CCA Practice Comprehensive Resource To Help You Ace
2026-2027 Exams Includes Frequently Tested Questions
With Elaborated 100% Correct Complete Solutions
Guaranteed Pass First Attempt!! Current Update!!
1. Which of the following materials is not documented in an emergency care record?
A patient's instruction at discharge
B time and means of the patient's arrival
C patient's complete medical history
D emergency care administered before arrival at the facility - CORRECT ANSWER
Patient's complete medical history
2. Which of the following provides macroscopic and microscopic information about tissue
removed during an operative procedure?
A. anesthesia report
B. laboratory report
C. operative report
D. pathology report - CORRECT ANSWER Pathology report
3. What is the defining characteristic of an integrate health record format? - CORRECT
ANSWER Integrated health record components are arranged in strict and chronological
order
4. Which of the following represents documentation of the patient's current and past
health status?
A physical examination
B medical history
C physician orders
D patient consent - CORRECT ANSWER Medical history
,5. Which of the following contains the physician's findings based on an examination of the
patient?
A physical examination
B discharge summary
C medical history
D patient instructions - CORRECT ANSWER Physical examination
6. What is the function of a consultation report? - CORRECT ANSWER Documents opinions
about the patient's condition from the perspective of a physician not previously involved
in the patient's care
7. What is the function of physician's orders? - CORRECT ANSWER To document the
physician's instructions to other parties involved in providing care to the patient
8. In the acute care facility, the patient identity management tool that ensures that the
right patient connects to the right information relies on? - CORRECT ANSWER Master
patient index (MPI)
9. An outpatient clinic is reviewing the functionality of an EHR it is considering for
purchase. Which of the following data sets should the clinic consult to ensure that all the
federally recommended data elements for Medicare and Medicaid outpatients are
collected by the system?
a. DEEDS
b. EMEDS
c. UACDS
d. UHDDS - CORRECT ANSWER UACDS
10. Standardizing medical terminology to avoid differences in naming various medical
conditions and procedures (such as the synonyms bunionectomy, McBride procedure,
and repair of hallus valgus) is one purpose of: - CORRECT ANSWER Vocabulary standards
, 11. A family practitioner requests the opinion of a physician specialist who reviews the
patient's health record and examines the patient. The physician specialist would record
findings, impressions, and recommendations in what type of report?
a. consultation
b. medical history
c. physical examination
d. progress notes - CORRECT ANSWER Consultation
12. Which of the following is not a function of the discharge summary?
a. providing information about the patient's insurance coverage
b. ensuring the continuity of future care
c. providing information to support the activities of the medical staff review committee
d. providing concise information that can be used to answer information requests - CORRECT
ANSWER Providing information about a patient's insurance coverage
13. Under HIPAA, at the time of admission to the facility or prior to treatment by the provider,
patients must be informed about the use of individual identifiable health information by signing
the? - CORRECT ANSWER Notice of privacy practices
14. A 65 year old white male was admitted to the hospital on 1/15 complaining of abdominal
pain. The attending physician requested an upper GI series and laboratory evaluation of CBC,
and UA. The x-ray revealed possible cholelithiasis, and the UA showed an increase white blood
cell count. The patient was taken to surgery for an exploratory laparoscopy, and a ruptured
appendix was discovered. The chief complain was? - CORRECT ANSWER Ruptured appendicitis
15. All documentation entered in the medical record relating to the patient's diagnosis and
treatment is considered as this type of data?
a. clinical
b. identification
c. secondary
, d. financial - CORRECT ANSWER Clinical
16. What type of data is exemplified by the insured party's member identification number?
a. demographic data
b. clinical data
c. certification data
d. financial data - CORRECT ANSWER Financial data
17. Which part of the problem-oriented medical record is used by many facilities that have not
adopted the whole problem-oriented format?
a. Problem list as an index
b. Initial plan
c. SOAP form of progress notes
d. Database - CORRECT ANSWER SOAP form of progress
18. A method of documenting only abnormal or unusual findings or deviations from the
prescribed plan of care is?
a. flow chart
b. discharge summary
c. charting by exception
d. care paths - CORRECT ANSWER Charting by exception
19. According to the joint commission accreditation standards, which document must be places
in the patient's record before a surgical procedure may be performed?
a. admission record
b. physician's order
c. report of history and physical examination
2026-2027 Exams Includes Frequently Tested Questions
With Elaborated 100% Correct Complete Solutions
Guaranteed Pass First Attempt!! Current Update!!
1. Which of the following materials is not documented in an emergency care record?
A patient's instruction at discharge
B time and means of the patient's arrival
C patient's complete medical history
D emergency care administered before arrival at the facility - CORRECT ANSWER
Patient's complete medical history
2. Which of the following provides macroscopic and microscopic information about tissue
removed during an operative procedure?
A. anesthesia report
B. laboratory report
C. operative report
D. pathology report - CORRECT ANSWER Pathology report
3. What is the defining characteristic of an integrate health record format? - CORRECT
ANSWER Integrated health record components are arranged in strict and chronological
order
4. Which of the following represents documentation of the patient's current and past
health status?
A physical examination
B medical history
C physician orders
D patient consent - CORRECT ANSWER Medical history
,5. Which of the following contains the physician's findings based on an examination of the
patient?
A physical examination
B discharge summary
C medical history
D patient instructions - CORRECT ANSWER Physical examination
6. What is the function of a consultation report? - CORRECT ANSWER Documents opinions
about the patient's condition from the perspective of a physician not previously involved
in the patient's care
7. What is the function of physician's orders? - CORRECT ANSWER To document the
physician's instructions to other parties involved in providing care to the patient
8. In the acute care facility, the patient identity management tool that ensures that the
right patient connects to the right information relies on? - CORRECT ANSWER Master
patient index (MPI)
9. An outpatient clinic is reviewing the functionality of an EHR it is considering for
purchase. Which of the following data sets should the clinic consult to ensure that all the
federally recommended data elements for Medicare and Medicaid outpatients are
collected by the system?
a. DEEDS
b. EMEDS
c. UACDS
d. UHDDS - CORRECT ANSWER UACDS
10. Standardizing medical terminology to avoid differences in naming various medical
conditions and procedures (such as the synonyms bunionectomy, McBride procedure,
and repair of hallus valgus) is one purpose of: - CORRECT ANSWER Vocabulary standards
, 11. A family practitioner requests the opinion of a physician specialist who reviews the
patient's health record and examines the patient. The physician specialist would record
findings, impressions, and recommendations in what type of report?
a. consultation
b. medical history
c. physical examination
d. progress notes - CORRECT ANSWER Consultation
12. Which of the following is not a function of the discharge summary?
a. providing information about the patient's insurance coverage
b. ensuring the continuity of future care
c. providing information to support the activities of the medical staff review committee
d. providing concise information that can be used to answer information requests - CORRECT
ANSWER Providing information about a patient's insurance coverage
13. Under HIPAA, at the time of admission to the facility or prior to treatment by the provider,
patients must be informed about the use of individual identifiable health information by signing
the? - CORRECT ANSWER Notice of privacy practices
14. A 65 year old white male was admitted to the hospital on 1/15 complaining of abdominal
pain. The attending physician requested an upper GI series and laboratory evaluation of CBC,
and UA. The x-ray revealed possible cholelithiasis, and the UA showed an increase white blood
cell count. The patient was taken to surgery for an exploratory laparoscopy, and a ruptured
appendix was discovered. The chief complain was? - CORRECT ANSWER Ruptured appendicitis
15. All documentation entered in the medical record relating to the patient's diagnosis and
treatment is considered as this type of data?
a. clinical
b. identification
c. secondary
, d. financial - CORRECT ANSWER Clinical
16. What type of data is exemplified by the insured party's member identification number?
a. demographic data
b. clinical data
c. certification data
d. financial data - CORRECT ANSWER Financial data
17. Which part of the problem-oriented medical record is used by many facilities that have not
adopted the whole problem-oriented format?
a. Problem list as an index
b. Initial plan
c. SOAP form of progress notes
d. Database - CORRECT ANSWER SOAP form of progress
18. A method of documenting only abnormal or unusual findings or deviations from the
prescribed plan of care is?
a. flow chart
b. discharge summary
c. charting by exception
d. care paths - CORRECT ANSWER Charting by exception
19. According to the joint commission accreditation standards, which document must be places
in the patient's record before a surgical procedure may be performed?
a. admission record
b. physician's order
c. report of history and physical examination
