AAMA CMA Practice Test

Chlorhexidine gluconate (CHG) at about 2 % in 70 % isopropyl alcohol combines the rapid, broad-spectrum kill of alcohol with the residual binding of CHG to the stratum corneum, providing antimicrobial activity that persists for hours. Plain 70 % isopropyl alcohol works quickly but loses activity as soon as it evaporates. Povidone-iodine offers broad coverage but has little residual effect once dry, and hydrogen peroxide is not recommended for surgical skin prep because of limited spectrum, tissue toxicity, and lack of sustained action.

The Sims position, also known as the left lateral decubitus position, is the best choice because it provides optimal exposure for rectal examinations, treatments, and some gynecological procedures. In this position, the patient lies on their left side with their right knee bent toward the chest and their left arm positioned behind the body, creating easier access for the provider to the rectal area while maintaining patient comfort. The Trendelenburg position is not suitable as it involves lying on the back with the body tilted so that the head is lower than the feet, which is generally used for procedures where improved venous return to the heart is desired. The prone position does not provide access to the anterior portions of the body and thus is not suitable for gynecological procedures. The Fowler's position, typically involving the patient seated with the head of the bed raised, is more appropriate for respiratory evaluations and less invasive exams.

When a medical office has exhausted in-house attempts to collect an overdue payment, such as sending multiple statements and making phone calls, and the account remains unpaid after a reasonable period (typically 90-120 days), it is generally advisable to turn the account over to a collection agency. This step comes after the office has attempted to work with the patient and has given adequate notice that the account may be sent to collections if not resolved. Sending the patient to the collection agency too early without proper notice or without attempting to resolve the issue may compromise the relationship with the patient and might not adhere to office policies or regulations.

The correct action to take when faced with a denial due to a dispute over medical necessity is to file an appeal and include supporting documentation, such as medical records, that demonstrate the procedure's necessity. It’s essential for the appeal to be accompanied by a thorough explanation and any relevant evidence that substantiates the claim. Merely resubmitting the claim or providing insufficient documentation will not address the denial effectively and could delay the resolution.

Projection is a defense mechanism where individuals deflect unwanted emotions or traits they don't like about themselves onto someone else, rather than admitting to or dealing with the unwanted feelings. Denial involves ignoring the existence of a distressing reality, suppression is a conscious form of exclusion of uncomfortable thoughts, and regression is the reversion to an earlier stage of development in the face of unacceptable thoughts or impulses.

The correct answer is 'Advance Beneficiary Notice (ABN)'. ABNs are used to inform Medicare patients about services and items that Medicare is not expected to pay for. By signing an ABN, the patient acknowledges their understanding that they may be responsible for the payment. This document is essential to ensure that the practice complies with Medicare rules and to prevent unexpected charges for the patient. An Explanation of Benefits (EOB) is incorrect because it is a document sent to patients after a claim has been processed by insurance, detailing what was covered and what the patient owes. A Remittance Advice is provided to a healthcare provider by the payer, showing the payment and adjustments made to a claim. Pre-certification refers to obtaining prior authorization for certain services but does not involve informing the patient of potential non-coverage.

An elevated hematocrit level indicates a higher-than-normal percentage of red blood cells in the blood. This can be caused by a decrease in plasma volume, which occurs during dehydration, making the red blood cells more concentrated. Other less common causes include conditions that increase red blood cell production, such as polycythemia vera or chronic low oxygen levels. Anemia, overhydration, and active bleeding would all typically result in a low hematocrit level.

For an abdominal ultrasound, it is often necessary that the patient's bladder be full to improve the visualization of the abdominal organs, which is why instructing the patient not to empty their bladder is correct. Eating and drinking before an abdominal ultrasound can interfere with the imaging process by causing gas in the intestines, and fasting is usually recommended. Vital signs and an EKG are not standard preparation steps for an abdominal ultrasound.

Hand hygiene is recognized as one of the most important practices to prevent the spread of infectious agents. Influenza can be transmitted through direct or indirect contact with respiratory droplets from an infected person. Proper handwashing or the use of alcohol-based hand rubs removes or kills the virus that might have been picked up by the hands, preventing it from being transferred to oneself or others.

Ensuring the test site is clean and devoid of any lotions or creams is critical. If the site is contaminated with substances that could interfere with the test, it could cause a false positive or false negative result by either triggering a reaction by itself or by preventing a reaction from an allergen. Cleansing with alcohol removes these contaminants. Proper patient identification is essential in all procedures but does not directly influence the accuracy of the intradermal test results. While minor bleeding may occur, it does not typically impact the test outcome unless significantly altering the test site's appearance. Similarly, applying a bandage is not related to the accuracy of the results, as the reading is based on the skin's response.

The first step in managing a hazardous spill is to alert others in the area to prevent them from coming into contact with the spill, which could potentially spread contamination or result in personal injury. Subsequent steps would involve donning personal protective equipment (PPE), containing the spill if possible, and then cleaning it up using a spill kit. Calling a professional cleaning service may be the right choice for very large or dangerous spills, but for standard spills in a medical setting, using a spill kit is generally the first action after alerting others and putting on PDE.

Growth charts are the standard tool used by healthcare providers to track a child's growth pattern over time. By plotting the measurements of height, weight, and head circumference, providers can compare a child's developmental progress against established percentile rankings based on a reference population. This comparison is essential for identifying any potential growth abnormalities or health concerns.

The deductible is the amount a patient is required to pay out-of-pocket before their insurance company begins to cover the costs of their healthcare services. Understanding the term 'deductible' is essential for managing patient accounts accurately and ensuring clarity in patient billing.

RAST is an in-vitro radioimmunoassay that detects and quantifies allergen-specific IgE bound to solid-phase allergen extracts. Elevated specific IgE levels indicate that the patient has been sensitized to the tested substance. Other immunoglobulin classes (IgG, IgM, IgA) are not measured by this assay and therefore do not provide information about Type I hypersensitivity reactions.

The correct procedure in this situation is for the medical assistant to follow up with the insurance companies regarding the status of the claims. Timely follow-up is crucial to ensure that unpaid claims are addressed and resolved, which could involve re-submission, providing additional information, or correcting any errors that may have led to the delay in payments. Notifying the provider or supervisor would generally come either after determining the cause of delay or if the medical assistant requires further advice or authority to resolve the claim issues. Waiting another week is not a proactive approach, and contacting patients directly is inappropriate until it's confirmed that there is patient responsibility for the claim (such as due to a rejection or patient deductible).