Questions with verified answers
A data governance steering committee is formed and tasked with developing the
goals of a data governance program.
Which generally accepted record-keeping principle is described in this scenario?
Ans✓✓✓ Accountability
A hospital is informing the Infection Control Committee about the number of
postoperative infections it had during a given time period.
Which principle for information governance is used in this scenario? Ans✓✓✓
Transparency
A hurricane has occured and a hospital's health information clerk needs to
relocate information systems to an alternate site.
Which plan should the HIM clerk reference to ensure that correct procedures are
followed? Ans✓✓✓ Disaster Recovery Plan
A local skilled nursing facility (SNF), hospital, and public health agency all
participate in a health information exchange (HIE). The data is pushed from their
facilities into one repository where they all have access to retrieve data when
needed.
Which model is described in this scenario? Ans✓✓✓ Centralized
,A nurse enters a patient's zip code, and the state is automatically populated.
What type of data is described? Ans✓✓✓ Structured
A paragraph in a physician's order specifies information about a patient's
discharge.
What type of data is described in this scenario? Ans✓✓✓ Unstructured
A report is needed from a disease registry, but patients' names must be de-
identified.
Which category of key principles and practices applies to this scenario? Ans✓✓✓
Responsbility of health data steward
An acute care facility is concerned with identity theft and wants to update policies
to detect identity theft in day-to-day operations, take steps to prevent the crime,
and mitigate its damage.
Which prevention program element should the facility update? Ans✓✓✓ Red
Flags Rule
For which healthcare setting is the patient's history and physical exam a required
part of the health record? Ans✓✓✓ Acute care and behavioral health
How long do medical records newborns must be retained? Ans✓✓✓ for seven
years after the patient reaches the age of majority
, How long does CMS require health records to be maintained? Ans✓✓✓ At least 5
years
In a physician's practice, a doctor is attempting to submit a claim to Medicare, but
the system is experiencing an outage. Which form should this doctor use to
submit a paper claim? Ans✓✓✓ CMS-1500
In which healthcare setting does CMS require specific documentation by the
attending physician and an update to the patient's plan of care? Ans✓✓✓ Home
healthcare
To which organization must a sentinel event be reported? Ans✓✓✓ The Joint
Commission
True or False?
The health record may reflect one episode of care or an accumulation of all
episodes of care (longitudinal record) Ans✓✓✓ True
What are administrative safeguards? Ans✓✓✓ Policies and procedures to
manage administrative actions, policies, and procedures to prevent, detect,
contain, and correct security violations
What are consultation reports? Ans✓✓✓ - Consultations are opinions of
physicians with specialty training beyond general board certification such as
oncologists, cardiologists, or dermatologists