This work is funded by the National Science Foundation
Advanced Technological Education Grant 1003223
The CAHIMS Exam Preparation Course
and the CAHIMS exam are the result of
collaboration between the Life Science
Informatics Center at Bellevue College
and the Healthcare Information and
Management Systems Society (HIMSS).
Significant content found in the CAHIMS
Exam Preparation Course stems from the
Office of the National Coordinator for
Health Information Technology. Creation
of the CAHIMS Exam Preparation Course
and the CAHIMS exam was made
possible through support from the National
Science Foundation (NSF).
Curriculum Team:
Margaret Schulte, DBA
Michèle Royer, PhD
Nathan Savage, MLIS
This work is funded by the National Science Foundation
Advanced Technological Education Grant 1003223
Section 2 - Technology Environment
Lesson 2.6 - Healthcare Data Exchange and Standards
Assessment Questions Answer Key
Lecture 1
1. Select the true statement about a standardized terminology or healthcare
language.
*a. It facilitates the measure of patient outcomes.
b. It inhibits the linking of diagnoses.
c. It is only useful with exchange of information within organization
d. It interferes with education and practice.
Answer: a. It facilitates the measure of patient outcomes.
Lecture(s)/Slide(s): 1/7
2. Identify the comprehensive controlled terminology that is published in
numerous languages and used all over the world designed to capture information
in the EHR.
a. CDT
b. HCPCS
*c. SNOMED CT
d. NDC
Answer: c. SNOMED CT
Lecture(s)/Slide(s): 1/27
3. Which of the following standards for the exchange of administrative data
includes insurance claims?
a. DICOM
*b. ANSI ASCX12N
c. HL 7
d. CHI
Answer: b. ANSI ASCX12N
Lecture(s)/Slide(s): 1/9
This work is funded by the National Science Foundation
Advanced Technological Education Grant 1003223
Page 1
4. Which of the following standards can be used across various healthcare
settings to address the capture of data structure and message exchange
associated with diagnostic images?
*a. DICOM
b. ANSI ASCX12N
c. HL 7
d. CHI
Answer: a. DICOM
Lecture(s)/Slide(s): 1/10
5. Select the INCORRECT statement regarding HIPAA.
a. HIPAA contains the standards related to privacy and security regulations
b. HIPAA mandates the use of coding and classifications systems to be used by
covered entities
c. HIPAA supports standards for the electronic health records by mandating
electronic transactions each covered entity has to use
*d. HIPAA mandates the use of SNOMED CT in electronic health records
Answer: d. HIPAA mandates the use of SNOMED CT in electronic health records
Lecture(s)/Slide(s): 1/16
6. Which term best describes the grouping of similar or related data for the
purpose of external reporting?
*a. Classification systems
b. Clinical terminologies
c. Categories and subcategories
d. Compilation Coding
Answer: a. Classification systems
Lecture(s)/Slide(s): 1/12
7. A patient is admitted to the hospital for appendicitis and has an appendectomy.
Which of the following would be used to report the diagnosis and procedure?
*a. ICD-9-CM
b. HL7
c. CDT
d. CPT
This work is funded by the National Science Foundation
Advanced Technological Education Grant 1003223
Page 2
Answer: a. ICD-9-CM
Lecture(s)/Slide(s): 1/11, 12, 17
8. Select the classification of nursing diagnoses that is organized around 13
domains that includes examples such as nutrition, and activity or rest.
*a. NANDA
b. NIC
c. NOC
d. PNDS
Answer: a. NANDA
Lecture(s)/Slide(s): 1/22, 23
9. If an organization purchased a system that allows for the capture of
information during the perioperative period from preadmission to recovery at
home, an entry stating “Permit Signed” would represent
a. a nursing diagnosis
b. a nursing intervention
*c. an operation outcome
d. a potential problem
Answer: c. a operation outcome
Lecture(s)/Slide(s): 1/24
10. A reference used with standardized data that contains definitions, principles
and guidelines, the values, format and synonyms for each data element is
referred to as a:
a. formulary
b. vocabulary
c. metadata
*d. data dictionary
Answer: d. data dictionary
Lecture(s)/Slide(s): 1/5
This work is funded by the National Science Foundation
Advanced Technological Education Grant 1003223
Page 3
11. Which of the following HIPAA code sets would be used by dental practices to
report dental procedures?
a. CPT
b. NDC
c. ICD-9-CM
*d. CDT
Answer: d. CDT
Lecture(s)/Slide(s): 1/17, 21
Lectures 4 & 5
12. Starting with the layer that is closest to the user what is the correct order of
layers of the OSI model?
a. Physical, Data Link, Network, Transport, Session, Presentation, Application
b. Presentation, Data Link, Network, Transport, Session, Physical, Application
*c. Application, Presentation, Session, Transport, Network, Data Link, Physical
d. Application, Physical, Session, Transport, Network, Data Link, Presentation
Answer: c. Please refer to the slide for the order of the OSI model layers.
Lecture(s)/Slide(s): 4/9
13. Starting with the layer closest to the network media/medium what is the
correct order of the layers of the TCP/IP model?
*a. Network Access, Internetwork, Transport, Application
b. Network Access, Network, Transport, Application
c. Application, Transport, Internet, Network Access
d. Physical, Transport, Internet, Application
Answer: a. Please refer to the slide for the order of the TCP/IP model layers.
Lecture(s)/Slide(s): 4/9
14. In the Network Layer of the OSI model, what is the protocol data unit (PDU)
called?
a. Data
*b. Packets
c. Segments
d. Frames
This work is funded by the National Science Foundation
Advanced Technological Education Grant 1003223
Page 4
Answer: b. At the network layer the PDU is a packet.
Lecture(s)/Slide(s): 4/10
15. Which Application Layer protocol is used for converting host names and
domain names into IP addresses?
a. DHCP
b. SMTP
c. HTTP
*d. DNS
Answer: d. DNS converts host names and domain names into IP addresses.
Lecture(s)/Slide(s): 4/12
16. Which Presentation Layer protocol specifies how messages must be
formatted so that they can be exchanged between different email systems?
a. SMTP
*b. MIME
c. SSL
d. XDR
Answer: b. MIME is used so that messages can be exchanged between different
email systems.
Lecture(s)/Slide(s): 4/14
17. T/F IPv4 has 128 bits.
a. T
*b. F
Answer: b. IPv4 has 32 bits and IPv6 has 128 bits.
Lecture(s)/Slide(s): 5/4
18. 132.16.9.0 is what class of IPv4 address?
a. Class A
*b. Class B
c. Class C
d. Class D
Answer: b. Class B addresses have a first octet between 128-191.
This work is funded by the National Science Foundation
Advanced Technological Education Grant 1003223
Page 5
Lecture(s)/Slide(s): 5/5
19. A ____ is a term used to describe the movement of data from one router to
another.
*a. hop
b. skip
c. route
d. jump
Answer: a. A hop is used to describe the movement of data from one router to
another.
Lecture(s)/Slide(s): 5/12
20. T/F Ethernet uses CSMA/CA.
a. T
*b. F
Answer: b. Ethernet uses CSMA/CD. Wireless uses CSMA/CA.
Lecture(s)/Slide(s): 5/20
21. A _______________ is a unique address assigned to most network interface
cards (NICs) by the manufacturer for identification.
a. IP address
b. Unicast
c. Ethernet address
*d. MAC address
Answer: d. MAC addresses are assigned to NICs by the manufacturer. IP
addresses are assigned by the network administrator.
Lecture(s)/Slide(s): 5/17
This work is funded by the National Science Foundation
Advanced Technological Education Grant 1003223
Page 6
Lecture 2
22. According to the presentation, which of the following BEST describes why
CHINs failed in the 1990s?
*a. A lack of focus on community stakeholders resulted in competitors being
unable to agree on key issues.
b. Technology was not yet available to accomplish the goals of CHINs.
c. HIPAA regulations made the sharing of protected health information too
burdensome.
d. Privacy concerns among patients led to a grassroots political movement.
Answer: a. A lack of focus on community stakeholders resulted in competitors
being unable to agree on key issues.
Lecture(s)/Slide(s): 2/11
23. Which of the following statements BEST describes the current state of the
National Health Information Network (NHIN)?
*a. NHIN is in its early developmental stages.
b. NHIN is in “beta testing” mode and is getting ready to be deployed for national
use.
c. Planning for the NHIN has been authorized by the HITECH Act and is
scheduled to begin in fiscal year 2011.
d. NHIN is fully operational.
Answer: a. NHIN is in its early developmental stages.
Lecture(s)/Slide(s): 2/9
24. According to the lecture, which of the following is the most common form of
health information exchange today?
a. Email
b. Secure messaging
*c. Fax
d. File transfer protocol (FTP)
Answer: c. Fax
Lecture(s)/Slide(s): 2/8
This work is funded by the National Science Foundation
Advanced Technological Education Grant 1003223
Page 7
25. What is the MAJOR difference between the RHIOs of the 2000s and the CHINs
of the 1990s? RHIOs focus on
*a. quality rather than cost savings.
b. cost savings rather than efficiency.
c. efficiency rather than patient safety.
d. patient safety rather than community stakeholders.
Answer: a. quality rather than cost savings.
Lecture(s)/Slide(s): 2/14, 11
26. According to the lecture, a 2006 failure of a prominent RHIO caused a major
uproar in the HIT community. Where was this RHIO located?
a. Hartford, CT
b. New York, NY
c. San Francisco, CA
*d. Santa Barbara, CA
Answer: d. Santa Barbara, CA
Lecture(s)/Slide(s): 2/16
27. Which of the following is likely to result in significant progress towards
realizing the goals of HIE in the US?
a. A technological breakthrough that allows for HIE to be feasible at a much
lower cost
*b. The broad federal support for HIE outlined in HITECH
c. The recent Supreme Court decision allowing for the exchange of patient
information via the Internet
d. A general consensus among stakeholders that HIE will save money
Answer: b. The broad federal support for HIE outlined in HITECH
Lecture(s)/Slide(s): 2/19
28. According to the lecture, which of the following ‘benefits’ is not a part of the
goal of the Nationwide Health Information Network?
a. Provide a common platform to communicate patient-level information between
healthcare organizations
b. Interconnect HIE systems between RHIOs and federal agencies
c. Facilitate data retrieval for researchers
*d. Eliminate competition between healthcare organizations
This work is funded by the National Science Foundation
Advanced Technological Education Grant 1003223
Page 8
Answer: d. Eliminate competition between healthcare organizations
Lecture(s)/Slide(s): 2/9
29. Which of the following was not a significant barrier to the formation of RHIOs
in the early 2000s?
*a. Technology
b. Politics
c. Market competition
d. Regulations
Answer: a. Technology
Lecture(s)/Slide(s): 2/14
30. The functions of a RHIO include all EXCEPT
a. initiating collaboration of stakeholders.
*b. matching the national model for RHIOs.
c. formulating associational agreements
d. constructing security and access procedures
Answer: b. Matching the national model for RHIOs
Lecture(s)/Slide(s): 2/14
31. According to the lecture, which entity frequently became the leader in HIE
through RHIO development on a state level?
a. Insurance companies
*b. Medicaid programs
c. Physicians
d. Federally funded research groups
Answer: b. Medicaid programs
Lecture(s)/Slide(s): 2/15
32. The success of a RHIO is dependent on all of the following EXCEPT
a. involvement of healthcare payers
b. trust between stakeholders
*c. local government support
d. perpetual maintenance of business agreements
This work is funded by the National Science Foundation
Advanced Technological Education Grant 1003223
Page 9
Answer: c. local government support
Lecture(s)/Slide(s): 2/16
Lecture 6
33. Health Information Exchange enables the interoperable linkage of health care
information across organizations within a ______________?
a. A hospital
b. An enterprise system
c. A region
d. Across a nation
*e. All of the above
Answer: e. Health Information Exchange enables the interoperable linkage of
health care information across organizations within a hospital, an enterprise
healthcare system, a region, or a nation.
Lecture(s)/Slide(s): 6/3
34. Complete interoperability of centralized and federated EHRs is already in
place.
a. True
*b. False
Answer: b. False. However, for interoperability, it is important that data elements
have the same coding and meaning and that they can be interchanged when
necessary. Complete interoperability does not exist at present. Consequently,
data elements must be mapped, often with a subsequent loss of information,
between the different sites.
Lecture(s)/Slide(s): 6/5
35. A major concern that people have about including their data in federated
EHRs relate to __________.
a. Misinterpretation of data
b. Inability for their provider to access the data
c. Possibility for incorrect data to be present
*d. Privacy of their data
Answer: d. Privacy of their data. There is an inherent fear that a national health
information interchange means that there will be a big database in Washington
This work is funded by the National Science Foundation
Advanced Technological Education Grant 1003223
Page 10
DC, run by the US government, and any privacy will not exist. There are even
concerns at the state level.
Lecture(s)/Slide(s): 6/8
36. ___________ must exist to support an HIE?
a. Standards – what we have discussed in this component,
b. Infrastructure to support aggregation of data into a single patient record which
requires
c. Infrastructure to support a regional network
d. Infrastructure and linkage of regional networks to provide a virtual national
network
e. a, b and c
*f. All of the above. Each of the following must exist to support a HIE.
Answer: f. All of the above. Each of the following must exist to support a HIE.
Standards, Infrastructure to support aggregation of data into a single patient
record which requires, Infrastructure to support a regional network, Infrastructure
and linkage of regional networks to provide a virtual national network, A business
case based on supported facts and includes a financial model that balances
rewards with costs, A workable process that permits us to reach the destination
in doable chunks, Understanding and creating the necessary linkages among
stakeholders and State efforts blended into a common process that will support
interoperability among states
Lecture(s)/Slide(s): 6/9
37. Which of the following is NOT a feature of a control center?
a. Accommodate 3 to 5 million persons
b. Contain aggregated data for an Essential HER
*c. Be external to the region database
d. Be Available 24/7
e. Contain linkages to other centers so patients crossing boundaries of regions
can be aggregated
Answer: c. A control center must be local to the region database.
Lecture(s)/Slide(s): 6/16
This work is funded by the National Science Foundation
Advanced Technological Education Grant 1003223
Page 11