Homework SourseQUESTION 156 How can the healthcare facility determine which
QUESTION 156
How can the healthcare facility determine which physician has the best patient outcomes?
Qualitative analysis
Data mining
Quantitative analysis
Version control
2 points
QUESTION 157
Which of the following HIM tasks is eliminated by the electronic health record system?
Document imaging
Analysis
Assembly
Indexing
2 points
QUESTION 158
In which department or unit does the health record typically begin?
HIM department
Patient registration
Nursing unit
Billing department
2 points
QUESTION 159
Which one of the following is an example of virtual HIM?
Information systems that store back-up data off site
Employees who code from home
Information systems employees access remotely from the hospital
Documentation physicians add from their office
2 points
QUESTION 160
The coding of clinical diagnoses and healthcare procedures and services after the patient is discharged is what type of review?
Proactive
Prospective
Concurrent
Retrospective
2 points
QUESTION 161
Which specialized type of progress note provides healthcare professionals impressions of patient problems with detailed treatment action steps?
Flow record
Vital signs record
Care plan
Surgical note
2 points
QUESTION 162
Which of the following is an example of a long-term care setting?
Assisted living facility
Ambulatory surgery center
Community mental health center
Acute care hospital
2 points
QUESTION 163
Which of the following elements is typically found in the paper health record?
Patient identification
Radiology imaging
MRI imaging films
Financial information
2 points
QUESTION 164
The ambulatory surgery record contains information most similar to which records?
Physician\'s office records
Emergency care records
Hospital operative records
Hospital obstetric records
2 points
QUESTION 165
Which of the following assists in locating misfiles in the paper-based filing systems?
Color coding
Weight of folder
Number of files on shelf
Thickness of folder
2 points
QUESTION 166
Which of the following tools is usually used to track paper-based health records that have been removed from their permanent storage locations?
Deficiency slips
Master patient index
Outguides
Requisition slip
2 points
QUESTION 167
Which of the following should be taken into consideration when designing a health record form?
Choosing the field type such as radio buttons
Number of clicks to access data
Including original and revised dates
Difference between paper and screen
2 points
QUESTION 168
True or false? Auto-authentication is not in compliance with the CMS Interpretive Guidelines for Hospitals.
True
False
2 points
QUESTION 169
Which of the following represents the attending physician\'s assessment of the patient\'s current health status?
Physical examination
Medical history
Progress notes
Discharge summary
2 points
QUESTION 170
What would be the linear filing inch capacity for a shelving unit with 6 shelves, each measuring 36 inches?
42 inches
3,600 inches
252 inches
216 inches
2 points
QUESTION 171
Which of the following is a micrographic method of storing health records in which each document page is placed sequentially on a long strip?
Document image
Microfilm roll
Microfilm jacket
Microfiche
2 points
QUESTION 172
When correcting erroneous information in a paper health record, which of the following is appropriate?
Print \"addendum\" above the entry
Backdate to the date that the addendum covers
Add the reason for the change
Use a black pen to obliterate the entry
2 points
QUESTION 173
Why should the copy and paste function should not be used in the electronic health record?
The content may contain outdated information
Joint Commission standards prevent this practice
This feature is never found in the electronic health record
Medicare has a regulation against this practice.
2 points
QUESTION 174
The overall goal of documentation standards is to _____________.
Ensure what is documented in the health record is complete and accurately reflects the treatment provided to the patient
Ensure that the healthcare provider organization is reimbursed appropriately by payers
Ensure that the Centers for Medicare and Medicaid Services (CMS) do not find reason to fine the healthcare provider organization
Ensure physicians have access to the health record information they need to care for the patient
2 points
QUESTION 175
Which of the terms below represents fixed rules that must be followed?
Standard
Guidelines
Forms control program
Policy
2 points
QUESTION 176
What is the software that is used for voice recognition known as?
Data mining
Voice mail
Electronic health record
Natural language processing
2 points
QUESTION 177
True or false? The Joint Commission surveys healthcare provider organizations for clinical and operational practice compliance.
True
False
2 points
QUESTION 178
Which of the following filing methods is considered the most efficient?
Alphabetical filing
Alphanumeric filing
Straight numeric filing
Terminal digit filing
2 points
QUESTION 179
Patient history questionnaires are most often used in what setting?
Ambulatory care
Rehabilitative care
Home healthcare
Long-term care
2 points
QUESTION 180
Which of the following is a secondary purpose of the health record?
Support for provider reimbursement
Support for patient self-management activities
Support for research
Support for patient care delivery
2 points
QUESTION 181
Which system is best suited for a small healthcare facility such as a one-physician practice?
Alphabetic filing system
Serial unit numbering system
Serial numbering system
Unit numbering system
2 points
QUESTION 182
Which of the following indexes is key to locating a health record?
Disease index
Master patient index
Operation index
Physician index
2 points
QUESTION 183
Which of the following represents documentation of the patient\'s current and past health status?
Medical history
Physical exam
Physician orders
Patient consent
2 points
QUESTION 184
When defining the legal health record, what must the healthcare provider do?
Assess the legal environment
Determine what the other healthcare providers are doing
Decide if the legal health record is needed
Include only the paper components of the health record
2 points
QUESTION 185
True or false? The term ambulatory is the same as the term outpatient.
True
False
2 points
QUESTION 186
An RAI/MDS and care plan are found in records of patients in what setting?
Home healthcare
Long-term care
Behavioral healthcare
Rehabilitative care
2 points
QUESTION 187
True or false? An accreditation organization (AO) must participate in its own CMS review in order to receive deemed status, allowing the AO to survey other healthcare providers for compliance.
True
False
2 points
QUESTION 188
Critique this statement: Version control is not an issue in the EHR.
This is a true statement.
There are issues related to versions of documents, such as there must be a flag to indicate a previous version.
There are issues related to versions of documents, such as each version should be visible to all users.
There are issues related to versions of documents which include the need to delete the old version when a new one is added.
2 points
QUESTION 189
What is the function of a consultation report?
Provides a chronological summary of the patient\'s medical history and illness
Documents opinions about the patient\'s condition from the perspective of a physician not previously involved in the patient\'s care
Concisely summarizes the patient\'s treatment and stay in the hospital from the time of admission to the time of discharge
Documents the physician\'s instructions to other parties involved in providing care to a patient
2 points
QUESTION 190
Consider the following sequence of numbers. What filing system is being used if these numbers represent the health record numbers of three records filed together within the filing system?
36-45-99
37-45-99
38-45-99
Straight numerical
Terminal digit
Middle digit
Unit
2 points
QUESTION 191
Which of the following contains the physician\'s findings based on an examination of the patient?
Patient instructions
Discharge summary
Medical history
Physical exam
2 points
QUESTION 192
True or false? CMS does not require healthcare providers to inform their patients about general patient rights afforded to them.
True
False
2 points
QUESTION 193
The annual volume statistics for General Hospital are noted below. How many shelving units will be required to store this year\'s inpatient discharge records?
Average inpatient discharges = 12,000
Average inpatient record thickness = ¾ inch
Shelving units shelf width = 36 inches
Number of shelves per unit = 6
41
41.67
42
74
2 points
QUESTION 194
The term used for health record moved to an inactive file area because they have not been at the healthcare facility for a predefined period of time is:
Inactivated
Purged
Clearing
Removal
2 points
QUESTION 195
Which of the following is a request from a clinical area to charge out a health record?
Outguide folder
Requisition
MPI
Patient registry
| Qualitative analysis | ||
| Data mining | ||
| Quantitative analysis | ||
| Version control |
Solution
Which of the following is a request from a clinical area to charge out a health record
sol: Requistion
Question 158:In which department or unit does the health record typically begin?
sol:Patient Registration
questiopn 164:
The ambulatory surgery record contains information most similar to which records?
sol: Hospital operative records
QUESTION 162
Which of the following is an example of a long-term care setting?
sol:Ambulatory surgery center
Which of the following contains the physician\'s findings based on an examination of the patient?
sol: Physical exam
QUESTION 189
What is the function of a consultation report?
sol:Documents opinions about the patient\'s condition from the perspective of a physician not previously
involved in the patient\'s care
QUESTION 185
True or false? The term ambulatory is the same as the term outpatient.
True
QUESTION 183
Which of the following represents documentation of the patient\'s current and past health status?
sol: medical history
QUESTION 182
Which of the following indexes is key to locating a health record?
sol:Master patient index
QUESTION 180
Which of the following is a secondary purpose of the health record?
sol:Support for research
QUESTION 179
Patient history questionnaires are most often used in what setting?
sol:Ambulatory care
QUESTION 178
Which of the following filing methods is considered the most efficient?
sol:Terminal digit filing
QUESTION 176
What is the software that is used for voice recognition known as?
sol:Electronic health record
