CHIMA NCE Data & HER UPDATED
ACTUAL Exam Questions and CORRECT
Answers
An organization's legal health record definition must identify the following regarding
individually identifiable data:
a. Sources
b. Medium
c. Location
d. All of the above - CORRECT ANSWER -d
It is best practice to establish a ____ when defining the legal health record.
a. Policy
b. Master patient index
c. Health record matrix
d. Both a and c - CORRECT ANSWER -d
The legal health record can only be comprised of documentation that physically exists in an
electronic system.
True/False - CORRECT ANSWER - False
Which function is the first step in the creation of a patient's medical record and initiates the flow
of patient information within the EHR?
a. Analysis
b. Patient registration
c. Scheduling
d. Coding - CORRECT ANSWER -b
Which of the following processes includes deficiency analysis and chart completion?
,a. Release of information
b. Incomplete record
c. Coding
d. Chart reviews - CORRECT ANSWER -d
Malpractice cases generally fall into the category of _____.
a. Negligence torts
b. Intentional torts
c. Fraud cases
d. Criminal cases - CORRECT ANSWER -a
In a negligence case, a physician will be held to a standard of providing care that reflects what is
called _____ care.
a. Minimal
b. Optimal
c. Maximum
d. Reasonable - CORRECT ANSWER -d
A physician who fails to treat a patient who is brought to him or her for care is guilty of _____.
a. Malfeasance
b. Misfeasance
c. Nonfeasance
d. Malpractice - CORRECT ANSWER -c
A physician who performs a surgical procedure without patient consent may be prosecuted for
_____.
a. Assault
b. Battery
, c. Negligence
d. Malfeasance - CORRECT ANSWER -b
Defaming another person in writing is called _____.
a. Libel
b. Slander
c. Invasion of privacy
d. Fraud - CORRECT ANSWER -a
To successfully prosecute an individual for slander, the plaintiff must prove that:
a. Actual harm occurred
b. There was harmful intent
c. There was dissension between the parties involved
d. Lost wages resulted from the slander - CORRECT ANSWER -a
Information systems which help with treatment choices, advance care planning and palliative
care are issues that result for those dealing with _____.
a. End of life
b. Integrated
c. Managed
d. Quality - CORRECT ANSWER -a
Problems with verifying admissions to a facility and children's protective services are ethical
issues for those working with ______ information:
a. Drug, alcohol, sexual, and behavioral
b. Genetic
c. Managed care
d. Public health - CORRECT ANSWER -a
ACTUAL Exam Questions and CORRECT
Answers
An organization's legal health record definition must identify the following regarding
individually identifiable data:
a. Sources
b. Medium
c. Location
d. All of the above - CORRECT ANSWER -d
It is best practice to establish a ____ when defining the legal health record.
a. Policy
b. Master patient index
c. Health record matrix
d. Both a and c - CORRECT ANSWER -d
The legal health record can only be comprised of documentation that physically exists in an
electronic system.
True/False - CORRECT ANSWER - False
Which function is the first step in the creation of a patient's medical record and initiates the flow
of patient information within the EHR?
a. Analysis
b. Patient registration
c. Scheduling
d. Coding - CORRECT ANSWER -b
Which of the following processes includes deficiency analysis and chart completion?
,a. Release of information
b. Incomplete record
c. Coding
d. Chart reviews - CORRECT ANSWER -d
Malpractice cases generally fall into the category of _____.
a. Negligence torts
b. Intentional torts
c. Fraud cases
d. Criminal cases - CORRECT ANSWER -a
In a negligence case, a physician will be held to a standard of providing care that reflects what is
called _____ care.
a. Minimal
b. Optimal
c. Maximum
d. Reasonable - CORRECT ANSWER -d
A physician who fails to treat a patient who is brought to him or her for care is guilty of _____.
a. Malfeasance
b. Misfeasance
c. Nonfeasance
d. Malpractice - CORRECT ANSWER -c
A physician who performs a surgical procedure without patient consent may be prosecuted for
_____.
a. Assault
b. Battery
, c. Negligence
d. Malfeasance - CORRECT ANSWER -b
Defaming another person in writing is called _____.
a. Libel
b. Slander
c. Invasion of privacy
d. Fraud - CORRECT ANSWER -a
To successfully prosecute an individual for slander, the plaintiff must prove that:
a. Actual harm occurred
b. There was harmful intent
c. There was dissension between the parties involved
d. Lost wages resulted from the slander - CORRECT ANSWER -a
Information systems which help with treatment choices, advance care planning and palliative
care are issues that result for those dealing with _____.
a. End of life
b. Integrated
c. Managed
d. Quality - CORRECT ANSWER -a
Problems with verifying admissions to a facility and children's protective services are ethical
issues for those working with ______ information:
a. Drug, alcohol, sexual, and behavioral
b. Genetic
c. Managed care
d. Public health - CORRECT ANSWER -a
