Chapters: 17, 18, & 19
Information accessed through the internet is highly reliable because the content is regulated by the government.
False
It is not necessary to backup data if your computer has a large hard drive with adequate storage space.
False
Most employers allow their employees to send personal emails and conduct internet searches as long as it does not interfere with their work.
False
Most words in English are spelled according to a set of rules.
False
Complete personal, familial, and social information.
Medical history
Collection of documents that forms the complete health history of a patient.
Medical record
Which of the following professional titles is written correctly?
Stephen Carruthers, O.D
The federal government is providing funds to help health care providers develop electronic medical record systems.
True
The health care professional cannot depend on word processing spell checkers to catch all the spelling errors in a document prepared on the computer.
True
Which of the following personnel may write progress notes that are included in the patient's official medical record?
any health care professional who provides a direct service to the patient
To seperate the words in a series
comma
Only health care professionals who work in office environments or highly technical occupations are likely to use computers in their work.
False
If an urgent care center wants to estimate the number of physician assistants it will need next year based on projected numbers of patients, it might use:
electronic spreadsheet software
Patient confidentiality rules only apply to written materials if they contain potentially embarrassing info about the patient.
False
Preparing accurate and meaningful content should be emphasized in health care writing more than grammatical details.
False
A good way for health care pro. to increase their efficiency is to gather all the records for patients to be seen that day are prepare the written documentation in advance for procedures to be done during the day.
false
An example of a chief complaint would be when the health care provider notes an increase in blood pressure that requires treatment.
false
Medical charting should be done in pencil because mistakes can be easily and neatly corrected.
false
Source-oriented charting format is a better approach than continuous chronological record format.
false
The physician's orders are the primary tool used to record, communicate, and coordinate the care given to the patient.
false
Hair-thin cables that transmit data, such as internal images of the body during surgery, are called - .
fiber optics
Karen is using the internet to locate as much information as possible about treatments for cancer. A - website would be a good starting point because it would provide her with links to many potentially useful websites.
gateway
What is one of the purposes of medical documentation?
helps ensure compliance with regulatory agencies
The main difference between the three block style business letter formats is:
how the lines of text are lined up with the margins.
Before the writer begins to write a report, an informal outline should be prepared
if the writer finds this organizational technique helpful.
Combination of applications needed to carry on the operations of a medical office.
integrated program
Medical documentation that is not - is useless and may cause legal problems.
legible
The most serious consequence of sending a poorly written - to a patient may lose confidence in the level of care being provided.
letter
If you are in a hurry to get an important letter out and are not sure about how to spell a word, the best thing to do is
look up the spelling in a reliable source.
Measure hydrogen atom activity to view tumors
magnetic resonance imaging
Which of the following items would be part of the familial history?
medical problems of relatives
In addition to providing information for people who are not able to attend, the - of staff meetings provide documentation of discussions and decisions.
minutes
What is the best way to record in a patient's report that he only slept from about 1:00 a.m. to 4:30 a.m.?
patient states, "I only slept 3 1/2 hours last night."
After most abbreviations
period
Use injected radioactive substance to study brain function
positron emission tomography
The development of fiber optics has enabled dentist to:
project views from inside the patient's mouth onto a screen
The purpose of an expert system is to:
provide quick access to diagnostic and treatment information
The use of Electronic Communication Privacy Act of 1986 - against the unauthorized access to computerized records.
provides protection
Around titles of magazine srticles
quotation marks
The exact words of a speaker or writer should be enclosed by - .
quotation marks
When a database is created, a collection of related data is called a -
record
A coworker calls from home and asks you to sign his name on a patient chart that he forgot to sign after administering a medication. What should you do?
refuse to sign either name
Bioinformatics refers to the organization of information that enables:
research to increase scientific progress by collecting and analyzing information.
Health care professionals use MEDLINE/PubMed to:
search for information among millions of references
Between independent clauses joined by a connecting word
semicolon
Document containing permission to load an application software program on five office computers.
site license
A major barrier that must be overcome in order for telemedicine to be more widely practiced is:
state licensing laws for physicians
The principal purpose of the computer's hard drive is to:
store instructions and data
Many English words can be changed by adding a - to the end of the word.
sufix
Measure signals from sound waves to examine organs and fetuses
ultrasonography
Delicate surgical procedures can be practiced before performing the actual surgery on a patient through the use of:
virtual reality technology
Downloading from the Internet should be done with great care because doing so can transfer destructive - .
viruses
Reports, info sheets, memos
word processing
Professional writers suggest that a good way to prevent being overwhelmed by a long writing project is to
write the first draft quickly without worrying about perfect grammar and spelling.
Which statement is true regarding the way computer programs save the data you input?
you must give the computer a command to save your data or set it to save a regular intervals.
At the end of a clause that introduces a list
colon
A medical receptionist reminds a patient to call and schedule her annual physical exam.
Recall
Which of the following is the best definition of charting?
Records, observations, and information about patients.
Measure electrical currents to detect differences in tissues
electrical impedance tomography
Budgets, patient bills, business projections, graphs
electronic spreadsheet software
In medical usage which is the correct way to express percentage?
85%
Which word correctly applies the rule for adding a final suffix?
Admitting
When should a report contain a well- written conclusion?
All reports should contain a well written conclusion.
Which of the following items would be included in the personal history?
Allergies
An office manager sends new office schedule and payment information.
Announcement
Opinions of a health care professional about the nature of the patient's problem.
Assessment
Which type of software would be the best choice for maintaining the personnel records in a large health clinic?
Database
Which method of organization describes the source-oriented approach to medical record keeping?
By health care specialty
Recording observations and information about patients.
Charting
Reason the patient seeks medical care.
Chief complaint
An administrative assistant asks a patient to pay an overdue bill.
Collection
A physician requests that a physical therapist see a patient.
Consultation
Which is the correct way to punctuate the salutation in a business letter?
Dear Mrs. Chen:
Results of x-rays, electrocardiograms (EKG or ECG), and blood tests.
Diagnostic tests
- x-rays, used by many dentists,use less radiation than traditional x-rays and can be electronically stored in the patient's record.
Digital
Which of the following is the correct plural form of the word "diverticulum"?
Diverticula
Which of the following statements are true about personal health records (PHR)?
Documents created and maintained by the individual
Developing good written communication skills is only important for learners who want to work in office or administrative positions in health care.
False
Which sentence is written correctly?
Dr. Hernandez prefers to spend time with each patient, but he can't always do so.
What is the correct way to abbreviate electrocardiogram?
ECG
Which action is most likely to result in damage to your computer hardware?
Eating popcorn while entering data
Message sent to all members about an upcoming professional meeting
Electronic mail
Which health care function is made easier by point-of-care charting.
Entering patient data during a home visit
A physician writes to a patient's employer, stating that he is unfit for work following and injury.
Explanation
A major difficulty with the electronic medical records is the inability of various systems to communicate and share information.
False
Comprehensive systems of computerized patient records are fairly inexpensive to purchase and implement.
False
To be computer literate means to be able to correctly use many sophisticated computer programs and applications.
False
Voice dictation software used for medical charting is nearly as accurate as written notes.
False
When writing a report, it is permissible to copy material from a website without siting it because the information is available for the public to use.
False
Which of the following words is spelled correctly?
February
How should the healthcare professional select appropriate abbreviations to use in written documentation?
Follow facility policies.
A physician informs a patient about the results of diagnostic tests.
Follow-up
- letters must be used with care, because some patients find them to be cold and uncaring.
Formal
- is the set of rules that determines how a given language is organized.
Grammer
Visual format for recording measurements such as blood pressure.
Graphics
Which type of address form is recommended by the post office to ensure proper delivery?
IVANA PETROKOV MD 8713 MARCOS LANE SAN DIEGO CALIFORNIA 92120-1245
Four major purposes of writing health care documents are to persuade, gather info, encourage, action, and - .
Inform
A medical assistant asks a vendor for information about new medical office management software.
Inquiry
Why must written communication be organized even more carefully than oral communication?
It lacks nonverbal clues, because there is no interaction between the sender and receiver
- are focused light rays that can cut and remove tissue, helping to make surgical incisions cleaner and more accurate.
Lasers
When you are beginning the process of writing a report on a health care topic, it is recommended that you start by:
Listing every idea you can think of, including those that seem unlikely.
Medications and treatments that have been prescribed.
Physician's orders
Which word correctly applies the rule about adding letters to words that end in "y"?
Played
In what sentence is the apostrophe used correctly?
Please tell the medical assistants that it's about time for a meeting.
Which of the following words is correctly spelled?
Pneumonia
Insurance company records, pharmaceutical test trials, inventory management
RAM
Which word correctly applies the rule about forming plurals?
Radios
Chronological record of care administered.
Progress notes
Which word correctly applies the "i before e" rule?
Relieve
Every entry on a medical record must include the - and - and the - of the health care professional who made the entry.
Requested info, date, and signature
What determines the tone of a written document?
The specific circumstances.
An important result of the widespread use of computers is the elimination of repetitious tasks.
True
Documents created with word processing software can be stored for later use.
True
Many employers today use social networking sites to screen job applicants.
True
Minutes of facility meetings may serve as documentation for certain regulatory purposes.
True
Reading written material backwards is an effective way to check spelling.
True
health care providers must submit all medicare claims for reimbursement electronically.
True
Which sponsor is most likely to have a web site that contains current and accurate information about the link between nutrition and cancer?
University medical school
Which is the correct way to document a patient's statement about symptoms experienced?
Write direct quotes and enclose the entry in quotation marks
Which sentence is correctly written?
Your leg is almost healed; the cast can probably be removed next week.
When using the method known as "charting by exception," only - are noted.
abnormal finds
Software used to find websites about brain injury
browser
Measure density of tissues to perform evaluations
computerized tomography
A - is the combination of two words in which missing letters are replaced by an apostrophe.
contraction
Computer work area containing data you have just entered
database
A tracking system called MEADERS is being developed to help prevent - errors that result in thousands of deaths and injuries annually.
dosage
A medical record refers to the collection of all documents that are filed together and form a complete chronological health history of a particular patient.
true
Flow sheets are forms for specialty needs.
true
Incomplete documentation can result in denial of payment to health providers by insurance companies.
true
Medical documentation refers to notes and documents that healthcare workers add to the medical record.
true
Medical records are legal documents that can be used as legal evidence in court.
true
Which of the following is NOT a characteristic of computerized database?
Mistakes are automatically corrected.
what is the main purpose of a staff meeting agenda?
To encourage attendees to prepare in advance and be on time.
To create possessive forms of nouns
apostrophe