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CHIM NCE Practice Exam 3

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CHIM NCE Practice Exam 3

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200
Format
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2 years
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About these practice questions

These practice questions will help you prepare for the CHIM national certification exam.

This practice test contains 200 practice questions covering the six sections of the CHIM national certification exam:

  1. Information governance
  2. Data quality
  3. Clinical knowledge
  4. Analytics
  5. Privacy
  6. Technology

All questions have been carefully designed to reflect the questions on the real exam, to help you prepare and get a passing grade.

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Sample practice questions

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Section 1: Information governance

1) When you are unsure of a patient’s preferred pronouns, what is the most appropriate action?
  1. Ask a family member of the person
  2. Ask the person what pronouns they use
    The respectful approach is to ask the person which pronouns they use.
  3. Avoid using pronouns and only use the patient’s name
  4. Decide based on a person’s appearance
2) Which type of health record is maintained by the patient?
  1. EHR
    Healthcare providers manage electronic health records (EHRs).
  2. EMR
  3. EPR
  4. PHR
    Patients own and maintain personal health records (PHR).
3) What is the main purpose of incident reports?
  1. To assign legal responsibility for failures
  2. To identify the person responsible for the incident
  3. To improve safety and quality
    An incident is any event that caused (or could have caused) injury or property damage. They include fires, chemical spills, and releases of hazardous materials. The main goal of reporting incidents is to improve the safety and quality of the laboratory. By understanding one mistake, the laboratory can stop it from happening again.
  4. To reduce the documentation workload
4) After identifying the problem, what is the next step in a corrective action plan?
  1. Conduct a root-cause analysis
    The first step of a corrective action plan is identifying the root cause of the problem.
  2. Conduct follow-ups
  3. Implement the plan
  4. Notify the accreditation body
5) Which management philosophy aims to generate the maximum amount of value with the least amount of waste?
  1. Agile
  2. Lean
    The central idea in the Lean philosophy is waste elimination. Any activity that does not add value to the end product has to be treated as waste. This helps to create value with fewer resources and less waste.
  3. Six Sigma
  4. Theory of Constraints
6) What are the four steps of the Shewhart Cycle?
  1. Analyze, create, inspect, and create again
  2. Initiate, plan, execute, and close
  3. Plan, do, check, and act
    The Shewhart cycle (also known as the PDCA cycle) is a method for improving processes and products. The four steps are Plan (identify the problem), Do (test potential solutions), Check (study the results), and Act (implement the best solution).
  4. Specify, produce, inspect, and change
7) In which organizational structure is a 'silo' mentality most likely to occur?
  1. Flattened
  2. Functional
    In a functional structure, employees are grouped by their specialized function or department. Silo mentalities are most likely to occur in this kind of structure, because departments don't always talk to each other.
  3. Matrix
  4. Process-oriented
8) Which tool is most useful for identifying inefficiencies in workflow?
  1. Calibration curve
  2. Control chart
  3. Process map
    A process map is a visual diagram of the entire workflow of a system. It can identify inefficiencies by allowing teams to spot bottlenecks, redundancies, delays, and unnecessary complexities.
  4. Reference interval
9) What is the main purpose of Failure Mode and Effects Analysis (FMEA)?
  1. To correct failures after they have been detected
  2. To determine the effects of failures
  3. To determine the root cause of failures
  4. To prevent failures before they occur
    Failure Mode and Effects Analysis (FMEA) is a proactive process that identifies potential failures before they occur. It analyzes how systems might fail, evaluates the consequences of these failures, and helps prevent the failures from happening.
10) Which of these is an example of quality assurance rather than quality control?
  1. Calibrating an analyzer
  2. Repeating an out-of-range control
  3. Reviewing incident reports
    Quality control (QC) focuses on monitoring test performance (e.g., running controls), whereas quality assurance (QA) is a broader term and focuses on preventing errors before they occur (e.g., setting standards, staff training, audits). Reviewing incident reports is an example of quality assurance because it helps identify the root cause of errors to prevent them from happening again.
  4. Running daily controls
11) Which system is used to identify, investigate, and eliminate the root causes of quality issues to prevent them from happening again?
  1. CAPA
    CAPA (Corrective and Preventive Action) focuses on identifying the root cause of problems, fixing it, and preventing it from happening again.
  2. Just-in-time (JIT)
  3. Lean
  4. Shewhart Cycle
12) Which group of people refuses blood transfusions due to religious beliefs?
  1. Buddhists
  2. Jehovah's Witnesses
    Jehovah's Witnesses generally refuse blood transfusions due to their interpretation of scripture. While other religions may have beliefs about blood or its sacredness, Jehovah's Witnesses have a stricter interpretation that prohibits blood transfusions in most cases.
  3. Mormons
  4. Muslims
13) Which type of care improves the quality of life for patients facing serious, life-threatening illnesses?
  1. Palliative care
    Palliative care focuses on relieving symptoms and stress in patients with serious or life-threatening illnesses to improve their quality of life.
  2. Rehabilitative care
    Rehabilitative care helps patients regain mental, physical, or cognitive abilities they have lost.
  3. Respite care
    Respite care provides temporary relief for caregivers.
  4. Tertiary care
    Tertiary care refers to highly specialised medical care.
14) Which of these is one of the phases of the information lifecycle?
  1. Classification
  2. Destruction
    The five phases of information lifecycle management are often described as creation, storage, retrieval, usage, and retirement/destruction. Other sources may give the phases as collection, storage, use, retention, and destruction.
  3. Formatting
  4. Reparation
15) What ethical dilemma does a healthcare provider face when a patient refuses a life-saving treatment?
  1. Being honest vs. withholding information
  2. Healthcare needs vs. resource allocations
  3. Patient autonomy vs. the duty to provide care
    The dilemma is between patient autonomy and the duty to provide care. The doctor must respect the patient’s right to refuse treatment (autonomy), even when ethically obliged to protect patients from harm (duty to provide care).
  4. Pro-choice vs. pro-life
    Pro-choice vs. pro-life focuses on abortion rights, not a patient's right to refuse treatment at the end of life.
16) What is the main purpose of a master patient index (MPI)?
  1. To manage billing information
  2. To store laboratory test results
  3. To track medications
  4. To uniquely identify patients
    A master patient index (MPI) is a database where every patient has a unique identifier. It is used to uniquely identify patients.
17) What is the main purpose of health records?
  1. To assist in the accreditation of an individual or facility
  2. To determine or audit funding levels
  3. To document and support patient care services
    The main purpose of health records is to document and support patient care services and provide continuity of care. While health records can be used for legal, billing, and accreditation purposes, those are secondary purposes.
  4. To serve as evidence in legal proceedings
18) What format is commonly used for progress notes in the POMR system?
  1. ABCDE (Airway, Breathing, Circulation, Disability, Exposure)
  2. BIRP (Behaviour, Intervention, Response, and Plan)
  3. DAP (Data, Assessment, and Plan)
  4. SOAP (Subjective, Objective, Assessment, Plan)
    The POMR (problem-oriented medical record) often uses the SOAP format to record patient encounters in a structured and clinical way. SOAP stands for Subjective, Objective, Assessment, and Plan.
19) A hospital uses a terminal digit filing system. To find record 12-08-35, which number(s) would you use first?
  1. 08
  2. 35
    In the terminal digit filing system, the primary digits are the final numbers, the secondary digits are the middle numbers, and the tertiary digits are the first numbers. So for 12-08-35:
    • Primary digits: 35 (the last two numbers)
    • Secondary digits: 08 (the middle two numbers)
    • Tertiary digits: 12 (the first two numbers)
    To find patient record 12-08-35, you would first use the primary digits (35) to go to the correct shelving unit. Next, you would use the middle digits (08) to find the correct shelf. Finally, you would use the first two digits (12) to find the correct file.
  3. 12
  4. 5
20) Which method of organizing medical records puts the most recent documents first?
  1. Direct
  2. Indirect
  3. Reverse chronological
    In a reverse chronological system, the most recent documents are placed first. This system is common in medical records because it allows clinicians to see the latest information first.
  4. Terminal

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About the CHIM national certification exam

What is the CHIM national certification exam?

The CHIM NCE (Certified in Health Information Management National Certification Examination) is an exam administered by the Canadian College of Health Information Management (CCHIM).

The exam assesses entry-level knowledge of health information management, including information governance, medical terminology, analytics, and privacy.

Passing the exam is a requirement to become a Certified Health Information Management (CHIM) professional in Canada.

Applying for CHIM NCE

The first step for applying for the CHIM NCE is to join CHIMA. Go to echima.ca/membership to sign up if you're not already a member. CHIMA membership costs $40.75 + taxes if you're enrolled in a health information program, or $130.00 + taxes for an affiliate membership.

Once you've joined CHIMA, sign into your CHIMA account at echima.ca to apply for the CHIM NCE. You'll need to pay the exam fee ($498.00 + taxes)

Computer requirements

The CHIM NCE is home-based, which means you will take the exam at home on your own computer or laptop. You will need a PC, Mac, or laptop to take the exam. Tablets and smartphones are not allowed.

Before your exam day, go to quiz.proctor.alemira.com/precheck to check if your computer meets the exam requirements.

Exam day

On exam day, first you will complete a system check to make sure your webcam and microphone work. Then your proctor will ask you to show your room via your webcam to prove you are alone in the room and do not have any books or study notes with you.

You will also need to show a photo of your ID. The ID must:

  • be valid (not expired)
  • be government-issued
  • have your photo and signature

Examples of valid IDs are a passport or driving license.

The CHIM NCE lasts two hours. Questions are multiple-choice with only one correct answer. You can use paper, pencils, and a non-scientific (simple) calculator.

Passing the exam

To pass the exam, you will need to

  • score at least 60% overall on the exam and
  • score at least 50% on each of the six practice areas (Information Governance, Data Quality, Clinical Knowledge, Analytics, Privacy, and Technology)

Getting your results

Around 4 weeks after the exam, you'll find your exam results by logging into echima.ca.

If you pass the exam, the Canadian College of Health Information Management (CCHIM) will post you a certificate and welcome letter within 45 business days. You'll also need to continue fulfilling the following requirements to maintain your CHIM designation:

  • Pay the annual membership fee to CHIMA
  • Complete continuing professional education (CPE) credits
  • Uphold the CHIMA code of ethics

Cancelling your exam

If you need to cancel your exam, send your cancellation request in writing to CHIMA.

Cancel at least two weeks in advance for a full refund. If you cancel less than two weeks before your exam date, you won't receive a refund.

What if I fail the exam?

If you fail the CHIM NCE, you can retake the exam two more times (for a total of three attempts). You must pay the exam fee of $498.00 + taxes each time.

If you fail the CHIM NCE on your third attempt, you will have to undergo a CHIMA review before you can retake it again.

Recommended study resources

CHIMA recommends the following resources to prepare for the CHIM NCE:

  • Adamson, Bonnie. Fundamentals of Health Information Management, 2nd Edition. Canadian Healthcare Association (CHA).
  • CHIMA. The Canadian Health Information Management Lifecycle. (Available to buy at echima.ca)
  • CHIMA. The Study Guide for the Fundamentals of Health Information Management, 2nd edition. (Available to buy at echima.ca)

Overview of the practice areas

The CHIM NCE covers six practice areas:

  1. Information governance
  2. Data quality
  3. Clinical knowledge
  4. Analytics
  5. Privacy
  6. Technology

Each practice area has 15 questions, making 90 questions in total.

Continue reading for more information about each practice area.

1. Information Governance

The first practice area of the CHIM NCE is Information Governance. This practice area will ask you questions about:
  • The information lifecycle, including typical information roles and the relationship between data governance, information governance, and the HIM lifecycle
  • Healthcare policy and procedures, including differences between principles, policies, and procedures, and the overall structure of the Canadian health system
  • Quality management practices such as CQI, LEAN, and TQM, including the process of implementing and maintaining a quality management program
  • Equity, diversity, and inclusion in health care policies, addressing accessibility issues and strategies to represent marginalized groups
  • Ethical decision-making frameworks, including the implications of unethical decisions and cultural competence
  • Sensitivity training for individual beliefs, age, gender, religion, languages, and cultural beliefs
  • Professional codes of ethics, such as those from the Canadian College of Health Information Management and other organizations
  • Health records management, including interpretability, linkability, and timeliness for meaningful insights
  • Legislation requirements for health information, including documentation standards and reporting requirements
  • Documentation standards across different health care environments
  • Error detection and correction procedures
  • Master Patient Indexes (MPIs) and Enterprise Master Patient Indexes (EMPIs), including their definition, development, and maintenance

2. Data Quality

The second practice area of the CHIM NCE is Data Quality. This practice area will ask you questions about:
  • Data collection principles, frameworks, and policies for ethical data management
  • The DIKW (data, information, knowledge, wisdom) pyramid
  • Data collection strategies such as surveys, questionnaires, interviews, and experiments
  • Health information flow and utilization management across various levels of care
  • Health data repositories, including CIHI, Statistics Canada, and Ministries of Health
  • Data quality principles, including accuracy, reliability, timeliness, and data stewardship
  • Data integrity practices, including standards and error detection in electronic systems
  • Data standards development and the standards lifecycle
  • Interoperability and standards development organizations like Canada Health Infoway and CIHI
  • Data submission tools and coding classifications, such as DAD, NACRS, ICD-10-CA, and CCI
  • Case mix groups and the impact of social determinants of health

3. Clinical Knowledge

The third practice area of the CHIM NCE is Clinical Knowledge. This practice area will ask you questions about:
  • Anatomy and physiology, including structural units of the body and anatomical structures
  • Diseases, including etiology, clinical manifestations, diagnostic and therapeutic interventions, and prognosis
  • Normal and abnormal results for common medical tests
  • Health risk factors, including genetics, lifestyle, and environmental factors
  • Types of interventions, such as counseling, surgical, pharmaceutical, and radiological
  • Sick-role behavior and its implications in health care
  • Medical terminology, abbreviations, and acronyms commonly found in health care documentation

4. Analytics

The fourth practice area of the CHIM NCE is Analytics. This practice area will ask you questions about:
  • Health care statistics, including descriptive statistical theory and hospital statistics
  • Research design and methods, including ethics approval, qualitative and quantitative research, and epidemiology
  • Data collection strategies and authoritative sources of health data
  • Analytics indicators, including the creation and use of performance indicators and health care quality monitoring
  • Business intelligence tools for data presentation, such as balanced scorecards and dashboards
  • Consumer informatics, including personalized information needs, Internet of Things, and wearable technology
  • Finance, including MIS standards, case costing activities, and funding models

5. Privacy

The fifth practice area of the CHIM NCE is Privacy. This practice area will ask you questions about:
  • Privacy principles, frameworks, policies, and compliance with legal and statutory drivers
  • Key privacy legislation such as PIPEDA and provincial/territorial statutes
  • Privacy, security, and confidentiality principles in health information practice
  • Management of privacy or security breaches and the tools used for privacy risk assessment
  • Individuals' rights to access and request changes to their personal health information
  • Retention and destruction policies for health information
  • Legal terms related to health information privacy
  • Critical issues addressed by ethics and law in health information
  • Security infrastructure, including principles, frameworks, policies, and processes for technology platforms
  • Internal and external access control tools and practices
  • Principles for external data sharing and access, including third-party queries and policies for Métis, Inuit, First Nations, and Indigenous populations

6. Technology

The sixth and final practice area of the CHIM NCE is Technology. This practice area will ask you questions about:
  • Technology systems principles, policies, and processes for data maintenance, including storage, encryption, retention, and access management
  • Systems development lifecycle and IT procurement processes
  • Systems implementation, including IT infrastructure support, training, and conversion plans
  • Concepts of EHR, PHR, EMR, and EPR
  • Project management and change management concepts
  • Types of health care information systems and their information flow
  • Ethical issues in health policy, systems research, and EHR implementation
  • Equity, diversity, and inclusion standards in information systems
  • Health information exchange, including data integration and linkage theories and standards for data transmission
  • Benefits and challenges of standards and the impact of interoperability on health care quality and outcomes