ANSWERS GRADED A+
◍ The discharge summary must be completed within _________ after
discharge for most patients but within ________ for patients
transferred to other facilities. Discharge summaries are not always
required for patients who were hospitalized for fewer than _______
hours.. Answer: 30 days, 24 hours, 48 hours
◍ If an analyst is studying the wait times at a clinic and the only list
of patients available is on hard copy, which sampling technique is the
easiest to use?. Answer: Systematic sampling
◍ In a long term care setting, these are problem oriented frameworks
for additional patient assessment based on problem identification
items (triggered conditions). Answer: Resident Assessment Protocols
(RAPs)
◍ What data model is most widely used to illustrate a relational
database structure?. Answer: Entity-relationship diagram (ERD)
◍ Alex, an HIM analyst, reviews the record of Patty Eastly, a patient
in the facility, to ensure that all documents are complete and
signatures are present. This is an example of a:. Answer: Concurrent
Review
,◍ In assessing the quality of care given to patients with diabetes
mellitus, the quality team collects data regarding blood sugar levels
on admission and on discharge. These data are called a (n):. Answer:
Indicator
◍ Which of the following is used by a long term care facility to
gather information about specific health status factors and includes
information about specific risk factors in the resident's care?. Answer:
Minimum Data Set
◍ Dr. Collins admitted Mr. Smith to the University Hospital, Blue
Cross Insurance will pay Mr. Smith's hospital bill. Upon discharge
from the hospital, who owns the health record of Mr. Smith?. Answer:
University Hospital
◍ In a relational database, which of the following is an example of a
many to many relationship?. Answer: Patients to consulting
physicians
◍ Anywhere Hospital has mandated that the Social Security number
will be displayed in the XXX-XX-XXX format for their patients. This
is an example of the use of a:. Answer: Mask
◍ Sue is updating the data dictionary for her organization. In this dat
dictionary, the data element name is considered which of the
following?. Answer: Metadata
,◍ Why could it be difficult for a healthcare entity to respond to
pulling an entire, legal health record together for an authorized
request for information?. Answer: It can exist in seperate and multiple
paper-based or electronic systems.
◍ According to the Joint commission accreditation standards, which
document must be placed in patient's record before a surgical
procedure may be performed?. Answer: report of history and physicial
examination
◍ When defining the legal health record in a healthcare entity, it is
best practice to establish a policy statement of the legal health record
as well as:. Answer: Health Record Matrix
◍ A subpoena duces tecum compels the recipient to:. Answer: Bring
records to a legal proceeding
◍ A researcher's informed consent form stated that the patients'
information would be anonymous. Later in the application form for
institutional review board( (IRB) approval, the researcher described a
coding system to trach respondents and nonrespondents. The IRB
returned the application to the researcher with the stipulation that the
informed consent must be changed. What raised the red flag?.
Answer: The description of the use of a coding system to track
respondents and nonrespondents.
◍ What is the implication regarding the confidentiality of incident
reports in a legal proceeding when a staff member documents in the
health record that an incident report was completed about a specific
, incident. Answer: The data, documents, reports and information that
comprise the formal business records of any healthcare entity that are
to be utilized during legal proceedings
◍ Anywhere Hospital's coding staff will be working remotely. The
entity wants to ensure that they are complying with the HIPAA
security rule. What type of network uses a private tunnel through the
internet as a transport medium that will allow the transmission of
ePHI to occur between the coder and the facility securely?. Answer:
Virtual private network
◍ An individual designated as an inpatient coder may have access to
an electronic medical record in order to code the record. Under what
access security mechanism is the3 coder allowed access to the
system?. Answer: Role-based
◍ The privacy rule generally requires documentation related to its
requirements to be retained:. Answer: 6 Years
◍ Which legal doctrine was established by the Darling v. Charleston
Community Hospital case of 1965?. Answer: Corporate Negligence
◍ Linda Wallace is being admitted to the hospital. She is presented
with a "Notice of Privacy Practices" In the Notice, it is explained to
her that PHI will be used and disclosed for treatment, payment, and
operations (TPO) purposes. Linda states that she doesn't want her PHI
used for those purposes. Of the options listed here, what is the best
course of action?. Answer: The hospital is not required to honor her