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2016 Jun HIT-001 Study Guide Questions:

Q241. A electronic patient database has reached end-of-life according to the policies of your healthcare facility, and it has been tagged for destruction to keep patient data confidential. Which method of destruction is NOT appropriate for this data? 

A. Physically destroying storage media like CDs and DVDs with a shredder. 

B. Deleting all files and programs that used those files on the server. 

C. Using Department of Defense-accepted software to overwrite hard drives and replace previously stored information with a meaningless pattern. 

D. Magnetically erasing or degaussing hard drives 

Answer: B 

Explanation: Option B is NOT an appropriate method of destroying records. It is not sufficient to delete a file, as often the file can still be accessed from the hard drive or reconstituted from storage media. True disposal of electronic records must be permanent and be written over, shredded or magnetically erased. Answer: A is incorrect. Physical destroying storage media like CDs and DVDs with a special shredder is a viable option for destroying electronic records. Answer: C is incorrect. Using specialized software to overwrite files with a meaningless pattern so that the original file cannot be accessed is a viable means of record disposal. Answer: D is incorrect. Magnetically erasing hard drives or magnetic tapes is another viable method of deleting files and destroying records so that the protected health information cannot be accessed by unauthorized persons. 

Q242. It is time for your medical practice's annual spring cleaning. Your employer has instructed you that all medical records belonging to patients who haven't been a part of the practice for at least five years need to be destroyed. Many of those patients were charted using paper medical records, before the practice adopted its current EMR system. Under the privacy laws, what can you do? 

A. Dump them in the dumpster behind the practice. 

B. Both B, C. 

C. Securing the records until an outside vendor who has a BAA with you can pick them up to destroy them. 

D. Shredding them yourself. 

Answer: B 

Explanation: HIPAA's main concern is that the public or those unauthorized to review PHI will access disposed records and both these options achieve that. Answer: A is incorrect. Simply putting them in the outdoors dumpster is not enough because the public and unauthorized people may be able to access the records. HIPAA requires that if you do place them in dumpster, all PHI must be rendered completely unreadable or indecipherable first. Answer: D is incorrect. You could shred them yourself, since you work for the entity and are charge of this work; this prevents the public from accessing the records. This is one correct option Answer: C is incorrect. HIPAA allows the record destruction to take place off-premises as long as the records are secured from any possible violation or theft until the shredding vendor picks them up. The practice should also have a BAA with the vendor since they are now a 3rd party with access to the PHI. But patients do not need to know about this process as long as they received a Privacy Notice initially when they came into the practice explaining that access to their PHI would be occur as part of the normal operations of the business. 

Q243. Which of the following IEEE standards defines Ethernet and the use of copper cabling in a network? 

A. ISO/IEC 11801 

B. IEEE 802.1X 

C. IEEE 802.3 

D. IEEE 802.11i 

Answer: C 

Explanation: The IEEE 802.3 standards define the physical layer and the media access control (MAC) sublayer of the data link layer of a wired Ethernet. These standards are made for physical connections between nodes and infrastructure devices by various types of copper or fiber cable. Infrastructure devices include hubs, switches, routers, etc. The IEEE 802.3 standard also defines the use of copper cabling in a network. Answer: D is incorrect. 802.11i, also referred to as IEEE 802.11i-2004, is a standard for wireless local area networks (WLANs). It provides improved encryption for networks that use the popular 802.11a, 802.11b (which includes Wi-Fi), and 802.11g standards. It is an amendment to the original IEEE 802.11. The 802.11i standard requires new encryption key protocols, known as Temporal Key Integrity Protocol (TKIP) and Advanced Encryption Standard (AES). The 802.11i specification offers a level of security sufficient to satisfy most government agencies. However, AES requires a dedicated chip, and this may mean hardware upgrades for most existing Wi-Fi networks. Other features of 802.11i are key caching, which facilitates fast reconnection to the server for users who have temporarily gone offline, and pre-authentication, which allows fast roaming and is ideal for use with advanced applications such as Voice over Internet Protocol (VoIP). Answer: B is incorrect. IEEE 802.1X is an IEEE Standard for port-based Network Access Control (PNAC). It is part of the IEEE 802.1 group of networking protocols. It provides an authentication mechanism to devices wishing to attach to a LAN, either establishing a point-to-point connection or preventing it if authentication fails. IEEE 802.1X defines the encapsulation of the Extensible Authentication Protocol (EAP) over IEEE 802 which is known as "EAP over LANs" or EAPOL. EAPOL was originally designed for IEEE 802.3 Ethernet in 802.1X-2001, but was clarified to suit other IEEE 802 LAN technologies such as IEEE 802.11 wireless and Fiber Distributed Data Interface (ISO 9314-2) in 802.1X-2004. The EAPOL protocol was also modified for use with IEEE 802.1AE (MACSec) and IEEE 802.1AR (Secure Device Identity / DevID) in 802.1X-2010. Answer: A is incorrect. International standard ISO/IEC 11801 specifies general-purpose telecommunication cabling systems (structured cabling) that are suitable for a wide range of applications (analog and ISDN telephony, various data communication standards, building control systems, factory automation). This standard is defined by ISO/IEC. It covers both balanced copper cabling and optical fiber cabling. The standard was designed for use within commercial premises that may consist of either a single building or of multiple buildings on a campus. It was optimized for premises that span up to 3 km, up to 1 km2 office space, with between 50 and 50,000 persons, but can also be applied for installations outside this range. A corresponding standard for small-office/home-office (SOHO) environments is ISO/IEC 15018, which also covers 1.2 GHz links for cable and satellite TV applications. 

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Q244. Which of the following statements are true regarding the security advantages of cloud computing?Each correct answer represents a complete solution. Choose all that apply. 

A. It has advanced honeypot capabilities. 

B. It provides a greater resiliency. 

C. It can be implemented without any organizational changes. 

D. It provides fault tolerance and reliability. 

Answer: ABD 

Explanation: The security advantages for cloud computing are as follows: It provides data fragmentation and dispersal. It builds a dedicated security team. It has a greater investment in security infrastructure. It provides fault tolerance and reliability. It provides a greater resiliency. It provides hypervisor protection against network attacks. It offers possible reduction of Certification and Accreditation activities. It provides simplification of compliance analysis. An unbiased party holds the data. It has low-cost disaster recovery and data storage solutions. It provides on-demand security controls. It provides real-time detection of system tampering. It provides rapid re-constitution of services. It has advanced honeypot capabilities. Answer: C is incorrect. Organizational changes are needed to implement cloud computing. 

Q245. You are working on a problem in a system which sending insurance billing information to a remote site. The systems uses messaging with HL7 interface specifications. What is the message identifier field for insurance information? 

A. IN1 

B. OBR 

C. MSA 

D. SCH 

Answer: A 

Explanation: IN1 is the message identifier field for insurance information. Data fields within the insurance information segment include IN1-2, insurance ID number, IN1-8, group number, and similar data fields. Answer: C is incorrect. MSA is the message identifier field for "message acknowledgement segment" and is used to acknowledge a previously received message. Answer: B is incorrect. OBR is a message segment for a laboratory order requesting observation. Answer: D is incorrect. SCH is the schedule activity information segment that is used for messaging in scheduling programs. 

Q246. Which of the following tools is used for an outdoor site survey? 

A. Spectrum analyzer 

B. Antenna 

C. Topography map 

D. Access point 

Answer: C 

Explanation: A topography map is a tool used for an outdoor site survey. It is a detaileA, Dccurate graphic representation of cultural and natural features on the ground. These maps are based on topographical surveys performed at large scales. Answer: B, D, and A are incorrect. Following are the tools that are used for an indoor site survey:Antenna. A wide variety of both omni-directional and indoor semi-directional antennas are used in every indoor site survey. Access point. An access point is a wireless LAN device. It provides a means for wireless clients to send data to one another and to a wired network. AP connects to both wireless LAN and wired Ethernet LAN. Spectrum analyzer. A spectrum analyzer, or spectral analyzer, is a device that is used to examine the spectral composition of some electrical, acoustic, or optical waveform. It may also measure the power spectrum.The analog and digital spectrum analyzers are as follows: 1.An analog spectrum analyzer uses either a variable band-pass filter whose mid-frequency is automatically tuned (shifted, swept) through the range of frequencies of which the spectrum is to be measured. 2.A digital spectrum analyzer computes the discrete Fourier transform (DFT), a mathematical process that transforms a waveform into the components of its frequency spectrum. 

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Q247. Healthcare facilities need to have strict policies about mobile devices and remote access to the organization's network when access to protected health information is involved. You are asked by a healthcare provider to help her set up a way to access her account while she is at a conference in Denver. What are some policies that your organization might have to this kind of arrangement? Each correct answer represents a complete solution. Choose all that apply. 

A. No remote access is allowed for any reason due to the possibility of protected health information becoming vulnerable. 

B. It is necessary to install a VPM or virtual private network on the provider's laptop, one that is approved by the IT staff and has been demonstrated to be secure. 

C. As long as the desktop is locked for access with a password, network access to the providers personal computer shouldn't be a problem. 

D. No PHI may be stored on a home or personal computer for any reason, and a home or personal computer should never be considered a secure location. 

Answer: ABD 

Explanation: Option A, option B and option D may sound contradictory, but any of these could be part of the remote access policy of the healthcare facility a healthcare IT technician could work for. Remote access and mobile devices may be important for the smooth functioning of the organization, but security of PHI is very important, and different IT departments will maintain different policies regarding access depending upon the needs of the organization and the employees. It may be that if the management does not see a benefit in remote access and the risk is too great, that no remote access is allowed into the network. Some organizations may allow access through a secure Virtual Private Network, and may allow no PHI to be transferred or stored on a home or personal computer or device. Answer: C is incorrect. A home or personal computer cannot be considered a secure device, even with password protection. If the laptop or computer is stolen, it is all too easy for passwords to be decrypted and information stored on the device to be access and PHI confidentiality to be breeched. 

Q248. Which of the following agencies is responsible for accrediting, certifying and evaluating health care organizations to insure they are providing the highest quality of care? 

A. The Joint Commission 

B. Occupational Safety and Health Administration 

C. Food and Drug Administration 

D. Department of Health and Human Services 

Answer: A 

Explanation: The purpose of The Joint Commission is to continuously improve health care for the public by evaluating health care organizations and inspiring them to excel in providing safe and effective care of the highest quality and value. This agency also distributes accreditation and certifications to those health care organizations who meet the requirements of The Joint Commission. Answer: D is incorrect. Department of Health and Human Services is as this agency is protecting the health of all Americans and providing essential human services, especially for those who are least able to help themselves. Answer: B is incorrect. Occupational Safety and Health Administration (OSHA) is as the purpose of this agency is to ensure safe and healthful working conditions for working men and women by setting and enforcing standards and by providing training, outreach, education and assistance. Answer: C is incorrect. Food and Drug Administration is as the purpose of this agency is to protect the public health by assuring the safety, efficacy, and security of human and veterinary drugs, biological products, medical devices, our nation's food supply, cosmetics, and products that emit radiation, and by regulating the manufacture, marketing, and distribution of tobacco products. 

Q249. In the above example #11, what is the best practice the nurse could say to maintain HIPAA compliance? 

A. "Yes, sure just let me ask the front office what time your mother's appointment finishes." 

B. "I don't know if we have a patient here by that name; however, if you have a family code I can try to find out." 

C. "Can you tell me the patient's date of birth and mother's maiden name?" 

D. "Can you tell me your date of birth and your relationship to the patient?" 

Answer: B 

Explanation: It is the best practice because it does not confirm in any way that a patient by that name is in the practice and it also ensures that it is a family members or caretaker who has a code provided by the practice to individuals the patient has authorized to receive PHI. Answer: A is incorrect. While polite, it confirms that patient is there and does nothing to verify the caller's identity. Answer: C is incorrect. While this may verify the patient's identity, it still confirms that the patient is there, which doesn't protect the patient from controlling who receives her information. Furthermore, it releases PHI to a caller who is not corroborated at all. Answer: D is incorrect. This confirms that the patient is there, before the caller is validated. It also still leaves room for information to be forged. Codes on the other hand are controlled by the practice itself. 

Q250. You are responsible for applying the appropriate ICD-9 code for all services obtained for patients at your facility. Which of the following types of data are you responsible for? 

A. Numbers 

B. Text 

C. Images 

D. Signals 

Answer: A 

Explanation: Numeric data is a type of data that may be found in a patient's electronic health record. Examples of numerical data would be ICD-9 codes, blood pressure readings, body weight and temperature readings. 

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