- V3
- Between V2 and V4
- V4
- Fifth interspace, midclavicular
- V5
- Anterior axillary, level V4
- V6
- Midaxillary, level with V4
- Wandering baseline
- Check electrode adhesion
- Somatic artifact
- Reduce patient movement
- AC artifact
- Remove electrical interference
- Before recording
- Explain and position patient
- After recording
- Label and route tracing
Informed vs Implied Consent
Informed
- Material information explained
- Voluntary patient decision
Implied
- Conduct shows agreement
- Routine action context
Explained choice vs conduct
Law and Ethics
- HIPAA
- Protects health information
- HITECH
- Strengthens electronic privacy enforcement
- OSHA
- Protects worker safety
- CLIA
- Regulates laboratory testing
- DEA
- Enforces controlled-substance law
- Scope
- State law plus authorization
- Informed consent
- Provider explains material information
- Implied consent
- Conduct indicates agreement
- Battery
- Unauthorized intentional touching
- Negligence
- Breach of reasonable care
- Record correction
- Preserve original entry
- Incident report
- Follow facility policy
- Patient refusal
- Respect, document, report
- Mandatory report
- Follow applicable law
HIPAA vs OSHA
HIPAA
- Patient information
- Privacy and security
OSHA
- Worker protection
- Workplace hazards
Privacy vs workplace safety
Eligibility and Exam Rules
- Current student route
- Enrolled authorized program
- Graduate route
- Authorized graduate within five years
- Experience route
- 2080 qualifying hours
- Military route
- Equivalent military training
- High school route
- Authorized program, five-year window
- Instructor route
- Teaching plus practice experience
- Eligibility window
- Generally five years
- First failure
- Wait 30 days
- Second failure
- Wait 30 days
- Third failure
- Wait 90 days
- Fourth or later failure
- 180 days, appeal, remediation evidence
- Scaled score
- Not raw percentage
- Test-day ID
- Valid nonmilitary government photo ID
- High-school ID exception
- Current school ID permitted
Scored vs Pretest Items
Scored
- 125 items
- Affects scaled score
Pretest
- 25 items
- Does not affect score
Answer every item
Core Medication Rights
Patient, drug, dose, route, time, documentation.
PatientDrugDoseRouteTimeDocumentation
Generic vs Trade
Generic
- Nonproprietary name
- Lowercase convention
Trade
- Brand name
- Manufacturer selected
Drug name vs brand
Medication Basics
- Right patient
- Verify two identifiers
- Right drug
- Match authorized order
- Right dose
- Calculate and verify
- Right route
- Match order and formulation
- Right time
- Follow ordered schedule
- Right documentation
- Record after administration
- Oral
- Swallowed through GI tract
- Sublingual
- Under tongue
- Topical
- Applied to surface
- Intradermal
- Into dermis
- Subcutaneous
- Into fatty tissue
- Intramuscular
- Into muscle
- Dose formula
- Desired over available times quantity
- Drug reference
- Verify unfamiliar medication
Allergy vs Side Effect
Allergy
- Immune response
- May become severe
Side effect
- Known secondary effect
- Not necessarily immune
Immune vs expected secondary
Medical Knowledge
- Generic name
- Nonbrand drug name
- Trade name
- Manufacturer brand
- Indication
- Reason for use
- Contraindication
- Reason to avoid
- Adverse effect
- Harmful unintended response
- Allergic reaction
- Immune-mediated response
- Anterior
- Toward front
- Posterior
- Toward back
- Medial
- Toward midline
- Lateral
- Away from midline
- Proximal
- Nearer attachment
- Distal
- Farther from attachment
SOAP Note
Subjective, objective, assessment, plan.
SubjectiveObjectiveAssessmentPlan
CPT vs ICD-10-CM
CPT
- Procedures and services
- What was performed
ICD-10-CM
- Diagnoses and conditions
- Why care occurred
What vs why
Administration and Coding
- CPT
- Procedures and services
- HCPCS
- Products, supplies, services
- ICD-10-CM
- Diagnoses and conditions
- Modifier
- Adds service context
- Prior authorization
- Payer approval before service
- Eligibility check
- Verify active coverage
- Telephone call
- Document facts and disposition
- Urgent symptom
- Follow triage protocol
- Referral
- Coordinate specialty care
- Copayment
- Patient cost share
- EOB
- Not a bill
- EHR access
- Use role-authorized job access
Common Traps
Credential Mix-Up
NCCT owns NCMA ≠ Not NHA CCMA
Clinical Weight
72 of 125 scored ≠ Not 72 of 150 delivered
Pretest Items
Unscored pretest status ≠ Never safe to skip
Scaled Passing Score
575 is not percent ≠ Raw cutoff unpublished
Scope Boundaries
State rules vary ≠ Do not diagnose
Glove Misconception
Gloves never replace hygiene ≠ Clean hands after removal
Record Corrections
Never erase originals ≠ Use approved correction method
Patient Refusal
Do not force care ≠ Document and notify
Eligibility Evidence
Passing score alone ≠ Does not replace eligibility documents
Last Minute
- 1.150 total, 125 scored
- 2.Clinical equals 72 scored
- 3.Pass point is 575
- 4.Use two patient identifiers
- 5.Report abnormal findings promptly
- 6.Avoid recapping used needles
- 7.Label specimens beside patient
- 8.Blue precedes serum tubes
- 9.Check ECG electrode contact
- 10.CPT means procedures
- 11.ICD-10-CM means diagnoses
- 12.No penalty for guessing
- 13.Arrive fifteen minutes early
- 14.Respect and document refusal
- 15.Protect original chart entries
- 16.Scope unclear: stop, escalate
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