AHA CHFM Certified Health Care Facility Manager (CHFM) Exam Practice Test

NFPA 80 (Standard for Fire Doors and Other Opening Protectives) and NFPA 101 (Life Safety Code) both require that fire doors in a means of egress must be self-closing and equipped with a positive-latching device. This ensures that the door will automatically return to the closed position and latch securely to prevent fire and smoke from spreading through the egress path.

A: Doors can be held open magnetically only when connected to the fire alarm system, but the essential code requirement is positive latching.

B: Materials and vision panels are not universal requirements.

D: Smoke-tight doors are required in smoke barriers, not all egress fire doors.

In a primary-secondary chilled water system, the primary loop is constant volume, supplying chilled water from the chiller plant. The secondary loop uses variable volume pumping to match distribution system load demand efficiently.

A. Secondary loop (Correct): Where variable flow is applied.

B. Open loop: Not a recognized term in this context.

C. Primary loop: Constant flow design.

D. Cooling tower loop: Separate condenser water system, not chilled water distribution.

To stay within the $5,000,000 annual budget, the facilities department must reduce monthly spending to $337,500 for the remaining 8 months.

NFPA 70 (NEC) Article 110.26(A)(1) establishes the depth of working space in front of electrical equipment. For systems 0–150 volts to ground, the minimum depth is 3 ft (36 in.); for 151–600 volts, the required depth is 3–4 ft depending on the condition (exposed live parts and grounded surfaces). In healthcare facilities, unless a more stringent “condition” applies, the baseline minimum clearance encountered for 600 V or less is 36 inches.

According to standard accounting practices, when an overhaul or replacement extends the useful life of an asset, it is considered a capital expenditure. Operating costs are day-to-day expenses; contingency is reserved budget for unforeseen costs; non-depreciable refers to land, not equipment.

The FGI Guidelines and ASHRAE healthcare design standards recommend steam humidifiers for duct-mounted systems in hospitals, since they minimize microbial growth. Reservoirs, spray, and pan humidifiers pose contamination risks and are not permitted for patient care areas.

For electrical systems, real power (kW) is obtained by multiplying apparent power (kVA) by the power factor (PF):

kW = kVA × PF

This formula gives the average power consumed by a single-phase motor.

C. KVA × PF (Correct): Standard power equation for real power.

A. KVA / PF: Incorrect; dividing by PF would increase kVA, not convert to kW.

B. kW × PF / 1,000: Incorrect; kW already accounts for PF, and the division by 1,000 is irrelevant here.

D. amps / PF: Incomplete and not dimensionally correct.

The CHFM exam Financial Management domain requires knowledge of cost savings and revenue generation calculations from operational changes such as recycling initiatives. In this example, gross revenue is calculated by summing the total recycling income streams (cardboard and aluminum).

Correct Answer (C. $7,200): Derived from combining $6,000 (cardboard) and $1,200 (aluminum) revenue.

Other options are incorrect because:

A ($6,000): Considers cardboard only.

B ($6,600): Misapplies aluminum tonnage conversion.

D ($18,000): Exaggerates revenue beyond calculated amounts.

Hospitals must have a Type 1 Essential Electrical System (EES) as required by NFPA 99. Type 1 systems provide at least two separate branches: the Life Safety branch and the Critical branch, ensuring continuous power to essential life support, patient care, and safety functions during utility outages.

Type 2 systems (for smaller facilities) have fewer requirements.

Type A and B are not classifications under NFPA 99.

The requirement for Spill Prevention, Control, and Countermeasure (SPCC) planning is specifically mandated under Federal Regulations 40 CFR Part 112, under the Clean Water Act (Oil Pollution Act amendments). Facilities with aboveground storage exceeding 1,320 gallons or underground storage over 42,000 gallons must develop and implement an SPCC plan to prevent oil discharges into navigable waters.

Correct Answer (A): Federal 40 CFR Part 112 establishes the threshold quantities and program requirements.

B (Joint Commission): TJC standards govern utility management but do not set SPCC requirements.

C (OSHA 1926.153): This regulation applies to liquefied petroleum gas safety, not petroleum or oil spill prevention.

D (NFPA 430): Governs oxidizers, not oil storage or spill prevention.

The primary cause of change orders is incomplete or unclear plans and specifications. Ensuring that drawings and specs are fully developed before bidding reduces ambiguity, scope gaps, and the likelihood of modifications during construction.

A (Correct): Complete plans/specs = fewer change orders.

B: Bonds/policies protect financially but do not reduce change orders.

C: Prequalification ensures capable bidders but doesn’t eliminate scope issues.

D: Competent managers/subcontractors help but cannot offset incomplete design docs.

For a single-user office, the most cost-effective and functional choice is a key lock. Other options (keypad, badge, biometric) are appropriate for higher-security or multi-user access points but are excessive in cost and complexity for one occupant.

B. Key lock (Correct): Meets the requirement simply and inexpensively.

A. Keypad lock: Adds unnecessary technology and cost.

C. Biometric lock: High cost, appropriate for sensitive areas only.

D. Badge access lock: Requires system integration and ongoing management not justified for a single office.

Calculation:

234,480 ÷ 15,000 = 15.63 days → ≈ 15 days supply available.

Predictive maintenance involves techniques that monitor the condition of equipment to anticipate failure before it occurs. Common predictive techniques include:

Vibration monitoring (1) – Detects imbalance, misalignment, or bearing wear.

Oil analysis (2) – Identifies contamination, wear particles, or breakdown in lubricants.

Ultrasound (4) – Detects leaks, arcing, and mechanical friction.

PM frequency analysis (3) is part of preventive maintenance, not predictive maintenance.

Best practice in safety and risk management is to have a final inspection performed by individuals with “fresh eyes” and go/no-go authority. Those directly involved may overlook issues due to task familiarity. Independent inspection reduces risk before re-energization.

Acceptable indoor CO₂ concentrations in healthcare facilities are generally expected to remain below 1,000 ppm, as recommended by ASHRAE Standard 62.1 (Ventilation for Acceptable Indoor Air Quality). A reading of 1,500 ppm typically signals inadequate ventilation and insufficient outside air being introduced into the space. This is a direct indicator of poor dilution of indoor contaminants.

Correct: Lack of outside air (C) – High CO₂ concentrations are directly linked to reduced outside air supply.

Incorrect:

A. Within design – Not correct, since 1,500 ppm exceeds design thresholds.

B. Vehicular exhaust – Would raise CO and NOx levels, not primarily CO₂.

D. Humidity/dewpoint – Unrelated to CO₂ measurement.

CMS Condition of Participation 482.41(c)(2) requires hospitals to ensure that elevator equipment is routinely inspected, tested, and maintained. Appendix A to this regulation clarifies that documentation of these three elements demonstrates compliance.

Correct (C): Maintenance – Inspections and testing alone are insufficient; ongoing maintenance must be documented.

Incorrect:

A. recalls: Not part of CMS 482.41(c)(2).

B. cleaning: While important, cleaning is not listed as a compliance requirement.

D. repairs: Only performed when problems are found; maintenance is the proactive required element.

To evaluate overall building condition, the Facility Condition Index (FCI) is commonly used. FCI = Deferred Maintenance ÷ Current Replacement Value. A lower FCI indicates better building condition (less deferred maintenance relative to value).

Building 1: 1,200,000 ÷ 25,000,000 = 0.048

Building 2: 200,000 ÷ 2,500,000 = 0.080

Building 3: 25,000 ÷ 600,000 = 0.0417

Building 4: 900,000 ÷ 10,000,000 = 0.090

Building 3 has the lowest FCI (0.0417), which means it has the least deferred maintenance compared to its value and therefore is in the best overall condition.

Incorrect Options:

Building 1 (0.048) – Good, but not the lowest.

Building 2 (0.080) – Higher FCI means poorer condition.

Building 4 (0.090) – Highest FCI of the group.

NFPA 101 (Life Safety Code, Chapter 18/19.7.1.4) requires healthcare fire drills to include transmission of the fire alarm signal and a simulation of emergency fire conditions, ensuring staff are trained to carry out emergency duties. Full evacuation of patients is not required during drills.

The Joint Commission (TJC) aligns with NFPA 101: Life Safety Code. For business occupancies (such as outpatient clinics), the requirement is that fire drills be conducted annually (every 12 months).

Quarterly (every 3 months) drills are required for healthcare occupancies (hospitals, nursing care).

Outpatient business occupancies are less stringent.

NFPA 25 (2011), Standard for the Inspection, Testing, and Maintenance of Water-Based Fire Protection Systems, specifies that a fire pump flow test must be performed annually. This ensures that the pump delivers adequate flow and pressure under actual operating conditions. Weekly no-flow (churn) tests are also required, but full-flow condition testing is mandated at least once per year.

The simple payback period is calculated by dividing the initial investment cost by the annual operating savings (reduction in operating cost). It does not consider time value of money, inflation, or full life-cycle costs.

A (Correct): Annual operating cost directly determines the annual savings, which is essential for payback calculation.

B: Inflation is considered in more advanced financial models (e.g., NPV, IRR), not simple payback.

C: Replacement cost is relevant for life-cycle cost analysis, not simple payback.

D: Life of the equipment may determine feasibility but is not part of the basic payback formula.

The Safe Medical Device Act (SMDA) of 1990 requires healthcare facilities to report to the FDA and the manufacturer when a device is suspected of causing or contributing to death or serious injury.

C. death or injury (Correct): Specifically mandated under SMDA.

A. inappropriate application: A usage issue, not a reporting trigger.

B. recall: Issued by the FDA/manufacturer, not the facility’s reporting obligation.

D. major breakdown: Requires service but not mandatory reporting.

Written fire procedures must include the method for promptly notifying the fire department or emergency response agency, ensuring immediate response to protect life and property. Evacuation routes and equipment locations are important operational elements, but the mandatory code requirement is a defined notification procedure.

The Centers for Disease Control and Prevention (CDC) published the document “Guidelines for Preventing the Transmission of Mycobacterium Tuberculosis in Healthcare Facilities”. These guidelines provide infection control practices for healthcare facilities, including engineering controls, ventilation requirements, and personal protective equipment (PPE) to minimize the risk of TB transmission.

Correct: CDC (B) – Responsible for publishing this guideline.

Incorrect:

A. FDA – Regulates drugs and medical devices.

C. EPA – Oversees environmental protection and pollutants, not healthcare infection prevention.

D. OSHA – Issues workplace safety standards, but this TB guideline is from CDC.

Federal and accreditor requirements establish two emergency exercises per year for hospitals: one full-scale community-based (or facility-based if community-based is not available) and a second exercise (which may be a second full-scale or an exercise such as a tabletop). Real events may be used to meet one of the required exercises when criteria are met.

22% excess oxygen is far higher than normal (typical excess O₂ is 3–6%). This means there is too much air compared to fuel, causing inefficiency.

The corrective action is to increase fuel pressure, which reduces excess oxygen by balancing the air-fuel ratio.

D. Increase the fuel pressure (Correct): Restores optimal combustion balance.

A. Steam atomization: Not relevant unless using certain oil burners.

B. Increase nozzle air pressure: Would worsen the excess O₂ condition.

C. No adjustment necessary: Incorrect because efficiency is compromised.

In a fire tube boiler, hot gases of combustion pass through tubes, and water surrounds those tubes, absorbing the heat to create steam or hot water.

Correct: Fire tube (B) – Gases inside tubes, water outside.

Incorrect:

A. Water tube – The reverse: water flows inside the tubes, combustion gases surround them.

C. Vertical tube – Refers to orientation but still a water-tube or fire-tube design.

D. Cast iron sectional – Built from joined cast iron sections, not tubular gas-through-water design.

According to NFPA 251 (Standard Methods of Tests of Fire Resistance of Building Construction and Materials), once a material or assembly is tested and a measure of time is obtained, that result is defined as the fire resistance rating. This rating expresses the duration that a building element can withstand a standardized fire exposure while maintaining structural integrity.

Correct Answer (B. fire resistance rating): NFPA 251 specifically defines this as the time result from fire exposure testing. It applies to walls, floors, and structural assemblies.

Incorrect Options:

A. flame spread rating: This measures only the surface burning characteristics of materials, determined using ASTM E84 or UL 723, not the endurance of an entire assembly.

C. fire assembly rating: This is not an officially recognized NFPA term; the proper terminology is fire resistance rating.

D. fire protection rating: This applies to opening protectives such as doors, windows, or shutters, which are tested using NFPA 252 or NFPA 257, not NFPA 251. Fire protection ratings are distinct from fire resistance ratings, since they do not measure full structural endurance.

Relevance to CHFM Compliance Domain:

The Certified Health Care Facility Manager (CHFM) exam includes compliance with fire and life safety codes under its “Compliance” content area. The CHFM Candidate Handbook emphasizes the requirement to understand and apply NFPA standards in healthcare facilities, ensuring compliance with regulatory fire safety measures such as those defined in NFPA 251.

According to NFPA 101 Life Safety Code and CMS/TJC corridor obstruction guidance, only certain items deemed essential for immediate patient care may be left unattended in inpatient care corridors. Crash carts are specifically allowed because they are emergency life-saving equipment. Other items, such as hampers, WOWs, and bins, are considered obstructions and must be removed when not in active use.

Comprehensive and Detailed Explanation From Exact Extract:

Symptoms such as nausea, dizziness, headaches, and drowsiness are commonly associated with poor indoor air quality (IAQ). The most likely cause in this case is insufficient outside air ventilation, which allows buildup of carbon dioxide and other indoor contaminants.

Correct Answer (C. insufficient outside air): According to ASHRAE Standard 62.1 (Ventilation for Acceptable Indoor Air Quality) and referenced in NFPA 99 Health Care Facilities Code, inadequate outside air results in occupant discomfort and health complaints known as “sick building syndrome.”

Incorrect Options:

A. mercury spill: Causes more acute, localized toxic exposure symptoms; less likely across an entire wing unless a large spill occurred (and it would be unusual in general occupancy areas).

B. humidity levels: Low or high humidity can cause discomfort, but not typically dizziness or drowsiness.

D. medical gas leak: Could cause similar symptoms depending on the gas, but would typically trigger alarms and affect specific zones tied to gas lines, not general wing-wide complaints.

Relevance to CHFM:

This question relates to the Compliance and Maintenance & Operations domains. CHFM professionals must ensure compliance with ventilation codes (ASHRAE 62.1, NFPA 99, Joint Commission EC standards) and manage HVAC systems to maintain proper indoor air quality, protecting patient and staff health.