CERTIFIED MEDICAL ASSISTANT (CMA) FINAL EXAM
COMPLETE QUESTIONS WITH 100% CORRECT ANSWERS
AND RATIONALE
1. A patient presents with sudden dyspnea, pleuritic chest pain, and tachycardia.
Which condition is most likely?
A. Pneumothorax
✔ B. Pulmonary embolism
C. Asthma exacerbation
D. Pericarditis
Rationale: Pulmonary embolism often presents with sudden dyspnea, pleuritic
chest pain, tachypnea, and tachycardia. Pneumothorax typically has absent breath
sounds; asthma has wheezing; pericarditis pain is positional but less acute
dyspnea.
2. Which lab value is most indicative of acute kidney injury?
A. Elevated BUN
✔ B. Rapid rise in serum creatinine
C. Decreased urine specific gravity
D. Hypernatremia
Rationale: Serum creatinine rises quickly in AKI due to reduced GFR. BUN can be
elevated but is less specific (affected by hydration).
3. A medical assistant is measuring blood pressure. The first Korotkoff sound
appears at 130 mmHg and disappears at 80 mmHg. Which is the diastolic
,pressure?
A. 130 mmHg
✔ B. 80 mmHg
C. 65 mmHg
D. 50 mmHg
Rationale: Diastolic pressure is the point where Korotkoff sounds disappear (Phase
V), unless sounds persist to zero (then Phase IV).
4. Which medication is a loop diuretic?
A. Hydrochlorothiazide
✔ B. Furosemide
C. Spironolactone
D. Metolazone
Rationale: Furosemide (Lasix) acts on the ascending loop of Henle. HCTZ and
metolazone are thiazides; spironolactone is potassium-sparing.
5. A patient with type 2 diabetes has a fasting glucose of 210 mg/dL and HbA1c of
9.5%. What is the most appropriate next step?
A. Start insulin glargine
✔ B. Intensify oral hypoglycemic therapy
C. Refer to nutritionist only
D. Recheck glucose in 3 months
*Rationale: HbA1c >9% indicates poor control; intensifying therapy (e.g.,
metformin + second agent) is indicated before insulin unless severe symptoms.*
6. Which needle gauge has the largest lumen?
✔ A. 18 gauge
B. 22 gauge
,C. 25 gauge
D. 30 gauge
*Rationale: Smaller gauge number = larger diameter. 18G is larger than 22G, used
for blood donation or rapid fluids.*
7. The surgical scrub should last at least:
A. 30 seconds
✔ B. 2–6 minutes
C. 10 minutes
D. 15 minutes
*Rationale: Traditional surgical scrub with antimicrobial soap is 2–6 minutes;
alcohol-based rubs may be shorter but with specific protocols.*
8. A patient’s ABG shows pH 7.25, PaCO2 55 mmHg, HCO3 24 mEq/L. This
indicates:
A. Metabolic acidosis
✔ B. Respiratory acidosis
C. Metabolic alkalosis
D. Respiratory alkalosis
*Rationale: Low pH (<7.35) + elevated PaCO2 (>45) = respiratory acidosis. HCO3
normal suggests acute.*
9. Which vein is most commonly used for venipuncture in the antecubital fossa?
A. Cephalic
✔ B. Median cubital
C. Basilic
D. Radial
, Rationale: Median cubital is large, stable, and less painful, preferred for
phlebotomy.
10. Which immunization is contraindicated in pregnancy?
A. Tdap
✔ B. Measles-mumps-rubella (MMR)
C. Influenza (inactivated)
D. Hepatitis B
Rationale: MMR is live attenuated virus, contraindicated in pregnancy due to
theoretical fetal risk. Tdap, inactivated flu, Hep B are safe.
11. A patient on warfarin has an INR of 4.5. No bleeding. Next step:
A. Give vitamin K 10 mg IV
✔ B. Hold warfarin and monitor INR
C. Give fresh frozen plasma
D. Increase warfarin dose
Rationale: INR 4.5 without bleeding: hold warfarin, recheck. Vitamin K reserved for
higher INR or bleeding.
12. Which of the following is a sign of hypokalemia?
A. Tetany
✔ B. U waves on ECG
C. Peaked T waves
D. Constipation
Rationale: Hypokalemia causes U waves, flat T waves, and ventricular
arrhythmias. Tetany and peaked T waves are hyperkalemia.
COMPLETE QUESTIONS WITH 100% CORRECT ANSWERS
AND RATIONALE
1. A patient presents with sudden dyspnea, pleuritic chest pain, and tachycardia.
Which condition is most likely?
A. Pneumothorax
✔ B. Pulmonary embolism
C. Asthma exacerbation
D. Pericarditis
Rationale: Pulmonary embolism often presents with sudden dyspnea, pleuritic
chest pain, tachypnea, and tachycardia. Pneumothorax typically has absent breath
sounds; asthma has wheezing; pericarditis pain is positional but less acute
dyspnea.
2. Which lab value is most indicative of acute kidney injury?
A. Elevated BUN
✔ B. Rapid rise in serum creatinine
C. Decreased urine specific gravity
D. Hypernatremia
Rationale: Serum creatinine rises quickly in AKI due to reduced GFR. BUN can be
elevated but is less specific (affected by hydration).
3. A medical assistant is measuring blood pressure. The first Korotkoff sound
appears at 130 mmHg and disappears at 80 mmHg. Which is the diastolic
,pressure?
A. 130 mmHg
✔ B. 80 mmHg
C. 65 mmHg
D. 50 mmHg
Rationale: Diastolic pressure is the point where Korotkoff sounds disappear (Phase
V), unless sounds persist to zero (then Phase IV).
4. Which medication is a loop diuretic?
A. Hydrochlorothiazide
✔ B. Furosemide
C. Spironolactone
D. Metolazone
Rationale: Furosemide (Lasix) acts on the ascending loop of Henle. HCTZ and
metolazone are thiazides; spironolactone is potassium-sparing.
5. A patient with type 2 diabetes has a fasting glucose of 210 mg/dL and HbA1c of
9.5%. What is the most appropriate next step?
A. Start insulin glargine
✔ B. Intensify oral hypoglycemic therapy
C. Refer to nutritionist only
D. Recheck glucose in 3 months
*Rationale: HbA1c >9% indicates poor control; intensifying therapy (e.g.,
metformin + second agent) is indicated before insulin unless severe symptoms.*
6. Which needle gauge has the largest lumen?
✔ A. 18 gauge
B. 22 gauge
,C. 25 gauge
D. 30 gauge
*Rationale: Smaller gauge number = larger diameter. 18G is larger than 22G, used
for blood donation or rapid fluids.*
7. The surgical scrub should last at least:
A. 30 seconds
✔ B. 2–6 minutes
C. 10 minutes
D. 15 minutes
*Rationale: Traditional surgical scrub with antimicrobial soap is 2–6 minutes;
alcohol-based rubs may be shorter but with specific protocols.*
8. A patient’s ABG shows pH 7.25, PaCO2 55 mmHg, HCO3 24 mEq/L. This
indicates:
A. Metabolic acidosis
✔ B. Respiratory acidosis
C. Metabolic alkalosis
D. Respiratory alkalosis
*Rationale: Low pH (<7.35) + elevated PaCO2 (>45) = respiratory acidosis. HCO3
normal suggests acute.*
9. Which vein is most commonly used for venipuncture in the antecubital fossa?
A. Cephalic
✔ B. Median cubital
C. Basilic
D. Radial
, Rationale: Median cubital is large, stable, and less painful, preferred for
phlebotomy.
10. Which immunization is contraindicated in pregnancy?
A. Tdap
✔ B. Measles-mumps-rubella (MMR)
C. Influenza (inactivated)
D. Hepatitis B
Rationale: MMR is live attenuated virus, contraindicated in pregnancy due to
theoretical fetal risk. Tdap, inactivated flu, Hep B are safe.
11. A patient on warfarin has an INR of 4.5. No bleeding. Next step:
A. Give vitamin K 10 mg IV
✔ B. Hold warfarin and monitor INR
C. Give fresh frozen plasma
D. Increase warfarin dose
Rationale: INR 4.5 without bleeding: hold warfarin, recheck. Vitamin K reserved for
higher INR or bleeding.
12. Which of the following is a sign of hypokalemia?
A. Tetany
✔ B. U waves on ECG
C. Peaked T waves
D. Constipation
Rationale: Hypokalemia causes U waves, flat T waves, and ventricular
arrhythmias. Tetany and peaked T waves are hyperkalemia.
