CHIMA NCE Examination Prep Health Information Management National
Certification – 350+ Verified Q&A & Rationales
Prepare for your Canadian HIM certification with this comprehensive CHIMA NCE
2026 study guide featuring over 350 verified practice questions. It provides in-depth
rationales for critical domains including data quality standards, privacy legislation
(PIPEDA/PHIPA), and health information lifecycle management. Fully updated for the
2026 testing cycle, this resource is designed to help you master the professional
practice standards required to earn your CHIM designation on the first attempt.
Which of the following is the primary purpose of a "Discharge Summary"?
A. To provide a list of every nurse who saw the patient.
B. To provide a concise overview of the patient's hospitalization for follow-up care
providers.
C. To bill the patient for their stay.
D. To document the patient's food preferences for the next visit.
Answer: B. To provide a concise overview of the patient's hospitalization for
follow-up care providers.
Rationale: The discharge summary is a critical communication tool that summarizes the
reason for admission, significant findings, procedures performed, and the plan for
follow-up care.
Question 2: Biomedical Sciences
What is the medical term for "shingles"?
A. Varicella
B. Herpes Zoster
C. Rubella
D. Variola
Answer: B. Herpes Zoster
,Rationale: Herpes Zoster is the reactivation of the varicella-zoster virus (which causes
chickenpox) in the body, resulting in a painful, blistering skin rash.
Question 3: Health Information Analysis
Which statistical measure is most affected by "outliers" (extreme values) in a data set?
A. Median
B. Mode
C. Mean
D. Range
Answer: C. Mean
Rationale: Because the mean (average) is calculated by summing all values, one
extremely high or low number will pull the average significantly toward that outlier.
Question 4: Access and Security
Which of the following is a "Technical" safeguard?
A. Staff training on privacy laws.
B. Using a shredding service for paper records.
C. Automatic log-off after a period of inactivity.
D. Checking a new employee's references.
Answer: C. Automatic log-off after a period of inactivity.
Rationale: Technical safeguards are the technology and policy measures used to
protect electronic PHI, such as encryption, access controls, and session timeouts.
Question 5: Information Systems and Technology
A "Legacy System" is best described as:
A. A brand-new system just installed yesterday.
B. An older computer system or application that is still in use but may not be compatible
with newer systems.
C. A system used only by the hospital's CEO.
D. A backup generator for the server room.
Answer: B. An older computer system or application that is still in use but may not
be compatible with newer systems.
,Rationale: Legacy systems are often kept because they contain vital historical data, but
they can pose challenges for interoperability and security.
Question 6: Ethics and Practice
According to the CHIMA Code of Ethics, if an HIM professional notices a coding error
that resulted in an overpayment, they should:
A. Ignore it to save the hospital money.
B. Correct the error and notify the appropriate department to return the overpayment.
C. Keep the information to use as leverage against their boss.
D. Wait for an external auditor to find it first.
Answer: B. Correct the error and notify the appropriate department to return the
overpayment.
Rationale: The Code of Ethics requires HIM professionals to maintain the integrity of
health information and ensures that coding and billing are accurate and honest.
Question 7: Health Care Systems in Canada
What does "Universality" mean in the context of the Canada Health Act?
A. All services are free everywhere in the world.
B. Every person is entitled to health care regardless of where they live in Canada.
C. All residents of a province/territory must be covered by the public health insurance
plan on uniform terms and conditions.
D. Everyone must see the same doctor.
Answer: C. All residents of a province/territory must be covered by the public
health insurance plan on uniform terms and conditions.
Rationale: Universality prevents discrimination in health coverage; all residents must
have access to the same level of insured services.
Question 8: Health Information Science
What is "Concurrent Coding"?
A. Coding that happens 10 years after a patient dies.
B. Coding that takes place while the patient is still receiving treatment in the facility.
C. Coding that is done by two people at the exact same time.
D. Coding that only uses computer software without human review.
, Answer: B. Coding that takes place while the patient is still receiving treatment in
the facility.
Rationale: Concurrent coding helps with real-time clinical documentation improvement
(CDI) and allows for more accurate resource tracking while the patient is still in-house.
Question 9: Biomedical Sciences
Which of the following is a "benign" tumor of the smooth muscle?
A. Leiomyoma
B. Leiomyosarcoma
C. Adenocarcinoma
D. Lipoma
Answer: A. Leiomyoma
Rationale: The suffix "-oma" usually indicates a benign tumor, whereas "-sarcoma"
indicates malignancy. A leiomyoma is commonly known as a fibroid.
Question 10: Information Systems and Technology
"Data Mining" is the process of:
A. Digging for old paper files in a basement.
B. Discovering patterns and trends in large sets of data using software.
C. Deleting duplicate patient records.
D. Installing new fiber optic cables.
Answer: B. Discovering patterns and trends in large sets of data using software.
Rationale: Data mining uses statistical algorithms to find correlations within "Big Data,"
which can help predict patient outcomes or manage costs.
Question 11: Access and Security
Under "FIPPA" (Freedom of Information and Protection of Privacy Act) in many
Canadian provinces, "Privacy" refers to:
A. The right of an individual to control their own personal information.
B. The right of the government to see everything you do.
C. The hospital's right to sell your data to advertisers.
D. Keeping your medical record in a locked box under your bed.
Certification – 350+ Verified Q&A & Rationales
Prepare for your Canadian HIM certification with this comprehensive CHIMA NCE
2026 study guide featuring over 350 verified practice questions. It provides in-depth
rationales for critical domains including data quality standards, privacy legislation
(PIPEDA/PHIPA), and health information lifecycle management. Fully updated for the
2026 testing cycle, this resource is designed to help you master the professional
practice standards required to earn your CHIM designation on the first attempt.
Which of the following is the primary purpose of a "Discharge Summary"?
A. To provide a list of every nurse who saw the patient.
B. To provide a concise overview of the patient's hospitalization for follow-up care
providers.
C. To bill the patient for their stay.
D. To document the patient's food preferences for the next visit.
Answer: B. To provide a concise overview of the patient's hospitalization for
follow-up care providers.
Rationale: The discharge summary is a critical communication tool that summarizes the
reason for admission, significant findings, procedures performed, and the plan for
follow-up care.
Question 2: Biomedical Sciences
What is the medical term for "shingles"?
A. Varicella
B. Herpes Zoster
C. Rubella
D. Variola
Answer: B. Herpes Zoster
,Rationale: Herpes Zoster is the reactivation of the varicella-zoster virus (which causes
chickenpox) in the body, resulting in a painful, blistering skin rash.
Question 3: Health Information Analysis
Which statistical measure is most affected by "outliers" (extreme values) in a data set?
A. Median
B. Mode
C. Mean
D. Range
Answer: C. Mean
Rationale: Because the mean (average) is calculated by summing all values, one
extremely high or low number will pull the average significantly toward that outlier.
Question 4: Access and Security
Which of the following is a "Technical" safeguard?
A. Staff training on privacy laws.
B. Using a shredding service for paper records.
C. Automatic log-off after a period of inactivity.
D. Checking a new employee's references.
Answer: C. Automatic log-off after a period of inactivity.
Rationale: Technical safeguards are the technology and policy measures used to
protect electronic PHI, such as encryption, access controls, and session timeouts.
Question 5: Information Systems and Technology
A "Legacy System" is best described as:
A. A brand-new system just installed yesterday.
B. An older computer system or application that is still in use but may not be compatible
with newer systems.
C. A system used only by the hospital's CEO.
D. A backup generator for the server room.
Answer: B. An older computer system or application that is still in use but may not
be compatible with newer systems.
,Rationale: Legacy systems are often kept because they contain vital historical data, but
they can pose challenges for interoperability and security.
Question 6: Ethics and Practice
According to the CHIMA Code of Ethics, if an HIM professional notices a coding error
that resulted in an overpayment, they should:
A. Ignore it to save the hospital money.
B. Correct the error and notify the appropriate department to return the overpayment.
C. Keep the information to use as leverage against their boss.
D. Wait for an external auditor to find it first.
Answer: B. Correct the error and notify the appropriate department to return the
overpayment.
Rationale: The Code of Ethics requires HIM professionals to maintain the integrity of
health information and ensures that coding and billing are accurate and honest.
Question 7: Health Care Systems in Canada
What does "Universality" mean in the context of the Canada Health Act?
A. All services are free everywhere in the world.
B. Every person is entitled to health care regardless of where they live in Canada.
C. All residents of a province/territory must be covered by the public health insurance
plan on uniform terms and conditions.
D. Everyone must see the same doctor.
Answer: C. All residents of a province/territory must be covered by the public
health insurance plan on uniform terms and conditions.
Rationale: Universality prevents discrimination in health coverage; all residents must
have access to the same level of insured services.
Question 8: Health Information Science
What is "Concurrent Coding"?
A. Coding that happens 10 years after a patient dies.
B. Coding that takes place while the patient is still receiving treatment in the facility.
C. Coding that is done by two people at the exact same time.
D. Coding that only uses computer software without human review.
, Answer: B. Coding that takes place while the patient is still receiving treatment in
the facility.
Rationale: Concurrent coding helps with real-time clinical documentation improvement
(CDI) and allows for more accurate resource tracking while the patient is still in-house.
Question 9: Biomedical Sciences
Which of the following is a "benign" tumor of the smooth muscle?
A. Leiomyoma
B. Leiomyosarcoma
C. Adenocarcinoma
D. Lipoma
Answer: A. Leiomyoma
Rationale: The suffix "-oma" usually indicates a benign tumor, whereas "-sarcoma"
indicates malignancy. A leiomyoma is commonly known as a fibroid.
Question 10: Information Systems and Technology
"Data Mining" is the process of:
A. Digging for old paper files in a basement.
B. Discovering patterns and trends in large sets of data using software.
C. Deleting duplicate patient records.
D. Installing new fiber optic cables.
Answer: B. Discovering patterns and trends in large sets of data using software.
Rationale: Data mining uses statistical algorithms to find correlations within "Big Data,"
which can help predict patient outcomes or manage costs.
Question 11: Access and Security
Under "FIPPA" (Freedom of Information and Protection of Privacy Act) in many
Canadian provinces, "Privacy" refers to:
A. The right of an individual to control their own personal information.
B. The right of the government to see everything you do.
C. The hospital's right to sell your data to advertisers.
D. Keeping your medical record in a locked box under your bed.
