CHIMA MOCK EXAM PREP 2026|NEW
UPDATE|&As|ALREADY GRADED A+|100% VERIFIED —
200 Questions and Answers Already Graded A+ Premium Exam
Tested And Verified
Subject Area Health Information Management / CHIMA Certification
Description This mock exam simulates the CHIMA (Canadian Health Information
Management Association) national certification exam, covering data quality,
classification systems, privacy legislation, health informatics, and management.
Questions are designed to reflect the depth and rigor of US university-level HIM
programs, with a focus on critical thinking and application of standards.
Screenshots are included and cannot be highlighted.
Expected Grade A+
Total Questions 200
Duration 3 hours
Learning Outcomes 1. Apply ICD-10-CA/CCI coding conventions and Canadian Coding Standards for
complex cases
2. Analyze health information privacy and security requirements under PIPEDA
and provincial legislation
3. Evaluate data quality frameworks and implement improvement strategies
4. Interpret health informatics concepts including EHR adoption and
interoperability
5. Demonstrate management skills in resource allocation and performance
improvement
Accreditation Aligned with CHIMA National Competency Profile and US CAHIIM
accreditation standards for Health Information Management programs.
Page 1
,1. A health record review reveals that a patient's discharge summary lists the
principal diagnosis as 'Acute myocardial infarction, unspecified site' (I21.3), but the
ECG and troponin results indicate a 'Non-ST elevation myocardial infarction'
(NSTEMI) of the anterior wall. According to Canadian Coding Standards, which of
the following actions is most appropriate?
A. Code I21.3 as the principal diagnosis because the physician documented it first.
B. Query the physician for clarification and assign I21.09 (NSTEMI anterior wall) if
confirmed.
C. Assign I21.09 as the principal diagnosis based on the clinical evidence without querying.
D. Code both I21.3 and I21.09 and sequence I21.3 first.
Answer: B. Query the physician for clarification and assign I21.09 (NSTEMI
anterior wall) if confirmed.
The correct answer is B. Canadian Coding Standards require coding based on the most
specific diagnosis supported by clinical evidence. When documentation is conflicting, a
physician query is necessary to ensure accuracy. Option A violates the specificity
standard, C bypasses the query process, and D would result in incorrect coding and
potential DRG misclassification.
2. A health information manager is evaluating the accuracy of coded data for a
hospital's annual report. The manager compares the coded data to a random sample
of records and calculates a kappa statistic of 0.45. Which interpretation of this result
is most accurate?
A. The data have excellent agreement beyond chance, indicating high accuracy.
B. The data have poor agreement beyond chance, indicating the coding process needs
revision.
C. The data have moderate agreement beyond chance, suggesting some inconsistency but not
critical.
D. The kappa statistic cannot be used for coded data; a different measure is needed.
Answer: C. The data have moderate agreement beyond chance, suggesting some
inconsistency but not critical.
A kappa statistic of 0.45 indicates moderate agreement (0.41-0.60) beyond chance.
While not poor, it suggests room for improvement. Option A is incorrect because 0.45 is
not excellent ("e0.80). Option B overstates the severity. Option D is false; kappa is
commonly used for inter-rater reliability in coding audits.
Page 2
,3. A regional health authority implements a new electronic health record (EHR)
system. The project manager must ensure compliance with PIPEDA for the
collection, use, and disclosure of personal health information. Which of the following
practices would violate PIPEDA requirements?
A. Obtaining implied consent for sharing health information with other healthcare providers
involved in the patient's care.
B. Allowing patients to access their own health records upon written request within 30 days.
C. Using de-identified data for internal quality improvement without patient consent.
D. Disclosing a patient's health information to law enforcement without a warrant or
subpoena.
Answer: D. Disclosing a patient's health information to law enforcement without a
warrant or subpoena.
PIPEDA requires that disclosure of personal health information to law enforcement be
authorized by law, typically through a warrant or subpoena. Option D violates this
principle. Option A is acceptable under implied consent for treatment purposes. Option
B is a patient right. Option C is permissible when data is de-identified.
4. A coder is abstracting a record for a patient admitted for diabetic ketoacidosis
(DKA) due to noncompliance with insulin therapy. The patient also has chronic
kidney disease stage 3 (CKD). According to Canadian Coding Standards, how
should these conditions be coded and sequenced?
A. Sequence DKA as principal diagnosis and code CKD as a secondary diagnosis; link DKA
to diabetes with a combination code.
B. Sequence CKD as principal diagnosis because it is chronic and more resource-intensive;
code DKA as secondary.
C. Code DKA with a combination code for diabetes with ketoacidosis, and code CKD
separately; sequence the diabetes code first.
D. Code only the DKA because CKD is a chronic condition that does not affect the current
episode.
Answer: A. Sequence DKA as principal diagnosis and code CKD as a secondary
diagnosis; link DKA to diabetes with a combination code.
The principal diagnosis is the condition chiefly responsible for the admission, which is
DKA. A combination code for diabetes with ketoacidosis (e.g., E10.11) should be used.
CKD is a secondary diagnosis. Option B incorrectly prioritizes CKD. Option C
sequences the diabetes code first, but the diabetes code is not the principal diagnosis;
the manifestation (DKA) drives admission. Option D omits a significant comorbidity.
Page 3
, 5. A health information department is transitioning from paper to electronic records.
Which data governance principle is most critical to ensure the integrity of the EHR
during the transition?
A. Implementing role-based access controls to limit data entry to authorized personnel.
B. Conducting a data mapping exercise to ensure all paper fields have corresponding EHR
fields.
C. Establishing an audit trail that logs all changes to records with timestamps and user IDs.
D. Training all staff on the new EHR system before go-live.
Answer: C. Establishing an audit trail that logs all changes to records with
timestamps and user IDs.
An audit trail is essential for data integrity as it provides a record of who accessed or
modified data, when, and what changes were made. This ensures accountability and the
ability to detect unauthorized alterations. While options A, B, and D are important,
they do not directly address integrity as comprehensively as an audit trail.
6. A researcher requests access to a hospital's database of patient records for a
retrospective study on surgical site infections. The request includes patient
identifiers. Which of the following must be obtained before the data can be released?
A. Informed consent from each patient whose data will be used.
B. Approval from the hospital's institutional review board (IRB) or research ethics board
(REB).
C. A data use agreement (DUA) signed by the researcher.
D. Both B and C are required.
Answer: D. Both B and C are required.
For research involving identifiable health information, both REB/IRB approval and a
DUA are typically required. Informed consent (A) may be waived by the REB if the
research poses minimal risk and consent is impractical, but it is not automatically
required. Options B and C are both necessary, making D correct.
Page 4
UPDATE|&As|ALREADY GRADED A+|100% VERIFIED —
200 Questions and Answers Already Graded A+ Premium Exam
Tested And Verified
Subject Area Health Information Management / CHIMA Certification
Description This mock exam simulates the CHIMA (Canadian Health Information
Management Association) national certification exam, covering data quality,
classification systems, privacy legislation, health informatics, and management.
Questions are designed to reflect the depth and rigor of US university-level HIM
programs, with a focus on critical thinking and application of standards.
Screenshots are included and cannot be highlighted.
Expected Grade A+
Total Questions 200
Duration 3 hours
Learning Outcomes 1. Apply ICD-10-CA/CCI coding conventions and Canadian Coding Standards for
complex cases
2. Analyze health information privacy and security requirements under PIPEDA
and provincial legislation
3. Evaluate data quality frameworks and implement improvement strategies
4. Interpret health informatics concepts including EHR adoption and
interoperability
5. Demonstrate management skills in resource allocation and performance
improvement
Accreditation Aligned with CHIMA National Competency Profile and US CAHIIM
accreditation standards for Health Information Management programs.
Page 1
,1. A health record review reveals that a patient's discharge summary lists the
principal diagnosis as 'Acute myocardial infarction, unspecified site' (I21.3), but the
ECG and troponin results indicate a 'Non-ST elevation myocardial infarction'
(NSTEMI) of the anterior wall. According to Canadian Coding Standards, which of
the following actions is most appropriate?
A. Code I21.3 as the principal diagnosis because the physician documented it first.
B. Query the physician for clarification and assign I21.09 (NSTEMI anterior wall) if
confirmed.
C. Assign I21.09 as the principal diagnosis based on the clinical evidence without querying.
D. Code both I21.3 and I21.09 and sequence I21.3 first.
Answer: B. Query the physician for clarification and assign I21.09 (NSTEMI
anterior wall) if confirmed.
The correct answer is B. Canadian Coding Standards require coding based on the most
specific diagnosis supported by clinical evidence. When documentation is conflicting, a
physician query is necessary to ensure accuracy. Option A violates the specificity
standard, C bypasses the query process, and D would result in incorrect coding and
potential DRG misclassification.
2. A health information manager is evaluating the accuracy of coded data for a
hospital's annual report. The manager compares the coded data to a random sample
of records and calculates a kappa statistic of 0.45. Which interpretation of this result
is most accurate?
A. The data have excellent agreement beyond chance, indicating high accuracy.
B. The data have poor agreement beyond chance, indicating the coding process needs
revision.
C. The data have moderate agreement beyond chance, suggesting some inconsistency but not
critical.
D. The kappa statistic cannot be used for coded data; a different measure is needed.
Answer: C. The data have moderate agreement beyond chance, suggesting some
inconsistency but not critical.
A kappa statistic of 0.45 indicates moderate agreement (0.41-0.60) beyond chance.
While not poor, it suggests room for improvement. Option A is incorrect because 0.45 is
not excellent ("e0.80). Option B overstates the severity. Option D is false; kappa is
commonly used for inter-rater reliability in coding audits.
Page 2
,3. A regional health authority implements a new electronic health record (EHR)
system. The project manager must ensure compliance with PIPEDA for the
collection, use, and disclosure of personal health information. Which of the following
practices would violate PIPEDA requirements?
A. Obtaining implied consent for sharing health information with other healthcare providers
involved in the patient's care.
B. Allowing patients to access their own health records upon written request within 30 days.
C. Using de-identified data for internal quality improvement without patient consent.
D. Disclosing a patient's health information to law enforcement without a warrant or
subpoena.
Answer: D. Disclosing a patient's health information to law enforcement without a
warrant or subpoena.
PIPEDA requires that disclosure of personal health information to law enforcement be
authorized by law, typically through a warrant or subpoena. Option D violates this
principle. Option A is acceptable under implied consent for treatment purposes. Option
B is a patient right. Option C is permissible when data is de-identified.
4. A coder is abstracting a record for a patient admitted for diabetic ketoacidosis
(DKA) due to noncompliance with insulin therapy. The patient also has chronic
kidney disease stage 3 (CKD). According to Canadian Coding Standards, how
should these conditions be coded and sequenced?
A. Sequence DKA as principal diagnosis and code CKD as a secondary diagnosis; link DKA
to diabetes with a combination code.
B. Sequence CKD as principal diagnosis because it is chronic and more resource-intensive;
code DKA as secondary.
C. Code DKA with a combination code for diabetes with ketoacidosis, and code CKD
separately; sequence the diabetes code first.
D. Code only the DKA because CKD is a chronic condition that does not affect the current
episode.
Answer: A. Sequence DKA as principal diagnosis and code CKD as a secondary
diagnosis; link DKA to diabetes with a combination code.
The principal diagnosis is the condition chiefly responsible for the admission, which is
DKA. A combination code for diabetes with ketoacidosis (e.g., E10.11) should be used.
CKD is a secondary diagnosis. Option B incorrectly prioritizes CKD. Option C
sequences the diabetes code first, but the diabetes code is not the principal diagnosis;
the manifestation (DKA) drives admission. Option D omits a significant comorbidity.
Page 3
, 5. A health information department is transitioning from paper to electronic records.
Which data governance principle is most critical to ensure the integrity of the EHR
during the transition?
A. Implementing role-based access controls to limit data entry to authorized personnel.
B. Conducting a data mapping exercise to ensure all paper fields have corresponding EHR
fields.
C. Establishing an audit trail that logs all changes to records with timestamps and user IDs.
D. Training all staff on the new EHR system before go-live.
Answer: C. Establishing an audit trail that logs all changes to records with
timestamps and user IDs.
An audit trail is essential for data integrity as it provides a record of who accessed or
modified data, when, and what changes were made. This ensures accountability and the
ability to detect unauthorized alterations. While options A, B, and D are important,
they do not directly address integrity as comprehensively as an audit trail.
6. A researcher requests access to a hospital's database of patient records for a
retrospective study on surgical site infections. The request includes patient
identifiers. Which of the following must be obtained before the data can be released?
A. Informed consent from each patient whose data will be used.
B. Approval from the hospital's institutional review board (IRB) or research ethics board
(REB).
C. A data use agreement (DUA) signed by the researcher.
D. Both B and C are required.
Answer: D. Both B and C are required.
For research involving identifiable health information, both REB/IRB approval and a
DUA are typically required. Informed consent (A) may be waived by the REB if the
research poses minimal risk and consent is impractical, but it is not automatically
required. Options B and C are both necessary, making D correct.
Page 4
