DOMAIN 3

44. In this experimental study, blood pressure is taken before and after an experimental medication is used as the intervention in a sample of participants that were previously unable to control their blood pressure with other medications. In this example, the independent variable is the ________ and the dependent variable is the________.

a. Experimental medication; blood pressure

34. 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:

c. Recommended for staff reappointment

56. In which type of distribution are the mean, median, and mode equal?

d. Normal distribution

45. The hospital's Performance Improvement Council has compiled the following data on the volume of procedures performed. Given this data, which procedures should the council scrutinize in evaluating performance?

d. Procedures 1, 4, 6, 7

41. What term is used for the number of inpatients present at any one time in a healthcare facility?

Census

42. The number of inpatients present in a healthcare facility at any given time is called a ________.

Census

96. Data found on sites such as Hospital Compare use aggregated data to describe the experiences of unique types of patients with one or more aspects of their care. This data collection is called:

Comparative

8. Data elements collected on large populations of individuals and stored in databases are referred to as:

c. Aggregate data

77. Community Hospital wants to compare its hospital-acquired urinary tract infection (UTI) rate for Medicare patients with the national average. The hospital is using the MEDPAR database for its comparison. The MEDPAR database contains 13,000,000 discharges. Of these individuals, 200,000 were admitted with a principal diagnosis of UTI; another 300,000 were admitted with a principal diagnosis of infectious disease, and 700,000 had a diagnosis of hypertension. Given this information, which of the following would provide the best comparison data for Community Hospital?

c. All individuals in the MEDPAR database except those admitted with a principal diagnosis of UTI or infectious disease

67. Mr. Jones was admitted to the hospital on March 21 and discharged on April 1. What was the length of stay for Mr. Jones?

11 days

66. What is the mean for the following frequency distribution: 10, 15, 20, 25, 25?

19

68. Community Hospital had 25 inpatient deaths, including newborns, for the month of June. The hospital performed five autopsies for the same period. What was the gross autopsy rate for the hospital for June?

20%

65. Community Hospital had 250 patients in the hospital at midnight on May 1. The hospital admitted 30 patients on May 2. The hospital discharged 40 patients, including deaths, on May 2. Two patients were both admitted and discharged on May 2. What was the total number of inpatient service days for May 2?

242

99. In May, 270 women were admitted to the obstetrics service. Of these, 263 women delivered; 33 deliveries were by C-section. What is the denominator for calculating the C-section rate?

263

93. If an employee produces 2,080 hours of work in the course of one year, how many employees will be required for the coding area if the coding time on average for one record is 30 minutes and there are 12,500 records that must be coded each year?

3

31. Given the numbers 47, 20, 11, 33, 30, 30, 35, and 50, what is the mode?

30

21. Community Memorial Hospital had 25 inpatient deaths, including newborns, during the month of June. The hospital had a total of 500 discharges for the same period, including deaths of adults, children, and newborns. The hospital's gross death rate for the month of June was:

5%

81. Community Memorial Hospital had 25 inpatient deaths, including newborns, during the month of June. The hospital had a total of 500 discharges for the same period, including deaths of adults, children, and newborns. The hospital's gross death rate for the month of June was:

5%

77. On October 1st, a hurricane hit a small coastal community, which has a community hospital licensed for 50 beds. Hospital staff set up 10 additional beds around the facility and used three labor room beds and two treatment room beds in order to help take care of patients. Which of the following would be the denominator used to determine the percentage of occupancy for October 1st?

50

11. Analyze the following report of physician deficiency rates and determine which physician has the lowest deficiency rate for H&Ps completed within 24 hours of admission.

637

54. A coding supervisor wants to use a fixed percentage random sample of work output to determine coding quality for each coder. Given the work output for each of the four coders shown here, how many total records will be needed for the audit if a 5 percent random sample is used?

82

29. The following data were derived from a comparative discharge database for hip and femur procedures:

Aggregate

25. The hospital-acquired infection rate for our hospital is 0.2%, whereas the rate at a similar hospital across town is 0.3%. This is an example of a:

Benchmark

30. Information that has been taken from the health records of injured patients and entered into the trauma registry database has been:

Abstracted

69. After the types of cases to be included in a trauma registry have been determined, what is the next step in data acquisition?

Abstracting

70. If you want to display the parts of a whole in graphic form, what graphic technique would you use?

Pie chart

19. One of the pediatricians at Community Physician's Clinic worked with a software vendor to get a display of the patients she currently has in the hospital on her smart phone that lets her know current information such as lab results, vital signs, medications given. This is called a ________.

Dashboard

90. Which of the following is a technique for graphically depicting the structure of a computer database?

Data model

7. This type of chart plots all data points as a cell for two given variables of interest and, depending on frequency of observations in each cell, provides color to visualize high or low frequency.

Heatmap

86. Which of the following is made up of claims data from Medicare claims submitted by acute-care hospitals and skilled nursing facilities?

MEDPAR

88. Which of the following reportable diseases usually requires telephone reporting as opposed to other methods of reporting?

Measles

23. Given the following information, from which payer does the hospital proportionately receive the least amount of payment?

Medicaid

40. What do the wedges or divisions in a pie graph represent?

Percentages

28. One of the questions on the patient satisfaction survey that is sent to the patient after discharge asks for the number of times the nurses checked the patient's vital signs in a day. This is an example of which type of data?

Quantitative

91. Community Hospital is using a system that will help them detect when intracranial pressure becomes high in patients with a recent CVA that will quickly send an alert to the physician. This is an example of ________.

Real-time analysis

84. David works for an organization that utilizes health record data to prove or disprove the efficacy of a healthcare treatment. What type of organization does David work for?

Research

22. A family practitioner in your local physician's clinic saw 150 adults in one week for their annual physical examinations. Sixty-seven received the flu vaccine and three patients received the pneumococcal pneumonia vaccine. What is the rate of the flu vaccine administration for this physician?

a. 44.7%

100. To use a data element for aggregation and reporting, that data element must be:

a. Abstracted or indexed

4. What number is assigned to a case when it is first entered in a cancer registry?

a. Accession number

74. Secondary data is used for multiple reasons including:

a. Assisting researchers in determining effectiveness of treatments

95. Suppose that five patients stayed in the hospital for a total of 27 days. Which term would be used to describe the result of the calculation 27 divided by 5?

a. Average length of stay

20. The process of extracting and analyzing large volumes of data from a database for the purpose of identifying hidden and sometimes subtle relationships or patterns and using those relationships to predict behaviors is called:

a. Data mining

98. Your administrator has asked you to generate a report that gives the number of hypertension patients last year. This is an example of ________.

a. Descriptive analytics

13. To be reliable, statistical data must:

a. Have some consistency

43. Case finding is a method used to:

a. Identify patients who have been seen or treated in a facility for a particular disease or condition for inclusion in a registry

57. Which of the following is the first step in analyzing data?

a. Know your objectives or purpose of the data analysis

38. Certificates, such as those for births and fetal-deaths, are reported by hospitals to the individual state registrars and maintained permanently. State vital statistics registrars then compile the data and report them to which of the following:

a. National Center for Health Statistics

1. A health data analyst has been asked to abstract patient demographic information into an electronic database. Which of the following would the analyst include in the database?

a. Patient date of birth

60. Which of the following best represents the definition of the term data?

a. Patient's laboratory value is 50.

48. Which of the following is not a component of the data analytics process?

a. Software testing

69. Which events must occur in order to maintain patient identity data integrity?

a. The data must be accurately queried

59. An employee views a patient's electronic health record. It is a trigger event if:

a. The employee and patient have the same last name

49. Recently, a local professional athlete was admitted to your facility for a procedure. During this patient's hospital stay, access logs may need to be checked daily in order to determine:

a. Whether all access by workforce is appropriate

86. At Community Hospital, each full-time employee is required to work 2,080 hours annually. The table below shows the amount of time that five employees were absent from work over the past year.

b. 0.98%

50. The coding department at Community Physician's Clinic developed the following report for the denials committee at the clinic. The billing report shows the following information. How many hours will it take to reconcile these denials if each denial takes 1.5 hours to review and resubmit the bill?

b. 264 hours

9. Given the numbers 47, 20, 11, 33, 30, 30, 35, and 50, what is the median?

b. 31.5

88. The HIM professional reported to the quality improvement committee at Community Hospital that there were 58 patients with influenza discharged from the hospital in January. Of those, 3 died. What is the case fatality rate for influenza for January?

b. 5.17%

37. Community Hospital discharged 9 patients on April 1. The length of stay for each of the patients was as follows: for patient A, 1 day; for patient B, 5 days; for patient C, 3 days; for patient D, 3 days; for patient E, 8 days; for patient F, 8 days; for patient G, 8 days; for patient H, 9 days; for patient I, 9 days. What was the average length of stay for these nine patients?

b. 6 days

City Hospital's HIM department made a decision to discontinue outsourcing its release of information (ROI) function and perform the function in house. Because of HIPAA implementation, the department wanted better control over tracking release of information. Given the graph shown here, how would you evaluate the ROI revenue growth?

b. Annualized revenue for YR-7 is more than the costs.

33. A quality goal for the hospital is that 98 percent of the heart attack patients receive aspirin within 24 hours of arrival at the hospital. In conducting an audit of heart attack patients, the data showed that 94 percent of the patients received aspirin within 24 hours of arriving at the hospital. Given this data, which of the following actions would be best?

b. Determine whether there was a medical or other reason why patients were not given aspirin

62. Large population-based studies are used to identify the care processes or interventions that achieve the best healthcare outcomes in different types of medical practice. This research concept is called?

b. Evidence-based medicine

85. Sometimes data do not follow a normal distribution and are pulled toward the tails of the curve. When this occurs, it is referred to as having a skewed distribution. Because the mean is sensitive to extreme values or outliers, it gravitates in the direction of the extreme values thus making a long tail when a distribution is skewed. When the tail is pulled toward the right side, it is called a ________.

b. Positively skewed distribution

67. The type of statistics that makes a best guess about a larger group of data by drawing conclusions from a smaller group of data is called:

b. Inferential statistics

12. Why is the MEDPAR file limited in terms of being used for research purposes?

b. It only contains Medicare patients

63. Which term is used to describe the number of calendar days that a patient is hospitalized?

b. Length of stay

46. The business office at Community Hospital is looking at software that can help them with decreasing their fraud and abuse cases. The software claims to be able to flag those patients that would most likely be involved in fraud by examining many databases at the same time and finding those patients with demographic discrepancies. This is an example of ________.

b. Predictive analytics

27. A managed care organization is using a system that examines the past healthcare behaviors of their patients to determine their future costs for their healthcare. This is an example of ________.

b. Predictive modeling

32. Health departments use the health record to monitor outbreaks of diseases. In this situation what type of use of the health record does this represent?

b. Public health and research

61. Which tool is used to display performance data over time?

b. Run chart

26. The HIM manager at Community Hospital is responsible for reviewing audit trails detailing potential access issues within the EHR. Which one of the following would be a type of activity that the manager would want to review?

b. Whether the person viewed, created, updated, or deleted information belonging to a patient with the same last name

11. The facility privacy officer receives a phone call from a patient who is concerned that her former sister-in-law who is a hospital employee has accessed her health record. The privacy officer requests an audit log of activity within the patient's health record. What part of the audit log must be analyzed to determine if this complaint has merit?

b. Which employees viewed, created, updated, or deleted information

39. The HIM department recently performed an audit of health records. The audit showed that for the 10,000 records filed there was a 7 percent error rate. Given that the national average labor cost of each misfile is $200, what is the labor cost for the department for handling these misfiled records?

c. $140,000

3. For research purposes, an advantage of the Healthcare Cost and Utilization Project (HCUP) is that it:

c. Contains data on all payer types

48. Community Hospital performed a cost-savings analysis between its current paper-based, on-site coding processes and an e-WebCoding telecommuting model. Given the graph here, what does the cost analysis show?

c. Cost comparison reflects a net reduction in overall expenses on a monthly basis for the e-WebCoding system.

51. What is the official count of inpatients taken at midnight called?

c. Daily inpatient census

Community Hospital has been collecting quarterly data on the average monthly health record delinquency rate for the hospital. This graph depicts the trend in the delinquency rate. The hospital has established a 35 percent benchmark. Given this data, what should the hospital's Performance Improvement Council recommend?

c. Further analyze the data to determine why the benchmark is not being met

87. Which rate is used to compare the number of inpatient deaths to the total number of inpatient deaths and discharges?

c. Gross hospital death rate

84. Suppose that you want to display the number of deaths due to breast cancer for the years 2005 through 2015. What is the best graphic technique to use?

c. Line graph

6. The following data fields comprise a database table: patient last name, patient first name, street address, city, state, zip code, patient date of birth. Given this information, which of the following is a true statement about maintaining the data integrity of the database table?

c. None of the data fields are adequate to use as a primary key for the table.

70. 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 should the director take?

c. Suggest that the data be adjusted for possible differences in type and volume of patients treated.

92. A secondary data source includes ________.

c. The physician's index

35. The HIM department at Community Hospital has three full time coders. One is considered the lead coder and his salary is $20.35 per hour. One coder is a new graduate who makes $15.50 per hour and the third coder is an experienced employee who earns $18.90 per hour. The lead coder codes four records per hour; the new coder codes three records per hour and their experienced coder codes six records per hour. Using a 7.5-hour productive day, what is the unit cost for the new graduate coder?

d. $5.51 per record

45. Community Hospital had a total of 3,000 inpatient service days for the month of September. What was the average daily census for the hospital during September?

d. 100 patients

99. Using the information in the table below, calculate the vaginal delivery rate at University Hospital for the semiannual period.

d. 79.96%

14. Community Hospital's HIM department conducted a random sample of 200 inpatient health records to determine the timeliness of the history and physicals completion. Nine records were found to be out of compliance with the 24-hour requirement. Which of the following percentages represents the H&P timeliness rate at Community Hospital?

d. 95.5%

97. Which of the following is an example of how an internal user utilizes secondary data?

d. Benchmarking with other facilities

52. After the types of cases to be included in a registry have been determined, what is the next step in data acquisition?

d. Case finding

68. A consumer nonprofit organization wants to conduct studies on the quality of care provided to Medicare patients in a specific region. An HIT professional has been hired to manage this project. The nonprofit organization asks the HIT professional about the viability of using billing data as the basis for its analysis. Which of the following would not be a quality consideration in using billing data?

d. Cost to process the data

72. Which term is used to describe the number of inpatients present at the census-taking time each day plus the number of inpatients who were both admitted and discharged after the census-taking time the previous day?

d. Daily inpatient census

10. Based on the payment percentages provided in this table, which payer contributes most to the hospital's overall payments?

d. Medicare

34. The HIM data analytics professional is reviewing a chart (shown here) on nosocomial infections presented by the hospital's infection control committee. The committee is reporting that the decrease in infection rate has accelerated during the past 10 years. What comments should the data analytics professional make?

d. Request a new data chart be presented that accurately reflects the trend of infection rate

2. Which of the following is true about a primary key in a database table?

d. Uniquely identifies each row in a table

1. Recently, a state senator was admitted to your facility for a serious medical condition. The facility privacy officer has been tasked with reviewing access logs daily to determine which of the following?

d. Whether all access by hospital employees was appropriate

96. As part of your job duties, you are responsible for reviewing audit trails of access to patient information. All of the following are types of activity that you would monitor except:

d. Whether the patient setup an account in the patient portal

71. Which autopsy rate compares the number of autopsies performed on hospital inpatients to the total number of inpatient deaths for the same period of time?

gross