AAMA CMA Practice Test

Gentle, graded palpation is necessary to assess areas of tenderness and possible inflammation without causing excessive discomfort or further injury to the patient. Starting palpation away from the painful area helps to relax the patient and makes it easier to identify the exact point of maximal tenderness. Deep palpation or vigorous palpation of the tender area could exacerbate the pain and may potentially cause harm, especially if the appendix is inflamed and at risk of rupture. Therefore, employing a gentle, graded approach is most appropriate. Serial palpation at intervals is not a technique for exploring acute tenderness as it refers to repeated examinations over time, not assessing tenderness progressively. Moreover, using rebound tenderness as a part of palpation technique is helpful but is not the initial palpation technique used for assessment; it is rather a sign elicited after careful palpation.

The correct response is to document the no-show in the patient's medical record as it is necessary to maintain an accurate account of the patient's appointment history. It helps in identifying patterns of non-attendance and may also have implications for billing and future scheduling. Calling the patient to schedule a new appointment, considering charging a no-show fee, and sending a letter to the patient about the missed appointment are subsequent steps after the no-show has been documented. It is essential not to jump to conclusions or take punitive measures without first recording the incident accurately.

The correct answer is the appendix, which is located in the lower right quadrant of the abdomen. It is important to know the location of specific organs within the body cavities because pain in certain areas can indicate issues with particular organs. While the other answers may also be found in the abdominal cavity, they are not typically associated with the lower right quadrant. The stomach is primarily located in the upper left quadrant, the spleen in the upper left quadrant, and the liver is mostly in the right upper quadrant.

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.

The correct action is to gently rewarm the patient because a core body temperature of 35°C (95°F) indicates mild hypothermia. The patient should be warmed slowly to avoid any complications associated with a rapid change in body temperature. The use of hot water or excessively heating methods can cause burns or a sudden change in blood flow which may lead to shock, thus it is not recommended. Ignoring the signs or assuming the patient simply needs rest could result in the progression of hypothermia, which can become life-threatening.

According to the U.S Preventive Services Task Force, osteoporosis screening with a DEXA scan is recommended for women aged 65 years or older and younger women at increased risk for fractures. The female patient aged 70 with a history of smoking and sedentary lifestyle represents the profile aligned most closely with these guidelines. Smoking and lack of physical activity are both risk factors that contribute to bone loss and fracture risk, which alongside her age, make her the best candidate for screening.

The correct answer is: Daily. End-of-day (daily) reconciliation ensures that every charge, payment, and adjustment entered during the workday matches the corresponding encounter forms and deposit records. Performing this task daily allows discrepancies to be caught and corrected immediately, supports accurate accounts-receivable totals, and helps prevent cash-flow or fraud problems. Waiting until the end of the week or month allows errors to accumulate and makes them harder to trace.

The diagnostic code for acute viral pharyngitis should be linked to the throat culture procedure because it represents the diagnosis established after evaluating the patient and the test performed. Linking the procedure to the final diagnosis supports the clinical reason for conducting the test and demonstrates medical necessity since the procedure was used to differentiate between a bacterial infection requiring antibiotics and a viral infection which does not. Linking a throat culture to a diagnosis code for conditions unrelated to the throat, such as gastroesophageal reflux disease or chronic tonsillitis, would be incorrect, as these conditions would not justify the need for a throat culture based on medical necessity guidelines.

The healthcare provider is required to grant the patient access to inspect and obtain a copy of their medical records as per HIPAA regulations. The provider should comply with this request within a timely manner, often specified as within 30 days. Refusal to provide access can only occur under specific circumstances, such as if access would likely endanger the life or physical safety of the individual or another person.

"Subcutaneous" begins with the Latin prefix sub-, which means "under" or "below." The other choices begin with Greek (hypo-), descriptive (hyper-), or directional (ab-) prefixes that do not meet the Latin criterion.

Battery in a medical setting occurs when a healthcare professional intentionally performs a physical act on a patient without the patient’s consent. In the correct answer, physical contact is made without explicit consent. Obtaining consent and respecting patient autonomy are critical to avoid accusations of battery. The incorrect options either involve verbal actions with consent or lack intentional inappropriate physical contact.

The International Normalized Ratio (INR) is a standardized calculation derived from the prothrombin time that measures the extent of anticoagulation produced by vitamin K antagonists such as warfarin. Clinicians adjust the dose of warfarin to keep the INR in a target therapeutic range (for many indications 2.0-3.0). Monitoring the INR helps prevent thrombotic events when values are too low and bleeding complications when values are too high. Hemoglobin A1c is used for long-term glycemic control, blood urea nitrogen assesses renal function, and LDL cholesterol evaluates lipid status; none of these are used to guide warfarin dosing.

The Centers for Disease Control and Prevention (CDC) is the primary national public health institute in the United States and provides the most current and reliable immunization schedules, which are used as the standard for healthcare providers. The CDC’s immunization schedules are reviewed and updated annually based on the latest scientific evidence and are endorsed by public health authorities, making them the best resource for this information. Other options, while they may offer related information, do not have the authority or comprehensive, up-to-date schedules that the CDC provides.

A Complete Blood Count (CBC) typically requires whole blood collected into a tube with an anticoagulant, such as EDTA, which preserves the cellular components of the blood. Glucose level analysis, often after a period of fasting, is performed on serum; hence, blood needs to clot first in a tube without an anticoagulant, like a serum separator tube, typically a grey top tube that may also contain an antiglycolytic agent to prevent glycolysis. It is critical to collect the specimens in the appropriate tubes to ensure the accuracy of the test results and avoid cross-contamination of additives between the tubes.

An in-office (point-of-care) urine pregnancy test detects human chorionic gonadotropin (HCG) just as a home test does, but it allows the health-care team to verify the result under controlled conditions and document it in the medical record immediately. The test is quick, inexpensive, non-invasive, and sufficiently reliable for routine confirmation. Quantitative serum HCG testing is reserved when earlier detection, dating, or evaluation of pregnancy complications is needed, and ultrasound is typically used later to assess viability and gestational age. Repeating a home test adds no clinical value once the patient is in the office.