Updated: Jun 03, 2026
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1. Which of the following criteria for clinical documentation means the content of the record is trustworthy, safe, and yielding the same result when repeated?
A) Complete
B) Reliable
C) Precise
D) Legible
2. A query should include
A) the impact on quality
B) relevant clinical indicators
C) the impact of reimbursement
D) information from previous encounters
3. A clinical documentation integrity practitioner (CDIP) has been successful in getting physicians to respond to queries. However, when the CDIP poses a query to a specific doctor, there is no response at all. The CDIP has tried face-to-face conversations, calling, emails, texts, but still gets no response. What is the next step the CDIP should take?
A) Hold a meeting with the CDI director and the doctor to find out why the doctor is not responding to the queries
B) Report the doctor to the Vice President of Medical Affairs so the doctor understands the importance of clinical documentation
C) Warn the other CDIPs that the doctor is a non-responder and to forego querying
D) Elevate the issue to the physician advisor/champion after the CDI supervisor has reviewed the case and deemed the query appropriate
4. Based on the flowchart below, at what point might the clinical documentation integrity practitioner (CDIP) enlist the help of the physician advisor/champion?
A) D - No retrospective query opportunity identified
B) E - Physician agrees with query and documents in MR
C) C - Retrospective query opportunity identified
D) H - Physician fails to respond tocquery
5. The BEST place for the provider to document a query response is which of the following?
A) The next progress note and all subsequent notes including the discharge summary
B) The next progress note and the problem list
C) The query form
D) An addendum to the history and physical
Solutions:
| Question # 1 Answer: B | Question # 2 Answer: B | Question # 3 Answer: D | Question # 4 Answer: D | Question # 5 Answer: B |
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