CMA — the credentialing body practice for the CMA credential

Active listening during a patient interview is best demonstrated by:

1. Typing continuously into the EHR while the patient talks, head down
2. Interrupting to keep the visit on time
3. Periodic eye contact, reflective restatement, and brief verbal acknowledgements
4. Finishing the patient's sentences

Answer: C — Periodic eye contact, reflective restatement, and brief verbal acknowledgements

A) Reduces engagement + signals distraction. C) Hallmarks of active listening. B) Interrupting truncates the history + erodes rapport. D) Assumes content the patient may not have intended.

Performing a procedure on a competent adult patient without their consent is most precisely:

1. Libel
2. Assault
3. Battery
4. Negligence

Answer: C — Battery

A) Defamation. B) Threat without contact. C) Unconsented touching is battery, even if well-intentioned + medically beneficial. D) Negligence is a separate tort (breach of standard of care).

In the patient-MA relationship, 'beneficence' is the ethical principle of:

1. Doing no harm
2. Respecting patient choice
3. Treating like cases alike
4. Acting in the patient's best interest and promoting good

Answer: D — Acting in the patient's best interest and promoting good

A) Non-maleficence. D) Beneficence — active promotion of patient welfare. C) Justice. B) Autonomy.

HIPAA's minimum-necessary standard means:

1. Share everything
2. Use/disclose only the minimum PHI needed for the purpose
3. No sharing
4. Family only

Answer: B — Use/disclose only the minimum PHI needed for the purpose

A/C/D) Wrong. B) Correct — minimum necessary for TPO + authorized disclosures.

An Electronic Remittance Advice (ERA) is most accurately:

1. The patient's bill
2. An electronic version of the explanation of benefits sent to the provider summarizing payments and adjustments
3. The provider's enrollment form
4. The claim form itself

Answer: B — An electronic version of the explanation of benefits sent to the provider summarizing payments and adjustments

A) Patient receives the EOB. B) ERA = 835 transaction, the electronic counterpart of the EOB sent to the provider. C) Enrollment form is CMS-855. D) Claim transmission is the 837.

A 'no-show' policy is most defensible when it:

1. Charges patients without prior notification of the policy
2. Is documented, communicated to patients in advance, and applied consistently
3. Is applied only to patients with private insurance
4. Is not in writing

Answer: B — Is documented, communicated to patients in advance, and applied consistently

A) Surprise fees are unenforceable + erode trust. B) Disclosure + consistency are the legal + ethical standard. C) Discriminatory application violates anti-discrimination + payer policies. D) Undocumented policy is not enforceable.

The 2021 office/outpatient E/M code revisions changed code selection to be primarily based on:

1. Total time on the date of the encounter OR medical decision making (MDM)
2. History and physical examination key components
3. The patient's insurance type
4. Whether the patient was new or established only

Answer: A — Total time on the date of the encounter OR medical decision making (MDM)

A) Since 2021, level of service for 99202-99215 is selected by time or MDM. B) The old key-component framework was retired. C) Insurance does not determine level. D) New vs established is one factor but not the determinant of level.

The MIPS program under MACRA evaluates eligible clinicians on:

1. Volume of services only
2. Quality, cost, improvement activities, and promoting interoperability (EHR use)
3. Patient satisfaction surveys alone
4. Medicaid enrollment numbers

Answer: B — Quality, cost, improvement activities, and promoting interoperability (EHR use)

A) Volume is the opposite philosophy. B) MIPS = Merit-based Incentive Payment System: 4 performance categories. C/D) Single dimensions do not capture MIPS.

Two-patient-identifier requirement means:

1. Two staff members verify
2. Two unique identifiers per patient (e.g., name + DOB)
3. Room number
4. Photo only

Answer: B — Two unique identifiers per patient (e.g., name + DOB)

A/C/D) Wrong. B) Correct — name + DOB is canonical.

An apical pulse should be:

1. Counted for 15 seconds and multiplied by 4
2. Counted only when the carotid is impalpable
3. Counted at the radial artery
4. Counted for a full 60 seconds, especially in pediatric or irregular rhythms

Answer: D — Counted for a full 60 seconds, especially in pediatric or irregular rhythms

A) 15-second counts miss subtle irregularities. D) Apical pulses, particularly in infants + with arrhythmias, are auscultated at the 5th ICS midclavicular line for a full minute. C) Apical = at the apex of the heart, not the wrist. B) Apical assessment is not a fallback for carotid technique.

A normal sinus rhythm on a 12-lead EKG most reliably includes:

1. Absent P waves and irregularly irregular R-R intervals
2. Wide QRS with no preceding P
3. Sawtooth flutter waves at 300/min atrial rate
4. Upright P waves in lead II, a P before every QRS, regular R-R intervals, rate 60-100

Answer: D — Upright P waves in lead II, a P before every QRS, regular R-R intervals, rate 60-100

A) Atrial fibrillation pattern. D) Definition of NSR. C) Atrial flutter. B) Ventricular rhythm.

Sterilization monitoring with biological indicators (spore tests) should be performed:

1. Daily
2. At least weekly + with every implant load
3. Quarterly
4. Only when sterilizer is serviced

Answer: B — At least weekly + with every implant load

A) Above standard frequency. B) AAMI/CDC: at minimum once weekly; with each load containing implantables; also after major repairs. C) Quarterly is too infrequent. D) Service is one trigger, not the only one.

Incident report?

Document factual account of any unusual event (medication error, fall, needlestick). Used for QI, not punishment. Do NOT mention in chart.

Pediatric weight-based dosing — key safety step before administering?

Calculate the total daily dose from mg/kg/day, then divide by the number of doses per day; always double-check the calculated dose against the drug's safe pediatric dosing range before administration (double-check with a second qualified staff member per policy).

Hand hygiene?

Soap + water for ≥20 sec when visibly soiled OR after C. difficile contact. Alcohol-based hand rub OK otherwise. Before/after every patient contact.

HIPAA — what does it stand for?

Health Insurance Portability and Accountability Act (1996). Federal law protecting health information privacy + setting standards for electronic exchange.

Informed consent?

Patient must be given information about the procedure, risks, benefits, alternatives + must understand + agree voluntarily. Documented in chart.

BLS for healthcare providers — adult CPR ratio?

30 compressions : 2 breaths (single + 2-rescuer without advanced airway). Rate 100-120/min. Depth ≥2" (5 cm). Allow full recoil. Switch every 2 min to prevent fatigue.