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Medical Records (questions with correct answers) A+ rated

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Medical Records (questions with correct answers) A+ rated

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Medical Records
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Medical Records

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Medical Records (questions with
correct answers) A+ rated

1. Permission granted by an individual voluntarily and in his right mind is known as

A. consent.

B. compliance.

C. standard of care.

D. duty of care.

Submit My Response - correct answer ✔✔Consent

Implied or expressed consent is the voluntary permission given by the patient for examination,
testing, and treatment. Compliance is the act of following orders or doing what is expected or
asked, standard of care is a set of guidelines that should be followed for each patient, and duty
of care refers to a set of actions that a person is obligated to follow in order to prevent harm to
others.



2. A medical office assistant's family asks to see the medical information of her brother-in-law
who has just been brought into the emergency room. If the medical office assistant accesses the
information it is

A. appropriate because she is a family member.

B. a violation of the Privacy Rule.

C. permissible because she is an employee.

D. prosecutable as fraud.

Submit My Response - correct answer ✔✔Violation of the Privacy Rule.

The HIPAA Privacy Rule provides federal protections for health information held by medical
facilities and gives patients rights with respect to that information. Disclosure to anyone other
than the patient or healthcare provider is a violation of the Privacy Rule. The Privacy Rule is
balanced so that it permits the disclosure of health information, within the healthcare setting,
for access to the needed information for patient care and other important purposes.

, 3. Which of the following is the role of a medical transcriptionist in the health care setting?

A. converting paper-based records into electronic medical records

B. retrieving information from medical records

C. transforming medical information into a permanent document

D. editing electronic medical records - correct answer ✔✔Transforming medical information
into a permanent document:::::

Medical transcriptionists transform medical information, whatever the format, into a
permanent record whether electronic or paper to document the care a patient receives in the
healthcare environment.



4. Which of the following is a characteristic of an EMR system used by a medical office?

A. It is the principal medical record used in healthcare facilities.

B. It incorporates computer systems from many different vendors.

C. It requires clinicians to use an interface to view data from different systems.

D. It must be accessible to any specialists who are also treating the patient.

Submit My Response - correct answer ✔✔It is the principal medical record used in healthcare
facilities.

An electronic medical record (EMR) is kept in a computer system and serves as the principle
medical record for each patient. There are numerous vendors that provide EMR systems, so
systems will vary among medical practices. Each medical practice has its own electronic system
that is accessible solely by that practice. An electronic medical record (EMR) is the principal
medical record method used in most current healthcare facilities. It contains the patient's
demographics (name, age, address), a record of medical treatment received, possible allergies
and medication history.



5. In which of the following medical record categories should the medical office assistant file a
patient's electrocardiogram result?

A. therapeutic service documents

B. diagnostic procedure documents

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Institution
Medical Records
Course
Medical Records

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