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Q21. You are responsible for ensuring that all dictations made by physicians become part of the patient's permanent electronic health record. Which of the following types of data are you responsible for? 

A. Numbers 

B. Voice 

C. Signals 

D. Images 

Answer: B 

Explanation: Voice data is a type of data that may be found in a patient's electronic health record. Examples of voice data include stored dictations of radiology images from interpreting radiologist, or any other dictated evaluation. Answer: D is incorrect. Images is incorrect as this data type is normally represented by x-rays or document images themselves, the interpretation of radiology images are considered voice data. Answer: A is incorrect. Numbers is incorrect as this data types usually is represented by ICD-9 codes, blood pressure readings and temperature readings. Answer: C is incorrect. Signals is incorrect as this data type is normally represented by EEG tracings or EKG tracings. 


Q22. As part of your new job at a hospital, you are asked to obtain a copy of the form that would allow requests for patient health information so that it can be added to a database of scanned legal forms. What department would you go to in order to obtain this form? Each correct answer represents a complete solution. Choose all that apply. 

A. Accounts payable 

B. Release of Information Office 

C. Health Information Management Services 

D. Medical Records 

Answer: BCD 

Explanation: There are many names for a department in a hospital that manages access to patient information. The use, disclosure and requests for protected health information are an important part of hospital functions, and the information management department may be split into several different departments or have different names at different facilities. In some small hospitals, the release of information is done within the medical records department. Some hospitals name the medical records department the Health Information Management Department, and some hospitals are so large they maintain a separate office solely to deal with release of information requests, often within the larger Health Information Management Services department. Answer: A is incorrect. It is unlikely that an accounting, billing or accounts payable department would have control over medical records or the release of patient information. 


Q23. A 44 year old female presents to the emergency room with chest pain. She is denied care because she is uninsured. Which of the following pieces of legislation has been violated? 

A. EMTALA 

B. HIPPA 

C. MIPPA 

D. Patient Bill of Rights 

Answer: A 

Explanation: The Emergency Medical Treatment and Active Labor Act (EMTALA) is the piece of legislation legally obligates health care facilities to provide emergent care regardless of citizenship, legal status or ability to pay. Answer: B is incorrect. HIPPA is incorrect as this legislation is designed to insure the privacy and security of personal health information. 


Q24. Which of the following types of health insurance allows the patient to direct his/her own care? 

A. HMO 

B. Indemnity Plan 

C. Point of Service 

D. PPO 

Answer: B 

Explanation: An indemnity plan allows you to visit any doctor, any hospital and direct your own care. Answer: A is incorrect. HMO is incorrect as this offers healthcare services for a prepaid fixed amount of reimbursement. In an HMO, providers and subscribers voluntarily enroll and the HMO assumes responsibility and financial risks. Answer: D is incorrect. PPO is incorrect as this is a network of physicians or healthcare organizations that provide healthcare at a discounted rate in return for higher patient volume. Answer: C is incorrect. Point of Service (POS) is an agreement where a patient is permitted to choose a provider each time healthcare service is required. 


Q25. Implementing an electronic health information system for hospital drug prescribing can reduce medication errors by upwards of 55%. If you are installing a drug prescribing system where doctor prescriptions are forwarded to the pharmacy via computer, what is this system better known as? 

A. Leapfrog 

B. Encoder 

C. ePharmacy 

D. Computerized Physician Order Entry 

Answer: D 

Explanation: Computerized prescribing systems are referred to as Computerized Physician Order Entry or CPOE. Often they can also include orders to the pharmacy, radiology and the laboratory and with proper training and reduce medication errors by up to 55% in some studies. Answer: C is incorrect. ePharmacy is the name of a company in Australia and is not a product in the United States and is not a CPOE product. Answer: B is incorrect. Encoder is a health information system used to generate diagnosis and billing codes using the ICD9, ICD10, CPT and MSDRG systems. It does not involved drug prescribing. Answer: A is incorrect. The Leapfrog Group is the name of an organization which works to prevent errors in medical care like medication mistakes and works to improve the quality of health care. Although they have done studies on the effectiveness of CPOE system, they do not market a particular system. 


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Q26. You are the responsible for the medical records of a high profile, well known, adult patient. Which of the following do not require a disclosure of information form in order for medical records be released? 

A. News Media 

B. Patient's Attorney 

C. Physician other than Primary Care Physician 

D. Patient's Parents 

Answer: A 

Explanation: It is not required, but is generally discouraged, for a disclosure of patient information form to be signed in order for a health care facility to release health information to the news media. This is true even thought the patient's privacy may be compromised with release of patient health information that is of public interest and right to know. Answer: B is incorrect. It is required by law for a disclosure of patient information to be signed in order for protected health information to be released to the patient's attorney. Answer: D is incorrect. It is required by law for a disclosure of patient information to be signed in order for protected health information to be released to the parents of an adult child. Answer: C is incorrect. It is required by law for a disclosure of patient information to be signed in order for protected health information to be released to another physician. 


Q27. A patient comes into the hospital with pain in her chest and the physician wants to determine if there are abnormalities in the electrical impulses of her heart that could indicate damage. What medical device measures the electrical signal of the heart and often prints it out in a waves format? 

A. EKG 

B. CT 

C. EEG 

D. Ultrasound 

Answer: A 

Explanation: An EKG is the acronym for an electrocardiogram is the recording from electrodes connected to the skin in key places on the body, which can measure the electrical signals of the heart muscle as it pumps. Changes or abnormalities in the signal waves from the heart muscle can indicate disease or injury to the heart muscle. Answer: D is incorrect. During a diagnostic ultrasonography, an ultrasound device uses inaudible sound waves to bounce off of structures inside the body and return an image of those structures, including tendons, muscles, vessels and internal organs. An ultrasound can be done of many structures, including obstetric use to visualize a growing fetus. The heart can be looked at with a diagnostic ultrasound, but this is rare as a first assessment for chest pain and this does not measure the electrical signals of the heart. Answer: C is incorrect. EEG is the acronym for an electrocencephalograph, or a recording of measurements of the electrical impulses of the brain through the scalp, not the electrical impulses of the heart. Answer: B is incorrect. CT is an acronym for X-ray computed tomography. It's a computed three-dimensional picture of multiple two dimensional x-rays mapped together to form a three dimensional image. Cardiac CT can be very useful, but it is not the first line of treatment for initial chest pain and does not measure the electrical signals of the heart. 


Q28. You are asked to reduce medical records for a dental practice, you can eliminate all records that are older than which of the following? 

A. 4 years 

B. 6 years 

C. 10 years 

D. 30 years 

Answer: A 

Explanation: All primary dental records must be retained for a period of at least 4 years from the date of the patient's last episode of care. Answer: B is incorrect. 6 years is incorrect as this is the amount of time in which all materials containing HIPAA information must be kept. Answer: C is incorrect. 10 years is incorrect as this is the amount of time all primary medical records must be retained. Answer: D is incorrect. 30 years is incorrect as no medical information is required to be retained for 30 years. 


Q29. Which of the following pieces of legislation requires health care facilities to provide emergency care regardless of ability to pay? 

A. MIPPA 

B. EMTALA 

C. Patient Bill of Rights 

D. HIPPA 

Answer: B 

Explanation: The Emergency Medical Treatment and Active Labor Act (EMTALA) is the piece of legislation legally obligates health care facilities to provide emergent care regardless of citizenship, legal status or ability to pay. Answer: D is incorrect. HIPPA is incorrect as this legislation is designed to insure the privacy and security of personal health information. 


Q30. You are asked to design an information system in which the client-server platform is based on the following schematic. What type of architecture is incorporated within your information system? 


A. LAN Technology 

B. WAN Technology 

C. Three-Tier Architecture 

D. Two-Tier Architecture 

Answer: D 

Explanation: Two-tier architecture is the client-server platform that consists simply with a PC interfaced with a database. Answer: A is incorrect. LAN Technology is incorrect as this is a mode of communication, not a client-server platform, that this refers to communication devices in a small geographic area such as PC and printer or PC and PC within a facility. Answer: B is incorrect. WAN Technology is incorrect as as this is a mode of communication, not a client-server platform, that allows for communication among a large geographic environment such as two or more LANs connected via a telephone system or satellite. Answer: C is incorrect. Three tier architecture is incorrect as this client server platform consists of a PC, database server and an application server that contains software to process the data. 



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