NHA Medical Assistant (CCMA) — All Questions

A provider gives a verbal order during a busy clinic. What should the medical assistant do?

• a.Carry it out and rely on the provider to enter the order in the record afterwards
• b.Ask the provider to write it down before anything is done, and decline to act until they do
• c.Carry it out and enter it in the record as though the provider had entered it themselves, which keeps the documentation consistent and saves the provider a step during a busy clinic session
• d.Repeat it back to confirm it, carry it out within scope, and document it for the provider to sign✓

Reading the order back catches the misheard drug, dose or patient before anything happens, and the order is then documented as a verbal order with the time, the provider's name and the assistant's signature, for the provider to authenticate. Acting without a read-back or documenting it as the provider's own entry both remove the check the process exists for.

A message arrives through the patient portal describing worsening symptoms. How should it be handled?

• a.Triage it the same way as a telephone call and escalate urgent content immediately✓
• b.Reply that portal messages are answered within five working days and take no further action
• c.Print it and place it in the provider's paper tray to be seen at the end of the clinic session, since a written message is by its nature less urgent than one the patient made the effort to telephone
• d.Delete it and telephone the patient to ask them to book a routine appointment instead

A portal message is a clinical communication and is screened against the same urgency criteria as a call, because a patient describing new chest pain in writing is in the same danger as one who telephones. Content that cannot wait goes to a clinician now, everything is documented in the record, and no message is deleted.

What does the phrase res ipsa loquitur describe in a malpractice context?

• a.That an expert witness must always testify in person before negligence can be established at trial
• b.That the injury is of a kind that does not happen without negligence, so it speaks for itself✓
• c.That the patient consented to the risk in writing before the procedure took place
• d.That the employer answers for acts an employee committed within the scope of employment

Res ipsa loquitur applies where the harm could not ordinarily occur without negligence and the instrumentality was under the defendant's control, the classic example being an instrument left inside a patient. Respondeat superior is the employer liability doctrine, and consent and expert testimony are separate matters.

A sixteen-year-old asks to be seen without a parent present. What determines whether that is permitted?

• a.The medical assistant's judgement of how mature the patient seems during the intake
• b.The parent's written permission, which is required in every state for a patient under eighteen
• c.State law and practice policy, which allow certain minors or services to be handled directly✓
• d.Whether the patient is able to pay for the visit without using a parent's insurance plan

States define which minors may consent for themselves, such as emancipated minors or those who are married or serving in the military, and which services a minor may seek directly, commonly including sexually transmitted infection testing, contraception and mental health or substance use care. The practice follows its state's rules rather than a judgement made at the desk.

What is the purpose of an encounter form, sometimes called a superbill?

• a.To record the clinical findings and the plan agreed with the patient at the visit
• b.To collect the patient's insurance details and demographic information at registration
• c.To capture the diagnoses and services from one visit so the charge can be generated✓
• d.To document that the patient received and understood the practice's privacy notice, which the practice must be able to demonstrate if it is ever asked to show that the notice was provided

The encounter form links the visit to the codes that will be billed: the diagnoses that explain why the patient was seen and the procedures and services provided. Clinical detail belongs in the progress note, demographics are collected at registration and the privacy notice acknowledgement is a separate document.

A medical assistant recognises a patient in the waiting room as a neighbour. What is the correct behaviour?

• a.Greet the patient normally but do not mention the visit or the reason for it outside work✓
• b.Avoid all eye contact so that nobody in the waiting room can connect the two of them at all
• c.Mention to the patient afterwards, outside work, that they were seen at the clinic, so the neighbour knows the assistant was discreet and did not say anything to anyone else about it
• d.Ask a colleague to take the patient through so that no professional contact takes place

The fact that someone attended is itself protected, so the assistant behaves normally at work and says nothing about the visit outside it, including to the patient in a social setting, which invites a conversation others may overhear. Refusing all contact is conspicuous, and handing the patient to a colleague may be courteous but is not the requirement.