,1. Which FHIR resource best represents a patient's self-reported alcohol use in
USCDI v6?
A. Observation
B. SocialHistory
C. QuestionnaireResponse
D. Condition
Answer: A. Observation
USCDI v6 maps social determinants of health, including alcohol use, to FHIR
Observation resources using standardized LOINC codes. SocialHistory is not a FHIR
resource; QuestionnaireResponse captures form answers but not the standardized data
element; Condition represents diagnoses, not behaviors.
2. A hospital's EHR alert fatigue reduction strategy best aligns with which CDS
Hooks component?
A. Prefetch templates
B. Card decision logic
C. Hook context filtering
D. Service discovery
Answer: C. Hook context filtering
CDS Hooks 'hook context filtering' allows the EHR to send only relevant context and
suppress low-value alerts, directly reducing fatigue. Prefetch optimizes data retrieval,
card logic defines recommendations, and service discovery enables endpoint
registration-none inherently filter alert burden.
3. Which LOINC artifact is most appropriate for reporting a calculated eGFR
value?
A. Document ontology
B. Laboratory observation code
C. Survey instrument
D. Order code
Answer: B. Laboratory observation code
LOINC laboratory observation codes are used for reporting quantitative lab results
including calculated eGFR. Document ontology codes classify document types; survey
instruments capture patient-reported data; order codes specify test orders, not results.
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,4. Under HIPAA, which action requires a covered entity to obtain patient
authorization?
A. Disclosure to a public health authority for disease reporting
B. Use of PHI for internal quality assessment
C. Sale of PHI to a marketing firm without consent
D. Disclosure to a health oversight agency for audit
Answer: C. Sale of PHI to a marketing firm without consent
HIPAA requires patient authorization for any sale of PHI unless an exception applies;
marketing use also generally requires authorization. Disclosures to public health and
oversight agencies are permitted without authorization, and internal quality assessment
is a treatment/payment/operations function.
5. Which interoperability standard is specifically designed for exchanging clinical
documents using a CDA template?
A. HL7 v2 ADT
B. IHE XDS
C. FHIR Questionnaire
D. DICOM SR
Answer: B. IHE XDS
IHE XDS (Cross-Enterprise Document Sharing) specifies a registry/repository
architecture for sharing CDA documents across enterprises. HL7 v2 ADT handles
admissions messages, FHIR Questionnaire captures form data, and DICOM SR
represents structured reports, not document exchange.
6. In a project using the HL7 FHIR maturity model, which level indicates the
resource is ready for production use?
A. Draft (0)
B. Trial Use (2)
C. Normative (4)
D. Informative (1)
Answer: C. Normative (4)
FHIR maturity levels range from 0 (draft) to 5 (normative); level 4 (normative)
indicates the resource has passed balloting and is stable for production. Trial Use (2) is
for early adopters, Draft (0) is unstable, and Informative (1) is for reference only.
Page 3
, 7. Which telehealth modality poses the greatest risk for diagnostic error due to
limited physical examination?
A. Store-and-forward
B. Real-time video
C. Remote patient monitoring
D. Audio-only
Answer: D. Audio-only
Audio-only telehealth lacks visual cues and physical exam capabilities, increasing
diagnostic uncertainty. Store-and-forward allows asynchronous review of images/data,
real-time video enables visual assessment, and remote monitoring provides objective
physiologic data.
8. Which ethical principle is most directly challenged by using predictive analytics to
allocate scarce ICU beds?
A. Beneficence
B. Justice
C. Autonomy
D. Nonmaleficence
Answer: B. Justice
Justice concerns fair distribution of resources; algorithmic bed allocation raises equity
and bias concerns. Beneficence and nonmaleficence relate to benefit and harm, while
autonomy concerns patient choice-none is as directly tied to distributive fairness.
9. Which data quality dimension is most compromised when an EHR interface maps
a local code to the wrong LOINC term?
A. Timeliness
B. Completeness
C. Semantic accuracy
D. Consistency
Answer: C. Semantic accuracy
Incorrect LOINC mapping means the data value does not accurately represent the
intended concept, violating semantic accuracy. Timeliness, completeness, and
consistency are unaffected if the data is present, timely, and uniformly mapped-though
consistently wrong.
Page 4
USCDI v6?
A. Observation
B. SocialHistory
C. QuestionnaireResponse
D. Condition
Answer: A. Observation
USCDI v6 maps social determinants of health, including alcohol use, to FHIR
Observation resources using standardized LOINC codes. SocialHistory is not a FHIR
resource; QuestionnaireResponse captures form answers but not the standardized data
element; Condition represents diagnoses, not behaviors.
2. A hospital's EHR alert fatigue reduction strategy best aligns with which CDS
Hooks component?
A. Prefetch templates
B. Card decision logic
C. Hook context filtering
D. Service discovery
Answer: C. Hook context filtering
CDS Hooks 'hook context filtering' allows the EHR to send only relevant context and
suppress low-value alerts, directly reducing fatigue. Prefetch optimizes data retrieval,
card logic defines recommendations, and service discovery enables endpoint
registration-none inherently filter alert burden.
3. Which LOINC artifact is most appropriate for reporting a calculated eGFR
value?
A. Document ontology
B. Laboratory observation code
C. Survey instrument
D. Order code
Answer: B. Laboratory observation code
LOINC laboratory observation codes are used for reporting quantitative lab results
including calculated eGFR. Document ontology codes classify document types; survey
instruments capture patient-reported data; order codes specify test orders, not results.
Page 2
,4. Under HIPAA, which action requires a covered entity to obtain patient
authorization?
A. Disclosure to a public health authority for disease reporting
B. Use of PHI for internal quality assessment
C. Sale of PHI to a marketing firm without consent
D. Disclosure to a health oversight agency for audit
Answer: C. Sale of PHI to a marketing firm without consent
HIPAA requires patient authorization for any sale of PHI unless an exception applies;
marketing use also generally requires authorization. Disclosures to public health and
oversight agencies are permitted without authorization, and internal quality assessment
is a treatment/payment/operations function.
5. Which interoperability standard is specifically designed for exchanging clinical
documents using a CDA template?
A. HL7 v2 ADT
B. IHE XDS
C. FHIR Questionnaire
D. DICOM SR
Answer: B. IHE XDS
IHE XDS (Cross-Enterprise Document Sharing) specifies a registry/repository
architecture for sharing CDA documents across enterprises. HL7 v2 ADT handles
admissions messages, FHIR Questionnaire captures form data, and DICOM SR
represents structured reports, not document exchange.
6. In a project using the HL7 FHIR maturity model, which level indicates the
resource is ready for production use?
A. Draft (0)
B. Trial Use (2)
C. Normative (4)
D. Informative (1)
Answer: C. Normative (4)
FHIR maturity levels range from 0 (draft) to 5 (normative); level 4 (normative)
indicates the resource has passed balloting and is stable for production. Trial Use (2) is
for early adopters, Draft (0) is unstable, and Informative (1) is for reference only.
Page 3
, 7. Which telehealth modality poses the greatest risk for diagnostic error due to
limited physical examination?
A. Store-and-forward
B. Real-time video
C. Remote patient monitoring
D. Audio-only
Answer: D. Audio-only
Audio-only telehealth lacks visual cues and physical exam capabilities, increasing
diagnostic uncertainty. Store-and-forward allows asynchronous review of images/data,
real-time video enables visual assessment, and remote monitoring provides objective
physiologic data.
8. Which ethical principle is most directly challenged by using predictive analytics to
allocate scarce ICU beds?
A. Beneficence
B. Justice
C. Autonomy
D. Nonmaleficence
Answer: B. Justice
Justice concerns fair distribution of resources; algorithmic bed allocation raises equity
and bias concerns. Beneficence and nonmaleficence relate to benefit and harm, while
autonomy concerns patient choice-none is as directly tied to distributive fairness.
9. Which data quality dimension is most compromised when an EHR interface maps
a local code to the wrong LOINC term?
A. Timeliness
B. Completeness
C. Semantic accuracy
D. Consistency
Answer: C. Semantic accuracy
Incorrect LOINC mapping means the data value does not accurately represent the
intended concept, violating semantic accuracy. Timeliness, completeness, and
consistency are unaffected if the data is present, timely, and uniformly mapped-though
consistently wrong.
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