CCMA Clinical Duties 2 — Questions and Answers

Question 1: When assisting with a minor surgical procedure, the medical assistant hands instruments to the physician with:

The handle pointing toward the medical assistant
The handle pointing toward the physician (Correct answer)
Both hands, placing it on the sterile drape
The sharp end pointing toward the physician

Correct answer: The handle pointing toward the physician

Instruments are passed with the handle directed toward the physician so they can grasp it immediately without reorientation, maintaining efficiency and safety.

During surgical instrument passing, the medical assistant holds the instrument at the body or proximal end and presents the handle to the physician. This allows the physician to accept and immediately use the instrument without repositioning. Sharps (scissors, scalpels) should never be pointed at the physician — pass scalpels with the blade down. When in doubt, place the instrument on the sterile field rather than hand it directly. Proper instrument passing maintains sterility and workflow efficiency.

Question 2: Which wound closure technique is typically used for wounds that are too large for adhesive strips but not deep enough to require sutures?

Staples
Steri-strips or wound closure strips (Correct answer)
Mattress sutures
Figure-eight sutures

Correct answer: Steri-strips or wound closure strips

Steri-strips (wound closure strips) are adhesive tapes used to approximate the edges of superficial wounds that do not require sutures.

Wound closure strips (Steri-strips, butterfly closures) are used for superficial lacerations, skin tears, or post-procedure wounds. They work by pulling skin edges together and are held in place with adhesive. They are less invasive than sutures or staples and leave minimal scarring. Staples are used for larger surgical wounds, particularly on the scalp and trunk. Sutures are used for deeper wounds requiring layer closure. Closure strips typically fall off naturally within 5–7 days as the wound heals.

Question 3: When performing an eye irrigation, the solution should be directed:

From the outer canthus toward the inner canthus
From the inner canthus toward the outer canthus (nasal side to temporal side) (Correct answer)
Directly onto the center of the cornea
Upward toward the superior lid

Correct answer: From the inner canthus toward the outer canthus (nasal side to temporal side)

Irrigating from the inner to the outer canthus directs contaminated fluid away from the other eye and nasolacrimal duct, reducing the risk of further contamination.

Eye irrigation (ocular lavage) directs irrigation solution from the inner canthus (nasal corner) toward the outer canthus (temporal corner) to flush contaminated fluid away from the unaffected eye and prevent entry into the nasolacrimal duct (which connects to the nasal cavity). The patient should be positioned with the affected eye down if possible. Use normal saline or sterile water at room temperature. Continue irrigation for at least 15–20 minutes for chemical exposures. Never rub the eye.

Question 4: The Snellen eye chart is used to assess:

Intraocular pressure
Visual acuity (distance vision) (Correct answer)
Color vision deficiency
Peripheral visual field

Correct answer: Visual acuity (distance vision)

The Snellen chart tests visual acuity — specifically the ability to read letters at a standardized distance of 20 feet.

The Snellen eye chart tests distance visual acuity. The patient stands 20 feet from the chart and reads progressively smaller lines. 20/20 vision means the patient can see at 20 feet what a normal eye sees at 20 feet. 20/40 means the patient must be at 20 feet to see what a normal eye sees at 40 feet. Intraocular pressure is measured by tonometry. Color vision is tested with Ishihara plates. Visual fields are tested by confrontation or perimetry. Each eye is tested separately; cover one eye at a time.

Question 5: When applying a sterile dressing, the medical assistant should:

Use clean gloves throughout the procedure
Handle the dressing material with sterile gloves and sterile forceps only (Correct answer)
Blow on the wound to dry it before applying dressing
Touch only the outer edges of the sterile dressing

Correct answer: Handle the dressing material with sterile gloves and sterile forceps only

Sterile dressing application requires sterile gloves and sterile forceps to maintain asepsis and prevent introducing microorganisms into a wound.

Sterile dressing change procedure: (1) Explain procedure, provide privacy; (2) Perform hand hygiene; (3) Open sterile supplies using sterile technique; (4) Don sterile gloves; (5) Cleanse wound with prescribed solution using sterile gauze (wipe once per piece, discard); (6) Apply sterile dressing without contaminating the wound-contact surface; (7) Secure with tape; (8) Remove gloves, perform hand hygiene; (9) Document wound assessment, drainage characteristics, and dressing applied. Clean technique (non-sterile gloves) is used only for routine wound care of chronic, non-surgical wounds.

Question 6: Which position is used for a patient undergoing a rectal examination or proctoscopy?

Supine (dorsal recumbent)
Fowler's
Sims' (left lateral) (Correct answer)
Trendelenburg

Correct answer: Sims' (left lateral)

Sims' position (left lateral with upper knee flexed) provides optimal exposure for rectal and sigmoid colon examinations.

Sims' (lateral recumbent) position: patient lies on left side, lower arm extended behind the back, upper arm flexed at elbow, upper knee flexed toward chest. This position facilitates rectal examinations, enemas, sigmoid colon visualization, and obstetric examinations. Dorsal recumbent is used for abdominal and pelvic exams; Fowler's for respiratory difficulty and cardiac exams; Trendelenburg (supine with feet elevated) is used for shock and certain surgical procedures; lithotomy is used for pelvic exams and gynecologic procedures.

CCMA Clinical Duties 2

When assisting with a minor surgical procedure, the medical assistant hands instruments to the physician with: