Are you on your way to becoming a registered health information technician? If you said yes, you are in luck as the quiz below is precisely what you need to refresh your memory on record keeping and what someone in your position is expected to do when it comes to access and details. How about you check it out and see how good you will do.
Permanently
For 25 years
For 15 years
For 10 years
Social security
Family
Unit
Serial-unit
Family
Nurse
Patient
Physician
JCAHO
COP
SOH
OBRA
Drawing a single line through the error
Obliterating the incorrect document
Documenting the reason for the error
Obtaining the supervisor's co-signature
Patient's hospitalization is under 48 hours' duration with minor problems
Circumcised newborn who develops an infection is discharged within 48 hours
Obstetrical patient delivers a healthy female newborn via cesarean section
Expected death of a terminal patient occurs within 48 hours of admission
Facility's admitting department
Attendig physician's office
Hospital nursing station
Preadmission testing department
Misnumbering of health records
Misfiling of health record folders
Misinterpretation of record content
Misplacement of forms in the record
Diseased tissue only that is removed at surgery
All tissue removed during a surgical procedure
Cancer tissue only or tissue that might be cancerous
Tissue sent to the pathology at the discretion of the surgeon
Community care
Respite care
Rehab care
Hospice care
Filed with the mother's record only if the infant was a premature newborn
Separate from the mother's record and contains a few routine forms and reports
Filed with the mother's record if the infant is normal (i.e., healthy newborn)
Separate from them other's record if she experienced no delivery complications
Social security number as unit number
Family numbering for all outpatients
Serial-unit numbering and filing system
Straight numberic filing and numbering
S. Peter Jones
Steven Peter Jones
Stephen Peter Jones
S. Jones
Permanently
25 years
10 years
5 years
25 records
50 records
100 records
200 records
Many patients receive home care services as part of hospice care
A family member is required to be the primary care person in the home
Curative care can be privided to the patient in a convenient manner
It is difficult to arrange for inpatient services when they are deemed necessary
JCAHO, state licensing regulations, Conditions of Participation
State health department rules, Conditions of Participation, JCAHO
Conditions of Participation, JCAHO, Memo of Understanding
State licensing regulations, JCAHO, Memo of Understanding
Spacing needed for typing
Purpose and need for it
Number of copies included
Information to be documented
70%
80%
90%
100%
Assisted living facility
Substance abuse facility
Independent living facility
Domiciliary facility
Accrediation
Certification
Licensure
Regulation
Cost overutilization
Cost underutilization
Essential medical care
Medical necessity
Children's hospitals
Neighborhood health centers
Rehabilitation hospitals
Proprietary hospitals
Federal regulation
JCAHO
Medicare COP
State statutes
Database, problem list, initial plans, progress notes
Problem list, SOAP notes, nursing notes, graphic sheets
History and physical, problem list, SOAP notes, resume
Initial plans, problem list, SOAP notes, nursing notes
Upon the patient's first visit to the emergency department
Each time the patient is seen in the emergency department
When the patient is diagnosed with a different condition
If the patient has changed his or her primary physician
There is utilization of a fee-for-service system
Fixed premiums are prepaid for health services
Their mission is to bring health care to the indigent
Seven days per week, 12-16 hours per day care is provided
The facility was in almost total compliance with the JCAHO standards
Within an 18-month time frame the facility will undergo self-assessment
A plan of correction must be completed by the facility within 6 months
Reaccreditation will be unneccessary in the future as it is automatically renewable
It is stored in the health information department and is used ony by Dr. Day
It is used by Dr. Day and her clinical staff because seh gave them permission to do so
Dr. Day signed a statement regarding its use; the statement is stored with the facility's administration
It is utilized only Dr. Day and the other physicians involved in her group practice
Classification system used by the facility
Numbering system used by the facility
Filing system used by the facility
Registration method used by the facility
Required authentication of all entries
Use of abbreviations on the face sheet
Potentially compensable events
Consistency in documentation of provider entries
Terminial digit
Middle digit
Stright numeric
Serial numeric
Patient billing/collections
Environmental services
Biomedical maintenance
Clinical laboratory/pathology
It consists of a single specialty or multi-specialty and privides comprehensive
It has management responsibility for providing comprehensive prepaid patient care
It is an organized outpatient department physically separate from the hospital
It is a freestanding facility that provides surgical services only to the patients
Ophthalmologists
Osteopaths
Anesthesiologist
Optometrists
Analysis after health providers have worked on records, but prior to permanent filing
The assembly of the health record upon receipt from the facility's nursing units
Authentication of incomplete health records after initial analysis has been done
Computerized abstracting of health records after the provider has completed them
It requires the attending physician to consider all of the patient's problems
It is easily accepted by physicians, nurses, and allied health professionals
It clearly indicates the goals and methods of the physician in treating the patient
It allows physicians and others to follow the course of any one problem more easily
30 days
2 weeks
60 days
6 months
May or may not be associated with a hospital
Is physically separate from the hospital
Can be attached to the hospital itself
Privides comprehensive care for patients
Decrease in acute care facility lengths of stay
Decrease in number of home health patients
Increase in the country's costs of health care
Increase in long-term care facility admissions
Aperture cards
Roll film
Microfiche
Microfilm jackets
Must be authenticated by the physician after being filed in the chart
Can be excluded from the record if they are posted in the nursing unit
May be presigned by the physician prior to dupicating the orders
Need to be signed only if the attending physician alters the orders
10921
17845
16888
10922
Less time spent retrieving appropriate records
More time spent retrieving appropriate records
Less cost in preparing and utilizing the index
Less time spent in preparing the indices
Primary
Secondary
Tertiary
Terminal
Procedure registry
Population based cancer registry
Hospital cancer registry
Special-purpose registry
Ambulatory surgery
Ancillary services
Emergency department
Outpatient department
Ambulatory health care costs will continue to increase dramatically
Access to ambulatory health care services will be limited geographically
Ambulatory health care is being selected as an alternate form of care
Technological breakthroughs will limit ambulatory health care services
Quiz Review Timeline (Updated): Mar 21, 2022 +
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