Medical Assistant Certification (CMA / RMA) Laboratory and Diagnostic Testing Syllabus

Laboratory and Diagnostic Testing syllabus — full chapter and topic list

Expand any chapter to see its topics and sub-topics. This is the whole examinable outline for Laboratory and Diagnostic Testing in Medical Assistant Certification (CMA / RMA), not a summary of it.

1. 1

   Phlebotomy and Specimen Collection

   4 topics

   • Venipuncture Technique
     • Site selection and vein anatomy
     • Evacuated tube system and order of draw
   • Capillary Puncture
   • Patient Preparation and Identification
   • Complications and Troubleshooting
     • Hemolysis and hematoma
     • Fainting and nerve injury
2. 2

   Specimen Handling and Processing

   4 topics

   • Labeling and Chain of Custody
   • Centrifugation and Aliquoting
   • Storage and Transport Requirements
   • Urine and Stool Collection
     • Clean-catch midstream
     • 24-hour collection
3. 3

   CLIA-Waived and Point-of-Care Testing

   5 topics

   • Urinalysis
     • Physical, chemical, microscopic exam
   • Blood Glucose and Hemoglobin A1c
   • Rapid Strep, Mono, and Influenza Tests
   • Pregnancy and Occult Blood Testing
   • Quality Control and Reagent Management
4. 4

   Diagnostic Cardiology and Imaging Support

   4 topics

   • Electrocardiography (ECG)
     • Lead placement (limb and precordial)
     • Artifact identification and correction
   • Holter and Stress Test Assistance
   • Spirometry and Pulmonary Function
   • Patient Prep for Radiology and Imaging

Laboratory and Diagnostic Testing flashcards for Medical Assistant Certification (CMA / RMA)

25 of 75 cards from the Laboratory and Diagnostic Testing deck — real questions with worked answers.

1. What is venipuncture?

   The puncture of a vein with a needle to collect a blood sample (most commonly from the median cubital vein in the antecubital fossa).

2. In the standard order of draw for evacuated (Vacutainer) tubes, what is the correct sequence by tube color?

   1) Blood culture (yellow/sterile), 2) Light blue (sodium citrate), 3) Red/gold/SST (serum), 4) Green (heparin), 5) Lavender/purple (EDTA), 6) Gray (sodium fluoride/oxalate).

3. Why must the light-blue sodium citrate (coagulation) tube be filled completely?

   It has a fixed 9:1 blood-to-anticoagulant ratio; underfilling alters the ratio and produces falsely prolonged PT/PTT results.

4. Which additive is in a lavender/purple-top tube and what tests is it used for?

   EDTA (an anticoagulant that binds calcium); used for CBC and most hematology tests.

5. What additive does a light-blue top tube contain and what is it used for?

   Sodium citrate (anticoagulant); used for coagulation studies (PT, PTT, INR).

6. What is the purpose of the additive in a gray-top tube?

   Sodium fluoride (an antiglycolytic agent, often with potassium oxalate) preserves glucose by inhibiting glycolysis; used for glucose and lactate testing.

7. What is the recommended needle gauge range for routine adult venipuncture, and which has the larger bore?

   21–23 gauge is typical (21G is standard); the smaller the gauge number, the larger the bore.

8. How long should a tourniquet stay on the arm, and why?

   No more than 1 minute; prolonged application causes hemoconcentration, which falsely elevates analytes like proteins and cells.

9. At what angle should the needle be inserted during routine venipuncture?

   At a 15–30 degree angle, bevel up.

10. What is capillary (dermal) puncture and when is it preferred?

    A skin puncture to collect capillary blood; preferred for infants, point-of-care tests, and when only a small sample is needed or veins are inaccessible.

11. What is the recommended puncture site for a heel stick in an infant?

    The medial or lateral plantar surface (sides) of the heel, avoiding the center and the arch.

12. Why must the first drop of blood be wiped away during a capillary puncture?

    The first drop is contaminated with tissue fluid (and any residual alcohol), which can cause inaccurate results.

13. What is the recommended fingerstick site and depth considerations for an adult capillary puncture?

    The side of the fleshy pad of the middle or ring finger, puncturing across (perpendicular to) the fingerprint lines; depth must not exceed about 2.0 mm to avoid bone.

14. What is the order of draw for capillary collection?

    1) Blood gases, 2) EDTA (lavender), 3) other additive tubes, 4) serum tubes — EDTA first (after gases) to ensure an adequate hematology sample before clotting/platelet clumping.

15. What are the two required patient identifiers for specimen collection?

    At least two identifiers such as full name and date of birth (and/or medical record number); never the room/bed number alone.

16. How should a patient be identified before drawing blood?

    Ask the patient to actively state their full name and date of birth, then compare against the requisition and ID band/record (active identification).

17. How many hours of fasting are typically required for a fasting blood glucose or lipid panel?

    Usually 8–12 hours, with water permitted.

18. What is hemolysis and what causes it during a draw?

    The rupture of red blood cells releasing contents into the serum/plasma; caused by vigorous shaking, small-bore needles, prolonged tourniquet use, or forcing blood through a needle.

19. Which common test result is falsely elevated by hemolysis?

    Potassium (K+), because RBCs release intracellular potassium; LDH, AST, and magnesium are also affected.

20. What is a hematoma and how should you respond if one forms during venipuncture?

    A swelling/bruise from blood leaking into tissue; immediately release the tourniquet, remove the needle, and apply firm pressure to the site.

21. What is hemoconcentration and what causes it?

    An increased concentration of cells and large molecules in blood; caused by prolonged tourniquet application or excessive fist pumping.

22. If blood stops flowing into the tube during a draw ('missed vein'), what adjustments can you try?

    Slightly advance or withdraw the needle, rotate the bevel, try another tube, or check that the tube vacuum is intact; if unsuccessful, discontinue and select another site.

23. What is venous reflux and how is it prevented?

    Backflow of tube additive into the patient's vein; prevented by keeping the patient's arm downward and the tube below the puncture site so it fills from the bottom up.

24. What is the minimum information that must appear on a specimen label?

    Patient full name, unique identifier (DOB or MRN), date and time of collection, and the collector's initials/ID.

25. When must a specimen be labeled?

    Immediately at the patient's side (bedside), in the presence of the patient, before leaving the patient.

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