TEST BANK Law & Ethics for the Health Professions 10th Edition by Karen Judson, Carlene Harrison

Law & Ethics for Health Professions 10e Karen Judson, Carlene Harrison and Tammy Albright

Chapter 1-13 With Answer Key Chapter 1

Student name: 1) Law may be defined as A) a moral code.

B) good manners.

C) rules of conduct.

D) protocol.

2) Etiquette rules used in the workplace are called A) protocol.

B) ethics.

C) policies.

D) morals.

3) Which of the following is/are not enacted by government?

A) Laws B) Statutes C) Etiquette rules D) Medical practice acts

4) What do professional organizations create to govern their members?

A) Laws B) Codes of ethics C) Statutes D) Procedure manuals

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5) What is the purpose of formalized codes of ethics in the health care professions?

A) To increase the competence within the profession.

B) To revoke the licenses of unethical practitioners.

C) To provide a consistent guide for protocol.

D) To relieve the lawmaking bodies of their legal responsibilities.

6) Which document serves as a guideline about professional behavior and etiquette for

employees?

A) The AMA's Code of Ethics.

B) The facility policy manual.

C) Medical practice acts.

D) Emily Post's Guide to Etiquette.

7) What is the meaning of the term litigious?

A) Higher number of practicing lawyers.

B) Decreased legal liability.

C) Increase in the number of lawsuits.

D) Increase in consumer awareness of health care.

8) The plaintiff in a lawsuit is the A) party against whom criminal or civil charges have been filed.

B) party filing the civil charges.

C) party held liable.

D) party that testifies.

9) A pledge for physicians that remains influential today is A) Code of Hammurabi.

B) Babylonian Ethics Code.

C) Hippocratic oath.

D) Socrates' pledge.

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10) The defendant in a lawsuit is the A) party against whom criminal or civil charges have been filed.

B) party filing the civil charges.

C) party held liable.

D) party that testifies.

11) An attorney files a motion that pleads there is no basis for a trial. This is called A) acceptance.

B) precedent.

C) summary judgment.

D) administrative law.

12) Another term for legal responsibility is A) liability.

B) litigious.

C) testimony.

D) defense.

13) Ethics may be defined as A) a standard of competence.

B) principles, standards, and a guide to conduct.

C) courtesy and manners.

D) beliefs formed through the influence of family, culture, and society.

14) Bioethics is concerned with A) etiquette in medical research.

B) health care law.

C) the ethics of scientists doing research in a university.

D) ethical implications of biological research methods and results.

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15) Which of the following is a synonym for "good manners"?

A) Protocol B) Etiquette C) Morals D) Laws

16) The first step in critical thinking problem solving is to A) evaluate the evidence.

B) gather information.

C) identify and clarify the problem.

D) consider alternatives.

17) A medical-surgical nurse is going off shift and giving her report to the nurse coming on duty.

She is clearly and accurately describing the conditions of the patients she cared for during her shift. This is an example of what skill?

A) People skills.

B) Critical-thinking skills.

C) Technical skills.

D) Moral values skills.

18) Which of the following is an example of a healthcare practitioner displaying compassion for

a patient?

A) A physician making rounds in a hospital asks a patient how he is doing.

B) A nurse feels sorry for a patient who was just diagnosed with cancer.

C) A physician sits down with a patient and addresses all the concerns of the patient.

D) An LPN helps an elderly person walk through the hallways.

19) A radiology technician approaches a new patient and states, "I am Jennifer and I will be

taking care of you today." Which of the three "Cs" is an example of this?

A) Common sense B) Compassion C) Courtesy D) Coordination

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20) A student medical assistant doing his or her internship in a physician's office refuses to wipe

up a spilled drink in the exam room hallway because he or she believes housekeeping is not part of his or her job description. The student is demonstrating the absence of which quality deemed necessary for successful health care practitioners?

A) Compassion B) Technical skill C) Common sense D) Courtesy

21) Formed through the influences of family, culture, and society, which of these serve as the

basis for ethical conduct?

A) Moral values B) Code of etiquette C) Protocol standards D) Laws

22) A health care practitioner completes a course in law and ethics. In this field of study, Which

of the following reasons should be most important to health care professionals?

A) To promote patient and employee safety.

B) To help explain the process of informed consent to patients.

C) To help avoid legal entanglements.

D) To learn the inner workings of the health care system.

23) Unlawful acts are always A) unacceptable.

B) unethical.

C) punishable by legal means.

D) punishable by professional groups.

24) Unethical behavior is always A) unacceptable.

B) illegal.

C) punishable by legal means.

D) punishable by professional groups.

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25) Which of the following is considered a technical skill?

A) Tact B) Problem-solving C) Common sense D) Computer literacy

26) A precedent is a(n) A) law enacted by the federal government.

B) case that serves as a model for future cases.

C) protocol rule.

D) summary judgment.

27) Written codes of ethics for health care practitioners A) evolved primarily to serve as moral guidelines for those who provide care.

B) are legally binding.

C) did not exist in ancient times.

D) are used in legal cases.

28) The health care professional who studies law and ethics gains perspective on current issues

that affect health care practice. Which of the following accurately describes one of those issues?

A) A decrease in health care costs makes health care more affordable.

B) The media has ensured that everyone has the same access to medical care.

C) With the advancement of medical technology, patients expect favorable outcomes.

D) Health care professionals should not be involved in the legal issues of patients.

29) A new employee in a large medical practice is looking for the professional etiquette staff

members are expected to follow. Which would be the best source for learning these rules?

A) The employee's professional code of ethics.

B) The state's medical practice acts.

C) The bulletin board in the employee lounge.

D) policy manual.

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30) Dishonest or deceitful practices in depriving, or attempting to deprive, another of his or her

rights is considered to be

31) Standards of behavior, developed as a result of one's concept of right and wrong, is known as

32) A specialist who consults with physicians, researchers, and others to help them make difficult

decisions is known as

33) Rules of etiquette applicable to one's place of employment are known as

Answer Key Test name: chapter 1 1) C

Laws are rules that require everyone to behave the same way or face formal punishment.

2) A

Different offices may follow different etiquette rules.

3) C

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Etiquette changes depending on the organization and situation.

4) B

A code of ethics allows standards to be set to define competency.

5) A

A code of ethics allows standards to be set to define competency.

6) B

Most organizations have a policy manual that provides employees with guidance as to how to act in certain situations.

7) C

A litigious society is one in which patients, relatives, and others are inclined to sue health care practitioners, health care facilities, manufacturers of medical equipment and products, and others when medical outcomes are not acceptable.

8) B

The plaintiff is the person(s) filing the lawsuit. A defendant is the person being sued. Witnesses testify in court, and judges preside over lawsuits.

9) C

Hippocrates created an oath that is still in use today.

10) A

A defendant is the person being sued and who must defend himself or herself in court. Witnesses testify in court, and judges preside over lawsuits. The plaintiff is the person(s) filing the lawsuit.

11) C

Summary judgment states that one party is entitled to win as a matter of law and no trial is necessary.

12) A

Legal responsibility is also known as legal liability. A person(s) or organization may be found legally responsible for an action.

13) B

Ethics and moral values are sometimes confused. Ethics are a guide to conduct, while moral values are the beliefs formed through the influence of family culture and society.

14) D

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Bioethics is the study of how biological research and ethical guidelines are established.

15) B

Etiquette is the basic rules of behavior usually known as good manners.

16) C

Identifying and clarifying the problem is the first step in critical thinking. It is followed by gathering information, evaluating the evidence, considering the alternatives, and implementing the decision.

17) A

People skills include good communication skills. Critical thinking is a problem-solving skill, and technical skills may include proficiencies in working with equipment.

18) C

Compassion is empathy—identifying and understanding another's situation, feelings, and motives. This occurs when the physician takes the time to listen to the patient and answer questions. Sympathy is when one feels sorry for another. Asking about a patient's family is courtesy, and helping a patient walk is a work-related task.

19) C

The simple definition of courtesy is good manners, as is displayed when the technician introduces herself to the patient.

20) C

All health care personnel are responsible for maintaining a safe workplace. If a patient or another employee were to slip and fall because the student thought it was not his or her job, it demonstrates a lack of common sense.

21) A

Our values are determined by a variety of influences including our family, culture, and society.

Sometimes, one of these influences has more weight than others.

22) C

The study of law and ethics will aid the health care professional in practice to avoid legal problems.

23) B

An illegal act is always considered unethical, which may be punishable by legal means.

24) A

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Although unethical behavior is wrong, it is not necessarily illegal. For example, some providers believe that it is unethical to perform an abortion; however, it is not illegal.

25) D

Technical skills include those abilities acquired in a course of study, such as computer skills.

Tact is a people skill, and common sense and problem solving are critical-thinking skills.

26) B

In case law, previous cases often serve as guidance for the court.

27) A

Although codes of ethics are important and have been around for a long time, they are not legally binding.

28) C

As medical technology has advanced, patients have come to expect favorable outcomes from medical treatment. Rising costs lead to questions concerning access to care, and health care practitioners need to be concerned about how law and ethics may affect the patients they treat.

29) D

Most health care facilities have their own policies concerning etiquette that staff members are expected to follow. These manuals may serve as both a permanent record, and guidelines, for employees.

30) Short Answer

Fraud or intentional deceit.

Dishonest or deceitful practices in depriving, or attempting to deprive, another of his or her rights is considered to be fraud or intentional deceit.

31) Short Answer

ethics, which is concerned with the concept of right or wrong over and above that which is legal in a given situation.

Standards of behavior, developed as a result of one's concept of right and wrong, is known as ethics, which is concerned with the concept of right or wrong over and above that which is legal in a given situation.

32) Short Answer

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a medical ethicist or bioethicist.

A specialist who consults with physicians, researchers, and others to help them make difficult decisions is known as a medical ethicist or bioethicist.

33) Short Answer

protocol, which is a set of rules that everyone must follow within an organization.

Rules of etiquette applicable to one's place of employment are known as protocol, which is a set of rules that everyone must follow within an organization.

Student name: 34) In Abraham Maslow's hierarchy of human needs, the need for basic life (food, shelter), a safe

environment, and to belong and be loved are designated "D" needs. What does "D" stand for?

A) Deficiency B) Deprivation C) Destitute D) Demanding

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35) Which of the following is known as a B-need in Maslow's hierarchy of human needs?

A) A patient with cancer needs chemotherapy.

B) A medical assistant needs to be respected by his/her fellow medical assistants.

C) A child in the waiting room needs a safe play area.

D) A family needs food from the food bank.

36) Psychologists question how individuals develop values that guide them in ethical decision

making. Which of the following reflects current thought on value development?

A) Individuals move from a personal value system to a needs-based motivation.

B) Value development is the same for all people regardless of culture.

C) Value development is not influenced by economic status.

D) When people are born, they have no values in place.

37) A health practitioner is interviewing a 6-year-old male child who is in Piaget's preoperational

stage. Which of the following is characteristic of this stage?

A) The child views the world from his own perspective.

B) The child is totally self-centered.

C) The child tends to see things as either right or wrong.

D) The child begins to develop abstract thought.

38) A child life specialist caring for children in the pediatric ward plays a game with a young

patient who is enjoying the game, but makes up the rules as she goes along. This behavior is characteristic of what stage of moral development?

A) Sensorimotor stage B) Preoperational stage C) Concrete operational stage D) Formal operational stage

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39) A child tells a nurse that he stole money from his mother's purse because he needed to buy

some candy. He also states that he knows what he did was wrong and will not do it again.

Based on this conversation, what stage of moral development would this child be experiencing?

A) sensorimotor stage B) preoperational stage C) concrete operational stage D) formal operational stage

40) Which of the following theorists believed that human behavior is based on specific human

needs that must often be met in a specific order?

A) Abraham Maslow B) Jean Piaget C) Lawrence Kohlberg D) Immanuel Kant

41) Lawrence Kohlberg modified and expanded Piaget's work, laying the groundwork for

modern studies on moral development. On which of the following tenets did the two disagree?

A) That children under 12 years of age could develop moral values.

B) That children form ways of thinking through their experiences.

C) That the process of moral maturity took longer than 12 years.

D) That children under 12 years of age could understand moral concepts.

42) A person who makes a commitment to universal principles such as social justice, equal

rights, and respect for the dignity of all people is in what stage of Kohlberg's developmental theory?

A) Preconventional morality, Stage 1 B) Preconventional morality, Stage 2 C) Conventional morality D) Postconventional morality, Stage 2

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43) Jean Piaget is one of the most famous researchers in value development. How did Piaget

formulate that there are four levels of moral development?

A) By interviewing families with children.

B) By interviewing grandparents.

C) By observing children at play.

D) By researching the discipline patterns of parents.

44) A hospital administrator makes a decision to shut down a wing due to budget cuts even

though some people will lose their jobs. The decision is based on results that will produce the greatest balance of good over evil, everyone considered. What type of framework is the administrator employing to make this value decision?

A) Duty-oriented theory B) Deontological theory C) Rule-utilitarianism D) Act-utilitarianism

45) A nurse manager determines the work shifts for the staff based on a predetermined health

care facility guidelines. This is an example of what type of decision making?

A) Rule-utilitarianism B) Act-utilitarianism C) Duty-oriented D) Deontological

46) When using the utilitarianism method of problem solving, which of the following do

proponents of this method indicate should be the solution of choice?

A) The option with the earliest solution to the problem.

B) The option that reflects the decider's highest principles.

C) The solution that provides happiness over pain for those involved.

D) The solution that has the best long-term results.

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47) A health care facility administrator considers the principle of utility when making decisions

that affect the employees of the facility. Which of the following describes this principle?

A) It is based upon absolute truths applied in other situations.

B) It brings about positive results when generalized to a wide variety of situations.

C) It is the decision that is desired by the majority.

D) It is the decision that has the fewest adverse effects on the facility as a whole.

48) Immanuel Kant defined categorical imperative as the guiding principle for all decision-

making. What is the meaning of this principle?

A) There are no exceptions to the rule.

B) It is imperative to solve problems in a timely fashion.

C) All categories of decision-making are subject to the same scrutiny.

D) The consequence of the act is more important than whether it was right or wrong.

49) A physician running a busy practice makes decisions for his employees on a regular basis.

The physician would describe himself as a "moral man with common sense, a sense of justice, and courage who makes the right decisions in life by focusing on these moral traits."

What theory of decision making is being employed by this physician?

A) Deontological B) Utilitarian C) Virtue ethics D) Consequence-oriented theory

50) Virtue ethics focuses on the traits, characteristics, and virtues that a moral person should

have. Who is the most well-known ethicist to write about this ethical decision making process?

A) Alasdair MacIntyre B) Immanuel Kant C) Abraham Maslow D) Jean Piaget

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51) According to MacIntyre's theory of virtue ethics, what principle helps the decision maker

arrive at a decision?

A) Belief in a higher being.

B) Loyalty to the role he or she plays.

C) Belief in the golden rule.

D) Looking to the future.

52) What basic flaw do critics cite as the major problem with using value ethics as a decision-

making tool?

A) The decision-making framework is too rigid.

B) People in different walks of life would come to different decisions.

C) Not all people are moral or use common sense.

D) The past may not provide the right answer.

53) A housekeeper at a local hospital has worked her way up to housekeeping supervisor. But as

she thinks about her future, she realizes that she only works to be recognized and have responsibility. She determines that she is not recognized for her work and decides to go to a nursing school. At what stage might she be in Maslow's Hierarchy of Needs?

A) Esteem stage.

B) Safe and secure environment stage.

C) Concrete operational stage.

D) Conventional morality stage.

54) Autonomy is considered one of the seven universal principles of health care ethics. Which of

the following is an example of autonomy?

A) A physician performs health care screenings for impoverished patients.

B) A housekeeper in the hospital performs duties following safety procedures.

C) A health care practitioner makes competent decisions related to patient care.

D) An x-ray technician follows HIPAA regulations when displaying x-rays.

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55) A patient undergoing surgery signs an informed consent for the procedure. Which of the

following principles of health care ethics does informed consent protect?

A) Autonomy B) Role fidelity C) Confidentiality D) Nonmaleficence

56) A patient who was injured in a fall in a health care facility due to the negligence of the nurse

is filing a medical malpractice lawsuit. Which ethical principle applies in this situation?

A) Autonomy B) Role fidelity C) Veracity D) Justice

57) An x-ray technician witnesses a nurse diagnosing a medical problem for a patient. Which of

the seven principles of health care ethics has this nurse violated?

A) Justice B) Nonmaleficence C) Role fidelity D) Veracity

58) A doctor prescribes a placebo for a patient who he feels is complaining of pain that is not

there. This is an example of a violation of what principle of health care ethics?

A) Justice B) Veracity C) Role fidelity D) Beneficence

59) A nurse caring for older adults in a nursing home has a paternalistic view about telling

patients the truth about their conditions. Which of the following best describes the practice of paternalism?

A) Thinking that "I know what is best for the patient."

B) Being a strong patient advocate.

C) Acting like a parent to the patient.

D) Forcing patients to do things against their will.

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60) A lab technician is speaking loudly about the reason a patient is having a blood test outside

the patient's door. What principle of health care ethics has the tech violated?

A) Justice B) Veracity C) Confidentiality D) Role fidelity

61) A physician is caring for an indigent 37-year-old male patient with no health insurance, who

is admitted to the hospital with acute pancreatitis related to alcohol abuse. The administrator questions whether this patient is entitled to health care because he did not take responsibility for his actions leading to this condition and he has no health insurance plan. What is the ethical principle guiding the physician's actions?

A) Nonmaleficence B) Veracity C) Justice D) Confidentiality

62) What is the unique focus of health care providers that challenges them to make sound ethical

decisions?

A) The administration of medications.

B) The performance of medical procedures.

C) The health and well-being of the patient.

D) The allocation of scarce resources.

63) The need for a person to develop a sense of self-worth is part of Maslow's hierarchy of needs.

Which need is it?

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64) In Jean Piaget's stages of development, in what age range is a child in the egocentric stage?

65) This value choices theory states that decisions should be made by determining what will

produce the best outcome.

66) This theory focuses on the essential rightness or wrongness of an act, not the consequence of

the act.

67) An act performed by a health care practitioner to help a patient stay healthy or recover from

illness is which principle of health care ethics?

68) Define social determinants of health.

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69) What is a health disparity? How is it different from health equity?

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Answer Key Test name: chapter 2 34) A

Maslow defined needs 1 to 3 as deficiency or D-needs. Needs 1 to 3 include the physiological needs of water and food, the safety needs of shelter, and the love and belongingness needs of obtaining and giving affection. Needs 4 and 5 are growth needs, also known as being or B-needs.

Esteem needs are at level 4 and self-actualization is at level 5.

35) B

The need for esteem and respect is a B-need. The need for chemotherapy and food along with the assistance with a medical problem are D-needs. Safety needs would include a safe play area for children in the physician's office.

36) D

People are born without values. Many psychologists believe that individuals move from needsbased motivation to a personal value system that develops from childhood. The value system people develop as they grow and mature is dependent on the cultural framework and economic situation in which they live.

37) A

During the preoperational stage (2 to 7 years), the child views the world from his or her own perspective. In the sensorimotor stage (birth to 2 years), the child is totally self-centered. In the concrete operational stage (7 to 12 years), the child tends to see things as either right or wrong, and in the formal operational stage, children develop abstract thought and begin to understand there may be varying degrees of wrongdoing.

38) B

The child in the preoperational stage of moral development views the world from his or her own perspective. For example, when playing a game, the child is not particularly concerned with the rules of play, rather the focus is on fun.

39) D

During the formal operational stage, children develop abstract thought and begin to understand that there may be different degrees of wrongdoing. During this stage, intentions, such as lying (I intend to deceive you) and stealing (I intend to take that money) are central to the decisions made.

40) A

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Abraham Maslow is the best known psychologist for the needs-based motivation theory. By observing children at play, Piaget described four levels of moral development. Lawrence Kohlberg modified and expanded Piaget's work, laying the groundwork for modern studies on moral development. Immanuel Kant is considered the father of duty-oriented theory.

41) C

Consistent with Piaget, Lawrence Kohlberg proposed that children form ways of thinking through their experiences that include understanding of moral concepts such as justice, rights, equality, and human welfare. Kohlberg differed from Piaget in that he followed the development of moral judgment beyond the ages studied by Piaget, and he determined that the process of attaining moral maturity took longer and was more gradual than Piaget had proposed.

42) D

The second stage of postconventional morality is called universal principles. In this stage, an individual makes a personal commitment to universal principles such as social justice, equal rights, and respect for the dignity of all people and realizes that conventional norms and conventions are necessary to uphold society. If there is a conflict between these values and the social contract, the individual follows his or her basic principles.

43) C

A variety of theories exist about how people develop values. Most focus on the stages of development from childhood to adulthood. By observing children at play, Piaget described four levels of moral development.

44) D

Teleological or consequence-oriented theory judges the rightness of a decision based on the outcome or predicted outcome of the decision. Utilitarianism is the most well-known of these theories. In act-utilitarianism, a person makes value decisions based on results that will produce the greatest balance of good over evil. In rule-utilitarianism, a person makes value decisions based on a rule that if generally followed would produce the greatest balance of good over evil.

Deontological or duty-oriented theory focuses on the essential rightness or wrongness of an act, not the consequences of the act.

45) A

In rule-utilitarianism, a person makes value decisions based on a rule that if generally followed would produce the greatest balance of good over evil, everyone considered. In act-utilitarianism, a person makes value decisions based on results that will produce the greatest balance of good over evil, everyone considered. Deontological or duty-oriented theory focuses on the essential rightness or wrongness of an act, not the consequences of the act.

46) C

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Often when describing utilitarianism, writers indicate that the solution that provides happiness or a net increase in pleasure over pain for those involved should be selected.

47) B

Supporters of the utilitarian theory have created a principle of utility. The principle of utility requires that the rule used to make the decision be a rule that brings about positive results when generalized to a wide variety of situations. There are, however, no absolute truths in utilitarianism.

48) A

Deontological or duty-oriented theory focuses on the essential rightness or wrongness of an act, not the consequences of the act. Immanuel Kant is considered the father of duty-oriented theory.

He defined the categorical imperative as the guiding principle for all decision making. This principle means that there are no exceptions (categorical) from the rule (imperative). The right action is the one based on a determined principle, regardless of outcome.

49) C

Rather than focusing on decision making or reasoning to arrive at a right action, virtue ethics focuses on the traits, characteristics, and virtues that a moral person should have. Virtue ethicists believe that someone who has appropriate moral virtues such as practical wisdom (common sense), a sense of justice, and courage will make the right decision. Deontological or dutyoriented theory focuses on the essential rightness or wrongness of an act, not the consequences of the act. Utilitarianism is a consequence-oriented theory which states that decisions should be made by determining what results will produce the best outcome for the most people.

50) A

MacIntyre argued that the practice of medicine has traditions and standards of practice that apply to every health care practitioner and which may be used to follow the dictates of an idealized role. Immanuel Kant is considered the father of duty-oriented theory. He defined the categorical imperative as the guiding principle for all decision making. Abraham Maslow identified a hierarchy of needs that motivates our actions. By observing children at play, Piaget described four levels of moral development. Lawrence Kohlberg laid the ground for studies of moral development.

51) B

In virtue ethics, the loyalty to the role the decision maker plays helps make the decision. The decision maker looks to what has been done in the past, assuming that it represents the right answer. Belief in a higher being and the golden rule are characteristics of deontological or dutyoriented theory.

52) D

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Like the other theories, virtue ethics has its critics, especially because the past may not provide the right answer. Situations that were appropriate in health care 10 years ago may not apply today.

53) A

Maslow's hierarchy recognizes the esteem stage as the stage where status, responsibility, and recognition are most important. The safe and secure environment and basic life stage come before the esteem stage. The concrete operational stage is a stage for Piaget's theories. The conventional morality stage is from Kohlberg's research.

54) C

Autonomy is characterized by competency, ability to act on decisions, and respect for the autonomy of others. Performing screenings for impoverished patients is an example of beneficence. Keeping patients safe is an example of nonmaleficence. Confidentiality is protected when the HIPAA act is followed.

55) A

Informed consent is vital to preserving a health care consumer's autonomy. Role fidelity refers to a health care practitioner being true to his role. Confidentiality involves keeping the patient information private. Nonmaleficence, as paraphrased from the Hippocratic Oath, means the duty to "do no harm."

56) D

Providing a patient with what they are due is justice. When a patient is injured due to the negligence of their care giver, they are due justice. In the medical setting, this usually involves filing a medical malpractice lawsuit. Autonomy is self-determination, role fidelity refers to a health care practitioner being true to his or her role, veracity is truth-telling, and beneficence is the act of helping people stay healthy.

57) C

All health care practitioners have a specific scope of practice for which they are licensed, certified, or registered, and from which the law says they may not deviate. In addition to the laws that affect scope of practice, it is a basic ethical principle that a practitioner must be true (have fidelity) to his or her role. Justice refers to what is due to an individual. Nonmaleficence means doing no harm to the patient. Veracity is truth-telling.

58) B

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Veracity or truth-telling has always had an ambiguous place in the health care practitioner's world. Because medical providers want to do what is best for the patient, they may not always tell the whole truth, as is the case in this example. Justice refers to what is due to an individual.

Role fidelity is being faithful to the health care role, and beneficence means helping people stay healthy.

59) A

Some medical providers take a paternalistic view about truth telling, determining that what the patient doesn't know won't hurt them. This practice does not always involve advocacy (acting in a patient's best interest) and is not always acting like a parent to a child. Forcing patients to do things against their will is a form of bullying or abuse.

60) C

Health care practitioners mindful of protecting privacy and confidentiality do not conduct conversations about patients in the hospital hallway, in the medical office break room, or with an acquaintance on the street or in any other public place. Justice refers to what is due to an individual, veracity refers to truth-telling, and role fidelity is being faithful to the health care role.

61) C

Justice is defined as what is due to an individual. However, there is a debate over whether the distribution of scarce resources and the expense of providing them should allow us to provide all care for all patients. Others argue that people must take responsibility for their actions, such as not abusing alcohol, before assuming they can have justice. Nonmaleficence refers to doing no harm, veracity is truth telling, and confidentiality involves protection of privacy and confidentiality for patients.

62) C

Health care ethics are drawn from the same pool of basic ethical principles that might be listed for any profession, but the nature of health care provides a unique focus. Primarily because a person's health is paramount to his or her living a successful and satisfying life, health care practitioners are routinely challenged to make sound decisions—concerning not only the appropriate medical care for each patient's condition but also the patient's future health and wellbeing, and sometimes the health and well-being of the patient's family. Administering medications, performing medical procedures, and allocating resources are integral parts of the decision-making process, but the health of the patient is the main focus.

63) Short Answer

Esteem, The need for esteem, where status, responsibility, and recognition are important.

64) Short Answer

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Ages 2 to 7. During this time period, the child views the world from his or her own perspective.

65) Short Answer

Utilitarianism, which is a consequence-oriented theory.

66) Short Answer

Duty-oriented theory, which states the rightness or wrongness of an act.

67) Short Answer

Beneficence. Beneficence is defined as acts of charity and mercy but it means more for health care workers. Beneficence is acts performed by a health care practitioner to help people stay healthy or recover from illness.

68) Short Answer

Social determinants of health are living conditions that affect health, such as shelter, food, income, education, a stable environment, sustainable resources, social justice, and equity.

69) Short Answer

A health disparity is a particular type of health difference that is closely linked with economic, social, or environmental disadvantage. Health equity is when those differences are no longer a problem for all people, including those at a greater risk of poor health.

Student name: 70) A valid out-of-state license is accepted as the basis for issuing a license in a second state

without reexamination. This is called A) Certification.

B) Accreditation.

C) Registration.

D) Reciprocity.

71) Which of the following credentials are voluntary, and require a national examination that

shows the level of competency for an individual?

A) Certification and Registration B) Accreditation and Certification C) Registration and Endorsement D) Reciprocity and Certification

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72) Which of these credentials is mandatory for certain health professionals to practice in their

field?

A) B) C) D)

Certification Accreditation Registration Licensure

73) A health care provider is explaining to staff members about the accreditation process. Which

of the following may be accredited?

A) A pharmacist B) A hospital C) A pharmaceutical company D) A pharmacy

74) A new long-term care facility is applying for accreditation of the facility. To which of the

following organizations should the facility submit the accreditation application?

A) The American Health Care Association B) The National Committee for Quality Assurance C) The Joint Commission D) The Commission on Accreditation of Allied Health Education Programs

75) A health care provider is explaining to staff members about the accreditation process. Which

of the following may be accredited?

A) A pharmacist B) A hospital C) A pharmaceutical company D) A pharmacy

76) Which of the following is not sufficient grounds for revoking a medical license?

A) Conviction of a felony B) Falsifying medical records C) Misdiagnosis D) Personal incapacity

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77) Many hospitals, neighborhood health clinics, and some Blue Cross Blue Shield companies

are examples of A) For-profit businesses.

B) Health care companies that make products.

C) Not-for-profit businesses.

D) Government health facilities.

78) A copayment is A) a percentage of the fee for services provided that the patient pays.

B) a set amount that each patient pays for each office visit.

C) a portion of the fee that the physician must write off.

D) the actual payment the insurance company makes to the provider.

79) When physicians, hospitals, and other health care providers contract with one or more HMOs

or directly with employers to provide care, it is called a(n) A) health maintenance plan.

B) physician hospital organization.

C) fee-for-service plan.

D) indemnity plan.

80) A patient is established with a physician in a primary care practice that provides a team based

approach to health care with an emphasis on preventive services, care coordination, and enhanced access for patients. This is known as a(n): A) Health maintenance plan.

B) Primary care medical home.

C) Patient-centered medical home.

D) Independent practice home.

81) Coinsurance is A) a percentage of the fee-for-services provided that the patient pays.

B) a set amount that each patient pays for each office visit.

C) a portion of the fee that the physician must write off.

D) the actual payment the insurance company makes to the provider.

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82) A method used by a health plan to measure the amount and appropriateness of health services

used by its members is called a(n) A) coinsurance review.

B) utilization review.

C) accountable care review.

D) formulary review.

83) Under which type of plan, a patient may see providers outside the plan, but the patient pays a

higher portion of the fees?

A) Health maintenance plan B) Indemnity plan C) Fee-for-service plan D) Preferred provider plan

84) The oversight of all educational accrediting bodies in higher education is done by A) U.S. Department of Education and Council on Higher Education Accreditation.

B) Commission on Accreditation of Allied Health Education Programs.

C) The Joint Commission.

D) Accrediting Bureau of Health Education Schools.

85) Jeanna is the new director of a nursing education program at a local college. The program is

an associate degree program in nursing. Which agency accredits associate degrees in nursing programs?

A) Commission on Accreditation of Allied Health Education Programs B) Commission on Collegiate Nursing Education C) Accrediting Bureau of Health Education Schools D) Accreditation Commission for Education in Nursing

86) The National Practitioner Data Bank may disclose information to which of the following

groups?

A) Medical malpractice insurers B) Defense attorneys C) State licensing boards D) The general public

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87) A practice act A) Defines what is meant by practice of the individual profession in each state.

B) Explains requirements for licensing of a profession.

C) Defines grounds for suspension or revocation for a specific profession.

D) All of these are part of a practice act.

88) A health care profession that is certified may find the scope of practice for that profession in

the

practice act.

A) nursing B) hospital C) medical D) ambulatory care facilities

89) The largest integrated health care system in the United States is (are) A) Blue Cross Blue Shield Insurance Companies.

B) Veterans Health Administration.

C) Federally Qualified Health Centers.

D) State Health Departments.

90) Which of the following is not true about certification?

A) If you lose your certification, you cannot work in your profession.

B) If you lose your certification, you can continue to work in your profession.

C) Certification is voluntary.

D) Certification requires an exam.

91) Reciprocity may apply to A) certified professionals.

B) licensed professionals.

C) licensed and certified professionals.

D) licensed and registered professionals.

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92) The Joint Commission accredits A) educational institutions.

B) managed care organizations.

C) hospitals and other patient care organizations.

D) professional associations like the College of Health Care Executives.

93) The Commission on Accreditation of Allied Health Education Programs (CAAHEP)

oversees the accreditation process of a variety of individual allied health educational programs. Which of the following educational programs is not accredited by the CAAHEP? A) Medical assisting B) Surgical Assistants C) Emergency Medical Technicians D) Registered Nurses

94) What is the difference between licensure and certification?

95) The term that refers to a process for officially authorizing or approving health care

practitioners, education programs, health care facilities, and managed care plans is called

96) What feature of the United States health care industry makes it somewhat unique from other

industries?

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97) Health insurance that covers the insured against a potential loss of money from medical

expenses resulting from an illness or accident is known as

98) What is the purpose of a practice act in health care?

99) Identify at least three reasons a physician's license may be revoked.

100)

Identify and define the four types of health care business.

101)

Who may own a health care corporation?

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Answer Key Test name: chapter 3 70) D

Reciprocity is when a second state accepts the first state's credentials for licensing a health care provider. Certification, registration, and accreditation are not licensure methods.

71) A

Certification and registration are both voluntary and will require an exam. Reciprocity is when a second state accepts the first state's credentials for licensing a health care provider. Licensure is a mandatory process. Accreditation is used for organizations, not individuals. Endorsement is on a case-by-case basis and infrequently used.

72) D

Licensure is a mandatory process. Certification, registration, and accreditation are not licensure methods.

73) B

Accreditation is the process by which health care practitioner education programs, health care facilities, and managed care plans are officially authorized. It is the official approval for conforming to specific standards.

74) C

The Joint Commission accredits health care organizations that meet certain standards. The National Committee for Quality Assurance is a recognized accrediting agency for management care plans. An accrediting agency for health care practitioner education programs is the Commission on Accreditation of Allied Health Education Programs. The American Health Care Association is a industry-specific professional organization.

75) B

Accreditation is the process by which health care practitioner education programs, health care facilities, and managed care plans are officially authorized. It is the official approval for conforming to specific standards.

76) C

In the options provided, a physician may, depending on the state medical practice act, lose his or her license for conviction of a felony, falsifying medical records, incapacity, or unprofessional conduct. A misdiagnosis is not grounds for revoking a license but that does not mean that the physician won't be sued for the misdiagnosis.

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77) C

While some hospitals and Blue Cross Blue Shield insurance companies may be for-profit, many are not-for-profit business. A not-for-profit business must still earn enough money to stay in business and have a reserve.

78) B

A copay and coinsurance are both related to what the patient pays. However, coinsurance is always a percentage, not a set fee.

79) B

In many areas, physicians and hospitals join forces to negotiate with the HMOs or large employers to provide care. A fee-for-service plan focuses on patient choice, while an indemnity plan is a more traditional insurance plan, sometimes called fee-for-service.

80) C

A patient-centered medical home (PCMH) provides the patient with a physician practice whose focus is on coordination of care and shared decision making.

81) A

A copay and co-insurance are both related to what the patient pays. Coinsurance is always a percentage, not a set fee.

82) B

A utilization review is the method used by health plans to measure appropriate services. A formulary is a list of approved prescriptions for which it will reimburse subscribers. Coinsurance refers to the amount of money that insurance plan members pay out of pocket.

83) D

In a preferred provider plan, patients have a monetary incentive to stay within the preferred provider plan, but they have a choice of seeking care outside the plan and can seek some reimbursement. An HMO-enrolled patient is prohibited from going outside the plan. Indemnity plans and fee-for-service plans allow patients to see physicians of their choosing.

84) A

All accrediting agencies must have review and approval by the U.S. Department of Education Council on Higher Education Accreditation. The other three choices are accrediting programs for specific health care programs and facilities.

85) D

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The Accreditation Commission for Education in Nursing accredits all levels of nursing programs. The Commission on Collegiate Nursing Educations is responsible for only masters’ and bachelors’ programs.

86) C

State licensing boards are entitled to the information. Only hospitals conducting professional review and other health care entities with formal peer review programs, a self-query, and some plaintiffs' attorneys under certain circumstances may access the information.

87) D

Practice Acts in each state are designed to protect the public’s safety by defining what is meant by practice of a profession, explaining requirements for licensing, and defining grounds for suspension or revocation of a license for a specific profession.

88) C

Health care professions that have certification requirements may find their scope of practice in the individual state’s medical practice act.

89) B

The Veterans Health Administration is the largest integrated health care system in the United States. Blue Cross Blue Shield, Federally Qualified Health Centers and State Health Departments are not integrated into one system.

90) A

Certification is voluntary and requires an exam. However, if you lose your certification or never take the exam, you can still work in the field.

91) B

Reciprocity may be granted to individuals who are licensed in one state to practice in a second state. Most certification and registration processes are national in scope.

92) C

The Joint Commission accredits hospitals, ambulatory care facilities, home care facilities, as well as other institutional providers of health care. Educational institutions are accredited by a variety of organizations and the National Committee on Quality Assurance accredits managed care organizations.

93) D

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The nursing profession has several different accreditation agencies that are specific to nursing.

CAAHEP accredits 28 different health care educational programs.

94) Short Answer

Licensure is a mandatory credentialing process, and certification is a voluntary credentialing process.

95) Short Answer

Accreditation is official authorization or approval for conforming to a specified standard.

96) Short Answer

The United States health care system’s costs are almost entirely paid by a third party payor—an insurance company, a federal or state health program, and non-profit organizations that help people pay their medical bills.

97) Short Answer

Indemnity insurance. Indemnity is a traditional form of health insurance.

98) Short Answer

The purpose of a practice act is to define what is meant by "practice of a specific health profession" in each state, explain requirements and methods for licensure, provide for the establishment of licensing boards, establish grounds for suspension or revocation of license, and identify conditions for license renewal.

99) Short Answer

While laws vary in different states, a physician's license may be revoked for prescribing drugs in excessive amounts or without legitimate reason, impaired ability to practice due to addiction or physical or mental illness, and conviction of a felony.

100)

Short Answer For-profit health care organizations include proprietorships and professional corporations, partnerships and limited liability partnerships, small corporations and large publicly held corporations. A second form is not-for-profit health care organizations. While not-for-profit hospitals are the most familiar form of not-for-profit health care, organizations such as neighborhood clinics, federally qualified health clinics, and some of the Blue Cross Blue Shield insurance companies are other examples. Government health care facilities, such as Veteran’s Health Administration, are the third type of health care business. The last type of health care business consists of those companies that make products used in health care.

101)

Short Answer

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Ownership of health care corporations may be traced to any number of sources, such as groups of physicians, health care professionals practicing the same medical specialty, groups of investors (e.g., Hospital Corporation of America, Ardent, Capella, and Cirrus Health), religious groups (e.g., Catholic or Jewish hospitals), state or local governments, university-affiliated medical schools, or insurance companies and managed care organizations (MCOs), where physicians and other health care practitioners are often salaried employees.

Student name: 102)

The highest law in our country is A) the Bill of Rights.

B) the U.S. Constitution.

C) the doctrine of respondeat superior.

D) a Supreme Court decision.

103)

Laws enacted by state or federal legislatures are called A) case law.

B) bills.

C) amendments.

D) statutes.

104)

The president of the United States exercises limited legislative powers when issuing A) executive orders.

B) public notices.

C) statutes.

D) common law.

105)

Broad enabling statutes defining an agency's powers and procedures are known as A) administrative laws.

B) common laws.

C) substantive laws.

D) acts.

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106)

Those responsibilities not set by the United States Constitution are left to the states.

Which of the following is an exclusive power of state governments?

A) Establish post offices.

B) Issue licenses.

C) Print money.

D) Nominate judges for the federal courts.

107)

There are A) five B) two C) three D) four

108)

A felony is A) a less serious criminal act.

B) a more serious criminal act.

C) punishable by less than one year in prison.

D) a civil offense.

branches of the federal government.

109)

Practicing medicine without a license is an example of which of the following types of laws?

A) criminal law B) common law C) administrative law D) civil law E) substantive law

110)

A nurse who steals drugs from a medication cart is committing an offense under what kind of law?

A) Common law B) Criminal law C) Administrative law D) Civil law

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111)

A misdemeanor is A) punishable by at least one year in prison.

B) a federal violation of the law.

C) a less serious criminal act.

D) a more serious criminal act.

112)

Battery is defined as A) publicly damaging another's reputation.

B) the action that causes bodily harm to someone.

C) needless or willful damage.

D) the open threat of bodily harm.

113)

Assault is defined as A) publicly damaging another's reputation.

B) the action that causes bodily harm to someone.

C) needless or willful damage.

D) the open threat of bodily harm.

114)

Unintentionally, a health care provider fails to exercise what is considered ordinary care.

This is called and the provider may be sued by the patient.

A) a mistake B) precedent C) criminal D) negligence

115)

A state court would have jurisdiction in which of the following cases?

A) Copyright infringement B) Antitrust C) Admiralty law D) License revocation

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116)

The relatives of a patient in a nursing home have been prevented from seeing their family member by one of the staff in the nursing home. The patient had filed a complaint about the staff member, so the staff member thought it appropriate to prevent visitors. Which of the following torts might the staff member be convicted of?

A) False imprisonment B) Conversion C) Trespass D) Deceit

117)

If a mentally incompetent person enters into a contract, the agreement may be set aside or validated at a later date. In this case, the agreement is said to be A) voidable.

B) nullified.

C) enforced.

D) breached.

118)

When entering into a contract, certain conditions must pertain to the offer. Which of the following accurately describes one of these conditions?

A) It may only relate to the future.

B) It must be communicated.

C) It must be made under duress.

D) It must be clearly understood by at least one of the parties.

119)

Which list describes the elements of a contract?

A) Agreement, subject matter, legality, and contractual capacity.

B) Agreement, consideration, trade, and contractual capacity.

C) Agreement, accounting, legality, and subject matter.

D) Agreement, consideration, legal subject matter, and contractual capacity.

120)

A physician assistant provides treatment to a person who has come to the emergency room for treatment of a painful rash. This is an example of a(n) A) written contract.

B) limited contract.

C) verbal contract.

D) implied limited contract.

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121)

Dr. Giles and his practice manager are considering charging interest on unpaid balances.

Which law says the doctor must first tell the patients of this change in policy?

A) Fair Debt Collection Practices Act B) Regulation Z of the Consumer Protection Act C) Health Insurance Portability and Accountability Act D) Health Collection Act

122)

The Easy Collection Agency continues to call Susan at work to talk to her about her past due account at St. John's Hospital. The Easy Collection Agency is violating which law?

A) Fair Debt Collection Practices Act B) Regulation Z of the Consumer Protection Act C) Health Insurance Portability and Accountability Act D) Health Collection Act

123)

From which of the following does an implied contract result?

A) The terms of the spoken agreement.

B) The legally worded contract.

C) The actions of the parties involved.

D) The written contract.

124)

Which of the following must be in writing?

A) Third-party contract for health care coverage.

B) Implied contract.

C) Expressed contract.

D) Employment contract.

125)

A patient has not paid the balance due after insurance payments. The practice manager has sent numerous reminders and the patient has not contacted the practice. At this point, the practice manager A) may sue the patient for the balance.

B) may have the physician sign a letter of dismissal with 30 days to find a new physician.

C) can do nothing; the practice is out the money owed.

D) may begin calling the patient at work.

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126)

Both parties in the physician-patient relationship have certain rights and responsibilities.

Which of the following is a physician responsibility?

A) Exercise his or her best professional judgment in all cases.

B) Treat every patient who seeks medical care.

C) Restore the patient to his or her original state of health.

D) Possess the highest skills possible within the profession.

127)

Which brochure applies to both hospital and health care visits and encourages high quality care?

A) Patient Care Partnership: Understanding Expectations, Rights, and Responsibilities.

B) Patient information.

C) DASH-Direct Admit System for Hospitals.

D) Hospital Plan Plus.

128)

A patient leaves the hospital before their physician discharges them. This is referred to as leaving A) against hospital advice.

B) against insurance company advice.

C) against nonmedical advice.

D) against medical advice.

129)

According to the AHRQ, patients who are most likely to leave the hospital against physician's orders are A) those who do not like injections.

B) those who believe they are no longer ill.

C) those who have a substance abuse problem.

D) those who have to get back to work.

130)

Which of the following is not a patient responsibility in the physician-patient relationship?

A) Follow instructions given by the physician B) Give relevant information to the physician and staff C) Refer other patients to the physician D) Pay the fees for services rendered

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Answer Key Test name: chapter 4 102)

B The U.S. Constitution serves as the highest law. The Bill of Rights is included in the Constitution, and the Supreme Court was created to uphold the Constitution. The doctrine of respondeat superior is case law.

103)

D A law is a statute. Case law is established in the courts, bills are proposed laws and amendments are changes to laws.

104)

A Presidents may issue executive orders. Statutes are laws. Public notices simply notify the public of certain things. Common law is based on custom and tradition.

105)

A An agency is given power to set policy and procedure by the use of administrative law.

106)

B Issuing licenses is an exclusive power of state government. Printing money, nominating judges for federal courts and establishing post offices are all powers of the federal government.

107)

C The three branches of the federal government are the judicial, the executive, and the legislative.

108)

B A felony is a serious crime punishable by more than a year in prison.

109)

A Criminal law is a law that involves crimes against the state. Practicing medicine without a license is a form of criminal law because serious harm could be done. Civil law, administrative law, and common law are not considered as criminal law.

110)

B Stealing drugs is considered an offense under criminal law, particularly if they are narcotic drugs.

111)

C

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A misdemeanor is a less serious criminal act that is punishable by a fine and/or less than a year in prison.

112)

B Battery is the action that causes bodily harm. Assault is the open threat of bodily harm.

113)

D Assault is the open threat of bodily harm. People often confuse this term with battery, which is the actual act of bodily harm. Raising a fist may be considered assault, while actually hitting the person with the fist is battery.

114)

D The tort of negligence is when a health care provider does not exercise what is considered ordinary care. It is a part of civil law.

115)

D State courts have jurisdiction over the licensing and revocation of licenses of health care workers. The federal courts have jurisdiction in antitrust, patients, copyright, and areas of admiralty law (pertaining to the sea).

116)

C Trespass is wrongful injury or interference with another person's property.

117)

A If either of the concerned parties is incompetent at the time a contract is made, the agreement may be voidable and able to be set aside or validated at a later date.

118)

B Certain conditions must be met in the offer. It must relate to the present or the future, it must be communicated, it must be made in good faith and not under duress, it must be understood by both parties, and it must define what both parties will do if the offer is accepted.

119)

D All contracts must contain an agreement, consideration, legal subject matter, and contractual capacity in order to be enforceable.

120)

D In an emergency room, there is an assumption of consent to treatment. The assumption extends to treatment for the presenting condition only, so it is limited.

121)

B

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It is legal under Regulation Z of the Consumer Protection Act to charge interest. However, the patient must be notified in advance of the interest charges.

122)

A Calling a patient at work is considered harassment under the Fair Debt Collection Practices Act. 123)

C An implied contract is an unwritten and unspoken agreement whose terms result from the actions of the parties involved. An expressed contract may be written or oral, but all terms of the contract are explicitly stated.

124)

A An implied contract is an unwritten and unspoken agreement whose terms result from the actions of the parties involved. An expressed contract may be written or oral, but all terms of the contract are explicitly stated. Not all employment arrangements or termination notices are in contractual form. Because a third-party contract for health care is very detailed and involves at least three different parties, it is usually in writing.

125)

B A provider has a responsibility to notify the patient about the reason for discontinuing care and give the patient time, usually 30 days, to find a new physician. While the physician may eventually sue the patient for the balance, notice of discontinuance of care must be done first.

126)

A A physician is expected to use their best professional judgment in all cases. Physicians are free to choose their own patients, unless they are working in the emergency room. It is not always possible to restore patients to their original state of health or to guarantee successful results, and physicians are not expected to possess the highest skills possible within the profession.

127)

A A variety of attempts were made to make the AHA Bill of Rights a federal law, but none succeeded. In 2003, the AHA dropped the Bill of Rights and created a brochure entitled "Patient Care Partnership: Understanding Expectations, Rights and Responsibilities" for hospitals, medical offices, and other health care facilities to use at their discretion.

128)

D When a patient leaves the hospital before the physician has discharged them it is known as against medical advice.

129)

C

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A study done by the AHRQ indicates that the top three reasons for patients to leave the hospital against medical advice are when they are worried about paying the bill, they have substance abuse problems, and they have a previous against-medical-advice incident.

130)

C A patient is under no obligation to refer other people to the physician. However, the patient is responsible for following doctors' orders and paying the bill.

Student name: 131)

The definition of liability is A) the legal responsibility of competent adults for their own acts.

B) applied only to on-the-job acts.

C) duty of care.

D) standard of care.

132)

As employers, physicians have general liability for many aspects of their business. Which of the following does not fall under the responsibility of the employers?

A) The practice's buildings and grounds B) Automobiles used in the practice C) Employee safety D) Employees driving to and from the workplace

133)

A physician working in an emergency room is obligated to treat all the patients who come through the door. This is an example of which of the following concepts?

A) Standard of care B) Duty of care C) Reasonable person standard D) Reasonable person care

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134)

A physician working in a nursing home warns the residents of an outbreak of a communicable disease and takes measures to protect them from exposure. This is an example of what principle?

A) Standard of care B) Reasonable person care C) Reasonable person standard D) Duty of care

135)

A medical assistant takes universal precautions while drawing blood for analysis. This is an example of A) standard of care.

B) reasonable person care.

C) reasonable person standard.

D) duty of care.

136)

If a patient is injured because a health care professional failed to exercise the care and expertise that under the circumstances could reasonably be expected of a professional with similar experience and training, then that professional may be liable for A) standard of care.

B) negligence.

C) reasonable person standard.

D) duty of care.

137)

A physician is a specialist in obstetrics. Which of the following is true regarding the standard of care expected of this physician?

A) The physician will be held to the same standard of care as a general practitioner.

B) The physician will be held to the same standard of care as other obstetricians.

C) The physician will be held to a lower standard of care than a gynecologist.

D) The physician will be held to the same standard as a gynecologist.

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138)

In a hospital, a certain standard of care is expected of health care practitioners. Which of the following best describes this concept?

A) Legal responsibility.

B) Minimum care as needed.

C) An expected level of performance.

D) Obligation to care.

139)

The failure to act when one should is called A) malfeasance.

B) nonfeasance.

C) damages.

D) dereliction.

140)

A provider breaches duty of care to a patient. This element of negligence is defined as A) malfeasance.

B) nonfeasance.

C) damages.

D) dereliction.

141)

A patient is properly cared for by the nurse practitioner. Which of the following describes one of the elements that the nurse practitioner has successfully met?

A) Dereliction B) Duty C) Damages D) Direct cause

142)

A surgeon removes the wrong kidney from a patient. The patient can sue under which of the following legal doctrines?

A) Res judicata B) Respondeat superior C) Res ipsa loquitur D) Caveat emptor

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143)

A patient was harmed when the oxygen tank she was using exploded. When filing a lawsuit, what type of damages might this patient be awarded?

A) General compensatory B) Consequential C) Special compensatory D) Punitive

144)

A patient's mammogram is reviewed and the radiologist reports a normal exam. Six months later, the patient finds a lump in her breast. The patient has a lumpectomy and makes a full recovery. It was determined that the mass was present and visible in the original mammogram. The patient sued claiming mental anguish. What type of damages might she be awarded?

A) General compensatory B) Consequential C) Special compensatory D) Punitive

145)

Those damages awarded by the court to punish the defendant are called A) general compensatory.

B) consequential.

C) special compensatory.

D) punitive.

146)

According to Medscape, which of the following medical specialties is most likely to be sued?

A) Oncology B) Ob/gyn C) Internal medicine D) Radiology

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147)

The family of a patient sues for wrongful death when the patient's death was judged to have been due to the negligence of the health care practitioners. What might the family collect from a settlement of this case?

A) An award to punish the health care provider.

B) An award for the loss to the patient's estate for future earnings.

C) An award covering medical costs for the patient.

D) An award providing health care for the family.

148)

A plea made for a case to be reviewed by the higher court occurs in the of a lawsuit.

A) trial B) interrogatory C) appeal D) mediation

149)

A jury is selected in the A) trial B) interrogatory C) appeal D) pretrial

phase

stage of a lawsuit.

150)

A(n) is issued by the clerk of the court and is delivered with a copy of the complaint to the defendant.

A) trial B) summons C) appeal D) interrogatory

151)

What is the difference between a subpoena and subpoena duces tecum?

A) There is no difference.

B) Subpoena duces tecum is just an old-fashioned term for subpoena.

C) A subpoena duces tecum requires that documents and records be brought to court.

D) A subpoena requires that an individual appear in court.

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152)

A deposition may be taken in which phase of the lawsuit?

A) Trial B) Interrogatories C) Pleadings D) Summons

153)

Instead of going to court, two parties in dispute agree to a neutral third party listening to both sides of the argument and helping to resolve the dispute. What is the term for this type of always non-binding dispute resolution?

A) Med-arb B) Discovery C) Mediation D) Arbitration

154)

Alternative dispute resolution has become increasingly popular over the years. What is the reason for this increase?

A) Shortage of attorneys to represent clients B) Ease of proceedings C) Better overall results D) Overcrowding of court calendars

155)

Some states require mediation and/or arbitration for certain civil cases, while in other states alternative dispute resolution methods are voluntary. Under the terms of a written contract, who chooses an arbitrator?

A) Both parties B) The defendant C) The plaintiff D) The American Arbitration Association

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156)

In an informal proceeding of arbitration, each side presents evidence and witnesses. In the dispute resolution method, referred to as med-arb, who resolves the dispute if the two parties are unable to reach an agreement after mediation?

A) The mediator B) The jury C) The judge D) The court

157)

When no written contract exists, who chooses an arbitrator to resolve disputes?

A) The American Arbitration Association.

B) The two parties select an arbitrator and the two arbitrators select a third to act.

C) The two parties select an arbitrator and the court decides.

D) The court selects an arbitrator of its choosing.

158)

All of the following guidelines are in place to help health care practitioners stay within their scope of practice and operate within the law except A) following an employer's established policies dealing with the health care contract.

B) maintaining and disposing of regulated substances in compliance with government guidelines.

C) maintaining confidentiality.

D) documenting care accurately for a fellow medical assistant.

159)

The law of A) liability B) expression C) the agent D) agency

makes employers liable for the actions of their employees.

160)

Amanda is a nurse in Dr. Smith's pediatric practice. She accidently gives a patient the wrong medication. Dr. Smith is held responsible under A) res ipsa loquitur.

B) respondeat superior.

C) implied contract.

D) expressed contract.

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161)

For which of the following actions would an employer be responsible under respondeat superior?

A) An employee assaults a patient in the parking lot.

B) An employee steals narcotic drugs from the medication room.

C) An employee accidently prescribes the wrong medication.

D) An employee knowingly defames the character of a patient.

162)

For which of the following examples would implied consent not be legally appropriate?

A) A physician treating a patient for lung cancer.

B) A patient providing a urine specimen to check for a UTI. C) A nurse taking a blood pressure in the exam room.

D) A patient agreeing to a test for HIV.

163)

Which of the following is an example of a patient who usually cannot give informed consent?

A) An emancipated minor.

B) A married minor.

C) A mature minor.

D) An adult who is mentally incompetent.

164)

Which of the following aspects of patient care is the most vital factor in the issue of informed consent?

A) Patient care B) Patient education C) Patient compliance D) Patient maturity

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Answer Key Test name: chapter 5 131)

A Liability is the legal responsibility of all competent adults to be responsible for their own acts, both on the job and in their private lives. Duty of care is the legal obligation of health care workers to patients, and sometimes to nonpatients. Standard of care is the level of performance expected of a health care professional.

132)

D Employers are not responsible for employees traveling to and from work. However, if the employee must use their personal automobile for the employer's purposes during the day, then the employer is liable. Employers are also responsible for the building and grounds and employee safety.

133)

B Duty of care is the obligation of health care workers to patients, and in some cases, nonpatients.

Physicians have a duty of care to patients with whom they have established a doctor-patient relationship, or in the case above been hired to treat. Standard of care refers to the level of performance expected of a health care practitioner in carrying out his or her professional duties.

The reasonable person standard or care means the physician or other provider may be charged with negligence if someone is injured because he or she failed to perform an act that a reasonable person, in similar circumstances, would perform.

134)

D Duty of care is the obligation of health care workers to patients, and in some cases, nonpatients.

Physicians have a duty of care to patients with whom they have established a doctor-patient relationship, or in the case above been hired to treat. Standard of care refers to the level of performance expected of a health care practitioner in carrying out his or her professional duties.

The reasonable person standard or care means the physician or other provider may be charged with negligence if someone is injured because he or she failed to perform an act that a reasonable person, in similar circumstances, would perform.

135)

A Standard of care refers to the level of performance expected of a health care practitioner in carrying out his or her professional duties. The reasonable person standard or care means that an individual would be charged with negligence if someone is injured because he or she failed to perform an act that a reasonable person, in similar circumstances, would perform. It is reasonable to assume that universal precautions are necessary when drawing blood.

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136)

B Health care professionals are expected to behave as a reasonable person would in order to avoid liability for negligence. Standard of care refers to the level of performance expected and duty of care is a legal obligation.

137)

B An obstetrician will be held to the same standard of care as other obstetricians. Direct patient contact is not always necessary for establishing a duty.

138)

C An expected level of performance is referred to as a standard of care.

139)

B Nonfeasance is the failure to act. Malfeasance is to act in a wrongful or unlawful way. Damages are the legally recognizable injury to a patient. Dereliction is when the health care provider breaches duty of care.

140)

D Dereliction is when the health care provider breaches duty of care. Nonfeasance is the failure to act. Malfeasance is to act in a wrongful or unlawful way. Damages are the legally recognizable injury to a patient.

141)

B Duty is the provision of care. Dereliction is when the health care provider breaches duty of care.

Damages are the legally recognizable injury to a patient. Direct cause is when the provider's actions are a direct cause of the patient's injury.

142)

C Res ipsa loquitur is also known as the doctrine of common knowledge, meaning that the mistake is so obvious that negligence is obvious. Res judicata is the Latin term for the thing has been decided, that is, a claim cannot be retried if it has been legally resolved. Respondeat superior is Latin for let the master answer, which means that the employer is responsible for the acts of the employee. Caveat emptor is Latin for buyer beware.

143)

B Consequential damages are used to compensate for losses caused indirectly by a product defect.

General compensatory damages are used to compensate for injuries or losses due to violation of patient's rights. Special compensatory damages are awarded for losses not directly caused by the wrong. Punitive damages are awarded to punish the offender.

144)

A

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General compensatory damages are used to compensate for injuries or losses due to violation of patient's rights, including mental anguish. Consequential damages are used to compensate for losses caused indirectly by a product defect. Special compensatory damages are awarded for losses not directly caused by the wrong. Punitive damages are awarded to punish the offender.

145)

D Punitive damages are awarded to punish the offender. General compensatory damages are used to compensate for injuries or losses due to violation of patient's rights, including mental anguish.

Consequential damages are used to compensate for losses caused indirectly by a product defect.

Special compensatory damages are awarded for losses not directly caused by the wrong.

146)

B According to a survey of 1,000 physicians in 2017 in the online publication Medscape, ob/gyn specialties and surgeons were more likely to be sued than any other specialty.

147)

B When it is determined that there was a wrongful death due to negligence, the court will award damages to the patient's estate for future earnings.

148)

C An appeal is heard after the lower court makes a decision. A trial is when the plaintiff's and defendant's positions are heard in open court. Interrogatories are a written set of questions from a plaintiff or defendant under oath. Mediation is a form of alternative dispute resolution.

149)

A A trial is when the plaintiff's and defendant's positions are heard in open court. If a jury is to be selected, it is at the beginning of this stage. An appeal is heard after the lower court makes a decision. Interrogatories are a written set of questions from a plaintiff or defendant under oath.

Mediation is a form of alternative dispute resolution.

150)

B A summons is issued by the court and delivered to the defendant along with a copy of the complaint. A trial is when the plaintiff's and defendant's positions are heard in open court. An appeal is heard after the lower court makes a decision. Interrogatories are a written set of questions from a plaintiff or defendant under oath.

151)

C A subpoena requires the recipient to appear in court as a witness. A subpoena duces tecum requires the individual to bring certain records and documents to court.

152)

B

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In the interrogatory phase of a lawsuit, a court order may be issued commanding the presence of an individual to provide sworn testimony outside the court. A trial is when the plaintiff's and defendant's positions are heard in open court. A summons is an order for the court to appear, but it could be to appear in court during the trial. Pleadings are documents filed with the court before the trial.

153)

C Mediation is a method in which a neutral third party listens to both sides of the argument and then helps resolve the dispute. Med-arb is a combination of both mediation and arbitration.

Discovery is a phase of a lawsuit. Arbitration is a method of settling a dispute where both parties agree to abide by the decision of an arbitrator and is usually established by contract.

154)

D Alternative dispute resolution has become popular over the years because the court calendars have become overcrowded. The process is not always easy and, depending on which side you are on, the better overall results could be disputed.

155)

D Under the terms of a written contract, either the American Arbitration Association or the court chooses an arbitrator.

156)

A In the alternative dispute resolution method called med-arb, the mediator resolves the dispute if the two parties are unable to reach an agreement after mediation.

157)

B If no contract exists, each of the two parties selects an arbitrator and the two arbitrators select a third arbitrator who works the case.

158)

D Following an employer's established policies dealing with the health care contract, maintaining and disposing of regulated substances in compliance with government guidelines, maintaining confidentiality, and practicing within the scope of your training and education are all guidelines established to help health care practitioners stay within their scope of practice and operate within the law. Documenting, although accurately, for a fellow medical assistant is not lawful. Only the practitioner who provides patient care should document services rendered.

159)

D The law of agency makes employers liable for the actions of their employees.

160)

B

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Respondeat superior is the Latin term for "let the master answer."

161)

C Employers are liable for the acts of their employees performed "within the course and scope" of employment if two elements are present. The employee must be engaged in the furtherance of the employer's business and must be acting within the scope of the business. If the act committed is purely personal, the employer is not liable.

162)

D By giving consent, the patient gives permission, either expressed (orally or in writing) or implied, for the physician to examine him or her, to perform tests that aid in diagnosis, and/or to treat for a medical condition. When the patient makes an appointment for an examination, that patient has given implied consent for the physician to perform the exam. Likewise, when he or she cooperates with various diagnostic testing procedures, implied consent for the tests has been given. However, testing for HIV must have written consent from the patient.

163)

D Individuals judged by the court to be insane, senile, mentally challenged, or under the influence of drugs or alcohol cannot give informed consent. In these cases, a competent person may be designated by the court to act as the patient's agent. Minors cannot generally give informed consent unless they are emancipated, married, or mature.

164)

B Patient education is vital to the issue of informed consent. Patients who sue have successfully claimed lack of informed consent because they did not read the consent form they signed or did not read brochures handed to them. Health care personnel should be sure that patients understand all forms and all treatments/surgeries to be performed before signing.

Student name: 165)

A health care practitioner who practices the "four Cs of medical malpractice prevention" finds two important benefits related to one of the "Cs"—that is, improvement in patients' medical conditions and the decreased likelihood that they will sue. Which "C" is most likely to provide these benefits?

A) Caring B) Communication C) Control D) Competence

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166)

A certified medical assistant is constantly updating her knowledge and skills by attending in-services and seminars. This person is practicing which of the "4 Cs of medical malpracticeprevention"?

A) Caring B) Competence C) Charting D) Communication

167)

For legal purposes, the health care professional should know that if it isn't in writing and explained completely and accurately, it wasn't done. To which of the following "4 Cs of medical malpractice prevention" does this statement refer?

A) Caring B) Competence C) Charting D) Communication

168)

Patients sue for a variety of reasons. Which of the following is not one of the top recurring reasons patients sue?

A) Failure to diagnose B) Failure to treat C) Correction of a mistake D) Poor documentation

169)

Enterprise risk management A) is done on a department-by-department basis.

B) focuses on clinical departments.

C) is the responsibility of only a few individuals in the organization.

D) looks at total value of organization.

170)

Which of the following is a recommended communication technique to prevent medical malpractice lawsuits?

A) Do not advise patients over the phone.

B) Avoid statements that could be construed as an admission of fault.

C) Do not insist on a professional consult if the patient is not doing well.

D) Do not allow patients to participate in decision-making.

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171)

What would be the best advice for a nurse caring for patients who have complained about their treating physician?

A) Verbally agree with them.

B) Steer the conversation to something else.

C) Listen carefully and see that the comments reach the physician.

D) Tell the patient they are wrong.

172)

Which doctrine says a lawsuit cannot move forward if a certain period of time has elapsed?

A) Res judicata B) Release of tortfeasor C) Good Samaritan statutes D) Statute of limitations

173)

A patient sues a physician for negligence and loses. The patient then sues the physician for breach of contract. The second suit is dismissed under what doctrine?

A) Res judicata B) Release of tortfeasor C) Good Samaritan statutes D) Statute of limitations

174)

Release of tortfeasor is a(n) A) affirmative defense.

B) technical defense.

C) denial defense.

D) contributory negligence defense.

175)

When the defense claims that the patient's actions caused or contributed to the injury, this is called a(n) A) positive defense.

B) technical defense.

C) denial defense.

D) contributory negligence defense.

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176)

Which of the following is not a form of an affirmative defense to a professional liability suit?

A) Contributory negligence B) Denial C) Comparative negligence D) Emergency

177)

One of the most common occurrences for marking the beginning of the statutory period for medical malpractice includes A) the day a lawsuit was filed.

B) the time a patient recovers from injury.

C) the day the alleged negligent act was committed.

D) the day the patient dies.

178)

A physician assistant (PA) accused of medical malpractice claims that the charge does not meet all of the elements of the theory of recovery. Which of the following defenses is being used by the PA? A) Denial B) Assumption of risk C) Comparative negligence D) Technical negligence

179)

The health care practitioner who comes to the aid of an accident victim at the scene may not be held liable under which type of defense?

A) Tortfeasor release B) Denial C) Emergency D) Contributory negligence

180)

If the patient knew the before treatment, the defendant may use contributory negligence as a defense in a lawsuit.

A) cause and effect of care B) diagnosis C) prognosis D) inherent risk

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181)

The statute of limitations is A) a federal law.

B) the same law in every state.

C) different depending on the state.

D) determined by the courts.

182)

Using the process of comparative negligence, a judge determines that the patient contributed 35% to the injury and the physician contributed 65%. Which of the following is the outcome of the case?

A) No damages would be awarded.

B) The patient would be given 35% of the damage award.

C) The patient would be awarded full damages since the percentage is under 50%.

D) The patient's damage award would be reduced by 35%.

183)

A medical malpractice lawsuit has been decided under the doctrine of res judicata. What does this Latin term mean?

A) The tortfeasor has been released.

B) The thing has been decided.

C) The statute of limitations is up.

D) The thing speaks for itself.

184)

What instrument of risk management is particularly beneficial for following coding and billing regulations for Medicare, Medicaid, and other government plans?

A) Quality improvement B) Compliance plan C) Quality assurance

185)

A physician joins a group practice and is applying at the local hospital for admission privileges, also known as credentialing. Which of the following is the final step in verifying the physician's credentials?

A) The National Practitioner Data Bank checks sanctions and malpractice history.

B) A peer review committee completes the process.

C) Listed sources are checked.

D) Provider presents copies of requested credentials.

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186)

The employer physician puts a plan in place to ensure that all government regulations are enforced in the practice. This is referred to as a plan.

A) credentialing B) quality improvement C) quality management D) compliance

187)

Which of the following is an example of a physician using risk management to reduce the likelihood of a malpractice lawsuit against his office?

A) Removing standard office procedures manuals from the employees' desks.

B) Providing time off for employees.

C) Providing written job descriptions for employees.

D) Reducing the incidence of telephone conversations.

188)

Risk management is a process to A) minimize danger, hazard, and liability.

B) assess liability insurance.

C) manage difficult patients.

D) manage billing and coding to ensure the best reimbursement.

189)

Methods used to manage risk are considered a part of which of the following?

A) Assumption of risk B) telemedicine C) Quality assurance D) Comparative negligence

190)

Medical malpractice insurance that covers the insured only for those claims made while the policy is in force is called A) prior acts coverage.

B) self-insured coverage.

C) claims-made coverage.

D) occurrence coverage.

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191)

Medical malpractice insurance that covers the insured only for any claims arising from an incident that occurred, or is alleged to have occurred, during the time the policy was in force, regardless of when the claim is made is called A) prior acts coverage.

B) self-insured coverage.

C) claims-made coverage.

D) occurrence coverage.

192)

Which of the following insurance policies cover incidents that occurred before the beginning of the new insurance relationship but that have not yet been brought to the insured's attention as a claim?

A) Prior acts coverage B) Self-insured coverage C) Claims-made coverage D) Occurrence coverage

193)

A physician who owns a medical practice decides his malpractice insurance is too expensive and drops the policy. Which of the following aspects of this physician's practice will impact the physician the most?

A) Having hospital privileges.

B) Attracting competent staff.

C) Receiving payment from insurance companies for services provided for patients.

D) Maintaining membership in physician organizations.

194)

The cost of malpractice liability insurance is based upon which of the following?

A) Physician specialty and dollar amount covered by the policy.

B) Physician credentials and ability to pay the policy.

C) Number of employees and number of incidences that will be covered.

D) Government agencies regulating the purchase of liability insurance by all physicians.

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195)

When a physician has malpractice insurance, who should they contact first when faced with a malpractice lawsuit?

A) The patient B) The office manager C) The insurance company D) The lawyers

196)

What are the two limitations to a physician choosing to be covered by a self-insurance malpractice plan?

A) State law limitation and type of medical practice.

B) Hospitals not allowing privileges to physician with this type of insurance policy plan and the AMA. C) Raising cost of insurance premiums and state law limitations.

D) State law limitation and hospital not allowing privileges to physician with this type of insurance policy.

197)

What are the two factors that would influence the cost of premiums for a malpractice insurance policy?

A) Size of the practice and the number of staff members.

B) The dollar amount covered by the insurance policy and the physician's specialty.

C) The length of time the physician has been a specialist and the dollar amount covered.

D) Whether the physician has hospital-admitting privileges and the type of practice.

198)

Explain several steps office staff could take to document missed appointments in an attempt to reduce the possibility of a malpractice lawsuit.

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199)

A physician decides to retire and move to another state. The physician is going to cancel their claims-made policy. What type of policy may the physician choose to purchase to cover any future claims from when the physician carried the claims-made policy?

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Answer Key Test name: chapter 6 165)

A There are two important benefits in showing patients a caring attitude. First is improvement in their medical condition. A secondary benefit is the decreased likelihood that patients will feel the need to sue if treatment has unsatisfactory results, or if adverse events occur. The practitioner should be sincere, because others often quickly sense insincerity.

166)

B In order to be competent, the health care professional should stay informed about general medical and scientific progress by reading professional journals, attending seminars and professional association meetings, and fulfilling continuing education requirements.

167)

C For legal purposes, if it isn't in writing and explained completely and accurately, it wasn't done.

This is called charting and includes all types of records related to the patient's health.

168)

C When a mistake is made, but corrected, patients are not as likely to sue. The failure to diagnose, failure to treat, poor documentation, and failure to follow safety procedures are some of the top reasons patients sue.

169)

D Enterprise risk management (ERM) is a concept that has been used in business for many years.

The concepts of enterprise risk management for use in health care are now being used in many organizations. Risk management has traditionally been overseen by a specific department within an organization. ERM in healthcare links risk management and quality improvement with an organization-wide framework, rather than a departmental focus. ERM looks at risk management and total value of the organization.

170)

B Health care professionals should avoid statements that could be construed as an admission of fault on the physician's part. All health care professionals should allow time for telephone consultations, allow patients to participate in the decision-making process, and insist on a professional consult if the patient is not doing well.

171)

C

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While listening carefully to a patient, a provider should not verbally agree with them, ignore them, or steer the conversation to something else. They should listen carefully to complaints and see that the comments reach the appropriate person.

172)

D The statute of limitations sets the time period in which a party may be sued for negligence. The Good Samaritan statute protects individuals who act in an emergency. Release of tortfeasor is a technical defense in an already filed lawsuit. Res judicata means the claim cannot be retried.

173)

A Res judicata means the claim cannot be retried. The statute of limitations sets the time period in which a party may be sued for negligence. The Good Samaritan statute protects individuals who act in an emergency. Release of tortfeasor is a technical defense in an already filed lawsuit.

174)

B Release of tortfeasor is a technical defense in an already-filed lawsuit. An affirmative defense is one in which factual evidence is produced by the defendant that the patient's condition was caused by some factor other than the defendant's negligence. Denial and contributory negligence are forms of an affirmative defense.

175)

D Contributory negligence is when the defense claims that the patient contributed to the injuries. A technical defense is one in which the defendant claims on technical grounds, not factual evidence, that the suit may not move forward.

176)

B Denial is an assertion of innocence. Contributory negligence is when the defense claims that the patient contributed to the injuries. In comparative negligence, it is alleged that the patient contributed to the injuries to a certain degree.

177)

C The statutory time period is usually marked by when the alleged negligent act was committed. In some cases, the alleged malpractice may not be discovered until years later, so this can sometimes create problems.

178)

A

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Denial of wrongdoing, or the assertion of innocence, may be used as a defense in professional liability suits. In other words, the charge may be missing one of the four Ds of negligence.

Comparative negligence is an affirmative defense claimed by the defendant, alleging that the plaintiff contributed to the injury by a certain degree. Assumption of risk is a defense based on the contention that the patient knew of the inherent risks before treatment was performed and agreed to those risks.

179)

C Under the emergency defense, if a true emergency existed and was not caused by the defendant, and if the appropriate standard of care was met, then the provider may claim emergency. Release of tortfeasor is a technical defense in an already-filed lawsuit. Denial is an assertion of innocence. Contributory negligence is when the defense claims that the patient contributed to the injuries.

180)

D By providing informed consent for the patient, the inherent risks are presented to the patient before care is provided.

181)

C Statutes of limitation are determined by each state.

182)

D In some states, damages are awarded according to the degree to which a plaintiff contributed to the injury. In this instance, the court decided that through the patient's own negligence, the patient contributed 35% to the problem, so the damages awarded would be reduced by 35%.

183)

B Under the doctrine of res judicata, "The thing has been decided," a claim cannot be retried between the same parties if it has already been legally resolved.

184)

B A compliance plan is developed to help ensure that all governmental regulations are followed.

Such a plan is especially beneficial for following coding and billing regulations for Medicare, Medicaid, and other government plans. These plans are one aspect of quality improvement/quality assurance or quality management. Credentialing is the process of verifying a health care provider's credentials.

185)

B

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Credentialing usually consists of the following: (1) A provider fills out an application and attaches copies of his or her medical license, proof of malpractice insurance coverage, and other requested credentials; (2) The listed sources are asked to verify the information; (3) Medicare and Medicaid sanctions and malpractice history are checked via the National Practitioner Data Bank; (4) The findings are presented to a credentialing committee; and (5) A peer review process completes the credentialing procedure.

186)

D A compliance plan is developed to help ensure that all governmental regulations are followed.

Such a plan is especially beneficial for following coding and billing regulations for Medicare, Medicaid, and other government plans. These plans are one aspect of quality improvement, quality assurance, or quality management. Credentialing is the process of verifying a health care provider's credentials.

187)

C Risk management activities that may help avoid litigation include providing written job descriptions and procedure manuals to all employees. Paid time off are human resource policies.

Communicating with patients by telephone is also important in reducing risk.

188)

A Risk management is an approach to minimize liability by assessing danger, hazards, and employee behavior. It includes things like assessing documentation, having policy and procedure manuals, and providing employees with job descriptions.

189)

C Methods used to manage risk are part of quality assurance (QA) or quality improvement (QI).

QA and/or QI are programs of practices performed by health care professionals to uphold the quality of care (QA/QI) programs, and will assess performance by auditing charts and observing behavior. Areas of weakness are identified and processes put in place to strengthen performance.

190)

C Claims-made insurance covers the insured only for those claims made (not for any injury occurring) while the policy is in force. With this kind of insurance, the determining factor is when the claim is made, not when the injury occurs. Occurrence insurance (also known as claims-incurred insurance) covers the insured for any claims arising from an incident that occurred or is alleged to have occurred while the policy is in force, regardless of when the claim is made. Liability coverage is a general term regarding coverage for negligence. Self-insurance is when a provider uses a trust fund for coverage.

191)

D

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Occurrence insurance (also known as claims-incurred insurance) covers the insured for any claims arising from an incident that occurred or is alleged to have occurred while the policy is in force, regardless of when the claim is made. Claims-made insurance covers the insured only for those claims made (not for any injury occurring) while the policy is in force. Self-insurance is when a provider uses a trust fund for coverage.

192)

A Prior acts coverage, also known as "nose" coverage, covers incidents that occurred prior to the beginning of the new insurance relationship but that have not yet been brought to the insured's attention as a claim. Occurrence insurance covers the insured for any claims arising from an incident that occurred or is alleged to have occurred while the policy is in force, regardless of when the claim is made. Claims-made insurance covers the insured only for those claims made (not for any injury occurring) while the policy is in force. Self-insurance is when a provider uses a trust fund for coverage.

193)

A Some physicians drop malpractice insurance coverage when rates become too high. However, this can adversely affect a physician's practice, since most hospitals require proof of coverage up to a predetermined minimum amount to grant hospital privileges. In addition, managed care organizations require physicians to provide proof of liability insurance coverage as a prerequisite for entering into a contractual agreement and as a component of their credentialing process.

194)

A The cost of liability insurance premiums for a physician is based on the physician's specialty and the dollar amount covered by the policy. Insurance for those physicians in the least risky insurance risk class (e.g., family practitioners and specialists who do not perform surgery) is generally less costly than insurance for those in specialties considered riskier (e.g., orthopedic surgeons and obstetricians).

195)

C The physician should contact the malpractice insurance company. Sometimes the insurance company will provide their own lawyer to help with the defense of the case.

196)

D Some states have insurance laws and regulations that limit this type of insurance policy, thus physicians cannot utilize this type of coverage. Additionally, hospitals that extend admitting privileges may not accept physicians with this type of plan because they pose a higher insurance risk.

197)

B

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The type of specialty and the dollar amount of coverage are two factors that will increase the cost of premiums for malpractice insurance.

198)

Short Answer An office should designate one individual to gather all missed appointment records and documents so that notes can be made concerning missed appointments. The physician should review the record to determine if a follow-up visit is required.

199)

Short Answer The physician may decide to carry tail coverage to cover any claims covering the time the physician carried the claims-made policy.

Student name: 200)

Medical records are A) legal documents.

B) not legal documents if kept electronically.

C) always the property of the patient.

D) never the property of the patient.

201)

To correct an error discovered after the patient's written copy of his or her medical records has been recorded, a medical assistant should A) erase the mistake and type in the correction.

B) get written consent from the patient to correct the error.

C) draw a line through the mistake, make and label it as a correction, initial and date it.

D) draw a line through the error and enter the new information.

202)

An addendum to an electronic health record (EHR) is a A) note made after the patient's visit which is entered into the EHR. B) significant change or addition to the EHR. C) part of the financial information for payment of services.

D) lab report added to the EHR.

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203)

Which of the following observations should not be included in a patient's medical record?

A) Notes regarding reaction to anesthesia.

B) Change of marital status.

C) Change in weight.

D) Notes regarding patient's participation in a rally.

204)

A plastic surgeon routinely photographs patients to document care. Which of the following accurately describes information that should be included on the consent form for this type of photography?

A) The patient understands that ownership rights to the photos belong to the patient.

B) The patient understands that the photos will be kept for an undetermined time period.

C) The patient understands that he or she cannot view the photographs.

D) The patient understands that authorization must be given to release photos outside the facility.

205)

The five Cs are used to describe the attributes of entries into patients' medical records.

Which of the following is not one of the five Cs? A) Clean B) Complete C) Clear D) Correct

206)

Allison is required to have a physical before starting her job as a nurse. Her employer pays for the physical. The employer should A) keep the physical exam records in Allison's personnel records.

B) keep the physical exam records in a separate file from general personnel records.

C) review the physical exam records and destroy them.

D) review the physical exam records and return them to the provider.

207)

A hospital maintains medical records on all patients treated in the hospital. Who owns the information in the hospital records?

A) The treating physician.

B) The patient.

C) The hospital.

D) The insurance company paying the bills.

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208)

A physician has a private practice employing a physician assistant, a nurse, and a medical assistant. The physician also has hospital privileges at a nearby facility. Who owns the medical records generated by him and the staff at the practice?

A) The physician.

B) The physician assistant if he or she treated the patient.

C) The hospital.

D) The insurance company paying the bills.

209)

The doctrine of professional discretion pertains to medical record keeping. Which of the following describes this doctrine in more detail?

A) Patients should be able to obtain access to or copies of their medical records.

B) It is up to the discretion of the physician whether or not to allow all patients access to their medical records.

C) It is up to the discretion of the patient whether or not he or she may see the records.

D) It is up to the insurance company's discretion as to whether or not a patient may see his or her records.

210)

The law that mandated electronic health records and provides the rules for patient access to their records is A) OSHA. B) The Joint Commission.

C) FDA. D) HIPAA.

211)

Medical records should be kept until the applicable statute of limitations period has elapsed. What is the usual time frame for this period?

A) 1-3 years B) 1-5 years C) 2-10 years D) 2-7 years

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212)

A medical clinic does preemployment physicals for a local employer. The employer pays for the physical exams. Who is the owner of the medical record in this case?

A) The employer.

B) The patient.

C) The medical clinic.

D) The physician who did the physical.

213)

Which of the following describes the proper protocol for the release of medical records?

A) Medical records may be released to third-party payers without patient consent.

B) When medical records are subpoenaed, the patient should be notified in writing.

C) Signed consent for medical records is not required for use in a lawsuit.

D) When medical records are released, the entire medical record should be released.

214)

In which of the following examples would patient authorization for release of his or her medical record be waived?

A) For an insurance claim.

B) For medical injuries sustained in an auto accident.

C) When a subpoena duces tecum is issued.

D) When a patient dies.

215)

Which of the following is not true about authorizations for release of records?

A) All patient authorizations should be witnessed by a notary public.

B) Patient authorizations should be witnessed.

C) Authorizations should be in writing.

D) Authorizations should be dated.

216)

A subpoena duces tecum is issued for medical records of a patient who is suing the physician for malpractice. Which of the following is a guideline for sending this information?

A) Verify that the patient named was not a patient of the physician.

B) Notify the insurance company.

C) Review the record closely for any incriminating information and delete incriminating information.

D) Offer sworn testimony regarding the record if instructed to do so by the court.

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217)

Which of the following information is the federal statute known as the Confidentiality of Alcohol and Drug Abuse Patient Records designed to protect?

A) Victims of crimes committed by drug addicts.

B) Patient convictions.

C) Patient behavior.

D) Patient treatment.

218)

The person in charge of medical records for a physician's office is preparing to release medical records requested by an insurance company. Which of the following is a recommended guideline for this procedure?

A) Release the entire record, not just the information requested.

B) Include the patient's name, address, and date of birth on the authorization.

C) Warn the patient that once authorization is given, it cannot be rescinded.

D) Receive a verbal authorization from the patient prior to release of the record.

219)

A remote consultation with physicians or other health care professionals is called A) social media.

B) patient monitoring.

C) open access.

D) telemedicine.

220)

A patient portal is A) online access to a variety of health care services and communications with providers.

B) an educational program for patients.

C) an educational program for providers.

D) a medical device to provide nutrients to patients.

221)

Facebook, Twitter, and blogs are examples of A) wikis.

B) discussion sites.

C) social media.

D) telemedicine.

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222)

Which of the following is not a purpose of social media?

A) Emotional support for patients with similar illnesses.

B) All of these are purposes of social media.

C) Awareness of causes or personal health crises.

D) Capture patient satisfaction and feedback.

223)

Which of the following organizations is a major user of forms of telemedicine?

A) Medicare B) Medicaid C) Veterans Affairs D) Blue Cross and Blue Shield

224)

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) was created to A) provide Medicare for all U.S. citizens regardless of age.

B) change the way Medicare rewards clinicians for value over volume.

C) allow physicians to opt out of meaningful use.

D) accelerate medical product design.

225)

The 21st Century Cures Act (Cures Act) is designed to A) find a cure for cancer.

B) accelerate medical product development.

C) establish a new payment system for hospitals.

D) solve the opiod crisis.

226)

Explain the differences among the medical record, the electronic medical record, and the electronic health record.

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227)

Describe the process to correct an error in a written medical record.

228)

List the five C's that describe the attributes of a good entry into the medical record.

229)

Describe the process a provider should take to ensure confidentiality before photographing a patient.

230)

What is an addendum to an electronic health record?

231)

Identify five purposes for the medical record.

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232)

Discuss the statute of limitations as it relates to the retention of medical records.

233)

A physician is employed by a group practice. The physician decides to leave the practice and open his own private practice. May he have the records of the patients he is currently seeing? Why or why not?

234)

Describe the doctrine of professional discretion as used by physicians and other health care providers.

235)

What is the purpose of the federal statute entitled Confidentiality of Alcohol and Drug Abuse Patient Records?

236)

Define meaningful use.

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237)

Define health information technology.

238)

Give at least five examples of how social media is used in health care.

239)

Provide at least two advantages and two disadvantages in using telemedicine.

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Answer Key Test name: chapter 7 200)

A A medical record is a legal document, whether on paper or electronic format. Although the patient has a right to a copy of the record, the record is the property of the provider(s).

201)

C Standard practice in written medical records requires that the error be acknowledged and corrected.

202)

B An addendum to the EHR is a significant change or addition to the record. Although it could be something simple like a date change, it is more often completion of information. It must be signed and dated by the provider. While notes added after a visit, a surgical procedure, or lab report may be considered addendums, they are not limited to just those items.

203)

D All notes in the medical record should be pertinent to the patient's care. His or her participation in a rally is not related to care.

204)

D If a health care facility routinely photographs patients to document care, a special consent form should be signed stating that (1) the patient understands that photographs, videotapes, and digital or other images may be taken to document care, (2) the patient understands that ownership rights to the images will be retained by the health care facility, but that he or she will be allowed to view them or to obtain copies, (3) the images will be securely stored and kept for the time period prescribed by law or outlined in the health care facility's policy, and (4) images of the patient will not be released and/or used outside the healthcare facility without written authorization from the patient or his or her legal representative.

205)

A The five Cs of charting are (1) concise, (2) complete (and objective), (3) clear (and legibly written), (4) correct, and (5) chronologically ordered.

206)

B

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An employer should never keep employees' medical records in the general personnel records.

This avoids a potential HIPAA violation. The record technically belongs to the physician, but the record sent would not be an original, as the physician must keep the record. If Allison would like a copy, she should contact the physician.

207)

B The facility where the medical records were created owns the documents, but the patient owns the information they contain. On signing a release, patients may usually obtain access to or copies of their medical record.

208)

A Patients' medical records are considered the property of the owners of the facility where they were created. For example, a physician in private practice owns his or her records; records in a clinic are the property of the clinic. Hospital records are the property of the admitting hospital.

209)

B On signing a release, patients may usually obtain access to or copies of their medical records.

However, under the doctrine of professional discretion, courts have held that in some cases, patients treated for mental or emotional conditions may be harmed by seeing their own records.

210)

D The Health Insurance Portability and Accountability Act (HIPAA) is a federal law providing privacy and other healthcare rights of patients, including seeing or copying their medical record.

The FDA (Federal Drug Administration) works to ensure safe medications. The Joint Commission is involved in licensing and credentialing of health care facilities. OSHA (Occupational Safety and Health Administration) deals with safety in the workplace.

211)

D As a protection in the event of litigation, records should be kept until the applicable statute of limitations period has elapsed, which generally ranges from two to seven years. In some cases, this involves keeping the medical records of minor patients for a specified length of time after they reach legal age.

212)

C When a medical clinic provides services, the clinic is the owner of the record even though the employer paid for the services.

213)

B

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Medical records should not be released to a third party without written permission, signed by the patient or the patient's legal representative. Only the information requested should be released.

When medical records are requested for use in a lawsuit, a signed consent for the release of the records must be obtained from the patient, unless a court subpoenas the records. In this case, the patient should be notified in writing that the records have been subpoenaed and released. All records, appropriately requested, should be released regardless of the time frame.

214)

C When a subpoena duces tecum is issued, the patient's consent is not necessary. Patients must authorize release of medical records for other purposes. In the event a patient has died, the executor of the estate may authorize release, but it is best to consult with an attorney in those cases.

215)

A Patient authorizations do not need to be witnessed by a notary public. Patient authorizations are normally in writing, have a witness, are dated, and identify what information should be released.

216)

D The person in charge of records should offer sworn testimony regarding the record, if so instructed by the court; verify that the patient named was a patient of the physician named; notify the physician that a subpoena was received, and then notify the physician's insurance company or attorney, if so directed; and check all subpoenaed records to be sure they are complete, but never alter them in any way.

217)

D The federal statute known as Confidentiality of Alcohol and Drug Abuse Patient Records protects patients with histories of substance abuse regarding the release of information about treatment. Under no circumstances should information of this type be released without specific, written permission from the patient to do so.

218)

B Guidelines for authorization for releasing patient information include (1) authorizations should be in writing; (2) authorizations should include the patient's name, address, and date of birth; (3) the patient should sign a general authorization, unless he or she is not a legal, competent adult. In that case, parents or guardians should sign authorizations. (4) Only the information specifically requested should be released, and (5) the patient has the right to rescind a consent to release information, in which case information should not be released.

219)

D

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Telemedicine refers to remote consultations with physicians or other health care professionals.

Social media began as social networking, but is also now being used with health care. Patient monitoring may be done by closed-circuit television as a form of telemedicine.

220)

A A patient portal is a secure online Web site that gives patients 24-hour availability to health care providers. Educational programs are one feature of a patient portal, but there are many others.

221)

C According to a 2012 report from the Health Research Institute, the various types of social media have become a part of our health care delivery system. Wikis and discussion sites are two other examples of social media.

222)

B Social media provides information for Internet users in a variety of ways including emotional support for patients with similar illness, clinical research insights, awareness of causes, and capturing of patient satisfaction and feedback.

223)

C While there are new users of telemedicine every year, the Veterans Administration has been an important user of telemedicine in caring for veterans.

224)

B MACRA is federal legislation created to reward clinicians for value over volume. The EHR is key to allowing providers to collect the necessary data.

225)

B The Cures Act is designed to accelerate medical product development. It is also is designed to resolve the interoperability issues in the exchange of electronic health information.

226)

Short Answer The medical record is the written record of care provided by a physician. The electronic medical record is the collection of information about the care of the patient by a physician in electronic format. The electronic health record is the collection of all care provided to the patient by a variety of health care providers and hospitals.

227)

Short Answer Standard practice in written medical records requires the error to be acknowledged and corrected by drawing a line through the error, writing or typing in the correction, noting why the correction was made, entering the date and time, and initialing the correction.

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228)

Short Answer Entries in a patient record must be concise, complete, and objective; clear and legibly written; correct; and chronologically ordered. They should never contain inappropriate judgments or observations or attempts at humor.

229)

Short Answer Patients should sign a detailed release regarding the use of the photographs. Photographing or otherwise recording a patient's image without proper consent may be interpreted in a court of law as invasion of privacy. Invasion of privacy charges are most often upheld in court if the patient's image was used for commercial purposes, but such claims have also been upheld under public disclosure of embarrassing private facts.

230)

Short Answer An addendum is a significant change or addition to an electronic health record.

231)

Short Answer (1) Required by licensing authorities and provides a format for tracking, documenting, and maintaining a patient's communication; (2) documentation of continuing health care; (3) provides a foundation for managing a patient's health care; (4) serves as a legal document in lawsuits, and (5) provides clinical data for education, research, statistical tracking, and assessing the quality of health care.

232)

Short Answer As a protection in the event of litigation, records should be kept until the applicable statute of limitations period has elapsed, which generally ranges from two to seven years. In some cases, this involves keeping the medical records for minor patients for a specified length of time after they reach legal age.

233)

Short Answer The facility where the medical records were created owns the documents, but the patient owns the information they contain. A patient may sign a release, allowing the records to be transferred to the new practice.

234)

Short Answer Under the doctrine of professional discretion, courts have held that in some cases, patients treated for mental or emotional conditions may be harmed by seeing their own records. It is up to the discretion of the physician whether or not to allow all patients access to their medical records. On signing a release, patients may usually obtain access to or copies of their medical records.

235)

Short Answer

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This statute protects patients with histories of substance abuse regarding the release of information about treatment. It requires that a separate authorization be done by the patient.

236)

Short Answer Meaningful use is a process where health care providers use an electronic health record under federal guidelines.

237)

Short Answer The electronic systems that health care professionals and patients use to store, share, and analyze health information.

238)

Short Answer Twitter, Facebook, blogs, forums, social bookmarking, and health providers sharing information online in various formats are just several of the many uses.

239)

Short Answer Advantages include timely diagnostic information for the providers of care, convenience for the patient, referral to specialists and both patient and provider education opportunities.

Disadvantages may include patient resistance and lack of provider reimbursement.

Student name: 240)

While privacy is not directly expressed in the amendments to the Constitution, which of the following is one of the amendments that the U.S. Supreme Court has used to cover privacy issues?

A) Second B) Third C) Sixth D) Eighth

241)

Which of the following court cases first declared that a constitutional right to privacy was implied?

A) Griswold v. Connecticut B) OPIS v. Florida Agency for Health Care Administration C) Roe v. Wade D) Board of Education v. Earls

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242)

Which of the following court cases held that federal privacy laws like HIPAA may preempt stricter state privacy laws?

A) Griswold v. Connecticut B) OPIS v. Florida Agency for Health Care Administration C) Roe v. Wade D) Board of Education v. Earls

243)

The first federal law to specifically deal with the privacy of health care records was A) Electronic Communication Privacy Act. B) Gramm-Leach-Bliley Act. C) Health Insurance Portability and Accountability Act. D) Computer Abuse Amendments Act.

244)

Which federal law made substantive changes to HIPAA? A) HITECH Act B) Graham-Leach-Bliley Act C) Electronic Communication Act D) Patient Safety and Quality Act

245)

Which HIPAA standard requires providers to protect electronically transmitted and otherwise stored personal health information?

A) Standard 1 B) Standard 2 C) Standard 3 D) Standard 4

246)

Which HIPAA standard requires that all providers secure a unique provider identity number?

A) Standard 1 B) Standard 2 C) Standard 3 D) Standard 4

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247)

Which HIPAA standard requires providers and their business associates to put in place policies and procedures that ensure privacy of the health record?

A) Standard 1 B) Standard 2 C) Standard 3 D) Standard 4

248)

Which of the following statements is true about HIPAA Standard 2?

A) All providers must have a unique identifier number for submittal of claims for payment.

B) All providers must have policies to secure health records from unauthorized disclosures.

C) Protected Health Information (PHI) covers only electronic records.

D) Protected Health Information (PHI) is any written, spoken or electronic form.

249)

How many HIPAA-defined permissions exist?

A) Three B) Four C) Five D) Six

250)

A permission is defined as A) a request for records.

B) a covered entity.

C) a de-identifier.

D) a reason under HIPAA for disclosing patient information.

251)

A provider may release information about a victim of abuse, neglect, or domestic violence under which permission of HIPAA? A) Treatment, payment, or health care operations.

B) Incidental use.

C) Public interest and benefit activities.

D) Limited data set.

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252)

In a physician's office, a sign-in sheet is permissible to use as long as A) the receptionist immediately crosses off the name.

B) the sign-in sheet is a peel-off label for each patient.

C) the actual time of the appointment is not recorded.

D) you do not ask for the reason for the visit.

253)

A patient believes her privacy rights have been violated by a local hospital. Under HIPAA, the patient A) may immediately file a lawsuit in federal court.

B) may immediately file a lawsuit in a small claims court.

C) must first file a written complaint with the Secretary of Health and Human Services through the Office of Civil Rights.

D) must first file a written complaint with the local district attorney.

254)

A breach under HIPAA A) is an unauthorized acquisition, access, use, or disclosure of personal health information.

B) is a use of a firewall.

C) is the transfer of records by e-mail.

D) is an unauthorized use of the medical record that is not disclosed.

255)

Which of the following are considered covered entities?

A) Rehabilitation facilities B) Hospitals C) All of these D) Insurance companies

256)

Under the Security Rule, Covered Entities must A) ensure the confidentiality, integrity, and availability of all PHI they create, receive, maintain, or transmit.

B) identify and protect against reasonably anticipated threats to the security or integrity of the information.

C) All of these.

D) ensure compliance by their workforce.

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257)

As of February 2019, the single largest individual HIPAA settlement was A) $16 million.

B) $12 million.

C) $22 million.

D) $14 million.

258)

Any breach of over 500 records requires the Covered Entity to A) do a memo to staff.

B) shut down their EMR software.

C) notify the FBI. D) notify all the media.

259)

The Security Rule requires Covered Entities to A) ensure confidentiality, integrity, and availability of all records they create.

B) identify and protect against threats to security or integrity of records.

C) protect against reasonable anticipated impermissible uses or disclosures, and compliance by staff.

D) all of these

260)

Which law made significant changes to provisions in the Health Insurance Portability and Accountability Act? A) Patient Protection and Affordable Care Act B) Health Care and Education Reconciliation Act C) Patient Safety and Quality Improvement Act D) American Recovery and Reinvestment Act

261)

The Health Information Technology for Economic and Clinical Health Act (HITECH) was part of what other law?

A) Patient Protection and Affordable Care Act B) Health Care and Education Reconciliation Act C) Patient Safety and Quality Improvement Act D) American Recovery and Reinvestment Act

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262)

As of January 2018, the Medicare Fraud Strike Force had initiated how many criminal actions?

A) 1,938 B) 2,113 C) 1,722 D) 1,435

263)

Which of the following is not a reason that Medicare fraud is difficult to estimate?

A) Health care claims are destroyed after 2 years.

B) Fraud is hard to detect.

C) Sometimes a claim is partially fraudulent and partially accurate.

D) Dollar amounts spent in a single incident of fraud are increasing.

264)

Under the Federal False Claims Act, a citizen may A) file a claim on behalf of the federal government for false claims made for payment of health services.

B) pay someone else's medical bill.

C) file criminal charges against someone who has filed false claims.

D) repay claims made erroneously.

265)

An orthopedic surgeon refers his patients to a radiology facility owned by his brother.

What law is potentially being violated?

A) Federal Anti-Kickback law B) Stark Law C) Federal False Claims Act D) HIPAA

266)

A medical assistant who is recording data in a patient's medical record maintains confidentiality at all times. Which of the following describes this practice?

A) Not allowing the patient to see the medical record.

B) Not conferring with other health care professionals about the patient.

C) Not releasing patient information to unauthorized individuals.

D) Releasing patient information to unauthorized individuals.

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267)

Which of the following is an example of a privileged communication?

A) A patient tells her physician that she uses illegal drugs.

B) A custodian speaks with a nurse about a problem with a disinfectant.

C) Parents discuss treatment options for their child who has autism.

D) A nurse practitioner explains a procedure to a patient.

268)

Which of the following is not a violation of patient confidentiality?

A) While the patient is in the waiting room, a nurse tells a patient his diagnosis.

B) Medical assistants are discussing a patient by name outside the exam room.

C) An office clerk calls a patient by name at the checkout desk.

D) A radiology technician discusses with the patient results of the x-rays.

269)

HIPAA allows a state preemption. What does that mean?

270)

Of the four standards set forth in HIPAA, which two are concerned with privacy and security?

271)

What was the first federal law that covered privacy and security for health care information?

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272)

What is Protected Health Information (PHI)?

273)

What is a permission under HIPAA?

274)

Identify the six HIPAA-defined permissions.

275)

Before filing a lawsuit, what must a patient do when they believe their health information privacy has been violated?

276)

What is a breach under HIPAA?

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277)

Why was the Medicare Fraud Strike Force established?

278)

What is a Covered Entity?

279)

Give five examples of how the Health Information Technology for Economic and Clinical Health Act (HITECH) strengthened privacy and security.

280)

What is the purpose of the Federal False Claims Act?

281)

What is the difference between the Federal Anti-Kickback Law and the Stark Law?

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282)

What is the Criminal Health Care Fraud Statute?

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Answer Key Test name: chapter 8 240)

B Contrary to popular belief, the term privacy (freedom from unauthorized intrusion) does not appear in the U.S. Constitution or the Bill of Rights. However, the U.S. Supreme Court, the court responsible for determining constitutional issues, has ruled in favor of privacy interests (and occasionally against them), deriving the right to privacy from the First, Third, Fourth, Fifth, Ninth, and Fourteenth Amendments to the Constitution.

241)

A As a result of the Supreme Court's decision in Griswold v. Connecticut, patients possess certain rights, which affect the delivery of medical services and health care. OPIS v. Florida AHCA determined that HIPAA preempts state law in certain cases. Roe v. Wade legalized abortion in the United States. In the case Board of Education v. Earls, the U.S. Supreme Court held that drug testing of student athletes (and others) was not a violation of the Fourth Amendment.

242)

B OPIS v. Florida AHCA determined that HIPAA preempts state law in certain cases. Under Griswold v. Connecticut, patients possess certain rights, which affect the delivery of medical services and health care. Roe v. Wade legalized abortion in the United States. In the case Board of Education v. Earls, the U.S. Supreme Court held that drug testing of student athletes (and others) was not a violation of the Fourth Amendment.

243)

C The Health Insurance Portability and Accountability Act, passed in 1996, was the first federal law to specifically address the privacy and security of the medical record. The Electronic Communication Privacy Act passed in 1986 addresses general electronic communications. The Gramm-Leach-Bliley Act passed in 1999 requires privacy policies for financial institutions and insurance companies. The Computer Abuse Amendments Act of 1994 makes the transmission of harmful computer code such as viruses illegal.

244)

A The HITECH Act made substantive changes to HIPAA. The other laws also impacted privacy but were not as specific to privacy.

245)

C

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There are four standards set forth in HIPAA. Standard 3 is the Security Rule, which requires that all health records be secured and protected from unauthorized use. Standard 1 Transactions and Code Sets requires providers to use specific code sets such as Current Procedural Terminology (CPT) and the International Classifications of Diseases. Standard 2 is HIPAA's privacy rule.

Standard 4 required national identifier standards.

246)

D There are four standards set forth in HIPAA. Standard 4 required national identifier standards.

Standard 1 Transactions and Code Sets requires providers to use specific code sets such as Current Procedural Terminology (CPT) and the International Classifications of Diseases.

Standard 2 is HIPAA's privacy rule. Standard 3 is the Security Rule.

247)

B There are four standards set forth in HIPAA. Standard 2 is HIPAA's privacy rule. Standard 1 Transactions and Code Sets requires providers to use specific code sets such as Current Procedural Terminology (CPT) and the International Classifications of Diseases. Standard 3 is the Security Rule and Standard 4 required national identifier standards.

248)

D HIPAA's Standard 2 covers Protected Health Information (PHI) in any written, spoken, or electronic form.

249)

D There are six HIPAA-defined permissions used to disclose Protected Health Information (PHI): (1) disclosures to patients; (2) for treatment, payment, or health care operations; (3) disclosures with opportunity to agree or object; (4) limited incidental disclosures; (5) public interest and benefit activities; and (6) in a limited data set.

250)

D A permission is a reason under HIPAA to disclose patient information. There are six HIPAAdefined permissions used to disclose Protected Health Information (PHI): (1) disclosures to patients; (2) for treatment, payment, or health care operations; (3) disclosures with opportunity to agree or object; (4) limited incidental disclosures; (5) public interest and benefit activities; and (6) in a limited data set.

251)

C The provider may be able to release information under public interest and benefit activities in the event the injuries have been reported to local law enforcement.

252)

D

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A sign-in sheet is acceptable in a physician or other health care office as long as the reason for the visit is not part of the sign-in sheet. Various organizations do have staff immediately cross the name off, use a peel-off label, or record the time of arrival and appointment but are not required to do so.

253)

C The HIPAA Privacy Rule does not give patients the express right to sue when they believe their privacy has been violated. They must first file a written complaint with the Secretary of Health and Human Services through the Office of Civil Rights. The HHS Secretary determines whether or not to investigate the complaint. Patients may have other legal standing to sue under state privacy laws in state courts.

254)

A A breach under HIPAA is an unauthorized acquisition, access, use, or disclosure of personal health information that compromises the security or privacy of such information. Lack of compliance to the security rules can lead to substantial fines.

255)

C A Covered Entity is any organization that has and maintains personal health information.

256)

C Covered entities are responsible for maintaining and protecting the electronic medical record.

This includes identifying and protecting against reasonably anticipated threats and ensuring compliance by their workforce.

257)

A Based on the data collected by the HHS OCR, as of February 1, 2019, the single largest individual HIPAA settlement was against Anthem, Inc. for $16 million. This represented a threefold increase over the previous settlement of $5.5 million in 2016.

258)

D Covered entities are required to notify the media of any breach of more than 500 records. This is so that individuals who may be affected can take any necessary action to protect their privacy.

259)

D The Security Rule requires that all Covered Entities ensure confidentiality, protect against threats to security, protect against reasonable anticipated impermissible uses, and ensure compliance by the staff.

260)

D

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The American Recovery and Reinvestment Act made substantial changes to HIPAA, including privacy and security regulations, enforcement of the HIPAA regulations, and other provisions regarding health information. The changes were found as part of the Health Information Technology for Economic and Clinical Health Act which was part of the ARRA. 261)

D The Health Information Technology for Economic and Clinical Health Act (HITECH) was part of the American Recovery and Reinvestment Act (ARRA). HITECH made substantial changes to HIPAA, including privacy and security regulations, enforcement of the HIPAA regulations, and other provisions regarding health information.

262)

A The Strike Force had initiated 1,938 criminal actions—cases against possible fraud.

263)

A Medicare fraud is often difficult to detect because of the size of the system, which leads to partially accurate and partially fraudulent claims. While records are kept for many years, the actual statistics are not as reliable because more and more ways are found to defraud Medicare.

264)

A The Federal False Claims Act is a law that allows for individuals to bring civil actions on behalf of the U.S. government for false claims made to the federal government, under a provision of the law call qui tam from the Latin meaning "to bring an action for the kind and for oneself."

265)

B The Stark Law prohibits physicians or their family members who own health care facilities from referring patients to those entities if the federal government is paying for the treatment.

266)

C All health care professionals have a legal duty to safeguard a patient's privacy and maintain confidentiality. Confidentiality is the act of holding information in confidence, not to be released without authorization from the patient.

267)

A Privileged communication refers to information held confidential within a protected relationship.

Explaining a procedure to a patient is an example of informed consent.

268)

C

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Addressing a patient by name in a public place is not a violation of patient confidentiality, as long as no medical information is shared. Discussing a patient's care when others may hear it, including leaving voice mail messages, are violations of confidentiality. A radiology technician's discussion of results is a violation of both confidentiality and the technician's scope of practice.

269)

Short Answer If a state's privacy laws are stricter than HIPAA, the state laws may take precedence.

270)

Short Answer Standard 2 is HIPAA's privacy rule. Standard 3 is the security rule.

271)

Short Answer The Health Insurance Portability and Accountability Act (HIPAA) was passed in 1996 and was the first federal law to deal explicitly with the privacy of medical records. Both civil and criminal sanctions are part of the law.

272)

Short Answer Protected Health Information (PHI) is any information that contains one or more patient identifiers. Examples are date of birth, Social Security number, e-mail address, copy of driver's license, and photos of the patient.

273)

Short Answer Under HIPAA, a permission is a reason for disclosing patient information.

274)

Short Answer The six HIPAA-defined permissions used to disclose Protected Health Information (PHI) are (1) disclosures to patients; (2) for treatment, payment, or health care operations; (3) disclosures with opportunity to agree or object; (4) limited incidental disclosures; (5) public interest and benefit activities; and (6) in a limited data set.

275)

Short Answer The patient must first file a written complaint with the Secretary of Health and Human Services through the Office of Civil Rights. The HHS Secretary determines whether or not to investigate the complaint. Patients may have another legal standing to sue under state privacy laws in state courts.

276)

Short Answer A breach under HIPAA is an unauthorized acquisition, access, use, or disclosure of personal health information which compromises the security or privacy of such information. Lack of compliance to the security rules can lead to substantial fines.

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277)

Short Answer In 2007, a Medicare Fraud Strike Force was established to combine the resources of federal, state, and local law enforcement entities to prevent and combat health care fraud, waste, and abuse. As of June 2018, the Strike Force had initiated 1,938 criminal actions and had 2,498 indictments.

278)

Short Answer Health care providers who conduct administrative and financial transactions in electronic form are called Covered Entities. This includes all employees, volunteers, trainees, and all others who are under the control of the entity.

279)

Short Answer HITECH extended compliance with HIPAA privacy and security to business associates and their subcontractors, prohibited the sale of protected health information without appropriate authorization, expanded individual rights to electronically access one's PHI, and prohibited the use of genetic information for insurance underwriting purposes. In addition, HITECH finalized the breach notification requirements, expanded individuals' rights to obtain restrictions on certain PHI if services are paid for out of pocket, and established new limitations on the use and disclosure of protected health information for marketing and fund-raising purposes. Finally, HITECH made it easier for schools to access immunization records and removed restrictions of the privacy rule if an individual had been deceased for more than 50 years.

280)

Short Answer The Federal False Claims Act is a law that allows for individuals to bring civil actions on behalf of the U.S. government for false claims made to the federal government. This is under a provision of the law call qui tam from the Latin meaning "to bring an action for the kind and for oneself."

281)

Short Answer The Federal Anti-Kickback Law covers activities where one person is paid a fee for referring patients to another entity. The Stark Law prohibits physicians or their family members who own health care facilities from referring patients to those entities.

282)

Short Answer The Criminal Health Care Fraud Statute is a section of the United States Code that prohibits fraud against any health care benefit program at the federal level.

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Student name: 283)

The states and the federal government collect vital statistics in the United States that include births, deaths, marriages, divorces, and changes in civil status. What is the main purpose for collection of this information?

A) To assess population trends and needs.

B) To distribute goods and services fairly.

C) To control population growth or decline.

D) To provide information to marketing services.

284)

Who is responsible for gathering and filing many of the vital statistics collected by the states and the federal government?

A) School administrators B) Financial executives C) County commissioners D) Health care practitioners

285)

Examples of public data collected by law from physicians include A) murders and child abuse incidents.

B) births, deaths, rapes, and assaults.

C) incidents of allergic reaction to drugs.

D) auto accidents where the physician was attending.

286)

If a patient dies of natural causes while under his or her physician's care, who is responsible for completion of the medical portion of the death certificate?

A) Morgue attendant B) Attending physician C) Medical examiner D) Any health care practitioner in attendance at the time of death

287)

Which of the following is not required on a death certificate?

A) Date of death B) Time of death C) Decedent's complete medical history D) Cause of death

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288)

The public official who investigates and holds inquests concerning those who die from unknown or violent causes is the A) coroner.

B) attending physician.

C) medical examiner.

D) forensic pathologist.

289)

An obstetrician who delivers babies knows that all live births need to be recorded. To which of the following agencies should these births be reported?

A) Local county registrar B) State registrar C) Federal registrar D) Census bureau

290)

Generally, birth and death certificates are not required for fetal deaths occurring prior to what week of gestation?

A) Week 15 B) Week 16 C) Week 17 D) Week 20

291)

In which of the following cases would it be legal for a physician to sign a death certificate?

A) If the physician attended to the deceased before the death.

B) If the death was possibly due to criminal causes.

C) If the cause of death was undetermined by the physician.

D) If the cause of death was violent.

292)

A person dies as a result of a carjacking. Who is responsible for signing the death certificate for this individual?

A) The chief of police B) The mortician C) The next of kin D) The coroner

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293)

A death has occurred under normal circumstances and the body released to the funeral home. Who is responsible for filing the death certificate with the state?

A) The mortician B) The physician C) The coroner D) The hospital

294)

Which of the following accurately describes the role of the coroner or medical examiner in the event of a violent death?

A) A coroner, who is always a physician, holds an inquest to determine cause of death.

B) A coroner or medical examiner conducts a trial to determine the cause of death.

C) A medical examiner, who is frequently a pathologist, may order and perform an autopsy.

D) A coroner investigates the crime scene and presents medical proof at a trial.

295)

A division of medicine that incorporates law and medicine and involves medical issues or medical proof at trials having to do with malpractice, crimes, or accidents is called A) criminal medicine.

B) investigative medicine.

C) examiner medicine.

D) forensic medicine.

296)

Which of the following is not a purpose of public health functions?

A) Checking water quality.

B) Requiring physicians to take public health courses.

C) Inspecting restaurants and other facilities that serve food.

D) Exterminating pest and vermin that can spread disease.

297)

The power of the states to initiate public health statutes is inferred from which amendment to the U.S. Constitution?

A) First Amendment B) Second Amendment C) Sixth Amendment D) Tenth Amendment

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298)

Which of the following is an example of federalism?

A) A state retains police powers not expressively granted to the federal government.

B) The federal government has more powers than the state government.

C) If state and federal government statutes conflict, the federal statute takes precedence.

D) If state and federal government statutes conflict, the state statute takes precedence.

299)

The state of Virginia checks all restaurants to make sure the conditions are sanitary. This is an example of which of the following?

A) Criminal law B) Civil statutes C) Federal health law D) Public health statutes

300)

Which of the following is an example of a state law that requires behavioral changes on the part of the public?

A) Vaccinations to enter school.

B) Spraying communities for mosquito control.

C) Promoting the use of child safety seats.

D) Inspecting restaurants for sanitary conditions.

301)

Which of the following examples of public health statutes are enforced by citations for noncompliance?

A) Vaccinations to enter school B) Spraying communities for mosquito control C) Smoking bans D) Fluoride in the public water supply

302)

Certain sexually transmitted infections (STIs) must be reported whenever diagnosed.

Which of the following is not a reportable STI? A) Syphilis B) Cervical cancer C) Public lice D) Scabies

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303)

What is the main reason for health care practitioners to report sexually transmitted infections (STIs) to the state health department?

A) To quarantine the individual with the infection B) To treat others who may be infected C) To track the incidence of STIs in communities D) To arrest the individual with the infection

304)

Which of the following individuals with a sexually transmitted disease would be required by all states to tell a sexual partner of this disease?

A) A person with syphilis.

B) A person with gonorrhea.

C) A person with HIV. D) A person with genital warts.

305)

Which of the following individuals would probably have more stringent reporting requirements if they have a communicable disease?

A) A stay-at-home parent B) A lawyer C) An office manager D) A waitress

306)

The National Childhood Vaccine Injury Act of 1986 created the National Vaccine Injury Compensation Program (VICP). Which of the following was this legislation created to protect?

A) Vaccine manufacturers and providers B) Parents of children with vaccination injuries C) Schools requiring vaccinations for entrance D) Children injured by vaccinations

307)

Who decides who gets compensation as a result of problems caused by vaccines?

A) U.S. Supreme Court B) individual state Supreme Court C) National Vaccine Injury Compensation Program D) U.S. Court of Federal Claims

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308)

In most states, which of the following cases is not mandated as a reportable injury?

A) A physician suspects child abuse in a child with multiple fractures.

B) A physician suspects spousal abuse, however the patient does not admit it occurred.

C) A physician treats a patient who states that she was raped.

D) A physician treats a person who was assaulted in a parking lot.

309)

Samantha lives next door to a ninety-year-old woman named Ruth. She usually sees Ruth every couple of days in her garden. Recently, Ruth's son Joseph moved in with his mother.

Samantha has heard yelling and screaming coming from Ruth's house and has not seen Ruth in several weeks. When she goes over to visit Ruth, Joseph answers the door and will not let Samantha in the house. What should Samantha consider as a first step?

A) Nothing. It is not her business.

B) Call the police.

C) Talk to another neighbor.

D) Report the problem to the elder abuse hotline.

310)

Which of the following victims was the Laci and Conner's Act passed to protect?

A) Vulnerable adults B) Older adults C) Children D) Fetuses

311)

Which agency tests and approves prescription drugs before releasing them for public use?

A) Drug Enforcement Administration B) Food and Drug Administration C) Controlled Substances Agency D) Centers for Disease Control

312)

Which of the following agencies registers physicians for the writing of prescriptions of controlled substances?

A) Drug Enforcement Administration B) Food and Drug Administration C) Controlled Substances Agency D) Centers for Disease Control

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313)

General regulations mandated by the Controlled Substances Act require physicians who purchase, prescribe, dispense, administer, or in any way handle controlled drugs to follow certain procedures. Which of the following accurately describes one of these procedures?

A) A physician who registers with the Drug Enforcement Administration may store controlled substances in multiple locations within the division office region.

B) The physician must keep records concerning the administering or dispensing of a controlled drug on file for two years.

C) The physician must make a written inventory of drug supplies every five years and keep such records an additional two years.

D) The physician must keep drugs in an unlocked storage room and report any thefts immediately to the nearest DEA office and the local police.

314)

A physician issues a medical prescription for a patient. The correct term for this practice

is A) B) C) D)

315)

dispense. administer. prescribe. register.

Marijuana is listed as a A) Schedule I B) Schedule II C) Schedule III D) Schedule IV

drug.

316)

A physician prescribes Oxycodone for a patient who is experiencing severe back pain.

Oxcodone is an example of what schedule of drug?

A) Schedule I B) Schedule II C) Schedule III D) Schedule IV

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317)

Which of the following is an example of a Schedule V drug?

A) B) C) D)

Xanax Valium Ativan Lyrica

318)

What is the procedure for the attending physician after a person is pronounced dead?

319)

Define autopsy.

320)

What is forensic medicine?

321)

What is the difference between a coroner and a medical examiner?

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322)

Who must sign a death certificate when the person died from a fatal shooting?

323)

If a death did not occur because of suspicious circumstances, who must give consent for an autopsy to be performed?

324)

What is the process for reporting all live births in the hospital?

325)

What is federalism?

Explain the relationship between the 10th Amendment of the U.S. Constitution and public health statutes.

326)

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327)

What medical treatment must children have in order to enter public schools?

328)

What program is a no-fault system designed to compensate those individuals, or families of individuals, who have been injured by childhood vaccines?

329)

Define the National Childhood Vaccine Injury Act.

330)

Discuss the role of the Food and Drug Administration as it relates to prescription drugs.

331)

Discuss the role of the federal Drug Enforcement Administration as it relates to prescription drugs.

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Answer Key Test name: chapter 9 283)

A To assess population trends and needs, states and the federal government collect vital statistics.

Vital events for which statistics are collected include live births, deaths, fetal deaths, marriages, divorces, induced terminations of pregnancy, and any change in civil status that occurs during an individual's lifetime.

284)

D Vital events for which statistics are collected include live births, deaths, fetal deaths, marriages, divorces, induced terminations of pregnancy, and any change in civil status that occurs during an individual's lifetime. Health care practitioners help in gathering this information and in filling out forms for filing with the appropriate state and federal agencies.

285)

B Physicians are required to report basic vital statistics such as births and deaths, as well as possible criminal activities such as rape. Although physicians are required to report child abuse, all citizens are required to report murders.

286)

B If a patient dies of natural causes while under his or her physician's care, the attending physician is responsible for the medical portion of the death certificate.

287)

C A death certificate requires date and time, place, and cause of death. To include a medical history would create more information than necessary.

288)

A The coroner is the individual who investigates and holds the inquest. A medical examiner, forensic pathologist, morgue attendant, or attending physician may be called to testify, but those individuals are not responsible for holding an inquest.

289)

B All live births must be reported to the state registrar.

290)

D

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In some states, separate birth and death certificates must be filed for stillbirths, while in others there are special forms for stillbirths that include both birth and death information. Generally, birth and death certificates are not required for fetal deaths in which the fetus has not passed the 20th week of gestation.

291)

A In most states, it is against the law for an attending physician to sign a death certificate if the death was possibly due to criminal causes, not attended by a physician within a specified length of time before death, due to causes undetermined by the physician, or violent or otherwise suspicious.

292)

D In most states, it is against the law for an attending physician to sign a death certificate if the death was possibly due to criminal causes, not attended by a physician within a specified length of time before death, due to causes undetermined by the physician, or violent or otherwise suspicious. In any of these cases, a coroner or medical examiner must sign the death certificate.

293)

A When death has occurred under normal circumstances, after authorization has been obtained from the next of kin or from a legally responsible party, the body can be removed to a funeral home. The mortician or undertaker (person trained to attend to the dead) files the death certificate with the state.

294)

C A medical examiner is a physician, frequently a pathologist, who investigates suspicious or unexplained deaths in a community. As a physician, the medical examiner can order and perform autopsies. A coroner is a public official who investigates and holds inquests over those who die from unknown or violent causes; he or she may or may not be a physician, depending on state law. The purpose of a coroner's inquest is to gather evidence that may be used by the police in the investigation of a violent or suspicious death. It is not a trial, but it is a criminal proceeding, in the nature of a preliminary investigation. Forensic scientists investigate crime scenes and present medical proof at trials and hearings.

295)

D Forensic medicine is a division of medicine that incorporates law and medicine and involves medical issues or medical proof at trials having to do with malpractice, crimes, or accidents.

296)

B The licensing board for a physician or other health care provider sets the continuing education requirements for their specific profession.

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297)

D The power of the states to initiate public health statutes is inferred from the Tenth Amendment to the U.S. Constitution, included in the Bill of Rights. The amendment states "The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States, respectively, or to the people." In other words, states retain police powers and all other powers not expressively granted to the federal government.

298)

A States retain police powers and all other powers not expressly granted to the federal government—a practice referred to as "federalism"—the sharing of power among national, state, and local governments.

299)

D In all states, public health statues help guarantee the health and well-being of citizens. All Public Health Functions provide for guarding against unsanitary conditions in public facilities, inspecting establishments where food and drink are processed and sold, exterminating pests and vermin that can spread disease, checking water quality, setting up measures of control for certain diseases, and requiring physicians, school nurses, and other health care workers to file certain reports for the protection of citizens.

300)

C Child safety seat laws require behavioral changes on the part of the parents using them.

Vaccinations require parental cooperation, and spraying for mosquitoes, fluoridating the water supply, and inspecting restaurants requires no participation on the part of the public.

301)

C Smoking bans may be enforced by citations for noncompliance. Fluoridation of the public water supply is enforced by periodic checking of the public water supply. Vaccinations for school entry are enforced by requiring proof of vaccination when children enter school. Food supply inspections may be enforced by the FDA initiating civil action or criminal prosecution. Fluoride in the public water supply is a decision made at the local level.

302)

B Reportable STIs differ among states but generally include gonorrhea, syphilis, chlamydia, lymphogranuloma venereum, chancroid, granuloma inguinale (genital warts), scabies, pubic lice, and trichomoniasis.

303)

B Public health practitioners use reported cases of STIs to find and treat others who may have been infected through sexual contact with the named individual.

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304)

C All 50 states require that individuals infected with HIV notify past and present sexual partners.

The other diseases listed should be reported to the state public health departments.

305)

D Reporting requirements for communicable diseases are usually more stringent for patients who are employed in restaurants, cafeterias, day care centers, schools, health care facilities, and other places where contagion can be rampant.

306)

A The reason for creating the VICP system was to relieve vaccine manufacturers and providers from having to pay judgments for vaccine injuries that, in turn, could lead to a shortage of vaccines due to the disincentive of legal liability.

307)

D The VICP is a no-fault system designed to compensate those individuals, or families of individuals, who have been injured by childhood vaccines. The program serves as an alternative to suing vaccine manufacturers and providers, but does not take away an injured person's right to sue vaccine manufacturers and providers. The U.S. Court of Federal Claims decides who will get compensation as the result of problems.

308)

B In all states, physicians must immediately report to law enforcement officials medical treatment of patients whose injuries resulted from certain acts of violence, such as assault, rape, or domestic violence, so that authorities can investigate the incident. However, in many states, spousal abuse is reportable only if the patient says his or her injuries are due to spousal abuse.

309)

D This is a difficult situation. At a minimum, Samantha should find out about the reporting systems in place to report this possible abuse. Most of them do not require that you leave a name. Many states require health professionals, particularly physicians to report suspected elder abuse.

310)

D The Laci and Conner's Act, also called the Unborn Victims of Violence Act, is a 2004 federal law that provides for the prosecution of anyone who causes injury to, or the death of, a fetus in utero.

311)

B

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The Food and Drug Administration (FDA), an agency within the Department of Health and Human Services, tests and approves drugs before releasing them for public use. This agency also oversees drug quality and standardization. The Drug Enforcement Administration (DEA), a branch of the Department of Justice, regulates the sale and use of drugs by the authority granted in the Comprehensive Drug Abuse Prevention and Control Act of 1970, commonly called the Controlled Substances Act. 312)

A The Drug Enforcement Administration (DEA), a branch of the Department of Justice, regulates the sale and use of drugs by the authority granted in the Comprehensive Drug Abuse Prevention and Control Act of 1970, commonly called the Controlled Substances Act. 313)

B The physician must keep records concerning the administering or dispensing of a controlled drug on file for two years. The physician is issued a DEA number for a specific physician in a specific location. That location is the only one at which the physician may store controlled substances, including salespeople's samples. The physician must make a written inventory of drug supplies every two years and keep such records an additional two years. The physician must also keep drugs in a locked cabinet or safe, and report any thefts to the DEA office and local police.

314)

C To prescribe is to issue a medical prescription for a patient. To dispense is to deliver controlled substances in some type of bottle, box, or other container to a patient. To administer is to instill a medication into the body of a patient. A physician registers with the Drug Enforcement Administration through a division office to store and prescribe controlled substances.

315)

A Marijuana is listed as a Schedule I drug as of Summer 2019.

316)

B With Schedule II drugs, potential for abuse of these narcotic drugs is high, but there are currently accepted medical uses for the drug or substance in the United States, often with severe restrictions. Examples of such drugs include Dexedrine®, and Ritalin®.

317)

D Schedule V drugs have a low potential for abuse relative to the drugs or other substances in Schedule IV, and currently are accepted for medical use in the United States.

318)

Short Answer

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After a person is pronounced dead, the attending physician must complete the medical portion of the certificate of death, and state the cause, date and time, place, gender, and whether or not an autopsy was performed.

319)

Short Answer An autopsy is a postmortem examination to determine the cause of death or to obtain physiological evidence, as in the case of a suspicious death.

320)

Short Answer Forensics is a division of medicine that incorporates law and medicine and involves medical issues or medical proof at trials having to do with malpractice, crimes, and accidents. Forensic scientists investigate crime scenes and present medical proof at trials and hearings.

321)

Short Answer A medical examiner is a physician, frequently a pathologist, who investigates suspicious or unexplained deaths in a community. As a physician, the medical examiner can order and perform autopsies. A coroner is a public official who investigates and holds inquests concerning those who die from unknown or violent causes. Coroners may or may not be physicians, depending on state law.

322)

Short Answer If a death was due to criminal causes, was not attended by a physician within a specified length of time after death, was due to causes undetermined by the physician, or was violent or suspicious, the coroner or medical examiner must sign the death certificate.

323)

Short Answer If the death did not occur under suspicious circumstances, consent from the next of kin or a legally responsible party must be obtained for an autopsy to be performed. If a death occurs under suspicious circumstances, permission from the next of kin is not needed for an autopsy to be performed.

324)

Short Answer Hospitals file birth certificates with the state registrar for babies born to mothers who have been admitted as patients. The attending physician must verify all medical information contained in the birth certificate.

325)

Short Answer Federalism is the sharing of power among national, state, and local governments. States retain police powers and all other powers not expressly granted to the federal government.

326)

Short Answer

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The power of the states to initiate public health statutes is inferred from the Tenth Amendment to the U.S. Constitution, included in the Bill of Rights. The amendment states "The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States, respectively, or to the people."

327)

Short Answer Parents usually begin programs of vaccination against certain communicable diseases for their children when they are infants. When children reach school age, most states ask for proof of vaccination for children entering the public school system for the first time. Medical and religious reasons may be considered as reasons to opt out of vaccinations.

328)

Short Answer The National Childhood Vaccine Injury Act of 1986 created the National Vaccine Injury Compensation Program (VICP). The reason for creating the VICP system was to relieve vaccine manufacturers and providers from having to pay judgments for vaccine injuries that, in turn, could lead to a shortage of vaccines due to the disincentive of legal liability. The VICP is a nofault system designed to compensate those individuals, or families of individuals, who have been injured by childhood vaccines.

329)

Short Answer The National Childhood Vaccine Injury Act of 1986 created the National Vaccine Injury Compensation Program (VICP). The reason for creating the VICP system was to relieve vaccine manufacturers and providers from having to pay judgments for vaccine injuries that, in turn, could lead to a shortage of vaccines due to the disincentive of legal liability.

330)

Short Answer The Food and Drug Administration (FDA), an agency within the Department of Health and Human Services, tests and approves drugs before releasing them for public use. This agency also oversees drug quality and standardization. The FDA also has responsibility for major product recalls—a function vital to maintaining public health.

331)

Short Answer At the federal level, the Drug Enforcement Administration (DEA), a branch of the Department of Justice, regulates the sale and use of drugs by the authority granted in the Comprehensive Drug Abuse Prevention and Control Act of 1970.

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Student name: 332)

Title VII of the Civil Rights Act of 1964 covers which of the following?

A) Makes discrimination in the workplace illegal B) Applies to businesses with 25 employees or more C) Does not cover discrimination with respect to gender D) Applies only to the hiring and firing of employees

333)

A practice manager fires a medical assistant and cannot provide a legal reason for the dismissal. This is an example of which of the following?

A) Employment-at-will B) Wrongful discharge C) Just cause D) Discrimination

334)

Which of the following may be used as evidence of just cause for termination, should a wrongful discharge lawsuit be filed against an employer?

A) The employee speaks out against discrimination in the workplace.

B) The employee is a whistle-blower.

C) The employee is disabled.

D) The employee is sexually harassing another employee.

335)

Quid pro quo is prohibited under the Equal Employment Opportunity Commission (EEOC) definition of sexual harassment. Which of the following is an example of this type of harassment?

A) A physician makes a nurse feel uncomfortable by constantly commenting on her attire and physical appearance.

B) A surgical resident is offered opportunities to scrub in on a procedure if he dates the surgeon.

C) A nurse in a nursing home sexually harasses physically disabled patients whom she is helping to take a shower.

D) A physician constantly talks about his "love life" in front of the office staff.

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336)

Which of the following federal laws makes it illegal to discriminate in hiring or firing because of union membership or organizational activities?

A) Civil Rights Act of 1964 B) Civil Rights Act of 1991 C) Wagner Act of 1935 D) Lilly Ledbetter Fair Pay Act of 2009

337)

A nursing home administrator sets up programs to give preferential treatment for minorities. This is being done because the current workforce at the nursing home is predominantly white. What is the term for this policy?

A) Equal opportunity B) Fair labor standards C) Wage and hour laws D) Affirmative action

338)

Which of the following wage and hour laws provides for overtime pay and a minimum wage?

A) Civil Rights Act of 1964 B) Fair Labor Standards Act of 1938 C) Wagner Act of 1935 D) Lilly Ledbetter Fair Pay Act of 2009

339)

The primary source of information for OSHA standards is A) the medical office policy handbook.

B) OSHA Web site.

C) OSHA state law.

D) OSHA federal law.

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340)

OSHA has six priorities. Which of the following lists those priorities in order?

A) Imminent danger situations, severe injuries and illnesses, employee complaints, referral of hazards from other agencies, targeted inspections, and follow-up inspections.

B) Investigating fatalities, imminent danger situations, employee complaints, programmed inspections, targeted inspections, and follow-up inspections.

C) Employee complaints, investigating fatalities, imminent danger situations, programmed inspections, severe injuries, and follow-up inspections.

D) Programmed inspections, investigating fatalities, imminent danger situations, referral of hazards from other agencies employee complaints, and follow-up inspections.

341)

An OSHA inspector finds that a hospital lab is operating under unsafe conditions that could endanger the lives of employees. What is the initial action that would be taken by the inspector?

A) Apply to the federal district court for an injunction.

B) Close down the lab until the unsafe condition is remedied.

C) Report the problem to an OSHA compliance officer.

D) Ask the employer to remedy the situation.

342)

Many states have right-to-know laws. These laws offer employees A) protection from unsafe work environments.

B) protection from discrimination.

C) protection from sexual harassment.

D) protection from required union membership.

343)

Which of the following occurs when an OSHA compliance officer informs an employer the business is subject to "failure to abate" alleged violations?

A) The business is permanently shut down.

B) The business is subject to daily penalties.

C) The business is temporarily shut down.

D) The business is featured on the evening news.

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344)

Safety Data Sheets (SDS) are A) only used in hospitals.

B) only used in medical labs.

C) sometimes used in medical offices.

D) required in any business that has any hazardous material.

345)

The Bloodborne Pathogen Standard is designed to protect health care workers against which of the following?

A) Any contagious disease B) Cancer-causing agents C) Contagious diseases like HBV D) Contagious diseases like the flu

346)

OSHA standards for medical settings and health care workers are often influenced by, or associated with, guidelines issued by A) The Joint Commission.

B) CMS. C) CLIA. D) CDC.

347)

Employees in medical facilities often use hazardous materials in their workplace. Which of the following is a guideline for safely handling these materials?

A) Only licensed health care workers may handle hazardous substances.

B) The employer must provide a Safety Data Sheet for each hazardous chemical.

C) Each hazardous product must have a poison label on the packaging.

D) Safety Data Sheets must be filed in a locked drawer in the main office.

348)

Which of the following specifically states that any equipment that may pose a health risk is included as a hazard?

A) CDC guidelines B) Chemical Hygiene Plan C) General Duty Clause D) Medical Waste Tracking Act

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349)

Which of the following acts mandated that employers maintain a sharps injury log and involved nonmanagerial employees in selecting safer medical devices?

A) Occupational Exposure to Bloodborne Pathogens Standard B) Chemical Hygiene Plan C) General Duty Clause D) Medical Waste Tracking Act

350)

In 2012, OSHA published the first major revision to the Hazard Communication Standard. What was the main purpose of the revision?

A) Require better labels on all items in a health care facility B) Transform the right of employees to know about workplace hazards to the "right to understand" workplace hazards C) Require employees to maintain a sharps injury log D) Require employees to double-glove when handling toxic materials

351)

The CDC publishes an online guide for preventing transmissions of infectious agents.

This guide is intended for A) all of these.

B) health care administrators.

C) physicians.

D) ancillary health care personnel.

352)

In the revision to the Hazard Communication Standard, OSHA created a new name for Material Safety Data Sheets. What is the new acronym?

A) CDC B) CHP C) BPS D) SDS

353)

The OSHA Ionizing Radiation Standard applies to all medical and dental offices that have A) hazardous chemicals.

B) blood draw stations.

C) centrifuges.

D) x-ray machines.

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354)

Sarah is starting a new job as a medical assistant at a local clinic. Under OSHA regulations, what must her employer offer her as part of her employment?

A) Free lunches at least once a week B) Uniforms C) No-cost hepatitis B vaccinations D) No-cost flu vaccinations

355)

Which of the following is an OSHA guideline for disposal of medical waste material?

A) Dispose of chemicals in a glass or metal container.

B) Dispose of sharp objects in a glass container.

C) Do not flush any chemicals down the drain.

D) Do not incinerate medical wastes.

356)

Which of the following is not a requirement of the Clinical Laboratory Improvement Act (CLIA)?

A) Obtain certification.

B) Follow minimum regulations regarding quality control.

C) Follow maximum quality standards for lab testing.

D) Pay applicable fees.

357)

Federal and state workers' compensation laws establish procedures for compensating workers who are injured on the job. Which of the following accurately describes an aspect of these laws?

A) The employee pays the cost of the insurance premium.

B) State laws cover workers in Washington, DC and maritime workers.

C) The injured employee can file a claim with the government instead of suing.

D) Only injuries are covered by workers' compensation; diseases are not.

358)

An employee of a hospital is injured on the job and files for workers' compensation.

Which of the following type of state compensation benefits would be available to this injured worker?

A) Permanent disability indemnity in the form of weekly cash payments.

B) A lump sum for a temporary disability.

C) Weekly cash payments for living expenses.

D) Salary replacement.

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359)

An employee of a nursing home is injured on the job while lifting patients. She believes her back has been injured, but not badly. What is the initial action she should be taking after hurting her back?

A) Tell her coworkers to call an ambulance.

B) Report the injury to a supervisor.

C) Report the injury to the Workers' Compensation agency.

D) Report the injury to the human resources department.

360)

An employee who is laid off from his job files for unemployment insurance. Which of the following accurately describes the management of unemployment funds available to this worker?

A) The funds are managed solely by the state government.

B) The funds are managed solely by the federal government.

C) Employees contribute to a fund that is paid out to eligible unemployed workers.

D) In all but a few states, the total cost is covered by the employer.

361)

Which of the following information should not be included on an employee's W-2 form?

A) Employer tax ID number.

B) Employee's Social Security number.

C) Amounts deducted for life insurance.

D) Total earnings paid by the employer.

362)

A practice manager is interviewing a medical assistant for a new position in the office.

Which of the following information can an employer legally ask of a prospective employee?

A) Religion B) Political affiliation C) Education D) Number of children

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363)

A practice manager is interviewing medical assistants for several new positions in an expanding medical practice. Which of the following is not a recommended guideline for conducting the interviews?

A) Stick to a list of questions for all candidates that relate to the job description.

B) Do not rush the interview; allow it to last as long as the candidate prefers.

C) Do not ask why the person is leaving his or her current position.

D) Always ask about child care arrangements.

364)

A bonded employee in a medical office embezzles money from the employers. In most situations, from whom will the money ultimately be recovered?

A) The employee B) The insurance carrier C) The employee's family D) The government

365)

Which of the following is not an area of questioning appropriate for the employer to ask a job applicant?

A) Work experience B) Hours available to work C) Birth date D) Social Security number

366)

What does the term "wrongful discharge" mean?

367)

What does the term "employment-at-will" mean?

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368)

Discuss the concept of public policy as it relates to the hiring and firing of employees.

369)

Identify at least three employment activities that are considered discrimination under federal law.

370)

Describe the circumstances of the Lily Ledbetter case.

371)

What is the major responsibility for the Occupational Safety and Health Administration (OSHA)?

372)

Identify, in order, the Occupational Safety and Health Administration's (OSHA's) six priorities for workplace inspections.

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373)

What responsibilities do employees have under OSHA standards?

374)

What is the purpose of the Bloodborne Pathogen Standard?

375)

What is the purpose of the Hazard Communication Standard?

376)

Discuss the changes made in 2012 to the Hazard Communication Standard.

377)

What is the purpose of the Clinical Laboratory Improvement Act of 1988?

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378)

What are the five types of state workers' compensation benefits?

379)

Identify the specific areas of discrimination in hiring, promoting, and firing.

380)

What is the purpose of an I-9 form?

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Answer Key Test name: chapter 10 332)

A Title VII applies to businesses with 15 or more employees, covers discrimination, and is focused on a much broader area than simply hiring and firing.

333)

B Wrongful discharge is a concept established by precedent that says an employer risks litigation if he or she does not have just cause (a legal reason) for firing an employee. Discrimination in the workplace is treating employees differently in hiring, firing, work assignments, or other aspects of employment because of personal traits or practices. Discrimination may be a cause of wrongful discharge. Public policy in the context of employment refers to the idea that the employee terminated was acting in the common good by challenging workplace policies.

334)

D If a nonsupervisory employee sexually harasses another worker, the employer is held liable only if he or she knew or should have known about the offense and did nothing to stop it. Sexual harassment of another employee would constitute just cause for dismissing the offending employee. Federal laws prohibit employers from firing or otherwise discriminating against employees for any of the following reasons: belonging to a particular race or religion; being male or female; being a particular age or having a disability; joining a union or engaging in political activity; preventing the collection of retirement benefits; reporting company safety violations (whistle-blowing); exercising the right to free speech; or refusing to take drug or lie detector tests (with some exceptions).

335)

B Unwelcome sexual advances, requests for sexual favors, and other verbal or physical conduct of a sexual nature constitute sexual harassment when (1) submission to such conduct is made either explicitly or implicitly a term or condition of an individual's employment; (2) submission to or rejection of such conduct by an individual is used as a basis for employment decisions affecting such individual; or (3) such conduct has the purpose or effect of unreasonably interfering with an individual's work performance or creating an intimidating, hostile, or offensive working environment. While the other examples are possible forms of sexual harassment, they are not examples of quid pro quo.

336)

C

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The Wagner Act of 1935 makes it illegal to discriminate in hiring or firing because of union membership or organizational activities. Title VII of the Civil Rights Act of 1964 prevents employers from discriminating in hiring or firing on the basis of race, color, religion, sex, or national origin. The Civil Rights Act of 1991 provided two new important benefits for employees who prove discrimination: (1) employees may collect punitive damages; (2) employees may collect damages for emotional distress associated with incidents of discrimination. The Lilly Ledbetter Fair Pay Act revised other legislation by providing statutes of limitation trigger dates, extending the class of plaintiffs to any individual who is "affected by" unlawful discrimination, and providing recovery of back pay.

337)

D Affirmative action involves programs that use goals and quotas to provide preferential treatment for minority persons determined to have been underutilized in the past.

338)

B The 1938 Fair Labor Standards Act prohibits child labor and the firing of employees for exercising their rights under the act's wage and hour standards. It also provides for overtime pay and a minimum wage. The Wagner Act of 1935 makes it illegal to discriminate in hiring or firing because of union membership or organizational activities. Title VII of the Civil Rights Act of 1964 prevents employers from discriminating in hiring or firing on the basis of race, color, religion, sex, or national origin. The Lilly Ledbetter Fair Pay Act revised other legislation by providing statutes of limitation trigger dates, extending the class of plaintiffs to any individual who is "affected by" unlawful discrimination, and providing recovery of back pay. The Rehabilitation Act of 1973 prohibits companies with federal contracts from discriminating against disabled individuals.

339)

B Employers and employees may review all standards at OSHA's Web site—www.osha.gov.

340)

A The five priorities in order for OSHA are imminent danger situations, severe injuries and illnesses, employee complaints, referral of hazards from other agencies, targeted inspections.

341)

D Initially, if an OSHA inspector finds an imminent danger situation, he or she will ask the employer to voluntarily remedy the situation so that employees are no longer exposed to the dangerous situation. If the employer fails to do this, an OSHA compliance officer may apply to the federal district court for an injunction to stop work until unsafe conditions are corrected.

342)

A

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Right-to-know laws are state laws that allow employees access to information about toxic or hazardous substances, employer duties, employee rights, and other workplace health and safety issues.

343)

B If an employer has failed to abate a violation, the OSHA compliance officer informs the employer that he or she is subject to "failure to abate" alleged violations. This involves proposed additional daily penalties until the employer corrects the violation.

344)

D Safety Data Sheets are required in any business that has hazardous materials.

345)

C The Standard was designed to protect health care workers against those contagious diseases that remain active while in the blood or other human tissue.

346)

D OSHA standards for medical settings and health care workers often are influenced by and/or closely associated with, guidelines issued by the Centers for Disease Control and Prevention (CDC). The Joint Commissionis involved with licensing and certification of medical facilities.

The Hazard Communication Standard (HCS) is an OSHA standard that is intended to increase health care practitioners' awareness of risk, improve work practices and appropriate use of personal protective equipment, and reduce injuries and illnesses. The Clinical Laboratory Improvement Act (CLIA) act established minimum quality standards for all laboratory testing.

CMS is the Centers for Medicare and Medicaid Services.

347)

B Under the Hazardous Communication Standard (HCS), medical facilities must have a written hazard communication program. A list of all office hazards must be compiled, posted on bulletin boards, and placed in a hazard communication manual. Each hazardous product in use must have a hazard label, which is a condensed version of the SDS. Employees must determine what hazardous chemicals are used, initial and date new SDSs as they are read, and initial and date records of safety training. Health care practitioners should see that a hazard communication manual is kept up to date and is accessible to all coworkers.

348)

C Under the General Duty Clause of the HCS, any equipment that may pose a health risk is included as a hazard. This clause covers all areas for which OSHA has not developed specific standards and holds the employer ultimately responsible for the safety of employees.

349)

A

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As mandated by the Needlestick Safety and Prevention Act, passed by Congress in 2000, the Occupational Exposure to Bloodborne Pathogen Standard was revised in 2001 to include new provisions requiring employers to maintain a sharps injury log and to involve nonmanagerial employees in selecting safer medical devices. The Chemical Hygiene Plan is the Standard for Occupational Exposures to Hazardous Chemicals in Laboratories, which clarifies the handling of hazardous chemicals in medical laboratories. The Medical Waste Tracking Act is the federal law that authorizes OSHA to inspect hazardous medical wastes and to cite offices for unsafe or unhealthy practices regarding these wastes. The CDC publishes a comprehensive online guide for all health care workers titled Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings.

350)

B The revision to the Hazard Communication Standard done in 2012 aligned the standard with the United Nations Globally Harmonized System of Classification and Labeling of Chemicals (GHS). The alignment is intended to transform the workers' right to know to the workers' right to understand workplace hazard.

351)

A The CDC publishes a comprehensive online guide for all health care workers entitled Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings, available at http://www.cdc.gov/hicpac/pubs.html. The document "is intended for use by infection control staff, health care epidemiologists, health care administrators, nurses, other health care providers, and persons responsible for developing, implementing, and evaluating infection control programs for health care settings across the continuum of care."

352)

D The "new" acronym is SDS or Safety Data Sheet. CDC is the Centers for Disease Control, CHP is the Chemical Hygiene Plan, and BPS is the Bloodborne Pathogen Standard.

353)

D All medical and dental offices that have x-ray machines must comply with the OSHA Ionizing Radiation Standard.

354)

C OSHA requires medical offices to provide no-cost hepatitis B vaccinations for employees at risk of exposure to HEP B. 355)

A

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OSHA requires medical offices to dispose of chemicals in a glass or metal container. Sharp objects should be disposed of in a leak-proof container. Some chemicals may be washed down the drain with large quantities of water. Medical waste may be incinerated by appropriate licensed medical waste handlers.

356)

C The CLIA is a federal statute passed in 1988 that established minimum quality standards for all laboratory testing. The law requires that laboratories obtain certification, pay applicable fees, and follow regulations concerning testing, personnel, inspections, test management, quality control, and quality assurance.

357)

C Workers' compensation laws allow the injured worker to file a claim for compensation with the state or the federal government instead of suing. However, the laws require workers to accept workers' compensation as the exclusive remedy for on-the-job injuries. The employer pays the cost of the insurance premium for the employee. Federal laws cover the following employees: workers in Washington, DC, coal miners, maritime workers, and federal employees. State laws cover those workers not protected under federal statutes. Occupational diseases contracted as a result of workplace exposure are covered.

358)

A Workers who are injured on the job or who contract an occupational disease may apply for five types of state compensation benefits: (1) medical treatment, including hospital, medical and surgical services, medications, and prosthetic devices; (2) temporary disability indemnity, in the form of weekly cash payments made directly to the injured or ill employee; (3) permanent disability indemnity, which can be a lump sum award or a weekly or monthly cash payment; (4) death benefits for survivors, which consist of cash payments to dependents of employees killed on the job.

359)

B Employees who are injured on the job or become ill due to work-related causes must immediately report the injury or illness to a supervisor. An injury report and claim for compensation are then filed with the appropriate state workers' compensation agency.

360)

D

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Unemployment insurance (sometimes called reemployment insurance) funds are managed jointly by state and federal governments. Under the Federal Unemployment Tax Act (FUTA), employers contribute to a fund that is paid out to eligible unemployed workers. Each state also provides unemployment insurance, and credit is given employers against the FUTA tax for amounts paid to the state unemployment fund. The total cost is borne by the employer in all but a few states.

361)

C The W-2 shows the following information: employer's tax identification number, employee's Social Security number, total earnings (wages and other compensation) paid by the employer, amounts deducted for income tax and Social Security, and amount of advance earned income credit payment, if any.

362)

C An employer may ask a prospective employee about education, but not about religion, political affiliation, marital status, or number of children.

363)

D The following guidelines can help those employees who are responsible for conducting preemployment interviews: (1) make a list of questions that relate specifically to the job description of the position to be filled, and stick to them; (2) do not rush the interview, nor let it drag on beyond reasonable time limits; (3) use general questions such as "Why are you leaving your present position?"; and (4) indicate when a decision will be made and follow through on a promise to inform the applicant of the decision. Do not ask questions about child care arrangements.

364)

A If a bonded employee should embezzle or otherwise absconds with funds, the employer can collect from the insurance carrier up to the amount of the bond. However, the employer must have filed a complaint against the alleged dishonest employee in order to collect on the bond. If the insurance company pays the bond, it will then seek to recover the amount from the offending employee.

365)

C

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Questions concerning one's Social Security number, qualifications (including license or certificate), and job experience are proper, and they should be answered as thoroughly and truthfully as possible. While asking about hours available to work, an employer should be cautious in the way the question is asked so as not to inadvertently ask an illegal question. For example, asking "Are you available to work 8 a.m. until 5 p.m. Monday through Friday" is okay.

Asking the candidate if he or she has child care so that they may work Monday through Friday is not appropriate. Questions about age or birth dates are not legal.

366)

Short Answer When no law exists that prohibits a specific reason for firing an employee, the discharged worker may have cause for litigation under a precedent for wrongful discharge. Generally, in such cases, the employer must have documentation that shows a legal reason (just cause) for dismissing the employee.

367)

Short Answer Employment-at-will generally means that employees could be refused employment and could be disciplined or fired for any or no reason. In fact, either the employer or the employee could end the employment at any time.

368)

Short Answer State courts vary in their willingness to accept the common law concept of wrongful discharge, but most recognize public policy or "common good" reasons for lawsuits brought by fired employees, such as refusing to commit an illegal act, whistle-blowing, performing a legal duty, or exercising a private right.

369)

Short Answer Federal laws prohibit employers from firing or otherwise discriminating against employees for any of the following reasons: belonging to a particular race or religion; being male or female; being of a particular age or having a disability; joining a union or engaging in political activity; preventing the collection of retirement benefits; reporting company safety violations; exercising the right to free speech; and refusing to take drug or lie detector tests (with some exceptions).

370)

Short Answer Lily Ledbetter retired from Goodyear Tire after working for 19 years as a night supervisor. She discovered six years before her retirement that for most of her career she had earned 20% less than her male counterparts. She filed a charge of unlawful employment practice. The case reached the U.S. Supreme Court. The Supreme Court threw out the case on grounds that the statute of limitations, as mandated in Title VII had run out. This triggered Congress to pass legislation dealing with the statute of limitations use. The law was signed by President Obama on January 29, 2009.

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371)

Short Answer OSHA is the federal organization that is charged with writing and enforcing compulsory standards for health and safety in the workplace.

372)

Short Answer The six priorities in order for OSHA are imminent danger situations, severe injuries and illnesses employee complaints, referral of hazards from other agencies, targeted inspections, and followup inspections.

373)

Short Answer Employees must comply with all applicable OSHA standards, report hazardous conditions, follow all safety and health rules established by the employers, and use protective equipment when necessary.

374)

Short Answer The Occupational Exposure to Bloodborne Pathogen Standard is an OSHA regulation passed in 1991. The standard is designed to protect workers in health care and related occupations from the risk of exposure to bloodborne pathogens (disease-causing organisms) such as the human immunodeficiency virus (HIV) and the hepatitis B virus (HBV).

375)

Short Answer The Hazard Communication Standard is intended to increase health care practitioners' awareness of risk, improve work practices and appropriate use of personal protective equipment, and reduce injuries and illnesses.

376)

Short Answer The changes aligned the standard with the United Nations Globally Harmonized System of Classification and Labeling of Chemicals (GHS). New wording is intended to transform the right of employees to know about workplace hazards to the "right to understand" workplace hazards.

The goal is to ensure the safe use of chemicals by providing practical, reliable, consistent, and easy to understand information for workers and students everywhere.

377)

Short Answer The Clinical Laboratory Improvement Act of 1988 established minimum quality standards for all laboratory testing.

378)

Short Answer Workers' compensation may pay for medical treatment, temporary disability indemnity, permanent disability indemnity, death benefits, and rehabilitation benefits.

379)

Short Answer

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Because of federal and state laws against discrimination in hiring, inquiries cannot be made concerning an applicant's religion, race, color, creed, family, marital status, gender, birth control, age, disability, residency, national origin, military experience, and membership in organizations.

These same criteria apply in promotion and firing.

380)

Short Answer Completion of an I-9 form is necessary in employment to prove citizenship or the right to work in the United States.

Student name: 381)

The children in a family all have blue eyes. The biological parents also have blue eyes.

The science that explains these similarities is called A) genetics.

B) genetic engineering.

C) stem cells.

D) genomes.

382)

The process by which traits are passed on to offspring is known as A) genetics.

B) genetic engineering.

C) stem cells.

D) heredity.

383)

The combination of proteins called nucleotides that are arranged to make up each human is known as which of the following?

A) Stem cells B) DNA C) Gene D) Chromosomes

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384)

How many chromosomes are normally found inside the nucleus of every human cell except egg and sperm cells?

A) 23 B) 43 C) 46 D) 52

385)

Which of the following do chromosomes normally carry that are responsible for all human characteristics from eye, skin, and hair color to height, body type, and intelligence?

A) Sperm B) Stem cells C) Eggs D) Genes

386)

How are the chromosomes that make up the human genome inherited from parents?

A) One-third from the mother and two-thirds from the father.

B) Half from the mother and half from the father.

C) Three-fourths from the mother and one-fourth from the father.

D) Three-fourths from the father and one-fourth from the mother.

387)

The Human Genome Project, funded by the U.S. government, was started in 1990. What was the purpose of this project?

A) To pinpoint certain inherited diseases, such as sickle cell anemia.

B) To determine which genes are inherited from which parent.

C) To further the development of creating human clones.

D) To locate and map the genes in the 23 pairs of chromosomes.

388)

A gene that predisposes a woman to breast cancer has been discovered by scientists.

Women who are tested to see if this gene is present are using what type of genetic testing?

A) Carrier B) Forensic C) Diagnostic D) Predictive

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389)

The medical examiner is attempting to eliminate a suspect in a crime. What type of DNA testing might the medical examiner do?

A) Carrier B) Forensic C) Prenatal testing D) Tracing lineage

390)

Amniocentesis is what type of genetic testing?

A) Carrier B) Forensic C) Prenatal testing D) Tracing lineage

391)

A permanent change in DNA is the usual cause of genetic diseases. What is the term for this harmful effect?

A) Mutation B) Cloning C) Multipotent stem cells D) mtDNA

392)

An obstetrician is caring for a young woman who wants to undergo genetic testing prior to becoming pregnant. What would be the best response to this patient?

A) Tell her that genetic testing will not determine genetic disorders passed on to a fetus.

B) Tell her that genetic testing is not recommended when determining pregnancy.

C) Refer the woman to a qualified genetic counselor.

D) Tell her about the emotional aspects of caring for a baby with a genetic disease.

393)

The court case EEOC v. Founders Pavillion, Inc. illustrated enforcement of which law(s)?

A) GINA and ADA B) GINA and HIPAA C) GINA D) HIPAA

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394)

In 1996, a federal law was passed that prevents health insurers from denying coverage based on genetic information for individuals moving between group health insurance plans.

This federal law is known as A) Privacy Act. B) Civil Liberties Act. C) HIPAA. D) Americans with Disabilities Act.

395)

In 2008, what federal law was passed that prohibits discrimination in employment based on genetic information?

A) Privacy Act B) GINA C) HIPAA D) Americans with Disabilities Act

396)

The question of who may patent genes was decided by the U.S. Supreme Court in June 2013. What was the decision?

A) The individual may patent both their own and manipulating genes.

B) Only the federal government may patent genes.

C) Only corporations may patent genes.

D) A gene is a naturally occurring substance and may not be patented.

397)

Scientists are able to manipulate DNA within the cells of plants, animals, and other organisms to ensure that certain advantageous traits will appear and be passed on, or that certain harmful traits are eliminated. What is the term for this process?

A) Genetic engineering B) Cloning C) Genetic discrimination D) Stem cell manipulation

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398)

One type of genetic engineering that is extremely controversial is cloning. Which of the following statements accurately describes an aspect of this process?

A) The egg and sperm cells in our bodies are clones.

B) A clone is an organism produced asexually from a cell from each of the parents.

C) A clone is genetically identical to the parent.

D) Fraternal twins are clones.

399)

Which of the following is an objective of cloning farm animals?

A) To produce animals with high-fat meat.

B) To produce medically useful substances.

C) To prevent animal diseases.

D) To produce perfect animals.

400)

Transplanting animal tissues and organs into humans is called A) xenotransplantation.

B) gene cloning.

C) therapeutic cloning.

D) gene transplantation.

401)

What court case allows for patenting of live human-made organisms?

A) Association for Molecular Pathology v. Myriad Genetics Inc. B) Diamond v. Chakrabarty C) EEOC v. Founders Pavillion D) Johnson v. Calvert

402)

Which of the following statements regarding stem cell use is true?

A) Adult human body tissues do not produce stem cells.

B) Adult stem cells are pluripotent.

C) Embryonic stem cells have a greater potential to treat a wider variety of diseases.

D) Embryonic stem cells are multipotent.

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403)

A physician is using somatic gene therapy for a patient with a severe genetic disorder.

What is involved in this process?

A) Inserting normal copies of the gene B) Blocking an overactive pathway C) Correcting an abnormality in the genes of sperm or egg D) Replacing a deficiency

404)

Infertility is considered to be the failure to conceive in how many months or longer?

A) 6 B) 8 C) 12 D) 18

405)

A fertility specialist brings an infertile couple's eggs and sperm together in a test tube and when fertilization occurs, he transplants the resulting embryo back into the female uterus.

What is the term for this type of fertilization?

A) In vitro fertilization B) Homologous artificial insemination C) Heterologous artificial insemination D) Surrogacy

406)

Which of the following accurately describes the difference between a traditional and gestational surrogate mother?

A) A gestational surrogate is related to the fetus and is paid to carry the child.

B) A gestational surrogate is related to the fetus, while the traditional surrogate is not.

C) A traditional surrogate is related to the fetus, while the gestational surrogate is not.

D) A gestational surrogate is paid to carry the child but the traditional surrogate is not.

407)

A young infertile couple asks their physician about adopting a baby. Which of the following statements is true regarding the process of adoption?

A) Any adult who shows the desire to be a fit parent may adopt a child.

B) Only married couples may adopt a child.

C) People with genetic disorders may not adopt a child.

D) Gay couples have the same success with being allowed to adopt as straight couples.

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408)

An infertile couple who is adopting a child locates a birth mother and then asks an agency to take over the adoption process. This is an example of what type of adoption?

A) Agency adoption B) Independent adoption C) International adoption D) Identified adoption

409)

Which of the following types of adoption generally involves placing children who have been orphaned or whose parents have lost or relinquished parental rights through abuse, abandonment, or the inability to support them?

A) Private adoption B) Agency adoption C) Identified adoption D) Relative adoption

410)

A state agency removes a 10-year-old male child from the home of parents who abused him. What is the name of the legal doctrine that allows the state to act in the best interest of the child?

A) Safe haven law B) Parens patriae C) Best interest of the child concept D) Res ipsa loquitur

411)

Which of the following legislation allows physicians to legally withhold treatment, including food and water, from infants who are chronically and irreversibly comatose?

A) Federal Child Abuse Amendments B) Best interest of the child act C) Abandoned infant act D) Parens patriae

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412)

A new mother leaves her infant daughter in a safe place at a nurse's station in a hospital.

This mother is protected from legal prosecution or with reduced legal prosecution by what legislation?

A) Parens patriae B) Safe haven law C) Best interest of the child act D) Federal Child Abuse Amendments

413)

Which of the following is true regarding the legal rights of newborns in the United States?

A) They are not protected under the Constitution.

B) They are determined by the parents in charge.

C) They are the same as for any other American citizen of any age.

D) They do not have any legal rights until they reach age 21.

414)

A 17-year-old female lives with her parents and meets the requirements to give informed consent to have a small basal cell carcinoma removed. Which of the following would this teenager be considered?

A) Knowledgeable minor B) Emancipated minor C) Protected minor D) Mature minor

415)

Which of the following is a right guaranteed to emancipated minors?

A) Right to purchase cigarettes B) Right to vote C) Right to privacy D) Right to forgo school attendance

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416)

A teenager who is pregnant receives an abortion without parental notice due to "judicial bypass." What does this term signify?

A) The teenager has traveled to another state to obtain the abortion without parental notification.

B) The teenager has obtained approval from a judge for the abortion without parental notification.

C) The state in which the teenager lives allows practitioners to perform abortions without parental consent.

D) The judge has decided that the teenager is an emancipated minor and may receive the abortion without parental notification.

417)

What does the term genetics mean?

418)

What does the term heredity mean?

419)

What is a gene?

420)

What does a genetic counselor do?

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421)

What is genetic discrimination?

422)

What is genetic engineering?

423)

What is cloning?

424)

What is gene therapy?

425)

What is in vitro fertilization?

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426)

Discuss the various forms of surrogacy.

427)

Compare agency adoptions and independent/private adoptions.

428)

What does the doctrine of parens patriae mean? Give an example.

429)

Identify the medical conditions under which a physician may legally withhold treatment, including food and water, from an infant under the federal Child Abuse Amendments.

430)

What is the safe haven law?

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431)

Discuss the difference between a mature minor and an emancipated minor.

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Answer Key Test name: chapter 11 381)

A Genetics is the science that accounts for natural differences and resemblances among organisms related by descent. Genetic engineering has allowed scientists to manipulate DNA within the cells of plants, animals, and other organisms to ensure that certain advantageous traits will appear and be passed on, or that certain harmful trails are eliminated. Stem cells are early embryonic cells that have the potential to become any type of body cell. A genome is all the DNA in an organism, including its genes.

382)

D Heredity is the process by which organisms pass genetic traits on to their offspring and is part of the wider scope of the term genetics. Genetics is the science that accounts for natural differences and resemblances among organisms related by descent. Genetic engineering has allowed scientists to manipulate DNA within the cells of plants, animals, and other organisms to ensure that certain advantageous traits will appear and be passed on, or that certain harmful traits are eliminated. Stem cells are early embryonic cells that have the potential to become any type of body cell.

383)

B DNA (deoxyribonucleic acid) is the combination of proteins called nucleotides that are arranged to make up each human chromosome. Blastocysts are composed of stem cells that can become any type of body cell. Each gene is a tiny segment of DNA that holds the formula for making a specific molecule.

384)

C Forty-six chromosomes (23 pairs) are found inside the nucleus of every human cell, except egg and sperm cells, which have 23 chromosomes each.

385)

D Forty-six chromosomes carry the genes responsible for all our human characteristics from eye, skin, and hair color to height, body type, and intelligence. Each gene is a tiny segment of DNA that holds the formula for making a specific molecule.

386)

B Forty-six chromosomes (23 pairs) are found inside the nucleus of every human cell, except egg and sperm cells, which have 23 chromosomes each. We inherit half of our chromosome complement from our mother and half from our father.

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387)

D The Human Genome Project was a scientific project funded by the U.S. government, begun in 1990 and successfully completed in 2000, for the purpose of mapping all of a human's genes.

388)

D Predictive testing is used to see if genes are present that could lead to hereditary diseases or other harmful genetic conditions. Carrier testing is used to determine if individuals carry harmful genes that could be passed on to offspring. Forensic testing is used in law enforcement to eliminate or designate suspects in a crime, identify homicide victims, or to otherwise analyze DNA samples for law enforcement purposes. If symptoms have appeared, doctors can order diagnostic testing for patients to confirm or rule out certain genetic diseases.

389)

B Forensic testing is used in law enforcement to eliminate or designate suspects in a crime, identify homicide victims, or to otherwise analyze DNA samples for law enforcement purposes.. Carrier testing is used to determine if individuals carry harmful genes that could be passed on to offspring. Tracing lineage is used to determine parentage or other relationships within families.

Prenatal testing is done to see if harmful genes are present in the fetus.

390)

C Prenatal testing is done to see if harmful genes are present in the fetus. Forensic testing is used in law enforcement to eliminate or designate suspects in a crime, identify homicide victims, or to otherwise analyze DNA samples for law enforcement purposes. Carrier testing is used to determine if individuals carry harmful genes that could be passed on to offspring. Tracing lineage is used to determine parentage or other relationships within families.

391)

A Permanent changes in DNA, or mutations, often cause genetic diseases. A clone is an organism grown from a single cell of the parent, and so it is genetically identical to the parent. Multipotent stem cells are adult cells that can become a limited number of types of tissues and cells. mtDNA is mitochondrial DNA. 392)

C Health care practitioners should refer any patient who wants to undergo genetic testing to a genetic counselor. Genetic counselors can explain test results and help patients deal with difficult questions concerning those results.

393)

A

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The EEOC charged that Founders Pavilion requested family medical history as part of its postoffer, preemployment medical exams of applicants. The Genetic Information Nondiscrimination Act, passed by Congress in 2008 and enforced by the EEOC, prevents employers from requesting genetic information or making employment decisions based on genetic information.

The EEOC also alleged that Founders Pavilion fired two employees because they were perceived to be disabled, in violation of the Americans with Disabilities Act. 394)

C In addition to state laws against genetic discrimination and GINA at the federal level, the Health Insurance Portability and Accountability Act (HIPAA) passed in 1996 prevents health insurers from denying coverage based on genetic information. HIPAA, however, applies only to individuals moving between group health insurance plans. The Americans with Disabilities Act (ADA) of 1990 also offers some protection against genetic discrimination in the workplace.

395)

B The Genetic Information Non-discrimination Act (GINA) of 2008 prohibits discrimination in insurance and employment. Broader than HIPAA, the act defines genetic information as data about an individual's genetic tests and about genetic tests among that individual's family. The same rules apply to insurance companies selling policies.

396)

D In Association for Molecular Pathology v. Myriad Genetics, Inc., it was determined by the U.S. Supreme Court that naturally occurring genes like the BRCA1 gene could not be patented. The Court said "Had Myriad created an innovative method of manipulating genes while searching for the BRCA1 and BRCA2 genes, it could possibly have sought a method patent. But the processes used by Myriad to isolate DNA were well understood and widely used by geneticists at the time of Myriad's patents."

397)

A Genetic engineering is done by scientists to manipulate DNA within the cells of plants, animals, and other organisms to ensure that certain advantageous traits will appear and be passed on, or that certain harmful traits are eliminated. A clone is an organism grown from a single cell of the parent, and thus is genetically identical to the parent. Genetic discrimination is the different treatment of individuals based on actual or presumed genetic differences. Stem cells are early embryonic cells that have the potential to become any type of body cell.

398)

C A clone is an organism grown from a single cell of the parent, and thus is genetically identical to the parent. In other words, the genes and chromosomes found in each cell's nucleus are the same in clone and parent. So are all the cells in our bodies except for eggs and sperm.

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399)

B Scientists have continued to clone cattle, goats, mice, monkeys, pigs, and sheep. One objective of the cloning of farm and laboratory animals is to breed genetically identical animals that can produce substances useful in medicine, such as insulin and growth hormones. Another objective in cloning farm animals is the consistent production of prime, low-fat meat.

400)

A Xenotransplantation is the transplanting of animal tissues and organs into humans. Gene cloning produces exact copies of the segments of DNA called genes. Therapeutic cloning produces copies of embryonic stem cells with the professed purpose of repairing injured or diseased tissue in the human body.

401)

B After genetically engineering a bacterium capable of breaking down crude oil, Ananda Chakrabarty, who worked for General Electric, sought to patent his creation. The U.S. Patent Office denied his patent saying living things could not be patented. The U.S. Supreme Court said that while natural laws, physical phenomena, abstract ideas, or newly discovered minerals are not patentable, a live artificially engineered microorganism is. The Association for Molecular Pathology v. Myriad Genetics case indicated that genes cannot be patented. The EEOC case involves genetic discrimination against employees, and Johnson v. Calvert is a surrogacy case.

402)

C Scientists have discovered that some adult human body tissues, such as bone marrow and fat, also contain cells that can function as stem cells. Adult stem cells are multipotent, however, which means that they can become only a limited number of types of tissues and cells in the body. Embryonic stem cells have a greater potential to treat a wider variety of diseases because they are pluripotent—they can become almost all types of tissues and cells in the body.

403)

A Somatic gene therapy may involve the insertion of normal copies of a gene into the cells of persons with a specific genetic disease. The other choices are also possible gene therapies.

404)

C Infertility is the failure to conceive for a period of 12 months or longer due to a deviation from or interruption of the normal structure or function of any reproductive part, organ, or system.

405)

A

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During in vitro fertilization, eggs and sperm are brought together outside the body in a test tube or petri dish. When fertilization takes place, the resulting embryo can then be frozen in liquid nitrogen for future use or implanted in the female uterus for pregnancy to occur. If the husband's sperm cells are used to fertilize the wife's eggs, the process is called homologous artificial insemination. If the husband's sperm cells are not viable, a donor's sperm may be used to fertilize the wife's eggs. This is called heterologous artificial insemination. A surrogate mother is a woman who agrees to carry a child to term for a couple, often for a fee.

406)

C A surrogate mother is a woman who agrees to carry a child to term for a couple, often for a fee.

If the surrogate is not genetically related to the embryo, the type of surrogacy is called gestational surrogacy. If the surrogate contributes eggs to produce the embryo or is related to either husband or wife, the type of surrogacy is called traditional surrogacy.

407)

A Typically, any adult who shows the desire to be a fit parent may adopt a child. Depending on state law, both married and unmarried couples may adopt, and single people may adopt through a process called single parent adoption. Some single individuals or couples may have a more difficult time qualifying as adoptive parents than others. For example, single men, gay singles, and homosexual couples may not specifically be prevented from adopting by state law, but they may have a more difficult time meeting state and agency requirements than married couples would.

408)

D Identified adoptions are those in which adopting parents locate a birth mother, or vice versa, and then ask an agency to take over the adoption process. Prospective parents who find a birth mother willing to give up her child can bypass the long waiting lists that most agencies maintain for adoptions and can perhaps be better assured that the adoption will proceed in an orderly and legal fashion. Agency adoptions occur when state-licensed and/or state-regulated public or private adoption agencies place children with adoptive parents. Independent or private adoptions are arranged without the involvement of adoption agencies. International adoptions occur when couples adopt children who are citizens of foreign countries.

409)

B Agency adoptions occur when state-licensed and/or state-regulated public or private adoption agencies place children with adoptive parents. Charities or religious or social service organizations often operate private agencies. Adoption agencies usually place those children who have been orphaned or whose parents have lost or relinquished parental rights through abuse, abandonment, or the inability to support them.

410)

B

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Parens patriae is a legal doctrine that gives the state the authority to act in a child's best interest.

When alternatives are available for child placement or for determining medical treatment for minor children, the common standard is the "best interest of the child." Safe haven laws allow abandonment of a baby at a fire station, police station, or hospital. Some say that the "no hassle" provisions for baby abandonment discourage mothers from using established adoption and child welfare policies, while encouraging irresponsible and destructive behavior.

411)

A Under the federal Child Abuse Amendments, if the parents agree, physicians may legally withhold treatment, including food and water, from infants who are chronically and irreversibly comatose, who will most certainly die and for whom treatment is considered futile, or who would suffer inhumanely if treatment were provided.

412)

B By 2010, all 50 states had enacted some form of safe haven law, allowing abandonment at a fire station, police station, or hospital. Parens patriae is a legal doctrine that gives the state the authority to act in a child's best interest. When alternatives are available for child placement or for determining medical treatment for minor children, the common standard is the "best interest of the child." Under the federal Child Abuse Amendments, if the parents agree, physicians may legally withhold treatment, including food and water, from infants who are chronically and irreversibly comatose, who will most certainly die and for whom treatment is considered futile, or who would suffer inhumanely if treatment were provided.

413)

C Legally, the legal rights of newborns are the same as those of any other American citizen of any age. For newborns who are severely disabled, however, existing law provides for several treatment options.

414)

D Mature minors are individuals in their mid-to late teens who are considered mature enough to comprehend a physician's recommendations and give informed consent. Individuals in their midto late teens who legally live outside parents' or guardians' control are called emancipated minors.

415)

C Minors have the same constitutional rights as adults, including the right to privacy. Emancipated minors do not usually gain all the rights of adults. Some limits, such as the legal age for purchasing alcohol or tobacco products, voting age, mandatory school attendance age (unless married), and other legal age restrictions, still apply.

416)

B

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In many states, minors seeking an abortion must involve at least one parent in the decision. This means that teenagers who do not tell their parents about a pregnancy must either travel out of state or obtain approval from a judge—a process known as judicial bypass—to obtain an abortion. Currently, the trend is toward state and federal legislation making it increasingly difficult for minors to obtain an abortion without parental involvement.

417)

Short Answer Genetics is the science that accounts for natural differences and resemblances among organisms related by descent.

418)

Short Answer Heredity is the process by which organisms pass genetic traits on to their offspring.

419)

Short Answer A gene is a tiny segment of DNA found on the chromosome within a cell's nucleus.

420)

Short Answer A genetic counselor is an expert in human genetics who is also qualified to counsel individuals who may have inherited genes for certain diseases or conditions.

421)

Short Answer Genetic discrimination is differential treatment of individuals based on their actual or presumed genetic differences.

422)

Short Answer Genetic engineering is the manipulation of DNA within the cells of plants and animals through synthesis, alteration, or repair to ensure that certain harmful traits will be eliminated in offspring and that desirable traits will appear and be passed on.

423)

Short Answer Cloning is the process by which organisms are created asexually, usually from a single cell of the parent organism.

424)

Short Answer Gene therapy is treating harmful genetic diseases or traits by eliminating or modifying the harmful gene.

425)

Short Answer In vitro fertilization takes place outside a woman's body, literally "in glass," as in a test tube with the sperm and the egg.

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426)

Short Answer A surrogate mother is a woman who agrees to carry a child to term for a couple, often for a fee.

If the surrogate is not genetically related to the embryo, the type of surrogacy is called gestational surrogacy. If the surrogate contributes eggs to produce the embryo or is related to either husband or wife, the type of surrogacy is called traditional surrogacy.

427)

Short Answer Agency adoptions occur when state-licensed and/or state-regulated public or private adoption agencies place children with adoptive parents. Independent or private adoptions are arranged without the involvement of adoption agencies.

428)

Short Answer Parens patriae is a legal doctrine that gives the state the authority to act in a child's best interest.

One example might be when the state takes a child away from a parent who is known to be abusing their child.

429)

Short Answer A physician may legally withhold treatment from the infant who is chronically and irreversibly comatose, who will most certainly die and for whom treatment is considered futile, and who would suffer inhumanely if treatment were provided.

430)

Short Answer Safe haven laws are state laws that allow mothers to abandon newborns to designated safe facilities without penalty. The laws vary among the 50 states.

431)

Short Answer Mature minors are individuals in their mid- to late teens who are considered mature enough to comprehend a physician's recommendations and give informed consent. Individuals in their midto late teens who legally live outside parents' or guardians' control are called emancipated minors.

Student name: 432)

For which of the following reasons did pagan tribes begin the custom of covering the face of the deceased with a sheet?

A) They believed that the spirit of the deceased escaped through the mouth.

B) They believed that the spirit of the deceased would call other family members.

C) They believed that the spirit of the deceased could see other family members.

D) They were afraid the deceased would cast a spell on other family members.

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433)

Which of these ARE true about living wills?

A) Each state may have different regulations regarding living wills.

B) A living will may detail specific treatments that may be stopped.

C) A living will may identify which heroic measures may be used.

D) All of these are correct.

434)

The Patient Self-Determination Act provides for: A) documentation in the patient's record of any advance directives.

B) no discrimination on the part of the provider if the patient does not have advance directives.

C) providers must educate staff about advance directives.

D) All of these are correct.

435)

A medical order, written by a physician, that instructs health care providers about emergency care for a patient when the patient has stopped breathing is known as a(an) A) Do not resuscitate (DNR).

B) living will.

C) generic end-of-life order.

D) Emergency Medical Order (EMO).

436)

States have their own criteria for determining when death actually occurs, but most have adopted the definition of brain death proposed by which of the following?

A) American Bar Association B) American Medical Association's Act C) President's Commission for the Study of Ethical Problems D) Uniform Determination of Death Act

437)

According to the Uniform Determination of Death Act, which of the following is a criteria for death?

A) Irreversible coma occurs B) Entire brain ceases to function C) Circulation has increased D) Breathing is labored

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438)

A persistent vegetative state (PVS) exists as a result of severe mental impairment, characterized by irreversible cessation of the higher functions of the brain, most often caused by damage to which of the following organs?

A) Cerebral cortex B) Cerebellum C) Medulla oblongata D) Brain stem

439)

Technically, it can be said that death results from a lack of A) brain waves.

B) blood circulation.

C) oxygen.

D) reflexes.

440)

A patient dies under suspicious conditions. Which of the following might occur to determine cause of this patient's death?

A) Autopsy B) Postmortem hearing C) Lawsuit D) Criminal investigation

441)

According to the Palliative Care Journal (November 2018) palliative care is becoming a critical component for treating: A) cancer B) heart disease C) respiratory disease D) infectious disease

442)

According to the information on cancer.gov (January 2019) approximately how many people in the United States may be cancer survivors?

A) 12.2 million B) 16.9 million C) 18.3 million D) 19.1 million

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443)

A patient has been diagnosed with incurable lung cancer and it is determined that death is imminent. What type of care would best serve this patient?

A) Curative B) Palliative C) Hospitalization D) Homeopathic

444)

Which of the following is not a goal of palliative care?

A) Using current research studies to find a cure for a terminal illness.

B) Providing comfort to dying patients.

C) Providing symptom management to a patient with a terminal illness.

D) Using pain management to promote comfort for a patient with a terminal illness.

445)

What does the American Association of Colleges of Nursing now require in undergraduate nursing programs?

A) Complete a clinical in a hospice.

B) Complete a clinical in a hospital palliative care unit.

C) Complete 17 competencies in palliative care.

D) Complete a course in palliative care.

446)

A physician suggests hospice care for a patient with aggressive brain cancer who is not responding to curative care. Which of the following is true about hospice care?

A) The care occurs in a hospice facility that is separate from other medical facilities.

B) It focuses on relieving pain using alternative comfort measures instead of medications.

C) It is not designed to meet the emotional needs of the patient or family.

D) It is not designed to target the underlying disease process.

447)

For patients to be eligible for hospice care, physicians usually must certify that they are not expected to live beyond how many months?

A) 3 B) 6 C) 9 D) 12

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448)

Which of the following correctly describes an aspect of hospice care?

A) Patients are referred to clergy for bereavement care.

B) Interdisciplinary care is not available to patients on hospice care.

C) Hospice care is not reimbursed by Medicare or Medicaid.

D) Most in-home hospice programs are independently run.

449)

Palliative care programs are available in hospitals. In the United States, what is the approximate percentage of large hospitals (300 + beds) that have palliative care programs?

A) 70% B) 75% C) 80% D) 90%

450)

A medical board subspecialty in hospice and palliative care requires a physician to be board certified in a specialty such as internal medicine, surgery, or family medicine. What is(are) the other requirement?

A) Treating at least 20 terminal ill patients.

B) Employed by a hospice.

C) Employment in a palliative care unit.

D) Completing a one-year fellowship in hospice and palliative care.

451)

ARNPs and may earn certificates in palliative care.

A) undergraduate nurses B) patient advocates C) social workers D) health care administrators

452)

The right to die first became a matter for the courts to deliberate in 1976, with the death

of A) B) C) D)

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Nancy Beth Cruzan.

Karen Ann Quinlan.

Jack Kevorkian.

Luis Kutner.

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453)

The 1989 Uniform Rights of the Terminally Ill Act serves as a guideline for state legislatures in constructing laws addressing which of the following?

A) Advance directives B) Right to die C) Euthanasia D) Palliative care

454)

Which state law was the first state law passed to permit physician-assisted suicide in certain circumstances?

A) California's Natural Death Act B) Patient Self-Determination Act C) Oregon's Death with Dignity Act D) Uniform Rights of the Terminally Ill Act

455)

In 1967, what entity devised the original living will?

A) American Hospital Association B) U.S. Supreme Court C) California Supreme Court D) Euthanasia Society

456)

A patient asks his physician "Can you help me die in peace?" The physician agrees to withhold medical treatment for this patient. This is an example of what type of euthanasia?

A) Active B) Passive C) Involuntary D) Physician-assisted

457)

Which of the following is the legal term for an advance directive that specifies an individual's end-of-life wishes for medical treatment without necessarily appointing a designee to make legal decisions for him or her?

A) Living will B) Durable power of attorney C) Patient self-determination D) Health care proxy

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458)

How is a health care power of attorney different than a durable power of attorney?

A) A health care power of attorney must be redone every 5 years.

B) A health care power of attorney cannot specify end-of-life medical decisions.

C) A health care power of attorney designee must be related to the patient.

D) A health care power of attorney designee can only make health care decisions.

459)

Passed in 1984, what does the National Organ Transplant Act address?

A) Safety of organs B) Transportation of organs C) Shortage of organs D) Maintenance of organs

460)

What organization maintains a national waiting list for available organs?

A) National Organ Transplant Administration B) Health Resources and Services Administration C) Centers for Medicare and Medicaid D) Organ Procurement and Transplant Network

461)

What was the purpose of the creation of the Uniform Anatomical Gift Act? A) To allow individuals to donate body parts for money.

B) To allow individuals to donate their bodies to science after death.

C) To allow individuals to bid on donated organs.

D) To allow physicians to use organs as they see fit.

462)

Which of the following is not an organ that can be transplanted?

A) Heart B) Kidney C) Brain D) Stomach

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463)

Which of the following statements best describes the term "grief"?

A) Grief is an emotion felt only when a loved one dies.

B) Grief is the human reaction to loss.

C) Grief is the process that occurs after resolution takes place.

D) Grief is general sadness that occurs when things go wrong.

464)

What aspect of death and dying did the late Elisabeth Kübler-Ross, MD, describe?

A) Grieving rituals B) Religious aspects of death and dying C) The coping methods of persons who are grieving D) Impact of the death of a relative on the family structure

465)

Which of the following is an example of a person who is experiencing the third stage of grief according to Elisabeth Kübler-Ross, MD? A) A person who is dying asks God to keep her alive to see the birth of her grandchild.

B) A terminally ill person seeks another doctor because she doesn't believe her diagnosis.

C) A person who is dying is angry at God for the loss of control over her life.

D) A person who is dying feels hopeless and cries frequently.

466)

Which of the following occurs in Stage 5 of Elisabeth Kübler-Ross's grieving process?

A) Denial B) Anger C) Acceptance D) Rejection

467)

Define brain death.

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468)

Define persistent vegetative state (PVS).

469)

Define palliative care.

470)

Define curative care.

471)

Describe hospice.

472)

Define voluntary euthanasia.

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473)

What does the Patient Self-Determination Act (PSDA) cover?

474)

What is a living will?

475)

What is a durable power of attorney?

476)

What is physician-assisted death?

477)

What is the purpose of the National Organ Transplant Act?

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478)

If a person donated an organ, would the recipient and/or the recipient's family learn the donor's identity and contact the donor or his or her family?

479)

Define grief.

480)

Using Kübler-Ross's model, identify the five stages of grief.

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Answer Key Test name: chapter 12 432)

A Pagan tribes began the custom of covering the face of the deceased with a sheet, because they believed that the spirit of the deceased escaped through the mouth. They often held the mouth and nose of a sick person shut, hoping to retain the spirit and thus delay death.

433)

D Living wills may vary from state to state and may not be accepted in all states. The patient has the right to detail specific treatments to be stopped and emergency measures that may be used.

434)

D The PSDA is federal law that encourages patients to complete advance directives and requires providers to determine if their patients have advance directives. It is not a requirement that a patient have advance directives; it is only a recommendation.

435)

A Living wills are written by the patient, often with an attorney's assistance. A DNR is an order, written by the physician, to provide guidance in resuscitation.

436)

D In 1981, a Uniform Determination of Death Act was proposed by the President's Commission for the Study of Ethical Problems in Medicine and Biomedical Research working in cooperation with the American Bar Association, the American Medical Association, and the National Conference of Commissioners on Uniform State Laws. States have their own criteria for determining when death actually occurs, but most have adopted the act's definition of brain death as a means of determining when death actually occurs.

437)

B The Uniform Determination of Death Act defines brain death as: (1) circulatory and respiratory functions have irreversibly ceased, and (2) the entire brain (including the brain stem) has irreversibly ceased to function.

438)

A Patients can and do recover from comas, as opposed to a persistent vegetative state. A persistent vegetative state (PVS) exists as a result of severe mental impairment, characterized by irreversible cessation of the higher functions of the brain, most often caused by damage to the cerebral cortex.

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439)

C Today, the declaration of death occurs only when the last signs of brain and respiratory activity are gone. Technically, death results from the lack of oxygen. When deprived of oxygen, cells cannot maintain their metabolic functions and soon begin to deteriorate.

440)

A After a patient is declared dead, family members (next of kin) may be asked to consent to an autopsy. An autopsy is a postmortem examination to determine the cause of death and/or to obtain physiological evidence when necessary.

441)

A More treatments are available for cancer and people are living longer.

442)

B More treatments are available for cancer and people are living longer 443)

B When it becomes evident that a patient's disease is incurable and death is imminent, palliative care may serve the dying patient better than curative care. Curative care consists of treatments and procedures directed toward curing a patient's disease.

444)

A Curative care consists of treatments and procedures (including new research) directed toward curing a patient's disease. Palliative care, also called comfort care, is directed toward providing relief to terminally ill patients through symptom and pain management. The goal is not to cure, but to provide comfort and maintain the highest possible quality of life. Palliative care is also emerging as a way to help patients, with serious illnesses, live a more comfortable and fulfilling life, whether their diseases are terminal or not.

445)

C In early 2016, the American Association of Colleges of Nursing (AACN) announced its new set of competencies and recommendations for palliative care education in undergraduate nursing.

There are 17 palliative care competencies that student nurses should achieve before graduation.

446)

D In the United States, hospice care may be provided in facilities built especially for that purpose, in hospitals and nursing homes, or at home. Hospice care focuses on relieving pain (through traditional medication use as well as alternative methods), controlling symptoms, and meeting emotional needs and personal values of the terminally ill, instead of targeting the underlying disease process.

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447)

B For patients to be eligible for hospice care, physicians usually must certify that the patient is not expected to live beyond six months.

448)

D Most in-home hospice programs are independently run in a fashion similar to visiting nurse or home health care agencies. Hospice programs generally provide bereavement services through discussion groups, follow-up visits from hospice personnel, and sometimes referral to appropriate mental health professionals. Patients receive coordinated care at home by multidisciplinary teams composed of physicians, nurses, social workers, home health aides, pharmacists, physical therapists, clergy, volunteers, and family members. Hospice care is generally reimbursed by Medicare, Medicaid, and many private insurance companies and managed care programs.

449)

D Approximately 90% of hospitals in the United States have some type of palliative care program.

450)

D The current requirement is to complete a one-year fellowship in hospice and palliative care. The likelihood is that the physician will spend a great deal of time in either a hospice or palliative care unit but it may not be as an employee.

451)

C Social workers may earn a certificate in palliative care as part of their master's program.

452)

B The right to die first became a matter for the courts to deliberate in 1976, with the death of Karen Ann Quinlan. The Quinlan case raised important questions in bioethics, euthanasia, and the legal rights of guardians. The case resulted in the development of formal ethics committees in hospitals, long-term care facilities, and hospices. It also called attention to the need for advance health directives. Nancy Beth Cruzan was another landmark case in the right to die movement.

Dr. Kevorkian was a proponent of euthanasia, as was Luis Kutner who founded the Euthanasia society.

453)

A The 1989 Uniform Rights of the Terminally Ill Act serves as a guideline for state legislatures in constructing laws addressing advance directives.

454)

C

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In 1997, Oregon's Death with Dignity Act was passed for the second time by the voters, making the state the first to permit physician-assisted suicide in certain circumstances. In 1976, California's Natural Death Act was the nation's first right to die statute. In 1990, congress passed the Patient Self-Determination Act, the first federal act concerning advance directives. The 1989 Uniform Rights of the Terminally Ill Act serves as a guideline for state legislatures in constructing laws addressing advance directives.

455)

D In 1967, attorney Luis Kutner and members of the Euthanasia Society (later called Choice in Dying and then Partnership for Caring, both organizations now defunct) devised the original living will. The American Hospital Association created the Patient's Bill of Rights. The U.S. Supreme Court held that state bans on physician-assisted suicide do not violate the U.S. Constitution. The California Supreme Court clarified the right to die.

456)

B Passive euthanasia is the act of allowing a patient to die naturally, without medical interference.

Active euthanasia is a conscious medical act that results in the death of a dying person.

Involuntary euthanasia is the act of ending a patient's life by medical means without the consent of the patient or his or her representative. Physician-assisted suicide loosely refers to any of these euthanasia situations in which a doctor takes part in a patient's suicide.

457)

A A living will directly provide instructions to physicians, hospitals, and other health care providers involved in a patient's treatment about end-of-life issues. A durable power of attorney is an advance directive that confers upon a designee the authority to make a variety of legal decisions on behalf of the grantor, usually including health care decisions. A health care proxy is a durable power of attorney issued for purposes of health care decisions only. As with the living will, this document outlines specific types of care and treatment that should be permitted or excluded. It also carefully outlines the specific responsibilities and authority of the proxy.

458)

D A health care power of attorney is a state-specific, end-of-life document. The health care power of attorney differs from the durable power of attorney in that it pertains just to health care decisions and not to other legal decisions. With it, individuals specify their wishes and designate an agent (not necessarily related or an attorney) to make medical decisions for them in the event they lose the ability to reason or communicate.

459)

C

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Passed in 1984, the National Organ Transplant Act addresses the severe shortage of organs available for transplantation. It provides funds for (1) grants to qualified organ procurement organizations (OPOs) and (2) the establishment of an Organ Procurement and Transplantation Network (OPTN) to assist OPOs in the distribution of unused organs outside their geographical area.

460)

D The OPTN is the organization that keeps the waiting lists for transplants.

461)

B In 1968, the Uniform Anatomical Gift Act was approved by the National Conference of Commissioners on Uniform State Laws for the purpose of allowing individuals to donate their bodies or body parts, after death, for use in transplant surgery, tissue banks, or medical research or education.

462)

C Organs that can be transplanted include the heart, kidney, pancreas, lung, stomach, and small and large intestines.

463)

B Grief is the human reaction to loss. Individuals may grieve over a divorce, the loss of a job, or relocation, but grief after the death of a loved one is undoubtedly the most painful. Patients who are diagnosed with a terminal illness also experience profound grief. The grieving process is necessary, in both instances, for healing or resolution to take place.

464)

C The late Elisabeth Kübler-Ross, MD, recognized for many years as an authority in the field of death and dying, was the first to list and describe the coping mechanisms of people who grieve.

Such individuals experience five stages of grief, she maintained, not necessarily in any particular order, before coming to terms with the death of a loved one or the prospect of imminent death.

465)

A In Stage 3, grieving individuals respond with attempts at bargaining and guilt, such as bargaining with God to stay alive long enough to see her grandchild. The second answer is Stage 1: feelings of denial and isolation. The third answer is Stage 2: anger, rage, and resentment. The fourth answer is Stage 4: depression or sadness, and the fifth answer is Stage 5.

466)

C

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In Stage 5, those experiencing the grieving process reach a stage of acceptance. At this point, the person has finally accepted his or her loss. Terminally ill patients have come to terms with dying, and bereaved persons have accepted that the loved one is gone.

467)

Short Answer Brain death is the final cession of bodily activity, used to determine when death actually occurs; circulatory and respiratory functions have irreversibly ceased, and the entire brain has irreversibly ceased to function.

468)

Short Answer PVS is severe mental impairment characterized by irreversible cessation of the higher functions of the brain, most often caused by damage to the cerebral cortex.

469)

Short Answer Palliative care is the treatment of a terminally ill patient's symptoms to make the dying patient more comfortable. It normally begins when it is determined that curative care will not be successful.

470)

Short Answer Curative care is treatment directed toward curing a patient's disease.

471)

Short Answer Hospice is a facility or program, most often carried out in a patient's home, in which teams of health care practitioners and volunteers provide a continuing environment that focuses on the physical, emotional, and psychological needs of the dying patient.

472)

Short Answer Voluntary euthanasia requires the patient's consent or that of his designated representative to use medical means to end the patient's life.

473)

Short Answer The PSDA was the first federal act covering advance directives. The act requires hospitals and other health care providers to provide written information to patients regarding their rights under state law to make medical decisions and execute advance directives.

474)

Short Answer A living will is an advance directive that specifies an individual's end-of-life wishes.

475)

Short Answer

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A durable power of attorney is an advance directive that confers upon a designee the authority to make a variety of legal decisions on behalf of the grantor, usually health care decisions.

476)

Short Answer A physician-assisted death is when a patient asks for assistance in dying from a physician.

477)

Short Answer The National Organ Transplant Act was passed in 1984, and is a federal statute that provides grants to qualified organ procurement organizations and established an Organ Procurement and Transplantation Network.

478)

Short Answer A donor's name is released to recipients only if the recipient asks for the information and the donor's family agrees.

479)

Short Answer Grief is the reaction to loss. An individual may grieve over the loss of a job, a relocation, or other sudden change, but grief after the death of a loved one is undoubtedly the most painful.

480)

Short Answer Kübler-Ross defined the five stages of grief as denial, anger, bargaining/guilt, depression, and acceptance.

Student name: 481)

What is the term for those individuals who have a vested interest in the health care industry?

A) Stakeholders B) Consumers C) Providers D) Agents

482)

Which of the following stakeholders are considered to be at the head of the list?

A) Employers B) Health care practitioners C) Insurance companies D) The public

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483)

Employers hope to contract with health care providers who can deliver quality services at a reasonable cost because they provide which of the following to their employees?

A) Wages B) Medicare C) Medicaid D) Health care benefits

484)

Programs such as Medicare, Medicaid, the Federal Employees Health Benefits Program, the Military Health System, the Veterans Health Administration, the Indian Health Service, and the State Children's Health Insurance Program help to pay the costs of health care services. What health care stakeholder is involved in this concept?

A) Health care facilities B) Health care practitioners C) Governments D) Managed care organizations

485)

Which of the following organizations reimburse health care providers with a focus on making a profit?

A) Medicare B) Medicaid C) Insurance companies D) State children's health insurance program

486)

Which of the following may be traded on the nation's stock market?

A) Volunteer organizations B) Professional organizations C) State children's health insurance program D) Pharmaceutical companies

487)

What must a nonprofit health insurance organization do if at the end of the budget year, they have made a profit?

A) Give the profit back to the shareholders.

B) Put the profit back into services for those covered under their insurance.

C) Donate the extra money to another health care entity.

D) Refund the patients.

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488)

Professional health care organizations are stakeholders in the health care system. They provide A) ethical standards for each profession.

B) education opportunities.

C) professional news and information.

D) All of these.

489)

Medicaid is financed by A) taxes paid at both the federal and state level.

B) taxes paid at only the federal level.

C) taxes paid at only the state level.

D) contributions from the wealthy.

490)

The term that describes the amount of money that health care stakeholders spend on health care in the United States is A) cost.

B) access.

C) quality.

D) value.

491)

The total cost of health care in the United States is often expressed as a percentage of the country's gross domestic product (GDP). The GDP represents what percentage of the country's income for all goods and services?

A) 25% B) 50% C) 75% D) 100%

492)

For the calendar year 2017, Medicaid covers what percentage of health care costs in the United States?

A) 14% B) 16% C) 20% D) 23%

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493)

For the calendar year 2017, health insurance covers what percentage of health care costs in the United States?

A) 15% B) 25% C) 50% D) 75%

494)

For the calendar year 2017, hospital care represented what percentage of the cost of health care?

A) 21% B) 33% C) 43% D) 50% E) 55%

495)

Expenditures for residential care facilities, ambulance providers, medical care delivered in nontraditional settings such as senior citizens centers, schools and military field stations, and expenditures for the Home and Community Waiver Programs under Medicaid represent what percentage of the costs of health care?

A) 20% B) 14% C) 10% D) 5%

496)

According to organizations such as the Bipartisan Policy Center, CMS, and the Alliance for Health Reform, which of the following contributes to the rising cost of health care?

A) Lifestyle factors B) Personal choices C) Aging population D) All of these.

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497)

For fair access to health care to exist, there must be which of the following?

A) Adequate services for all B) Ability of population to utilize the system C) Ability of individuals to receive ongoing care D) Adequate services for all, ability of population to utilize the system, and ability of individuals to receive ongoing care must all be in place E) Adequate services for all and ability of individuals to receive ongoing care

498)

The National Quality Strategy set forth by the U.S. Department of Health and Human Services has three broad aims for the improvement of health care. They are A) health insurance for all citizens, safer care, and prevention of illness.

B) better care, healthy people and communities, and affordable care.

C) better care, safer care, and family-focused care.

D) healthy people, healthy communities, and affordable care.

499)

How many priorities does the National Quality Strategy have?

A) Three B) Four C) Five D) Six

500)

According to the 2017 AHRQ report on quality and disparities, patient safety improved to include A) two-thirds of patient safety measures were improving overall.

B) a two-thirds reduction in hospitalizations for cardiovascular problems.

C) a two-thirds reduction in chronic diseases.

D) a two-thirds reduction in patient injuries while hospitalized.

501)

According to the World Health Organization, maternal death rates in the United States A) are ranked near the bottom when compared to other western countries.

B) are 5.87 for every 1,000 births.

C) compare poorly to countries like Sweden (2 deaths per 1,000) and Canada (4.5 deaths per 1,000).

D) All of these.

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502)

The AHRQ Report for 2017 indicated that A) the United States spend less on health care and its citizens were healthier than those in other nations.

B) the United States spend more on health care and its citizens were healthier than those in other nations.

C) the United States spend about the same as other countries on health care.

D) the United States spend more on health care and its citizens were less healthy than those in other nations.

503)

Which of the following best defines the term birth rates within a population?

A) The total number of live births in an entire country for one year.

B) The total number of live births per 1000 women in a specific age group.

C) The total number of live births recorded in each state each year.

D) The total number of live births per 1,000 women aged 15 to 44 years.

504)

Infant mortality is one major measure of a country's health system. The United States infant mortality rate is A) ranked near the bottom of comparable countries.

B) ranked near the top of comparable countries.

C) comparable to Sweden, Japan, and Finland.

D) comparable to Iceland.

505)

Life expectancy at birth for Americans in 2017 was approximately A) 65 years.

B) 70 years.

C) 73 years.

D) 78 years.

506)

Under the Patient Protection and Affordable Care Act of 2010, insurance companies must do all of the following except A) phase out annual and lifetime limits to coverage.

B) no longer limit or deny coverage to patients under 19 with preexisting conditions.

C) cover children up to age 30 on their parents' health insurance policy.

D) remove insurance company barriers to emergency service.

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507)

Which of the following statements is true about the Patients' Bill of Rights?

A) The Patients' Bill of Rights is the fifteenth amendment to the U.S. Constitution.

B) The Patients' Bill of Rights is part of HITECH. C) No one universal government statute exists.

D) The American Hospital Association has a Patients' Bill of Rights that became federal law.

508)

Identify at least four of the stakeholders in the health care system. Give examples of each.

509)

What are the three major concerns for all stakeholders?

510)

What are the three areas where most of the health care dollar is spent?

511)

Health insurance makes up 74% of the sources of payment for health care. What is the breakdown between the types of health insurance?

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512)

Identify at least three reasons that the cost of health care is rising.

513)

Define access as it relates to health care.

514)

What is the role of the Agency for Healthcare Research and Quality?

515)

Define life expectancy and life span.

516)

Define fertility rate and birth rate.

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517)

What are the most listed reasons for the high infant mortality rate in the United States?

518)

What are the three broad aims of the National Quality Strategy?

519)

Life expectancy in the United States has declined. What has the CDC determined to be the reasons for this decline?

520)

What are the four parts of Medicare? What do they cover?

521)

The purpose of TRICARE and CHAMPVA is to

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522)

How is Medicaid funded? Are the plans similar in every state?

523)

What population does CHIP cover for health care?

524)

In 2019, the enrollment in the Affordable Care Act coverage dropped. Why did that happen?

525)

What are some forms of patient rights that are currently protected by law?

526)

Does your state have a Patients’ Bill of Rights? What rights are protected by your state?

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Answer Key Test name: chapter 13 481)

A Those who have a vested interest in the health care industry in the United States, and in any efforts to reform the industry, are called stakeholders.

482)

D The patients who use health care services will always be at the head of the list of stakeholders.

When health problems arise, everyone wants the best medical care available, conveniently delivered, at an affordable cost.

483)

D Since employers often provide health care benefits for employees, they hope to contract with health care providers who can deliver quality services at a reasonable cost.

484)

C Governments help pay the cost of health care services through Medicare, Medicaid, the Federal Employees Health Benefits Program, the Military Health System, the Veterans Health Administration, the Indian Health Service, the State Children's Health Insurance Program, and other state and federal government-financed programs. For that reason, governments are near the top of the list of health care stakeholders.

485)

C Most insurance companies, including managed care organizations, must make money to continue in business. While government insurance like Medicare, Medicaid, and state health insurance must be profitable to remain in business, their first focus is on services.

486)

D Pharmaceutical companies are often publicly owned—which means that their stock is traded on the stock market.

487)

B While it is important that all companies make more money than they spend, a nonprofit health insurance organization may use the "profit" to improve services the following year. For-profit companies may provide dividends to shareholders.

488)

D

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Various professions in health care have formed national associations, such as the American Association of Medical Assistants, the American Nurses Association, the American Medical Association, the American College of Healthcare Executives (it is not a college but it does offer educational opportunities) the American Association of Healthcare Administrative Managers, and the American Health Information Management Association. They are all examples of associations for professionals in health care. These organizations provide not just ethical standards for the specific profession(s), but also education opportunities, professional news and information, and a variety of other services.

489)

A Medicaid is financed by both federal and state level taxes. However, the larger share is federal income tax.

490)

A Cost refers to the amount individuals, employers, state and federal governments, managed care organizations, private insurers, and other stakeholders spend on health care in the United States.

Access is the number of people who have access to health care services—that is, the number of people for whom the services are available and for which they as consumers can pay. This also helps determine costs. In addition, the cost of health care services also directly affects the quality, or degree of excellence, of health care services offered.

491)

D The total cost of health care in the United States is often expressed as a percentage of the country's gross domestic product (GDP). The GDP represents 100% of the country's income for all goods and services.

492)

B Medicaid is financed by both state/local government taxes (6%) and federal taxes (11%).

493)

D Private health insurance, which includes managed care plans, covers 75% of health care costs in the United States.

494)

B Hospital costs represent 33% of the dollars spent in health care in 2017.

495)

D

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While the many types of expenditures could possibly indicate a higher percentage, only 5% of the health care dollar is spent delivering health care in residential care facilities, ambulance providers, medical care delivered in nontraditional settings such as senior citizens centers, schools and military field stations, and expenditures for the Home and Community Waiver Programs under Medicaid.

496)

D People are living longer, have more chronic diseases, and make unhealthy personal choices like smoking, as well as lifestyle factors like eating an unhealthy diet.

497)

D Fair access requires not only adequate and ongoing care, but individuals must be able to use the health care system. Social and cultural barriers must be removed and the care must be affordable.

498)

B The three major aims of the National Quality Strategy (NQS) are better care, healthy people and communities, and affordable care. While health insurance for all, safer care, prevention of illness, and family-focused care may be part of how these aims are advanced, the three aims are broad in nature.

499)

D There are three aims in the National Quality Strategy and six priorities to advance the aims. The six priorities are reducing harm (making care safer) patient/family engagement in care, effective communication and coordination of care, prevention and effective treatment for leading causes of mortality, working with communities and making quality care affordable for not just individuals, but for employers and governments.

500)

A The AHRQ report on quality and disparities for 2017 reported that two-thirds of safety measures were improving overall from 2000 to 2015, but the pace of improvement varied by priority areas.

501)

D Complications from pregnancy that result in death have worsened in the United States since 1990 in both Serbia and the United States. The CDC is working on measures to improve the reporting of maternal deaths, as the current number is inexact.

502)

D While our country spends more per capita on health care than any other country, we do not always have the best health outcomes.

503)

B

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Birth rates are the total number of live births within a specific age group. Examples would be ages 15-19 or over 35.

504)

A Infant mortality is near the bottom, with a rate of 6.1 deaths for every 1,000 live births. Other countries have between 1.6 and 2.0 deaths for every 1,000 births.

505)

D Life expectancy at birth for Americans in 2017 was approximately 78.6 years. This is a decrease from 2015 when it was 78.8 years.

506)

C Under the PPACA, insurance companies must cover children up to age 26 on their parents' health insurance policy. Insurance companies must also phase out annual and lifetime limits to coverage, no longer limit or deny coverage to patients under 19 with preexisting conditions, phase out arbitrary withdrawals of insurance coverage, and remove insurance company barriers to emergency service. There are additional privacy rights contained in the PPACA. 507)

C Currently, no official federal government statute exists that tells health care consumers exactly what their rights are. While HIPAA provides a list of rights in its Privacy Rule, those rights cover privacy issues only. Some individual states have passed a Patients' Bill of Rights.

508)

Short Answer There are at least 11 different stakeholders in the health care system. They include the public; employers; health care facilities and providers; federal, state, and local governments; private insurers; voluntary facilities; health care training institutions; professional associations; medical, biotechnology, and pharmaceutical companies, and other companies related to health care.

509)

Short Answer Cost, access, and quality are of concern for all stakeholders.

510)

Short Answer Hospital care 33%, Physician and Clinical Services 20%, and 14% in a combination; the Centers for Medicaid and Medicare Services (CMS) refers to as "other" that includes durable medical equipment, residential and personal care, public health, home health, and other nondurable medical products.

511)

Short Answer

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Private health insurance 33%, Medicare 20%, Medicaid (federal) 11%, Medicaid (state and local) 6%, and VA, DOD, and CHIP at 4%.

512)

Short Answer There are more than nine reasons that health care costs are rising. They are the fee for service reimbursement system, fragmentation in payment and care delivery, administrative burdens, advances in medical technology, tax treatment of health insurance, changing trends in health care market consolidation, and competition for providers and the legal and regulatory environment.

The aging population, rising rates of chronic disease, and lifestyle factors also affect health care costs.

513)

Short Answer Access to health care means that people are able to use appropriate health care services when necessary in order to maintain and improve their health.

514)

Short Answer The AHRQ is the lead federal agency responsible for tracking and improving the quality, safety, efficiency, and effectiveness of health care for Americans.

515)

Short Answer Life expectancy is the number of years an individual can expect to live, calculated from his or her birth. Life span is the actual number of years a person lives.

516)

Short Answer Fertility rate is defined by the National Center for Health Statistics as the total number of live births per 1,000 women aged 15-44. Birth rate is a reference to a specific age group, that is, the denominator may be different than aged 15-44.

517)

Short Answer Cost and access to care, as well as too few resources devoted to public health and primary care.

518)

Short Answer The three broad aims of the NQS are better care, healthy people and healthy communities, and affordable care.

519)

Short Answer The CDC has determined that an increase from suicide, diabetes, flu, pneumonia, and unintentional injuries are the major reasons for the decline in life expectancy. Unintentional drug overdoses were the cause for slightly less than half of the accidental deaths.

520)

Short Answer

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Part A covers inpatient care, skilled nursing facility care, hospice care, and home health care.

Part B covers physician and other health care provider services, home health care, durable medical equipment and other preventive services. Part C of Medicare includes the Medicare Advantage Plans. Medicare Advantage plans cover Part A and B of traditional Medicare. Part D is cost of prescription drugs. All four parts may have deductibles and limitations on coverage of specific care.

521)

Short Answer Provide federal health care coverage for families of current military personnel, retired military personnel, and veterans. Both plans provide coverage similar to private insurance.

522)

Short Answer Medicaid is funded by both federal and state tax dollars. States differ in the plans that are offered.

523)

Short Answer The State Children’s Health insurance plan, commonly called CHIP, covers children whose parents make too much money to qualify for Medicaid and too little money to afford private health insurance.

524)

Short Answer The enrollment dropped in 2019 for several reasons. More people were employed and covered by employer plans. The federal government advertised the ACA less for 2019 and the individual mandate requirement was removed by Congress. The mandate required everyone to either enroll in a plan or pay a tax.

525)

Short Answer There is no federal Patient Bill of Rights. However, patients are protected by informed consent, HIPAA’s privacy and security rules, and the PPACA. 526)

Short Answer Answers will vary.

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