RHIT Domain 3 Exam Solutions Manual Fully Solved (Latest Update 2025)
Community Hospital had 250 patients in the hospital at midnight on May 1. The hospital admitted 30
patients on May 2. The hospital discharged 40 patients, including deaths, on May 2. Two patients were
both admitted and discharged on May 2. What was the total number of inpatient service days for May
2?
a. 240
b. 242
c. 280
d. 320 - Answers b
A unit of measure that reflects the services received by one inpatient during a 24-hour period is called
an inpatient service day. The number of inpatient service days for a 24-hour period is equal to the daily
inpatient census—that is, one service day for each patient treated. The calculation is: [(250 + 30) − 40] +
2 = 242 (Horton 2016b, 386).
After the types of cases to be included in a registry have been determined, what is the next step in data
acquisition?
a. Case registration
b. Case definition
c. Case abstracting
d. Case finding - Answers d
After the cases to be included have been determined, the next step is usually case finding. Case finding
is a method used to identify the patients who have been seen or treated in the facility for the particular
disease or condition of interest to the registry (Sharp 2016, 175).
Community Hospital's HIM department conducted a random sample of 200 inpatient health records to
determine the timeliness of the history and physicals completion. Nine records were found to be out of
compliance with the 24-hour requirement. Which of the following percentages represents the H&P
timeliness rate at Community Hospital?
a. 4.5%
b. 21.2%
,c. 66.7%
d. 95.5% - Answers d
A complete history and physical report represents the attending physician's assessment of the patient's
current health status, and accreditation standards require it to be completed within 24 hours of
admission. In this case, 191 instances of timely H&Ps out of 200 sampled is 95.5% accuracy. The
calculation is (191/200) × 100 = 95.5% (Brickner 2016, 84; Horton 2016b, 383).
Which rate is used to compare the number of inpatient deaths to the total number of inpatient deaths
and discharges?
a. Net hospital death rate
b. Fetal/newborn/maternal hospital death rate
c. Gross hospital death rate
d. Adjusted hospital death rate - Answers c
The gross hospital death rate is the proportion of all hospital discharges that ended in death. It is the
basic indicator of mortality in a healthcare facility. The gross death rate is calculated by dividing the total
number of deaths occurring in a given time period by the total number of discharges, including deaths,
for the same time period (Horton 2016b, 392-393).
This type of chart plots all data points as a cell for two given variables of interest and, depending on
frequency of observations in each cell, provides color to visualize high or low frequency.
a. Barplot
b. Scatter plot
c. Boxplot
d. Heatmap - Answers d
A heat map plots all data points as a cell for two given variables or interest, and depending on frequency
of observations in each cell, provides color to visualize high or low frequency (Kellogg 2016a, 41).
Mr. Jones was admitted to the hospital on March 21 and discharged on April 1. What was the length of
stay for Mr. Jones?
,a. 5 days
b. 10 days
c. 11 days
d. 15 days - Answers c
Length of stay (LOS) is calculated for each patient after he or she is discharged from the hospital. It is the
number of calendar days from the day of patient admission to the day of discharge (31 - 21) + 1 = 11
days (Horton 2016b, 390).
A statewide data base is used by your performance improvement department each month to compare
other facilities' readmission rates to your facility's rates. This is an example of ________.
a. Internal data
b. External data
c. Ratio data
d. Nominal data - Answers b
External data sources refers to data collected outside an organization. For example, a census, reports
from the Centers for Medicare and Medicaid Services (CMS) or the Centers for Disease Control (CDC),
economic databases, journals, even social media have links to outside data (Horton 2016a, 323).
Which of the following is true about a primary key in a database table?
a. Usually is not a unique number
b. Changes in value
c. Is dependent on the data in the table
d. Uniquely identifies each row in a table - Answers d
Primary keys ensure that each row in a table is unique. A primary key must not change in value.
Typically, a primary key is a number that is a one-up counter or a randomly generated number in large
databases. A number is used because a number processes faster than an alphanumeric character. In
large tables, this makes a difference. In the PATIENTS table, the PATIENT_ID is the primary key. It is good
, programming practice to create a primary key that is independent of the data in a table (Johns 2015,
127-128).
The hospital's Performance Improvement Council has compiled the following data on the volume of
procedures performed. Given this data, which procedures should the council scrutinize in evaluating
performance? (graph unable to be added)
a. Procedures 1, 4
b. Procedures 2, 3, 5
c. Procedures 6, 7
d. Procedures 1, 4, 6, 7 - Answers d
Performance measurement in healthcare provides an indication of an organization's performance in
relation to a specified process or outcome. Healthcare performance improvement philosophies most
often focus on measuring performance in the areas of systems, processes, and outcomes. Outcomes
should be scrutinized whether they are positive and appropriate or negative and diminishing (Shaw and
Carter 2015, 44-47).
The Medical Staff Executive Committee has requested a report that identifies all medical staff members
who have been suspended in the last six months due to delinquent health records. This is an example of
what type of report?
a. Ad hoc or demand
b. Annual report
c. Exception
d. Periodic scheduled - Answers a
As opposed to periodic and exception reports, demand reports, also known as ad hoc reports, are
produced as needed, whenever a manager demands or asks for it. Usually, demand reports are
produced through report generators or database query languages and are customized by the manager
(Johns 2015, 236).
Hospital A discharges 10,000 patients per year. Hospital B is located in the same town and discharges
5,000 patients per year. At Hospital B's medical staff committee meeting, a physician reports that he is
concerned about the quality of care at Hospital B because the hospital has double the number of deaths
per year than Hospital A. The HIM director is attending the meeting in a staff position. Which of the
following actions should the director take?
Community Hospital had 250 patients in the hospital at midnight on May 1. The hospital admitted 30
patients on May 2. The hospital discharged 40 patients, including deaths, on May 2. Two patients were
both admitted and discharged on May 2. What was the total number of inpatient service days for May
2?
a. 240
b. 242
c. 280
d. 320 - Answers b
A unit of measure that reflects the services received by one inpatient during a 24-hour period is called
an inpatient service day. The number of inpatient service days for a 24-hour period is equal to the daily
inpatient census—that is, one service day for each patient treated. The calculation is: [(250 + 30) − 40] +
2 = 242 (Horton 2016b, 386).
After the types of cases to be included in a registry have been determined, what is the next step in data
acquisition?
a. Case registration
b. Case definition
c. Case abstracting
d. Case finding - Answers d
After the cases to be included have been determined, the next step is usually case finding. Case finding
is a method used to identify the patients who have been seen or treated in the facility for the particular
disease or condition of interest to the registry (Sharp 2016, 175).
Community Hospital's HIM department conducted a random sample of 200 inpatient health records to
determine the timeliness of the history and physicals completion. Nine records were found to be out of
compliance with the 24-hour requirement. Which of the following percentages represents the H&P
timeliness rate at Community Hospital?
a. 4.5%
b. 21.2%
,c. 66.7%
d. 95.5% - Answers d
A complete history and physical report represents the attending physician's assessment of the patient's
current health status, and accreditation standards require it to be completed within 24 hours of
admission. In this case, 191 instances of timely H&Ps out of 200 sampled is 95.5% accuracy. The
calculation is (191/200) × 100 = 95.5% (Brickner 2016, 84; Horton 2016b, 383).
Which rate is used to compare the number of inpatient deaths to the total number of inpatient deaths
and discharges?
a. Net hospital death rate
b. Fetal/newborn/maternal hospital death rate
c. Gross hospital death rate
d. Adjusted hospital death rate - Answers c
The gross hospital death rate is the proportion of all hospital discharges that ended in death. It is the
basic indicator of mortality in a healthcare facility. The gross death rate is calculated by dividing the total
number of deaths occurring in a given time period by the total number of discharges, including deaths,
for the same time period (Horton 2016b, 392-393).
This type of chart plots all data points as a cell for two given variables of interest and, depending on
frequency of observations in each cell, provides color to visualize high or low frequency.
a. Barplot
b. Scatter plot
c. Boxplot
d. Heatmap - Answers d
A heat map plots all data points as a cell for two given variables or interest, and depending on frequency
of observations in each cell, provides color to visualize high or low frequency (Kellogg 2016a, 41).
Mr. Jones was admitted to the hospital on March 21 and discharged on April 1. What was the length of
stay for Mr. Jones?
,a. 5 days
b. 10 days
c. 11 days
d. 15 days - Answers c
Length of stay (LOS) is calculated for each patient after he or she is discharged from the hospital. It is the
number of calendar days from the day of patient admission to the day of discharge (31 - 21) + 1 = 11
days (Horton 2016b, 390).
A statewide data base is used by your performance improvement department each month to compare
other facilities' readmission rates to your facility's rates. This is an example of ________.
a. Internal data
b. External data
c. Ratio data
d. Nominal data - Answers b
External data sources refers to data collected outside an organization. For example, a census, reports
from the Centers for Medicare and Medicaid Services (CMS) or the Centers for Disease Control (CDC),
economic databases, journals, even social media have links to outside data (Horton 2016a, 323).
Which of the following is true about a primary key in a database table?
a. Usually is not a unique number
b. Changes in value
c. Is dependent on the data in the table
d. Uniquely identifies each row in a table - Answers d
Primary keys ensure that each row in a table is unique. A primary key must not change in value.
Typically, a primary key is a number that is a one-up counter or a randomly generated number in large
databases. A number is used because a number processes faster than an alphanumeric character. In
large tables, this makes a difference. In the PATIENTS table, the PATIENT_ID is the primary key. It is good
, programming practice to create a primary key that is independent of the data in a table (Johns 2015,
127-128).
The hospital's Performance Improvement Council has compiled the following data on the volume of
procedures performed. Given this data, which procedures should the council scrutinize in evaluating
performance? (graph unable to be added)
a. Procedures 1, 4
b. Procedures 2, 3, 5
c. Procedures 6, 7
d. Procedures 1, 4, 6, 7 - Answers d
Performance measurement in healthcare provides an indication of an organization's performance in
relation to a specified process or outcome. Healthcare performance improvement philosophies most
often focus on measuring performance in the areas of systems, processes, and outcomes. Outcomes
should be scrutinized whether they are positive and appropriate or negative and diminishing (Shaw and
Carter 2015, 44-47).
The Medical Staff Executive Committee has requested a report that identifies all medical staff members
who have been suspended in the last six months due to delinquent health records. This is an example of
what type of report?
a. Ad hoc or demand
b. Annual report
c. Exception
d. Periodic scheduled - Answers a
As opposed to periodic and exception reports, demand reports, also known as ad hoc reports, are
produced as needed, whenever a manager demands or asks for it. Usually, demand reports are
produced through report generators or database query languages and are customized by the manager
(Johns 2015, 236).
Hospital A discharges 10,000 patients per year. Hospital B is located in the same town and discharges
5,000 patients per year. At Hospital B's medical staff committee meeting, a physician reports that he is
concerned about the quality of care at Hospital B because the hospital has double the number of deaths
per year than Hospital A. The HIM director is attending the meeting in a staff position. Which of the
following actions should the director take?
