Question 1

Patient presents to the emergency room complaining of right forearm/elbow pain after racquetball last night. Patient states that he did not fall, but overworked his arm. Past medical history is negative and the physical examination reveals the patient is unable to supinate. A fourlview x-ray of the right elbow is performed and is negative. The physician signs the patient out with right elbow sprain. Prescription of Motrin is given to the patient.

Accepted Answer

A)  841.8, 73080 
B)  841.9, E928.9, 99281, 73070 
C)  841.2, 73080, 99282, 73040 
D)  841.9, E927.2, 99281, 73080

Question 2

The Credentialing Committee discovered the problems with Dr. Hernandez's hip replacements by

Accepted Answer

A)  sampling and reviewing Dr. Hernandez's patient records. 
B)  reviewing Dr. Hernandez's quality profile. 
C)  querying the National Physician Data Bank. 
D)  interviewing the Chief of Surgery.

Question 3

Which of the following should be required to sign a confidentiality statement before having access to patients' medical information?

Accepted Answer

A)  nursing students 
B)  medical students 
C)  HIM students 
D)  all of the above

Question 4

The patient has hypertensive heart disease and nephrosclerosis with chronic kidney failure. The patient had placement of arteriovenous fistula in his left wrist to prepare for the hemodialysis. Dialysis was also performed on this admission.

Accepted Answer

A)  404.93, 585.9, 54.98, 39.27 
B)  404.92, 585.6, 39.95, 39.27 
C)  404.93, 585.6, 39.95, 39.27 
D)  404.92, 585.9, 38.95, 39.27

Question 5

Your facility conducted a study of patient satisfaction, but you question the reliability of the questionnaire you used. The high degree of patient satisfaction expressed on the questionnaire just doesn't match the large number of complaints you have been receiving. You decide to try switching to an investigative strategy that will give you an immediate opportunity to review patient responses and correct errors. You have decided to use

Accepted Answer

A)  samples. 
B)  interviews. 
C)  observations. 
D)  questionnaires.

Question 6

As information security officer, you are revising the policies at your rehabilitation facility for handling all patient clinical information. Your best resource for checking out specific accreditation standards and guidelines is the

Accepted Answer

A)  Conditions of Participation for Rehabilitation Facilities 
B)  Medical Staff Bylaws, Rules, and Regulations 
C)  Joint Commission manual 
D)  CARF manual

Question 7

Fibrocystic disease of the breast; needle biopsy of breast

Accepted Answer

A)  610.1, 85.11 
B)  610.3, 85.12 
C)  610.2, 85.11 
D)  610.9, 85.12

Question 8

You have been asked to reduce your department's operating budget by 20%. In order to do you will have to effect reductions in your largest budget line. You will have to make cuts in

Accepted Answer

A)  equipment. 
B)  personnel. 
C)  supplies. 
D)  contracts.

Question 9

Fetal monitoring strips are part of the _________ record and should be maintained ______.

Accepted Answer

A)  newborn's; 10 years past the age of majority 
B)  mother's; according to the length of time required for a minor's records 
C)  newborn's; according to the time period specific  in the state's statue of limitations 
D)  mother's; 10 years

Question 10

The health information reception desk is experiencing a huge influx of phone calls on Monday, Tuesday, and Wednesday mornings. This is creating a problem in getting requested patient information out within an acceptable time frame. The reception staff work group has agreed to start recording the reason for the phone calls for the next 4 weeks. They want to focus on solving the response-time problem by reducing the turnaround time for the largest category of phone calls. Which QI tool best supports this goal?

Accepted Answer

A)  control chart 
B)  Pareto chart 
C)  run chart 
D)  scatter diagram

Question 11

The medical record documentation is unclear as to whether the condition was present on admission.

Accepted Answer

A)  Y=Yes 
B)  N=No 
C)  U=Unknown 
D)  W=clinically undetermined 
E)  Unreported/Not Used (Exempt from PO
A)  reporting

Question 12

Case Study #1 Dr. Roberts, an orthopedic surgeon, and Nurse Parrish head nurse on the orthopedic surgery unit, have had an acrimonious working relationship for years. While making rounds on the unit, Dr. Roberts discovered that the physical therapy evaluation he has ordered for one of his patients had not been performed and became outraged. Even though he did not have proof, Dr. Roberts placed the blame for missed evaluation with Nurse Parresh. Dr. Roberts wrote in the patient's medical record that Nurse Parrish frilled to properly order the physical therapy evaluation because she was incompetent and could not be trusted to carry out even the simplest order. After heaving read Dr. Roberts note, Nurse Parrish countered by making a disparaging remark about Dr. Roberts to the medical personnel at the nurces' station. Nurse Parrish stated that Dr. Roberts was one who was incompetent and was responsible for the needless suffering of countless patients over the years. Referring to Case Study #1, the written statement by Dr. Roberts about Nurse Parrish's professional competence in the patient's medical record can constitute

Accepted Answer

A)  libel. 
B)  slander. 
C)  perjury 
D)  defamation.

Question 13

Which of the following is classified as a poisoning in ICD-9-CM?

Accepted Answer

A)  syncope due to Contac pills and a three martini lunch 
B)  digitalis intoxication 
C)  reaction to dye administered for pyelogram 
D)  idiosyncratic reaction between various drugs

Question 14

If this physician is a participating physician who accepts assignment for this claim, the total amount of the patient's financial liability (out-of-pocket expense) is

Accepted Answer

A)  $200.00. 
B)  $40.00. 
C)  $160.00. 
D)  $30.00.

Question 15

The manager of a Health Information Department has many training and development methods available for the departmental and nondepartmental staff. Consider the following situation. The department's working hours are 8:00 AM to 6:00 PM. After 6:00 PM, if a record is needed in the emergency room for a possible readmission, the ER clerk has access to the HID in order to retrieve the record. On the occasions when the ER clerk has retrieved a record, she has left the department open, the records have been pulled and not replaced, and it appears as if the clerk was viewing records unnecessarily. What would be the best training or development method for the ER clerk in order to rectify this situation?

Accepted Answer

A)  receive training by an ER coworker 
B)  receive training by an expert in record documentation 
C)  attend an outside workshop or seminar 
D)  receive training by the supervisor of files

Question 16

You are the Quality Coordinator for the medical staff. Analyze the chart above and determine steps to be taken next.

Accepted Answer

A)  Plot control limits, check indicator threshold, and take December charts to OB/GYN Committee if threshold exceeded. 
B)  Plot control limits and take December charts to OB/GYN Committee if December data poi exceeds UCL. 
C)  Plot control limits, pull charts for December, and do a focused review screening. 
D)  Plot control limits and refer to Medical Executive Committee for variation review.

Question 17

In retrieval of optical image files, cache memory

Accepted Answer

A)  decreases access time for all users on the system. 
B)  increases exchange time on the jukebox. 
C)  is resident on the jukebox. 
D)  is a way of defragmenting a WORM platter.

Question 18

Today is August 30, 2008. When can the training records for the HIPAA privacy training being conducted today be destroyed?

Accepted Answer

A)  August 30, 2013 
B)  August 30, 2014 
C)  August 30, 2016 
D)  August 30, 2018

Question 19

Which disease is a malignancy of the lymphatic system?

Accepted Answer

A)  cystic fibrosis. 
B)  supplies. 
C)  neutropenia. 
D)  von Willebrand's disease.

Question 20

Under APCs, payment status indicator "S" means

Accepted Answer

A)  ancillary services. 
B)  medical visits. 
C)  multiple procedure reduction applies. 
D)  multiple procedure reduction does not apply.

Exam 1: Registered Health Information Administrator