CH.9 LEGAL HEALTH RECORD:
MAINTENANCE, CONTENT,
DOCUMENTATION, AND DISPOSITION 2026
ACTUAL QUESTIONS WITH VERIFIED
ANSWERS.
Who has the ultimate legal responsibility for the quality of care
rendered in a healthcare organization? - correct answer-A.
Governing Body
B. Medical Staff
C. Administration
D. Providers
Answer: A
Which Act served to make electronic transactions as
enforceable as paper transactions? - correct answer-A. Patient
Self-Determination Act
B. Uniform Electronic Transactions Act
C. Health Care Quality Improvement Act
D. Best Evidence Act
Answer: B
,A countersignature _____> - correct answer-Signifies review
and evaluation of the first providers entry
A personal health record (PHR) ___. - correct answer-may be
housed in a system that a provider owns and controls
Staff disagreements within the health record should be __. -
correct answer-Avoided
Legally, which of the following is the most important in
determining the length of time that a hospital must retain
medical records ? - correct answer-Statute of limitations
A goal of E-SIGN legislation was to - correct answer-give
electronic signatures increased legal standing
Auto-authentication - correct answer-contradicts basic
authentication standards
, Marci, a health information professional is speaking to a high
school class of potential future HIMS professionals about
documentation in a health record. The students are surprised to
learn from Marci that changes to heath record entries ___. -
correct answer-Are indicative of negligent care
In general, the Uniform Photographic Copies of Business and
Public Records as Evidence Act (UPA) does which of the
following? - correct answer-B. Allows record reproductions to
be admitted as evidence
Which of the following statements about the "legal health
record" or the "designated record set" is incorrect? - correct
answer-D. Designated record set is determined by medical staff
Destruction of health records ___. - correct answer-may be a
prudent business practice
Business Record - correct answer--Made & kept in usual
course of business at or near the time of a recorded event
MAINTENANCE, CONTENT,
DOCUMENTATION, AND DISPOSITION 2026
ACTUAL QUESTIONS WITH VERIFIED
ANSWERS.
Who has the ultimate legal responsibility for the quality of care
rendered in a healthcare organization? - correct answer-A.
Governing Body
B. Medical Staff
C. Administration
D. Providers
Answer: A
Which Act served to make electronic transactions as
enforceable as paper transactions? - correct answer-A. Patient
Self-Determination Act
B. Uniform Electronic Transactions Act
C. Health Care Quality Improvement Act
D. Best Evidence Act
Answer: B
,A countersignature _____> - correct answer-Signifies review
and evaluation of the first providers entry
A personal health record (PHR) ___. - correct answer-may be
housed in a system that a provider owns and controls
Staff disagreements within the health record should be __. -
correct answer-Avoided
Legally, which of the following is the most important in
determining the length of time that a hospital must retain
medical records ? - correct answer-Statute of limitations
A goal of E-SIGN legislation was to - correct answer-give
electronic signatures increased legal standing
Auto-authentication - correct answer-contradicts basic
authentication standards
, Marci, a health information professional is speaking to a high
school class of potential future HIMS professionals about
documentation in a health record. The students are surprised to
learn from Marci that changes to heath record entries ___. -
correct answer-Are indicative of negligent care
In general, the Uniform Photographic Copies of Business and
Public Records as Evidence Act (UPA) does which of the
following? - correct answer-B. Allows record reproductions to
be admitted as evidence
Which of the following statements about the "legal health
record" or the "designated record set" is incorrect? - correct
answer-D. Designated record set is determined by medical staff
Destruction of health records ___. - correct answer-may be a
prudent business practice
Business Record - correct answer--Made & kept in usual
course of business at or near the time of a recorded event
