CHFM Sample Questions Answers

Compute project labor:

Two carpenters (project): $40 × 20 hr/wk × 78 wk × 2 = $124,800

One laborer (project): $20 × 40 hr/wk × 78 wk = $62,400

Supervisor (project): $45 × 10 hr/wk × 104 wk = $46,800

Project total = $124,800 + $62,400 + $46,800 = $234,000

Compute operations/maintenance labor:

Two carpenters (maintenance): $40 × 20 hr/wk × 78 wk × 2 = $124,800

Supervisor (maintenance): $45 × 10 hr/wk × 104 wk = $46,800

Operations total = $124,800 + $46,800 = $171,600

Therefore: Project = $234,000; Operations = $171,600.

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.

When Alternate B is chosen, total price = Base Bid + price for Alternate B (or zero if “Included”).

A: Not available → cannot be selected.

B: $20,000 + Included ($0) = $20,000.

C: $19,000 + $500 = $19,500.

D: $19,000 + $1,000 = $20,000.

Lowest total = $19,500 (Company C).

Calculation:

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

The RCRA (1976) governs the proper management of hazardous waste from generation to disposal (“cradle to grave”). While healthcare organizations often think of sharps or medical waste, RCRA is broader, addressing hazardous chemicals, solvents, and pharmaceuticals. Medical waste is regulated under other federal and state rules.

Construction projects in healthcare facilities must have secured funding before starting. While approvals, staffing, and security considerations are important, the project cannot begin without the capital budget authorization. This aligns with AIA project delivery requirements and AHA/ASHE guidance for healthcare construction projects.

When fire protection systems (sprinklers, alarms) are impaired during construction, Interim Life Safety Measures (ILSM) must be implemented to maintain safety. These include fire watch, additional training, and temporary compensating measures.

B. ILSM (Correct): Required under TJC and NFPA 101 during impairments.

A. ICRA (Infection Control Risk Assessment): Applies to infection risk during construction, not fire protection.

C. PASS (Pull, Aim, Squeeze, Sweep): Fire extinguisher operation technique.

D. RACE (Rescue, Alarm, Contain, Extinguish): Emergency fire response procedure.

Simple payback is calculated as project cost divided by periodic savings; conversely, project cost = periodic savings × payback period. Monthly savings = $400 (utilities) + $25 (labor) = $425/month. A 2.5-year payback is 30 months. Estimated cost = $425 × 30 = $12,750 → D.

Building automation system (BAS) costs are based largely on the number of control points (sensors, outputs, and monitored parameters) that must be integrated. The cost is driven by how many signals must be tracked, rather than just the square footage or vendor.

A: Gross square footage can influence scope, but cost scales with monitored points.

B: Vendor may affect pricing, but primary cost driver is point count.

C: Technology choice matters, but the quantity of control points is more significant.

Practical and ethical water conservation measures include landscape irrigation reduction (1) and metering cooling tower usage (3) since cooling towers are a major consumer of water.

2. Campaigns: Awareness is useful but not as effective as operational controls.

4. Reducing patient showers: Not appropriate for patient care and safety.

Comprehensive and Detailed Explanation From Exact Extract:

Per NFPA 101: Life Safety Code, the maximum allowable capacity for soiled linen or trash receptacles located outside of hazardous storage rooms (such as within patient rooms or nurse stations) is 32 gallons (121 liters). If containers are larger than this, they must be stored in a room meeting hazardous area protection requirements.

Correct Answer (C. 32 gal.): Matches NFPA 101, 18/19.7.5.5.7 (Health Care Occupancies), which restricts container size to 32 gallons maximum unless in a protected hazardous storage room.

Incorrect Options:

A. 8 gal. and B. 16 gal. – These are not the standard NFPA thresholds.

D. 64 gal. – Exceeds NFPA’s maximum; would require special hazardous storage protections.

Relevance to CHFM: This falls under the Compliance domain, as CHFM professionals must ensure healthcare facilities follow NFPA 101 and Joint Commission standards regarding fire and life safety.

Symptoms of nausea, dizziness, and drowsiness are typical of poor indoor air quality (IAQ), most often due to insufficient outside air ventilation leading to buildup of carbon dioxide or other contaminants.

C. Insufficient outside air (Correct).

A. Mercury spill: Causes neurological issues but less common in general building complaints.

B. Humidity levels: Can cause discomfort but not acute dizziness/nausea.

D. Medical gas leak: Hazardous, but would usually trigger alarms and involve smaller affected areas (not whole wing complaints).

A Ground-Fault Circuit Interrupter (GFCI) continuously monitors the current balance between the “hot” and “neutral” conductors. If an imbalance greater than about 5 milliamps occurs (indicating leakage current flowing to ground), the GFCI trips instantly to protect personnel from shock.

Correct (D): Current – GFCIs detect differences in current between conductors.

Incorrect: Resistance (A), Voltage (B), and Power (C) are not directly monitored by GFCIs.

The transformer voltage ratio is determined by the turns ratio:

????

????

????

????

=

????

????

????

????

V

p

​

V

s

​

​

=

N

p

​

N

s

​

​

????

????

=

????

????

×

127

254

=

220

×

0.5

=

110

volts

V

s

​

=V

p

​

×

254

127

​

=220×0.5=110volts

A. 110 (Correct): Secondary voltage is half of the primary because turns ratio = 0.5.

B. 127: Incorrect, not consistent with ratio.

C. 220: Would occur only if turns ratio = 1.

D. 440: Would occur if secondary had twice as many turns as primary.

NFPA 101 (Life Safety Code, Section 9.6.1.6) requires that when a fire alarm system is out of service for more than 4 hours in a 24-hour period, the facility must (1) notify the authority having jurisdiction (AHJ) and (2) provide an approved fire watch until the system is restored. Internal notifications such as to administrators or vendors may occur, but the code specifically mandates AHJ notification and fire watch.

The correct calculation shows an annual energy consumption of 158,444 kWh. Smaller values (A and B) underestimate by factor of 10, while D overestimates by factor of 100.

NFPA 110 (Standard for Emergency and Standby Power Systems) requires that emergency generators be tested monthly under load. If the available load is less than 30% of the generator’s nameplate rating, the test may be conducted until operating parameters (water temperature, oil pressure) stabilize. For longer durations, supplemental loading or load bank testing applies, but the minimum standard is monthly operation until systems stabilize.

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.

Overage = 140 cu. ft.

Each small cylinder = 25 cu. ft.

140 ÷ 25 = 5.6 → minimum 6 needed if rounding up. However, since the question asks for the minimum number to remove to get below the limit, removing 5 cylinders = 125 cu. ft. would still leave 15 cu. ft. over the limit. Therefore, 6 cylinders must be removed.

Correct answer = C (6), not B.

In a standard patient room in a healthcare facility, the typical medical gas outlets include:

Oxygen (1) – for patient respiratory therapy.

Medical Air (2) – used for respiratory support.

Vacuum (4) – for suction applications.

Nitrogen (3) is not normally supplied in a patient room; it is typically used in surgical suites for powering tools.

According to federal and state healthcare waste management standards, regulated medical waste must always be separated from general waste streams at the point of generation. Proper segregation ensures compliance with OSHA’s Bloodborne Pathogens Standard, EPA’s Resource Conservation and Recovery Act (RCRA), and The Joint Commission’s Environment of Care standards. Containers for regulated waste must be red, leak-resistant, and labeled with the universal biohazard symbol.

Correct Answer (D. separated from other types of waste): CHFM compliance and Environment of Care standards require that infectious or hazardous medical waste be physically separated to prevent cross-contamination and maintain compliance with infection control protocols.

A (labeled with specific content): While containers must be labeled, they do not list specific contents; only the biohazard designation is required.

B (refrigerated at 40°F): Refrigeration applies only in specific storage conditions, not universally required for all regulated medical waste.

C (incinerated within 10 days): Time requirements vary by jurisdiction; incineration within 10 days is not a universal federal mandate.

Best practice in healthcare facilities management is to keep one critical spare part for each unique piece of patient-care equipment (not for every unit). This approach balances patient safety and risk mitigation while avoiding excessive storage costs.

A: “As needed” creates downtime risk.

B: Annual bulk purchase may leave gaps in urgent needs.

D: One-for-one spares is excessive, costly, and impractical.

Step 1: Calculate utility cost per square foot.

$1,200,000 ÷ 500,000 sq. ft. = $2.40 per sq. ft.

Step 2: Calculate new total square footage.

500,000 + 100,000 = 600,000 sq. ft.

Step 3: Projected utility cost.

600,000 × $2.40 = $1,440,000

Thus, the anticipated utility budget after expansion is $1,440,000.

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.

The evaluation of child abduction systems—such as infant security alarms, electronic tagging devices, and controlled access systems—falls under the expertise of security professionals. These professionals are trained to test, monitor, and validate the effectiveness of electronic security and surveillance systems. Their role ensures that abduction-prevention technology is properly installed, maintained, and capable of responding effectively in an emergency.

Correct Answer (B. security professionals): According to the CHFM exam content outline under Compliance, healthcare facilities are expected to implement and evaluate security measures that meet regulatory and safety requirements. The responsibility for the technical and functional evaluation of systems like infant abduction alarms lies with trained security staff.

Incorrect Options:

A. administration: While hospital administration sets policy and allocates resources, they are not directly responsible for evaluating technical systems.

C. the safety committee: Safety committees review incidents and provide oversight but do not conduct system-level technical evaluations.

D. risk managers: Risk managers focus on identifying potential liability and compliance issues but rely on security professionals to conduct the detailed evaluation of child abduction systems.

Relevance to CHFM Compliance Domain:

Within the Compliance domain of the CHFM exam, managers must demonstrate knowledge of regulatory standards for security in healthcare facilities, particularly in sensitive areas such as maternity wards. Evaluation of abduction-prevention systems aligns directly with security operations, which are managed and verified by trained security professionals to ensure compliance with The Joint Commission (TJC), CMS, and industry best practices.

MRI does not use ionizing radiation, so radiation-related injuries are not possible. The greatest risk is the “missile effect” where ferromagnetic objects (scissors, oxygen tanks, tools) are violently pulled into the MRI bore by its powerful magnetic field.

D. Missile projection (Correct): Most likely injury hazard.

A. Visual impairment: Not a typical MRI injury.

B. Radiation overexposure: MRI uses magnetic fields, not radiation.

C. Hearing loss: Possible from loud noise but mitigated with ear protection; less common than missile hazard.

Budget forecasting based on partial-year actuals uses the annualization formula:

Annual Forecast

=

Actual Costs for Months

Number of Months

×

12

Annual Forecast=

Number of Months

Actual Costs for Months

​

×12

For 5 months of data, the multiplier is 12/5.

Correct (D): current 5-month actual × 12/5.

Incorrect:

(A) × 5/12 would shrink the budget, not project it.

(B) Uses only one month, not representative.

(C) Uses only 2 months, less reliable.

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.

“WAGD” stands for Waste Anesthetic Gas Disposal. These outlets are installed in operating rooms to remove excess anesthetic gases exhaled by patients or escaping from anesthesia equipment. The purpose is to maintain staff safety and compliance with NFPA 99 (Health Care Facilities Code), which requires WAGD systems in anesthetizing locations.

Correct (D): Operating rooms require WAGD outlets as part of medical gas and vacuum systems.

Incorrect:

A. boiler room: No patient care; WAGD outlets are not relevant.

B. electrical closet: For electrical equipment only, no medical gases.

C. laundry room: Handles linens, not anesthetic gas removal.