Test Bank For Legal and Ethical Issues for Health Professions, 5th Edition 2024 by Elsevier Inc All

Test Bank For Legal and Ethical Issues for Health 5thProfessions, Edition bybyElsevier Legal Professions, and Ethical Issues for Health 5th 2024 Edition 2024 Elsevier Inc Inc Chapter 1-14 Chapters 1-14 Test Bank For

Chapter 01: The US Legal System Elsevier Inc: Legal and Ethical Issues for Health Professions, 5th Edition MULTIPLE CHOICE 1. All the following are examples of the use of laws except a. a woman takes her husband to court to obtain a divorce. b. an individual sues his neighbor over a property line. c. a man slashes his neighbor’s tires over a dispute. d. a child is taken from a neglectful parent and placed in foster care by the state.

ANS: C

Taking the law into one’s own hands never fulfills the goal of law and likely against the law. The goal of law is to resolve disputes without violence and to protect individual citizens’ health, safety, and welfare. Taking an individual to court or to the proper regulatory agency resolves matters peacefully.

OBJ: 2. Define law and the sources of law.

TOP:

What is the Law?

2. The fundamental of the law of the United States is a. state constitutions. b. municipal laws. c. district court decisions. d. the Constitution.

ANS: D

The US Constitution grants certain powers to the federal government. Unless a specific power is granted to the US government, that power is left to the jurisdiction of state government.

OBJ: 2. Define law and the sources of law.

TOP:

Constitutional Law

3. All the following are sources of law except a. administrative law. b. statutory law. c. state judicial rulings. d. Bill of Rights.

ANS: C

Sources of law are the Constitution, administrative law, statutory law, and common law.

OBJ: 3. Explain the different types of law in the United States.

TOP: Sources of Law

4. Which branch of government developed the source of law that implemented the Medicaid

and Medicare amendments to the Social Security Act of 1965? a. Legislative b. Judicial c. Executive d. Municipal ANS: A

The legislative branch of government develops statutory law. The executive branch can propose or veto laws, and the judicial branch develops and interprets statutory law.

OBJ: 1. Describe the three branches of the federal government in the United States.

TOP: Branches of Government 5. Which is not an agency that can enact rules that become administrative law? a. Occupational Safety and Health Administration b. American Bar Association c. Department of Health and Human Services d. Environmental Protection Agency ANS: B

The legislature enables certain agencies to develop rules and regulations, such as the Occupational Safety and Health Administration, the Department of Health and Human Services, and the Environmental Protection Agency. The American Bar Association is a private organization, not a governmental agency.

OBJ: 1. Describe the three branches of the federal government in the United States.

TOP: Branches of Government 6. Which statement about the checks and balances system is false? a. The legislature can develop statutes and override the veto of the executive branch. b. The executive branch has veto power and can interpret laws. c. The judicial branch interprets laws. d. The legislature proposes laws.

ANS: B

The executive branch can veto and propose legislation but cannot interpret laws. The judicial branch interprets laws and their application to individual cases. The legislature can propose laws and develop statutes and can override executive branch vetoes.

OBJ: 1. Describe the three branches of the federal government in the United States.

TOP: Checks and Balances 7. The pretrial discovery process includes the following strategies. a. Admissions of fact b. Burden of proof c. Interrogatories d. Requests for production of documents ANS: B

The pretrial discovery strategies include admissions of facts, interrogatories, and requests for production of documents.

OBJ: 5. Demonstrate understanding of the various levels of the United States court system.

TOP: Pretrial Discovery 8. All the cases below would be considered a civil case except a. divorce. b. breach of contract. c. dispute over real estate sale. d. terrorist threats.

ANS: D

Civil law includes areas of the law such as contract issues, intentional torts, negligence, malpractice, and privacy issues. A terrorist threat would be considered a criminal offense.

OBJ: 3. Explain the different types of law in the United States.

TOP: Types of Law

9. Which of the following would be considered a criminal case? a. A physician refuses to repay student loans. b. A physician performs a pelvic exam without the consent of the patient. c. An office assistant releases medical information without patient consent. d. An office assistant accesses medical information by computer about a patient who

is not under a physician’s care at the time.

ANS: B

The physician has probably committed battery, a criminal offense, on the patient by not getting the patient’s consent for the pelvic examination. Issues related to contracts, such as student loans, are civil matters. Privacy issues also fall under administrative law, which is part of the civil category.

OBJ: 4. Explain key laws affecting healthcare professionals.

TOP: Criminal Law

10. All the following are examples of in personam jurisdiction except a. a dispute between neighbors over a fence line. b. theft of a computer from a private home. c. vandalism to a car parked in a school lot. d. a bank account being divided between spouses due to a divorce.

ANS: D

In rem jurisdiction is when the court has jurisdiction over the property or thin itself rather than over the people involved. In personam jurisdiction means that the court has jurisdiction over the person involved in the case.

OBJ: 6. Describe the trial process in a lawsuit.

TOP: The Trial Process and Lawsuits 11. When a court has jurisdiction over property or a thing itself, rather than over the people

involved, the type of jurisdiction is called a. in rem jurisdiction. b. in personam jurisdiction. c. ad litem jurisdiction. d. appellate jurisdiction.

ANS: A

The court determines right to the property in an in rem jurisdiction case, which is usually binding against the whole world, not just the parties involved.

OBJ: 6. Describe the trial process in a lawsuit.

TOP: The Trial Process and Lawsuits 12. Which case could be sent from the district court to the appellate court? a. A woman suing for the right to have an abortion in her last trimester of pregnancy b. A man suing a physician for negligence c. A parent suing on behalf of a child injured in a car accident d. All the options ANS: D

The right to terminate a pregnancy is determined by the state statute. An appellate case must be sent to the appellate court from the district court. All these cases have the potential to be sent from the district court to the appellate court.

OBJ: 5. Demonstrate understanding of the various levels of the United States court system.

TOP: Courts of Appeals 13. The individual who brings a case to court is the a. defendant. b. prosecuting attorney. c. plaintiff. d. defending attorney.

ANS: C

The person bringing suit is the plaintiff, and the defendant is the person being sued.

Attorneys are not named as the person bringing suit. The names in the case reveal who is suing whom.

OBJ: 6. Describe the trial process in a lawsuit.

TOP: The Trial Process and Lawsuits 14. An official or formal change made to a law is called a. an amendment. b. burden of proof. c. admissions of fact. d. an ordinance.

ANS: A

An amendment is an official or formal change made to a law, contract, constitution or other legal document. Burden of proof is the legal responsibility and requirement to prove a claim is true. Admissions of fact establishes laws between citizens and government agencies and provide power to the agencies to enforce these laws. An ordinance is statutory law passed by local or city governments of councils.

OBJ: 2. Define law and the sources of law.

TOP: Constitution and Bill of Rights

15. A wrongful act that results in injury to another’s person, property, or reputation and for

which the injured party is entitled to compensation is a. statutory law. b. tort. c. writ of certiorari. d. statute.

ANS: B

A tort is a wrongful act in which an injured party is entitled to compensation. Statutory law is written laws that regulatory, administrative and common laws. Writ of certiorari is an order a higher court issues to review the decision of a lower court. A statute is a written law enacted by the state or federal legislative branch.

OBJ: 4. Explain key laws affecting healthcare professionals.

TOP: Civil Law

16. When the US Supreme Court decides a case, it is binding to a. only the parties involved. b. only the city involved and its residents. c. only the state involved and its residents. d. all state and federal courts.

ANS: D

Cases heard by the US Supreme Court are binding on all state and federal courts.

OBJ: 1. Describe the three branches of the federal government in the United States.

TOP: State Supreme Courts 17. If a man enters surgery to have his left leg amputated and leaves surgery with his right leg

amputated, which Latin term of law applies? a. Respondeat superior b. Res ipsa loquitur c. Stare decisis d. Quid pro quo ANS: B

Res ipsa loquitur means, ―the thing speaks for itself.‖ The presumption that the surgeon removed the wrong leg means that the plaintiff does not have to prove that negligence occurred to recover from the defendant.

OBJ: 4. Explain key laws affecting healthcare professionals.

TOP: The Trial Process and Lawsuits 18. If a judge decides a case based on the findings of a previous court in a similar case, which

Latin term applies? a. Respondeat superior b. Res ipsa loquitur c. Stare decisis d. Quid pro quo ANS: C

Stare decisis means ―to stand by things decided.‖ Courts often follow decisions made by courts of higher or equal jurisdiction.

OBJ: 5. Demonstrate understanding of the various levels of the United States court system.

TOP: Branches of Government 19. The Supreme Court hears cases from courts of which jurisdiction? a. Higher jurisdiction than the Supreme Court b. Lower jurisdiction than the Supreme Court c. Same jurisdiction to the Supreme Court d. No jurisdiction ANS: B

The Supreme Court only hears cases from courts with lower jurisdiction. No court has higher jurisdiction than the US Supreme Court.

OBJ: 5. Demonstrate understanding of the various levels of the United States court system.

TOP: Federal District Court System 20. Which is true about a malpractice case? a. There must be proof of a breach of duty. b. No damages can be present. c. The cause of the damages does not have to be specific. d. The person who caused the damages does not have the duty to care for the patient.

ANS: A

Four elements are required in a negligence action: duty, breach of duty, causation, and damages.

OBJ: 4. Explain key laws affecting healthcare professionals.

Malpractice

TOP: Negligence and

21. This branch of government proposes legislation and enforces laws. a. Legislative b. Executive c. Judicial d. Municipal ANS: B

The President or Governor proposes legislative action to be taken by individual legislators, either vetoes or approves laws agreed to by the legislature and enforces the laws.

OBJ: 1. Describe the three branches of the federal government in the United States.

TOP: Branches of Government 22. This branch of government establishes agencies to enact administrative law. a. Legislative b. Executive c. Judicial d. Municipal ANS: B

The executive branch also proposes and establishes certain agencies to enact rules and regulations that become administrative law. Once the legislature creates a statute, it empowers the appropriate executive agency to implement and establish rules and regulations to meet the intent of the statute.

OBJ: 1. Describe the three branches of the federal government in the United States.

TOP: Branches of Government 23. This branch of government interprets statutory law. a. Legislative b. Executive c. Judicial d. Municipal ANS: C

The judicial branch is also the source of common law, or case law, which is the law that develops from the decisions made by courts. Previous decisions are considered precedent and binding on all lower courts.

OBJ: 1. Describe the three branches of the federal government in the United States.

TOP: Branches of Government 24. OSHA was created by which branch of government? a. Legislative b. Executive c. Judicial d. Municipal ANS: B

Once the legislature creates a statute, it empowers the appropriate executive agency to implement and establish rules and regulations to meet the intent of the statute. These rules and regulations codify the interactions between the citizens and the agencies, provide for certain police powers to the agencies to enforce the regulations, and govern the agencies themselves.

OBJ: 1. Describe the three branches of the federal government in the United States.

TOP: Branches of Government 25. Which of the following develops from decisions previously made by courts, or precedents,

and is binding on all lower courts? a. Criminal law b. Common law c. Medical law d. None of the options ANS: B

In Latin this is called stare decisis, which means to stand by things decided or adhere to decided cases. Common law originated from England with the Pilgrims and original settlers of the land. Since that time, each state’s courts have made decisions regarding civil and criminal cases.

OBJ: 3. Explain the different types of law in the United States.

TOP: Types of Law

Chapter 02: Basis and Principles of Ethics Elsevier Inc: Legal and Ethical Issues for Health Professions, 5th Edition MULTIPLE CHOICE 1. The definition of ethics is a. the values that influence human behavior. b. tying our actions to what is right or wrong. c. one’s moral principles. d. all the options.

ANS: D

When discussing the definition of ethics, it can mean several things. As a branch of philosophy, ethics studies the values that influence human behavior, tying our actions to a sense of right and wrong. A second aspect is an individual’s ethics; this refers to one person’s moral principles, the values that govern a single person’s decisions with a goal of maintaining one’s integrity or conscience.

OBJ: 1. Define ethics and explain the different branches of ethics.

TOP: What is Ethics?

2. Values are a. thoughts a person has. b. principles one chooses to live by. c. knowing right from wrong. d. one’s integrity.

ANS: B

Values are the principles that an individual chooses to live by. Although these may be personal values, they are also the qualities that drive most ethical behavioral models for groups.

OBJ: 3. Understand the differences between ethics, morals, and values.

TOP: What is Ethics?

3. The principle of ―doing no harm‖ is called a. integrity. b. beneficence. c. nonmaleficence. d. autonomy.

ANS: C

Nonmaleficence is part of a physician’s oath to do no harm. In bioethical terms, the principle of nonmaleficence means that healthcare professionals should avoid harming a patient.

OBJ: 2. Examine the importance of ethics in healthcare.

TOP: Medical Ethics

4. A person dies and is a heart donor. Healthcare professionals must make the decision as to

who gets the heart transplant by treating everyone fairly. This is an example of which ethical principle?

a. b. c. d.

Integrity Beneficence Nonmaleficence Justice

ANS: D

The principle of justice means treating everyone fairly and distributing healthcare justly or fairly is a key issue in many ethical debates.

OBJ: 4. Describe the importance of a code of ethics for healthcare professionals.

TOP: Medical Ethics 5. The reason that most people enter the healthcare field is grounded in the principle of a. nonmaleficence. b. integrity. c. beneficence. d. justice.

ANS: C

Beneficence is another word for doing good, or being kind, which is a predominant reason that most people enter the healthcare field.

OBJ: 4. Describe the importance of a code of ethics for healthcare professionals.

TOP: Medical Ethics 6. Actions that show respect for human dignity, such as being honest and putting the patient

first, reflect which of the following principles? a. Integrity b. Justice c. Beneficence d. Nonmaleficence ANS: A

Integrity is part of the standards of the healthcare profession and the actions that show respect for human dignity.

OBJ: 1. Define ethics and explain the different branches of ethics.

TOP: What is Ethics?

7. According to the healthcare organization’s code of ethics, who is the most important

person? a. Healthcare professional b. Patient c. Physician d. Hospital administrator ANS: B

Usually, a healthcare organization’s code of ethics will include statements regarding the treatment and care of the patient as the most important priority, emphasizing handling all with dignity and respect. These in turn dictate such standards as guarding and respecting patient confidentiality.

OBJ: 4. Describe the importance of a code of ethics for healthcare professionals.

TOP: Codes of Ethics 8. When healthcare professionals attempt to improve the situations surrounding the patient,

they are practicing which of the following principles? a. Autonomy b. Beneficence c. Bioethics d. Nonmaleficence ANS: B

Beneficence means doing good or being kind, and the actions taken on behalf of the patient should always be aimed at helping the patient.

OBJ: 6. Relate specific ethical theories to healthcare situations.

TOP: Medical Ethics 9. A nurse rushes to help a shooting victim and taking the chance that she may also get shot.

This is an example of which of the following ethical theories? a. Rights b. Duty c. Utilitarianism d. Virtue ANS: B

Duty-based ethical theory is based on the duty of an individual to a society, group, or organization and focuses solely on the obligation of the individual to perform his or her responsibilities no matter the circumstances.

OBJ: 6. Relate specific ethical theories to healthcare situations.

TOP: Duty-Based Ethics (Deontology) 10. Unwavering adherence to an individual’s values and principles with dedication to high

standards is a. integrity. b. values. c. utilitarianism. d. tolerance.

ANS: A

Integrity is part of one’s individual ethics, which refers to one person’s moral principles, the values that govern a single person’s decisions with a goal of maintaining one’s integrity or conscience.

OBJ: 3. Understand the differences between ethics, morals, and values.

TOP: What is Ethics?

11. Principles that individuals choose to live by are called a. integrity. b. values. c. utilitarianism. d. tolerance.

ANS: B

Although these may be personal values, they are also the qualities that drive most ethical behavioral models for groups. Individually, a person may value loyalty or privacy as well as freedom. For a group, the code of ethics would mirror these values and require that all employees or individuals involved in that group adhere to the principles prescribed in that organizations’ code of ethics.

OBJ: 3. Understand the differences between ethics, morals, and values.

TOP: What is Ethics?

12. Ethical theory based on the greatest good for the greatest number is called a. integrity. b. values. c. utilitarianism. d. tolerance.

ANS: C

Also called beneficence, utilitarianism is doing the ―most good‖ and/or benefiting the largest number, which is one of the four foundational principles emphasized by the American Medical Association.

OBJ: 6. Relate specific ethical theories to healthcare situations.

TOP: Utilitarianism (Teleology) 13. A type of consequence-focused theory in which duty or moral obligation from which what

is good or desirable needs to be achieved. a. Teleology b. Deontology c. Rights-based ethics d. Justice-based ethics ANS: A

The general principle of teleology includes impartial thinking with respect to individuals.

All individuals are considered equal, and rules are absolute and should be obeyed by everyone. In other words, it is the duty of an individual to adhere to universal rules and regulations, regardless of circumstances.

OBJ: 6. Relate specific ethical theories to healthcare situations.

TOP: Utilitarianism (Teleology) 14. This type of ethics theory emphasizes the specific person and does not consider the general

population. a. Teleology b. Deontology c. Rights-based ethics d. Justice-based ethics ANS: C

This theory is based on the individual’s rights. The emphasis is on the specific person and does not always take the consequences of the general population into consideration, asserting instead that those rights should be upheld no matter what the circumstances. If misused, this could lead to individual gain without regard for damage or harm that can be caused to others.

OBJ: 6. Relate specific ethical theories to healthcare situations.

TOP: Rights-Based Ethics 15. ―Justice is blind‖ ethics theory is considered a. teleology. b. virtue-based ethics. c. rights-based ethics. d. justice-based ethics.

ANS: D

This theory is that all individuals should be treated with impartiality and there should be no advantages or disadvantages to individuals. Many believe this theory would prevent unfairness and injustice under social contracts, such as the distribution of organ donations.

OBJ: 6. Relate specific ethical theories to healthcare situations.

TOP: Justice-Based Ethics 16. This ethics theory is based on character traits and qualities of individuals. a. Teleology b. Virtue-based ethics c. Rights-based ethics d. Justice-based ethics ANS: B

The traits include honesty, integrity, and hard work. Its focus is the individual striving for a better life and is considered virtue-based ethics.

OBJ: 6. Relate specific ethical theories to healthcare situations.

TOP: Virtue-Based Ethics 17. What is the first question one should ask when making ethical business decisions based on

the Blanchard-Peale Model? a. Is it true? b. Is it legal? c. Is it balanced? d. How does it make me feel?

ANS: B

When facing a difficult choice, keep in mind that no ethical decision should be based on emotions. Ethical dilemmas should be faced and handled with logic and facts, weighing the alternatives and the consequences, and keeping an objective mind.

OBJ: 7. Apply one of the ethical decision-making models to a specific ethical healthcare dilemma.

TOP: Blanchard-Peale Model

18. In the seven-step decision-making model, what is the first step that should be taken? a. Determine the exact ethical issue involved. b. Determine the rules, laws, principles, or values are involved. c. Determine all the facts of the situation. d. List all possible courses of action.

ANS: C

The first step to be taken should be to determine the what, when, where, who, and why of the situation. The other options should be done after the facts are determined.

OBJ: 7. Apply one of the ethical decision-making models to a specific ethical healthcare dilemma.

TOP: The Seven-Step Decision-Making Model 19. In Dr. Bernard Lo’s clinical model method of decision making, one should first a. clarify the ethical issue. b. determine the pros and cons of each option. c. determine the exact ethical issue involved. d. gather information.

ANS: D

One should first gather the patient’s mental status, comorbidities, views of the other healthcare providers for the patient, and other issues that might complicate the patient’s case when making an ethical decision.

OBJ: 7. Apply one of the ethical decision-making models to a specific ethical healthcare dilemma.

TOP: Dr. Bernard Lo Clinical Model 20. Ethics committees formed at large healthcare facilities a. make decisions with the physicians’ input only. b. make decisions based on logic and the codes and standards of the facility. c. make decisions based on emotions. d. make decisions with the patient’s input only.

ANS: B

Ethics committees generally see or speak with the patients themselves but focus solely on the facts involved in the situation. This helps them make ethical determinations on the issues or cases brought before them based on logic, on the codes and standards, as opposed to emotions.

OBJ: 8. Explain the function of an ethics committee and risk management.

TOP: Ethics Committees 21. What is accreditation? a. Officially recognizing a person or organization for meeting standards established

by an industry b. Obtaining enough continuing education credits c. Recognizing the achievements of healthcare providers publicly d. Recognizing a healthcare provider for their years of service ANS: A

Accreditation uses standards of care established by an industry to officially recognize an individual or organization. Many facilities and organizations maintain voluntary participation with accreditation organizations, who routinely examine the organization or facility to verify (as an objective party) that the standards of care and procedures of the organizations are in compliance.

OBJ: 8. Explain the function of an ethics committee and risk management.

TOP: Accreditation 22. An important program each healthcare facility should have is a. an open policy to speak to any physician. b. an educational assistance for continuing education. c. an employee benefits that include healthcare. d. a quality assurance program.

ANS: D

These programs are formed to evaluate and ideally prevent situations that arise and cause ethical dilemmas. They evaluate patient satisfaction, complaints, and outcomes of treatment. These programs focus on prevention and improvement of policies and recommend and monitor actions that noncompliant healthcare facilities can take for improvement.

OBJ: 8. Explain the function of an ethics committee and risk management.

TOP: Risk Management and Quality Assurance 23. Which principle describes what is consistent and fair to everybody? a. Beneficence b. Nonmaleficence c. Autonomy d. Justice ANS: D

The four main principles of ethics are doing the ―most good‖ for the most people, doing the least harm to the least amount of people, giving people the right to make their own decisions, and ensuring justice, which requires consistency and fairness to all involved.

OBJ: 4. Describe the importance of a code of ethics for healthcare professionals.

TOP: Medical Ethics 24. Which of the following refers to the regulation of professional activities defined under

state law? a. Code of ethics b. Hippocratic oath c. Standard of care d. Standards of practice ANS: D

The standards of practice refer to the professional activities defined under state law.

OBJ: 5. Describe the difference between standards of practice and standards of care.

TOP: Standards of Practice and Standards of Care

25. What is the difference between ethics and laws? a. Illegal acts are most likely unethical. b. Unethical acts are illegal. c. Ethical acts are legal. d. Legal acts are ethical.

ANS: A

As healthcare professionals, it is vital that we understand all legal and ethical ramifications of our actions and behaviors. Most would agree that illegal acts are most likely unethical, but there are many unethical behaviors or actions that are not necessarily illegal.

OBJ: 2. Examine the importance of ethics in healthcare.

TOP: Medical Ethics

Chapter 03: Bioethical Issues in Healthcare Elsevier Inc: Legal and Ethical Issues for Health Professions, 5th Edition MULTIPLE CHOICE 1. Bioethics is defined as the field of study examining the ethical dilemmas surrounding a. advances in bioscience. b. advances in diagnostic treatment procedures. c. ethical issues surrounding medical research. d. All options are correct.

ANS: D

Although advances in bioscience and diagnostic treatment procedures, as well as medical research, provide important discoveries, they also involve challenges to the rights and privacy for the patient. Bioethics is the study of these ethical dilemmas.

OBJ: 1. Define the term bioethics.

TOP: Bioethics

2. What is the main goal of ethics in medical research? a. Make advances in the medical field b. Make treating patients easier on the patient c. Lessen the impact of our greatest diseases and disorders d. Discover cures ANS: C

While making advances in the medical field, making treatment easier on the patient, and discovering cures are all part of the goals of ethical medical research, the main goal is to battle diseases through restoration or prevention of illness, death, and disabilities.

OBJ: 3. Describe the ethical principles in medical research.

TOP: Bioethics

3. A double-blind study is when a. researchers do not tell the subject what is being studied. b. the subject does not know whether he is getting the trial drug or a placebo. c. researchers give random test agents to the subject. d. the subject is given the trial drug at random times.

ANS: B

In a blind study, the patient does not know whether he or she is getting the trial drug or a placebo. This ensures the patient will not have any preconceived effects of the drug so the patient will be more objective.

OBJ: 2. Discuss bioethical issues involved in clinical trials.

TOP: Medical and Scientific Research 4. One problem for a patient with a disease participating in a blind study drug trial is the

person may a. be too sick to participate. b. think he or she will be cured. c. be so desperate for a good outcome, he or she cannot be objective. d. receive a placebo and may not receive treatment for a long period of time.

ANS: D

If a patient participates in a blind study, the patient may receive only the placebo and none of the trial drug or any other treatment, which could ultimately place the patient in a worse situation than before he or she began the trial.

OBJ: 2. Discuss bioethical issues involved in clinical trials.

TOP: Medical and Scientific Research 5. Bioethics ensures that researchers and research can be held accountable to a. the public. b. themselves. c. the government. d. the company that funds the research.

ANS: A

Bioethics ensures that researchers and research can be held accountable to the public.

OBJ: 1. Define the term bioethics.

TOP: Bioethics

6. The research and findings that result from medical and scientific research must be valid

and a. b. c. d.

be profitable. result in a cure. have integrity. result from a double-blind study of at least 100 people.

ANS: C

The research and findings that result from medical and scientific research must be valid and have integrity.

OBJ: 2. Discuss bioethical issues involved in clinical trials.

TOP: Bioethics

7. What is the primary way that researchers find out if a new treatment is safe and effective? a. Gene therapy b. Stem cell research c. Clinical trials d. Genetic testing

ANS: C

Clinical trials are research studies performed in people that are aimed at evaluating a medical, surgical, or behavioral intervention. They are the primary way that researchers find out if a new treatment, like a new drug or diet or medical device is safe and effective in people.

OBJ: 2. Discuss bioethical issues involved in clinical trials.

TOP: Medical and Scientific Research 8. Which group receives a new, researched treatment in a clinical trial? a. Control group b. Experimental group c. Double-blind study d. Gene therapy group ANS: B

In clinical trials, the experimental group receives the new, researched treatment agent. The control group receives a placebo or no agent at all.

OBJ: 3. Describe the ethical principles in medical research.

TOP: Medical and Scientific Research 9. Ethical principles in medical research should include the following: a. Informed consent from potential research participants b. Minimized risk of harm c. Give participants the right to withdraw from the research d. All options are correct ANS: D

All the options are correct. Ethical principles also include protection of participants’ anonymity and confidentiality.

OBJ: 3. Describe the ethical principles in medical research.

TOP: Medical and Scientific Research 10. What is the name of the medical research program that was established to map and

sequence the number of genes that are within the 23 pairs of chromosomes? a. Tuskegee Syphilis Study b. Wakefield Study c. Human Genome Project d. GINA ANS: C

The Human Genome Project is a medical research program, sponsored by the federal government, established to map and sequence the number of genes that are within the 23 pairs of chromosomes (i.e., the 46 chromosomes) with the goal of advanced lifesaving or disease-preventing treatments.

OBJ: 3. Describe the ethical principles in medical research.

TOP: Bioethics in Genetics

11. Who enforces the Genetic Information Nondiscrimination Act (GINA)? a. Congress

b. U.S. Equal Employment Opportunity Commission c. Each state has the power to enforce GINA. d. The Supreme Court ANS: B

GINA is enforced by the U.S. Equal Employment Opportunity Commission.

OBJ: 6. Explain what genetic discrimination is and what defines it.

TOP: Genetic Discrimination 12. Gene therapy involves a. transferring diseases from one person to another. b. the transfer of stem cells from one person to another. c. surgery for a disease. d. altering genes to correct genetic defects.

ANS: D

Gene therapy is focused on preventing the transmission of diseases by correcting the genetic code in the current chromosomes; then the subsequent transmission, theoretically, would be corrected for future generations. This could lead to the elimination of diseases such as colon cancer, other cancers, and Alzheimer’s disease.

OBJ: 4. List the different types of genetic testing.

TOP: Gene Therapy

13. Committees designed to review all research proposals and make sure research standards

are met are called a. institutional ethics boards. b. institutional morale boards. c. institutional Q&A boards. d. institutional review boards.

ANS: D

Institutional review boards have been widely used since the 1970s and review the methods proposed for research to ensure that they are ethical and that the human subjects provide informed consent.

OBJ: 3. Describe the ethical principles in medical research.

TOP: Medical and Scientific Research 14. Why is stem cell research so important? a. Because they can theoretically provide essential replacement cells b. Because of the source of these cells c. Because they are easily accessible d. Because they can grow in laboratories ANS: A

Stem cells can divide indefinitely and develop into many different types of cells, particularly during early life when growth and development are underway. Their function is to aid healing by providing essential replacements.

OBJ: 5. Describe ethical considerations for healthcare professionals in issues of genetic testing and stem cell research.

TOP: Stem Cell Research

15. The Tuskegee Syphilis Study illustrated the need for a. control groups when conducting medical research. b. experimental groups when conducting medical research. c. informed consent when conducting medical research. d. further research.

ANS: C

The Tuskegee Syphilis Study brought up many ethical issues that have lasting effects even today. The study highlighted issues of lack of informed consent and the economic exploitation based on race and poverty.

OBJ: 3. Describe the ethical principles in medical research.

TOP: Medical and Scientific Research 16. What is an example of discrimination in the workplace according to the Genetic

Information Nondiscrimination Act of 2008? a. Conflict of interest b. Participating in the Human Genome Project c. Refusing to pay for genetic testing d. Increasing the cost of insurance for a worker with the BRCA1 gene ANS: D

Knowing that a woman carries the BRCA1 gene could potentially be used by health insurance companies to deny coverage or to increase their cost of insurance coverage. The recently passed Genetic Information Nondiscrimination Act of 2008 makes such a move illegal and makes discrimination in the workplace based on genetic traits also unlawful.

OBJ: 6. Explain what genetic discrimination is and what defines it.

TOP: Genetic Discrimination 17. Blood tests, amniocentesis and ultrasound scans are all examples of a. prenatal testing b. newborn testing. c. carrier testing. d. gene therapy.

ANS: A

Types of prenatal screening methods during pregnancy including blood test, amniocentesis and ultrasound scans. Newborn and carrier testing would not include amniocentesis. Gene therapy is not a test.

OBJ: 4. List the different types of genetic testing.

TOP: Genetic Testing and Screening 18. A physician is provided a trip to Hawaii by XYZ Drug Company as result of prescribing

the company’s medications to his patients. This would be an example of a. conflict of interest. b. immoral behavior. c. primum non nocere. d. safe harbor.

ANS: A

A conflict of interest occurs when self-interest affects an individual’s professional obligations to one’s patients, organization, and/or profession. Immoral behavior is one that violates moral principles. ―Primum non nocere‖ is the principle of ―do no harm‖ in healthcare. A safe harbor is a provision of a statute or a regulation that specifies that certain conduct will be deemed not to violate a given rule.

OBJ: 3. Describe the ethical principles in medical research.

TOP: Medical and Scientific Research 19. When is testing for phenylamine (PKU) performed? a. Prenatal testing b. Newborn screening c. Carrier testing d. During gene therapy ANS: B

Testing for PKU occurs during newborn screening.

OBJ: 4. List the different types of genetic testing.

TOP: Genetic Testing and Screening 20. Which of the following is an argument against gene therapy? a. How would society determine which human traits are normal? b. How would society view people who are different? c. How would society identify those disorders that would be appropriate for gene

therapy? d. All options are correct.

ANS: D

Gene therapy can prevent people from carrying defective genes and transmitting them to their children. However, there are numerous arguments against gene therapy that include: How do researchers determine which disorders or traits warrant gene therapy? Could the widespread use of gene therapy make society less accepting of people who are different?

Who decides which traits are normal and which constitute a disability or disorder?

OBJ: 6. Explain what genetic discrimination is and what defines it.

TOP: Genetic Discrimination 21. A participant in a clinical trial wants to stop because he thinks he is experiencing side

effects from the experimental drug. However, the study is almost over, and researchers fear the loss of his data in the trial. What should the researchers do? a. Inform him that the research is almost over. b. That he is in the placebo group and should not be experiencing any side effects. c. Allow him to withdraw from the trial. d. Encourage the patient to continue and that his participation is critical.

ANS: C

One of the ethical principles in medical research is giving participants the right to withdraw from the research.

OBJ: 3. Describe the ethical principles in medical research.

TOP: Medical and Scientific Research 22. You are enrolling participants in a clinical trial. In order to obtain informed consent, you

must discuss all the following except a. all possible risk to participating. b. how many participants are in the study and the amount of compensation. c. that participation is voluntary. d. purpose of the research.

ANS: B

In order to obtain informed consent, participants should be told of the possible risk, purpose of the research, the methods being used, and the possible outcomes of the research. Participants should be taking part without coercion.

OBJ: 3. Describe the ethical principles in medical research.

TOP: Medical and Scientific Research 23. A clinical trial is being designed where participants are assigned to either receive the

experimental drug or a placebo. Which kind of clinical trial is this? a. Double blind trial b. Non-randomized trial c. Randomized trial d. Single blind trial ANS: D

Non-randomized controlled trials are when the participants are assigned to the experimental group by a method that is not random. The investigator defines and manages the alternatives.

OBJ: 3. Describe the ethical principles in medical research.

TOP: Medical and Scientific Research 24. Which of the following disease does not have a genetic test for it? a. Cystic fibrosis b. Beta thalassemia c. Acquired immunodeficiency syndrome d. Sickle cell anemia ANS: C

Acquired immunodeficiency syndrome (AIDS) is a chronic, potentially life-threatening condition caused by a virus, the human immunodeficiency virus (HIV).

OBJ: 4. List the different types of genetic testing.

TOP: Genetic Testing and Screening 25. Which of the following statement is not true about stem cells? a. Stem cells must first be destroyed before being used in research. b. Stem cells from embryos were created in vitro fertilization. c. Stem cell research is currently legal in the United States. d. Stem cells are from human embryos, called human embryonic stem cells.

ANS: A

Stem cells are harvested from the inner cell mass of an embryo. These embryos were created through in vitro fertilization under laboratory conditions for research purposes and were then destroyed (with donor consent) when no longer needed. Stem cells must be alive in order to multiply and divide into different type of cells.

OBJ: 5. Describe ethical considerations for healthcare professionals in issues of genetic testing and stem cell research.

TOP: Stem Cell Research

Chapter 04: Healthcare Laws and Compliance Elsevier Inc: Legal and Ethical Issues for Health Professions, 5th Edition MULTIPLE CHOICE 1. A penalty that serves as a punishment or enforcement of rules and regulations is a. a sanction. b. a kickback. c. a compliance plan. d. bias.

ANS: A

A sanction is a penalty that serves as punishment or enforcement of rules and regulations.

OBJ: 3. Identify the purpose of disciplinary actions and list examples of ethical and illegal actions that would warrant disciplinary actions.

TOP: Enforcement and Disciplinary Actions 2. If a healthcare professional does something illegal, whose responsibility is it to enforce

sanctions? a. The person who caught them b. The person who did the illegal action c. The employer of the governing entity d. Their coworkers ANS: C

It is the duty of all healthcare professionals to monitor themselves and uphold the ethical standards of the profession. If an individual does something illegal or unethical, it is the responsibility of their employer or governing body to enforce the sanctions that would be appropriate for the violation that occurred.

OBJ: 2. List federal and state agencies that oversee and resolve matters that require disciplinary action. TOP: Regulating Agencies 3. A new Patient’s Bill of Rights was implemented in 2010 by a. The Joint Commission. b. The Affordable Care Act. c. The Office for Civil Rights. d. The Office of Inspector General.

ANS: B

Under the Affordable Care Act of 2010, the US Department of Health and Human Services issued regulations to implement a new Patient's Bill of Rights.

OBJ: 1. Discuss the Patient’s Bill of Rights.

TOP: Patient’s Bill of Rights

4. Workplace sanctions are determined by a. laws. b. whistleblowers. c. professional codes of conduct. d. policies and procedures.

ANS: C

Committing an illegal act in the workplace may bring fines and possible imprisonment under civil and criminal law. However, professional and workplace sanctions do not depend on laws but professional codes of conduct and may include such corrective actions as termination of employment or loss of license.

OBJ: 3. Identify the purpose of disciplinary actions and list examples of ethical and illegal actions that would warrant disciplinary actions.

TOP: Enforcement and Disciplinary Actions 5. Which is true about CLIA? a. It is a governmental agency. b. It is a professional organization. c. It is a group of laws. d. It is a proposed law.

ANS: C

The Clinical Laboratory Improvement Act (CLIA) set forth extensive conditions or standards that laboratories must meet to be certified by the US Department of Health and Human Services. It is not an actual agency but a group of laws.

OBJ: 2. List federal and state agencies that oversee and resolve matters that require disciplinary action. TOP: Clinical Laboratory Improvement Act 6. Which agency accredits hospitals and healthcare facilities and ensures standards and

guidelines for patient care? a. TJC b. EMTALA c. OIG d. HITECH ANS: A

The Joint Commission (TJC) establishes the standards and guidelines for medical care for hospitals and healthcare facilities. TJC accredits more than 4000 facilities throughout the United States.

OBJ: 2. List federal and state agencies that oversee and resolve matters that require disciplinary action. TOP: Regulating Agencies 7. Which of the following outlines the rights and responsibilities of patients and healthcare

providers to strengthen their relationship and helps patients feels more confident about the healthcare system? a. Civil Rights Act b. Patient’s Bill of Rights c. Occupational Safety and Health Act d. TJC

ANS: B

The Patient’s Bill of Rights helps patients feel more confident in the healthcare system, strengthens the relationship between patients and their healthcare provider by defining their rights and responsibilities and those of their healthcare provider, and the role patients play in their health.

OBJ: 1. Discuss the Patient’s Bill of Rights.

TOP: Patient’s Bill of Rights

8. Which of the following is NOT a guarantee under the Patient’s Bill of Rights? a. The right to privacy b. The right to respectful care c. The right to receive understandable information about your diagnosis and

treatment d. The right not to be contacted by a collection agency due to non-payment ANS: D

All the following are guarantees of the Patient’s Bill of Right, except for being contacted by a collection agency. The Fair Debt Collection Practices Act eliminates abusive, deceptive, and unfair debt collection practices.

OBJ: 1. Discuss the Patient’s Bill of Rights.

TOP: Patient’s Bill of Rights

9. A compliance plan is used to a. let the employee know the rules of his or her employer. b. provide guidelines for employees and inform them of what measures will be taken

when a policy is violated. c. inform the employee of the results of not reporting one of their coworkers for any wrongdoing. d. explain to the employee why he or she should not share a patient’s personal information.

ANS: B

A compliance plan is a written set of policies and procedures used to ensure that guidelines and regulations are obeyed, and includes protocols for auditing, monitoring, and protocol for taking action when infractions (whether deliberate or unintentional) are discovered. It promotes correct coding and billing practices and prevents fraud.

OBJ: 4. Discuss compliance plans and the role of the compliance officer.

TOP: Compliance Plan 10. Which of the following regulate laboratory testing and require clinical laboratories to be

certificated? a. Patient’s Bill of Rights b. EMTALA c. Compliance plan d. CLIA ANS: D

The Clinical Laboratory Improvement Act of 1988 regulates all laboratory facilities for safety and handling of specimens to ensure accuracy and timeliness of testing regardless of where the test is performed.

OBJ: 2. List federal and state agencies that oversee and resolve matters that require disciplinary action. TOP: Clinical Laboratory Improvement Act 11. Which of the following laws protects a patient needing critical care when arriving at any

hospital emergency room? a. AMA b. AHIMA c. OCR d. EMTALA ANS: D

EMTALA requires any hospital emergency room that receives payments from federal healthcare programs to provide an appropriate medical screening to any patient seeking treatment.

OBJ: 2. List federal and state agencies that oversee and resolve matters that require disciplinary action. TOP: Emergency Medical Treatment and Active Labor Act 12. Which of the following agency oversees CLIA? a. AMA b. OIG c. FDA d. OCR ANS: C

The Food and Drug Administration (FDA) is the federal agency that authorizes and implements the Clinical Laboratory Improvement Act (CLIA), which are the laws that determine the test complexity categories.

OBJ: 2. List federal and state agencies that oversee and resolve matters that require disciplinary action. TOP: Clinical Laboratory Improvement Act 13. A physician is placed on the OIG’s exclusion list. All the following may occur except a. the physician receives a fine. b. the physician may not be able to receive reimbursement from Medicaid. c. the physician receives imprisonment. d. the physician is not approved to prescribe ―off-label‖ drugs.

ANS: D

A physician placed on the OIG’s exclusion may face fines of up to $10,000 per item for knowingly submitting a false claim, and up to three times the total damages. Further, not only will an individual placed on the Exclusions list not receive payment from any federal or state programs, but also an organization may not receive payment for services provided by the excluded individual in its employ. Unless the physician loses his or her license, the physician can prescribe drugs.

OBJ: 4. Discuss compliance plans and the role of the compliance officer.

TOP: Enforcement and Disciplinary Actions 14. Which of the following is NOT an example of whistleblowing? a. Unsafe working conditions

b. Increasing service fees due to supply costs c. Falsifying research results d. fraudulent medical billing practices ANS: B

Whistleblowing is when an individual, usually an employee, turns in an employer for potential fraud and abuse.

OBJ: 6. Discuss fraud and abuse in healthcare and the relevant laws.

TOP: False Claims Act 15. The Office of the Inspector General functions under which agency? a. The American Medical Association b. The Occupational Safety and Health Administration c. The Department of Labor d. Department of Justice ANS: D

The Office of Inspector General (OIG) is an independent agency that functions under the Department of Justice to investigate and protect the integrity of the Department of Health and Human Resources (HHS) and their recipients, as well as welfare programs. There are more than 70 OIG offices throughout the United States.

OBJ: 2. List federal and state agencies that oversee and resolve matters that require disciplinary action. TOP: Regulating Agencies 16. A physician bills an insurance company for services never rendered. This is considered a. noncompliance. b. fraud c. a violation of the Medical Practice Acts. d. a violation of the Stark law.

ANS: B

Fraud is the intentional act to misrepresent facts or mislead in order to gain financially. In this case, the physician would gain financially, so it would be considered fraud.

OBJ: 6. Discuss fraud and abuse in healthcare and the relevant laws.

TOP: Fraud and Abuse Laws 17. Which law can be waived under certain circumstances? a. Patient’s Bill of Rights b. EMATLA c. OSHA d. CLIA ANS: D

Each laboratory test is categorized by level of complexity. Some CLIA-waived tests are simple tests with a minimal risk for an incorrect result.

OBJ: 2. List federal and state agencies that oversee and resolve matters that require disciplinary action. TOP: Clinical Laboratory Improvement Act

18. If a coder consistently puts the wrong code on a claim, this is considered a. a fraudulent claim. b. an infraction. c. acceptable. d. a simple mistake.

ANS: B

This mistake is not deliberate fraud, but it is of course an infraction—a breaking of the principles and requirements of the insurance carrier for billing and coding.

OBJ: 5. Describe key types of compliance violations.

TOP: Enforcement and Disciplinary Actions 19. A qui tam lawsuit is when a whistleblower files a lawsuit on behalf of the government. Qui

tam means a. you too. b. who as well. c. you cannot. d. who must.

ANS: B

Qui tam, in Latin, means ―who as well‖ and is the term used for a private citizen who exposes and sues a company or organization that is violating the law and/or breaching the contract with the government. Most healthcare cases that are qui tam cases have been fraud and abuse related, but any violation of government regulations or laws can be considered for qui tam.

OBJ: 6. Discuss fraud and abuse in healthcare and the relevant laws.

TOP: False Claims Act 20. If an insurance carrier finds an error, they look for a. the intent of the error. b. reasons to sue the physician. c. who is responsible for the error within the physician’s office. d. All the options ANS: A

Overall, the main focus of these cases is the intention of the provider. Was this act deliberate or intentionally misleading (and thus fraudulent)? Or did the provider and billing staff just make a mistake—that is, commit an infraction? If a case is found to be intentional, the fraudulent acts will lead to prosecution, and, as we have noted, the fines and penalties can be substantial.

OBJ: 6. Discuss fraud and abuse in healthcare and the relevant laws.

TOP: Fraud and Abuse Laws 21. If a physician receives financial incentives from a drug manufacturer to prescribe a

particular drug, this is considered a. a minor infraction. b. a felony. c. a violation of the Stark law. d. acceptable practice.

ANS: C

Kickbacks create in a physician a bias toward promoting certain specialists, treatments, drugs, and other services or products because promoting them brings personal financial gain for that physician. It is also an abuse of privilege and a violation of the Stark law.

OBJ: 6. Discuss fraud and abuse in healthcare and the relevant laws.

TOP: Physician Self-Referral Law (Stark Law) 22. The medical practice act that governs healthcare professionals is regulated a. locally. b. by individual states. c. AMA. d. by an employer.

ANS: B

Each state has its own medical practice act, which provides laws that govern healthcare professionals’ scope of practice and licensing requirements.

OBJ: 2. List federal and state agencies that oversee and resolve matters that require disciplinary action. TOP: Medical Practice Act 23. Which of the following is NOT considered a healthcare-related compliance violation? a. Providing treatment for a relative b. Confidentiality breach c. Falsifying documentation d. Negligence ANS: A

Healthcare-related offenses that may warrant disciplinary action include violation of patients’ right, working outside the employee’s scope of practice, failure to perform at the accepted standard of care, fraud, abuse, abandonment of patient, falsifying or lack of documentation, negligence, violation of Stark law.

OBJ: 5. Describe key types of compliance violations.

TOP: Enforcement and Disciplinary Actions 24. Which of the following reasons may a physician be placed on the OIG Exclusions list? a. Violated state employment laws b. Submitted fraudulent claims to seek Medicare reimbursements c. Prescribed morphine to manage a patient’s pain d. Prescribed a medication that is not approved by the FDA, or ―off-label‖ ANS: B

An excluded individual or organization placed on the OIG Mandatory Exclusions list may be due to felony violation, such as fraud, theft, of financial misconduct. The FDA does approve all prescription drugs. However, physicians may prescribe drugs for different indications other than the ones approved by the FDA. The OIG oversees federal laws and not state laws.

OBJ: 6. Discuss fraud and abuse in healthcare and the relevant laws.

TOP: Exclusion Authorities

25. EMTALA was enacted to eliminate a. patient-dumping. b. fraud. c. false claims. d. workplace injuries.

ANS: A

The Emergency Medical Treatment and Active Labor Act (EMTALA) was enacted to eliminate ―patient dumping‖ where a facility would transfer a patient based on a potentially high-cost diagnosis or treatment or refuse to treat patients based on their ability to pay.

OBJ: 7. Discuss the Emergency Medical Treatment and Active Labor Act and Clinical Laboratory Improvement Act of 1988.

TOP: Emergency Medical Treatment and Active Labor Act

Chapter 05: Torts in Healthcare Elsevier: Legal and Ethical Issues for Health Professions, 5th Edition MULTIPLE CHOICE 1. Which would not be considered a tort? a. Medical malpractice b. False imprisonment c. Trespass d. Theft of narcotics ANS: D

A tort is harm against a person, and a crime is harm against the state. Almost all torts can be crimes, but most crimes are not torts.

OBJ: 1. Discuss what is the basis of torts and how they relate to malpractice.

TOP: Torts 2. Which type of tort has at its essence the relationship to or ownership of the thing that

causes harm? a. Intentional torts b. Quasi-intentional torts c. Strict liability d. Negligence ANS: C

The essence of strict liability is the relationship to or ownership of the thing that causes harm. The essence of intentional and quasi-intentional torts is consent.

OBJ: 2. Describe the different types of torts.

3. Which is not among the major intentional torts? a. Battery b. Murder c. Assault

TOP: Torts

d. False imprisonment ANS: B

Broadly defined, intentional torts require that there be an intentional interference with one’s person, reputation, or property. Murder is not one of the major intentional torts and is considered harm against the state, or a crime.

OBJ: 3. List and describe the different types of intentional torts.

TOP: Torts 4. Placing a person in immediate fear or apprehension of harmful, such as touching without

consent is a. assault. b. battery. c. consent. d. negligence.

ANS: A

An assault is a threat or attempt to inflict offensive physical contact or bodily harm on a person that puts the person in immediate danger of or in apprehension of such harm or contact. Battery is defined as the harmful or offensive touching of another without consent or a legally justifiable reason. Consent means permission or approval, and negligence is a careless practice that causes harm.

OBJ: 3. List and describe the different types of intentional torts.

TOP: Intentional Torts 5. During which surgeries would it be reasonable for a physician to remove the organ

mentioned without specific consent from the patient? a. The physician removes an ovary that contains several cysts instead of removing the cysts alone. b. The physician finds an unexpected blood clot and removes it during heart surgery. c. The physician removes a uterus that is full of fibroid tumors. d. The physician notices a sebaceous cyst when removing suspicious moles from the surface of the skin and removes the cyst at the same time.

ANS: B

If a physician finds a blood clot while performing heart surgery, it would be enough of a threat to be considered an emergency and thus should be removed. However, in all the other situations, although the surgery might be inevitable, the physician should wait until the patient is able to give consent.

OBJ: 4. Explain the importance of consent and the different types of consent.

TOP: Informed Consent 6. Which patient could probably receive a blood transfusion without consent if the physician

obtains a court order? a. A 65-year-old nursing home patient b. A 20-year-old victim of an industrial accident c. A 17-year-old female whose parents refuse a transfusion d. A 42-year-old mentally incompetent patient who has a legal guardian present

ANS: C

Courts will often order lifesaving medical intervention, such as a blood transfusion, in the case of a minor. If a competent adult refuses life-saving treatment, the courts will not interfere, nor will they imply consent.

OBJ: 4. Explain the importance of consent and the different types of consent.

TOP: Types of Consent 7. Which of the following can be transferred? a. Consent b. Intent c. Defamation d. Torts ANS: B

Transferred intent does not often occur in the medical profession, but a rule of law states, ―Intent follows the bullet.‖ If one person is harmed in the course of an attempt to harm another, then courts can transfer that intent. Therefore, physicians would be responsible for the actions of a medical assistant in their practice.

OBJ: 3. List and describe the different types of intentional torts.

TOP: Intentional Torts 8. Consent is implied a. when the patient’s life is threatened if the procedure is not performed. b. when the physician acts in the patient’s best interest. c. when the physician finds other concerns during the course of surgery. d. during all these situations.

ANS: A

Consent is implied during emergencies, and only for those procedures that are absolutely necessary.

OBJ: 4. Explain the importance of consent and the different types of consent.

TOP: Types of Consent 9. For battery to occur, all of the following conditions must be met except a. contact occurs. b. general consent was given. c. intent to cause contact. d. contact was harmful.

ANS: B

For battery to occur, the following elements must be met: intent to cause contact; contact occurs; contact is harmful; and no consent was given.

OBJ: 3. List and describe the different types of intentional torts.

TOP: Battery 10. In which situation would a medical facility not face false imprisonment charges? a. A competent, elderly cancer patient needs surgery and refuses to stay in the

hospital.

b. A minor female is held against her parent’s will without a court order. c. A patient stops taking his medication and wants to commit suicide. d. A 20-year-old rape victim refuses to press charges to stay at the hospital for

treatment.

ANS: C

Medical facilities may be justified in involuntarily admitting or holding patients if they document that patients are a danger to themselves or others after physician examination.

Competent adults cannot be legally detained.

OBJ: 3. List and describe the different types of intentional torts.

TOP: False Imprisonment 11. A written statement of defamation is known as a. slander. b. assault. c. libel. d. negligence.

ANS: C

Defamation wrongfully damages the reputation of another person. Libel comprises written defamatory statements; slander comprises spoken defamatory statements.

OBJ: 5. List and describe specific types of quasi-intentional torts.

TOP: Quasi-Intentional Torts 12. A person arrives at the emergency department complaining of chest pain. While the

physician is examining the patient, the patient becomes unconscious. The physician determines that the patient needs emergency surgery or will die. The patient is rushed to surgery. This is an example of a. general consent. b. ethical dilemma. c. implied consent. d. informed consent.

ANS: C

Consent is implied in emergency situations. The situation must be life threatening or pose a risk of significant physical injury to the patient if the procedures are not performed.

OBJ: 4. Explain the importance of consent and the different types of consent.

TOP: Types of Consent 13. Which is necessary to help healthcare professionals avoid accusations of battery? a. Informed consent b. General consent c. Assumed consent d. Implied consent ANS: B

General consent is for medical care and treatment for other employees of the hospital to ―touch‖ the patient even in a therapeutic manner. Do not confuse general consent with an informed consent to surgery or to other invasive procedures.

OBJ: 4. Explain the importance of consent and the different types of consent.

TOP: Types of Consent 14. Raising a hand to strike a patient, even if the patient was not touched, can be considered a. assault. b. battery. c. libel. d. abuse.

ANS: A

An assault places someone in immediate fear or apprehension of a harmful or noxious touching without the patient’s consent. To commit an assault, the person must be aware that you are about to touch him or her.

OBJ: 3. List and describe the different types of intentional torts.

TOP: Types of Intentional Torts 15. Which type of tort is a failure to take reasonable care of steps to prevent loss or injury to

another person? a. Negligence b. Assault c. Intentional infliction of emotional distress d. Battery ANS: A

Negligence is a breach of established standards of care. It is a failure to take reasonable care or steps to prevent loss or injury to another person. In health care, negligence occurs when a healthcare professional fails to take reasonable care or steps to prevent loss or injury to a client.

OBJ: 2. Describe the different types of torts.

TOP: Torts

16. Use of a restraint on a nursing home patient who is constantly wandering the halls is an

example of a. slander. b. assault. c. abuse. d. false imprisonment.

ANS: D

False imprisonment is the unlawful detention of a person that deprives the person of his or her personal liberty of movement against his or her will and that is done without any authority to detain. To be falsely imprisoned, a person must be confined within a specific area against his or her will, be confined by means of physical barriers and/or by physical force or threat of physical force, and be aware of the confinement.

OBJ: 3. List and describe the different types of intentional torts.

TOP: Types of Intentional Torts 17. Which would not appear in an institution’s policy on use of restraints? a. Under what circumstances restraints may be used

b. What type of monitoring the patient will require c. What documentation is adequate to justify use of restraints d. What type of restraints can be used during a staffing shortage ANS: D

Your institution’s policy must be clear as to the circumstances under which restraints may be used, how they are to be used and for how long, what type of monitoring the patient requires, what documentation is adequate to justify the use of restraints, and how often the physician must reorder the use of physical restraint.

OBJ: 3. List and describe the different types of intentional torts.

TOP: False Imprisonment 18. Quasi-intentional torts include all the following except a. slander. b. battery. c. invasion of privacy. d. breach of confidentiality.

ANS: B

Quasi-intentional torts include defamation, invasion of privacy, and breach of confidentiality. Quasi means ―resembling.‖ Slander, invasion of privacy, and breach of confidentiality all infer intent.

OBJ: 5. List and describe specific types of quasi-intentional torts.

TOP: Quasi-Intentional Torts 19. A surgical technician takes a photo of a local celebrity getting plastic surgery and posts it

on her social media account. This is an example of which of the following? a. Invasion of privacy b. Breach of confidentiality c. Slander d. False imprisonment ANS: A

Invasion of privacy is sharing or disclosing private patient information without consent or authorization. differs from defamation. The most basic right of patients is the expectation that their personal and medical information will be kept confidential by the healthcare professional and organization.

OBJ: 5. List and describe specific types of quasi-intentional torts.

TOP: Invasion of Privacy 20. The passage of HIPAA helped to prevent which of the following type of tort? a. Defamation b. Invasion of privacy c. Breach of confidentiality d. Intentional ANS: C

As health care becomes more dependent on technology, this has created more occurrences of breaches of confidentiality. In 1996, Congress enacted the Health Insurance Portability and Accountability Act (HIPAA), which called for regulations to establish criteria for a federal standard in authorizing the release of medical information.

OBJ: 5. List and describe specific types of quasi-intentional torts.

TOP: Breach of Confidentiality 21. If a tort is committed a. an individual may bring the case against the state. b. an individual may bring the case against another individual. c. the state may bring the case against an individual. d. the federal government and the state may bring the case against an individual.

ANS: B

A tort is a wrongful act that results in injury to another’s person, property, reputation, or the like, and for which the injured party is entitled to compensation. In tort cases, the injured party sues another party for compensation.

OBJ: 1. Discuss what is the basis of torts and how they relate to malpractice.

TOP: Torts 22. Committing battery means a. a person tried to maliciously hurt a person. b. a person touched another person with his or her consent or legally justifiable

reason. c. touching something in close proximity to a person without his or her consent. d. All the options.

ANS: D

Battery can be obvious or subtle. Hitting a person is obvious battery, but so is inserting an IV into a patient without his or her consent. Battery includes maliciously hurting someone, touching another person without his or her consent, and touching something close to another person without his or her consent.

OBJ: 3. List and describe the different types of intentional torts.

TOP: Battery 23. An example of battery in health care is a. violating a patient’s confidentiality. b. the patient asks you to remove a catheter and you do so. c. a surgeon removes the wrong organ during a surgery. d. a physician is placing a cast on a patient, and the physician slips and falls and

injures the patient in the process.

ANS: C

Medical battery is when there is consent to perform a procedure, but another procedure is performed instead.

OBJ: 3. List and describe the different types of intentional torts.

TOP: Battery

24. A patient arrives at the emergency department behaving strangely. The attending physician

wants to perform a drug test but the patient refuses and wants to leave. The physician calls hospital security to prevent him from leaving. All the following requirements would be met to prove false imprisonment except a. the patient did not provide consent. b. the patient was involuntarily committed. c. the patient was detained against his will. d. the patient was detained, and no assessment was done to determine the patient was a harm to himself or others.

ANS: B

To prove false imprisonment, there must have been a willful detention, detention must have been without consent, and the detention was unlawful. The patient could have been legally detained if a physical assessment was performed and the patient was deemed a threat to himself or herself or to others.

OBJ: 3. List and describe the different types of intentional torts.

TOP: False Imprisonment 25. In the case of an intentional tort, which of the following is true about intent? a. The individual must intend to do harm. b. The individual must obtain content from the other party. c. The individual did not act how a reasonable person would or should act. d. The individual acted intentionally but no harm was done to others.

ANS: C

Intent is generally the willful decision to bring about a prohibited consequence. However, for an intentional tort to occur, it does not necessarily have to be established that the accused individual had a desire to bring about harm or injury to another person. It is enough to be able to demonstrate that any reasonable person would or should be substantially certain that specific results will follow from his or her actions. The willful decision to bring about a prohibited consequence.

OBJ: 3. List and describe the different types of intentional torts.

TOP: Intentional Torts

Chapter 06: Medical Malpractice and Liability Elsevier Inc: Legal and Ethical Issues for Health Professions, 5th Edition MULTIPLE CHOICE 1. Which of the following would a nurse be found guilty of negligence? a. The nurse explains a procedure to a patient using a patient information sheet as a

prompt. b. The nurse draws blood from the patient for lab tests to be performed that day,

though no one told her directly to do so. c. The nurse eats an orange while talking with a patient in the reception area. d. The nurse moves a patient in a wheelchair at a high speed and does not use wheel

brakes during stops.

ANS: D

Ordinary negligence is conduct that involves unreasonable risk of harm. The nurse’s reckless behavior would be considered ordinary negligence.

OBJ: 2. Define the four elements to negligence as it relates to the healthcare setting.

TOP: Malpractice and Negligence 2. Which situation does not illustrate the existence of a duty that has been breached? a. A physician mistakenly removes healthy ovaries from a 23-year-old patient. b. A radiology technician is reprimanded more than 5 times in writing regarding his

inability to perform his job accurately. c. A physician’s liability insurance has been canceled 12 times. d. A nurse verifies drug allergies before performing an injection.

ANS: D

The physician removing the ovaries has caused harm to the patient, and the radiology technician could have caused harm that occurs in the future, as could the physician whose liability insurance has been canceled so often. A nurse performing within the scope of her duties is fulfilling her duty to the patient.

OBJ: 4. Identify and explain three categories of dereliction of duty (breach).

TOP: Duty 3. What is the term for failure to use or not use the same care as used by a reasonably prudent

person? a. Negligence b. Malpractice c. Abuse d. Battery ANS: A

Negligence is a failure to use care or act in a certain way that a reasonably prudent and careful person would under similar circumstances. It is an act of omission or failure to do what a person of ordinary prudence would have done under similar circumstances.

OBJ: 2. Define the four elements to negligence as it relates to the healthcare setting.

TOP: Malpractice and Negligence 4. A patient sues a physician for an injury caused by an error during eye surgery. The patient

receives compensatory damages. Several years later, the patient continues to have eye pain and decides to sue the physician again. Which defense should the defending party use? a. Assumption of risk b. Res judicata c. Res ipsa loquitur d. Release of tortfeasor ANS: C

Res judicata is a technical defense in which the patient cannot sue a second time for the same damages once a case has already been resolved.

OBJ: 7. Define and explain defenses in malpractice cases.

TOP: Defenses Against Malpractice

5. What are awards based on an intentional or wrongful act that was performed called? a. Punitive damages b. Compensatory damages c. Nominal damages d. None ANS: A

Punitive damages are often awarded as a punishment for the wrongful act.

OBJ: 5. Outline the three categories of damages that are required in malpractice cases.

TOP: Damages 6. While running, a physician witnesses a man collapse and performs CPR. The man is

rushed to the hospital and survives but sues the physician for injuries from the CPR. Which of the following statement is true? a. The Good Samaritan Law would not apply because the defendant is a physician. b. No direct cause can be established. c. No damages occurred during the incident. d. No duty was established between the physician and the man.

ANS: B

One of the most important conditions of negligence is duty. In this case, the existence of a legal responsibility on the part of the physician to provide care or treatment has not been established. When providing emergency care, no relationship is established between the healthcare provider and patient.

OBJ: 4. Identify and explain three categories of dereliction of duty (breach).

TOP: Duty 7. What is a type of negligence in a party responsible for the care or treatment of an

individual results in damages or injury to the individual? a. Risk management b. Malpractice c. Arbitration d. Dereliction ANS: B

Malpractice is the failure of a professional to meet the standard of conduct that a reasonable and prudent member of the same profession would exercise in similar circumstances and that results in harm.

OBJ: 1. Define and explain malpractice.

TOP: Malpractice and Negligence

8. Which of the following involves a neutral person hearing arguments and evidence from

both sides and then deciding the outcome of the dispute? a. Negotiation b. Arbitration c. Mediation d. All the options ANS: B

In arbitration a neutral person, called an ―arbitrator,‖ is appointed to hear arguments and evidence from each side and then decide the outcome of the dispute.

OBJ: 7. Define and explain defenses in malpractice cases.

TOP: Defenses Against Malpractice 9. The process by which a neutral third party facilitates dispute resolution is called a. mediation. b. negotiation. c. arbitration. d. communication.

ANS: A

Mediation is the process in which a neutral third party facilitates and assists the parties in resolving a dispute or conflict. Mediation leaves control of the outcome with the parties.

OBJ: 7. Define and explain defenses in malpractice cases.

TOP: Defenses Against Malpractice 10. If a physician is being sued by a patient for the acts of a medical assistant, which of the

following applies? a. Stare decisis b. Respondeat superior c. Res ipsa loquitur d. Quid pro quo ANS: B

Respondeat superior is the legal doctrine stating that, in many circumstances, an employer is responsible for the actions of employees performed within the course of their employment.

OBJ: 3. Recognize the concept of respondeat superior and its role in malpractice cases.

TOP: Duty 11. What term is used to describe the amount of time a plaintiff has after an injury to file a

lawsuit? a. Statute of limitations b. Discovery rule c. Release of tortfeasor d. Respondeat superior ANS: A

Statute of limitations vary from state to state, but its purpose is to limit the amount of time after the injury or discovery of the injury (based on the discovery rule) for the plaintiff to file a lawsuit.

OBJ: 7. Define and explain defenses in malpractice cases.

12. What are the four elements needed in a negligence case? a. Consent, dereliction of duty, direct cause, damages b. Denial, direct cause, liability, damages c. Duty, dereliction of duty, direct cause, damages

TOP: Statute of Limitations

d. Duty, direct cause, liability, damages ANS: C

For negligence to be proven, the plaintiff must prove the defendant had a duty to perform, the defendant was derelict in his/her duty, and the damages incurred were directly related to the negligent act; and then the court determines what damages were caused by the defendant.

OBJ: 2. Define the four elements to negligence as it relates to the healthcare setting.

TOP: Malpractice and Negligence 13. Damages for financial losses based on actual income and expenses are called a. compensatory. b. nominal. c. punitive. d. none of the options ANS: C

Compensatory damages are financial losses based on actual income and expenses, for example. Recovery of these losses can be awarded in a court case. Punitive damages are rewarded to punish, and nominal damages are small awards given when no major damages were suffered.

OBJ: 2. Define the four elements to negligence as it relates to the healthcare setting.

TOP: Malpractice and Negligence 14. A defendant is asked, ―What did you see just before you stopped your car to help the

victims of the car wreck?‖ This may be a case of which of the following? a. Sovereign immunity b. Malpractice c. Good Samaritan d. Negligence ANS: C

Good Samaritan laws protect healthcare providers and citizens who care for a person involved in an emergency or disaster without reimbursement.

OBJ: 7. Define and explain defenses in malpractice cases.

TOP: Defenses Against Malpractice 15. ―The thing speaks for itself‖ is called a. res ipsa loquitur. b. respondeat superior. c. res judicata. d. duces tecum.

ANS: A

Res ipsa loquitur means that there is clear evidence of negligence and there was no possible way that the patient (plaintiff) could have effected a different outcome or contributed to the damages or injury.

OBJ: 6. Describe the process of establishing a case of malpractice or negligence.

TOP: Establishing a Case of Negligence 16. A defendant does not want to go through a trial and wants the issue at hand dealt with

expediently. He may use a. a release of tortfeasor. b. alternative dispute resolution. c. the discovery rule. d. All the options are correct.

ANS: B

Alternative dispute resolution can be used instead of going to trial and can include arbitration or mediation.

OBJ: 7. Define and explain defenses in malpractice cases.

TOP: Defenses Against Malpractice 17. This type of defense is a denial of negligence and argues that the patient’s condition is the

cause or contributed to the injury and not due to negligence. a. Technical defense b. Affirmative defense c. Emergency care defense d. Good Samaritan defense ANS: B

An affirmative defense asserts that the outcome was contributed to or possibly caused by other factors beyond the alleged negligence, either contributory negligence or comparative negligence.

OBJ: 7. Define and explain defenses in malpractice cases.

TOP: Defenses Against Malpractice 18. To reduce the amount awarded, the defendant assumes some liability but also seeks to

show that the plaintiff’s actions or inaction was a contributing factor in the damages. This is called a. comparative negligence. b. contributory negligence. c. compensatory negligence. d. assumption of risk.

ANS: A

In this form of defense, the defendant assumes some liability but shows that the actions or inaction of the plaintiff was a contributing factor in the damages that were incurred.

Instead of proving no liability, the defendant seeks to reduce the compensation to the injured party.

OBJ: 7. Define and explain defenses in malpractice cases.

TOP: Defenses Against Malpractice 19. In this type of defense, the medical record plays the largest part of the defense with the

patient signing a consent to treat form. a. Confirmative defense b. Emergency care defense

c. Assumption of risk defense d. Good Samaritan defense ANS: C

In assumption of risk, the medical record is the best defense, if documented properly, accurately, and completely. The records should show the entire series of events leading up to the point of the alleged negligence. A patient signing a consent form was explained and accepted the risk of the procedures.

OBJ: 7. Define and explain defenses in malpractice cases.

TOP: Defenses Against Malpractice 20. ―Let the master answer‖ in Latin is a. res ipsa loquitur. b. respondeat superior. c. res judicata. d. duces tecum.

ANS: B

Under the respondeat superior doctrine, the physician or provider would be liable for the actions of anyone under their employ. All parties involved would be liable for their contribution in the case, but the one held most responsible is the highest licensed of the practice and/or the employer of the individual named that caused the harm and/or showed negligence.

OBJ: 2. Define the four elements to negligence as it relates to the healthcare setting.

TOP: Duty 21. To help prevent malpractice, the best action healthcare providers should take is a. working within their scope of practice. b. making promises to cure a patient. c. treating patients as if they were friends. d. with permission from a superior, working outside their job description.

ANS: A

Healthcare providers should always work within their scope of practice, or potentially face a malpractice suit. They should never make promises to a patient, and never work outside their job description. The provider should also never treat patients as if they were friend but should always treat a patient with dignity and respect.

OBJ: 8. Define liability prevention strategies for both individual employees and managers in the healthcare setting.

TOP: Prevention of Liability and Malpractice 22. In many healthcare organizations, whose primary duty is to help protect a physician from

liability? a. Physician assistant b. Risk management manager c. Registered nurse d. Another physician ANS: B

The risk management supervisor can aid in protecting the provider or respondeat superior from liability. The risk management supervisor’s duties would include monitoring all aspects of prevention of malpractice and guarding the practice against issues of fraud and abuse.

OBJ: 8. Define liability prevention strategies for both individual employees and managers in the healthcare setting.

TOP: Prevention of Liability and Malpractice 23. The risk management manager is mainly responsible for a. talking to unruly patients. b. talking to new employees about their dress code violations. c. overseeing communications with patients to ensure proper documentation d. documenting employees’ time records.

ANS: C

The risk management supervisor is responsible for ensuring that all staff members are up to date on the policies and procedures that pertain to their roles in the practice and that all HIPAA confidentiality is safeguarded, for communicating with patients, and for overseeing all written communications to ensure compliance and proper documentation.

OBJ: 8. Define liability prevention strategies for both individual employees and managers in the healthcare setting.

TOP: Prevention of Liability and Malpractice 24. Which type of professional liability insurance provides lifetime coverage for incidents that

occurred while the policy was in effect, regardless of when the claim is filed? a. Occurrence-basis policy b. Claims-made policy c. Prior acts coverage d. Risk management ANS: A

An occurrence-basis policy provides lifetime coverage for incidents that occurred while the policy was in effect, regardless of when the claim is filed. Most healthcare facilities usually obtain this type of policy because it is difficult to know when a claim will be submitted.

OBJ: 8. Define liability prevention strategies for both individual employees and managers in the healthcare setting.

TOP: Prevention of Liability and Malpractice 25. Which of the following is an example of negligence? a. A patient is upset at his physician and posts on social media that she has lost her

medical license. b. A medical assistant becomes frustrated with a patient with dementia and yells at

him that she is going to hit him and raises her hand. c. A medical assistant forcibly pulls a patient out of the exam room because the

patient refuses to leave. d. During a busy day, the medical assistant forgets to take the patient’s blood glucose.

The patient leaves and later is hospitalized for diabetic ketoacidosis.

ANS: D

Negligence does not require a specific intent to harm someone and is not a deliberate action but is the result of an individual or party failing to act in a reasonable way where a duty was owed. The medical assistant failed to act in a reasonable way where a duty was owed, which was to take and monitor the patient’s blood glucose. This is negligence because there was no intent to harm the patient and it was not a deliberate action.

OBJ: 2. Define the four elements to negligence as it relates to the healthcare setting.

TOP: Malpractice and Negligence

Chapter 07: Healthcare Business and Operations Elsevier Inc: Legal and Ethical Issues for Health Professions, 5th Edition MULTIPLE CHOICE 1. Which of the following is an official permission to perform certain duties? a. Licensing b. Credentialing c. Registration d. All options are correct ANS: A

Licensing is an official permission to perform certain duties. The difference is that licenses are legal requirements, while certifications are desired but not required for employment.

OBJ: 2. Explain the role of credentialing, licensing, and registration in health care.

TOP: Types of Healthcare Professionals 2. These types of healthcare providers are not physicians but may perform many similar

services, such as diagnose and prescribe most medications. a. BSNs b. CMTs c. PAs d. EMTs ANS: C

Mid-level providers such as physician assistants (PAs) and nurse practitioners (NPs) are not physicians, but they may perform similar services such as writing prescriptions and are usually able to bill insurance companies for their services.

OBJ: 1. Describe types of healthcare providers and professionals.

TOP: Types of Healthcare Professionals 3. Which is a third-party payer? a. HMO b. Physician c. Mid-level provider d. Patient ANS: A

Third-party payer refers to an entity besides the patient who pays on the patient’s behalf, like an insurance company or government agency.

OBJ: 1. Describe types of healthcare providers and professionals.

TOP: Types of Healthcare Professionals 4. Which of the following types of insurance plans creates a savings account for employees

to fund their claims instead of paying premiums? a. HMO b. MCO c. PPO d. ERISA ANS: D

Another type of commercial insurance plan is the Employment Retirement Income Security Act (ERISA). With this plan, health claims are not prepaid through premiums but with a savings account established and funded, partly or all, funded by the employer.

OBJ: 5. Identify and describe different types of health insurance plans and related patient costs.

TOP: Types of Health Insurance Coverage 5. Which is not an advantage of group practice? a. Protection of assets b. More coverage for patient care c. Cost sharing d. Consistent salary ANS: D

Although healthcare providers may lose some autonomy, they may find that they have a consistent salary and less risk than if they started or joined a private practice.

OBJ: 3. List and describe types of practice structures.

TOP: Types of Medical Practice Structures 6. Which of the following healthcare professionals can bill to insurance companies for

reimbursements? a. RNs b. NPs c. LPNs d. BSNs ANS: B

Nonphysician providers, such as physician assistants (PAs) and nurse practitioners (NPs), can assist in seeing patients and handling emergencies. Almost all third-party payers recognize their services separately and their services are billable under the credentials of the mid-level provider directly. Most insurance carriers, however, do reduce the amount of reimbursement for services provided by a mid-level provider instead of a physician.

OBJ: 5. Discuss the different types of managed care organizations.

TOP: Types of Health Insurance Coverage 7. Which of the following insurance plans allow a patient to visit almost any physician or

hospital regardless of network? a. HMO b. Indemnity plans

c. Medicaid d. All the options are correct.

ANS: B

Indemnity plans are fee-for-service plans that allow patients to direct their own health care and can see providers both in-network and out-of-network coverage.

OBJ: 4. Identify and describe different types of health insurance plans and related patient costs.

TOP: Types of Health Insurance Coverage 8. This type of practice has multiple physicians working together, but only one physician

owns the practice. a. Solo b. Sole proprietorship c. Associate practice d. Group practice ANS: B

In a sole proprietorship, the physician has legal agreements to hire other physicians or mid-level providers to work for him or her, but still owns the practice and employs other providers on an hourly or daily basis.

OBJ: 3. List and describe types of practice structures.

TOP: Types of Medical Practice Structures 9. This type of practice is a corporate structure, and shares in the expenses, profit, and risk. a. Group practice b. Sole proprietorship c. Associate practice d. Sole practice ANS: A

A group practice has a corporate structure that assigns designated officers to manage the group, not only enabling the individual physicians to be covered when they are unavailable to see patients, but also enabling them to share overhead and staffing costs and personal protection from liability.

OBJ: 3. List and describe types of practice structures.

TOP: Types of Medical Practice Structures 10. This type of practice has two or more providers that share in overhead, but do not share in

the profits or losses. a. Solo b. Sole proprietorship c. Associate practice d. Group practice ANS: C

An associate practice is a common structure that shares overhead only. These corporate structures can be established as individual professional corporations (PCs) or could be established as limited liability corporations (LLCs).

OBJ: 3. List and describe types of practice structures.

TOP: Types of Medical Practice Structures 11. If an insurance plan is 80/20 after the deductible is met for in-network benefits, what kind

of plan is this? a. Indemnity b. HMO c. PPO d. Workers’ compensation ANS: A

If a patient has an 80/20 plan, this means that after the deductible is met, the insurance carrier is paying 80% of the fees and the patient is responsible for 20%. This is called a traditional indemnity plan. In this type of plan, the physician or provider cooperates with the insurance company by accepting an adjusted fee scale.

OBJ: 4. Identify and describe different types of health insurance plans and related patient costs.

TOP: Types of Health Insurance Coverage 12. In this insurance plan, patients choose their healthcare provider and pays a flat fee to the

provider in network. The patient has the option of going out-of-network but would have to pay more out-of-pocket fees. a. Indemnity b. HMO c. PPO d. Worker’s compensation ANS: C

Preferred Provider Organizations (PPOs) are some of the most common types of plans.

They allow patients to see any in-network provider without first obtaining a referral from the patient’s primary care provider. They typically allow out-of-network benefits but pay a lower percentage of the cost than in-network. Patients usually have a deductible as well as copays or coinsurance.

Under these plans, if the patient sees a provider who is in-network, the patient pays the flat copay amount. If the patient chooses to see a provider who does not participate with the plan, the patient must pay up front and then be reimbursed based on their out-of-network benefit and possibly a deductible as well.

OBJ: 5. Discuss the different types of managed care organizations.

TOP: Types of Health Insurance Coverage 13. A disadvantage to an HMO is a. they are too large. b. you must be approved before seeing a specialist. c. they give too many referrals to specialists. d. you must pay first, and then get reimbursed.

ANS: B

As a part of the health maintenance organization (HMO) model, patients must see their primary care provider, who serves as a gatekeeper, before seeing a specialist. This helps control unnecessary medical visit and costly tests to specialists.

OBJ: 5. Discuss the different types of managed care organizations.

TOP: Managed Care Organizations 14. Government carriers include all the following, except a. Medicaid. b. Medicare. c. Blue Cross/Blue Shield. d. TRICARE. ANS: C

Although Blue Cross/Blue Shield is widely known, they are a private organization and have no ties to the government.

OBJ: 6. Discuss the different types of government healthcare programs and who are eligible.

TOP: Preferred Provider Organizations 15. A person’s income is below the federal poverty level. What kind of government insurance

plan is this person eligible for? a. Medicaid b. Medicare c. Blue Cross/Blue Shield d. TRICARE ANS: A

Medicaid is a federal program that is governed and managed by each individual state to give aid to indigent or medically needy patients and to those whose incomes are below the federal poverty line.

OBJ: 6. Discuss the different types of government healthcare programs and who are eligible.

TOP: Preferred Provider Organizations 16. The insurance used to cover military members and their families is called a. Medicaid. b. Medicare. c. Blue Cross/Blue Shield. d. TRICARE. ANS: D

TRICARE (formerly known as the Civilian Health and Medical Program of the Uniformed Services, or CHAMPUS) coverage refers to the plans that cover active military individuals and their dependents, as well as retired military personnel who have served for 20 years or more. The enlisted persons who only serve a few years are not eligible for TRICARE once they leave their branch of service but may be eligible for other veteran’s benefits.

OBJ: 6. Discuss the different types of government healthcare programs and who are eligible.

TOP: Preferred Provider Organizations 17. Medical coverage for persons 65 and older is called a. Medicaid. b. Medicare. c. Blue Cross/Blue Shield. d. TRICARE.

ANS: B

Medicare is a federal program for coverage of eligible recipients 65 years old or older.

Generally, these recipients become eligible at age 65 to apply for Social Security benefits at the same time. This coverage is also given to permanently disabled individuals as well.

OBJ: 6. Discuss the different types of government healthcare programs and who are eligible.

TOP: Preferred Provider Organizations 18. Which part of Medicare covers prescriptions? a. A b. B c. C d. D ANS: D

Medicare Part D covers the prescription drug plan.

OBJ: 6. Discuss the different types of government healthcare programs and who are eligible.

TOP: Preferred Provider Organizations 19. Which part of Medicare covers hospital claims? a. A b. B c. C d. D ANS: A

Medicare Part A covers hospital claims.

OBJ: 6. Discuss the different types of government healthcare programs and who are eligible.

TOP: Preferred Provider Organizations 20. A person has both Medicaid and Medicare. Which kind of plan is this called? a. Medicare Advance b. ―Medi-Medi‖ c. CHAMPUS d. TRICARE ANS: B

Medicare beneficiaries sometimes carry a secondary insurance plan to cover coinsurance amounts. Beneficiaries may have Medicare and Medicaid if they are medically and/or financially eligible, often referred to as a ―Medi-Medi‖ plan.

OBJ: 6. Discuss the different types of government healthcare programs and who are eligible.

TOP: Preferred Provider Organizations 21. Which of the following insurance plans may use a ―gatekeeper‖ to control costs? a. HMO b. Indemnity plan c. Medicare d. All the options are correct.

ANS: A

HMO use gatekeepers (PCPs) to maintain and approve medical services to reduce costs and unnecessary spending.

OBJ: 5. Discuss the different types of managed care organizations.

TOP: Managed Care Organizations 22. A method of billing for services rendered by nonphysician providers is called a. copay. b. coinsurance. c. incident to billing. d. third-party payer.

ANS: C

Incident to billing is a method of billing outpatient services provided by a nonphysician provider when working under the direct supervision of a physician.

OBJ: 6. Discuss the different types of government healthcare programs and who are eligible.

TOP: Preferred Provider Organizations 23. Which of the following insurance plans allows patients to see any in-network provider

without first obtaining a referral from the patient’s primary care provider? a. HMO b. MCO c. PPO d. ERISA ANS: C

A Preferred Provider Organization (PPO) is a type of managed care organization that allow members to see any in-network provider without first obtaining a referral from the patient’s primary care provider.

OBJ: 5. Discuss the different types of managed care organizations.

TOP: Preferred Provider Organizations 24. A patient has an insurance policy that requires a copay of $15 and co-insurance of 80/20.

Her physician charges $100 for the visit. How much will she be responsible for? a. $15 b. $20 c. $35 d. $95 ANS: C

The patient is responsible for the copay ($15) plus 20% of the total cost of the visit, with her insurance plan paying 80% of the charge. Twenty percent of $100 is $20. Thus, $15 plus $20 equals $35.

OBJ: 5. Discuss the different types of managed care organizations.

TOP: Managed Care Organizations 25. Which of the following is a true statement regarding allied health professionals? a. They serve on a healthcare team and often work under a physician or provider.

b. They all require licenses and credentials. c. They can bill for reimbursements to patients’ insurance plans. d. They can be identified based on the colors of their medical scrubs.

ANS: A

Allied health professionals serve as essential members of the healthcare team and are often supervised by a physician or another healthcare provider. Instead of billing separately to insurance companies for their services, they operate as paid employees or contractors for hospitals and other healthcare facilities. Some professions may require licenses; however, most may only require a certification or registration. In most facilities, all employees must wear identification badges with their names, positions, and credentials.

OBJ: 2. Explain the role of credentialing, licensing, and registration in health care.

TOP: Types of Healthcare Professionals

Chapter 08: Workplace Issues and Employment Laws Elsevier Inc: Legal and Ethical Issues for Health Professions, 5th Edition MULTIPLE CHOICE 1. Which federal agency enforces employee protection laws and helps foster, promote, and

develop workers, including employee benefits and rights? a. EEOC b. DOL c. OSHA d. CMS ANS: B

The U.S. Department of Labor (DOL) enforces more than 180 employee protection laws.

The DOL help foster, promote, and develop the welfare of the wage earners, job seekers, and retirees of the United States; advance opportunities for profitable employment; and assure work-related benefits and right. The Occupational Safety and Health Administration (OSHA) functions to ―assure safe and healthful working conditions.‖ The Equal Employment Opportunity Commission (EEOC) is responsible for enforcing the Act and other employment laws to protect employees from discrimination and discriminatory practices. The Centers for Medicare & Medicaid Services (CMS) oversees federal healthcare programs, such as Medicare and Medicaid.

OBJ: 3. Discuss the different federal agencies that enact and enforce employment protection laws.

TOP: Employee Protection and Labor Laws 2. Define professionalism. a. Conduct in the workplace b. Finding humor in tough situations c. Acting with sympathy for a patient d. Bringing personal problems into the workplace ANS: A

Professionalism encompasses all the behaviors of an individual, their language used, and their appearance as well.

OBJ: 1. Describe the importance of professionalism and emotional intelligence for healthcare professionals.

TOP: Professionalism 3. Which Act protects patients from inaccurate information on their credit reports? a. Consumer Credit Protection Act b. Fair Credit Reporting Act c. Fair Debt Collection Practices Act d. Fair Credit Billing ANS: B

The Fair Credit Reporting Act protects patients from inaccurate information on their credit reports. The Fair Debt Collection Practices Act prohibits debt collectors, including physician office staff, from using deceptive or abusive practices in the collection of consumer debts. This would include contacting patients at odd hours and harassing them with repeated phone calls and threats. Consumer Credit Protection Act (1968) requires providers to be up front about fees and finance charges when offering credit. The Fair Credit Billing Act requires prompt written response to billing complaints and investigation of possible billing errors.

OBJ: 5. Define the different laws to protect patients and consumers in fair collections process.

TOP: Collection Standards 4. An employee handbook should outline all the following, except a. policies and procedures. b. hiring and termination. c. advancement within the organization. d. coworker responsibilities.

ANS: D

All employee handbooks should outline company policy and procedures and should include specific steps in the process for both hiring and job termination for the organization. Company policy regarding advancement and hiring from within the organization should also be addressed in the handbook.

OBJ: 2. List the different components in an employee handbook.

TOP: Employment Handbooks 5. Employment-at-will means a. the employee must be warned before being fired. b. the employee may perform duties not listed on the job description. c. the employer may change the employee’s position at-will. d. the employer may fire an employee without warning.

ANS: D

An employment-at-will is designed so that either party may discontinue the employment agreement at any time. For at-will employees, there is no need to follow protocols for termination; instead, the agreement itself dictates that this type of employee may be discharged without cause.

OBJ: 1. Describe the importance of professionalism and emotional intelligence for healthcare professionals.

TOP: Employment Contracts

6. Why are clear and concise expectations important for an employer to provide to an

employee on the grounds for immediate dismissal? a. So the employee knows what things he or she can do wrong without being terminated b. So a patient cannot sue the employer for questionable care c. So the employer may terminate an employee without following the corrective action procedures d. So the employer may terminate anybody at any time ANS: C

Some employers identify offenses that would be ―grounds for immediate dismissal,‖ and these include extreme offenses, such as, HIPAA violations or embezzlement. Again, the importance of clear and defined expectations and the clear and defined measures that would be taken if these are violated is essential for any employer, but especially in the medical field where patients’ lives are at stake.

OBJ: 2. List the different components in an employee handbook.

TOP: Due Process 7. Why are corrective action steps important to be included in an employer’s policy and

procedure manual? a. So the employee can make the mistake several times without being fired b. So the employer can get rid of someone with whom they have a personality conflict with c. So the employer can counsel the employee about his or her performance and help the employee improve d. So the employee can be trained correctly ANS: C

Many policies include a three-step model for corrective action with employees. Most have an initial verbal warning followed by a written warning, and then a third offense would mean termination. It is a chance for the employer to counsel the employee, and to help the employee improve their performance.

OBJ: 2. List the different components in an employee handbook.

TOP: Due Process 8. Which of the following topics would be considered illegal to ask in an interview? a. The candidate’s age b. The candidate’s work history c. The candidate’s references d. The reason why the candidate left the previous job ANS: A

It is illegal to ask the potential employee about age, religion, race, or color; the existence of children; weight and height; the existence of disabilities; arrest records; and maiden name.

OBJ: 3. Discuss the different federal agencies that enact and enforce employment protection laws.

TOP: Discrimination

9. Which Act requires prompt written response to billing complaints and investigation of

possible billing errors? a. Consumer Credit Protection Act b. Fair Credit Reporting Act c. Fair Debt Collection Practices Act d. Fair Credit Billing ANS: D

The Fair Credit Billing Act requires prompt written response to billing complaints and investigation of possible billing errors. The Fair Credit Reporting Act protects patients from inaccurate information on their credit reports. The Fair Debt Collection Practices Act prohibits debt collectors, including physician office staff, from using deceptive or abusive practices in the collection of consumer debts. This would include contacting patients at odd hours and harassing them with repeated phone calls and threats. Consumer Credit Protection Act (1968) requires providers to be up front about fees and finance charges when offering credit.

OBJ: 6. Define the different laws to protect patients and consumers in fair collections process.

TOP: Collection Standards 10. OSHA regulates a. physician licensing. b. privacy for patients. c. safety in the workplace. d. discrimination in hiring.

ANS: C

All physical hazard spaces, medical waste, and medical biohazards (such as used sharps) must be handled following specific guidelines initiated by OSHA, the Occupational Safety and Health Administration. OSHA has been established for all kinds of businesses and safeguards employees from potential risks for illness or injury.

OBJ: 3. Discuss the different federal agencies that enact and enforce employment protection laws.

TOP: Occupational Safety and Health Act 11. Which Act forbids contacting patients and harassing them with repeated phone calls and

threats regarding outstanding healthcare bills? a. Consumer Credit Protection Act b. Fair Credit Reporting Act c. Fair Debt Collection Practices Act d. Fair Credit Billing ANS: C

The Fair Debt Collection Practices Act prohibits debt collectors, including physician office staff, from using deceptive or abusive practices in the collection of consumer debts. This would include contacting patients at odd hours and harassing them with repeated phone calls and threats. The Fair Credit Billing Act requires prompt written response to billing complaints and investigation of possible billing errors. The Fair Credit Reporting Act protects patients from inaccurate information on their credit reports Consumer Credit Protection Act (1968) requires providers to be up front about fees and finance charges when offering credit.

OBJ: 6. Define the different laws to protect patients and consumers in fair collections process.

TOP: Collection Standards 12. All the following are examples of sexual harassment except a. overhearing an offensive joke with sexual innuendoes. b. an employee is denied a promotion unless she has coffee with her supervisor. c. a patient making unwanted contact with a nurse. d. all the options are correct.

ANS: D

Sexual harassment is the use of power or intimidation over an individual for sexual favors; unwanted or unwelcomed sexual advances and actions or behaviors with sexual implications or innuendoes leading another individual to feel uncomfortable or offended.

OBJ: 5. Define and describe types of harassment and workplace discrimination.

TOP: Sexual Harassment 13. What legislation made it illegal to discriminate against someone based on sex? a. The Civil Rights Act of 1964 b. Fair Labor Standards Act c. Family Medical Leave Act d. Americans with Disabilities Act ANS: A

The Civil Rights Act of 1964, sometimes referred to as Title VII, is a law making it illegal to discriminate against someone on the basis of race, color, religion, national origin, or sex.

OBJ: 3. Discuss the different federal agencies that enact and enforce employment protection laws.

TOP: Civil Rights Act 14. Most employers have a series of steps that must be taken before an employee can be

terminated, often detailed in the employee handbook. Before termination, the first offense often results in which of the following? a. A verbal warning before termination b. A corrective action plan c. A written warning before termination d. Immediate termination ANS: A

Most employers have a series of steps that must be taken before an employee can be terminated. For instance, policy may dictate that a first offense incurs a verbal warning; the second offense involves a written or more formal warning; and a third offense will result in termination.

OBJ: 2. List the different components in an employee handbook.

TOP: Due Process 15. Due process is a. giving employees the chance to explain themselves. b. interviewing employees and other coworkers who saw the offense. c. following policies and procedures through every step before termination, and

documenting that such steps were taken. d. firing an employee after speaking to him for the third time, but not needing to document it.

ANS: C

Most employers have a series of steps that must be taken before an employee can be fired.

The employer must document each step in the employee’s file to show that due process was followed and that the policy of the institution was obeyed.

OBJ: 2. List the different components in an employee handbook.

TOP: Due Process 16. If a company treats two employees differently for the same infraction, this is considered a. noncompliance. b. discrimination. c. harassment. d. illegal.

ANS: B

It is considered discrimination if a supervisor or employer treats any one individual differently than another. A compliance officer or the company’s human resources department can ensure this does not happen in the workplace.

OBJ: 5. Define and describe types of harassment and workplace discrimination.

TOP: Civil Rights Act 17. Which employees work well on teams and are more flexible in dealing with change? a. Employees with high qui tam b. Employees with high professionalism c. Employees with high emotional intelligence d. Employees with high discrimination ANS: C

Emotional intelligence (EQ) reflects a person’s level of self-awareness, empathy, and ability to get along with others. Employees with high EQ work well on teams and are more flexible in dealing with change. A higher EQ will reflect in positive relationships with colleagues and customers, and a staff that is productive and effective.

OBJ: 1. Describe the importance of professionalism and emotional intelligence for healthcare professionals.

TOP: Emotional Intelligence and Quotient

18. What is an indispensable tool in communication between employer and employee? a. Due process b. An employee handbook c. Employment protection laws d. EQ ANS: B

An employee handbook is an indispensable tool in communication between employer and employee. It can help an employee understand what is expected and improve morale by ensuring that employees are treated consistently and fairly.

OBJ: 2. List the different components in an employee handbook.

TOP: Employment Handbooks 19. What legislation in 1993 allowed for unpaid leave to help care for a family member’s

illness or to stay at home following the birth or adoption of a child? a. Patient Protection and Affordable Care Act b. Occupational Safety and Health Act c. Americans with Disability Act d. Family Medical Leave Act ANS: D

The Family Medical Leave Act (1993) required employers with 50 or more employees to allow eligible employees to take up to 12 weeks of unpaid leave to help care for a family member’s illness or to stay at home following the birth or adoption of a child.

OBJ: 3. Discuss the different federal agencies that enact and enforce employment protection laws.

TOP: Family Medical Leave Act 20. Which Act assures safe and helpful working conditions for working men and women by

setting and enforcing standards and by providing training, outreach, education and assistance? a. Fair Labor Standards Act b. Civil Rights Act c. Occupational Safety and Health Act d. American with Disabilities Act ANS: C

The Occupational Safety and Health Act’s function is to ―assure safe and healthful working conditions for working men and women by setting and enforcing standards and by providing training, outreach, education and assistance.‖ OBJ: 3. Discuss the different federal agencies that enact and enforce employment protection laws.

TOP: Employee Protection and Labor Laws 21. What does EI stand for? a. Employer interaction b. Employee intelligence c. Equal information

d. Emotional intelligence ANS: D

EI stands for emotional intelligence. EI is one's ability to perceive, understand, reason with, and manage his or her emotions and the emotions and behaviors of others.

OBJ: 1. Describe the importance of professionalism and emotional intelligence for healthcare professionals.

TOP: Emotional Intelligence and Quotient 22. An example of workplace violence is a. intimidation. b. physical altercations. c. threats. d. All the options are correct.

ANS: D

Workplace violence is any act or threat of physical violence, harassment, intimidation, or other threatening disruptive behavior that causes fear for personal safety in the workplace.

It can be a verbal threat or a physical altercation, and can involve employees, clients, customers, or visitors. Violence can arise from any number of situations, both real and perceived, such as anger over a disciplinary action, the belief that an employee was passed over for a promotion, or disapproval of a new regulation. It may originate with an unsatisfied customer, an abusive manager, or a domestic problem that carries over to the workplace.

OBJ: 3. Discuss the different federal agencies that enact and enforce employment protection laws.

TOP: Workplace Violence 23. Which of the following is not an example of workplace violence? a. A medical biller gets yelled at by a patient due to mistake on a bill. b. A surgeon gets threatened by a patient while at a restaurant due to a surgical error. c. A certified nursing assistant gets slapped by a patient with dementia. d. A pharmaceutical representative intimidates a physician into prescribing more

drugs.

ANS: B

Workplace violence is any act or threat of physical violence, harassment, intimidation, or other threatening disruptive behavior that causes fear for personal safety in the workplace.

It can be a verbal threat or a physical altercation and can involve employees, clients, customers, or visitors. Although inappropriate, the threat from the patient to the surgeon occurred outside of the workplace.

OBJ: 5. Define and describe types of harassment and workplace discrimination.

TOP: Workplace Violence 24. When injured, the most important thing for the employee to do is a. report the injury to the employer. b. go immediately to the emergency room to prevent costly injury. c. call the employee’s physician. d. refer to the company’s Workers’ compensation policy.

ANS: A

When injured in the workplace, the most important thing for the employee to do is report the injury even if immediate medical attention is not required.

OBJ: 3. Discuss the different federal agencies that enact and enforce employment protection laws.

TOP: Workers’ Compensation 25. Under the Americans with Disabilities Act, what of the following are considered

―reasonable accommodations?‖ a. Higher pay for the same work due to more effort required based on the disability b. Changes to a structure or facility to make it more accessible c. Provide meals and lodging d. Provide additional time off for medical appointments ANS: B

The phrase ―reasonable accommodations‖ refers to necessary and appropriate changes to any system or structure that would make the environment equal and fair. Under these laws, if a candidate applies for enrollment in an educational facility or an employment opportunity, the Americans with Disabilities Act provides that the candidate can expect ―reasonable‖ accommodations if necessary and should not be discriminated against in the pursuit of employment, education, or access to public places because of the disability.

OBJ: 4. List groups considered protected classes by the federal government.

TOP: American with Disabilities Act

Chapter 09: Medical Records and HIPAA Elsevier Inc: Legal and Ethical Issues for Health Professions, 5th Edition MULTIPLE CHOICE 1. The acronym for health information that can be linked to a patient is a. EHR. b. PHI. c. PIH. d. EMR. ANS: B

Protected health information (PHI) is all health information identifiable to a specific patient. It must be kept secure in all areas of the office and/or health facility.

OBJ: 5. Discuss the confidentiality and consent forms for release of medical records.

TOP: Privacy Rule 2. Which laws protect patients’ health information and sets rule and limits on who can view

review it? a. Affordable Care Act (ACA) b. Health Insurance Portability and Accountability Act (HIPAA) c. Health Information Technology for Economic and Clinical Health Act (HITECH) d. Protected health information (PHI) ANS: B

Health Insurance Portability and Accountability Act of 1996 (HIPAA) gives patients’ rights over their health information and sets rules and limits on who can look at and receive patients’ private information. HIPAA applies to protected health information (PHI), whether electronic, written, or oral.

OBJ: 1. Outline the purpose of medical records.

Records

TOP: Purpose of Medical

3. Ownership of a patient’s medical record usually remains with which party? a. courts b. third-party payers c. patients d. healthcare providers and facilities ANS: D

Patient data ownership can generally be broken into the ownership of the data versus the medical records and the ability of patients to access their data. Medical records are legal documents generated by the healthcare provider or facility. Because it is a legal document and even though the information in the medical records pertains to the patient, the patient's original medical records must remain with the healthcare facility, and the healthcare provider is the owner of the medical records.

OBJ: 4. Name key guidelines for storage, retention, and maintenance of medical records.

TOP: Ownership of Medical Records 4. The acronym that represents SOAP means a. summation of conversation, observation, assessment, plan. b. Summation of conversation, objective, assessment, priority. c. subjective, observation, assessment, priority. d. subjective, objective, assessment, plan.

ANS: D

The SOAP method of documenting the patient’s visit is an organized method of documenting the purpose of the patient’s visit, observe and measure the examination, possible diagnosis and planning the next step in treatment. This SOAP method assists the provider to accurately document the visit.

OBJ: 2. List the organization and contents within a medical record.

TOP: ―SOAP‖ Format 5. Most states may have different records retention requirements. What outlines the

minimum number of years medical records must be retained? a. Statutes of limitations b. Standard of care c. HIPAA d. Inactive patient files ANS: A

The statute of limitations outlines the minimum number of years patients’ medical records must be maintained. This may vary based on state, with most states requiring healthcare facilities retain medical records for a minimum of 10 year.

OBJ: 4. Name key guidelines for storage, retention, and maintenance of medical records.

TOP: Retention of Medical Records 6. In general, how long do patient files need to be maintained before becoming inactive in a

healthcare facility? a. Six months b. One year c. Two years d. Three years ANS: D

If a patient has not been seen in a healthcare facility, then the files could become inactive after three years. However, a healthcare facility may choose to keep files active for longer than the 3 years. Always check the state regulations on active and inactive files.

OBJ: 4. Name key guidelines for storage, retention, and maintenance of medical records.

TOP: Retention of Medical Records 7. The purpose of keeping accurate medical records includes all the following except a. serving as quality control. b. knowing the patient’s work status for insurance. c. protecting the patient and healthcare professional in cases of negligence and

malpractice. d. allowing members of the healthcare team to communicate with one another.

ANS: B

There are many components in keeping accurate patient medical records. Following protocol for accuracy in documentation is vital for current and future treatment; therefore, avoiding any negligence or malpractice, and most importantly treating the patient with the best medical practice possible.

OBJ: 3. Describe the importance of correct documentation in a patient medical record.

TOP: Documentation of Medical Records 8. A patient intake form includes all the following data below except a. insurance information. b. consent forms for HIPAA. c. medical history. d. names, contact information of all physicians seen in the last 2 years.

ANS: D

With the patient intake form, the healthcare professionals learn all the pertinent patient information to properly treat the patient. Insurance information is important as the patient and healthcare facility are aware of any potential cost incurred by the visit.

OBJ: 2. List the organization and contents within a medical record.

TOP: Elements of Medical Records 9. HIPAA was enacted in a. 1992. b. 2022. c. 1996.

d. 2004.

ANS: C

In 1996, the Health Insurance Portability and Accountability Act was passed to maintain the patient’s privacy, protect them for fraud, to keep simplified administration of health insurance, and to promote the use of medical savings for employees.

OBJ: 1. Outline the purpose of medical records.

Records

TOP: Purpose of Medical

10. Within the HIPAA guidelines, a patient’s medical records can be shared or transferred to a

covered entity, which include a. healthcare clearinghouses. b. healthcare providers. c. healthcare plans. d. All the options are correct.

ANS: D

With the implementation of medical records from paper charts to electronic medical charts, the HIPAA allows patient information to be shared or transferred electronically to any covered entity.

OBJ: 1. Outline the purpose of medical records.

Records

TOP: Purpose of Medical

11. Clinical documentation that is electronic and is collected beyond one healthcare provider

is called a/an a. electronic health record. b. electronic medical record. c. covered entity. d. SOAP format.

ANS: A

Electronic health records allow clinical patient information to be transmitted to other authorized healthcare providers for a patient in a secure manner.

OBJ: 1. Outline the purpose of medical records.

Records

TOP: Purpose of Medical

12. In the SOAP format, the ―O‖ would include a. chief complaint. b. history of present illness. c. past family history. d. information that the healthcare provider can measure.

ANS: D

SOAP format allows the healthcare provider a guideline to consistently document the patient’s visit especially documenting information that can be measured such as vital signs.

OBJ: 3. Describe the importance of correct documentation in a patient medical record.

TOP: Documentation of Patient Encounters

13. In the SOAP format, the ―A‖ would include a. information that the healthcare provider can measure. b. summation of the healthcare provider’s impression including the possible

diagnosis. c. past family history. d. chief complaint.

ANS: B

The assessment in the SOAP format will provide a diagnosis based on signs and symptoms from the patient’s visit to the healthcare provider.

OBJ: 3. Describe the importance of correct documentation in a patient medical record.

TOP: Documentation of Patient Encounters 14. Which of the following is an appropriate guideline in making a correction on an electronic

patient chart? a. Delete the change on the patient’s chart on the computer and retype the correct information. b. Making an appropriate change by adding an addendum with the appropriate healthcare provider signing and dating the change. c. It is not important to write a change if it is a minor omission or minor information. d. A narrative entry or comment should be added to the medical record indicating an error has been made and corrected.

ANS: D

Accurate documentation is of the utmost importance with the medical records of a patient as it is a legal document that will uphold in court. Therefore, all mistakes or omissions must be documented. Most electronic medical record systems allow error corrections.

OBJ: 3. Describe the importance of correct documentation in a patient medical record.

TOP: Corrections and Amendments to the Medical Record 15. All the following have a specific retention period of patient records as outlined by state

government laws except a. Medi-Cal patients. b. private insurers, such as Anthem Blue Cross Insurance. c. Knox-Keene Act. d. Workers’ Compensation Cases.

ANS: B

Certain government health plans require that patient records be kept for a specific length of time. Refer to specific states for their guidelines of retention of medical records. Private insurance does not have the same guidelines.

OBJ: 4. Name key guidelines for storage, retention, and maintenance of medical records.

TOP: Retention of Medical Records 16. The acronym HIPAA stands for a. Health Insurance to Protect and Advance Act. b. Health Insurance Portability and Accountability Act. c. Health Insurance Privacy and Accountability Act.

d. Health Insurance Portability and Accuracy Act. ANS: B

Health Insurance Portability and Accountability Act passed to protect patient’s information, to prevent fraud in healthcare, to help medical savings plans for employees, and make simple the administration of health insurance.

OBJ: 6. Discuss HIPAA privacy and security for medical records.

TOP: Health Insurance Portability and Accountability Act of 1996 17. HIPAA consists of a. three titles. b. four titles. c. five titles. d. six titles.

ANS: C

The Title I through V of HIPAA consist of different levels of protecting the patient with portability, renewability, preventing fraud and abuse, tax-related health provisions governing medical savings accounts, enforcement of group insurance requirements, as well as revenue that offsets tax deductions for employees.

OBJ: 6. Discuss HIPAA privacy and security for medical records.

TOP: Health Insurance Portability and Accountability Act of 1996 18. Which of the following meets the guideline(s) for physical safeguards for HIPAA? a. Keeping workstations with PHI out of high traffic areas b. Restricting access to client data from third parties using the facility equipment c. Preventing the visibility of computer screen to unauthorized users d. All the options are correct.

ANS: D

According to HIPAA guidelines for physical safeguards, it is important for all healthcare professionals and organizations to be mindful of keeping all patient records from the public view. This includes physical monitoring and access to protected health information.

OBJ: 7. Discuss the different types of safeguards for medical records.

TOP: Health Insurance Portability and Accountability Act of 1996 19. Based on the guidelines for HIPAA’s Security Rule, which of the following area would

need to be secure to protect patient’s information? a. Data storage b. Faxes c. Computer systems d. All the options are correct.

ANS: D

Healthcare organization must follow the guidelines regarding the Security Rule to safeguard all technical information that is sent through electronic devices.

OBJ: 7. Discuss the different types of safeguards for medical records.

TOP: Health Insurance Portability and Accountability Act of 1996

20. In which of the following situations would patients have to authorize to release their

medical records? a. The patient is being charged in and assault, and there is a court order. b. The patient is referred by his family physician to a specialist for additional care. c. The patient injured himself on the job and is applying for workers’ compensation. d. The patient was in contact with a person diagnosed with tuberculosis.

ANS: B

There are a few exceptions that would allow for the release of medical records without the patient's authorization or a signed release form from the patient. In most cases, patients must sign a release if a patient transfers to another healthcare provider. The new healthcare provider may obtain the medical records only after the patient signs a release form.

OBJ: 5. Discuss the confidentiality and consent forms for release of medical records.

TOP: Privacy Rule 21. According to the HIPAA Privacy Rule, which of the following is considered PHI? a. Name of the patient’s healthcare provider b. Name of the patient’s employer c. Billing information from the hospital d. A record of blood pressure reading without identifying information ANS: C

Protected health information (PHI) is all private patient information and must be kept secure at all times. It includes any information about a patient’s health status, health care, or payment for health services that is created or collected by a covered entity and can be linked to a specific individual.

OBJ: 6. Discuss HIPAA privacy and security for medical records.

TOP: Health Insurance Portability and Accountability Act of 1996 22. Violators of the HIPAA Privacy Rule could face a. criminal penalties. b. civil penalties. c. local penalties. d. criminal and civil penalties.

ANS: D

When a patient’s private information is compromised, the violator may face criminal and civil penalties.

OBJ: 6. Discuss HIPAA privacy and security for medical records.

TOP: HIPAA Violation Penalties 23. A psychiatrist improperly accessed the protected health information of celebrities and

other patients and sold the information to the press. He was sentenced to four-months.

What category would this HIPAA violation be? a. Category 1 b. Category 2 c. Category 3 d. Category 4

ANS: D

A Category 4 violation of the HIPAA rule is when there is willful neglect and not attempt had been made to correction the violation. Penalties may include a penalty and jail time.

OBJ: 6. Discuss HIPAA privacy and security for medical records.

TOP: HIPAA Violation Penalties 24. Which of the following patient information would not be included in the patient intake

form or registration form of the medical records? a. Demographics b. Medical history c. Communication d. Financial records ANS: D

Often, the financial records are kept separate from the patient’s medical records to safeguard against data breaches.

OBJ: 2. List the organization and contents within a medical record.

TOP: Elements of Medical Records 25. Health plans, healthcare clearinghouses, and healthcare providers under HIPAA who

electronically transmit any health information are considered a. A double lock system. b. covered entities. c. protected health information. d. Continuity of Care Record.

ANS: B

Covered entities are defined in the HIPAA rules as health plans, healthcare clearinghouses, and healthcare providers who electronically transmit any health information.

OBJ: 1. Outline the purpose of medical records.

Records

TOP: Purpose of Medical

Chapter 10: Mandatory Reporting and Public Health Elsevier Inc: Legal and Ethical Issues for Health Professions, 5th Edition MULTIPLE CHOICE 1. Which of the following is NOT subject to mandatory reporting? a. Adoptions b. Abuse c. Deaths d. Births ANS: A

Although these mandatory reporting guidelines may vary by state, prompt reporting of births, deaths, communicable diseases, assaults or criminal acts, abuse and substance abuse are mandatory. Adoption is not required to be reported.

OBJ: 1. Describe what is meant by mandatory reporting duties required of healthcare professionals.

TOP: Mandatory Reporting Duties 2. Why are mandatory reports required in the healthcare field? a. For legal purposes to prevent malpractice b. For statistical data c. For the welfare of the general public d. For insurance purposes ANS: C

Statutory report duties, in the healthcare field, refer mainly to the responsibility of healthcare providers to report areas of vital information to the necessary agencies as deemed necessary primarily for the welfare of the general public. These may vary from state to state.

OBJ: 1. Describe what is meant by mandatory reporting duties required of healthcare professionals.

TOP: Mandatory Reporting Duties 3. At the federal level, who mandates that communicable diseases are reported? a. OSHA b. CMS c. DHHS d. CDC ANS: D

The Centers for Disease Control and Prevention (CDC) is the national public health agency in the US. Since diseases can be quickly transmitted to many individuals and may endanger the general public, the CDC can mandate healthcare professionals and organizations to notify the proper authorities to prepare, prevent, or limit the spread of the disease and illness.

OBJ: 2. Explain the reasons for documentation of vital statistics.

TOP: Vital Statistics and Public Health Records 4. Who is ultimately responsible for verifying that the information reported is accurate and

complete? a. Office manager b. Physician c. Nurse d. Patient ANS: B

Although many healthcare professionals may assist in the completion and documentation of these events, it is ultimately the legal responsibility of the physician or provider signing the documentation to verify that the information is accurate and complete.

OBJ: 2. Explain the reasons for documentation of vital statistics.

TOP: Vital Statistics and Public Health Records 5. Where are births legally recorded?

a. b. c. d.

The local county clerk’s office The physician’s office of the birth mother The hospital The Department of Health and Human Services

ANS: A

After the birth certificate is signed by the physician or provider who assisted in the birth, it is taken by the local county clerk and recorded, and an official birth certificate is issued for the individual. Depending on the local requirements, the form for filing of births may be more extensive to include the health of the mother of the child and/or father if known.

OBJ: 3. Explain the importance of birth and death certificates and describe when a physician, medical examiner, or coroner needs to sign one.

TOP: Vital Statistics and Public Health Records 6. Which of the following would you not need a death certificate for? a. For comparison to the certificate of live birth b. For banking and other financial purposes c. For transfer of pension benefits d. For statistical purposes and medical research ANS: A

The death certificate is needed for proof of death for many reasons. Most often, for banking purposes, insurance companies, and Internal Revenue Service or Social Security notification, just to name a few. The information provided must be accurate and properly documented for the surviving family to manage the estate of the deceased and finalize the settlement of their responsibilities.

OBJ: 3. Explain the importance of birth and death certificates and describe when a physician, medical examiner, or coroner needs to sign one.

TOP: Vital Statistics and Public Health Records 7. In which instance is there no requirement for a HIPAA release from the patient? a. When a patient tells the provider they do not care about disclosing personal

information b. When a patient’s family member calls the hospital after hearing the family member

was admitted due to a car accident c. When a patient is involuntarily admitted into a psychiatric hospital d. When a patient is diagnosed with active tuberculosis ANS: D

HIPAA permits covered entities and their authorized business associates to disclose protected health information without the patient's authorization for specified public health purposes, such as preventing or controlling diseases, injuries, or disabilities.

OBJ: 4. Identify the communicable and sexually transmitted diseases that must be reported.

TOP: Vital Statistics and Public Health Records 8. If a patient presents with chest pains and tells you she was punched in the chest by her

spouse, what type of abuse is this considered? a. Physical b. Psychological

c. Verbal/emotional d. Sexual ANS: A

Physical abuse includes pushing, hitting, shoving and punching, biting or choking, and physically trapping or impeding movement.

OBJ: 5. Describe child, spousal, elder, and sexual abuse, and possible signs of abuse.

TOP: Abuse 9. What type of abuse is criticizing and belittling considered? a. Verbal/emotional b. Psychological c. Physical d. Sexual ANS: A

Verbal/emotional abuse includes criticizing, degrading, swearing, blaming, and any attacks that harm self-esteem.

OBJ: 5. Describe child, spousal, elder, and sexual abuse, and possible signs of abuse.

TOP: Abuse 10. A patient tells you that her spouse has been preventing her from leaving the house without

him, and she has been unable to see her family or friends. What type of abuse is this? a. Verbal/emotional b. Psychological c. Physical d. Sexual ANS: B

Psychological abuse includes throwing things, punching walls, breaking things, stalking, invading privacy or space, sabotaging plans or efforts of others—all to create a sense of fear.

OBJ: 5. Describe child, spousal, elder, and sexual abuse, and possible signs of abuse.

TOP: Abuse 11. Which of the following is not true of mandatory reporters? a. They are often the people who report cases of child abuse. b. Almost every state has laws that designate specific professions as mandatory

reporters. c. Anyone in the healthcare profession is required to report incidents of child abuse. d. They must have proof of child abuse before reporting.

ANS: D

Although the circumstances under which a mandatory reporter must make a report vary by state, a reporter generally must be made when the reporter suspects or has reason to believe that a child has been abused or neglected. When reporting an incident, the reporter does not have to provide proof that abuse or neglect has occurred.

OBJ: 5. Describe child, spousal, elder, and sexual abuse, and possible signs of abuse.

TOP: Abuse 12. A birth certificate may be used for all the following, except a. acquiring a Social Security number. b. registering for school. c. filing for a Certificate of Live Birth. d. applying for a marriage license.

ANS: C

A Certificate of Live Birth is an unofficial birth certificate. The Certificate of Live Birth must be sent to the Office of Vital Statistics or state registrar to be verified before an official birth certificate is issued.

OBJ: 3. Explain the importance of birth and death certificates and describe when a physician, medical examiner, or coroner needs to sign one.

TOP: Vital Statistics and Public Health Records 13. If you suspect child abuse and do not report it, what are the potential consequences? a. You may endanger the child further. b. You may be held legally responsible for further abuse. c. You may lose status with the child as a trustful person. d. All the options are correct.

ANS: D

There have been cases in which physicians were held legally responsible for further abuse and injuries sustained by children when they did not report the cases to the authorities when ―battered child syndrome‖ was suspected; not reporting abuse that may be happening can endanger the child further. A physician is also a trusted person by a child, and if he or she tells you he or she is being abused and you do not report it, you will lose the child’s trust.

OBJ: 5. Describe child, spousal, elder, and sexual abuse, and possible signs of abuse.

TOP: Abuse 14. A death certificate includes all the following information, except a. religious affiliation. b. name of decedent’s parents. c. final disposition. d. cause of death.

ANS: A

The death certificate provides important information about the decedent, or deceased individual, such as age, sex, race, education, date of death, his or her parents, and, if married, the name of the spouse; the circumstances and cause of death; and final disposition, such as burial or cremation. Religious affiliation is not included.

OBJ: 3. Explain the importance of birth and death certificates and describe when a physician, medical examiner, or coroner needs to sign one.

TOP: Vital Statistics and Public Health Records 15. A coroner or medical examiner would complete the death certificate except in cases of a. suicide.

b. heart attack at the hospital. c. homicide. d. the patient died alone in his home.

ANS: B

A coroner or a medical examiner would complete the death certificate in the following cases: a criminal act, such as a homicide; a lack of attendance at death; a patient found dead at home; accidental deaths; suicides; the cause of death is unknown; and when a postmortem needs to be performed.

OBJ: 3. Explain the importance of birth and death certificates and describe when a physician, medical examiner, or coroner needs to sign one.

TOP: Vital Statistics and Public Health Records 16. The Older Americans Act of 1987 protects adults older than age 60 from all the following

except a. abandonment. b. lack of healthcare. c. abuse. d. exploitation.

ANS: B

The Older Americans Act (OAA) of 1987 was designed to protect adults older than age 60 from abuse, neglect, abandonment, and exploitation and made it a reportable offense in most states. The OAA does not specifically address lack of healthcare unless it is related to neglect from another individual, such as a family member.

OBJ: 5. Describe child, spousal, elder, and sexual abuse, and possible signs of abuse.

TOP: Abuse 17. Intimate partner violence may occur between which parties except a. a mother and a daughter. b. a wife and husband. c. two females in a domestic and sexual relationship. d. a male and female who are dating.

ANS: A

Intimate partner violence is a form of domestic violence but a more inclusive term that includes a relationship between two people, with or without a marital or sexual relationship. It may occur between former partners or spouses and can occur between heterosexual or same-sex couples. Domestic violence between a mother and daughter is a type of nonintimate partner violence.

OBJ: 5. Describe child, spousal, elder, and sexual abuse, and possible signs of abuse.

TOP: Abuse 18. In intimate partner violence, which type of abuse often starts first? a. Emotional b. Physical c. Financial d. Stalking

ANS: A

Although two or more types of abuse are commonly present in intimate partner violence, emotional abuse often precedes, occurs with, and/or follows physical or sexual abuse in the relationship.

OBJ: 5. Describe child, spousal, elder, and sexual abuse, and possible signs of abuse.

TOP: Abuse 19. What drug schedule are amphetamines considered? a. Schedule I b. Schedule II c. Schedule III d. Schedule IV ANS: B

Schedule II drugs have a high potential for abuse and include some narcotics, amphetamines, and depressants, such as pentobarbital. However, they may be prescribed by an authorized healthcare provider.

OBJ: 6. Explain addiction and regulations of controlled substances and the U.S. Drug Enforcement Administration (DEA) schedule of drugs.

TOP: Substance Abuse 20. What drug schedule is diazepam considered? a. Schedule I b. Schedule II c. Schedule III d. Schedule IV ANS: D

Schedule IV drugs have a lower potential for abuse than Schedule III drugs, and include some depressants, such as diazepam. It is dispensed by prescription only.

OBJ: 6. Explain addiction and regulations of controlled substances and the U.S. Drug Enforcement Administration (DEA) schedule of drugs.

TOP: Substance Abuse 21. What schedule drugs are reparations containing limited quantities of narcotics (e.g., cough

medicine)? a. Schedule II b. Schedule III c. Schedule IV d. Schedule V ANS: D

Schedule V drugs have low potential for abuse and may be sold over the counter (OTC) by registered pharmacist depending on state laws. Preparations containing limited quantities of narcotics are generally cough and antidiarrheal preparations, such as cough syrups with codeine, diphenoxylate hydrochloride with atropine sulfate (Lomotil), and attapulgite (Parepectolin).

OBJ: 6. Explain addiction and regulations of controlled substances and the U.S. Drug Enforcement Administration (DEA) schedule of drugs.

TOP: Substance Abuse

22. Which Act enabled the federal government to add substances to the Schedules of

controlled substances under the Convention of Controlled Substances? a. The Chemical Diversion and Trafficking Act of 1988 b. The Controlled Substances Penalties Amendments Act of 1984 c. The Psychotropic Substances Act of 1978 d. The Domestic Chemical Diversion and Control Act of 1993 ANS: C

This Act made it easier for the federal government to add drugs to the various schedules of controlled substances under the Convention of Controlled Substances, which was a United Nations treaty designed to control the illegal trade of psychoactive substances.

OBJ: 6. Explain addiction and regulations of controlled substances and the U.S. Drug Enforcement Administration (DEA) schedule of drugs.

TOP: Substance Abuse 23. Which Act was created to combat designer drugs by allowing the DEA to treat any

substance that is similar to an illegal drug as if it were a Schedule I drug? a. The Domestic Chemical Diversion and Control Act of 1993 b. The Federal Analog Act c. The Chemical Diversion and Trafficking Act of 1988 d. The Controlled Substances Penalties Amendments Act of 1984 ANS: B

The DEA battled designer drugs that were found on the street but could not treat them as an illegal drug because they were not yet known to be on the Schedule of Controlled drugs, so this Act allowed them to treat substantially similar drugs as such.

OBJ: 6. Explain addiction and regulations of controlled substances and the U.S. Drug Enforcement Administration (DEA) schedule of drugs.

TOP: Substance Abuse

Chapter 11: Conflict Management Elsevier Inc: Legal and Ethical Issues for Health Professions, 5th Edition MULTIPLE CHOICE 1. Which is not an advantage of alternative dispute resolution? a. It is less expensive. b. It involves less publicity. c. No attorneys are allowed. d. There are no long court delays.

ANS: C

Attorneys are allowed in alternative dispute resolutions. This method of conflict resolution is usually less expensive and less public, and there are usually no long court delays.

OBJ: 6. Define alternative dispute resolution.

TOP: Conflict Resolution

2. Which of the following is not a technique in alternative dispute resolution? a. Negotiation b. Mediation c. Arbitration

d. Litigation ANS: D

Alternative dispute resolution (ADR) is the procedure for settling disputes by means other than litigation, which may be costly and time consuming.

OBJ: 7. Identify the components of alternative dispute resolution.

TOP: Conflict Resolution 3. When people bargain for what they want, which resolution method are they using? a. Mediation b. Negotiation c. Arbitration d. Communication ANS: B

Negotiation is any communication used in an attempt to achieve a goal, approval, or action by another.

OBJ: 7. Identify the components of alternative dispute resolution.

TOP: Conflict Resolution 4. The process by which a neutral third party facilitates dispute resolution is called a. mediation. b. negotiation. c. arbitration. d. communication.

ANS: A

Mediation is the process in which a neutral third party facilitates and assists the parties in resolving a dispute or conflict.

OBJ: 7. Identify the components of alternative dispute resolution.

TOP: Conflict Resolution 5. If a physician and patient need a controlled, structured setting, they may wish to try which

of the following? a. Mediation b. Negotiation c. Arbitration d. Communication ANS: C

Arbitration is the process of resolving issues in conflict in a more structured setting like formal litigation.

OBJ: 7. Identify the components of alternative dispute resolution.

TOP: Conflict Resolution 6. Which is not one of the usual stages of mediation? a. Identification of party’s interests b. Submission of documents to a court for approval

c. Information gathering d. Negotiation and selection of appropriate resolution ANS: B

Courts are not involved in the mediation process.

OBJ: 7. Identify the components of alternative dispute resolution.

TOP: Conflict Resolution 7. Which is the least adversarial method of alternative dispute resolution? a. Negotiation b. Mediation c. Facilitation d. Arbitration ANS: B

The mediation process is commonly used to resolve medical malpractice claims, personal injury claims, and employee disputes. It is the least adversarial method of alternative dispute resolution and can assist the parties to identify the real issues and options for settlement. Ultimately, the parties are able to maintain control of the outcome.

OBJ: 7. Identify the components of alternative dispute resolution.

TOP: Conflict Resolution 8. Which of the following is considered a conflict? a. Two co-workers going out to lunch but wanting to eat at different restaurants b. A physician refusing to give a phlebotomist a day off that he requested two months

ago c. A supply vendor meeting with an office manager about an increase in price d. A patient receiving a bill from a hospital with additional costs ANS: B

Conflict results from incompatible or opposing needs, drives, wishes, or external or internal demands. As opposed to a disagreement, which is simply a failure to agree, a conflict involves a perceived threat to an individual’s needs, interests, or concerns because of a disagreement.

OBJ: 6. Define alternative dispute resolution.

TOP: Conflict Resolution

9. When you feel rage after a conflict, this is considered what type of conflict response? a. Emotional b. Cognitive c. Physical d. None of the options ANS: A

These are the feelings we experience in conflict, ranging from anger and fear to despair and confusion. Emotional responses are often misunderstood, as people tend to believe that others feel the same as they do. Thus, differing emotional responses are confusing and, at times, threatening.

OBJ: 3. Identify the emotional, cognitive, and physical responses to conflict.

TOP: Emotional, Cognitive, and Physical Responses to Conflict 10. Two different hospitals decide to have a contest to see which hospital can raise the most

funds for a local cancer research center. This is considered a. competition. b. negotiation. c. positive conflict. d. negative conflict.

ANS: C

Positive conflict is the idea that healthy discussion can happen in the face of a disagreement, regardless of differing personalities, education levels, or responsibilities.

Positive conflict can be utilized in many ways. Positive conflict can inspire creativity and ―thinking outside the box‖ to resolve a problem.

OBJ: 1. Define conflict, differentiating between positive and negative conflict.

TOP: Positive Versus Negative Conflict 11. A patient enters a physician’s office very upset about her bill. After speaking to the office

manager, she is still upset and threatens her. This is considered a. positive conflict. b. negative conflict. c. disagreement. d. negotiation.

ANS: B

Negative conflict is when conflict devolves into disruptive behaviors or violence, usually attributable to the lack of trust, communication, and discussion. The important thing to note is that if conflict is identified and managed early, it can lead to a positive result.

OBJ: 1. Define conflict, differentiating between positive and negative conflict.

TOP: Positive Versus Negative Conflict 12. Mrs. Smith arrives for her appointment and is told the physician is running late on his

appointments. Despite a waiting room full of patients, she demands to receive care before anybody else. What type of conflict behavioral style is this? a. Competing b. Accommodating c. Avoiding d. Compromising ANS: A

Competing is a style in which an individual’s own needs are advocated over the needs of others. It relies on an aggressive style of communication, low regard for future relationships, and the exercise of coercive power.

OBJ: 2. Identify various conflict behavioral styles.

Styles

TOP: Conflict Behavioral

13. A nurse is ignoring the wishes of her coworkers and the policies of the institution, and

many of her coworkers are fed up with her antics. Another nurse encourages her coworkers to ―give it time, it will blow over.‖ What type of conflict behavioral style is this? a. Competing b. Accommodating c. Avoiding d. Compromising ANS: C

Avoiding is a common response to the negative perception of conflict. ―Give it time, it will blow over,‖ we say to ourselves. But, generally, all that happens is that feelings get pent up, views go unexpressed, and the conflict festers until it becomes too big to ignore.

OBJ: 2. Identify various conflict behavioral styles.

Styles

TOP: Conflict Behavioral

14. A physician really needs the day off for an important family event and always works for

other physicians when they need to be out of the office. No other physician in the practice will work for him, so he misses his family event. What type of conflict behavioral style is this? a. Competing b. Accommodating c. Avoiding d. Compromising ANS: B

Accommodating, also known as smoothing, is the opposite of competing. People using this style allow the group’s needs to take priority over their own in an effort to preserve the relationship.

OBJ: 2. Identify various conflict behavioral styles.

Styles

TOP: Conflict Behavioral

15. There are only two nurses in a physician’s office, and they both want Friday off. The

office needs to have at least one nurse on duty, so they agree to each work a half day to make sure the office is covered. What type of conflict behavioral style is this? a. Competing b. Accommodating c. Collaborating d. Compromising ANS: C

Collaborating is the pooling of individual needs and goals toward a common goal. Often called ―win-win problem-solving,‖ collaboration requires assertive communication and cooperation in order to achieve the best solution. It offers the chance for agreement, the integration of needs, and the potential to exceed the expectations of the conflict resolution.

OBJ: 2. Identify various conflict behavioral styles.

Styles

TOP: Conflict Behavioral

16. When you are thinking about a conflict and your inner voice is talking to yourself, what

type of conflict response is this? a. Emotional response b. Cognitive response c. Physical response d. Positive response ANS: B

These are our ideas and thoughts about a conflict, often present as our inner voice or internal observer in the midst of a situation. Such differing thoughts contribute to emotional and behavioral responses, where self-talk can promote either a positive or a negative feedback loop in the situation.

OBJ: 3. Identify the emotional, cognitive, and physical responses to conflict.

TOP: Emotional, Cognitive, and Physical Responses to Conflict 17. You break out in a sweat after a conflict. What type of conflict response is this? a. Emotional response b. Cognitive response c. Physical response d. Positive response ANS: C

Physical responses, or ―fight or flight‖ responses, are those we experience in high-anxiety situations, and they may be managed through stress management techniques. Establishing a calmer environment in which emotions can be managed is more likely if the physical response is addressed effectively.

OBJ: 3. Identify the emotional, cognitive, and physical responses to conflict.

TOP: Emotional, Cognitive, and Physical Responses to Conflict 18. Personal conduct, whether verbal or physical, that affects patient care negatively is called a. competing. b. negative conflict. c. disruptive behavior. d. accommodating.

ANS: C

Disruptive behavior is also considered conduct that interferes with one’s ability to work with other members of the healthcare team. Of course, physicians are not the only members of the healthcare team to exhibit disruptive behavior, and the challenge is to find a way of addressing any disruptive behavior in healthcare, whether by healthcare workers or patients.

OBJ: 4. Define disruptive behavior.

TOP: Disruptive Behavior

19. Many healthcare facilities and organizations are taking action to prevent and address

disruptive behavior. This includes all the following except a. offering counseling and other employee services b. eliminating performance reviews for employees c. creating a zero-tolerance policy for severe offences

d. taking swift action to prevent lawsuits ANS: B

Many healthcare organizations are taking a variety of actions to combat disruptive behavior, such as adopting a zero-tolerance policy against severe offences, such as sexual harassment and physical violence; and offering counseling, education, and training.

OBJ: 4. Define disruptive behavior.

TOP: Disruptive Behavior

20. What accrediting organization requires healthcare organizations to establish policies and

procedures for conflict management? a. The Joint Commission b. American Medical Association c. OSHA d. AHIMA ANS: A

The Joint Commission (TJC) references conflict management in its leadership standards, placing responsibility for implementation and application of conflict management variously on the organization, its governing body, and its leaders.

OBJ: 5. Compare and contrast the different types of conflict management and conflict resolution.

TOP: Conflict Management 21. The Joint Commission’s standards of performance, in regard to conflict management, refer

to a. b. c. d.

a system for resolving conflicts among individuals in a physician’s office. a system for resolving conflicts among individuals in a nursing home. a process for managing people who argue. a process for managing conflict among leadership groups.

ANS: D

The standards and their elements of performance refer to: (1) ―a system for resolving conflicts among individuals working in the hospital,‖ (2) ―an ongoing process for managing conflict among leadership groups,‖ and (3) ―a process for managing disruptive and inappropriate behavior.‖ OBJ: 5. Compare and contrast the different types of conflict management and conflict resolution.

TOP: Conflict Management 22. In 2008, the Joint Commission identified that the lack of which skills was the root cause

for disruptive behavior? a. Communication b. Conflict management c. Professional d. Negotiation ANS: B

The Joint Commission addressed this by recommending interventions such as educating team members, encouraging interprofessional dialog, and developing an organizational process for responding to intimidating and disruptive behavior.

OBJ: 5. Compare and contrast the different types of conflict management and conflict resolution.

TOP: Conflict Management 23. Which of the following type of alternative dispute resolution is most like a court system? a. Arbitration b. Facilitation c. Mediation d. Negotiation ANS: A

Arbitration is the process of resolving issues in conflict in a more structure setting, similar to formal litigation.

OBJ: 7. Identify the components of alternative dispute resolution.

TOP: Conflict Resolution 24. Which is not an example of disruptive behavior? a. Profane language b. Sexual comment c. Compliment to a patient d. Throwing a chart ANS: C

As long as the compliment is not inappropriate, complimenting a patient is not considered disruptive. A simple, ―You’re looking better today,‖ is not disruptive.

OBJ: 4. Define disruptive behavior.

TOP: Disruptive Behavior

Chapter 12: Birth and Life Elsevier Inc: Legal and Ethical Issues for Health Professions, 5th Edition MULTIPLE CHOICE 1. The legal process or action of when a minor has achieved independence from his or her

parents is called a. surrogacy. b. emancipation. c. eugenics. d. ethics.

ANS: B

Emancipation is the legal process or action of when a minor has achieved independence from his or her parents.

OBJ: 5. Define what an emancipated minor is and their rights in health care.

TOP: Emancipated Minors 2. In which case was it revealed that 100,000 to 150,000 poor people were being sterilized

each year under federally funded programs? a. Roe v. Wade b. Buck v. Bell c. Madrigal v. Quilligan

d. Relf v. Weinberger ANS: D

In 1974, the Southern Poverty Law Center filed a lawsuit on behalf of the Relf sisters, revealing that 100,000 to 150,000 poor people were being sterilized each year under federally funded programs.

OBJ: 2. Describe the role of eugenics in forced sterilization programs in the United States.

TOP: Ethical Issues in Reproductive Health 3. Any device or act whose purpose is to prevent a woman from becoming pregnant is

considered a. a contraceptive. b. an abortion. c. artificial insemination d. eugenics.

ANS: A

Any device or act whose purpose is to prevent a woman from becoming pregnant can be considered as a contraceptive.

OBJ: 3. Discuss the legal cases related to contraceptives in reproductive health.

TOP: Contraceptives 4. At what age does a minor generally achieve independence or age of majority from his or

her parents? a. 18 years of age b. 21 years of age c. 16 years of age d. 25 years of age ANS: A

Emancipation is the legal process or action of when a minor has achieved independence from his or her parents. Generally, this has been on the condition of a person reaching the age of 18, or age of majority, and is free from the custody of his or her parents.

OBJ: 5. Define what an emancipated minor is and their rights in health care.

TOP: Emancipated Minors 5. A male is forced to undergo a vasectomy. This is considered a. voluntary sterilization. b. involuntary sterilization. c. contraception. d. abortion.

ANS: B

Involuntary sterilization is usually ordered by a court. When a patient chooses to end his or her ability for reproduction, it is considered voluntary sterilization. Contraception is a temporary way to end reproduction abilities. Abortions end the life of the fetus.

OBJ: 2. Describe the role of eugenics in forced sterilization programs in the United States.

TOP: Sterilization

6. Which of the following key question is most commonly raised in debates about voluntary

abortion. a. When does human life begin? b. How old must a patient be to receive a voluntary abortion? c. Should parents be told about a minor requesting an abortion? d. Should the father of the child have to approve the abortion?

ANS: A

The age-old argument used in the debate about abortion has always been when human life begins—upon conception, in the embryo, in the fetus, or not until the child is born.

Although the age of the patients, minor children’s privacy rights, and the rights of the father are arguments used regarding abortion, they are not the key argument in the subject of abortion.

OBJ: 4. Discuss the legal cases related to abortion rights and access and Roe v. Wade.

TOP: Abortion 7. Implanting male sperm into the woman’s vagina to aid in conception is called a. in vitro fertilization. b. using a surrogate. c. artificial insemination. d. sterilization.

ANS: C

When a patient is unable to conceive a child by natural means, the patient may choose artificial insemination, which means implanting sperm into a woman’s vagina. The sperm may come from the woman’s partner, husband, or from a donor.

OBJ: 1. Identify two methods of artificial conception and discuss associated key ethical questions.

TOP: Assisted Conception Issues 8. An ethical dilemma of artificial insemination can be a. the woman may have too many babies as a result. b. full consent was not obtained by the partner for implantation. c. the woman may be too old. d. the couple breaks up.

ANS: B

For the healthcare provider, the best protection to avoid an ethical dilemma of artificial insemination is to ensure he or she has informed consent from both the patient and the partner.

OBJ: 1. Identify two methods of artificial conception and discuss associated key ethical questions.

TOP: Assisted Conception Issues 9. A woman’s ova are harvested and combined with a partner’s sperm cells and grown

outside the womb, and then implanted into the uterus later. This is called a. in vitro fertilization. b. using a surrogate.

c. artificial insemination. d. sterilization.

ANS: A

In vitro fertilization is used to assist couples who have difficulty in conception, and it involves combining the ova and sperm outside of the womb. Once the fertilization has occurred, they are placed back inside the uterus. It is now a commonly accepted procedure.

OBJ: 1. Identify two methods of artificial conception and discuss associated key ethical questions.

TOP: Assisted Conception Issues 10. In the argument of when life begins, which of the following is not part of the argument? a. The moment the sperm and ovum are joined b. When the fertilized egg becomes an embryo at 8 to 14 days c. When it becomes a fetus between the 18th and 19th week d. When the child is born ANS: C

An embryo becomes a fetus before the 18th and 19th week. It generally happens between the 8th and 9th week, which is one of the arguments of when life begins. Other arguments include life beginning when fertilization occurs, when the fertilized egg becomes an embryo, or when the child is born.

OBJ: 4. Discuss the legal cases related to abortion rights and access and Roe v. Wade.

TOP: Abortion 11. The Baby M case involved a. in vitro fertilization. b. using a surrogate. c. artificial insemination. d. sterilization.

ANS: B

When Mary Beth Whitehead agreed to be a surrogate mother for a couple, the Supreme Court granted parental rights to her, but awarded physical custody to the family who contracted the surrogate motherhood.

OBJ: 1. Identify two methods of artificial conception and discuss associated key ethical questions.

TOP: Assisted Conception Issues 12. A nurse practicing in a private hospital may refuse to participate in performing in vitro

fertilization due to ―ethical, moral or professional reasons.‖ This is an example of the nurse utilizing his or her right under a. the conscience clause. b. informed consent. c. his or her participation in therapeutic research. d. conflict of interest.

ANS: A

The conscience clause may constitutionally permit private hospitals and healthcare facilities and physicians, nurses, and other employees to refuse to perform or participate in medical procedures for ―ethical, moral, religious or professional reasons.‖ However, in public hospitals and healthcare facilities, the conscience clause does not apply.

Additionally, some hospitals may have their own conscientious clause where a healthcare professional may refuse to perform or participate in a procedure as long as there is another staff member to take over the duty.

OBJ: 1. Identify two methods of artificial conception and discuss associated key ethical questions.

TOP: Abortion 13. Which of the following Supreme Court decisions dealt with involuntary or coerced

sterilization? a. Roe v. Wade b. Hobby Lobby v. Burwell c. Planned Parenthood v. Casey d. Buck v. Bell ANS: D

In Buck v. Bell, the Supreme Court ruling led to the sterilization of 65,000 Americans with mental illness or developmental disabilities from the 1920s to the 1970s.

OBJ: 3. Describe the role of eugenics in forced sterilization programs in the United States.

TOP: Ethical Issues in Reproductive Health 14. Which human organ is the most commonly transplanted? a. Heart b. Kidney c. Liver d. Pancreas ANS: B

Organs that can be donated include the liver, kidney, pancreas, heart, and many others, with kidneys being the most commonly transplanted and in the greatest need.

OBJ: 6. Describe ethical issues associated with organ donation and transplantation.

TOP: Ethical Issues in Organ Donation and Transplantation 15. Which of the following ethical principles are involved with organ allocations? a. Justice b. Respect for persons c. Utility d. All the options are correct.

ANS: D

The three ethical principles that govern organ allocations policies are: ―utility (doing good and avoiding harm); justice; and respect for persons.‖ OBJ: 6. Describe ethical issues associated with organ donation and transplantation.

TOP: Ethical Issues in Organ Donation and Transplantation

16. What is the main factor in deciding how to treat a patient? a. What the physician thinks should happen b. What the patient wants c. What the family of the patient wants d. What is in the best interest of the patient ANS: D

What is in the best interest of the patient’s welfare and health should always be the main factor in deciding how to treat a patient.

OBJ: 4. Discuss the legal cases related to abortion rights and access and Roe v. Wade.

TOP: Abortion 17. Which organization established the Organ Procurement and Transplant Network? a. CDC b. CMS c. FDA d. UNOS ANS: D

The United Network for Organ Sharing (UNOS) has operated the National Organ Transplant Act, which established the Organ Procurement and Transplant Network, under a contract with the Division of Transplantation in the Department of Health and Human Services.

OBJ: 6. Describe ethical issues associated with organ donation and transplantation.

TOP: Ethical Issues in Organ Donation and Transplantation 18. Which of the following factors are not taken into consideration regarding organ donation? a. Patient’s blood type b. Patient’s ethnic background c. Patient’s time on the waiting list d. Patient’s proximity to the donor ANS: B

General principles that guide the allocation of organs include a patient's medical urgency, blood, tissue and size match with the donor, time on the waiting list, and proximity to the donor. Under certain circumstance, special allowances are made for children. For example, children under age 11 who need kidneys are automatically assigned preference. Factors such as a patient's income, celebrity status, and race or ethnic background play no role in determining allocation of organs.

OBJ: 6. Describe ethical issues associated with organ donation and transplantation.

TOP: Ethical Issues in Organ Donation and Transplantation 19. Which of the following Supreme Court decisions dealt with contraception in reproductive

health? a. Roe v. Wade b. Hobby Lobby v. Burwell c. Planned Parenthood v. Casey d. Buck v. Bell

ANS: B

In Hobby Lobby v. Burwell in 2014, the Supreme Court agreed that employers that object to the coverage of contraceptives for religious or moral reasons can decline to cover contraceptives for employees or students.

OBJ: 3. Discuss the legal cases related to contraceptives in reproductive health.

TOP: Ethical Issues in Reproductive Health 20. Most medical conscience clauses evolved as a result of a. Roe v. Wade. b. the Baby M court case. c. Buck v. Bell. d. Madrigal v. Quilligan.

ANS: A

Most states have conscience clauses that describe the right of physicians and other healthcare professionals to refuse to provide services, such as abortions and euthanasia.

Most of these conscience clauses, as well as similar federal statues and professional guidelines, were enacted after the passage of Roe v. Wade in 1973 to permit physicians to opt out of performing or participating in legalized abortions.

OBJ: 4. Discuss the legal cases related to abortion rights and access and Roe v. Wade.

TOP: Abortion

Chapter 13: Death and Dying Elsevier Inc: Legal and Ethical Issues for Health Professions, 5th Edition MULTIPLE CHOICE 1. The study of the effects of death and dying is a. thorantology. b. thanatology. c. teratology. d. trichology.

ANS: B

Thanatology is the study of the effects of death and dying, especially the investigation of ways to lessen the suffering and address the needs of the terminally ill and their survivors.

OBJ: 6. Define death and describe the criteria for determination of death.

TOP: Process of Dying 2. Because there were different beliefs in the definition of death, this Act was approved in

1981 to give a consistent definition. a. Uniform Definition of Death b. Uniform Definition of the Deceased c. Uniform Determination of Death d. Uniform Determination of the Deceased ANS: C

The Uniform Determination of Death Act is a model state legislation that has since been adopted by most US states and is intended ―to provide a comprehensive and medically sound basis for determining death in all situations.‖ OBJ: 6. Define death and describe the criteria for determination of death.

TOP: Determination of Death 3. According to the UDDA, one of the determinations of death is a. irreversible interruption of circulatory and respiratory functions. b. irreversible interruption of most brain activity and respiratory functions. c. irreversible interruption of most brain activity and eye movements. d. irreversible interruption of renal and circulatory functions.

ANS: A

For legal purposes, the UDDA states that for determination of death, an individual who has sustained either (1) irreversible interruption of circulatory and respiratory functions or (2) irreversible interruption of all functions of the entire brain, including the brain stem, is dead.

OBJ: 6. Define death and describe the criteria for determination of death.

TOP: Determination of Death 4. The criteria needed that must be met before a patient can be pronounced brain dead

include all the following, except a. no pupil response. b. no blinking reflex. c. no talking. d. no grimace reflex.

ANS: C

The criteria needed to be met to pronounce a patient brain dead include no pupil response, no blinking reflex, no grimace reflex, no response to pain, no coughing or gagging reflex, and no unassisted breathing.

OBJ: 6. Define death and describe the criteria for determination of death.

TOP: Determination of Death 5. If a patient is unable to accept his or her condition is terminal, this is considered which

stage of death? a. Denial b. Anger c. Bargaining d. Depression ANS: A

Denial is usually only a temporary defense for the patient. The patient may initially be unable to accept that his or her condition is terminal, and that death is inevitable. This feeling is generally replaced with heightened awareness of possessions and individuals who will be left behind after death.

OBJ: 1. Describe the stages of grief.

TOP: Grief

6. During this stage of death, the patient begins to understand that death is certain and

imminent. a. Denial b. Anger c. Depression d. Acceptance ANS: D

During the fourth stage, the patient begins to understand that death is certain and imminent. Because of this, the patient may become silent, refuse visitors, and spend much of the time crying and grieving. It is natural to feel sadness, regret, fear, and uncertainty when going through this stage.

OBJ: 1. Describe the stages of grief.

TOP: Grief

7. During this stage of death, the patient hopes to postpone death. a. Denial b. Anger c. Bargaining d. Depression ANS: C

In the third stage, the patient hopes to somehow postpone or delay death. Usually, the negotiation for an extended life is made with a higher power in exchange for a reformed lifestyle.

OBJ: 1. Describe the stages of grief.

TOP: Grief

8. A nursing home patient suffered from several strokes over the last year. Fearing that she

would have another that would eventually incapacitate her, she meets with her physician and decides she wants a do-not-resuscitate (DNR) order. Which form should the physician use? a. Durable power of attorney b. POLST c. Living will d. Advance directive ANS: B

A physician orders for life-sustaining treatment (POLST) form is a set of medical orders completed by the healthcare provider detailing the patient’s end-of-life care. The POLST forms involves a shared decision-making process between the healthcare provider and patient with advanced or terminal illness and adheres to the patient’s goal of care. This may include the patient's wishes regarding the use of CPR, artificial nutrition, hydration, and ventilation.

OBJ: 3. Define and differentiate the various types of advance directives.

TOP: Advance Directives 9. This Act states that all patients have the right to create a living will. a. Patient Self-Determination Act b. The Right to Die Act

c. Advance Directive Act d. Durable power of attorney ANS: D

The Uniform Rights of the Terminally Ill Act states that all patients have the right to create a living will to make their wishes known in the event they are incapacitated as well as designate alternate decision makers through a healthcare proxy or durable power of attorney.

OBJ: 2. Discuss the different laws regarding end-of-life planning.

TOP: Advance Directives 10. This Act requires providers to provide information to patients regarding their rights to

make medical decisions and execute advance directives. a. Patient Self-Determination Act b. The Right to Die Act c. Advance Directive Act d. Durable power of attorney ANS: A

The Patient Self-Determination Act mandates that hospitals, nursing homes, hospice providers, and other healthcare agencies provide written information to patients regarding their rights to make medical decisions and execute advance directives.

OBJ: 2. Discuss the different laws regarding end-of-life planning.

TOP: Advance Directives 11. Patient rights include all the following, except a. the right to facilitate their own healthcare decisions. b. the right to choose how they want to die. c. the right to accept or refuse medical treatment. d. the right to make an advance healthcare directive.

ANS: B

Patients cannot choose how they want to die, but they can choose to not opt for life-saving measures.

OBJ: 2. Discuss the different laws regarding end-of-life planning.

TOP: Advance Directives 12. Who is responsible for making sure an advance directive is followed? a. The patient b. The patient’s family c. The facility providing care d. The physician ANS: C

Facilities must inquire as to whether the patient has an advance healthcare directive and make note of this in their medical records. They must also provide education to their staff and affiliates about these directives.

OBJ: 3. Define and differentiate the various types of advance directives.

TOP: Advance Directives 13. If a patient becomes incapacitated and specifies what types of medical treatment he or she

wants, this is considered a a. durable power of attorney. b. living will. c. healthcare proxy. d. do not resuscitate order.

ANS: B

A living will is a written document that specifies what types of medical treatment are desired should the individual become incapacitated. A living will can be general or very specific.

OBJ: 3. Define and differentiate the various types of advance directives.

TOP: Advance Directives 14. A patient’s brother informs you that he has the right to make medical decisions for her.

This is a a. durable power of attorney. b. living will. c. healthcare proxy. d. do not resuscitate order.

ANS: C

This is a legal document in which an individual designates another person to make healthcare decisions if he or she is rendered incapable of making his or her wishes known.

The healthcare proxy has, in essence, the same rights to request or refuse treatment that the individual would have if capable of making and communicating decisions.

OBJ: 3. Define and differentiate the various types of advance directives.

TOP: Advance Directives 15. This document allows an individual to make bank transactions and write checks to pay the

bills while an individual is medically incapacitated. a. Durable power of attorney b. Living will c. Healthcare proxy d. Do not resuscitate ANS: A

The durable power of attorney allows an individual to make bank transactions, sign Social Security checks, apply for disability, or simply write checks to pay the utility bill while an individual is medically incapacitated.

OBJ: 3. Define and differentiate the various types of advance directives.

TOP: Advance Directives 16. Hospice care can include all the following, except a. treating physical symptoms. b. providing physician-assisted suicide. c. counseling about anxiety and grief.

d. providing support to all involved for the physical and psychological stresses of

terminal illness.

ANS: B

Hospice focuses on providing a peaceful, symptom-free, and dignified transition to death for patients whose diseases are advanced beyond a cure. It does not offer euthanasia.

OBJ: 4. Identify the functions of hospice.

TOP: Hospice Care

17. Euthanasia means a. ending a life to get rid of someone. b. ending life unintentionally. c. ending life intentionally to relieve pain or suffering. d. premeditated murder.

ANS: C

Euthanasia, from the Greek term meaning ―good death,‖ refers to the practice of intentionally ending a life in order to relieve pain and suffering through medical means. It is important to note that the word ―intentionally‖ is key to the definition of euthanasia.

OBJ: 5. Discuss the different types of euthanasia and the legal and ethical issues surrounding this issue. TOP: Euthanasia 18. Euthanasia conducted when the consent of the patient is unavailable or unattained is called a. voluntary. b. nonvoluntary. c. involuntary. d. active.

ANS: B

Nonvoluntary euthanasia is illegal in all countries, but it is conducted when the consent of the patient is unavailable or unattained.

OBJ: 5. Discuss the different types of euthanasia and the legal and ethical issues surrounding this issue. TOP: Euthanasia 19. The development of formal ethics committees in hospitals and the development of advance

health directives arose out of this court case. a. Nancy Cruzan b. Terri Schiavo c. Karen Ann Quinlan d. All the options are correct.

ANS: C

The case of Karen Ann Quinlan was an important precedent in the history of the right-to-die controversy in the United States. After being diagnosed as in a persistent vegetative state, her parents asked that care be discontinued. The hospital refused.

OBJ: 5. Discuss the different types of euthanasia and the legal and ethical issues surrounding this issue. TOP: Euthanasia TRUE/FALSE

1. Hospice is used to hasten or prolong death.

ANS: F

Hospice is, more accurately, a service that provides palliative care for patients in the late stages of a terminal illness.

OBJ: 4. Identify the functions of hospice.

TOP: Hospice

2. Hospice services include paying attention to religious values.

ANS: T

Hospice pays attention to personal, religious, spiritual, and cultural values of the dying patient.

OBJ: 4. Identify the functions of hospice.

TOP: Hospice

3. Hospice does not get paid by insurance companies for their services.

ANS: F

Medicare, Medicaid, and most private insurance carriers provide hospice benefits.

OBJ: 4. Identify the functions of hospice.

TOP: Hospice

4. Anger is the third stage of grief.

ANS: F

Anger is the second stage of grief when the patient recognizes that denial cannot continue.

Anger can manifest itself in different ways. People can be angry with themselves, or with others, and especially with those who are close to them.

OBJ: 1. Describe the stages of grief.

TOP: Grief

5. If a patient is in a persistent vegetative state, he or she may have moments of wakefulness

and reflexive responses.

ANS: T

In a persistent vegetative state, the individual may have moments of assumed wakefulness and reflexive responses but has permanently lost the higher functions of the brain. Only autonomic or involuntary processes remain.

OBJ: 6. Define death and describe the criteria for determination of death.

TOP: The Process of Dying 6. Death is the permanent ending of all biological functions that sustain a living organism.

ANS: T

Even from a purely scientific viewpoint, we encounter numerous approaches to the concept of death, which was once defined as the absence of a heartbeat and breathing.

However, the development of CPR and prompt defibrillation have rendered that definition useless because breathing and heartbeat can sometimes be restarted. The Uniform Determination of Death Act (UDDA) was enacted to provide a consistent definition.

OBJ: 6. Define death and describe the criteria for determination of death.

TOP: The Process of Dying

Chapter 14: Key Trends in Healthcare Law and Ethics Elsevier Inc: Legal and Ethical Issues for Health Professions, 5th Edition MULTIPLE CHOICE 1. Which of the following is not a role of public health in the United States? a. Promoting healthy lifestyles b. Researching disease and injury prevention c. Making the healthcare workforce more competitive by increasing education

requirements. d. Detecting, preventing, and responding to infectious diseases ANS: C

Public health is the science of protecting and improving the health of people and their communities. This is achieved by promoting healthy lifestyles; researching disease and injury prevention; and detecting, preventing, and responding to infectious diseases.

OBJ: 1. Discuss the role of public health in the United States.

TOP: Public Health

2. For what disease was the first vaccine mandate enacted? a. Smallpox b. The plague c. cholera d. tetanus ANS: A

The first state law mandating vaccination was enacted in Massachusetts in 1809 and authorized local boards of health to require smallpox vaccinations for those over 21 years of age.

OBJ: 2. Describe the history of vaccine mandates in the United States.

TOP: Vaccine Mandates 3. Which Supreme Court ruling upheld the right of local governments to require vaccinations

as a condition for attending public school? a. Jacobson v. Massachusetts b. Zucht v. King c. South Dakota v. Dole d. Bostock v. Clayton County ANS: B

In Zucht v. King in 1922, the Supreme Court decided in the case that unvaccinated students could be constitutionally excluded from attending schools in the district of San Antonio, Texas.

OBJ: 3. Discuss the different legal cases supporting and against vaccine mandates.

TOP: Vaccine Mandates 4. Which Supreme Court ruling upheld the right of states to compel vaccination? a. Jacobson v. Massachusetts b. Zucht v. King c. South Dakota v. Dole d. Bostock v. Clayton County ANS: A

In 1905, the United States Supreme Court issued its landmark ruling in Jacobson v.

Massachusetts upholding the right of states to compel vaccination. The Supreme Court held that a health regulation requiring smallpox vaccination was a reasonable exercise of the state’s power and that did not violate the liberty and rights of individuals under the Constitution.

OBJ: 3. Discuss the different legal cases supporting and against vaccine mandates.

TOP: Vaccine Mandates 5. Which exemption allows individuals to refuse to be vaccinated due to personal beliefs? a. Medical exemptions b. Philosophical exemptions c. Religious exemptions d. All the options are correct.

ANS: B

Philosophical exemptions are based on individual’s or parents' personal beliefs about vaccines.

OBJ: 4. Describe the different exemption laws for vaccine mandates.

TOP: Exemption Laws 6. Who did the American Medical Association (AMA) House of Delegates state have the

power to grant medical exemptions from vaccines in a resolution approved in 2021? a. Licensed physicians b. Parents c. State governments d. All healthcare personnel ANS: A

In November 2021, the American Medical Association (AMA) House of Delegates approved a resolution stating that only licensed physicians should have the medical authority and the power to grant medical exemptions from vaccines.

OBJ: 4. Describe the different exemption laws for vaccine mandates.

TOP: Exemption Laws

7. Which state was the first to mandate smallpox vaccinations in 1809 for anyone over 21

years of age? a. California b. Massachusetts c. Illinois d. Virginia ANS: B

The first state law mandating vaccination was enacted in Massachusetts in 1809 and authorized local boards of health to require smallpox vaccinations for those over 21 year so ago. Other states subsequently passed similar laws, including California, Illinois, Indiana, Minnesota, Utah, West Virginia, and Wisconsin during this time.

OBJ: 1. Discuss the role of public health in the United States.

TOP: Public Health

8. A nurse gets hired at a hospital. As part of her requirement to be employed there, she must

be vaccinated for MMR, hepatitis B, and influenza. This is an example of a/an a. mandate. b. epidemic. c. pandemic. d. parens patriae.

ANS: A

A mandate is an official order or requirement to carry out a policy or course of action. This may include an order from an executive body given by the legislature in a state of emergency.

OBJ: 1. Discuss the role of public health in the United States.

TOP: Public Health and Vaccine Mandates 9. In 2019, there was an outbreak of measles that affected 1,274 people in 31 states. An

outbreak that affects many people at one time and can spread through one or several communities is a/an a. mandate. b. epidemic. c. pandemic. d. parens patriae ANS: B

An epidemic is an outbreak that affects many people at one time and can spread through one or several communities.

OBJ: 1. Discuss the role of public health in the United States.

TOP: Public Health and Vaccine Mandates 10. Human immunodeficiency virus (HIV) was first discovered in the early 1980s. More than

79.3 million people have been infected with the HIV virus in the world. This is an example of a/an a. mandate. b. epidemic. c. pandemic.

d. parens patriae.

ANS: C

A pandemic is an outbreak that affects many people at one time and the spread is global.

OBJ: 1. Discuss the role of public health in the United States.

TOP: Public Health and Vaccine Mandates 11. As a result of the passage of the Affordable Care Act (ACA), healthcare providers are

required to do which of the following? a. Lower insurance premiums b. Lower insurance deductibles c. Exclude coverage for people with preexisting conditions d. Provide coverage to individuals of all genders ANS: D

In 2014, the ACA prohibited insurers from denying coverage to individuals on the basis of their gender identity.

OBJ: 6. Discuss the obstacles to healthcare access for transgender and gender nonconforming people.

TOP: Expanding Legal Protection 12. This term refers to a binary of being either female or male as denoted attributes that

comprise biological sex, such as presence of ovaries or testes. a. Gender expression b. Gender c. Gender identity d. Sex ANS: D

The concepts of sex and gender have often been used interchangeably. But the term sex is generally used to refer to a binary of being either female or male as denoted by attributes that comprise biological sex, such as presence of ovaries or testes.

OBJ: 5. Explain the difference between sex, gender identity, and gender expression.

TOP: Gender, Transgender, and Nonconforming Identities 13. This term refers the various socially constructed roles, behaviors, expressions and

identities of girls, women, boys, men, and gender-diverse people. a. Gender expression b. Gender c. Gender identity d. Sex ANS: B

Gender is meant to refer to the various socially constructed roles, behaviors, expressions and identities of girls, women, boys, men, and gender-diverse people.

OBJ: 5. Explain the difference between sex, gender identity, and gender expression.

TOP: Gender, Transgender, and Nonconforming Identities

14. Which of the following is one’s internal knowledge of one’s gender – for example, your

knowledge that you are a man, a woman, another gender, or neither? a. Gender expression b. Gender c. Gender identity d. Sex ANS: C

Gender identity is one’s internal knowledge of one’s gender – for example, your knowledge that you are a man, a woman, another gender, or neither.

OBJ: 5. Explain the difference between sex, gender identity, and gender expression.

TOP: Gender, Transgender, and Nonconforming Identities 15. This is how people present their gender on the outside, often through behavior, clothing,

hairstyle, voice, or body characteristics. a. Gender expression b. Gender c. Gender identity d. Sex ANS: A

Gender expression is how people present their gender on the outside, often through behavior, clothing, hairstyle, voice, or body characteristics.

OBJ: 5. Explain the difference between sex, gender identity, and gender expression.

TOP: Gender, Transgender, and Nonconforming Identities 16. Which Supreme Court ruling affirmed that Title VII of the Civil Rights Act of 1964

prohibited sex discrimination in employment to include sexual orientation and gender identity? a. Jacobson v. Massachusetts b. Zucht v. King c. South Dakota v. Dole d. Bostock v. Clayton County ANS: D

In the case of Bostock v. Clayton County, the Supreme Court affirmed that Title VII of the Civil Rights Act of 1964 prohibited sex discrimination in employment to include sexual orientation and gender identity.

OBJ: 6. Discuss the obstacles to healthcare access for transgender and gender nonconforming people.

TOP: Gender, Transgender, and Nonconforming Identities 17. The National Academy of Medicine and The Joint Commission has recommended

including which data collection in EHRs? a. COVID-19 vaccination b. Religious affiliation c. Gender identity d. Level of education ANS: C

Including gender identity data collection has been recommended by both the National Academy of Medicine and The Joint Commission as a way to learn about which populations are being served and to measure the quality of care provided to transgender and GNC people.

OBJ: 6. Discuss the obstacles to healthcare access for transgender and gender nonconforming people.

TOP: Gender, Transgender, and Nonconforming Identities 18. Which of the following is a state, period, or place of isolation in which people that have

been exposed to infectious or contagious diseases are placed? a. Quarantine b. Epidemic c. Pandemic d. Parens patriae ANS: A

Quarantine is a state, period, or place of isolation in which people or animals that have arrived from elsewhere or been exposed to infectious or contagious disease are placed.

OBJ: 1. Discuss the role of public health in the United States.

TOP: Public Health and Vaccine Mandates 19. The CDC sets vaccination requirements for schools. a. True b. False ANS: B

Although the Centers for Disease Control and Prevention (CDC) has a recommended schedule for child and adolescent immunization, it does not set vaccination requirements for schools. The CDC points out that each state makes its own decisions about which vaccines are required for school attendance in that state. Today, all 50 states have vaccine mandates for children attending school.

OBJ: 4. Describe the different exemption laws for vaccine mandates.

TOP: Vaccine Mandates 20. Which of the following established a federal grant-in-aid program to the states for

establishing and maintaining public health service and for training public health personnel? a. The Affordable Care Act b. The Social Security Act c. Medicare and Medicaid d. Occupational Safety and Health Act ANS: B

The Social Security Act was passed in 1935: One title of the act established a federal grant-in-aid program to the states for establishing and maintaining public health services and for training public health personnel.

OBJ: 1. Discuss the role of public health in the United States.

TOP: Public Health

21. In Zucht v. King in 1922, the Supreme Court decided in the case that unvaccinated

students could be constitutionally excluded from attending schools in the district of San Antonio, Texas. The doctrine that allowed that allowed states to exert their authority is a. Quarantine. b. Epidemic. c. Pandemic. d. parens patriae.

ANS: D

The doctrine of parens patriae allows states to exert their authority over child welfare.

OBJ: 1. Discuss the role of public health in the United States.

TOP: Public Health

22. Based on exemption laws, who can grant a medical exemption for a child who must be

vaccinated before attending school? a. Parents b. Child’s school c. Child’s healthcare provider d. Insurance company ANS: C

To seek a medical exemption, individuals must have their or their child’s healthcare provider sign a medical exemption form.

OBJ: 4. Describe the different exemption laws for vaccine mandates.

TOP: Exemption Laws 23. Which federal agency required all healthcare facilities that received funding from federally

sponsored programs, such as Medicare and Medicaid, to require COVID-19 vaccinations for employees? a. AMA b. CDC c. OSHA d. CMS ANS: D

During the COVID-19 pandemic, the Centers for Medicare & Medicaid Services (CMS) required all healthcare facilities to require COVID-19 vaccinations as a condition of receiving funding from federally sponsored programs. The Occupational Safety and Health Administration (OSHA) had a similar mandate but only required businesses with 100 or more employees to either mandate the vaccination or implement weekly testing for those employes who opt out.

OBJ: 3. Discuss the different legal cases supporting and against vaccine mandates.

TOP: Vaccine Mandates 24. Transgender and gender nonconforming patients may face all the following except a. being unable to apply or receive private health insurance. b. experiencing discrimination and harassment when they tell people who they are. c. facing barriers to accessing health care. d. having difficulty in applying for public health insurance programs due to legal

documents not matching their current name and gender identity.

ANS: A

Although many transgender and gender nonconforming (GNC) people face economic discrimination and disparities, they may still qualify for private insurance. At the state level, 24 states and the District of Columbia currently prohibit transgender exclusions in health insurance service coverage.

OBJ: 6. Discuss the obstacles to healthcare access for transgender and gender nonconforming people.

TOP: Gender, Transgender, and Nonconforming Identities 25. Accurate data collection, including sex and gender identity, is critical to providing quality

patient care. All the following agencies recommended EHR systems to collect accurate gender identity data except for a. The Joint Commission. b. Occupational Safety and Health Administration. c. National Academy of Medicine. d. US General Accountability Office.

ANS: B

The National Academy of Medicine, The Joint Commission, and US General Accountability Office’s Health Information Technology (HIT) Policy Committee have recommended the collection of accurate gender identity data in electronic health records.

OBJ: 6. Discuss the obstacles to healthcare access for transgender and gender nonconforming people.

TOP: Gender, Transgender, and Nonconforming Identities