Simulado CCMA

• A. The knee is distal to the ankle
• B. The elbow is proximal to the wrist
• C. The sternum is posterior to the spine
• D. The ears are inferior to the shoulders

Resposta: B. The elbow is proximal to the wrist

Proximal means closer to the trunk or the point of attachment, and distal means farther from it. The elbow is nearer the shoulder than the wrist is, so the elbow is proximal to the wrist. The knee is proximal to the ankle, the sternum is anterior to the spine because it sits on the front of the body, and the ears are superior to the shoulders. Learn the terms as opposite pairs: anterior and posterior, superior and inferior, medial and lateral, proximal and distal.

• A. Schedule I
• B. Schedule II
• C. Schedule III
• D. Schedule V

Resposta: A. Schedule I

Schedule I is the most restricted group. Schedule II drugs also carry a high potential for abuse, but they have an accepted medical use and are tightly controlled, for example with limits on prescription refills. The numbers then step down: Schedule III and IV carry less abuse potential, and Schedule V carries the least. The schedules are set by law and the DEA and the lists change over time, so for any real drug check the current schedule rather than relying on memory.

Marque todas as opções corretas.

• A. Strep throat
• B. Influenza
• C. Tuberculosis
• D. Chickenpox
• E. The common cold

Resposta: A. Strep throat, C. Tuberculosis

Strep throat comes from group A Streptococcus and tuberculosis from Mycobacterium tuberculosis, both bacteria. Influenza, chickenpox and the common cold are viral. The difference matters because antibiotics act on bacteria and do nothing against a virus. Whether any patient needs an antibiotic is the provider's decision, not the assistant's, but knowing which germ class a disease belongs to is core exam content.

• A. Ask, "Are you Maria Lopez?" and wait for a nod
• B. Match the name on the day's appointment list to the room number
• C. Ask the patient to state their full name and date of birth, then match both to the chart
• D. Ask the person who came with the patient to confirm the name

Resposta: C. Ask the patient to state their full name and date of birth, then match both to the chart

Use two identifiers and let the patient supply them. A yes or no question is a leading question: someone who is anxious, hard of hearing or distracted may nod at the wrong name. Asking for the full name and date of birth, then matching both to the chart, is the standard. A room number or a companion is not an identifier. A name alone is not enough either, because two patients can share one.

A patient who weighs 176 pounds weighs _____ kilograms, and a temperature of 100.4 degrees Fahrenheit equals _____ degrees Celsius.

Opções para a lacuna 1: 70, 80, 90, 387

Opções para a lacuna 2: 36.6, 37.5, 38.0, 39.0

Resposta: 80, 38.0

To go from pounds to kilograms, divide by 2.2: 176 divided by 2.2 is 80. The wrong answer 387 comes from multiplying instead of dividing, so check that the kilogram number is smaller than the pound number. For temperature, subtract 32 and multiply by 5/9: 100.4 minus 32 is 68.4, and 68.4 times 5/9 is 38.0. The test plan lists converting vital sign measurements as its own task, so expect arithmetic like this.

Marque todas as opções corretas.

• A. A warm, still hand resting at heart level
• B. Dark nail polish on the finger with the sensor
• C. Very cold fingers with poor blood flow
• D. Moving the hand while the device is reading
• E. A clean sensor placed as the device instructions show

Resposta: B. Dark nail polish on the finger with the sensor, C. Very cold fingers with poor blood flow, D. Moving the hand while the device is reading

A pulse oximeter shines light through the fingertip and needs a steady signal from pulsing blood. Dark polish can absorb the light, cold fingers carry too little blood flow for a clean signal, and movement scrambles the reading. Remove the polish or use another finger, warm the hand, and have the patient hold still before you record a number. A warm, still hand and a correctly placed clean sensor are good technique. A reading that stays low after you fix the technique goes to the provider under your clinic's policy.

• A. Mask
• B. Gown
• C. Goggles
• D. Gloves

Resposta: D. Gloves

Gloves are the most contaminated item, so they come off first. A common sequence for removal is gloves, then goggles or face shield, then the gown, then the mask last, with hand hygiene right after. Putting equipment on runs the other way: gown, mask, goggles, then gloves. Facilities post their own sequence, so follow the one at your site, but the principle on the exam is always to remove the dirtiest item first and to touch clean surfaces only with clean hands.

• A. Seasonal influenza
• B. Measles
• C. Strep throat
• D. Norovirus

Resposta: B. Measles

Measles, tuberculosis and chickenpox are the classic airborne diseases: the germ stays in the air in tiny particles and can travel across a room. Influenza and strep throat spread by larger droplets, which fall within a short distance of the patient and call for droplet precautions. Norovirus spreads through contact with contaminated hands, surfaces and food. Standard precautions apply to every patient, and these transmission-based precautions are added on top.

• A. It needs no quality checks at all
• B. Only a physician is allowed to perform it
• C. It is simple enough, with a low enough risk of a wrong result, that a site with a certificate of waiver may run it
• D. Every insurer will pay for it automatically

Resposta: C. It is simple enough, with a low enough risk of a wrong result, that a site with a certificate of waiver may run it

CLIA is the federal law that regulates clinical laboratory testing. Waived tests are the simple ones, such as a urine dipstick, a rapid strep test or a fingerstick glucose meter, which can be done at the point of care in a clinic with a certificate of waiver. Waived does not mean unregulated. You still follow the manufacturer's instructions exactly, run the controls as directed, check expiration dates and record the result and the lot number.

• A. To keep skin and urethral bacteria out of the sample, so the result reflects the urine itself
• B. Because the first part of the stream is the only part tested for glucose
• C. Because warm urine kills bacteria in the sample
• D. Because it is easier for the patient to hold the cup

Resposta: A. To keep skin and urethral bacteria out of the sample, so the result reflects the urine itself

The opening of the urethra and the surrounding skin carry normal bacteria. If they wash into the cup, a culture can grow organisms that were never in the bladder. The patient cleans the area as instructed, starts urinating into the toilet, then catches the middle part of the stream in the cup. Label the container with two identifiers, the date and the time, and send it for testing promptly, because bacteria multiply in a sample that sits out.

A standard resting EKG uses _____ electrodes to record _____ leads.

Opções para a lacuna 1: 6, 10, 12, 15

Opções para a lacuna 2: 3, 6, 12, 15

Resposta: 10, 12

Four limb electrodes plus six chest electrodes make 10. Those 10 electrodes produce 12 views of the heart: three limb leads (I, II and III), three augmented limb leads (aVR, aVL and aVF) and six chest leads (V1 to V6). So the number of leads is not the number of electrodes, which is a favorite exam trap. Recording a clean tracing is the assistant's job and reading it is the provider's.

• A. Ask, "Do you have any questions?"
• B. Ask, "Does that make sense?"
• C. Hand over a printed sheet and let the patient leave
• D. Ask the patient to explain the steps back in their own words

Resposta: D. Ask the patient to explain the steps back in their own words

This is the teach-back method. Questions like "Any questions?" or "Does that make sense?" invite a polite yes, even from a patient who is confused or embarrassed to say so. Asking the patient to say the plan back, for example when they stop eating and what they may drink, shows what they actually took in, and it lets you correct a mistake before they leave. A handout helps as a backup, but it is not a check. Use plain words, not medical terms, and put the responsibility for clear teaching on yourself.

ICD-10-CM codes describe the patient's _____, while CPT codes describe the _____ that was done.

Opções para a lacuna 1: diagnosis, insurance plan, home address, medication

Opções para a lacuna 2: diagnosis, service or procedure, payer, referral

Resposta: diagnosis, service or procedure

A claim tells the payer two things: what was done and why. The CPT code is the what, such as an office visit or a procedure, and the ICD-10-CM code is the why, the condition that made the care necessary. The payer checks that the two fit together. Codes come from the provider's documentation, never from guessing, and both code sets are updated on a schedule, ICD-10-CM each October and CPT each January, so use current versions.

• A. The medical assistant who hands out the form
• B. The provider who will perform the procedure
• C. The front desk, when the patient checks in
• D. The billing office, when it verifies insurance

Resposta: B. The provider who will perform the procedure

Informed consent is a conversation and not a signature. In general the provider performing the procedure must explain it and answer questions. The medical assistant can prepare the form and witness the signature, and should tell the provider if the patient seems confused or has questions. Implied consent is different: a patient who rolls up a sleeve for a blood pressure check has agreed by their actions. Details such as who may consent for a minor are set by state law and facility policy.

Marque todas as opções corretas.

• A. Telling the patient's employer the diagnosis because a manager asked
• B. Sending records to a specialist who will treat the patient
• C. Sharing visit details with a friend who phones the front desk
• D. Submitting a claim with the required details to the patient's insurer
• E. Reporting suspected child abuse to the agency the law names

Resposta: B. Sending records to a specialist who will treat the patient, D. Submitting a claim with the required details to the patient's insurer, E. Reporting suspected child abuse to the agency the law names

HIPAA allows sharing for treatment, payment and health care operations without a separate authorization, which covers the specialist and the insurer claim. It also allows disclosures that the law requires, such as mandatory reporting of suspected abuse. An employer or a friend is not covered, and marketing uses need written authorization too. Even permitted sharing follows minimum necessary: send only what the purpose needs. Some states add stricter rules, so your office policy and state law can be tighter than the federal floor.