TESTBANK FOR CLINICAL PROCEDURES FOR
MEDICAL ASSISTANTS 11TH EDITION/ALL CHAPTERS 1-
23/COMPLETE GUIDE
,CH 01: The Clinical Record
Bonewit-West: Clinical Procedures for Clinical Assistants, 11th Edition
MULTIPLE CHOICE
1. Which of the following is not a function of the clinical record?
a.
To provide information for making decisions regarding the patient’s care
b.
To document the patient’s progress
c.
To serve as a legal document
d.
To share information between members of the patient’s family
ACCURATE CHOICE:D REF: page. 2| CAAHEP Competency (2015):
VI.4 OBJ: 1
2. What information is contained in the clinical record?
a.
Health history report
b.
Results of the physical examination
c.
Laboratory reports
d.
Progress notes
e.
All of the above
ACCURATE CHOICE:E REF: page. 2-3| CAAHEP Competency
(2015): VI.4 OBJ: 2
3. The purpose of the HIPAA Privacy Rule is to
a.
reduce exposure of patients to bloodborne pathogens.
b.
provide patients with b e t t e rNcUo nRt Sr oIl NovGeTr
tBhe.CusOe Mand disclosure of their health information.
c.
prevent the patient’s records from being copied.
d.
encourage the patient to become more involved in preventive primary health care.
ACCURATE CHOICE: B REF: page. 4 | CAAHEP Competency
(2015): IX.3 OBJ: 2
4. All of the following are characteristics of the Notice of Privacy Practices except:
a.
Was developed by the American Clinical Association
b.
Must explain how a patient’s health information will be used and protected by
the clinical office
c.
Must be provided to each patient
d.
Must obtain a signed acknowledgment from the patient that he/she has received
an NPP
ACCURATE CHOICE:A REF: page. 4| CAAHEP Competency (2015):
IX.3 OBJ: 2
5. Health information in any form that contains patient identifiable information is known as
a.
PHI.
b.
NPAGE.
c.
OSHA.
d.
HIPAA.
, ACCURATE CHOICE:A REF: page. 4| CAAHEP Competency (2015):
IX.3 OBJ: 2
6. In which of the following situations does HIPAA not require written consent for the use
or disclosure of protected health information?
a.
Patient referral to a specialist
b.
Emergency care provided at a medical center
c.
Determination of eligibility for insurance benefits
d.
Training of primary health care students
e.
All of the above
ACCURATE CHOICE:E REF: page. 4| CAAHEP Competency (2015):
IX.3 OBJ: 2
7. Which of the following is not an example of a clinical office clinical document?
a.
Patient registration record
b.
Physical examination report
c.
Medication record
d.
Health history report
ACCURATE CHOICE:A REF: page. 2-3| CAAHEP Competency
(2015): VI.4 OBJ: 2
8. Which of the following is not a characteristic of a laboratory report?
a.
It relays results of laboratory tests to the provider
b.
It consists of a report of the analysis or examination of body specimens
c.
It assists in diagnosing and treating sickness
d.
It is a request for laborator yNtUesRt sStIo NbeGpTeBrf.orCmOeMd by an outside
laboratory
ACCURATE CHOICE:D REF: page. 2-3| CAAHEP Competency
(2015): VI.4 OBJ: 2
9. Which of the following is an example of a diagnostic procedure report?
a.
Electrocardiogram report
b.
Physical therapy report
c.
Urinalysis report
d.
Pathology report
ACCURATE CHOICE:A REF: page. 2-3| CAAHEP Competency
(2015): VI.4 OBJ: 2
10. What is the name of the type of report that documents the assessments and
treatments designed to restore a patient’s ability to function?
a.
Consultation report
b.
Diagnostic procedure report
c.
Pathology report
d.
Therapeutic service report
ACCURATE CHOICE:D REF: page. 2-3| CAAHEP Competency
(2015): VI.4 OBJ: 2
11. Which of the following is not an example of a medical center report?
a.
Operative report
, b.
Cytology report
c.
Discharge summary report
d.
Emergency department report
ACCURATE CHOICE:B
REF: page. 2-3| CAAHEP Competency (2015): VI.4 OBJ: 2
12. Which of the following is an example of a consent document?
a.
Patient registration record
b.
Notice of Privacy Practices form
c.
Release of clinical information form
d.
Patient instruction sheet
ACCURATE CHOICE:C REF: page. 2-3| CAAHEP Competency
(2015): VI.4 OBJ: 2
13. Which of the following can be performed by an electronic clinical record software program?
a.
Creation of a clinical record
b.
Storage of a clinical record
c.
Editing of a clinical record
d.
Retrieval of a clinical record
e.
All of the above
ACCURATE CHOICE:E REF: page. 3| CAAHEP Competency (2015):
V.8 OBJ: 3
14. All of the following are advantages of an electronic clinical record (EMR) except
a.
an EMR does not have to be filed.
b. N U R S I N G T B . C O M
documents in an EMR can be q u ic k ly re tr ie v ed .
c.
more than one person can view an EMR at the same time.
d.
EMRs are exempt from the HIPAA regulations.
ACCURATE CHOICE:D REF: page. 3, 6| CAAHEP Competency (2015):
VI.12 OBJ: 5
15. Which of the following are used to enter data into an electronic clinical record?
a.
Free-text entry
b.
Drop-down menus
c.
Radio buttons
d.
All of the above
ACCURATE CHOICE:D REF: page. 11| CAAHEP Competency (2015):
V.8 OBJ: 8
16. How are paper documents entered into a patient’s electronic clinical record?
a.
By scanning them into the computer
b.
By retyping them on the computer
c.
By photocopying them
d.
By transmitting them through a modem
ACCURATE CHOICE:A REF: page. 11| CAAHEP Competency (2015):
VI.4 OBJ: 8
MEDICAL ASSISTANTS 11TH EDITION/ALL CHAPTERS 1-
23/COMPLETE GUIDE
,CH 01: The Clinical Record
Bonewit-West: Clinical Procedures for Clinical Assistants, 11th Edition
MULTIPLE CHOICE
1. Which of the following is not a function of the clinical record?
a.
To provide information for making decisions regarding the patient’s care
b.
To document the patient’s progress
c.
To serve as a legal document
d.
To share information between members of the patient’s family
ACCURATE CHOICE:D REF: page. 2| CAAHEP Competency (2015):
VI.4 OBJ: 1
2. What information is contained in the clinical record?
a.
Health history report
b.
Results of the physical examination
c.
Laboratory reports
d.
Progress notes
e.
All of the above
ACCURATE CHOICE:E REF: page. 2-3| CAAHEP Competency
(2015): VI.4 OBJ: 2
3. The purpose of the HIPAA Privacy Rule is to
a.
reduce exposure of patients to bloodborne pathogens.
b.
provide patients with b e t t e rNcUo nRt Sr oIl NovGeTr
tBhe.CusOe Mand disclosure of their health information.
c.
prevent the patient’s records from being copied.
d.
encourage the patient to become more involved in preventive primary health care.
ACCURATE CHOICE: B REF: page. 4 | CAAHEP Competency
(2015): IX.3 OBJ: 2
4. All of the following are characteristics of the Notice of Privacy Practices except:
a.
Was developed by the American Clinical Association
b.
Must explain how a patient’s health information will be used and protected by
the clinical office
c.
Must be provided to each patient
d.
Must obtain a signed acknowledgment from the patient that he/she has received
an NPP
ACCURATE CHOICE:A REF: page. 4| CAAHEP Competency (2015):
IX.3 OBJ: 2
5. Health information in any form that contains patient identifiable information is known as
a.
PHI.
b.
NPAGE.
c.
OSHA.
d.
HIPAA.
, ACCURATE CHOICE:A REF: page. 4| CAAHEP Competency (2015):
IX.3 OBJ: 2
6. In which of the following situations does HIPAA not require written consent for the use
or disclosure of protected health information?
a.
Patient referral to a specialist
b.
Emergency care provided at a medical center
c.
Determination of eligibility for insurance benefits
d.
Training of primary health care students
e.
All of the above
ACCURATE CHOICE:E REF: page. 4| CAAHEP Competency (2015):
IX.3 OBJ: 2
7. Which of the following is not an example of a clinical office clinical document?
a.
Patient registration record
b.
Physical examination report
c.
Medication record
d.
Health history report
ACCURATE CHOICE:A REF: page. 2-3| CAAHEP Competency
(2015): VI.4 OBJ: 2
8. Which of the following is not a characteristic of a laboratory report?
a.
It relays results of laboratory tests to the provider
b.
It consists of a report of the analysis or examination of body specimens
c.
It assists in diagnosing and treating sickness
d.
It is a request for laborator yNtUesRt sStIo NbeGpTeBrf.orCmOeMd by an outside
laboratory
ACCURATE CHOICE:D REF: page. 2-3| CAAHEP Competency
(2015): VI.4 OBJ: 2
9. Which of the following is an example of a diagnostic procedure report?
a.
Electrocardiogram report
b.
Physical therapy report
c.
Urinalysis report
d.
Pathology report
ACCURATE CHOICE:A REF: page. 2-3| CAAHEP Competency
(2015): VI.4 OBJ: 2
10. What is the name of the type of report that documents the assessments and
treatments designed to restore a patient’s ability to function?
a.
Consultation report
b.
Diagnostic procedure report
c.
Pathology report
d.
Therapeutic service report
ACCURATE CHOICE:D REF: page. 2-3| CAAHEP Competency
(2015): VI.4 OBJ: 2
11. Which of the following is not an example of a medical center report?
a.
Operative report
, b.
Cytology report
c.
Discharge summary report
d.
Emergency department report
ACCURATE CHOICE:B
REF: page. 2-3| CAAHEP Competency (2015): VI.4 OBJ: 2
12. Which of the following is an example of a consent document?
a.
Patient registration record
b.
Notice of Privacy Practices form
c.
Release of clinical information form
d.
Patient instruction sheet
ACCURATE CHOICE:C REF: page. 2-3| CAAHEP Competency
(2015): VI.4 OBJ: 2
13. Which of the following can be performed by an electronic clinical record software program?
a.
Creation of a clinical record
b.
Storage of a clinical record
c.
Editing of a clinical record
d.
Retrieval of a clinical record
e.
All of the above
ACCURATE CHOICE:E REF: page. 3| CAAHEP Competency (2015):
V.8 OBJ: 3
14. All of the following are advantages of an electronic clinical record (EMR) except
a.
an EMR does not have to be filed.
b. N U R S I N G T B . C O M
documents in an EMR can be q u ic k ly re tr ie v ed .
c.
more than one person can view an EMR at the same time.
d.
EMRs are exempt from the HIPAA regulations.
ACCURATE CHOICE:D REF: page. 3, 6| CAAHEP Competency (2015):
VI.12 OBJ: 5
15. Which of the following are used to enter data into an electronic clinical record?
a.
Free-text entry
b.
Drop-down menus
c.
Radio buttons
d.
All of the above
ACCURATE CHOICE:D REF: page. 11| CAAHEP Competency (2015):
V.8 OBJ: 8
16. How are paper documents entered into a patient’s electronic clinical record?
a.
By scanning them into the computer
b.
By retyping them on the computer
c.
By photocopying them
d.
By transmitting them through a modem
ACCURATE CHOICE:A REF: page. 11| CAAHEP Competency (2015):
VI.4 OBJ: 8
