HIT 125 Final Exam with 100% Correct
Answers
health record - ANS-written or graphic information documenting facts and events during
the rendering of patient care. Either paper or electronic format.
most important function of the health record - ANS-storing patient information
who are primary users of the health record - ANS-clinical professionals providing direct
patient care
how does the patient registration department assist the HIM department - ANS-they
assign patients health record numbers
the master patient index contains ____________________ - ANS-basic demographic
information about the patient
What type of filing system is being used if records are filed in the following order : 12-
23-75, 12-34-29, 13-42-14, and 14-32-79? - ANS-terminal digit
what is the function of the ROI department - ANS-disclose patient identifiable
information to a third party
what filing system is typically found in a small physicians office - ANS-Alphabetic filing
system
in which filing system does a patient receive a unique numerical identifier at the first
encounter and maintains that number at subsequent encounters - ANS-Unit numbering
system
if a record is not completed within a specified time frame it is considered - ANS-
delinquent
what index would you use to locate a patients record in a numeric filing system - ANS-
Master Patient Index
some reasons using the copy/paste function is not advisable - ANS--content could
contain outdated information
-unable to identify the author
, is support for research a primary or secondary function of a health record? - ANS-
secondary
This type of health record combines paper and electronic and is used by healthcare
settings that are in transition to EHR - ANS-Hybrid
A patient's address is an example of what type of information - ANS-Administrative
information
Time and means of arrival must be contained in what type of record - ANS-Emergency
care
this type of report includes names of the surgeon and assistant, date, duration, and
description of procedure, as well as any specimens removed - ANS-Operative report
Physician's orders are an example of what type of data - ANS-Clinical data
Written or spoken permission to proceed with care is classified as: - ANS-Expressed
consent
SOAP notes are part of which type of medical record? - ANS-Problem-oriented health
record
this is an example of an acknowledgement - ANS-notice of privacy practices
The management of health information is a fundamental component of what - ANS-The
overall information governance model
Some common elements of a data dictionary are.. - ANS-Data field, definition, data
type, and format
a single fact representing a patient in healthcare - ANS-Data element
a patients birth date and gender documented in the health record are examples of -
ANS-a data element
this data set collects information on the provider, place of encounter, reason, problem,
diagnosis, assessment, therapeutic services, preventative services, and disposition -
ANS-Uniform Ambulatory Care Data Set (UACDS)
the collection of information on healthcare fraud and abuse was mandated by HIPAA
and resulted in the development of.. - ANS-Healthcare Integrity and Protection Data
Bank
Federal agencies are an example of an _____________ user utilizing _____________
data - ANS-External, Secondary
Answers
health record - ANS-written or graphic information documenting facts and events during
the rendering of patient care. Either paper or electronic format.
most important function of the health record - ANS-storing patient information
who are primary users of the health record - ANS-clinical professionals providing direct
patient care
how does the patient registration department assist the HIM department - ANS-they
assign patients health record numbers
the master patient index contains ____________________ - ANS-basic demographic
information about the patient
What type of filing system is being used if records are filed in the following order : 12-
23-75, 12-34-29, 13-42-14, and 14-32-79? - ANS-terminal digit
what is the function of the ROI department - ANS-disclose patient identifiable
information to a third party
what filing system is typically found in a small physicians office - ANS-Alphabetic filing
system
in which filing system does a patient receive a unique numerical identifier at the first
encounter and maintains that number at subsequent encounters - ANS-Unit numbering
system
if a record is not completed within a specified time frame it is considered - ANS-
delinquent
what index would you use to locate a patients record in a numeric filing system - ANS-
Master Patient Index
some reasons using the copy/paste function is not advisable - ANS--content could
contain outdated information
-unable to identify the author
, is support for research a primary or secondary function of a health record? - ANS-
secondary
This type of health record combines paper and electronic and is used by healthcare
settings that are in transition to EHR - ANS-Hybrid
A patient's address is an example of what type of information - ANS-Administrative
information
Time and means of arrival must be contained in what type of record - ANS-Emergency
care
this type of report includes names of the surgeon and assistant, date, duration, and
description of procedure, as well as any specimens removed - ANS-Operative report
Physician's orders are an example of what type of data - ANS-Clinical data
Written or spoken permission to proceed with care is classified as: - ANS-Expressed
consent
SOAP notes are part of which type of medical record? - ANS-Problem-oriented health
record
this is an example of an acknowledgement - ANS-notice of privacy practices
The management of health information is a fundamental component of what - ANS-The
overall information governance model
Some common elements of a data dictionary are.. - ANS-Data field, definition, data
type, and format
a single fact representing a patient in healthcare - ANS-Data element
a patients birth date and gender documented in the health record are examples of -
ANS-a data element
this data set collects information on the provider, place of encounter, reason, problem,
diagnosis, assessment, therapeutic services, preventative services, and disposition -
ANS-Uniform Ambulatory Care Data Set (UACDS)
the collection of information on healthcare fraud and abuse was mandated by HIPAA
and resulted in the development of.. - ANS-Healthcare Integrity and Protection Data
Bank
Federal agencies are an example of an _____________ user utilizing _____________
data - ANS-External, Secondary
