Medical Assistant Prep

MEDICAL ASSISTANT PREP: PASS YOUR CMA OR RMA CERTIFICATION EXAM

The CMA from AAMA has a 67 percent first-attempt pass rate. The RMA from AMT and the CCMA from NHA are similarly challenging. Candidates who fail are most often weak on EKG interpretation, medication administration routes, clinical procedures, and medical law and ethics.

VITAL SIGNS REFERENCE

Temperature: normal 97.8 to 99.1 degrees F. Axillary is 1 degree lower than oral. Rectal is 1 degree higher. Pulse: normal adult 60 to 100 bpm. Tachycardia above 100, bradycardia below 60. Sites: radial (most common), apical (infants and cardiac, full 60 seconds), brachial, carotid, femoral. Respirations: normal adult 12 to 20 per minute. Never count while patient is aware. One respiration equals one inhalation plus one exhalation. Blood pressure: normal below 120 over 80. Stage 1 hypertension 130 to 139 over 80 to 89. Stage 2 hypertension 140 plus over 90 plus. Hypertensive crisis 180 plus over 120 plus. Cuff must cover 80 percent of upper arm. Pulse oximetry: normal 96 to 100 percent. Below 90 requires immediate intervention.

EKG RHYTHM GUIDE

Lead placement: Limb leads RA, LA, RL, LL. V1 right of sternum 4th intercostal space. V2 left of sternum 4th intercostal space. V4 midclavicular 5th intercostal space. V6 midaxillary 5th intercostal space. Normal sinus rhythm: 60 to 100, regular, P before every QRS, PR 0.12 to 0.20 seconds, QRS less than 0.12 seconds.

12 rhythms covered: sinus tachycardia, sinus bradycardia, sinus arrhythmia, atrial fibrillation (irregularly irregular, no distinct P waves), atrial flutter (sawtooth P waves), first-degree AV block (prolonged PR), PVC (wide bizarre QRS), ventricular tachycardia, ventricular fibrillation. Common artifacts: somatic tremor, AC interference, baseline wander.

MEDICATION ROUTE CHART

Oral (PO): first-pass metabolism. Sublingual (SL): rapid absorption, bypasses first-pass. Subcutaneous (SQ): 45 to 90 degrees, 3/8 to 5/8 inch needle, max 1 mL, pinch technique. Intramuscular (IM): 90 degrees, 1 to 1.5 inch needle, max 3 mL, Z-track for irritating medications, sites (deltoid max 1 mL, vastus lateralis 3 mL, ventrogluteal 3 mL). Intradermal (ID): 10 to 15 degrees, bevel up, max 0.1 mL, wheal must form (TB test, allergy testing).

1,000+ PRACTICE QUESTIONS

GENERAL AND ADMINISTRATIVE (40%): Medical law (HIPAA, Stark Law, False Claims Act, respondeat superio