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RHIT EXAM PREP DOMAIN V PRACTICE QUESTIONS (Quality)

(366) A HIM department is researching various options for scanning the hospital’s health records. The department director would like to achieve efficiencies through scanning, such as performing coding and cancer registry functions remotely. Given these considerations, which of the following would be the best scanning process?

A) Scanning all documents at the time of patient discharge
B) Scanning all documents after physicians have completed any record deficiencies
C) Begin remote work only after all deficiencies have been corrected in the paper record
D) Using scanners with the maximum amount of output

A) Scanning all documents at the time of patient discharge
(367) In conducting a qualitative analysis to ensure that documentation in the health record supports the diagnosis of the patient, what documentation would a coder look for to substantiate the diagnosis of aspiration pneumonia?

A) Diffuse parenchymal lung disease on x-ray
B) Patient has history of inhaled food, liquid or oil
C) Positive culture for Pneumocystis carinii
D) Positive culture for Streptococcus pneumonia

B) Patient has history of inhaled food, liquid, or oil
(368) Which of the following is an organization’s planned response to protect its information in the case of a natural disaster?

A) Administrative controls
B) Audit trails
C) Business continuity plan
D) Physical controls

C) Business continuity plan
(369) Which of the following is NOT a responsibility of a healthcare organization’s quality management department?

A) Helping departments to identify potential clinical quality problems
B) Participating in regular departmental meetings across the organization
C) Conducting medical peer review to identify patterns of care
D) Determining the method for studying potential problems

C) Conducting medical peer review to identify patterns of care
(370) Which of the following has the ultimate responsibility for ensuring quality in a healthcare facility?

A) Board of directors
B) Quality management department
C) Medical staff
D) Utilization management department

A) Board of directors
(371) The process that involves ongoing surveillance and prevention of infections so as to ensure the quality and safety of healthcare for patients and employees is known as:

A) Utilization management
B) Infection control
C) Risk management
D) Case management

B) Infection control
(372) Every healthcare organization’s risk management plan should include the following components EXCEPT:

A) Loss prevention and reduction
B) Safety and security management
C) Peer review
D) Claims management

C) Peer review
(373) Hospital A discharges 10,000 patients per year, Hospital B is located in the same town and discharges 5,000 patients per year. At Hospital B’s medical staff committee meeting, a physician reports that he is concerned about the quality of care at Hospital B because the hospital has double the number of deaths per year than Hospital A. The HIM director is attending the meeting in a staff position. Which of the following actions shold the director take?

A) Make no comment since this is a medical staff meeting
B) Agree with the physician that the data suggest a quality issue
C) Suggest that the data be adjusted for possible differences in type and volume of patients treated
D) Suggest that an audit be done immediately to determine the cause of deaths within the hospital

C) Suggest that the data be adjusted for possible differences in type and volume of patients treated
(374) Which of the following provide process measure metrics in a precise format?

A) Dashboard
B) Scoreboard
C) Structured indicator
D) Outcome indicator

A) Dashboard
(375) Total quality management and continuous quality improvement are well-known ______

A) Performance improvement models
B) Quality indicators
C) Charge management techniques
D) Management philosophies

A) Performance improvement models
(376) Donabedian proposed three types of quality indicators: structure indicators, process indicators, and

A) Performance indicators
B) Management indicators
C) Outcome indicators
D) Output indicators

C) Outcome indicators
(377) Many organizations and quality experts define quality as meeting or exceeding:

A) Patient quotas
B) System outputs
C) Customer expectations
D) Data collection

C) Customer expectations
(378) Managing the adoption and implementation of new processes is called:

A) Management by design
B) Change management
C) Process flow implementation
D) Visioning

B) Change management
(379) A hospital is reviewing the quantity and type of resources being used in the provision of chemotherapy treatments. This is an example of:

A) FOCUS-PDCA review
B) Accreditation review
C) Medication reconciliation
D) Utilization management review

A) FOCUS-PDCA review
(380) A key feature of performance improvement is:

A) Replacing unstructured decision making
B) Developing managers to control processes
C) An endless loop of feedback
D) A continuous cycle of improvement

D) A continuous cycle of improvement
(381) Brainstorming, affinity grouping, and nominal group techniques are tools and techniques used during performance improvement initiatives to facilitate _______ among employees.

A) Communication
B) Knowledge
C) Quality improvement
D) Cooperation

A) Communication
(382) Periodic performance reviews:

A) Encourage good performance
B) Take the place of annual reviews
C) Are the only opportunity to discuss performance
D) Are only important when there are problems

A) Encourage good performance
(383) Which of the following is a data collection tool that records current processes?

A) Flow chart
B) Force-field analysis
C) Pareto chart
D) Scatter diagram

A) Flow chart
(384) According to the Pareto principle:

A) Twenty percents of the problems are responsible for eighty percent of the actual effects
B) Eighty percent of the problems are responsible for eight percent of the effects
C) Twenty percent of the problems are responsible for twenty percent of the effects
D) Eighty percent of the problems are responsible for one hundred percent of the effects

A) Twenty percent of the problems are responsible for eighty percent of the actual effects
(385) Change management is the process of planning for change. It concentrates on:

A) Addressing employee resistance to changes in processes, procedures and policies
B) Scheduling planned changes in processes, procedures and policies
C) Implementing the technology required to execute planned changes
D) Managing the cost of implementing planned changes

A) Addressing employee resistance to changes in processes, procedures and policies
(386) Which of the following statements does NOT represent a fundamental principle of performance improvement?

A) The structure of a system determines its performance
B) Systems are static and do not demonstrate variation
C) Improvements rely on the collection and analysis of data
D) Performance improvement requires the commitment and support of top administration

B) Systems are static and do not demonstrate variation
(387) Which of the following should be the first step in any quality improvement decision-making process?

A) Analyzing the problem
B) Identifying the problem
C) Developing an alternative solution
D) Deciding on the best solution

B) Identifying the problem
(388) Community Hospital has compared its 2008 and 2014 admission-type patient profile data. From a performance improvement standpoint, which admission types should the hospital examine for possible changes in capacity handling?
2008 2014
Newborn: 11% Newborn: 9%
Delivery: 10% Delivery: 8%
Emergency: 14% Emergency: 38%
Urgent: 28% Urgent: 16%
Elective: 37% Elective: 29%

A) Elective
B) Emergency
C) Newborn
D) Urgent

B) Emergency
(389) As part of the clinic’s performance improvement program, an HIM director wants to implement
bench-marking for the transcription division at a large physician clinic. The clinic has 21 transcriptionists who average about 140 lines per hour. The transcription unit supports 80 physicians at a cost of 15 cents per line. What should be the first step that the supervisor takes to establish bench-marks for the transcription division?

A) Clearly define what is to be studied and accomplished by instituting bench-marks
B) Hold a meeting with the transcriptionists to announce the bench-mark program
C) Obtain bench-marks from other institutions
D) Hire a consultant to assist with the process

A) Clearly define what is to be studied and accomplished by instituting bench-marks
(390) A record that fails quantitative analysis is missing the quality criterion of:

A) Legibility
B) Reliability
C) Completeness
D) Clarity

C) Completeness
(391) A report that lists the ICD-10-CM codes associated with each physician in a healthcare facility can be used to assess the quality of the physician’s services before he or she is:

A) Scheduled for a coding audit
B) Subjected to corrective action
C) Recommended for staff reappointment
D) Involved in an in-house training program

C) Recommended for staff reappointment
(392) When all required data elements are included in the health record, the quality characteristic for data ______ is met.

A) Security
B) Accessibility
C) Flexibility
D) Comprehensiveness

D) Comprehensiveness
(393) The quality improvement organizations (QIOs) under contract with CMS conduct audits on high-risk and hospital-specific data from claims data in this report:

A) Hospital Payment Monitoring Program
B) Payment Error Prevention Program
C) Program for Evaluating Payment Pattern Electronic Report
D) Compliance Program Guidance for Hospitals

C) Program for Evaluating Payment Pattern Electronic Report
(395) After an outpatient review, individual audit results by coder should become part of the:

A) Individual employee’s performance evaluation
B) Patient’s Health Record
C) Coding compliance review summary
D) Mission of the coding team

A) Individual employee’s performance evaluation
(397) The primary goal of the Hospital Standardization Program, established in 1918 by the American College of Surgeons, was to:

A) Establish minimum quality standards for hospitals
B) Train physicians and nurses for American hospitals
C) Standardize the educational curricula of American medical schools
D) Force substandard hospitals to close

A) Establish minimum quality standards for hospitals
(398) A quantitative tool that provides an indication of an organization’s performance in relation to a specified process or outcome is a(n):

A) Performance measure
B) Improvement opportunity
C) Team-based process
D) Data measure

A) Performance measure
(399) A standard of performance or best practice for a particular process or outcome is called a(n):

A) Performance measure
B) Benchmark
C) Improvement opportunity
D) Data measure

B) Benchmark
(400) This type of performance measure focuses on a process that leads to a certain outcome, meaning that a scientific or experimental basis exists for believing that the process, when executed well, will increase the probability of achieving a desired outcome.

A) Outcome measure
B) Data measure
C) Process measure
D) System measure

C) Process measure
(401) Which of the following is NOT a step in quality improvement decision making?

A) Determination of the quickest solution
B) Definition of the problem
C) Development of alternative solutions
D) Implementation and follow-up

A) Determination of the quickest solution
(402) The principal process by which organizations optimize the continuum of care for their patients is:

A) Utilization management
B) Services management
C) Case management
D) Resource management

C) Case management
(403) When the patient’s physician contacts a healthcare organization to schedule and episode of care service, the healthcare organization begins which step in the case management process?

A) Preadmission care planning
B) Care planning at the time of admission
C) Review the progress of care
D) Discharge planning

A) Preadmission care planning
(404) The National Patient Safety Goals (NPSGs) have effectively mandated all healthcare organizations to examine care processes that have a potential for error that can cause injury to patients. Which of the following processes are included in the NPSGs?

A) Identify patients correctly, prevent infection, and file claims for reimbursement
B) Check patient medicines, prevent infection, and identify patients correctly
C) File claims for reimbursement, check patient medicines, and improve staff communication
D) Improve staff communication, process claims timely, and prevent infections

B) Check patient medicines, prevent infection, and identify patients correctly
(405) The interrelated activities in healthcare organizations , which promote effective and safe patient outcomes across services and disciplines within an integrated environment, are included in what area of performance measure?

A) Outcomes
B) Processes
C) Systems
D) Beneficiaries

B) Processes
(406) A performance measure that enables healthcare organizations to monitor a process to determine whether it is meeting process requirements is called:

A) Indicator
B) Data measure
C) Ranking
D) System measure

A) Indicator
(407) What is the status conferred by a national professional organization that is dedicated to a specific area of healthcare practice?

A) Credential
B) Certificate
C) License
D) Degree

A) Credential
(408) The primary objective of quality in healthcare for both patient and provider is to:

A) Keep costs under control
B) Reduce death rates
C) Reduce the incidence of infectious disease
D) Arrive at the desired outcomes

D) Arrive at the desired outcomes
(409) Who is responsible for ensuring the quality of health record documentation?

A) Board of Directors
B) Administrator
C) Provider
D) Health information management professional

C) Provider
(410) All of the following services are typically reviewed for medical necessity and utilization EXCEPT:

A) Rehabilitative therapies
B) Inpatient admissions
C) Well-baby check
D) Mental health and chemical dependency care

C) Well-baby check
(411) A Joint Commission-accredited organization must review its formulary annually to ensure a medication’s continued:

A) Safety and dose
B) Efficiency and efficacy
C) Efficacy and safety
D) Dose and efficiency

C) Efficacy and safety
(412) Environmental assessments are performed as part of which of the following processes?

A) Strategic planning
B) Operational planning
C) Quality improvement planning
D) Budget planning

A) Strategic planning
(413) Which of the following actions is NOT included about a physician in the National Practitioner Data Bank?

A) Malpractice lawsuits
B) Disciplinary actions
C) Credentialing information from other facilities
D) Personal bankruptcy

D) Personal bankruptcy
(414) The Joint Commission’s quality improvement activities for health record documentation include all EXCEPT which of the following core performance measures for hospitals?

A) Acute myocardial infarction
B) Hypertension
C) Pregnancy and related conditions
D) Seizure disorder

D) Seizure disorder
(415) This data set was developed bu the National Committee for Quality Assurance to aid consumers with health-related issues with information to compare performance of clinical measures for health plans:

A) HEDIS
B) UHDDS
C) UACDS
D) ORYX

A) HEDIS
(416) In this case management step, the case manager confirms that the patient meets criteria for the care setting and that the services can be provided at the facility.

A) Predmission care planning
B) Care planning at the time of admission
C) Review the progress of care
D) Discharge planning

B) Care planning at the time of admission
(417) The final results of care, treatment, and services in terms of the patient’s expectations, needs, and quality of life, which may be positive and appropriate or negative and diminishing , are included in what area of performance measurement?

A) Outcomes
B) Processes
C) Systems
D) Benchmarks

A) Outcomes
(418) An established set of clinical decisions and actions taken by clinicians and other representatives of healthcare organizations in accordance with state and federal laws, regulations, and guidelines is called:

A) Standards of care
B) Clinical practice standards
C) Clinical pathways
D) Standard guidelines

A) Standards of care
(419) An HIM director reviews the departmental scanning productivity reports for the past three months and sees that productivity is below that of the national average. Which of the following actions should the director take?

A) Reduce the salary of nonproductive workers
B) Investigate whether there are factors contributing to the low productivity that are not reflected in the national benchmarks
C) Meet with departmental supervisors to discuss the issue
D) Assess whether or not the current economy is affecting productivity

B) Investigate whether there are factors contributing to the low productivity that are not reflected in the national benchmarks
(420) Through the establishment of the National Practitioner Data Bank, the federal government became involved in malpractice issues and what other type of issue?

A) Employment of physicians
B) Quality of care
C) Licensure of physicians
D) Pay for performance

B) Quality of care
(421) All of the following are Joint Commission core measures criteria sets EXCEPT:

A) Heart failure
B) Acute myocaridal infarction
C) Pneumonia
D) Diabetes mellitus

D) Diabetes mellitus
(422) During training, the employee should be:

A) Allowed to work without supervision
B) Expected to make no mistakes
C) Evaluated to make sure work is error free
D) Evaluated for productivity

C) Evaluated to make sure work is error free
(424) A coding supervisor who makes up the weekly work schedule would engage in what type of planning?

A) Long range
B) Operational
C) Tactical
D) Strategic

B) Operational
(425) Performance standards are used to:

A) Communicate performance expectations
B) Assign daily work
C) Describe the elements of a job
D) Prepare a job advertisement

A) Communicate performance expectations
(426) A supervisor wants to determine whether the release-of-information staff members are working at optimal output. Which of the following would be most useful to determine this?

A) Review work attendance records to see who is absent from work the most
B) Walk through the work area at random times of the day to make sure employees are at their desks and working
C) Set productivity standards for the area, and review results on a regular basis
D) Determine the backlog of work not performed each day

C) Set productivity standards for the area, and review results on a regular basis
(427) “I reviewed the health record of Mr. Brown and found there was no H&P on the record at seven hours past this patient’s admission time.” This would be an example of:

A) Quantitative analysis
B) Qualitative analysis
C) Data mining
D) Data warehousing

A) Quantitative analysis
(428) “I reviewed the health record of Sally Williams and found the physician stated on her post-op note, ‘examined after surgery’.” This would be an example of:

A) Quantitative analysis
B) Qualitative analysis
C) Data mining
D) Data warehousing

B) Qualitative analysis
(429) Fifty percent of our HIM staff members have a nationally recognized credential. This is an example of what type of indicator:

A) Structured
B) Process
C) Outcome
D) Internal

C) Outcome
(430) James Walker, an 85 year-old male, is admitted with a hip fracture that is repaired with a closed reduction and stabilization. During his hospital stay, a social worker assesses his situation and determines that long-term care placement is necessary when he is ready to leave the hospital. This process is called:

A) Preadmission review
B) Continued stay review
C) Ancillary services review
D) Discharge planning

D) Discharge planning
(431) A risk manager is called in to evaluate a situation in which a visitor to the hospital slipped on spilled water, fell, and fractured his femur. This situation was referred to the risk manager because it involves a:

A) Medical error
B) Claims management issue
C) Potentially compensable event
D) Sentinel event

C) Potentially compensable event

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