CDIP PRACTICE REAL EXAM 2 FINAL
ASSESSMENT SCRIPT 2026 SOLVED
QUESTIONS AND ANSWERS
◉ A patient presents with a myocardial infarction (MI) and
intervention was carried out. It was noted the patient does have
coronary artery disease (CAD). The consulting physician has stated
to staff the CAD should be sequenced first. What should be the
principal diagnosis?
a.CAD
b.MI
c.Chest pain
d.Ill-defined condition
Answer: b No, the consultant's advice is not correct. Sequence the
AMI as the principal diagnosis since it is the acute condition and the
reason for the admission. You should continue to follow correct
coding and reporting practices and report the AMI as the principal
diagnosis (AHA Third Quarter 2009, 9-10. AHA, First Quarter 2012,
7).
◉ At times, patients present to the hospital with hematoma. There is
noted midline shift of mass effect. Based on the diagnosis, signs or
symptoms, and treatment:
a.The CDS could consider mass effect query
,b.The CDS could consider cerebral blood clot query
c.The CDS could consider brain compression query
d.The CDS could have no considerations
Answer: c The coder should query the provider and if the provider
clarifies and documents that the mass effect or midline shift is brain
compression, the coder may then assign a code for the brain
compression (AHA 2011, 11).
◉ If a patient is given Levophed, the patient is most likely being
treated for which of the following diagnoses?
a.Shock
b.Infection
c.Hemorrhage
d.Infarction
Answer: a This is a treatment for shock (septic and cardiogenic).
(Society of Critical Care Medicine 2013)
◉ A 68-year-old nursing home patient with status post CVA 2 weeks
ago presents via the emergency department with a 1-day history of
fever, and elevated blood sugars in the 180-210 range. The patient
has stated they have significant pain of the right buttock since the
previous admission. The patient has a history of diabetes, and is on
long-term insulin. On physical exam, it is noted the patient had a
fever of 101.3 with purulent drainage with exposure of
subcutaneous fat. This type of ulcer can be called a:
,a.Stage I
b.Stage II
c.Stage III
d.Stage IV
Answer: c This is a Stage III ulcer; Full thickness skin loss. The
National Pressure Ulcer Advisory Panel (NPUAP) has redefined the
definition of a pressure ulcer and the stages of pressure ulcers. (AHA
Fourth Quarter 2008, 132)
◉ This catheter is inserted into larger, deeper veins such as the
subclavian, jugular, or femoral veins. The catheter is then advanced
into the superior vena cava leading directly to the heart.
a.Peripherally inserted central catheter (PICC)
b.Vascular access device (VAD)
c.Central venous catheter
d.None of the above
Answer: c Central venous catheters are inserted into larger, deeper
veins such as the subclavian, jugular, or femoral veins. The catheter
is then advanced into the superior vena cava leading directly to the
heart. Central venous catheters may be inserted by physicians, but
are often inserted by other specially trained personnel such as
physician assistants, nurse practitioners, or critical care nurses.
Central venous catheterization is usually performed in the
subclavian vein by a subclavicular approach. Another site is the
internal jugular vein. The femoral vein is used infrequently because
, of concern over deep vein thrombosis (DVT) (AHA First Quarter
1996, 3-4).
◉ Within 2 hours following surgery, a 68 year-old female began to
develop noisy breathing, fever, tachypnea, chest discomfort, and
cough. Chest x-ray was performed which showed increased
interstitial markings, lobar consolidation, and atelectasis. The
physician documented pneumonia; concern for aspiration. The
patient was started on Cefepime. The CDS would most likely query
for:
a.Postoperative aspiration pneumonia
b.Respiratory failure
c.Bacterial pneumonia
d.No query needed
Answer: a Postprocedural aspiration pneumonia was developed to
uniquely capture this condition and distinguish it from other
respiratory complications Query as appropriate utilizing
appropriate query format. (AHIMA 2013b).
◉ Patient is admitted with acute congestive heart failure treated
with diuretics and education. The patient also had atrial fibrillation
which the physician stated as the cause of the heart failure. Which
condition should be assigned as principal?
a.Coding rules state query should be performed
b.The condition documented as causing the admission
ASSESSMENT SCRIPT 2026 SOLVED
QUESTIONS AND ANSWERS
◉ A patient presents with a myocardial infarction (MI) and
intervention was carried out. It was noted the patient does have
coronary artery disease (CAD). The consulting physician has stated
to staff the CAD should be sequenced first. What should be the
principal diagnosis?
a.CAD
b.MI
c.Chest pain
d.Ill-defined condition
Answer: b No, the consultant's advice is not correct. Sequence the
AMI as the principal diagnosis since it is the acute condition and the
reason for the admission. You should continue to follow correct
coding and reporting practices and report the AMI as the principal
diagnosis (AHA Third Quarter 2009, 9-10. AHA, First Quarter 2012,
7).
◉ At times, patients present to the hospital with hematoma. There is
noted midline shift of mass effect. Based on the diagnosis, signs or
symptoms, and treatment:
a.The CDS could consider mass effect query
,b.The CDS could consider cerebral blood clot query
c.The CDS could consider brain compression query
d.The CDS could have no considerations
Answer: c The coder should query the provider and if the provider
clarifies and documents that the mass effect or midline shift is brain
compression, the coder may then assign a code for the brain
compression (AHA 2011, 11).
◉ If a patient is given Levophed, the patient is most likely being
treated for which of the following diagnoses?
a.Shock
b.Infection
c.Hemorrhage
d.Infarction
Answer: a This is a treatment for shock (septic and cardiogenic).
(Society of Critical Care Medicine 2013)
◉ A 68-year-old nursing home patient with status post CVA 2 weeks
ago presents via the emergency department with a 1-day history of
fever, and elevated blood sugars in the 180-210 range. The patient
has stated they have significant pain of the right buttock since the
previous admission. The patient has a history of diabetes, and is on
long-term insulin. On physical exam, it is noted the patient had a
fever of 101.3 with purulent drainage with exposure of
subcutaneous fat. This type of ulcer can be called a:
,a.Stage I
b.Stage II
c.Stage III
d.Stage IV
Answer: c This is a Stage III ulcer; Full thickness skin loss. The
National Pressure Ulcer Advisory Panel (NPUAP) has redefined the
definition of a pressure ulcer and the stages of pressure ulcers. (AHA
Fourth Quarter 2008, 132)
◉ This catheter is inserted into larger, deeper veins such as the
subclavian, jugular, or femoral veins. The catheter is then advanced
into the superior vena cava leading directly to the heart.
a.Peripherally inserted central catheter (PICC)
b.Vascular access device (VAD)
c.Central venous catheter
d.None of the above
Answer: c Central venous catheters are inserted into larger, deeper
veins such as the subclavian, jugular, or femoral veins. The catheter
is then advanced into the superior vena cava leading directly to the
heart. Central venous catheters may be inserted by physicians, but
are often inserted by other specially trained personnel such as
physician assistants, nurse practitioners, or critical care nurses.
Central venous catheterization is usually performed in the
subclavian vein by a subclavicular approach. Another site is the
internal jugular vein. The femoral vein is used infrequently because
, of concern over deep vein thrombosis (DVT) (AHA First Quarter
1996, 3-4).
◉ Within 2 hours following surgery, a 68 year-old female began to
develop noisy breathing, fever, tachypnea, chest discomfort, and
cough. Chest x-ray was performed which showed increased
interstitial markings, lobar consolidation, and atelectasis. The
physician documented pneumonia; concern for aspiration. The
patient was started on Cefepime. The CDS would most likely query
for:
a.Postoperative aspiration pneumonia
b.Respiratory failure
c.Bacterial pneumonia
d.No query needed
Answer: a Postprocedural aspiration pneumonia was developed to
uniquely capture this condition and distinguish it from other
respiratory complications Query as appropriate utilizing
appropriate query format. (AHIMA 2013b).
◉ Patient is admitted with acute congestive heart failure treated
with diuretics and education. The patient also had atrial fibrillation
which the physician stated as the cause of the heart failure. Which
condition should be assigned as principal?
a.Coding rules state query should be performed
b.The condition documented as causing the admission
