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CHIM NCE Practice Exam 1

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About the CHIM national certification exam

The Certified in Health Information Management national certification examination (CHIM NCE) is an exam for Canadians who want to become medical coders.

The exam will test you on the basics of medical coding and health information management. This includes topics such as information quality, medical terms, data analysis, privacy, leadership and the management of health data.

Exams take place three times a year, in April, July and October.

About these practice questions

These practice questions will help prepare you for the CHIM national certification exam.

This page contains 190 practice questions divided into the seven sections of the exam: 1. Biomedical sciences, 2. Health information science, 3. Health information analysis and presentation, 4. Technology and health information, 5. Access and security, 6. The health care system in Canada, and 7. Ethics and practice.

All questions have been carefully designed to mimic the questions on the real exam, to help you prepare and get a passing grade.

Check out all the practice tests in this series: Practice Test 1, Practice Test 2, and Practice Test 3.

Sections

  1. Biomedical sciences
  2. Health information science
  3. Health information analysis and presentation
  4. Technology and health information
  5. Access and security
  6. The health care system in Canada
  7. Ethics and practice

Section 1: Biomedical sciences

1.1) Which term of position literally means "toward the tail" and describes a position below another part of the body?
  1. Caudal
  2. Cephalic
  3. Distal
  4. Dorsal
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1.2) Which term means a location towards the front of the body?
  1. Anterior
  2. Distal
  3. Lateral
  4. Posterior
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1.3) Which plane separates the body into left and right?
  1. Medial
  2. Oblique
  3. Sagittal
  4. Transverse
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1.4) Which prefix means skin?
  1. Derm-
  2. Ichthyo-
  3. Pachyo-
  4. Ped-
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1.5) What does the prefix epi- mean?
  1. Above
  2. Below
  3. Between
  4. Next to
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1.6) In the context of healthcare, what does CBC stand for?
  1. Center for blood care
  2. Center for blood control
  3. Complete blood count
  4. Complete blood culture
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1.7) What does USP stand for in medicine?
  1. Underdeveloped specimen
  2. United States pharmacopeia
  3. Unwanted special properties
  4. User security policy
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1.8) What blood test does the acronym PPT stand for?
  1. Partial thrombin time
  2. Partial thromboplastin time
  3. Proportional thrombin time
  4. Proportional thromboplastin time
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1.9) What does the F stand for in FBS test?
  1. Fasting
  2. Fatal
  3. Final
  4. First
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1.10) What is the term for an injury where ligaments stretch too far or tear?
  1. Compression
  2. Sprain
  3. Strain
  4. Subluxation
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1.11) What is the medical term for fever?
  1. Hypertension
  2. Hypothermia
  3. Pyogenic
  4. Pyrexia
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1.12) What is the medical term for a heart attack?
  1. Angina
  2. Angina pectoris
  3. Cardiomyopathy
  4. Myocardial infarction
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1.13) Urticaria is another name for:
  1. hives
  2. malignancy of the basal cells
  3. scales
  4. severe itching
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1.14) What is edema?
  1. A bruise on the head
  2. A collection of blood outside blood vessels
  3. Swelling caused by fluid retention
  4. The final product of the blood coagulation step in hemostasis
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1.15) A patient who is 'febrile' has:
  1. a fever
  2. a weak heart rhythm
  3. low blood sugar
  4. muscle wasting
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1.16) What is otitis?
  1. An abnormal discharge from the nose
  2. An eye infection
  3. Ear inflammation
  4. Inflammation of the sinuses
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1.17) What is an embolism?
  1. A blockage in a blood vessel
  2. A bruise
  3. An inflamed area of the esophagus
  4. Swelling in a vein
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1.18) What is nocturia?
  1. Blood in the urine
  2. Difficulty urinating
  3. Excessive urination at night
  4. Pain during a period
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1.19) What is the medical term for itching?
  1. Alopecia
  2. Petechiae
  3. Pruritus
  4. Purpura
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1.20) What is the medical term for swelling caused by fluid trapped in the body's tissues?
  1. Edema
  2. Hemoconcentration
  3. Icterus
  4. Syncope
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1.21) What is the medical term for rapid breathing?
  1. Eupepsia
  2. Hyperkalemia
  3. Peritonitis
  4. Tachypnea
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1.22) What is the medical term for shortness of breath?
  1. Anosmia
  2. Dysphonia
  3. Dyspnea
  4. Tachypnea
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1.23) The function of the secretions of a serous membrane, like the pleura, is to:
  1. carry nervous impulses
  2. prevent infection
  3. protect the central nervous system
  4. reduce friction between neighbouring organs
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1.24) Adipose tissue is commonly found:
  1. in the cartilage of joints
  2. lining the chambers of the heart
  3. surrounding the brain
  4. under the skin
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1.25) Jaundice is caused by a buildup of ___________ in the blood.
  1. bilirubin
  2. hemoglobin
  3. potassium
  4. uric acid
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1.26) Which type of jaundice is caused by the excessive breakdown of red blood cells?
  1. Hepatocellular
  2. Neonatal
  3. Post-hepatic
  4. Pre-hepatic
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1.27) Which of the following is a sign of a detached retina?
  1. A dark shadow moving across your vision
  2. Decrease in the number of eye floaters
  3. Eye pain
  4. Increased peripheral vision
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1.28) In which disease is the body unable to use glucose for energy?
  1. Diabetes
  2. Hyperglycemia
  3. Hypoglycemia
  4. Stroke
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1.29) Parkinson's disease is due to low levels of which neurotransmitter?
  1. Acetylcholine
  2. Dopamine
  3. Glutamate
  4. Serotonin
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1.30) The significant signs of nephrotic syndrome are:
  1. gross hematuria and pyuria
  2. hyperlipidemia and lipiduria
  3. hypertension and heart failure
  4. pyuria and leucopenia
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1.31) Which cells produce histamine in a type 1 hypersensitivity reaction?
  1. Lymphocytes
  2. Macrophages
  3. Mast cells
  4. Neutrophils
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1.32) What is the Burch procedure performed for?
  1. Benign prostatic hyperplasia
  2. Fixation of humerus
  3. Urinary incontinence
  4. Uterine malignancy
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1.33) What is the heart's primary pacemaker?
  1. Bundle branches
  2. Bundle of His
  3. Purkinje fibers
  4. SA node
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1.34) Which organ system detects changes to the internal and external environments of the body and directs a response?
  1. Circulatory
  2. Endocrine
  3. Nervous
  4. Respiratory
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1.35) The kidney is part of which organ system?
  1. Circulatory
  2. Digestive
  3. Endocrine
  4. Urinary
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1.36) Which FAB group of acute lymphoblastic leukemias has basophilic cells with prominent cytoplasmic vacuoles?
  1. L1
  2. L2
  3. L3
  4. L4
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1.37) How is pernicious anemia treated?
  1. Blood transfusion
  2. Bone marrow transplantation
  3. Injections of vitamin B12
  4. Iron tablets
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1.38) Jaundice is the medical term for:
  1. inflammation
  2. liver disease
  3. skin disease
  4. yellow skin
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1.39) Which of these is a symptom of hypoglycemia in a diabetic?
  1. Confusion
  2. Deep, rapid breaths
  3. Frequent urination
  4. Thirst
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1.40) Which hematology test determines the percentage of each type of leukocyte in a blood sample?
  1. CBC
  2. Hematocrit
  3. Hemoglobin determination
  4. WBC differential
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1.41) A definitive diagnosis of meningitis requires which test?
  1. Blood culture
  2. Cerebrospinal fluid analysis
  3. Stool C&S
  4. Urinalysis
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1.42) Penicillin, amoxicillin and ciprofloxacin are examples of which type of drug?
  1. Antibiotics
  2. Anticoagulants
  3. Antihistamines
  4. Antivirals
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1.43) Antiemetic medications help to treat which health problem?
  1. Cancer
  2. Constipation
  3. Migraine
  4. Nausea
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1.44) What do diuretic medications do?
  1. Lower cholesterol
  2. Promote fluid excretion
  3. Stop blood clotting
  4. Widen blood vessels
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1.45) By what route are suppositories administered?
  1. inhalation
  2. parenteral
  3. rectal
  4. topical
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1.46) Drugs that block the release of a substance that causes allergic reactions are called:
  1. anticoagulants
  2. anticonvulsants
  3. antidiabetics
  4. antihistamines
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1.47) Which of these tests indicates the health of the kidneys?
  1. ALT
  2. Bilirubin
  3. Creatinine clearance
  4. TSH
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1.48) What is the primary screening test for thyroid dysfunction?
  1. Free T3 test
  2. Free T4 test
  3. TSH test
  4. Total T4 test
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1.49) Creatinine clearance tests check the health of which organ?
  1. Heart
  2. Kidney
  3. Liver
  4. Stomach
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1.50) What does the PKU test detect?
  1. A genetic defect in metabolism
  2. A sex-linked anemia
  3. A viral disease
  4. Severe kidney disease
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1.51) Glomerular filtration rate measures the health of which organ?
  1. Liver
  2. Kidneys
  3. Gallbladder
  4. Bladder
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Section 2: Health information science

2.1) The rule of nines:
  1. indicates the amount of IV fluid necessary
  2. indicates the amount of infection present
  3. indicates the depth of a burn
  4. indicates the percentage of body area affected by a burn
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2.2) In the SOAP note of problem‐oriented medical records, what does the letter “P” stand for?
  1. Patient
  2. Plan
  3. Problem
  4. Prognosis
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2.3) What are the parts of the Problem-Oriented Medical Record?
  1. Initial plans, progress notes, problem list, and standing orders
  2. Progress notes, initial plans, and physician orders
  3. The database, a problem list, initial plans, and progress notes
  4. The database, progress notes, standing orders, and a problem list
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2.4) Which documents must be included in a patient's medical record prior to performing a surgical procedure?
  1. Consent for the operative procedure, anaesthetic record, and surgical report
  2. Consent for the operative procedure, history, and physical examination
  3. History, physical examination, and anaesthetic record
  4. Physical exam, problem list, and anaesthetic record
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2.5) A hospital's strategy for managing health information should be based on:
  1. the information technology strategic plan
  2. the needs of the users
  3. the opinions of the Board of Directors
  4. the organizational strategic plan
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2.6) A PIA is completed when there is a:
  1. breach of privacy
  2. new medical record system being considered
  3. new physician joining the organization
  4. request for information
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2.7) An advantage of the POMR system over the SOMR system is that it:
  1. assures a team approach to care
  2. provides a systematic method of documentation for managing patient care
  3. requires that the physician treat one problem fully before proceeding to the next
  4. separates the documentation by provider ensuring maximum efficiency
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2.8) A patient with anorexia nervosa and an anxiety disorder was admitted to the hospital for total parenteral nutrition. While in the hospital, she developed a hospital-acquired infection that was treated with antibiotics. What is the main diagnosis?
  1. Anorexia nervosa
  2. Anxiety disorder
  3. Hospital-acquired infection
  4. Total parenteral nutrition
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2.9) What is the term for health records that are a combination of paper and computer-generated records?
  1. Blended
  2. Duel
  3. Hybrid
  4. Mixed
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2.10) When coding metastatic osteosarcoma of the lung, the primary site is:
  1. bone
  2. connective tissue
  3. lung
  4. unknown
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2.11) A 29-week gestational age baby was born at a general hospital and transferred to the local children’s hospital because of respiratory distress due to prematurity. The baby was given surfactant and treated with continuous ventilation for 5 days, then kept in an oxygenated bassinet for 2 weeks. When coding this chart at the children's hospital, the main diagnosis is:
  1. preterm infant
  2. respiratory distress
  3. single liveborn
  4. transfer patient
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2.12) Which of the following is coded as a late effect?
  1. Adverse effect of OTC drug
  2. Contracture of heel tendons due to polio
  3. Post operative infection
  4. Toxic effect of properly administered drug
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2.13) What is the ICD-10-CA diagnosis type for post-admit comorbidities?
  1. 1
  2. 2
  3. 3
  4. 4
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2.14) NEC is an abbreviation that:
  1. further defines a category within ICD
  2. indentifies codes to be used only when the information required to code to a more specific category is not available in ICD
  3. indicates that the ICD code is unspecific and the coder should seek additional information.
  4. provides instruction that a condition is to be coded elsewhere
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2.15) Documentation about a patient's marital status, diet, sleep patterns, exercise patterns, coffee use, tobacco use, and alcohol use may be found in the:
  1. admission form
  2. history
  3. operative note
  4. physical exam
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2.16) While a patient is receiving care, most paper records are filed in reverse chronological order. This is because:
  1. coders need data in that way
  2. it is easier to file loose reports
  3. it is required by legislation
  4. it is the most convenient way to quickly access current data
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2.17) When you find a document in the wrong record, you should:
  1. advise the attending physician
  2. delete the document and complete an incident report
  3. leave the document in the record and write on it 'wrong patient'
  4. remove the document and refile it in the correct record
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2.18) When the inpatient and outpatient records are filed together in a centralized system, the most practical method of numbering is:
  1. Decentralized-unit
  2. Serial
  3. Serial unit
  4. Unit
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2.19) With the terminal digit filing system:
  1. misfiles are more common
  2. records are more evenly distributed
  3. records have to be moved around frequently to make space for incoming files
  4. the middle digits are known as the tertiary digits
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2.20) An overlay is where:
  1. a patient is assigned two medical record numbers
  2. a patient is given the same medication twice
  3. a patient receives the same test twice
  4. two different patient records are wrongly identified as one individual
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2.21) What is the name of a filing system where files are kept in different places and departments?
  1. Centralized
  2. Decentralized
  3. Off-site storage
  4. Serial-unit
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2.22) For coding and Statistics Canada purposes, the "newborn period" is defined as the period from birth through to the _____ day following birth.
  1. 7th
  2. 14th
  3. 21st
  4. 28th
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2.23) When a patient is occupying a bed in a hospital and does not require the intensity of resources/services provided in this care setting (Acute, Complex Continuing Care, Mental Health or Rehabilitation), the patient must be designated as:
  1. ALC
  2. a block transfer patient
  3. an outlier
  4. extraneous
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Section 3: Health information analysis and presentation

3.1) A type 2 statistical error occurs in comparing drug treatment regimes when:
  1. the control is not a gold standard
  2. the exclusion criteria are too rigid
  3. the results do not show a difference but a difference exists
  4. the results show a difference but no difference exists
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3.2) If a relationship between two variables is statistically significant, it means the variables are:
  1. identical
  2. independent
  3. proportional
  4. related
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3.3) The best way to demonstrate trends over time is with a:
  1. frequency polygon
  2. histogram
  3. line graph
  4. pie chart
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3.4) The methodology that is most useful for displaying how a single total quantity is apportioned to a group of categories is the:
  1. bar graph
  2. histogram
  3. pie chart
  4. scatter plot
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3.5) What does the standard deviation tell you?
  1. How many errors are in the data set
  2. How spread out the data is
  3. The average value in the data set
  4. The number the data tends to cluster around
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3.6) In a normal distribution, what percentage of cases are above the mean?
  1. 50%
  2. 68%
  3. 75%
  4. 100%
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3.7) The rounding rule for the mean states that:
  1. the answer should be rounded to a whole number
  2. the answer should be rounded to one decimal place greater than the raw data
  3. the answer should be rounded to two decimal places greater than the raw data
  4. the answer should have the same number of decimal places as the raw data
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3.8) What is 21/25 expressed as a percentage?
  1. 4%
  2. 21%
  3. 46%
  4. 84%
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3.9) Data is reliable when:
  1. it answers the research question
  2. it relates to the issue being studied
  3. similar values are obtained in repeated measurements of the same group
  4. the instrument measurements are precise
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3.10) A rectangle shape on a workflow diagram indicates a:
  1. decision
  2. manual input
  3. process
  4. start/stop point
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3.11) If there are five cases of AIDS in a population of 500,000, what is the prevalence of AIDS per 1,000 people?
  1. 0.01/1000
  2. 0.1/1000
  3. 1/1000
  4. 10/1000
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3.12) ________ is the only clinical database that incorporates the Management Information System (MIS) Functional Centers (FC).
  1. DAD
  2. NACRS
  3. NRS
  4. OMHRS
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3.13) A hospital with a patient population of 40,000 people wanted to evaluate the epidemiology of heart disease in its patients. The information collected is shown in the following table:
Year Number of patients with heart disease
2020 1726
2021 1780
2022 1826
Calculate the incidence of new cases from 2021 to 2022.
  1. 1.15 per 1,000 population
  2. 1.30 per 1,000 population
  3. 1.45 per 1,000 population
  4. 1.60 per 1,000 population
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3.14) A disease that has a constant rate and prevalence within a specific geographic area or population is referred to as:
  1. endemic
  2. morbid
  3. mortal
  4. pandemic
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3.15) ______________ are standardized measurements that help to gauge the state and wellness of a population.
  1. Determinants of health
  2. Disease burden
  3. Health indicators
  4. Population-based surveillance
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3.16) A hospital records the following number of births and fetal deaths during a one-month period:
Live births 188
Early fetal deaths 12
Intermediate fetal deaths 7
Late fetal deaths 5
Calculate the fetal death rate.
  1. 5.2%
  2. 6%
  3. 10.32%
  4. 11.32%
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3.17) 500 people in a population of 20,000 have diabetes. If 20 new cases of diabetes were reported during January, calculate the incidence rate for January.
  1. 1 per 1,000 population
  2. 2.5 per 1,000 population
  3. 20 per 1,000 population
  4. 25 per 1,000 population
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3.18) Public Health Canada has issued a recall of a particular orthopedic implant. All facilities are requested to provide information on the number of patients receiving this implant over the last 5 years, aggregated by fiscal year. You would use a:
  1. frequency distribution
  2. measure of association
  3. pie chart
  4. t-test
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3.19) During one month, a 400-bed hospital reported 12 inpatient deaths and performed 6 autopsies. Calculate the gross autopsy rate.
  1. 25%
  2. 26%
  3. 50%
  4. 70%
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3.20) What does the gross autopsy rate include that the net autopsy rate does not?
  1. Autopsies performed by coroners or medical examiners
  2. Deaths due to unnatural causes
  3. Fetal deaths
  4. Inpatient deaths
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3.21) A patient was admitted for prostatectomy for prostate cancer and hernia repair. Five days after the operation, he developed deep vein thrombosis and a urinary tract infection. When coding this case, what would be the main diagnosis?
  1. Deep vein thrombosis
  2. Hernia
  3. Prostate cancer
  4. Urinary tract infection
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3.22) How is cost per weighted case (CPWC) calculated?
  1. Cases / number of weighted cases
  2. Costs / number of weighted cases
  3. Costs / total number of cases
  4. Number of weighted cases / costs
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3.23) The disease index may be used to retrieve health information to:
  1. locate a record when the physician remembers only the name
  2. locate cases of a specific physician
  3. obtain data on readmission rates by service
  4. review previous cases of a given disease
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3.24) Which of these is an example of secondary healthcare data?
  1. 237 nosocomial infections
  2. BP 120/80
  3. KCl 500 mg daily
  4. Measles immunization: 3/12/89
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3.25) A correlational analysis reveals a correlation of +0.95 between the length of hospital stay and the risk of acquiring a hospital-acquired infection. What does this tell you?
  1. The length of hospital stay and the risk of acquiring a hospital-acquired infection increase together
  2. The length of hospital stay and the risk of acquiring a hospital-acquired infection vary in opposite directions
  3. The longer patients stay in the hospital, the more infections they will get
  4. The more infections patients get, the longer they will have to stay in the hospital
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3.26) The CEO has requested that you complete a study on the potential impact of the implementation of self-register kiosks in the ER. One factor which is not considered in this initial discussion is:
  1. research of similar projects in other facilities
  2. results interpretation
  3. study parameters
  4. timelines
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3.27) In a case-control study, cases and controls are often matched on variables such as age and sex. This is to make cases and controls:
  1. similar except for the disease and health characteristic under study
  2. similar except for the disease under study only
  3. similar except for the health characteristic only
  4. similar for all aspects of the study
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3.28) The results of a patient satisfaction survey show there is a high degree of satisfaction. However, the hospital suspects that there is a questionnaire design flaw, as the survey results do not match the high number of complaints received. The hospital decides to switch to an investigative strategy that will provide an immediate opportunity to review patient responses and correct any errors. The best way to achieve this is through:
  1. document and forms review
  2. group analysis
  3. interviews
  4. observations
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3.29) A researcher wants to investigate whether children exposed to second-hand smoke in the previous 2 years have a higher rate of respiratory illnesses than those who were not exposed. Which retrospective study design would be best?
  1. Case control
  2. Cohort
  3. Cross sectional
  4. Randomized clinical trial
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3.30) An experiment tests the effects of a new antihypertensive medication on blood pressure. In this experiment, the medication is:
  1. a confounding factor
  2. the dependent variable
  3. the hypothesis
  4. the independent variable
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3.31) In which type of research study does the researcher have the most control?
  1. Correlational
  2. Descriptive
  3. Experimental
  4. Observational
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3.32) A tool for measuring the volume of activity provided by a specific functional centre in terms of a standardized unit of time is:
  1. activity studies
  2. interval studies
  3. time and motion studies
  4. workload measurement
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3.33) The one national database that truly incorporates all of Canada's acute care episodes of care is the:
  1. CCRS
  2. DAD
  3. HMDb
  4. NACRS
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3.34) The percentage of available beds in use at census-taking time is known as:
  1. efficiency
  2. occupancy
  3. overflow
  4. usage
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3.35) A 50-bed hospital has a total of 900 IPSDs in the month of September. What is the average occupancy for the month?
  1. 60%
  2. 70%
  3. 80%
  4. 90%
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3.36) An infection acquired during a hospital episode of care is known as a _________ infection.
  1. decubitus
  2. nosocomial
  3. puerperal
  4. septic
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3.37) A hospital has 250 beds. Over a period of 20 days, the hospital has 600 admissions and 500 discharges and serves 4,000 inpatient days. Calculate the inpatient occupancy rate for this period.
  1. 70%
  2. 75%
  3. 80%
  4. 85%
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3.38) During a week, a hospital has 900 inpatient days and 450 discharges. Calculate the average length of stay.
  1. 1 day
  2. 2 days
  3. 3 days
  4. 4 days
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3.39) A patient is admitted for chemotherapy and radiation to treat aggressive invasive cancer. Four days after admission, the patient complains of a sore throat and fever. Throat cultures are positive for strep. This strep infection will be:
  1. added to the denominator of the hospital's nosocomial infection rate
  2. added to the numerator of the community's infection rate
  3. added to the numerator of the hospital's nosocomial infection rate
  4. not included in the infection rate as the patient is immunosupressed from the chemotherapy
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3.40) A 200-bed hospital reported 45,810 impatient days, 10,381 discharges, and 1,529 consultations. What is the consultation rate for this facility?
  1. 14.7%
  2. 17.0%
  3. 17.7%
  4. 18.2%
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Section 4: Technology and health information

4.1) Which of the following is a disadvantage of electronic medical records?
  1. Allow family doctor’s offices to connect with specialists’ offices
  2. Enable patients to access their medical records and to participate in their own health care management
  3. Facilitate the prompt delivery of laboratory tests
  4. Puts patient data at risk of being hacked
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4.2) On electronic forms, the form identification number should be:
  1. in the lower right corner
  2. in the upper left corner
  3. in the upper right corner
  4. on the same place on each form
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4.3) In which file type are the values separated by commas?
  1. CSV
  2. DBF
  3. XLS
  4. XML
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4.4) The electronic record of encounters within a primary care physician's office is known as a:
  1. electronic health record (EHR)
  2. electronic medical record (EMR)
  3. electronic patient record (EPR)
  4. personal health record (PHR)
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4.5) Discrete data that is entered into formatted fields rather than entered in free text is known as:
  1. continuous data
  2. data integrity
  3. quantitative data
  4. structured data
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4.6) The amount of detail in data is known as:
  1. accuracy
  2. granularity
  3. precision
  4. relevancy
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4.7) Normalizing data tables (i.e. ensuring that data is stored in only one location) helps to:
  1. decrease the possibility of adding key attributes at a later date
  2. decrease the possibility of data anomalies
  3. increase the possibility of adding key attributes at a later date
  4. increase the possibility of data anomalies
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4.8) The first step in developing a problem-oriented medical record (POMR) is to:
  1. compile the progress notes
  2. create a database
  3. establish the problem list
  4. identify the action plan
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4.9) What is the diagnosis type for newborn codes?
  1. 0
  2. 1
  3. 2
  4. 4
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4.10) According to ICD, an elderly primigravida is defined as a woman who gives birth to her first child at the age of ______ or older.
  1. 30
  2. 35
  3. 38
  4. 40
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4.11) Which of these is an example of an administrative system safeguard?
  1. Automatic log-off after a period of inactivity
  2. Back up and recovery procedures
  3. Locating equipment in a secure area
  4. Use of a surge protector on equipment
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4.12) Which of these is an example of computer hardware?
  1. Internet browser
  2. Microsoft Excel
  3. Microsoft Word
  4. Mouse
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4.13) What does a relational database use to uniquely identify each row in a table?
  1. Index
  2. Primary key
  3. Relationships
  4. Statement
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4.14) What is data redundancy?
  1. A technique for eliminating duplicate copies of data
  2. The maintenance of data accuracy and consistency over its entire life-cycle
  3. When data is no longer accurate, relevant or up-to-date
  4. When the same data is in two or more places in a database
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4.15) Which is the most common type of relationship found between tables in a relational database?
  1. Many-to-many
  2. None-to-many
  3. One-to-many
  4. One-to-one
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4.16) Data normalization minimizes:
  1. redundancy
  2. relevancy
  3. completeness
  4. accuracy
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4.17) Database tables consist of:
  1. functions and queries
  2. keys
  3. rows and columns
  4. subtables
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4.18) Which normal form has no multi-valued dependency?
  1. 1NF
  2. 2NF
  3. 3NF
  4. 4NF
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4.19) Removal of which type of dependency is required for a table to move from second normal form to third normal form?
  1. Functional
  2. Multi-valued
  3. Partial
  4. Transitive
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Section 5: Access and security

5.1) Which of these laws primarily concerns data privacy?
  1. HCCA
  2. PIPEDA
  3. RHPA
  4. The Canada Health Act
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5.2) What is the term for the mechanisms and processes protecting health information from unauthorized access?
  1. Accountability
  2. Confidentiality
  3. Isolation
  4. Security
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5.3) In which of these circumstances does a person's consent to have their information shared NOT need to be obtained?
  1. A media request
  2. A public health occurrence
  3. A request by family
  4. Facility fundraising
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5.4) The origin of recorded information that is attributed to a specific individual or entity is known as:
  1. accuracy
  2. amendment
  3. auditing
  4. authentication
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5.5) Disposal of health information must be:
  1. irreversible
  2. rapid
  3. slow
  4. reversible
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5.6) A hacker accessed a ROI system. To determine how the hacker got through the firewall and exactly what was accessed, you would use a __________ process.
  1. forensic
  2. incident
  3. mitigation
  4. security
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5.7) Which of these is an example of an intentional threat to security?
  1. A flood
  2. Data entry error
  3. Data theft
  4. Equipment failure
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5.8) An identity thief is someone who:
  1. hacks into a computer
  2. steals data from a database, device or server
  3. uses someone else's accounts to obtain a good or service
  4. uses someone else's personal identifiable information to impersonate them and set up new records or accounts
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5.9) If a province does not have specific provincial legislation governing the privacy of PHI, the province would be required to comply with:
  1. CSA Standards
  2. PHIPA
  3. PIPEDA
  4. Public Hospitals Act
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5.10) In the event of a privacy breach or identity theft event, the __________ step is concerned with limiting the damage to the facility and the individuals.
  1. communication
  2. containment
  3. investigation
  4. process improvement
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5.11) Which privacy principle would be supported by posting notices of how the facility deals with patient complaints?
  1. Accountability
  2. Identifying purposes
  3. Openness
  4. Safeguards
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5.12) Which principle of PIPEDA states that data not required for the delivery of health care should not be collected?
  1. Challenging compliance
  2. Consent
  3. Limiting collection
  4. Limiting use, disclosure and retention
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5.13) Which of these is one of PIPEDA's ten privacy principles?
  1. Accuracy
  2. Data destruction
  3. Discrimination
  4. Fairness
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5.14) PIPEDA is "consent-based". What does this mean?
  1. Organizations affected by the legislation must consent to its enforcement
  2. Organizations can collect any data from people because consent is always implied
  3. People must give consent before organizations can collect and use their personal information
  4. Those who collect and use information must consent to do so
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Section 6: The health care system in Canada

6.1) Which of these is a benefit of electronic health care records?
  1. Increased confidentiality concerns
  2. Increased health care costs
  3. More graduating physicians choosing family medicine
  4. Prompt delivery of laboratory results
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6.2) Which of the following international organizations establishes and enforces quality accreditation standards for Health Information Management education programs?
  1. AIMA
  2. CAHIIM
  3. HIMSS
  4. IFHRO
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6.3) Which of these criteria must you meet to be eligible for recertification if you have been decertified from CHIM certification for more than three years?
  1. Accumulate 1 CPE credit for every month of decertification
  2. Pay the annual professional membership dues in full for the current fiscal year
  3. Rewrite and pass the CHIM national certification examination
  4. Write a letter explaining the reason for your decertification
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6.4) The Canadian Standards Association Model Code sets principles for:
  1. chain of custody documentation
  2. the collection and handling of patient specimens
  3. the protection of personal information
  4. the use and storage of workplace hazardous materials
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6.5) PIPEDA is known as consent-based legislation. This means:
  1. healthcare professionals must get consent before performing tests or treatment on patients
  2. organizations must get consent before collecting or using a person's personal information
  3. organizations that collect and use information must consent to do so
  4. provinces can choose whether to enforce the legislation or not
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6.6) Under the Canada Health Act, provincial governments are responsible for all of the following except:
  1. funding allocation to hospitals
  2. the regulation of health professions
  3. the regulation of hospitals
  4. worker compensation
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6.7) Two groups of people not covered by provincial health plans are:
  1. Inmates and newborns
  2. RCMP and inmates
  3. newborns and residents of another province
  4. residents of another province and the RCMP
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6.8) Under the Canadian Constitution, which level of government is responsible for the direct health care services of First Nations living on reserves, Inuit and Innu populations, veterans, and inmates of federal prisons?
  1. District
  2. Municipal
  3. Provincial and territorial
  4. Federal
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6.9) Clinical data on inpatient visits are reported to the _______ database at CIHI.
  1. CCRS
  2. CJRR
  3. DAD
  4. NACRS
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6.10) What is the primary function of the Canadian Institute of Health Research (CIHR)?
  1. Directing and funding research
  2. Obtaining funding for research from private companies
  3. Reviewing research from other countries
  4. Setting ethical guidelines for research
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6.11) Which of these was established to monitor and publicly report on the implementation of the Health Accord?
  1. Canada Health Infoway
  2. Canadian Insitute for Health Information
  3. Health Council of Canada
  4. Statistics Canada
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6.12) Established by the federal government, ______ is responsible for funding health research in Canada. The mandate of this agency is to apply new research it has produced to the improvement of health and health care delivery in Canada.
  1. CHI
  2. CIHI
  3. CIHR
  4. ICES
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6.13) In Canada, which level of government provides the legal framework that regulates most health care professions?
  1. District
  2. Federal
  3. Municipal
  4. Provincial and territorial
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6.14) Which Canadian province was the first to introduce publicly-financed hospital and medical care?
  1. Alberta
  2. British Columbia
  3. Ontario
  4. Saskatchewan
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6.15) Which of the following two professions are regulated?
  1. General medicine and aromatherapy
  2. General medicine and massage therapy
  3. Pharmacy and nursing
  4. Pharmacy and reflexology
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6.16) A payment from the federal government to the provincial government to cover all services is known as:
  1. a capitation payment
  2. a co-payment
  3. block funding
  4. extra-billing
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6.17) Which government body is responsible for health insurance for Aboriginal peoples?
  1. The First Nations Band Council
  2. The Ministry of Social Services
  3. The federal government
  4. The provincial or territorial government
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6.18) Which principle of PIPEDA states that everyone has a right to ask organizations for a copy of their personal information?
  1. Accountability
  2. Individual Access
  3. Openness
  4. Safeguards
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6.19) _____________ is a voluntary process of institutional or organizational review in which an accrediting body evaluates the quality of the performance against pre-established criteria.
  1. Accreditation
  2. Authorization
  3. Certification
  4. Recognition
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6.20) A national epidemic of viral infection would most likely be reported and tracked by:
  1. CIHI
  2. Infoway
  3. PHAC
  4. Statistics Canada
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6.21) The main disadvantage of Canada's universal health care system is:
  1. decreased wait time for medically necessary treatment
  2. increased rate of taxation to cover the costs of health services
  3. provinces are not able to determine how much they can spend on health care services and education programs
  4. the differences that exist between provincial plans
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6.22) Which of the following is a negative impact that the aging population is having on Canadian health care?
  1. Higher taxation base
  2. Lower taxation base
  3. More physicians specializing in gerontology
  4. Retention of expertise in the workplace
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6.23) A facility that provides supportive care to individuals who are in the final stages of a terminal illness is a:
  1. clinic
  2. hospice
  3. primary care faciity
  4. specialist
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6.24) Which of the following is an example of an alternative health care practitioner?
  1. Acupuncturist
  2. Nurse
  3. Occupational therapist
  4. Physician
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6.25) Which health professionals play an integral role in emergencies such as cardiac arrests and trauma?
  1. Occupational therapists
  2. Physical therapists
  3. Physiotherapists
  4. Respiratory therapists
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Section 7: Ethics and practice

7.1) What is the main role of a patient advocate?
  1. Analyzing and protecting medical information
  2. Guiding patients through the healthcare system
  3. Helping to feed and bathe patients
  4. Performing routine clinical and administrative duties for physicians
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7.2) Which College of Health Information Management (CCHIM) certification is for professionals specializing in terminology standards?
  1. CCCS
  2. CCDIS
  3. CTSS
  4. HICA
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7.3) Which of these is a requirement for maintaining CHIM NCE certification?
  1. Completing ethics and compliance training
  2. Gaining work experience as a HIM professional
  3. Repassing the CHIM NCE exam
  4. Upholding the professional code of ethics
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7.4) The International Federation of Health Information Management Associations (IFHIMA) was formerly known as the:
  1. Global Alliance of Health Information Management Organizations (GAHIMO)
  2. Global Alliance of Health Records Management Societies (GAHRMS)
  3. International Federation of Health Information Managers (IFHIM)
  4. International Federation of Health Records Organizations (IFHRO)
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7.5) CHIMA has how many chapters?
  1. 8
  2. 9
  3. 10
  4. 11
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7.6) What is the name of Alberta's health information management organization?
  1. AHIMA
  2. HIMAA
  3. HIMOA
  4. OHIMA
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7.7) The legal obligation to provide a standard of reasonable care and to avoid careless actions is called:
  1. autonomy
  2. duty of care
  3. nonmaleficence
  4. the Good Samaritan law
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7.8) Which of these actions helps ensure patient confidentiality?
  1. Discarding old records by throwing them into the trash
  2. Giving out patient information to journalists
  3. Sending confidential material via e-mail
  4. Verifying a patient's identity before giving confidential data
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7.9) A management philosophy that emphasizes the importance of knowing and meeting customer expectations, reducing variation within processes and relying on data for process improvement is known as:
  1. clinical decision support
  2. continuous quality improvement
  3. process diagraming
  4. workload measurement
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7.10) Actions taken to protect health care recipients from the potential harm of health care services is known as:
  1. patient saftey improvement
  2. quality improvement
  3. quality management
  4. risk management
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7.11) Under the CHIMA Code of Ethics, the HIM professional has an obligation to all of the following except the:
  1. college
  2. employer
  3. media
  4. profession
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7.12) What is the name of the CHIMA award that recognizes students for academic excellence and their passion for the health information profession?
  1. Academic Excellence in Health Information Award
  2. Distinguished Student Award
  3. Pinnacle Award
  4. The Future of Health Information Award
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7.13) What is the American equivalent of CHIMA?
  1. AHIMA
  2. HIMA
  3. HIMAA
  4. HIMAC
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7.14) An investigative method to examine the causes of patient adverse events is:
  1. affinity diagram
  2. brainstorming
  3. proactive risk assessment
  4. root cause analysis
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7.15) What organization represents health information management professionals in the United States?
  1. AHDI
  2. AHIMA
  3. AMA
  4. HIPAA
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7.16) A law that restricts the period of time during which an action may be brought against another party is known as:
  1. common law
  2. litigation
  3. statute of limitations
  4. summons
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7.17) The accreditation program of Accreditation Canada is called:
  1. AIM
  2. Qmentum
  3. Required Organizational Practices
  4. the Gold Seal of Approval
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7.18) A hospital’s mission statement describes the hospital's:
  1. history
  2. legal requirements
  3. purpose
  4. vision for the future
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