2
CRIS TEST questions with accurate detailed solutions
|| || || || || ||
Purposes of medical record - ✔✔1. To provide a communication tool between all healthcare
|| || || || || || || || || || || || ||
providers. A physician, nurse, and any healthcare professional that treats the patient will
|| || || || || || || || || || || || || ||
complete documentation within the medical records
|| || || || || ||
2. To provide documentation regarding diagnosis, treatment, and care of the patient while
|| || || || || || || || || || || || ||
to find a receiving services from a healthcare facility.
|| || || || || || || ||
3. To provide information needed for medical billing of services rendered to the patient and
|| || || || || || || || || || || || || || ||
hospital financial management. || ||
4. To provide a medium for analysis, study, and evaluation of the quality of care given to a
|| || || || || || || || || || || || || || || || || ||
patient.
5. To assist in protecting the legal rights of the patients, the healthcare facility, and other
|| || || || || || || || || || || || || || || ||
healthcare providers. ||
A master patient index (MPI) - ✔✔Tool gathered to obtain the complete medical record. (Is
|| || || || || || || || || || || || || || ||
electronic medical database that holds information on every patient registered at a
|| || || || || || || || || || || ||
healthcare organization.) ||
Discharge summary - ✔✔Summary of treatment the patient received. Includes the diagnosis
|| || || || || || || || || || ||
of their ailment. This is usually a transcribed report.
|| || || || || || || || ||
history and physical - ✔✔Reflects the history of the patients disease or injury, as well as the
|| || || || || || || || || || || || || || || ||
history of treatment. Usually transcribed, but may be hand written at the beginning of the
|| || || || || || || || || || || || || || || ||
progress notes. ||
Electrocardiogram (EKG or ECG) & electroencephalogram (eeg) - ✔✔These are specialized || || || || || || || || || || ||
tests for the heart (EKG) and the brain (EEG) that produce strips of findings that may be
|| || || || || || || || || || || || || || || || ||
mounted on individual pages. || || ||
, 2
Pulmonary function test (PFT) - ✔✔A test designed to measure how well the lungs are
|| || || || || || || || || || || || || || ||
working usually found in the respiratory section.
|| || || || || ||
Operative report - ✔✔This is a summary report of the operation including a description of
|| || || || || || || || || || || || || || ||
what was done and the findings.
|| || || || ||
Pathology report - ✔✔An analysis of anything removed from the patient during the
|| || || || || || || || || || || || ||
operation (i.e. To check for cancer) || || || || ||
Continuity of care document (CCD) - ✔✔The CCD is generated from an electronic health
|| || || || || || || || || || || || || ||
record (EHR). It is a summary data set with demographic & clinical information about a
|| || || || || || || || || || || || || || ||
patients healthcare covering one of more encounters.
|| || || || || ||
Who owns the medical record? - ✔✔It is the property of the facility in which it was
|| || || || || || || || || || || || || || || || ||
created.
Which law is stronger if in conflict? State or federal? - ✔✔Whichever is stricter than the 2
|| || || || || || || || || || || || || || || || ||
with more privacy protection will prevail.
|| || || || ||
Examples of a breach of confidentiality - ✔✔1. Disclosing the wrong patient's health
|| || || || || || || || || || || || ||
information or wrong type of information or dates. || || || || || || || ||
2. Releasing records without a valid authorization
|| || || || || ||
3. Elevator, cafeteria, or hallway talk about private patient information
|| || || || || || || || ||
4. Faxing records to an incorrect fax number
|| || || || || || ||
5. Tossing discarded copies of the patient's record without shredding or placement in a
|| || || || || || || || || || || || || ||
recycle bin ||
6. Taking records or copies of records home for personal use
|| || || || || || || || || ||
7. Leaving records open on counters, desks and any unauthorized area
|| || || || || || || || || ||
8. Discussing patient information with friends or family members
|| || || || || || || ||
CRIS TEST questions with accurate detailed solutions
|| || || || || ||
Purposes of medical record - ✔✔1. To provide a communication tool between all healthcare
|| || || || || || || || || || || || ||
providers. A physician, nurse, and any healthcare professional that treats the patient will
|| || || || || || || || || || || || || ||
complete documentation within the medical records
|| || || || || ||
2. To provide documentation regarding diagnosis, treatment, and care of the patient while
|| || || || || || || || || || || || ||
to find a receiving services from a healthcare facility.
|| || || || || || || ||
3. To provide information needed for medical billing of services rendered to the patient and
|| || || || || || || || || || || || || || ||
hospital financial management. || ||
4. To provide a medium for analysis, study, and evaluation of the quality of care given to a
|| || || || || || || || || || || || || || || || || ||
patient.
5. To assist in protecting the legal rights of the patients, the healthcare facility, and other
|| || || || || || || || || || || || || || || ||
healthcare providers. ||
A master patient index (MPI) - ✔✔Tool gathered to obtain the complete medical record. (Is
|| || || || || || || || || || || || || || ||
electronic medical database that holds information on every patient registered at a
|| || || || || || || || || || || ||
healthcare organization.) ||
Discharge summary - ✔✔Summary of treatment the patient received. Includes the diagnosis
|| || || || || || || || || || ||
of their ailment. This is usually a transcribed report.
|| || || || || || || || ||
history and physical - ✔✔Reflects the history of the patients disease or injury, as well as the
|| || || || || || || || || || || || || || || ||
history of treatment. Usually transcribed, but may be hand written at the beginning of the
|| || || || || || || || || || || || || || || ||
progress notes. ||
Electrocardiogram (EKG or ECG) & electroencephalogram (eeg) - ✔✔These are specialized || || || || || || || || || || ||
tests for the heart (EKG) and the brain (EEG) that produce strips of findings that may be
|| || || || || || || || || || || || || || || || ||
mounted on individual pages. || || ||
, 2
Pulmonary function test (PFT) - ✔✔A test designed to measure how well the lungs are
|| || || || || || || || || || || || || || ||
working usually found in the respiratory section.
|| || || || || ||
Operative report - ✔✔This is a summary report of the operation including a description of
|| || || || || || || || || || || || || || ||
what was done and the findings.
|| || || || ||
Pathology report - ✔✔An analysis of anything removed from the patient during the
|| || || || || || || || || || || || ||
operation (i.e. To check for cancer) || || || || ||
Continuity of care document (CCD) - ✔✔The CCD is generated from an electronic health
|| || || || || || || || || || || || || ||
record (EHR). It is a summary data set with demographic & clinical information about a
|| || || || || || || || || || || || || || ||
patients healthcare covering one of more encounters.
|| || || || || ||
Who owns the medical record? - ✔✔It is the property of the facility in which it was
|| || || || || || || || || || || || || || || || ||
created.
Which law is stronger if in conflict? State or federal? - ✔✔Whichever is stricter than the 2
|| || || || || || || || || || || || || || || || ||
with more privacy protection will prevail.
|| || || || ||
Examples of a breach of confidentiality - ✔✔1. Disclosing the wrong patient's health
|| || || || || || || || || || || || ||
information or wrong type of information or dates. || || || || || || || ||
2. Releasing records without a valid authorization
|| || || || || ||
3. Elevator, cafeteria, or hallway talk about private patient information
|| || || || || || || || ||
4. Faxing records to an incorrect fax number
|| || || || || || ||
5. Tossing discarded copies of the patient's record without shredding or placement in a
|| || || || || || || || || || || || || ||
recycle bin ||
6. Taking records or copies of records home for personal use
|| || || || || || || || || ||
7. Leaving records open on counters, desks and any unauthorized area
|| || || || || || || || || ||
8. Discussing patient information with friends or family members
|| || || || || || || ||
