Epic Skills Assessment — Questions and Answers

Question 1: What does 'Epic Upgrade' typically involve in an operational context?

Adding new patient beds
Replacing all computers in the hospital
Changing the hospital's billing vendor
A scheduled software version upgrade affecting all modules, requiring testing, training, and go-live support (Correct answer)

Correct answer: A scheduled software version upgrade affecting all modules, requiring testing, training, and go-live support

Epic upgrades involve moving to a new software version, which requires testing new functionality, updating documentation, retraining affected staff, and coordinating a go-live with Epic support.

Question 2: A patient requests an interpreter for their upcoming appointment. Where in Epic should this preference be documented?

In the patient's demographic record under preferred language or communication needs (Correct answer)
In the billing section of the account
In the provider's schedule template
In the appointment notes field

Correct answer: In the patient's demographic record under preferred language or communication needs

Interpreter needs should be documented in the patient's demographic or communication preferences so they follow the patient across all scheduling events.

Question 3: Which analogy is correct? Glove is to hand as boot is to __?

Leg
Foot (Correct answer)
Shoe
Sock

Correct answer: Foot

A glove covers a hand just as a boot covers a foot — same body-part relationship.

Question 4: A clinical analyst is asked to create a report showing all patients with a BMI over 30 seen in the last 90 days. Which Epic tool is most appropriate?

The eMAR
Epic Reporting Workbench or Clarity/Caboodle (Correct answer)
MyChart patient portal
The scheduling module

Correct answer: Epic Reporting Workbench or Clarity/Caboodle

Epic's Reporting Workbench (operational reports) or Clarity/Caboodle (data warehouse) are designed for population queries using clinical parameters like BMI and date ranges.

Question 5: Which word is most nearly OPPOSITE in meaning to 'ambiguous'?

Uncertain
Vague
Explicit (Correct answer)
Unclear

Correct answer: Explicit

'Ambiguous' means open to more than one interpretation; 'explicit' means clear and precise, making it the antonym.

Question 6: A sequence of colored blocks: R, G, B, R, G, B, R, __. What color comes next?

B
Y
G (Correct answer)
R

Correct answer: G

The pattern repeats RGB with period 3. Position 8: 8 mod 3 = 2, which corresponds to G (second element).

Question 7: A patient presents for registration but has a different insurance card than what is on file. What is the correct workflow?

Ask the patient to contact billing after the visit
Update the coverage in Epic and verify eligibility with the new plan (Correct answer)
Collect a self-pay deposit until the new insurance is verified
Proceed with the existing insurance on file to avoid delays

Correct answer: Update the coverage in Epic and verify eligibility with the new plan

The correct workflow is to update the coverage in Epic and run eligibility verification to confirm benefits before the encounter.

Question 8: In Epic's development lifecycle, what is the purpose of the 'SER' master file?

It defines security encryption rules
It stores provider and user identity records (Correct answer)
It tracks server performance metrics
It manages serial device connections

Correct answer: It stores provider and user identity records

The SER (Provider) master file stores records for all providers and users who interact with the Epic system, including their credentials and roles.

Question 9: In a sequence of dominoes, each domino's right half equals the next domino's left half: [1|3][3|5][5|7][7|?]. What fills the blank?

8
10
9 (Correct answer)
11

Correct answer: 9

The right halves are 3, 5, 7, 9 — increasing by 2 each time — so the blank is 9.

Question 10: Which Epic tool allows a provider to view a longitudinal summary of a patient's health history across multiple encounters?

Sticky Note
InBasket
Chart Review (Correct answer)
Snapshot

Correct answer: Chart Review

Chart Review aggregates data from multiple encounters into a longitudinal view, including labs, medications, and notes.

Question 11: A clinical informaticist is validating the logic for a new sepsis alert. The alert is designed to trigger if ALL of the following conditions are met simultaneously: (1) Temperature is greater than 100.4°F, (2) Heart Rate is greater than 90 bpm, AND (3) White Blood Cell (WBC) count is greater than 12,000/mcL. For which patient would the sepsis alert NOT trigger?

Patient C: Temp: 100.8°F, Heart Rate: 92 bpm, WBC: 12,100/mcL
Patient A: Temp: 101.0°F, Heart Rate: 95 bpm, WBC: 13,500/mcL
Patient B: Temp: 100.2°F, Heart Rate: 110 bpm, WBC: 15,000/mcL (Correct answer)
Patient D: Temp: 101.5°F, Heart Rate: 105 bpm, WBC: 18,000/mcL

Correct answer: Patient B: Temp: 100.2°F, Heart Rate: 110 bpm, WBC: 15,000/mcL

The alert requires all three conditions to be met for it to trigger. For Patient B, the temperature is 100.2°F, which is not greater than the 100.4°F threshold. Since this condition is not met, the entire rule evaluates to false, and the alert will not trigger, even though the other two conditions are met.

Question 12: Which figure completes the pattern: a 3×3 grid where each row contains a circle, triangle, and square, and the bottom-right cell is missing?

Triangle
Circle
Diamond
Square (Correct answer)

Correct answer: Square

Each row and column contains one of each shape, and the missing cell requires a square to complete the pattern.

Question 13: A shape series: pentagon (5 sides), hexagon (6), heptagon (7), __. Which comes next?

Nonagon
Octagon (Correct answer)
Decagon
Triangle

Correct answer: Octagon

Each shape adds one side: 5, 6, 7, 8 — the next is an octagon with 8 sides.

Question 14: A dual-axis chart shows hospital admissions (bars, left axis) and average length of stay (line, right axis) over 6 months. In month 3, admissions spike but LOS drops. What is the most likely interpretation?

More patients were admitted but discharged faster (Correct answer)
Data entry error in month 3
Fewer staff caused longer waits
Chart is incorrectly formatted

Correct answer: More patients were admitted but discharged faster

Higher admissions with lower LOS suggests the hospital processed more patients and discharged them more quickly — possibly due to improved efficiency or a higher proportion of lower-acuity cases.

Question 15: In a fictional language, 'PIVOT(matrix)' transposes a 2D array. What is PIVOT([[1,2],[3,4],[5,6]])?

[[1,3,5],[2,4,6]] (Correct answer)
[[6,5],[4,3],[2,1]]
[[2,1],[4,3],[6,5]]
[[1,2],[3,4],[5,6]]

Correct answer: [[1,3,5],[2,4,6]]

Transposing swaps rows and columns, so element at row i, col j moves to row j, col i.

Question 16: What is a 'remit code' (adjustment reason code) on an insurance remittance advice?

Codes remitting the claim to a secondary insurer automatically
Standardized codes (CARC/RARC) explaining why a claim was paid differently from billed charges — required to understand payment calculation and identify denial reasons for follow-up (Correct answer)
Provider codes identifying the rendering provider for payment routing
Patient codes identifying why the patient is responsible for the balance

Correct answer: Standardized codes (CARC/RARC) explaining why a claim was paid differently from billed charges — required to understand payment calculation and identify denial reasons for follow-up

Claim Adjustment Reason Codes (CARC) and Remittance Advice Remark Codes (RARC) explain payment adjustments: contractual (CO), patient responsibility (PR), other (OA), and payer-specific reasons. Revenue cycle staff use these codes to post payments accurately and identify denial types.

Question 17: What is the purpose of FictoScript's `seal` keyword applied to a module?

Marks all module functions as `@pure`
Compresses the module for faster loading
Prevents external modules from extending or overriding the module's definitions (Correct answer)
Encrypts the module's source code

Correct answer: Prevents external modules from extending or overriding the module's definitions

A `seal`ed module cannot have its definitions monkey-patched or extended by other modules, ensuring stability.

Question 18: A policy reads: 'Electronic prescriptions must be verified by a pharmacist before dispensing. Verbal orders are only accepted in emergency situations and must be documented within 24 hours.' In a non-emergency situation, a doctor calls in a prescription verbally. What should occur?

The verbal order is automatically valid if documented promptly
The pharmacist should dispense the medication immediately
The verbal order should be accepted and documented within 24 hours
The pharmacist should request an electronic prescription instead (Correct answer)

Correct answer: The pharmacist should request an electronic prescription instead

The policy restricts verbal orders to emergencies only, so in non-emergency situations an electronic prescription is required.

Question 19: What happens when a clinician uses the 'Pend' function on an order in Epic?

The order is saved but not yet active, awaiting co-signature or review (Correct answer)
The order routes to the billing department
The order is immediately sent to pharmacy
The order is cancelled pending patient consent

Correct answer: The order is saved but not yet active, awaiting co-signature or review

Pending an order saves it in a draft state so another provider (e.g., an attending) can review and co-sign before the order becomes active.

Question 20: When performing a workflow analysis for an Epic Ambulatory implementation, an analyst finds that the current paper-based referral process involves 14 manual steps. After mapping the future-state Epic workflow, the count drops to 6 steps. This reduction is BEST measured using which metric?

Server response time improvement
Number of Epic training hours required
Process cycle efficiency, comparing steps eliminated as a proportion of the original workflow (Correct answer)
User satisfaction score

Correct answer: Process cycle efficiency, comparing steps eliminated as a proportion of the original workflow

Process cycle efficiency quantifies the reduction in steps or waste, providing a concrete measure of workflow simplification achieved through Epic.

Question 21: A stacked bar chart shows patient fall risk categories per unit. The Orthopedic unit bar is tallest and the High Risk segment fills 60% of the bar. The ICU bar is shorter but High Risk fills 80%. Which unit has more high-risk patients?

Cannot be determined without knowing total patient counts (Correct answer)
They are equal
Orthopedic, because its bar is taller
ICU, because its percentage is higher

Correct answer: Cannot be determined without knowing total patient counts

Without knowing the actual total number of patients in each unit, the absolute number of high-risk patients cannot be determined from percentages and bar height alone.

Question 22: A bar chart in an Epic report shows monthly patient encounter volumes. March has 1,200 encounters and April has 900. What is the approximate percentage decrease from March to April?

30%
20%
25% (Correct answer)
15%

Correct answer: 25%

The decrease is 300 out of 1,200, which equals 25%.

Question 23: In CPOE, what is a 'dose range check,' and what triggers it?

A check that verifies the correct number of pills in a dispensed medication
A review of how many doses the patient has already received
A pharmacist's manual review of all doses before dispensing
An automatic check that alerts the prescriber when a medication dose is below the minimum or above the maximum safe range for the patient's weight, age, or renal function (Correct answer)

Correct answer: An automatic check that alerts the prescriber when a medication dose is below the minimum or above the maximum safe range for the patient's weight, age, or renal function

Dose range checks compare the entered dose against pre-defined safe dose ranges (often weight-based for pediatrics, renally-adjusted for renal impairment). They fire CDS alerts when doses fall outside safe parameters, prompting the prescriber to verify or adjust.

Question 24: When documenting a patient's advance directive status in Epic, which of the following is true?

Advance directives are stored only in the billing system
This information is optional and not required for inpatient encounters
The existence and location of the advance directive should be documented, and a copy can be scanned into the chart (Correct answer)
Only physicians may document advance directive status

Correct answer: The existence and location of the advance directive should be documented, and a copy can be scanned into the chart

Epic allows staff to document whether an advance directive exists, its location, and to attach a scanned copy, supporting legal and care planning requirements.

Question 25: Which Epic tool allows developers to compare two versions of a record to identify configuration changes between environments?

Sherlock (Correct answer)
Audit Trail
Record Viewer
Diff Detective

Correct answer: Sherlock

Sherlock is Epic's internal tool that allows developers to compare records across environments or versions, highlighting configuration differences.

Question 26: An analyst is asked to evaluate whether Epic's SmartText tools are being utilized effectively in provider notes. Which metric is MOST relevant to this analysis?

Total server storage consumed by note data
Number of active SmartText records in the system
Adoption rate showing what percentage of notes use SmartText versus fully manual free-text entry (Correct answer)
Number of SmartText records created per month

Correct answer: Adoption rate showing what percentage of notes use SmartText versus fully manual free-text entry

Adoption rate measures actual usage in practice, which is the true indicator of whether SmartText is delivering workflow efficiency.

Question 27: A hospital memo states: 'All nursing staff must complete annual compliance training by December 31st. Staff who fail to complete training will be suspended from clinical duties.' Which conclusion is best supported?

Staff who complete training by December 31st may continue clinical duties (Correct answer)
Only nursing staff are required to take compliance training annually
The hospital has no other compliance requirements
Staff suspended from clinical duties did not complete any training

Correct answer: Staff who complete training by December 31st may continue clinical duties

The memo establishes that failure to complete training results in suspension, so completing it allows continuation of clinical duties.

Question 28: What is the purpose of 'population health' tools in an EHR?

To study historical population trends for research
To track infectious disease outbreaks in a geographic region
To manage hospital bed allocation across a health system
To identify and manage care gaps across a patient panel — finding patients due for preventive care, poorly controlled chronic conditions, or at-risk populations (Correct answer)

Correct answer: To identify and manage care gaps across a patient panel — finding patients due for preventive care, poorly controlled chronic conditions, or at-risk populations

Population health management tools (registries, dashboards) let care teams proactively identify patients with care gaps (overdue mammograms, uncontrolled diabetes, missing vaccinations) and reach out before they become sicker — shifting from reactive to proactive care.

Question 29: Which cognitive skill is primarily tested when you must identify the odd item in a set of related objects?

Semantic categorization (Correct answer)
Spatial reasoning
Short-term memory
Processing speed

Correct answer: Semantic categorization

Identifying which item does not belong relies on semantic categorization — understanding conceptual groupings and relationships.

Question 30: Find the object that is not a part of the group.

B
D (Correct answer)
A
C

Correct answer: D

As the objects A, B, C, and D are not provided in the text, it's impossible to visually identify the outlier. In such 'odd one out' questions, object D would typically possess a unique characteristic, pattern, or function that differentiates it from the other three, which would share a common trait or category.

Question 31: Which algorithm strategy makes the locally optimal choice at each step without reconsidering past decisions?

Dynamic programming
Greedy (Correct answer)
Brute force
Branch and bound

Correct answer: Greedy

Greedy algorithms commit to the best immediate option at each step, which works when local optima lead to a global optimum.

Question 32: An inpatient nurse scans a patient's armband before administering a medication. Which Epic system validates the scan?

CPOE order entry
Chart Review
Bedside Verification (eMAR barcode scanning) (Correct answer)
ADT module

Correct answer: Bedside Verification (eMAR barcode scanning)

Bedside medication verification via eMAR barcode scanning confirms the five rights of medication administration before the dose is given.

Question 33: A passage describes two competing theories about hand hygiene compliance. The author presents both sides equally without taking a position. This writing style is best described as:

Emotional
Objective (Correct answer)
Persuasive
Anecdotal

Correct answer: Objective

Presenting both sides without bias or personal position reflects an objective writing style.

Question 34: Which sentence uses the word 'adverse' correctly?

He was adverse to try a new approach.
The nurse gave an adverse opinion to the patient.
The adverse listed the drug's benefits clearly.
She had an adverse reaction to the new medication. (Correct answer)

Correct answer: She had an adverse reaction to the new medication.

'Adverse' means harmful or unfavorable, making 'adverse reaction to medication' the correct usage.

Question 35: A list of patient appointment check-in times is generated and is already mostly sorted, but a few entries are out of order. To finalize the sort, which of the following sorting algorithms would be the most efficient choice for this specific scenario?

Quicksort
Insertion Sort (Correct answer)
Selection Sort
Merge Sort

Correct answer: Insertion Sort

Insertion Sort has a best-case time complexity of O(n) when the data is already sorted or nearly sorted. It works by iterating through the list and only shifting elements when an out-of-place item is found, making it very efficient for this use case. Other algorithms like Merge Sort (O(n log n)) or Selection Sort (O(n^2)) do not adapt as well to nearly-sorted data. [5, 8, 17, 21]

Question 36: In Epic's upgrade methodology, what is the purpose of 'Upgrade Guides' provided to technical staff?

A checklist of hardware prerequisites that must be validated before Epic software can be installed
Step-by-step scripts for migrating all custom configuration from one version to the next automatically
Release notes generated by Epic's QA team summarizing bugs fixed in the new version
Documentation detailing breaking changes, new features, and required manual review tasks for each upgrade (Correct answer)

Correct answer: Documentation detailing breaking changes, new features, and required manual review tasks for each upgrade

Epic's Upgrade Guides detail breaking changes, deprecated features, new configuration options, and manual review tasks that technical staff must address during each upgrade cycle.

Question 37: You notice that error rates spike every Monday morning. What type of pattern is this, and what is the most logical hypothesis?

A one-time incident that resolved itself
Random noise with no underlying cause
A permanent degradation in system performance
A cyclical pattern likely caused by a weekly event such as a batch job, system restart, or increased Monday traffic (Correct answer)

Correct answer: A cyclical pattern likely caused by a weekly event such as a batch job, system restart, or increased Monday traffic

A recurring pattern tied to a specific day strongly suggests a scheduled event or behavioral pattern — like a weekly batch process or first-day load surge.

Question 38: A project has 5 tasks: A(3d), B(2d, needs A), C(1d), D(4d, needs C), E(2d, needs B and D). What is the critical path?

A → B → E only
C → D → E only
A → B → E and C → D → E; the critical path is C→D→E→(via B) so total is longest chain: A-B plus C-D both feed E; longest = A(3)+B(2)+E(2)=7 vs C(1)+D(4)+E(2)=7; both are critical (Correct answer)
All tasks are on the critical path

Correct answer: A → B → E and C → D → E; the critical path is C→D→E→(via B) so total is longest chain: A-B plus C-D both feed E; longest = A(3)+B(2)+E(2)=7 vs C(1)+D(4)+E(2)=7; both are critical

Both chains (A→B→E = 7 days and C→D→E = 7 days) are equally long, making both critical paths since E depends on both chains completing.

Question 39: What is 'care gap' identification in scheduling and population health?

Identifying gaps in the appointment schedule where slots are unfilled
Identifying procedures that are not covered by the patient's insurance
Identifying patients who are overdue for preventive services (mammograms, colonoscopies, vaccinations, A1c checks) and proactively outreaching to schedule appointments (Correct answer)
Finding patients whose insurance has gaps in coverage

Correct answer: Identifying patients who are overdue for preventive services (mammograms, colonoscopies, vaccinations, A1c checks) and proactively outreaching to schedule appointments

Care gap programs use EHR data to identify patients overdue for preventive care, chronic disease management (annual eye exams for diabetics, BP checks for hypertensives), and screenings. Scheduling teams reach out proactively to close these gaps.

Question 40: A front-desk scheduler accidentally creates a duplicate patient record in Epic. What is the correct next step?

Delete the duplicate record immediately
Report the duplicate to the HIM or medical records team for an enterprise merge (Correct answer)
Continue using both records to avoid delays
Merge the records manually by copying notes between charts

Correct answer: Report the duplicate to the HIM or medical records team for an enterprise merge

Duplicate records must be reported to HIM for an authorized enterprise merge (MPI correction) to prevent data fragmentation and patient safety risks.

Question 41: In FictoScript, a function declared with `fn*` instead of `fn` is:

A function with variadic arguments
A pointer to another function
A private function that cannot be called externally
A generator function that can yield multiple values lazily (Correct answer)

Correct answer: A generator function that can yield multiple values lazily

`fn*` defines a generator that uses `yield` to produce values one at a time without computing all results upfront.

Question 42: An organization is evaluating whether to redesign its Epic surgical scheduling workflow. Which framework is MOST appropriate for structuring the analysis?

A vendor comparison matrix for alternative scheduling software
A financial ROI model based solely on revenue projections
A Plan-Do-Study-Act (PDSA) or DMAIC cycle to define the problem, measure current performance, analyze root causes, improve, and control changes (Correct answer)
SWOT analysis focused on competitor hospitals

Correct answer: A Plan-Do-Study-Act (PDSA) or DMAIC cycle to define the problem, measure current performance, analyze root causes, improve, and control changes

PDSA and DMAIC are structured quality improvement frameworks that ensure data-driven decision-making throughout the workflow redesign process.

Question 43: In object-oriented programming, what does 'encapsulation' mean?

Bundling data and the methods that operate on it into a single unit while restricting direct outside access (Correct answer)
Breaking a program into reusable standalone functions
Inheriting properties and behaviors from a parent class
Converting source code from one programming language to another

Correct answer: Bundling data and the methods that operate on it into a single unit while restricting direct outside access

Encapsulation groups related data and behavior into a class and hides internal implementation details from the outside, protecting data integrity and reducing complexity.

Question 44: During a workflow observation, an analyst notes that staff regularly bypass a required Epic field by entering placeholder text such as 'N/A.' What does this workaround MOST likely indicate?

The required field may not be clinically relevant to all workflows that encounter it, signaling a build configuration problem (Correct answer)
Epic has a software defect that should be reported to the vendor
The staff lacks basic Epic training
The field is optional and staff preference is acceptable

Correct answer: The required field may not be clinically relevant to all workflows that encounter it, signaling a build configuration problem

Consistent workarounds signal a misalignment between the system configuration and the clinical workflow, and should trigger a build review rather than retraining alone.

Question 45: A Pareto chart ranks causes of medication errors from most to least frequent: Omission 35%, Dosing 28%, Timing 20%, Documentation 12%, Other 5%. What percentage of errors do the top two causes represent?

83%
55%
63% (Correct answer)
35%

Correct answer: 63%

Omission (35%) plus Dosing (28%) equals 63% of all medication errors.

Question 46: Which number completes the analogy: 8 is to 27 as 64 is to ?

125 (Correct answer)
216
343
81

Correct answer: 125

8 is 2 cubed and 27 is 3 cubed; 64 is 4 cubed, so the answer is 5 cubed which equals 125.

Question 47: A developer writes a custom Epic web service. Which technology stack does Epic's Interconnect server natively support for hosting it?

ASP.NET on Windows Server using IIS (Correct answer)
Python Flask deployed via Apache WSGI
Java EE on a JBoss application server
Node.js with Express running on a Linux container

Correct answer: ASP.NET on Windows Server using IIS

Epic's Interconnect server is built on Microsoft's ASP.NET stack hosted on Windows Server with IIS, which is the native environment for Epic web services.

Question 48: What is the role of a 'clinical informaticist' or 'physician champion' in EHR optimization?

Manages the IT infrastructure supporting the EHR
Bridges clinical practice and technology — translates clinician workflow needs into EHR configurations and helps drive adoption and improvement (Correct answer)
Codes ICD-10 diagnoses for billing accuracy
Provides nursing education on EHR documentation

Correct answer: Bridges clinical practice and technology — translates clinician workflow needs into EHR configurations and helps drive adoption and improvement

Clinical informaticists and physician champions are clinicians with informatics expertise who advocate for clinician needs, participate in EHR design/optimization decisions, train colleagues, troubleshoot workflow issues, and measure outcomes.

Question 49: What does 'result acknowledged' mean in a results management workflow, and why is tracking this important?

The test result has been filed in the correct location in the record
The billing system has captured the charge for the test
The provider has viewed and confirmed awareness of a result, documented in the EHR; tracking ensures no critical result goes unseen and supports malpractice defense (Correct answer)
The patient has been notified of their result

Correct answer: The provider has viewed and confirmed awareness of a result, documented in the EHR; tracking ensures no critical result goes unseen and supports malpractice defense

Acknowledgment tracking ensures every result — especially critical values and abnormal findings — is seen and acted upon by a provider. Unacknowledged results remain flagged. Tracking provides documentation that providers reviewed results, important for both safety and liability.

Question 50: You are given a complex workflow with 12 interdependent steps. Which approach best helps you identify the root cause of a failure in step 9?

Skip step 9 and continue with step 10
Add more resources to step 9 only
Trace backward from step 9 to identify which upstream step produced faulty output (Correct answer)
Restart the entire workflow from step 1

Correct answer: Trace backward from step 9 to identify which upstream step produced faulty output

Tracing backward from the failure point systematically identifies which upstream step introduced the defect causing the downstream failure.

Epic Skills Assessment

The Epic Skills Assessment exam validates essential knowledge and skills required for certification or licensure in this field.

Questions

60 min

Time Limit

70%

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