Medical Assistant Certification (CMA / RMA) Clinical Procedures and Patient Care Syllabus

What does pulse oximetry measure and what is the normal range?

It non-invasively measures oxygen saturation (SpO2) of hemoglobin. Normal is 95-100%; below 90% indicates hypoxemia requiring intervention.

What scale is most commonly used for pain assessment and what does it range from?

The numeric rating scale (0-10), where 0 = no pain and 10 = worst possible pain. The Wong-Baker FACES scale is used for children and nonverbal patients.

What is the difference between a chief complaint and the history of present illness (HPI)?

The chief complaint (CC) is the patient's main reason for the visit stated briefly in their own words; the HPI is a detailed chronological description of the development of that complaint.

What is the difference between subjective and objective data in patient history?

Subjective data is what the patient reports (symptoms like pain, nausea); objective data is what can be measured or observed (signs like temperature, BP, rash).

Which patient position is used for vaginal/pelvic exams and Pap smears?

The lithotomy position: patient supine with legs flexed and feet in stirrups, buttocks at the edge of the table.

What positions are commonly used for a rectal exam or sigmoidoscopy?

Sims' position (left side-lying with right knee flexed) or the knee-chest/genupectoral position.

What is Fowler's position and when is it used?

Patient sitting with the head of the table elevated 45-90°. Used for patients with breathing difficulty and for exams of the head, neck, and chest.

What are the four examination methods used in physical examination?

Inspection (visual observation), palpation (touch), percussion (tapping to assess sounds/density), and auscultation (listening, usually with a stethoscope).

In what order are examination methods performed for the abdomen, and why is it different?

Inspection, auscultation, percussion, then palpation. Auscultation is done before palpation/percussion because touching the abdomen can alter bowel sounds.

What instrument is used to examine the ears, and how is the ear canal straightened in adults vs. children?

An otoscope. In adults, pull the pinna up and back; in children under 3, pull the pinna down and back.

What is the purpose of a Pap smear and how often is it typically recommended?

It screens for cervical cancer and precancerous cells. Generally recommended every 3 years for women 21-65 (or every 5 years with HPV co-testing for 30-65).

What are the sterile-field rules a medical assistant must follow during minor surgery?

Keep sterile items above waist level and in view, do not reach over the field, a 1-inch border is non-sterile, moisture contaminates the field, and never turn your back on it.

What suture removal interval is typical for the face vs. other body areas?

Facial sutures are usually removed in 3-5 days; sutures on other areas (limbs, trunk) in 7-14 days depending on tension and location.

What is the difference between an agonist and an antagonist drug?

An agonist binds to a receptor and produces a response (activates it); an antagonist binds to a receptor and blocks or prevents a response.

Define the drug classes: analgesic, antipyretic, antitussive, and diuretic.

Analgesic relieves pain; antipyretic reduces fever; antitussive suppresses cough; diuretic increases urine output to remove excess fluid.

What is the difference between a drug's generic name and brand (trade) name?

The generic name is the official non-proprietary name (e.g., acetaminophen), lowercase; the brand/trade name is the manufacturer's trademarked name (e.g., Tylenol), capitalized.

What are the main parenteral routes of medication administration?

Intradermal (ID, into dermis), subcutaneous (SubQ/SC, into fatty tissue), intramuscular (IM, into muscle), and intravenous (IV, into vein).

What needle angle is used for intradermal, subcutaneous, and intramuscular injections?

Intradermal 10-15°, subcutaneous 45° (or 90° with short needle), intramuscular 90°.

What are the common intramuscular injection sites?

Deltoid (arm), vastus lateralis (thigh, preferred for infants), and ventrogluteal (hip). The dorsogluteal site is avoided due to sciatic nerve risk.

What is the basic formula for calculating a medication dose?

Dose = (Desired dose ÷ Dose on hand) × Quantity on hand, i.e., D/H × Q. This gives the volume or number of units to administer.

Convert: 1 gram = how many milligrams, and 1 milligram = how many micrograms?

1 g = 1,000 mg, and 1 mg = 1,000 mcg. Each metric step changes by a factor of 1,000.

How many milliliters are in 1 teaspoon, 1 tablespoon, and 1 ounce?

1 tsp = 5 mL; 1 tbsp = 15 mL (3 tsp); 1 oz = 30 mL. Also 1 kg = 2.2 lb.

What are the Six Rights of medication administration?

Right patient, right drug, right dose, right route, right time, and right documentation. (Some add right reason and right to refuse.)

What information must appear on a complete prescription?

Patient name/date, drug name and strength, Sig (directions), quantity to dispense, number of refills, prescriber signature and DEA number (for controlled drugs).

Describe the DEA controlled substance schedules I through V.

Schedule I: no accepted medical use, high abuse (heroin, LSD). II: high abuse, accepted use (opioids, amphetamines). III: moderate (some codeine combos). IV: low (benzodiazepines). V: lowest (cough syrups with low codeine).

At what temperatures are refrigerated and frozen vaccines stored?

Refrigerated vaccines: 36-46°F (2-8°C). Frozen vaccines: -58 to +5°F (-50 to -15°C). Temperatures must be logged and monitored daily.

What is the difference between active and passive immunity?

Active immunity: the body produces its own antibodies after infection or vaccination (long-lasting). Passive immunity: antibodies are received from another source (mother, immunoglobulin), giving immediate but temporary protection.

What are the universal steps of adult CPR (compression rate, depth, and ratio)?

Compressions at 100-120/min, at least 2 inches deep, with a 30:2 compression-to-ventilation ratio for single rescuer. Allow full chest recoil between compressions.

What is the response for a conscious choking adult vs. an unconscious one?

Conscious: abdominal thrusts (Heimlich maneuver). Unconscious: begin CPR, checking the mouth for the object before giving breaths.

Name common items found on an emergency crash cart.

AED/defibrillator, airway equipment (Ambu bag, oral airways, oxygen), emergency drugs (epinephrine, atropine, nitroglycerin), IV supplies, and a backboard. Contents are checked and logged regularly.

What is shock, and what are the basic first-aid steps for it?

Shock is inadequate tissue perfusion/oxygenation. First aid: lay the patient flat, elevate legs ~12 inches (unless head/spine injury), keep warm, control bleeding, give oxygen, and monitor vitals.

Describe first-aid management for severe external bleeding and for a suspected fracture.

Bleeding: apply direct pressure with sterile dressing, elevate if possible, add tourniquet if uncontrolled. Fracture: immobilize/splint in position found, apply cold, do not attempt to realign the bone.

How are burns classified by depth?

First-degree (superficial): epidermis only, red and painful. Second-degree (partial-thickness): epidermis and dermis, blisters. Third-degree (full-thickness): all layers, charred/white, often painless due to nerve damage.

What are the signs of anaphylaxis and the first-line emergency treatment?

Signs: hives, swelling of throat/tongue, wheezing, difficulty breathing, hypotension. First-line treatment is intramuscular epinephrine (EpiPen), then call EMS.