CIRS Medical Terminology & Documentation 5

Question 1

A worker's record lists 'CTS, R > L.' What condition is documented?

Accepted Answer

Carpal tunnel syndrome, right worse than left

Answer

CTS is carpal tunnel syndrome, and 'R > L' indicates the right side is more affected than the left.

Question 2

Which term describes a joint position where the palm faces upward?

Accepted Answer

Supination

Answer

Supination rotates the forearm so the palm faces up, while pronation turns it down.

Question 3

An FCE report uses the term 'coefficient of variation' (CV) for repeated grip trials. What is it used to assess?

Accepted Answer

Consistency of effort across repeated trials

Answer

CV measures variability among repeated trials, and a low CV generally suggests consistent effort.

Question 4

A physician documents 'hypertonicity of the upper trapezius.' What does this indicate?

Accepted Answer

Increased muscle tone or tightness

Answer

Hypertonicity means abnormally increased muscle tone, often palpable as tightness or spasm.

Question 5

Under HIPAA, which practice best protects an injured worker's records shared with an employer during a return-to-work process?

Accepted Answer

Share only the minimum necessary information, such as functional abilities and restrictions, with proper authorization

Answer

The minimum necessary standard limits disclosure to information needed for the purpose, such as work restrictions rather than full diagnoses.

CIRS - Certified Industrial Rehabilitation Specialist Practice Test