AHIMA Registered Health
Information Technician (RHIA)
Practice Exam
150 Comprehensive Questions with
Detailed and verified Rationales
Based on the Latest AHIMA RHIA
Domains | 2025/2026 Edition
1|Page
,DOMAIN 1: DATA CONTENT, STRUCTURE, AND INFORMATION
GOVERNANCE
(Questions 1-25)
Question 1
According to the Uniform Hospital Discharge Data Set (UHDDS), which of the
following best defines the "principal diagnosis"?
A. The condition that requires the most resources during the hospital stay
B. The diagnosis that is the primary focus of outpatient treatment
C. The condition established after study to be chiefly responsible for
occasioning the admission of the patient to the hospital
D. The most severe condition documented during the hospital stay
Correct Answer: C
Rationale: The UHDDS defines principal diagnosis as "the condition
established after study to be chiefly responsible for occasioning the admission
of the patient to the hospital for care." This definition is fundamental to
accurate DRG assignment and reimbursement. It is not necessarily the most
severe condition or the one requiring the most resources, but rather the
reason the patient was admitted after diagnostic workup .
2|Page
,Question 2
A hospital is implementing a new electronic health record (EHR) system. The
HIM director is responsible for establishing policies that ensure data entered
into the system is accurate, complete, and consistent across all departments.
This is a function of:
A. Data analytics
B. Data governance
C. Data stewardship
D. Data warehousing
Correct Answer: B
Rationale: Data governance refers to the overall management of the
availability, usability, integrity, and security of data. It establishes the
processes, policies, standards, and responsibilities that ensure the quality of
data across the organization . Data stewardship (C) is a role that implements
the policies set by data governance. Data analytics (A) is the process of
examining data to draw conclusions. Data warehousing (D) is the electronic
storage of large amounts of data for analysis .
Question 3
Which of the following is the BEST example of a data dictionary element for a
field labeled "Date of Birth"?
A. Patient's age in years
B. MM/DD/YYYY format, required field, valid range 01/01/1900 to current
date
C. The date the patient was born
D. A dropdown menu with month, day, and year
3|Page
, Correct Answer: B
Rationale: A data dictionary defines the structure, attributes, and permissible
values of data elements. It includes technical specifications like data type,
format (MM/DD/YYYY), field requirements (required/optional), and
validation rules (valid date range) . Options A and C describe the data's
meaning or content, and D describes a user interface element, none of which
are the primary technical function of a data dictionary .
Question 4
What is the primary purpose of a master patient index (MPI)?
A. To store all clinical data for a patient's encounters
B. To uniquely identify all patients and link their records across multiple
encounters and systems
C. To track patient satisfaction scores and outcomes
D. To manage the hospital's bed census and admissions
Correct Answer: B
Rationale: The master patient index (MPI) is a database of all patients ever
treated at a facility or across a health system. Its core function is to assign a
unique identifier to each patient and link all their encounters, ensuring that
the correct record is retrieved each time and preventing duplication . This is
foundational for a unit record system and patient safety. It does not store
clinical data (A) directly but indexes where those records are located.
4|Page
Information Technician (RHIA)
Practice Exam
150 Comprehensive Questions with
Detailed and verified Rationales
Based on the Latest AHIMA RHIA
Domains | 2025/2026 Edition
1|Page
,DOMAIN 1: DATA CONTENT, STRUCTURE, AND INFORMATION
GOVERNANCE
(Questions 1-25)
Question 1
According to the Uniform Hospital Discharge Data Set (UHDDS), which of the
following best defines the "principal diagnosis"?
A. The condition that requires the most resources during the hospital stay
B. The diagnosis that is the primary focus of outpatient treatment
C. The condition established after study to be chiefly responsible for
occasioning the admission of the patient to the hospital
D. The most severe condition documented during the hospital stay
Correct Answer: C
Rationale: The UHDDS defines principal diagnosis as "the condition
established after study to be chiefly responsible for occasioning the admission
of the patient to the hospital for care." This definition is fundamental to
accurate DRG assignment and reimbursement. It is not necessarily the most
severe condition or the one requiring the most resources, but rather the
reason the patient was admitted after diagnostic workup .
2|Page
,Question 2
A hospital is implementing a new electronic health record (EHR) system. The
HIM director is responsible for establishing policies that ensure data entered
into the system is accurate, complete, and consistent across all departments.
This is a function of:
A. Data analytics
B. Data governance
C. Data stewardship
D. Data warehousing
Correct Answer: B
Rationale: Data governance refers to the overall management of the
availability, usability, integrity, and security of data. It establishes the
processes, policies, standards, and responsibilities that ensure the quality of
data across the organization . Data stewardship (C) is a role that implements
the policies set by data governance. Data analytics (A) is the process of
examining data to draw conclusions. Data warehousing (D) is the electronic
storage of large amounts of data for analysis .
Question 3
Which of the following is the BEST example of a data dictionary element for a
field labeled "Date of Birth"?
A. Patient's age in years
B. MM/DD/YYYY format, required field, valid range 01/01/1900 to current
date
C. The date the patient was born
D. A dropdown menu with month, day, and year
3|Page
, Correct Answer: B
Rationale: A data dictionary defines the structure, attributes, and permissible
values of data elements. It includes technical specifications like data type,
format (MM/DD/YYYY), field requirements (required/optional), and
validation rules (valid date range) . Options A and C describe the data's
meaning or content, and D describes a user interface element, none of which
are the primary technical function of a data dictionary .
Question 4
What is the primary purpose of a master patient index (MPI)?
A. To store all clinical data for a patient's encounters
B. To uniquely identify all patients and link their records across multiple
encounters and systems
C. To track patient satisfaction scores and outcomes
D. To manage the hospital's bed census and admissions
Correct Answer: B
Rationale: The master patient index (MPI) is a database of all patients ever
treated at a facility or across a health system. Its core function is to assign a
unique identifier to each patient and link all their encounters, ensuring that
the correct record is retrieved each time and preventing duplication . This is
foundational for a unit record system and patient safety. It does not store
clinical data (A) directly but indexes where those records are located.
4|Page
