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Qualifications · Healthcare Information Technologist Success Lab

Databases and Networks

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Q1 | DBMS

Which is an appropriate role of a database management system (DBMS)?

  1. Compress and decompress image data to save storage capacity
  2. Exchange route information between network devices and select packet routes
  3. Provide functions for creating, editing, and printing documents and tables
  4. Manage data centrally and control simultaneous use by multiple users
AnswerD. Manage data centrally and control simultaneous use by multiple users

A DBMS is middleware that manages data centrally and handles control of simultaneous use by multiple users and programs, maintenance of consistency, and management of authentication and access rights. Document creation is application software, route selection is a router's job, and image compression belongs to image processing software; none describes a DBMS.

Q2 | NoSQL

Which statement about NoSQL databases is appropriate?

  1. A database that can be operated only through SQL and by no other means
  2. Another name for the hierarchical database (HDB), which represents data in tree structures
  3. A general term for databases not based on the relational model, able to handle diverse data formats
  4. A database based on the relational model that handles data in tables of rows and columns
AnswerC. A general term for databases not based on the relational model, able to handle diverse data formats

NoSQL is a general term for databases not based on the relational model (RDB); there are diverse types such as key-value and document stores, and many suit distributed processing of large data volumes. A table-based database built on the relational model describes an RDB, and an HDB is the separate hierarchical category. The SQL-only claim is also wrong.

Q3 | Three-schema architecture

In the three-schema architecture, which schema defines the logical structure of the entire database?

  1. The internal schema
  2. The conceptual schema
  3. The external schema
  4. The physical schema
AnswerB. The conceptual schema

The conceptual schema is the layer that defines the logical structure of the entire database. The external schema defines the views seen by users and programs, and the internal schema defines the physical storage layout on the storage devices. There is no layer called the physical schema in three-schema terminology. Dividing into three layers increases data independence.

Q4 | E-R diagrams

Which statement about E-R diagrams is appropriate?

  1. A diagram showing the devices making up a network and how they are connected
  2. A diagram expressing the relationships and cardinality between entities
  3. A diagram expressing a program's processing steps with fixed symbols and flow lines
  4. A table listing every combination of inputs and outputs of a logic operation
AnswerB. A diagram expressing the relationships and cardinality between entities

An E-R diagram expresses entities and their attributes, the relationships between entities, and correspondence such as one-to-many (cardinality), and is used in conceptual database design. Processing steps are shown by flowcharts, device layouts by network diagrams, and logic operation inputs and outputs by truth tables.

Q5 | Primary keys

Which statement about the primary key in a relational database is appropriate?

  1. It uniquely identifies each row (record) in the table
  2. The same value may appear in multiple rows
  3. It is a key for referencing rows in another table
  4. NULL (an empty value) can be set as its value
AnswerA. It uniquely identifies each row (record) in the table

The primary key is a column (or combination of columns) that uniquely identifies each row in a table, and neither duplicate values nor NULL is allowed. The statements permitting duplicates or NULL are therefore wrong. Referencing another table's primary key is the role of a foreign key, which is distinct. The patient ID in a patient table is a typical primary key.

Q6 | Foreign keys

Which is an appropriate role of a foreign key?

  1. Act as a constraint prohibiting duplicate values in a column
  2. Act as an index to speed up searches and reduce lookup load
  3. Uniquely identify rows in the table, allowing no duplicates or empty values
  4. Reference the primary key of another table and maintain referential integrity between tables
AnswerD. Reference the primary key of another table and maintain referential integrity between tables

A foreign key is a column that references another table's primary key; through the referential integrity constraint — it cannot hold values absent from the referenced table — it keeps tables consistent. Uniquely identifying rows is the primary key, speeding up searches is an index, and prohibiting duplicates is a unique constraint; none describes a foreign key.

Q7 | Normalization

Which is an appropriate purpose of normalization in a relational database?

  1. Encrypt stored data to increase confidentiality
  2. Eliminate data duplication and prevent inconsistencies during updates
  3. Splitting tables always improves search speed
  4. Reduce data volume to shorten backup time
AnswerB. Eliminate data duplication and prevent inconsistencies during updates

Normalization splits tables so as to eliminate data duplication, with the aim of preventing contradictions (inconsistencies) during updates. Because split tables require joins, searches can actually become slower, so the claim that its purpose is faster searches is wrong. Encryption and shorter backup times are separate techniques unrelated to normalization.

Q8 | First normal form

Which operation converts an unnormalized table into first normal form?

  1. Eliminate repeating groups so that each field holds only 1 value
  2. Move columns that depend on the key through a non-key column into a separate table
  3. Add an index to every column
  4. Move columns that depend on only part of the primary key into a separate table
AnswerA. Eliminate repeating groups so that each field holds only 1 value

First normal form is the form in which repeating groups — multiple values in a single field — have been eliminated. Separating dependence on part of the primary key (partial functional dependence) yields second normal form, separating dependence through non-key columns (transitive functional dependence) yields third normal form, and adding indexes has nothing to do with normalization.

Q9 | SQL search

When the following SQL statement is run against the "patients" table, what value is returned?

-- 患者表患者ID | 氏名 | 年齢P001  | 佐藤 | 72P002  | 鈴木 | 45P003  | 高橋 | 65P004  | 田中 | 80P005  | 伊藤 | 301: SELECT COUNT(*) FROM 患者2: WHERE 年齢 >= 65;
  1. 1
  2. 4
  3. 3
  4. 2
AnswerC. 3

The WHERE condition "age >= 65" is satisfied by 3 rows — Sato (72), Takahashi (65), and Tanaka (80) — and COUNT(*) returns the number of matching rows, so the result is 3. Note that Takahashi, at exactly 65, is included by ">=". 2 is the value from leaving out Takahashi, and 4 comes from wrongly including Suzuki (45).

Q10 | GROUP BY

When the following SQL statement is run against the "visits" table, how many rows does the result contain?

-- 受診表受診ID | 診療科1     | 内科2     | 外科3     | 内科4     | 内科5     | 外科6     | 眼科1: SELECT 診療科, COUNT(*)2: FROM 受診3: GROUP BY 診療科;
  1. 3
  2. 4
  3. 5
  4. 6
AnswerA. 3

The GROUP BY clause groups rows by department value, so the result has as many rows as there are distinct departments. The table contains 3 departments — internal medicine, surgery, and ophthalmology — so the result is 3 rows (internal medicine 3, surgery 2, ophthalmology 1). 6 is the original row count without GROUP BY; the question tests how grouping works.

Q11 | Table joins

When the following SQL statement is run against the "patients" and "prescriptions" tables, how many rows does the result contain?

-- 患者表            -- 処方表患者ID | 氏名        処方ID | 患者ID | 薬剤名P001  | 佐藤        1     | P001  | 薬AP002  | 鈴木        2     | P003  | 薬BP003  | 高橋        3     | P003  | 薬C1: SELECT 患者.氏名, 処方.薬剤名2: FROM 患者3: INNER JOIN 処方4: ON 患者.患者ID = 処方.患者ID;
  1. 2
  2. 3
  3. 4
  4. 5
AnswerB. 3

INNER JOIN returns only the row pairs whose join condition (patient ID) matches. All 3 rows of the prescriptions table have matching rows in the patients table (1 for P001 and 2 for P003), so the result is 3 rows. Suzuki (P002), who has no prescriptions, does not appear. 2 comes from counting Takahashi's 2 rows as 1, and 5 confuses the answer with the simple total of row counts.

Q12 | Sorting

When the following SQL statement is run against the "patients" table, which name appears in the first row of the result?

-- 患者表患者ID | 氏名 | 年齢P001  | 佐藤 | 72P002  | 鈴木 | 45P003  | 高橋 | 80P004  | 田中 | 651: SELECT 氏名 FROM 患者2: ORDER BY 年齢 DESC;
  1. Sato
  2. Suzuki
  3. Takahashi
  4. Tanaka
AnswerC. Takahashi

ORDER BY age DESC sorts by age in descending order (largest first), so the oldest, Takahashi (80), comes first. Sato (72) is second. Confusing it with ascending order (ASC) would pick the youngest, Suzuki (45). Remember firmly that DESC means descending and ASC means ascending.

Q13 | Relational operations

Among the relational operations, which extracts the rows of a table that satisfy a condition?

  1. Union
  2. Projection
  3. Join
  4. Selection
AnswerD. Selection

Selection is the relational operation that extracts rows satisfying a condition; in SQL it corresponds to the WHERE clause. Projection extracts particular columns (the column list in SELECT), and join links multiple tables on a common column (JOIN). Union is a set operation combining the rows of 2 tables and differs from filtering rows.

Q14 | ACID properties

Among the ACID properties of transactions, which is the property that "either all of the processing is executed or none of it is"?

  1. Isolation
  2. Consistency
  3. Durability
  4. Atomicity
AnswerD. Atomicity

Atomicity (indivisibility) is the property that a transaction's processing is either fully executed or not executed at all, allowing no half-finished state. Consistency means integrity is maintained, durability means completed results are never lost, and isolation means freedom from interference by other transactions.

Q15 | Deadlock

What is the state in which 2 transactions each wait for the other to release its lock, so that neither can proceed?

  1. Roll-forward
  2. Livelock
  3. Checkpoint
  4. Deadlock
AnswerD. Deadlock

Deadlock is the state in which 2 transactions each wait for the release of the resources the other has locked and both stall; it is resolved by forcibly rolling one of them back. Livelock is a state in which processing keeps yielding and never progresses, roll-forward is a failure recovery process, and a checkpoint is a recovery starting point; all are different.

Q16 | Rollback

Which process returns the database to its pre-update state when a transaction ends abnormally?

  1. Rollback
  2. Two-phase locking
  3. Commit
  4. Roll-forward
AnswerA. Rollback

Rollback cancels the updates of an abnormally ended transaction using the before-images in the log, restoring the state before it began. Commit finalizes updates on normal completion, roll-forward redoes updates up to just before a media failure using backups and the log, and two-phase locking is a concurrency control scheme.

Q17 | Failure recovery

When a disk media failure occurs, which process restores the backup file and then uses the log (journal) file to redo updates up to the state just before the failure?

  1. Rollback
  2. Roll-forward
  3. Deadlock
  4. Commit
AnswerB. Roll-forward

Roll-forward restores the state as of the backup and then applies the after-images recorded in the log file in order, recovering to the state just before the failure. Rollback is the reverse process of cancelling updates, commit finalizes updates, and deadlock is a mutual lock wait; none is the recovery process from a media failure.

Q18 | ETL

Which is the series of processes that extracts and transforms data from operational systems and loads it into a data warehouse (DWH)?

  1. ETL
  2. Dashboard
  3. OLAP
  4. Data cleansing
AnswerA. ETL

ETL stands for Extract, Transform, and Load — the series of processes that brings operational system data into the analytical DWH. OLAP is multidimensional aggregation and analysis of accumulated data, data cleansing corrects errors and inconsistent notation, and a dashboard is a BI tool's visualization screen; the flow through to loading is ETL.

Q19 | OSI layer 3

Which is an appropriate role of layer 3 (the network layer) of the OSI reference model?

  1. Convert data representation formats between applications
  2. Convert bit strings into electrical or optical signals for transmission
  3. Transmit frames between adjacent devices
  4. Perform route selection (routing) based on IP addresses
AnswerD. Perform route selection (routing) based on IP addresses

The network layer performs route selection (routing) to the destination using IP addresses; IP is its representative protocol and the router its representative device. Frame transmission is layer 2, the data link layer; converting data representations is layer 6, the presentation layer; and converting to signals is layer 1, the physical layer.

Q20 | TCP and UDP

Which statement about TCP and UDP is appropriate?

  1. UDP is connection-oriented and more reliable than TCP
  2. UDP performs receipt confirmation and retransmission control
  3. TCP is a physical layer protocol in the OSI reference model
  4. TCP is connection-oriented and achieves highly reliable communication through delivery confirmation
AnswerD. TCP is connection-oriented and achieves highly reliable communication through delivery confirmation

TCP is a connection-oriented transport layer protocol that achieves reliable communication through delivery confirmation and retransmission control. UDP is connectionless and performs no confirmation or retransmission, which makes it lightweight and suited to real-time communication such as audio and video. The claims that TCP is physical layer and that UDP performs retransmission control are both wrong.

Q21 | MAC addresses

Which statement about MAC addresses is appropriate?

  1. An address assigned automatically by a DHCP server each time a terminal connects
  2. A 32-bit logical address used at the network layer
  3. A 48-bit physical address assigned to a network interface
  4. An address obtained from a domain name through DNS name resolution
AnswerC. A 48-bit physical address assigned to a network interface

A MAC address is a 48-bit physical address assigned to a network interface, identifying devices on Ethernet and Wi-Fi. What DHCP assigns is configuration such as IP addresses, the 32-bit logical address is an IPv4 address, and what is obtained from a domain name is also an IP address (DNS name resolution); none of these describes a MAC address.

Q22 | Subnets

What is the network address of the network to which a host with IP address 192.168.10.130/26 belongs?

  1. 192.168.10.0
  2. 192.168.10.192
  3. 192.168.10.128
  4. 192.168.10.64
AnswerC. 192.168.10.128

/26 corresponds to subnet mask 255.255.255.192, so the 4th octet is divided in steps of 64 (0, 64, 128, 192). Since 130 lies in the range from 128 up to but not including 192, the network address is 192.168.10.128. This can also be confirmed in binary: 130 is 10000010, and keeping the top 2 bits while zeroing the 6 host bits gives 10000000 = 128.

Q23 | Host count

In a subnet with prefix length /28, how many IP addresses can be assigned to hosts?

  1. 30
  2. 12
  3. 16
  4. 14
AnswerD. 14

With /28 the host part is 32 − 28 = 4 bits, so there are 2 to the 4th = 16 addresses. Of these, the network address (host bits all 0) and the broadcast address (host bits all 1) cannot be assigned, leaving 16 − 2 = 14 for hosts. 16 forgets to subtract the 2, and 30 is the value for /27.

Q24 | Same subnet

Which IP address belongs to the same subnet as a host with IP address 192.168.1.66 and subnet mask 255.255.255.224?

  1. 192.168.1.130
  2. 192.168.1.100
  3. 192.168.1.60
  4. 192.168.1.70
AnswerD. 192.168.1.70

With mask 255.255.255.224 (/27) the 4th octet divides in steps of 32, and 66 lies in the range 64-95 (network address 192.168.1.64). 70 is in the same 64-95 range and so is on the same subnet. 60 is in 32-63, 100 in 96-127, and 130 in 128-159, all belonging to different subnets.

Q25 | Private addresses

Which of the following is an IPv4 private address?

  1. 192.168.100.1
  2. 203.0.113.10
  3. 172.32.0.1
  4. 8.8.8.8
AnswerA. 192.168.100.1

Private addresses fall in the 3 ranges 10.0.0.0-10.255.255.255, 172.16.0.0-172.31.255.255, and 192.168.0.0-192.168.255.255, and 192.168.100.1 falls within them. 172.32.0.1 lies outside the range, which ends at 172.31. 8.8.8.8 and 203.0.113.10 are on the global side.

Q26 | DNS

Which is an appropriate role of DNS?

  1. Synchronize the clocks of devices on the network to a reference server
  2. Transfer email between mail servers and deliver it to the destination
  3. Automatically assign IP addresses and subnet masks to terminals
  4. Map domain names to IP addresses (name resolution)
AnswerD. Map domain names to IP addresses (name resolution)

DNS is the mechanism that maps domain names to IP addresses (name resolution), with DNS servers answering the queries. Automatic IP address assignment is DHCP, time synchronization is NTP, and mail transfer is SMTP — each a separate protocol. These role pairings appear often, so distinguish them reliably.

Q27 | DHCP

Which is an appropriate role of DHCP?

  1. Automatically assign network settings such as IP addresses to terminals
  2. Map domain names to IP addresses and answer name resolution queries
  3. Exchange route information between routers and decide the best route
  4. Send test packets to check reachability to a destination
AnswerA. Automatically assign network settings such as IP addresses to terminals

DHCP is the protocol that automatically hands out settings such as the IP address, subnet mask, and default gateway when a terminal connects. Name resolution is DNS, exchanging route information is done by routing protocols such as RIP and OSPF, and reachability checks are the role of ping, which uses ICMP.

Q28 | Port numbers

Which pairing of a service with its well-known port is appropriate?

  1. DNS - 25
  2. HTTP - 80
  3. NTP - 53
  4. SMTP - 110
AnswerB. HTTP - 80

The well-known port for HTTP is 80. SMTP is 25 (110 is POP3), DNS is 53 (25 is SMTP), and NTP is 123 (53 is DNS), so the other options mismatch the numbers. The port numbers of major services also matter for security configuration, so memorize them accurately.

Q29 | Sending mail

Which protocol is used to send email and to transfer it between mail servers?

  1. SMTP
  2. HTTP
  3. POP
  4. NTP
AnswerA. SMTP

SMTP is the protocol used for sending email and transferring it between mail servers. POP is the protocol by which users retrieve their own mail from a mail server and is not used for sending. HTTP transfers Web pages and NTP synchronizes time; neither has anything to do with mail transfer.

Q30 | NTP

Which is an appropriate role of NTP?

  1. Encrypt and store files
  2. Transfer Web pages between a Web server and a browser
  3. Receive email from a mail server
  4. Synchronize the clocks of devices on the network
AnswerD. Synchronize the clocks of devices on the network

NTP is the protocol that synchronizes device clocks on the network to a reference server. In medical information systems, synchronizing the clocks of servers and terminals is important for keeping the times in clinical records and logs trustworthy. Web page transfer is HTTP and mail retrieval is POP, and NTP is not a file encryption protocol.

Q31 | Routers

Which device forwards packets between different networks (routing) based on IP addresses?

  1. A UTP cable
  2. A router
  3. A hub (repeater hub)
  4. An L2 switch
AnswerB. A router

A router forwards packets between different networks based on IP addresses and its routing table; a switch with the equivalent function is an L3 switch. A hub relays received signals to every port, and an L2 switch forwards within the same LAN by looking at MAC addresses. A UTP cable is a transmission medium, not a device.

Q32 | Wireless LAN

Which statement about wireless LAN (IEEE802.11) is appropriate?

  1. Among encryption schemes, WPA2 is more secure than WEP
  2. Bluetooth is another name for the IEEE802.11 standard
  3. The SSID is the key used to encrypt communications
  4. Radio interference does not occur
AnswerA. Among encryption schemes, WPA2 is more secure than WEP

WEP is known to be easy to crack, so WPA and the stronger WPA2 are recommended. The SSID is a name identifying the access point (network), not an encryption key. Bluetooth is a separate short-range wireless standard from 802.11. In wireless LANs, interference occurs between radios on the same channel, so channel planning is necessary.

Q33 | VLAN

Which statement about VLANs is appropriate?

  1. One of the encryption standards defined to protect wireless LAN communications
  2. A technology that logically divides a network through switch configuration, independently of the physical wiring
  3. A public line provided by carriers to link physically distant sites
  4. One type of LAN cable using twisted pairs
AnswerB. A technology that logically divides a network through switch configuration, independently of the physical wiring

A VLAN is a technology that divides a network logically through switch configuration without changing the physical wiring. In healthcare institutions it is used to separate core networks such as the electronic medical record from administrative and guest networks. Wireless encryption standards are WPA2 and the like, cable types are UTP and STP, and the public line description is also wrong.

Q34 | VPN

Which statement about VPNs is appropriate?

  1. A network built solely from carriers' leased lines, using no public lines
  2. The name of the access point that wireless LAN terminals connect to
  3. A technology that provides redundancy by deploying multiple DNS servers
  4. A technology that builds a virtual private network over public lines using encryption and other techniques
AnswerD. A technology that builds a virtual private network over public lines using encryption and other techniques

A VPN is a technology that uses encryption and related techniques to build a virtual private network over public lines such as the Internet; it is used for site-to-site links, remote access, and protecting communications for remote maintenance of medical devices. It is not a physical leased line itself, and its distinguishing point is that it costs less to build than leased lines. It has nothing to do with access points or DNS redundancy.

Q35 | NAT

Which is an appropriate role of NAT (NAPT)?

  1. Determine the IP address from a MAC address to identify the communication partner
  2. Encrypt email and send it protected against tampering
  3. Synchronize device clocks on the network to a reference server
  4. Translate between private addresses and global addresses
AnswerD. Translate between private addresses and global addresses

NAT is a technology that translates between private and global addresses; NAPT additionally uses port numbers so that 1 global address can be shared by multiple terminals. It is used when in-house terminals with private addresses go out to the Internet. Time synchronization is NTP, and mail encryption is the role of S/MIME and the like.

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