Professional review guide for the RHIA and RHIT Examination 2011 Edition

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Health Statistics and Research

Sandy Beach Hospital reports 1,652 discharges for September. The infection control report documents 21 nosocomial infections and 27 community-acquired infections for the same month. What is the community-acquired infection rate?

A. 1.3
B. 1.4
C. 1.6
D. 2.9

C (27 × 100) / 1,652 = 1.6%

Physicians at South Seas Clinic are expected to see six patients per hour, on average. The physicians with the highest productivity each week are exempted from on-call responsibilities for the weekend. Which physician will get the weekend off this week?

SOUTH SEAS CLINIC PHYSICIAN PRODUCTIVITY
Week 1 January 2010
PHYSICIAN NAME NUMBER OF HOURS WORKED NUMBER OF PATIENTS SEEN
Robinson 32 185
Beasley 30 161
Hiltz 35 200
Wolf 26 157

A. Robinson
C. Hiltz
B. Beasley
D. Wolf

D Calculate the answer as follows:
PHYSICIAN
NAME NUMBER OF
HOURS WORKED NUMBER OF
PATIENTS SEEN NUMBER OF PATIENTS SEEN PER
HOUR WORKED
Robinson 32 1 85 1 85/32 = 5.78
Beasley 30 1 61 1 61 /30 = 5.37
Hiltz 35 200 200/35 = 5.71
Wolf 26 1 57 1 57/26 = 6.04

If there are 150,000 medical records and the Health Information Department receives 3,545 requests for records in a week, what percentage of the records are requested weekly?

A. 2.4%
B. 3.5%
C. 4.6%
D. 5.1%

A 3,545 requested records × 100 / 150,000 total records = 354,500/150,000 = 2.36 = 2.4%.

You are conducting a study on the pain associated with a specific illness. For the purpose of your study, you classify pain level as follows:
CODE PAIN LEVEL (as described by the patient)
01 None
02 Little or Minimal
03 Moderate
04 Heavy
05 Severe
This data is best described as

A. discrete.
B. continuous.
C. nominal.
D. ordinal.

D

You are choosing restaurants where you might eat while you are in Chicago at the AHIMA Leadership Conference. You have collected the following information about four possible lunch restaurants that are all located within easy walking distance of the meeting site. The data is displayed below:
RESTAURANT NAME MEAN LUNCH COST STANDARD DEVIATION
Bon Appetite $8.00 0.75
Mario's $7.50 1
Au Courant $9.00 1.25
The Windy City Grill $7.50 1.5

You want to stay within the reimbursement rate allowed by your Component State Association, so it is important to you that you have at least a 95% chance of eating a lunch that costs no more than $10.00. Therefore, when lunchtime comes, you head to

A. Bon Appetite or Mario's.
B. Mario's or Au Courant.
C. Au Courant or The Windy City Grill.
D. The Windy City Grill or Bon Appetite.

A CALCULATIONS: 95% of the observations fall within two standard deviations of the mean, so the cost of a lunch at Bon Appetite will be between $6.50
[8 - (2 × 0.75)] and $9.50 [8 + (2 × 0.75)].
Lunch at Mario's will be between $5.50 [7.5 - (2 × 1)] and $9.50 [7.5 + (2 × 1)].
Lunch at Au Courant will cost too much [$9 + (2 × 1.25) = $11.50].
As will the Windy City Grill [$7.50 (2 × 1.5) = $10.50].

Organizations collect statistics to increase their knowledge of a specified population. The knowledge does not come automatically —it is developed in the following sequence:

A. data → facts → information → knowledge.
B. data → information → facts → knowledge.
C. facts → data → information → knowledge.
D. facts → information → data → knowledge.

Questions 7 and 8 are based on the study and data below.
The coding supervisor at Bayside Hospital regularly has the coders recode records from the previous week in an effort to improve and monitor coding consistency. The supervisor has collected the data displayed below on four coders.
Coder Records Under Review Same Code on Self-Coding Review Same Code on Peer Coding Review
Coder A 28 22 20
Coder B 18 16 16
Coder C 45 42 43
Coder D 17 15 16

B

The data in the column on the far right were collected when the coders traded records for recoding. This is a common practice used to check

A. interrater reliability.
B. intrarater reliability.
C. interrater validity.
D. intrarater validity.

Coder Records Under Review Same Code on Self-Coding Review Same Code on Peer Coding Review
Coder A 28 22 20
Coder B 18 16 16
Coder C 45 42 43
Coder D 17 15 16

A

The coder with the highest overall accuracy rating will get the day after Thanksgiving off. Which coder will get to spend the day after Thanksgiving off rather than coding?

A. Coder A
B. Coder B
C. Coder C
D. Coder D

C Calculations:

Which of the following interactions fit the definition of a patient encounter?
Phyllis saw Dr. Holland during a scheduled office visit. Dr. Holland prescribed a new medication. Jean called Dr. Holland with a question about her medication. Dr. Holland returned the telephone call and answered Jean's question. Howard was seen by Dr. Holland in the hospital emergency department after having a reaction to his medication. The pharmacy received telephone approval from Dr. Horton for a refill on Jackson's prescription.

A. Phyllis, Jean, Howard, and Jackson
B. Jackson, Howard, and Jean
C. Jean, Phyllis, and Howard
D. Phyllis and Howard

D

A small portion of the form you are using for a research study is reproduced below.

Male 1
Female 2
This is an example of

A. ordinal data.
B. ranked data.
C. nominal data.
D. discrete data.

C

You have made a list of the advantages and disadvantages of a measure of central tendency:
ADVANTAGES DISADVANTAGES
Easy to obtain and interpret May not be descriptive of the distribution
Not sensitive to extreme observations in the frequency distribution May not be unique
Easy to communicate and explain to others Does not provide information about the entire distribution
The measure of central tendency you are describing is the

A. mean.
B. median.
C. range.
D. mode.

D

Office Visit ID Number Minutes with the Physician Physician
508-123 5 Robinson
508-124 9 Robinson
508-125 8 Beasley
508-126 12 Wolf
508-127 6 Beasley
508-128 7 Beasley
508-129 5 Wolf
508-130 10 Baumstark
508-131 7 Baumstark
508-132 9 Robinson
508-133 11 Wolf

12. The median number of minutes with the physician (considering all physicians) is

A. 7 minutes.
B. 8 minutes.
C. 8.4 minutes.
D. 9 minutes.

B

Office Visit ID Number Minutes with the Physician Physician
508-123 5 Robinson
508-124 9 Robinson
508-125 8 Beasley
508-126 12 Wolf
508-127 6 Beasley
508-128 7 Beasley
508-129 5 Wolf
508-130 10 Baumstark
508-131 7 Baumstark
508-132 9 Robinson
508-133 11 Wolf

13. The mean number of minutes with the physician (considering all physicians) is

A. 7 minutes.
B. 8 minutes.
C. 8.4 minutes.
D. 9 minutes.

B Calculation: 5 + 9 + 8 + 12 + 6 + 7 + 5 + 10 + 7 + 9 + 11 = 89/11 = 8.09

Office Visit ID Number Minutes with the Physician Physician
508-123 5 Robinson
508-124 9 Robinson
508-125 8 Beasley
508-126 12 Wolf
508-127 6 Beasley
508-128 7 Beasley
508-129 5 Wolf
508-130 10 Baumstark
508-131 7 Baumstark
508-132 9 Robinson
508-133 11 Wolf

14. Which physician spent the longest average time with patients on that day?

A. Beasley
B. Wolf
C. Baumstark
D. Robinson

B Calculate the mean time each physician spent with patients as follows: PHYSICIAN TIMES WITH
PATIENTS AVERAGE (MEAN) TIME
WITH PATIENTS
Beasley 8, 6, 7 7
Robinson 5, 9, 9 7.7
Baumstark 1 0, 7 8.5
Wolf 1 2, 5, 1 1 9.3

Use this portion of yesterday's discharges printout.
Patient # Admit Date Service Physician ID Room # LOS
12-32-21 1/02/08 MED 212 44-A 13
12-32-22 1/02/08 SURG 218 32 13
12-32-85 1/14/08 PEDS 214 23-B 1
11 -99-94 1/12/08 MED 212 46-A 3
10-93-23 1/10/08 MED 212 45 5
12-35-94 1/11/08 SURG 218 33 4
10-85-14 1/01/08 PEDS 214 23-A 14

Without even performing any complex calculations, you can get a quick, simple measure of dispersion in the LOS for yesterday's discharges by computing the
A. range of the data set.
B. mean of the data set.
C. variance of the data set.
D. coefficient of variation of the data set.

A

Patient # Admit Date Service Physician ID Room # LOS
12-32-21 1/02/08 MED 212 44-A 13
12-32-22 1/02/08 SURG 218 32 13
12-32-85 1/14/08 PEDS 214 23-B 1
11 -99-94 1/12/08 MED 212 46-A 3
10-93-23 1/10/08 MED 212 45 5
12-35-94 1/11/08 SURG 218 33 4
10-85-14 1/01/08 PEDS 214 23-A 14

16. Looking more closely at the LOS for these patients, when you calculate the standard deviation on the data, you would expect:

A. a large standard deviation because the dispersion is large.
B. a small standard deviation because the dispersion is small.
C. a large standard deviation because the dispersion is small.
D. a small standard deviation because the dispersion is large

A

Englewood Health Center collected the following data on patients discharged on January 1, 2010. Which measure of central tendency would be most affected by Mallory's extremely long LOS?
Patient Name Length of Stay
Ben 1
Josh 2
Emma 3
Bryan 4
Mallory 29
Taylor 2
Matthew 3
Aiden 2
Trevor 4
Tyler 2
B. Median
C. Mean
D. Mode

C

The major purpose of random assignment in a clinical trial is to

A. reduce selection bias in allocation of treatment.
B. help ensure that study subjects are representative of the general population.
C. facilitate double-blinding.
D. ensure that the study groups are comparable on baseline characteristics.

A

Patients in the pediatrics ward were studied to determine their favorite color. The survey results are listed below. The results of the favorite color study are reported in a


REPORTED FAVORITE COLOR OF PEDIATRIC PATIENTS
AZURE TIDES HOSPITAL
JANUARY 18, 2010
FAVORITE COLOR NUMBER OF RESPONDENTS
RED 12
GREEN 14
BLUE 22
YELLOW 18
ORANGE 16

A. frequency polygon.
B. line graph.
C. frequency distribution.
D. systematic fashion.

C

All of the following items mean the same thing, EXCEPT

A. inpatient service day.
B. daily inpatient census.
C. daily census.
D. inpatient census.

D

Pasadena Bay Hospital reports an average LOS in February of 3.7 days with a standard deviation of 20. This tells us that

A. most patients had a LOS of 3-4 days.
B. there was a small variation in the LOS.
C. patients at Pasadena Bay stay longer than average.
D. there was a large variation in the LOS.

D

Jason collected data on the length of stay (LOS) for 10 patients and then determined the median
LOS as follows:
1



← median
2
4
3
1
3
2
4
2
8

What is wrong with Jason's determination of the median?

A. There is nothing wrong with Jason's determination of the median.
B. Jason forgot to put the numbers in sequential order before determining the median.
C. It is not possible to determine the median on such a small number of data points.
D. It is not possible to determine the median on an even number of data points.

B

All Women's Hospital reports the following statistics:
Single births
Vaginal 40
c-section 0
Twin births
Twins—vaginal 12 (6 sets)
Twins—c-section 8 (4 sets)
Other multiple births 0
Intermediate fetal deaths
Vaginal 5
c-section 0
Late fetal deaths
Vaginal 2
c-section 0

How many deliveries occurred?

A. 50
B. 57
C. 60
D. 67

B 40 + 10 + 5 + 2 = 57

The inpatient census at midnight is 67. Two patients were admitted in the morning; one died 2 hours later; the second patient was transferred to another facility that same afternoon. The inpatient service days for that day will be

A. 65.
B. 67.
C. 68.
D. 69.

D 67 + 2 = 69 admissions/discharges same day (Transfers to other facilities and deaths are forms of discharge)

Bayside Hospital has 275 adult beds, 30 pediatric beds, and 40 bassinets. In a nonleap year, inpatient service days were 75,860 for adults, 7,100 for pediatrics, and 11,800 for newborns. What was the average daily census for the year?

A. 227
B. 208
C. 207
D. 259

A (75,860 + 7,100) / 365 = 227
(Note: Average daily census includes adult and pediatrics, but NOT newborns.)

In order to derive the total inpatient service days for any given day, you would need to

A. subtract intra-hospital transfers from the inpatient census.
B. add same-day admits and discharges to the inpatient census.
C. add intra-hospital transfers to the inpatient census.
D. subtract same day admits and discharges from the inpatient census.

B

Mr. McDonaldson was admitted to your hospital at 10:45 PM on January 1. He died at 4:22 AM on
January 3. How many inpatient service days did Mr. McDonaldson receive?

A. 1
B. 2
C. 3
D. 4

B The day of admission is counted as an inpatient service day, but the day of discharge is not.

A patient admitted to the hospital on January 24 and discharged on February 9 has a length of stay of
A. 16 days.
B. 15 days.
C. 17 days.
D. 14 days.

A 1/24 - 31 = 8 days + 2/1 through 2/8 = 8 days so 8 + 8 = 16 (Count day of admission but not discharge)

Royal Palm Hospital has 500 beds and 55 bassinets. In February of a nonleap year, it reported the following statistics:
Inpatient service days
Adult and pediatric 12,345
Newborn 553
Discharges:
Adult and pediatric 1,351
Newborn 77
Discharge days
Adult and pediatric 9,457
Newborn 231

29. What was the percentage of occupancy for adults and pediatrics in February?

A. 84.8%
B. 88.2%
C. 79.6%
D. 80.5%

B (12,345 × 100) / (500 × 28) = 88.2%

Inpatient service days
Adult and pediatric 12,345
Newborn 553
Discharges:
Adult and pediatric 1,351
Newborn 77
Discharge days
Adult and pediatric 9,457
Newborn 231

30. What was the average length of stay at Royal Palm Hospital in February?
A. 6.8 days
B. 7 days
C. 9 days
D. 9.1 days

B 9,457 discharge days/1,351 discharges = 7 days. (Count the day of admission but not discharge.)

You are responsible for calculating and reporting average length of stay (ALOS) for your hospital each month. This month, there were 92 discharges, and the total discharge days equal 875. One of the patients discharged this month had a total of 428 discharge days, so the ALOS is distorted by this unusually long stay. In this situation, you should report an ALOS of

A. 9.51 days— no further information is necessary.
B. 9.61 days and make a note that the one patient with an unusually long LOS was subtracted prior to making the calculation.
C. 4.86 days and make a note that one unusually long LOS was subtracted prior to making the calculation.
D. 4.91 days and make a note that the data on one patient with an unusually long LOS was subtracted prior to making the calculation.

D Only two answers, A and D, are correctly calculated. Should you choose to include the unusually long LOS, you should make a note to avoid confusing readers, which makes the answer "A" a poor choice. Should you choose to eliminate the potentially confusing LOS, you must subtract both the patient from the total discharges and the discharge days from the total discharge days.

A hospital reported the following statistics during a nonleap year. Calculate the percentage of occupancy for the entire year.
Time Period Bed Count Inpatient Service Days
January 1 - May 31 200 28,690
June 1 -October 15 250 27,400
October 1 6-December 31 275 19,250
A. 85.2%
B. 88%
C. 90.0%
D. 91.2%

B (28,690 + 27,400 + 19,250) × 100 (151 × 200) + (137 × 250) + (77 × 275) = 88.0 = 88%

Lake City Health Center has 200 beds and 20 bassinets. In a nonleap year, Styles Hospital admitted 16,437 adults and children; 16,570 adults and children were discharged. There were 1,764 live births and 1,798 newborns discharged. The bed turnover rate for the year was
A. 82.2.
B. 82.7.
C. 82.9.
D. 93.5.

C Use the direct method, bed turnover. 16,570 adult and peds discharges/200 adult and peds beds = 82.85 = 82.9%

Sea Crest Hospital has 200 beds and 20 bassinets. There was a sudden spurt in the birth rate in the town in November. The hospital set up five additional bassinets for the entire month. Total bed count days for Sea Crest Hospital in a nonleap year would be:

A. 73,000.
B. 80,300.
C. 80,450.
D. 80,455.

A 200 beds × 365 days in a non leap year = 73,000 (note: bassinets are excluded)

Use the statistics provided in the table to compute the fetal death rate at All Women's Hospital for March.
All Women's Hospital March Statistics
Live births 225
Intermediate and late fetal deaths 5
Early fetal deaths 4
Newborn discharges 235

A. 4.0%
B. 1.78%
C. 2.2%
D. 1.77%

C (5 × 100) = 2.2% (225 + 5)

The number of births in the facility in October is:

A. 53.
B. 55.
C. 56.
D. 58.
DELIVERED TOTAL DELIVERED BY C-SECTION
Live
Single infant
Twins
50
3 sets
15
1 set
Dead
Early fetal
Late fetal
1
1
0
1

C 50 + (3 sets of twins × 2 births per set) = 56 births

The number of deliveries in the facility in October is

A. 53
B. 55
C. 56
D. 58

B Multiple births are one delivery; fetal deaths are counted as deliveries 50 + 3 + 1 + 1 = 55

Ocean View Healthcare Center recorded six fetal deaths during the last year; details are listed below:
Fetal Death Information
ID WEIGHT GESTATIONAL AGE
A 526 g 22 weeks
B 405 g 18 weeks
C 81 7 g 26 weeks
D 1,023 g 30 weeks
E 629 g 24 weeks
F 1,113 g 29 weeks

How should these deaths be counted in the hospital death rates?

A. All the deaths except B will be included in the gross death rate.
B. Deaths D and F will be included in the gross death rate.
C. Deaths C, D, and F will be included in the gross death rate.
D. None of these deaths will be included in the gross death rate.

D

William Rumple was pronounced dead on arrival (DOA). The hospital pathologist performed an autopsy on Mr. Rumple's body. This statistical event would be counted in the

A. net death rate.
B. gross death rate.
C. net autopsy rate.
D. hospital autopsy rate.

D

Tampa Bay Health Center discharged 6,069 adults/children and 545 newborns last year. A total of 1,648 adults/children and 1,279 newborns were seen in the emergency department. Information on the deaths at Happy Valley last year is listed below. Use the data to answer the next two questions.

INPATIENT DEATHS
Adult/child 245 < 48 hrs 105 > 48 hrs
Newborn 8 < 48 hrs 3 > 48 hrs

OUTPATIENT (ED) DEATHS
Adult/child 2
Newborn 0

FETAL DEATHS
Early 1
Intermediate 3
Late 2

What was the gross (hospital) death rate at Tampa Bay Health Center last year?

A. 3.8%
B. 5.4%
C. 5.5%
D. 5.6%

C Calculations: 361 total inpatient deaths × 100/6614 total discharges = 5.45 = 5.5% Fetal deaths and outpatient deaths are not included in this calculation.

INPATIENT DEATHS
Adult/child 245 < 48 hrs 105 > 48 hrs
Newborn 8 < 48 hrs 3 > 48 hrs

OUTPATIENT (ED) DEATHS
Adult/child 2
Newborn 0

FETAL DEATHS
Early 1
Intermediate 3
Late 2

41. What was the net death rate at Tampa Bay Health Center last year?

A. 1.6%
B. 1.7%
C. 1.8%
D. 1.9%

B Calculations: (108 total inpatient deaths > 48 hours) × 100 = 10800
(6,614 total discharges - 253 deaths < 48 hours) = 6,361 =1.697 = 1.7%

During the month of September, Superior Health Care Center had 1,382 inpatient discharges, including 48 deaths. There were 38 deaths over 48 hours. Statistics also show 4 fetal deaths, 3 DOAs, and 4 inpatient coroner's cases. Which of the following calculations is correct to figure the net death rate?

A. (48 × 100)/ (1,382 - 10)
B. (48-10 × 100)/ (1,382 - 10)
C. (1,382 × 100)/ (48 - 10)
D. (1,382 - 10) × 100/ (48 - 10)

B 48 - 38 deaths over 48 hours = 10 deaths less than 48 hours. (48 - 10) (100) (1,382 - 10)

The best form/graph for demonstrating trends over time would be

A. frequency polygon.
B. line graph.
C. pie chart.
D. histogram.

B

Joseph Woodley has been on a third floor nursing unit since October of 2009 and was finally discharged to a nursing home in December of 2010. When the average length of stay is calculated for the year 2010, this very long length of stay will

A. have little impact on the average length of stay.
B. result in a special cause variation in the average length of stay.
C. result in a small variation in the average length of stay.
D. result in a common cause variation in the average length of stay.

B

Still thinking about Mr. Woodley and his long stay, if you were to graph the ALOS for the facility for 2010, which of the following graphs would you expect to see?

A.



B.




C.




D.

C LOS would increase through the year and drop when patient is discharged.

The New Beginnings Maternity Center recorded the following statistics in December:
FETAL DEATHS
EARLY 240
INTERMEDIATE 40
LATE 32
BIRTHS 980
DELIVERIES 994
NEWBORN DISCHARGES 1,008

What was the fetal death rate at New Beginnings Maternity Center in December?

A. 6.8%
B. 7.3%
C. 7.4%
D. 31.8%

A (72 intermediate and late fetal deaths × 100) = 7,200 = 6.8% (980 births + 72 intermediate and late fetal deaths) 1052

The statistics reported for a 300-bed hospital for 1 year were 20,932 discharges with 136,651 discharge days and 3,699 consultations performed. What was the consultation rate for the year?

A. 16.5%
B. 17.0%
C. 17.7%
D. 18.0%

C (3,699 × 100) / 20,932 = 17.7%

Look at the graph grid displayed above. If you want to follow accepted principles for graph construction, you will follow the three-quarter-high rule. That means the

A. height of the graph should be three-fourths the length of the graph.
B. length of the graph should be three-fourths the height of the graph.
C. height of the graph should display three-fourths of the data in the graph.
D. length of the graph should display three-fourths of the data in the graph.

A

You are preparing data from a series of weight loss studies for display. The data collected during the study is as follows:

POUNDS LOST NUMBER IN GROUP
A WITH THIS WEIGHT LOSS NUMBER IN GROUP B
WITH THIS WEIGHT LOSS
7.5- 9.4 1 2
9.5-11.4 3 2
11.5-13.4 6 5
13.5-15.4 5 4
15.5-17.4 8 7
17.5-19.4 2 3

If you want to allow the reader to compare the results of Group A with those of Group B on one graphic display, your best choice would be to construct a

A. bar chart.
B. line graph.
C. histogram.
D. frequency polygon.

C

A distribution is said to be positively skewed when the mean is

A. bimodal.
B. multimodal.
C. shifted to the left.
D. shifted to the right.

D

You want to graph the number of patients admitted to three different medical staff services on each day of the last month. Because you have a large number of observations (one for each day of the month) and you want to be able to compare the observations for each of the three services on one data display, your best choice is a

A. table.
B. bar chart.
C. line graph.
D. histogram.

C

You have just constructed the chart displayed below:


The names of the hospital services are hard to read. The best way to deal with this problem would be to

A. construct a line graph instead of a bar chart.
B. use a column chart instead of a bar chart.
C. plot your primary variable along the × axis.
D. divide the data into two charts.

B

The display below is a


A. bar chart, which is commonly used to display continuous data.
B. bar chart, which is commonly used to display discrete data.
C. histogram, which is commonly used to display continuous data.
D. histogram, which is commonly used to display discrete data.

C

The data display below is a

A. normal distribution or curve.
B. positive skewed curve.
C. negative skewed curve.
D. heterogeneous curve.

A

What conclusion can you make from the pie graph below?

A. A pie graph should not be used, because there are too many categories for effective display.
B. A pie graph should not be used, because the data are representational instead of quantitative.
C. A pie graph should not be used, because the data are qualitative instead of quantitative.
D. A pie graph is a good choice and is often used to display this kind of data.

A

You are trying to improve communications with your staff by posting graphs of significant statistics on the employee bulletin board. You recently calculated the percentage of time employees spend on each of six major tasks. Because you would like the employees to appreciate each task as a percentage of their whole day, you will post these figures using a
A. line graph.
B. bar graph.
C. scatter diagram.
D. pie graph.

D

The graph below can best be described as

A. sequential.
B. multimodal.
C. substitutional.
D. erratic.

B

Looking at the data represented in the scatter diagram below, you would conclude that there is

A. no correlation between Variable A and Variable B.
B. a positive correlation between Variable A and Variable B.
C. a negative correlation between Variable A and Variable B.
D. a cause and effect relationship between Variable A and Variable B.

B

The data displayed in the histogram below could best be described as

A. negatively skewed.
B. positively skewed.
C. evenly distributed.
D. normally distributed.

A

You want to construct a data display for a frequency distribution. You will use a

A. frequency polygon or histogram.
B. frequency polygon or bar chart.
C. line graph or histogram.
D. line graph or bar chart.

A

Look at the graph below. It is an example of a

A. stacked bar chart; it is well constructed.
B. histogram; it is well constructed.
C. comparison bar chart; it is not well constructed.
D. frequency polygon; it is not well constructed.

A

The total number of infections at South Beach Hospital during the first quarter (January-March) of
2010 was

A. 6.
B. 12.
C. 22.
D. 38.

D

Look again at the graph you used for the last question. From this graph, you can assume that more people

A. were admitted to the facility with infections than without infections.
B. were admitted to the facility with infections than is typical for U.S. hospitals.
C. were admitted to the facility with infections than acquired infections in the hospital.
D. acquired infections in the hospital than were admitted with infections.

C

What is the biggest problem with the pie graph displayed above?

A. There is not enough variation in the patterns to clearly distinguish between females and children.
B. The total males and females do not equal the total children, adolescents, and adults.
C. There are no definitions for children, adolescents, and adults.
D. There is more than one variable displayed on the chart.

D

The chart above shows a normal distribution. What percentage of the cases fall within the two lines showing the standard distribution between -1 and +1 on either side of the mean?

A. 68%
B. 75%
C. 95%
D. 99%

A

A transcription supervisor collected the data displayed above. What kind of data display is it?
And, how many errors are attributed to skipped words?

A. This is a Pareto diagram; twelve (12) errors were due to skipped words.
B. This is a bar chart; eighteen (18) errors were due to skipped words.
C. This is a Pareto diagram; eighteen (18) errors were due to skipped words.
D. This is a bar chart; twelve (12) errors were due to skipped words.

A

The time period of a facility's Institutional Review Board (IRB) or Independent Ethics Committee
(IEC) registration with the Department of Health and Human Services (HHS) is

A. 6 months.
B. 1 year.
C. 2 years.
D. 3 years.

D The Institutional Review Board (IRB) or Independent Ethics Committee (IEC) registration is effective for 3 years and must be renewed at the end of that period of time to remain effective. If the information on record with the Office for Human Research Protections (OHRP) for the IRB/IEC registration needs to be changed, those changes should be submitted within 90 days of the change. All updates of the IRB/IEC registration using the electronic system automatically renew the IRB/IEC registration for another 3 years. Complete updates (the Federal Wide Assurance [FWA] is fully completed) submitted in hard copy renew an FWA for another 3 years, while limited updates (the FWA is partially completed) submitted in hard copy will not change the FWA expiration date. For additional information you may want to visit
http://www.hhs.gov/ohrp/humansubjects/assurance/renwirb.htm

Harry H. Potter was admitted to your hospital to receive a second round of chemotherapy for an invasive tumor. Four days after admission, Harry complained of a sore throat and developed a fever. Harry's throat culture was positive for strep. His strep throat will be

A. added to the denominator of the hospital's nosocomial infection rate.
B. added to the numerator of the hospital's community-acquired infection rate.
C. considered separately because Harry H. Potter is immune suppressed from chemotherapy.
D. added to the numerator of the hospital's nosocomial infection rate.

D

Twelve new cases of a certain disease occurred during the month of August. If 4,000 persons were at risk during August, then the

A. prevalence was 3 per 1,000 persons.
B. prevalence was 6 per 1,000 persons.
C. incidence was 3 per 1,000 persons.
D. incidence was 6 per 1,000 persons.

C

The primary difference between an experimental (randomized) clinical trial and other observational study designs in epidemiology is that in an experimental trial, the
A. study is prospective.
B. investigator determines who is and who is not exposed.
C. study is case controlled.
D. study and control maps are selected on the basis of exposure to the suspected causal factor.

B

The ability to obtain the same results from different studies using different methodologies and different populations is

A. reliability.
B. validity.
C. confidence.
D. specificity.

A

You have been conducting productivity studies on your coders and find that 20% of their time is devoted to querying physicians about missing or unclear diagnoses. Assuming your coders work a 7-hour day, how many minutes do they spend per day querying physicians?

A. 21
B. 56
C. 84
D. 140

C 7 hours per day × 60 minutes per hour = 420 minutes per day. 20% of 420 = 84

Venice Bay Health Center collected the data displayed below concerning their four highest volume
MS-DRGs. MS-DRG A MS-DRG B MS-DRG C MS-DRG D
CMS WEIGHT NUMBER CMS
PATIENTS
WITH THIS
MS-DRG
WEIGHT NUMBER
PATIENTS
WITH THIS
MS-DRG
CMS
WEIGHT NUMBER
PATIENTS
WITH THIS
MS-DRG
CMS
WEIGHT NUMBER
PATIENTS
WITH THIS
MS-DRG
2.023 323 0.987 489 1 .925 402 1 .243 386

73. The MS-DRG that generated the most revenue for Venice Bay Health Center is

A. MS-DRG A.
B. MS-DRG B.
C. MS-DRG C.
D. MS-DRG D.

C Calculations:
• MS-DRG A = 2.023 × 323 = 653.43
• MS-DRG B = 0.987 × 489 = 482.64
• MS-DRG C = 1.925 × 402 = 773.85
• MS-DRG D = 1.243 × 386 = 479.80

CMS has increased the weight for MS-DRG A by 14%, increased the weight for MS-DRG B by
20%, and decreased the weight for MS-DRG D by 10%. Given these new weights, which MS-DRG
generated the most revenue for Venice Bay Health Center?
A. MS-DRG A
B. MS-DRG B
C. MS-DRG C
D. MS-DRG D

C Calculations:
• MS-DRG A = 2.023 × 0.14 = 0.283; 0.283 + 2.023 = 2.306 × 323 = 744.84
• MS-DRG B = 0.987 × 0.20 = 0.197; 0.987 + 0.197 = 1.184 × 489 = 578.98
• MS-DRG C = 1.925 × 402 = 773.85
• MS-DRG D = 1.243 × 0.10 = 0.124; 1.243 - 0.124 = 1.119 × 386 = 431.93

Sea Side Clinic (SSC) provides episode of care service for four insurance companies. Data on services provided and reimbursement received are provided below.

COMPANY UNITS OF
SERVICE
A
REIMBURSEMENT
FOR SERVICE A UNITS OF
SERVICE
B
REIMBURSEMENT
FOR SERVICE B
TOTAL
REIMBURSEMENT
Lifecare 259 31 ,1 96.55 81 2 1 63,577.40 1 94,773.95
Get Well 786 1 00,859.52 465 96,929.25 1 97,788.77
SureHealth 462 54,631 .50 509 1 07,093.60 1 61 ,725.1 0
Be Healthy 21 9 26,991 .75 41 7 89,425.65 1 1 6,41 7.40

75. It would be most profitable for Sea Side Clinic to increase episode of care service with

A. Lifecare.
B. Get Well.
C. SureHealth.
D. BeHealthy.

D Arrive at the answer by calculating the reimbursement per unit for each service and averaging those answers, as shown below:
INSURANCE
COMPANY

UNITS OF
SERVICE A

REIMBURSEMENT FOR
SERVICE A
REIMBURSEMENT PER
UNIT FOR
SERVICE A


UNITS OF
SERVICE B

REIMBURSEMENT FOR
SERVICE B
REIMBURSEMENT PER
UNIT FOR
SERVICE B

TOTAL
REIMBURSEMENT AVERAGE
REIMBURSEMENT PER
UNIT OF
SERVICE
Lifecare 259 31,196.55 120.45 812 163,577.40 201.45 194,773.95 160.95
Get Well 786 100,859.52 128.32 465 96,929.25 208.45 197,788.77 168.39
SureHealth 462 54,631.50 118.25 509 107,093.60 210.40 161,725.10 164.33
Be Healthy 219 26,991.75 123.25 417 89,425.65 214.45 116,417.40 168.85

The most profitable insurance company for the units of services Sea Side Clinic performs is

A. service A with Lifecare.
B. service B with GetWell..
C. service A with SureHealth.
D. service B with BeHealthy.

D Reference the table above.

The physicians at Sunset Shore Clinic reported the following statistics last Tuesday.
PHYSICIAN SERVICE A SERVICE B SERVICE C
Truba 10 18 14
Wooley 14 22 9
Howe 18 5 6
Masters 12 20 7

The physician who performed the highest number of services overall last Tuesday was Doctor

A. Truba.
B. Wooley.
C. Howe.
D. Masters.

B Calculate by adding total services:
PHYSICIAN
SERVICE A
SERVICE B
SERVICE C TOTAL
SERVICES
Truba 1 0 22 1 0 42
Wooley 1 4 22 9 45
Howe 1 8 5 6 29
Masters 1 2 20 7 39

It takes twice as long to perform Service C, so the doctors decided Service C should count as two services for the purpose of calculating workload. If Service C counts twice as much as Service A or
Service B, then the physician who provides the most services was Doctor

A. Truba.
B. Wooley.
C. Howe.
D. Masters.

A Double Service C in the table above.

Your facility conducted a study of patient satisfaction, but you question the reliability of the questionnaire you used. The high degree of patient satisfaction expressed on the questionnaire just does not match the large number of complaints you have been receiving. You decide to try switching to an investigative strategy that will give you an immediate opportunity to review patient responses and correct errors. You have decided to use

A. samples.
B. interviews.
C. observations.
D. questionnaires.

B

The researchers at AHIMA started by assuming there was no relationship between job stress and job satisfaction. This statement is generally called the

A. study statement.
B. false assumption.
C. null hypothesis.
D. correlation statement.

C

Based on the data displayed in the graph AHIMA created, you can assume there is

A. a positive relationship between variable A and variable B.
B. a negative relationship between variable A and variable B.
C. a causal relationship between variable A and variable B.
D. no assumptions can be made based on the data display

A

The researchers at AHIMA had professionals with 5 or more years HIM experience rate their stress on a scale of 1-5, as shown in the chart above. Job satisfaction and job stress are both continuous variables. If the AHIMA researchers want to assess both the direction and degree of the relationship between these two continuous variables, they may choose to compute the

A. variable correlation coefficient.
B. Pearson correlation coefficient.
C. continuous correlation coefficient.
D. Danbury correlation coefficient.

C

There were some HIM professionals who refused to participate in the job stress/job satisfaction study. This is of great concern to the AHIMA researchers, who worry about the introduction of

A. recall bias.
B. selection bias.
C. interviewer bias.
D. nonresponse bias.

D

A researcher has repeated the same study 10 times. Each time the study is repeated, the p value decreases. As the p value approaches zero, the:

A. size of the sample increases.
B. value of the study decreases.
C. chance that the results are due to a sampling error decreases.
D. chance that the results are due to a sampling error increases.

C

You and your colleague are designing a study to try to determine the ideal mean cost for a discretionary service. You will market your service to a very large population. Your colleague thinks you will get the best data if you take lots of small samples. You think the data will be more reliable if you take one or two very large samples.

A. Your colleague is right—the mean of multiple samples will yield more reliable results.
B. You are right—the means of a few large samples will yield more reliable results.
C. You are equally correct—there is little difference in the reliability of these sampling methods.
D. You are equally wrong—unless you use stratified sampling, you cannot expect reliable results.

B

You are conducting a patient satisfaction survey in your outpatient clinic using interviewers who administer a questionnaire. Because you typically see about 300 people per day in the clinic, you decide to have the interviewers administer the questionnaire on every tenth patient. You are using

A. systematic sampling.
B. stratified sampling.
C. variable sampling.
D. convenience sampling.

A

The people of Treasure Island Beach have been struck with a rash that seems to be infecting almost everyone in town. The staff of the hospital is working to design a study of this mysterious disease. They decide to do a cross-sectional study because cross-sectional or prevalence studies are known for
A. quickly identifying cause and effect relationships that can serve as a basis for treatment.
B. concurrently describing characteristics and health outcomes at one specific point in time.
C. providing the information necessary to test for the most effective treatment of an illness or condition.
D. supplying entire populations with therapeutic interventions on an epidemiologically sound basis.

B

You are planning a prospective study to try to prove a cause and effect relationship between dipping snuff and throat cancer. First, you identify subjects who regularly dip snuff and who are free of any signs of throat cancer. Next, you need to identify subjects who

A. dip snuff regularly and who currently have throat cancer.
B. dip snuff regularly and who currently have significant signs of throat cancer.
C. do not dip snuff and who currently have significant signs of throat cancer.
D. do not dip snuff and who are free of any signs of throat cancer.

D

Your administrator is concerned about the snuff study (see previous question, 88). The administrator would like to consider using a case control study model rather than the prospective one you are planning. One of the biggest reasons the administrator is promoting the case control model is because case control is

A. more likely to be free of design errors than a prospective study.
B. the best way to analytically test the hypothesis of cause and effect.
C. more likely to decrease recall bias errors than prospective studies.
D. less expensive than prospective studies because it uses existing records.

D

You point out to your administrator that the study model generally accepted to be the best method to determine the magnitude of risk in the population with the characteristic or suspected risk factor is the

A. descriptive study design.
B. analytic study design.
C. prospective study design.
D. case control study design.

C

Investigator A claims his results are statistically significant at the 10% level. Investigator B argues that significance should be announced only if the results are statistically significant at the 5% level. From this we can conclude that:

A. if investigator A has significant results at the 10% level, they will never be significant at the 5% level.
B. it will be more difficult for investigator A to reject statistical null hypotheses if he always works at the 10% level compared with investigator B who works at the 5% level.
C. if investigator A has significant results at the 10% level, they will also be significant at the 5% level.
D. it will be less difficult for investigator A to reject statistical null hypotheses if he always works at the 10% level compared with investigator B who works at the 5% level.

B

John Parker surveyed members of AHIMA's student COP regarding the relationship between clinical experiences and job opportunities. All respondents were seniors in HIA programs and each one expected to graduate and take the national exam within the next 6 months. Fifteen of the eighteen respondents indicated at least one clinical rotation had resulted in a job offer. Based on this information, Parker expects to be offered a job during senior clinical rotations. John is basing this expectation on:

A. scientific inquiry.
B. empiricism.
C. inductive reasoning.
D. deductive reasoning.

C

Use the formula below as a resource to answer questions 93 and 94.
FORMULA FOR CALCULATING SAMPLE SIZE

n = N p (1 - p)
(N - 1 ) (B 2) + (p) (1 - p)
4

If population size (N) = 1,200 and the proportion of subjects needed (p) = 0.5 and the acceptable amount of error (B) = 0.05, then sample size (n) =
A. 200.
B. 300.
C. 400.
D. 600.

B

After the researchers see the number of subjects they will have to interview, they reexamine their criteria. The researchers could decrease the number of subjects while having the least impact on the reliability of the study by
A. increasing p and decreasing B.
B. increasing p or decreasing B.
C. decreasing p and increasing B.
D. decreasing p or increasing B.

D

Which statistical analysis would be the best technique to use on the following problem? A study compared the effects of retesting on the scores of students who failed a writing test. Students who did not pass on their first attempt were allowed to retest. Results showed that students had higher mean scores at retest whether they attended additional training before retesting or not.
A. Descriptive stats
B. ANOVA
C. Regression
D. T test

D

The name given to the error committed when the null hypothesis is rejected and it is actually true:
The name given is
A. type II error.
B. selection bias.
C. type I error.
D. alternative hypothesis.

C

The OB/GYN Department reported the following information to the Quality
Management/Statistics Committee:

CASE NUMBER BRIEF DESCRIPTION
101 -43-26 A 32-year-old female was admitted through the ED following an automobile accident. She spontaneously delivered a 720 g fetus that showed no sign of life.

101 -44-23 A 22-year-old female was admitted in labor. Following an uneventful course, she delivered a 7 pound 4 ounce term male. The child developed sudden and unexpected respiratory distress. All attempts at resuscitation failed; the baby was pronounced dead less than 2 hours after delivery.

101 -48-69 A 19-year-old female spontaneously delivered a 475 g fetus following a fall down the stairs at home.

101 -56-29 A 28-year-old female was admitted for a late-term therapeutic abortion. The procedure was completed without complication; product of conception weighed 728 g. When the committee considers these adverse outcomes from the OB/GYN Department, which of the cases will be included in the numerator of the facility's fetal death rate?

A. 101-43-26
B. 101-43-26 and 101-44-23
C. 101-43-26 and 101-48-69
D. 101-43-26 and 101-56-29

A

Which of the cases listed above will have an impact on the facility's gross death rate?
A. 101-43-26
B. 101-44-23
C. 101-48-69
D. 101-56-29

B

A major disadvantage of cross-sectional studies is that
A. the time sequence of exposure and disease is usually not known.
B. they are usually more expensive and can take a long time to complete.
C. prevalence rates cannot be calculated.
D. they cannot provide information on both exposure and disease status in the same individual.

A

A study found that liver cancer rates per 100,000 males among cigarette smokers and nonsmokers in a major U.S. city were 48.0 and 25.4, respectively. The relative risk of developing liver cancer for male smokers compared to nonsmokers is
A. 1.89.
B. 15.6.
C. 22.6.
D. 48.0.

A RR = risk exposed divided by risk not exposed = 48 divided by 25.4 = 1.89

This means newborn discharges are separated from the discharges of adults and children. Next, remember not to be fooled by beds set up temporarily to meet unusual admission needs; all occupancy statistics should be calculated based on approved, permanent beds only. The common rates used for census and occupancy statistics are as follows:

Health Statistics Definitions and Formulas
There are a number of important things to think about when you tackle census and occupancy statistics. First, remember when it comes to occupancy, beds and bassinets are counted separately.

Daily Inpatient Census Total number of patients treated during a 24-hour period

Inpatient Service Day Services received by one inpatient in one 24-hour period

Total Inpatient Sum of all inpatient service days for each of the days in the period

Census Statistics

Average Daily Census

Total inpatient service days for a period (excluding newborns)
Total number of days in the period

FORMULA:
Average LOS

Total length of stay (discharge days)
Total number of discharges

Inpatient Bed Count Day

Counts the presence of one inpatient bed (occupied or vacant)
that is set up and staffed for use in one 24-hour period

Total Inpatient Bed Count Day

Sum of inpatient bed count days for each of the days in a period

Percentage of Occupancy
FORMULA:

Total number of inpatient service days for a period × 100
Total inpatient bed count days × number of days in the period

Direct Formula:

Total number of discharges for a period
Average bed count for the same period

Indirect Formula:
NOTE: The indirect formula must be used in cases where the bed count changes during the period in question.

Percentage of occupancy × Days in the period × 100
Average length of stay

Death (Mortality) Rates
Anesthesia Death Rate

Total number of deaths caused by an anesthetic agent × 100
Total number of anesthetics administered

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