CCMA Testing and Laboratory Procedures Practice Test

25 practice questions

Choose an answer, then check it under Show answer.

1. Question 1 of 25Easy

   A urine reagent strip is positive for both nitrite and leukocyte esterase. Which condition do these results most suggest?

   1. AA. Urinary tract infection
   2. BB. Uncontrolled diabetes
   3. CC. Liver disease
   4. DD. Dehydration
   Show answer to question 1

   Answer: A. Urinary tract infection

   Nitrite forms when certain bacteria convert nitrate in urine, and leukocyte esterase indicates white blood cells. Together, they suggest a urinary tract infection, which the provider may confirm with a culture.

   Why the other options are wrong

   • BUncontrolled diabetes is suggested by glucose and ketones in the urine.
   • CLiver disease is suggested by bilirubin in the urine.
   • DDehydration is suggested by a high specific gravity.

2. Question 2 of 25Medium

   A patient is scheduled for a point-of-care hemoglobin A1C test at her afternoon visit. No other tests are ordered. She calls to ask whether she must skip lunch before the test. How should the medical assistant respond?

   1. AA. Yes, fast for 12 hours before the test
   2. BB. Yes, drink only water for 4 hours before the test
   3. CC. No, fasting is not required for this test
   4. DD. No, but avoid all fluids for 2 hours before it
   Show answer to question 2

   Answer: C. No, fasting is not required for this test

   Hemoglobin A1C reflects average glucose over several months, so a recent meal does not significantly change the result. Fasting is not required for this test.

   Why the other options are wrong

   • AA 12-hour fast is not needed because A1C does not reflect short-term glucose changes.
   • BA water-only period is not required for an A1C test.
   • DRestricting fluids is unnecessary and could make a fingerstick collection harder.

3. Question 3 of 25Hard

   A 30-year-old woman has had vomiting for two days and has been drinking very little. Which urinalysis finding would the medical assistant most likely see?

   1. AA. Low specific gravity
   2. BB. High specific gravity
   3. CC. Positive nitrite
   4. DD. Very pale, watery color
   Show answer to question 3

   Answer: B. High specific gravity

   With fluid loss and low intake, the kidneys conserve water and produce concentrated urine. Concentrated urine has a high specific gravity and is usually dark yellow.

   Why the other options are wrong

   • ALow specific gravity indicates dilute urine, which is seen with high fluid intake, not dehydration.
   • CA positive nitrite suggests bacteria in the urine, which dehydration alone does not cause.
   • DPale, watery urine is dilute and does not fit a patient who is dehydrated.

4. Question 4 of 25Medium

   A medical assistant gives a patient a 24-hour urine container that already contains an acid preservative. Which instruction should the patient receive?

   1. AA. Keep the liquid in the container and avoid skin contact
   2. BB. Rinse the container with water before the first void
   3. CC. Pour the liquid into the toilet before collecting urine
   4. DD. Store the container next to a heater to keep it warm
   Show answer to question 4

   Answer: A. Keep the liquid in the container and avoid skin contact

   Some 24-hour urine tests require a preservative placed in the container before collection. The patient must not discard it and should avoid touching it, because acids can burn the skin.

   Why the other options are wrong

   • BRinsing would remove the preservative the test requires.
   • CDiscarding the preservative would make the specimen unacceptable for testing.
   • DMost 24-hour collections are kept cool, and heat can degrade the specimen.

5. Question 5 of 25Medium

   The instructions for a rapid strep test say to read the result at 5 minutes. The waiting room is busy, so a medical assistant reads the test at 2 minutes and sees only the control line. What is the main problem with this result?

   1. AA. The result should have been read at 10 minutes to be accurate
   2. BB. Reading early may produce a false-negative result
   3. CC. Reading early always produces a false-positive result
   4. DD. There is no problem, because the control line appeared
   Show answer to question 5

   Answer: B. Reading early may produce a false-negative result

   Waived tests must be performed and read exactly as the manufacturer directs. Reading before the stated time may not allow a positive test line to develop, which can produce a false-negative result.

   Why the other options are wrong

   • AThe result should be read at the time stated in the instructions, which is 5 minutes in this case.
   • CAn early reading is more likely to miss a developing line than to create a false-positive result.
   • DA visible control line does not make a reading valid when it is taken before the required time.

6. Question 6 of 25Easy

   A rapid CLIA-waived test that detects heterophile antibodies is used to help diagnose which condition?

   1. AA. Streptococcal pharyngitis
   2. BB. Influenza A or B
   3. CC. Urinary tract infection
   4. DD. Infectious mononucleosis
   Show answer to question 6

   Answer: D. Infectious mononucleosis

   Infectious mononucleosis, usually caused by Epstein-Barr virus, triggers heterophile antibodies that rapid mono tests detect in blood, serum or plasma. Results may be negative early in the illness.

   Why the other options are wrong

   • AStrep throat is detected with a rapid antigen test on a throat swab.
   • BInfluenza is detected by antigen or molecular tests on a nasal or nasopharyngeal swab.
   • CUrinary tract infection is screened with a urine reagent strip and confirmed by culture.

7. Question 7 of 25Easy

   A patient who takes warfarin comes to the clinic for a fingerstick test to monitor his anticoagulation therapy. Which point-of-care test is typically used?

   1. AA. Prothrombin time with INR
   2. BB. Hemoglobin A1C
   3. CC. Erythrocyte sedimentation rate
   4. DD. Total cholesterol
   Show answer to question 7

   Answer: A. Prothrombin time with INR

   Warfarin therapy is monitored with the prothrombin time reported as an INR. Several CLIA-waived fingerstick meters provide this result so the provider can adjust the dose.

   Why the other options are wrong

   • BHemoglobin A1C monitors long-term blood glucose control, not anticoagulation.
   • CThe sedimentation rate is a nonspecific marker of inflammation.
   • DTotal cholesterol helps assess cardiovascular risk and does not measure clotting time.

8. Question 8 of 25Hard

   A medical assistant finds an unlabeled urine specimen cup on the lab counter. Two patients gave urine specimens in the last 15 minutes, and it is unclear which one this is. What should the medical assistant do?

   1. AA. Reject the specimen and arrange to recollect, per policy
   2. BB. Label it with the name of the patient who arrived last
   3. CC. Test it and decide whose it is based on the results
   4. DD. Ask a coworker which patient most likely left the cup
   Show answer to question 8

   Answer: A. Reject the specimen and arrange to recollect, per policy

   A specimen that cannot be positively identified must never be labeled by guesswork. It is rejected according to policy, the problem is reported, and new specimens are collected so results are matched to the correct patient.

   Why the other options are wrong

   • BGuessing the source could attach one patient's result to another patient's record.
   • CTest results cannot reliably identify which patient produced a specimen.
   • DA coworker's memory is not positive identification and does not make the label reliable.

9. Question 9 of 25Medium

   When performing a urine reagent strip test, the medical assistant touches the edge of the strip to absorbent paper and holds the strip horizontally. What is the main reason for this technique?

   1. AA. To speed the color change on every pad
   2. BB. To keep the urine at body temperature
   3. CC. To make the pad colors darker and easier to read
   4. DD. To prevent chemicals from mixing between pads
   Show answer to question 9

   Answer: D. To prevent chemicals from mixing between pads

   Excess urine can run from one reagent pad to the next, carrying chemicals between pads and causing false color changes. Blotting the edge and holding the strip horizontally prevents this run-over.

   Why the other options are wrong

   • AEach pad must be read at its own specified time; the technique does not speed reactions.
   • BSpecimen temperature is not affected by how the strip is held.
   • CThe goal is accurate colors, not darker colors; run-over actually distorts them.

10. Question 10 of 25Hard

    A provider notes that a patient with chronic hemolytic anemia has a significantly lower hemoglobin A1c result than expected based on frequent elevated self-monitored blood glucose logs. Which of the following mechanisms explains this discrepancy?

    1. AA. Accelerated erythrocyte destruction inhibits hepatic glucose release into the blood.
    2. BB. Shortened red blood cell survival reduces the time available for glycosylation.
    3. CC. Hemolysis increases renal glucose clearance, lowering circulating blood glucose levels.
    4. DD. Chronic anemia expands intravascular plasma volume, diluting glycated hemoglobin.
    Show answer to question 10

    Answer: B. Shortened red blood cell survival reduces the time available for glycosylation.

    Hemoglobin A1c measurement assumes a normal erythrocyte lifespan of roughly 120 days; in hemolytic anemia, erythrocytes are destroyed prematurely, which leaves less time for hemoglobin to become glycated and produces a falsely low result. Hemolysis does not accelerate renal glucose filtration or dilute hemoglobin through fluid retention.

11. Question 11 of 25Hard

    A urine specimen for routine urinalysis was left on the counter at room temperature for 4 hours before testing. Which change in the specimen is most likely?

    1. AA. The glucose level increases as cells break down
    2. BB. The number of bacteria decreases over time
    3. CC. The pH rises as bacteria break down urea
    4. DD. Casts and cells become better preserved
    Show answer to question 11

    Answer: C. The pH rises as bacteria break down urea

    In unpreserved urine at room temperature, bacteria multiply and convert urea to ammonia, which makes the urine more alkaline. Specimens should be tested promptly or refrigerated if testing is delayed.

    Why the other options are wrong

    • AGlucose usually decreases because bacteria use it for energy.
    • BBacteria multiply rather than decrease in urine left at room temperature.
    • DCells and casts break down over time, especially in alkaline urine.

12. Question 12 of 25Medium

    A patient who has been following a very low-carbohydrate diet has a positive ketone result on a urine reagent strip. What does this finding indicate?

    1. AA. The kidneys are filtering excess protein
    2. BB. Bacteria are present in the urinary tract
    3. CC. The body is breaking down fat for energy
    4. DD. Red blood cells are present in the urine
    Show answer to question 12

    Answer: C. The body is breaking down fat for energy

    Ketones are produced when the body breaks down fat for energy because carbohydrate is not available or cannot be used. This occurs with low-carbohydrate diets, fasting, prolonged vomiting and uncontrolled diabetes.

    Why the other options are wrong

    • AProtein in the urine is detected by the protein pad, not the ketone pad.
    • BBacteria are suggested by a positive nitrite result.
    • DRed blood cells or hemoglobin are detected by the blood pad.

13. Question 13 of 25Easy

    A microscope has a 10x ocular lens, and the medical assistant is using the 40x objective. What is the total magnification?

    1. AA. 50x
    2. BB. 40x
    3. CC. 4,000x
    4. DD. 400x
    Show answer to question 13

    Answer: D. 400x

    Total magnification equals the ocular magnification multiplied by the objective magnification. A 10x ocular with a 40x objective gives 400x.

    Why the other options are wrong

    • AAdding 10 and 40 is incorrect; the magnifications are multiplied.
    • B40x is the objective's magnification alone, without the ocular.
    • C4,000x comes from a calculation error; 10 times 40 is 400.

14. Question 14 of 25Medium

    A family medicine clinic plans to perform only rapid strep tests, urine reagent strip tests and fingerstick glucose tests on site. Which CLIA certificate does the clinic need?

    1. AA. Certificate of Accreditation
    2. BB. Certificate of Compliance
    3. CC. Certificate of Waiver
    4. DD. Certificate for Provider-Performed Microscopy
    Show answer to question 14

    Answer: C. Certificate of Waiver

    Rapid strep, urine reagent strip and fingerstick glucose meter tests are CLIA-waived. A site that performs only waived tests needs a Certificate of Waiver and must follow the manufacturers' instructions.

    Why the other options are wrong

    • AA Certificate of Accreditation is for laboratories performing nonwaived testing that are inspected by an approved accrediting organization.
    • BA Certificate of Compliance is for laboratories performing nonwaived testing that are inspected by state survey agencies.
    • DThis certificate covers specific microscopy procedures performed by providers, such as wet mounts, which this clinic does not perform.

15. Question 15 of 25Easy

    A provider orders a urine culture and sensitivity. What does the sensitivity portion of the test determine?

    1. AA. The number of white blood cells in the specimen
    2. BB. How concentrated the urine specimen is
    3. CC. Whether the patient is allergic to an antibiotic
    4. DD. Which antibiotics will work against the organism
    Show answer to question 15

    Answer: D. Which antibiotics will work against the organism

    The culture identifies the organism that grows from the specimen, and the sensitivity test shows which antibiotics inhibit that organism. The provider uses this information to choose effective treatment.

    Why the other options are wrong

    • AWhite blood cells are estimated by a reagent strip or microscopic exam, not a sensitivity test.
    • BUrine concentration is measured by specific gravity.
    • CDrug allergies are identified from the patient's history, not from a culture.

16. Question 16 of 25Hard

    When a laboratory order is entered into a laboratory information system (LIS), a unique accession number is generated. What is the primary purpose of this number?

    1. AA. Tracking a specific specimen throughout testing and reporting
    2. BB. Verifying the patient's primary health insurance coverage
    3. CC. Specifying the expiration date of the collection supplies used
    4. DD. Identifying the state medical license of the ordering physician
    Show answer to question 16

    Answer: A. Tracking a specific specimen throughout testing and reporting

    An accession number is a unique tracking identifier assigned to a specific requisition or specimen to follow it through every phase of processing, analysis, and reporting. Insurance details are verified through policy numbers, and physician identification is verified using National Provider Identifiers or state license numbers.

17. Question 17 of 25Medium

    A medical assistant is packaging a labeled specimen in a biohazard transport bag for courier pickup. Where should the requisition be placed?

    1. AA. In the separate outer pocket of the bag
    2. BB. Inside the sealed compartment with the specimen
    3. CC. Wrapped around the tube with a rubber band
    4. DD. Taped to the outside of the specimen tube
    Show answer to question 17

    Answer: A. In the separate outer pocket of the bag

    Specimen transport bags have a sealed compartment for the specimen and a separate outer pocket for paperwork. This keeps the requisition clean and readable if the specimen leaks.

    Why the other options are wrong

    • BPaperwork inside the specimen compartment can become contaminated if the container leaks.
    • CWrapping the form around the tube can cover the label and exposes the paper to leakage.
    • DTaping paperwork to the tube can hide the label and is not a safe packaging method.

18. Question 18 of 25Medium

    A medical assistant is teaching a female patient how to collect a clean-catch midstream urine specimen for culture. Which instruction is correct?

    1. AA. Collect the first part of the stream, then finish in the toilet
    2. BB. Touch the inside of the cup lid to be sure it is clean
    3. CC. Clean front to back, start voiding, then collect midstream
    4. DD. Fill the sterile cup to the very top so there is enough urine
    Show answer to question 18

    Answer: C. Clean front to back, start voiding, then collect midstream

    For a clean-catch specimen, the patient cleanses the urinary opening from front to back, begins urinating into the toilet, collects the middle portion in the sterile cup and finishes in the toilet. This reduces contamination from skin and urethral bacteria.

    Why the other options are wrong

    • AThe first portion flushes bacteria from the urethra and should not be collected for culture.
    • BTouching the inside of the lid or cup contaminates the sterile container.
    • DOverfilling can cause spills and contamination; only the amount marked on the container is needed.

19. Question 19 of 25Medium

    A medical assistant is completing a requisition for a wound culture. Besides patient identifiers and the ordering provider, which detail is essential for the laboratory?

    1. AA. The patient's preferred pharmacy
    2. BB. The patient's emergency contact
    3. CC. The exact specimen source
    4. DD. The patient's appointment time
    Show answer to question 19

    Answer: C. The exact specimen source

    Culture requisitions must state the exact specimen source, such as a left heel wound, because the laboratory chooses culture methods and interprets growth based on the site. The collection date and time are also recorded.

    Why the other options are wrong

    • APharmacy information is not needed to process a culture.
    • BEmergency contact information does not affect specimen processing.
    • DThe appointment time does not tell the laboratory where or when the specimen was collected.

20. Question 20 of 25Hard

    A provider orders a urine nucleic acid amplification test for chlamydia and gonorrhea for a 22-year-old man. How should the medical assistant instruct him to collect the specimen?

    1. AA. Cleanse first, then collect the middle portion of the stream
    2. BB. Collect all urine produced over the next 24 hours
    3. CC. Collect the last portion of urine at the end of voiding
    4. DD. Collect the first part of the urine stream, not midstream
    Show answer to question 20

    Answer: D. Collect the first part of the urine stream, not midstream

    Urine tests for chlamydia and gonorrhea require a first-catch specimen, which contains the most organisms washed from the urethra. Patients are usually told not to urinate for at least one hour before collection and to follow the kit instructions.

    Why the other options are wrong

    • AA midstream clean-catch specimen washes away urethral organisms and lowers test sensitivity.
    • BA 24-hour collection is used for quantitative chemistry tests, not infection testing.
    • CThe last portion of urine contains fewer urethral organisms than the first-catch portion.

21. Question 21 of 25Medium

    A medical assistant has collected a urine specimen in a sterile cup with a screw-on lid. Where should the label be placed?

    1. AA. On the lid, so it is easy to read from above
    2. BB. On the side of the cup, not on the lid
    3. CC. On the specimen bag only, not on the cup
    4. DD. On the requisition only, not on the cup
    Show answer to question 21

    Answer: B. On the side of the cup, not on the lid

    Labels go on the container itself because lids can be removed and mixed up with other specimens in the lab. The label includes at least two patient identifiers and the other information the lab requires.

    Why the other options are wrong

    • AA label on the lid is separated from the specimen once the lid is removed.
    • CThe specimen container must be labeled, even when it travels in a bag.
    • DThe requisition does not replace a label on the specimen container.

22. Question 22 of 25Easy

    What is the main purpose of a chain-of-custody form in workplace drug testing?

    1. AA. To list the drugs the employer has asked the lab to detect
    2. BB. To document every person who handled the specimen
    3. CC. To record the donor's consent to share results with family
    4. DD. To show the donor's medication history for the reviewer
    Show answer to question 22

    Answer: B. To document every person who handled the specimen

    A chain-of-custody form documents each person who handles the specimen from collection to testing, with signatures, dates and times. This record protects the integrity of the specimen so the result can hold up legally.

    Why the other options are wrong

    • AThe tests ordered may appear on the form, but tracking specimen handling is its main purpose.
    • CResults are released to the employer's designated reviewer, not to family members.
    • DMedication information is discussed with the medical review officer, not used to track specimen handling.

23. Question 23 of 25Easy

    Which activity is an example of quality control rather than the broader quality assurance program?

    1. AA. Writing a policy for training new staff on point-of-care testing
    2. BB. Reviewing patient satisfaction surveys about wait times in the lab
    3. CC. Auditing charts to confirm results were documented within one day
    4. DD. Running a known positive and negative sample on a rapid test kit
    Show answer to question 23

    Answer: D. Running a known positive and negative sample on a rapid test kit

    Quality control checks whether a test system is performing correctly, most often by testing control materials with known results. Quality assurance is the overall program of policies, training, documentation and monitoring that supports accurate results.

    Why the other options are wrong

    • ATraining policies are part of the quality assurance program, not a direct check of test performance.
    • BReviewing satisfaction surveys is a quality improvement activity, not quality control of a test system.
    • CChart audits monitor processes and documentation, which falls under quality assurance.

24. Question 24 of 25Medium

    A medical assistant has focused a slide on low power and switches to the high-power objective. Which control should be used to sharpen the image?

    1. AA. The coarse adjustment knob
    2. BB. The fine adjustment knob
    3. CC. The iris diaphragm lever
    4. DD. The stage clip release
    Show answer to question 24

    Answer: B. The fine adjustment knob

    With the high-power objective, only the fine adjustment knob should be used to focus. The objective sits very close to the slide, and the coarse knob moves the stage enough to break the slide or damage the lens.

    Why the other options are wrong

    • AThe coarse adjustment is used only with low power to bring the specimen into rough focus.
    • CThe iris diaphragm controls the amount of light, not the focus.
    • DStage clips hold the slide in place and do not affect focus.

25. Question 25 of 25Hard

    A 58-year-old man with diabetes says he has been very thirsty and tired. His fingerstick glucose meter displays 'HI' instead of a number. What should the medical assistant do first?

    1. AA. Record 'HI' in the chart and room the next patient
    2. BB. Wait 30 minutes, then repeat the test before telling anyone
    3. CC. Give him fruit juice to drink while he waits
    4. DD. Notify the provider right away about the result
    Show answer to question 25

    Answer: D. Notify the provider right away about the result

    A 'HI' reading means the glucose is above the highest value the meter can measure, which can indicate dangerous hyperglycemia. The medical assistant notifies the provider immediately and follows orders or protocol, such as a repeat test or a laboratory glucose.

    Why the other options are wrong

    • ADocumenting without telling the provider delays care for a possibly dangerous result.
    • BWaiting 30 minutes delays the provider's assessment of a possibly critical value.
    • CJuice adds sugar and would make high blood glucose worse.

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