Ass. 3&4 Flashcards
1
Q
In Canada, health-care plans pay only health-care services normally defined as “ medically necessary”.
A
T
2
Q
The list of insured services is updated every 5 years.
A
F
3
Q
Services considered “ medically necessary” are the same services in all provinces and territories.
A
F
4
Q
A service that is no longer insured is deregulated.
A
T
5
Q
Medical procedures that are done in conjunction with a physician visit are billed at a lesser amount than those done separately.
A
T
6
Q
The Fee Schedule resource manual in Ontario is called the Medical Payment Schedule.
A
F
7
Q
As a student, you can legally download the OHIP fee schedule for your province or territory, from the internet for study purposes
A
T
8
Q
In Ontario, residents pay a health insurance premium.
A
T
9
Q
In Ontario, each person has an OHIP card number for life.
A
T
10
Q
It is legal to ask someone to show a health card for identification purposes when cashing a cheque.
A
F
11
Q
In Ontario, “snowbirds” who spend the winter in warmer climates , may be away from Ontario for 212 days in any 12 month period and still maintain continuous OHIP health coverage.
A
T
12
Q
The Workplace Safety and Insurance Board (WSIB) is the worker’s compensation board in Ontario.
A
T
13
Q
Clients may randomly be asked to show their health card before receiving care in their physician’s office.
A
F
14
Q
Family practice is a specialty area of medicine
A
T
15
Q
The AHP is primarily responsible for the claims submission in a medical office.
A
T
16
Q
EDT stands for External Data Transcription.
A
F
17
Q
If a health card will not swipe , putting a thin paper over the magnetic strip may help.
A
T
18
Q
Information from a health card may be manually entered if swiping the card does not work.
A
T
19
Q
When a client requests that their medical records be transferred, OHIP is charged.
A
F
20
Q
After three notices of an unpaid account, the account goes either to small claims court or to a collection agency.
A
F
21
Q
Canada Health Infoway is a provincially funded organization with a mandate to facilitate the national implementation of electronic health records.
A
F
22
Q
An “ electronic medical records system” is a legal health record in digital format.
A
F
23
Q
An “ electronic health record “ EHR is an accumulation of essential information from an individual’s electronic medical records
A
T
24
Q
” Open text” clinical records allows the provider of care to record the findings on a blank page or on a template such as one for SOAP charting.
A
T
25
A " fob"' is a small security device added to a computer, displaying a randomly generated access code which changes every few seconds.
T
26
Backups of system data should be performed at least once a week.
F
27
As an AHP your responsibilities will likely include creating the basic EMR.
T
28
Individuals who are not providing care for a specific client can be fired or suspended for accessing the client's medical record.
T
29
Numeric filing systems almost always require an index.
T
30
n Canada, no provincial/territorial or federal privacy legislation states how long health information must be kept.
T
31
In Ontario, physician's must retain client's health information for 7 years from the date of the last entry.
F
32
There is no minimum age for consent to the disclosure of personal health information.
T
33
Clients have a right to access all information contained in their medical chart.
T
34
"Private" health care facilities means that patients pay for services.
F
35
Chronic care facilities provide long-term inpatient medical care for people with little or no potential for rehabilitation.
T
36
Federal hospitals provide health care services for First nations people, veterans and military personnell.
T
37
A tertiary care hospital offers basic care , including health promotion and prevention of illness only.
F
38
Accreditation is the process by which facilities are granted recognition for meeting certain preset standards of care.
T
39
Clinical /secretarial responsibilities include processing diet changes for clients.
T
40
Included in a clinical secretary's scope of practice is the ability to give basic patient care such as helping a patient get up to the bathroom.
F
41
Mr. T , a senior citizen , has been prescribed a generic medication from a provincial drug benefit formulary. It is not managing his pain and makes him feel sick and lethargic. Previously he was using a brand name medication with good results and fewer side effects, but it was not listed in the drug benefit formulary and so was not paid for by the plan. How can the doctor attempt to get the more effective drug paid for by the provincial drug benefits plan when it is not on the list of selected drugs covered by the drug benefit plan?
a) the doctor can call the pharmacy and explain the situation
b) the doctor can call the Minisrty of Health and demand they allow the client the use of the best drug
c) the doctor can submit a limited use form for some drugs or write a letter and submit a different form for other drugs
d) the doctor can call the local media and put out a call for help in funding the more effective drug
C
42
Which of the following is the best description of drug benefit formulary?
a) a provincial/territorial list of selected drugs covered by the drug benefit plan
b) a manual listing the recommended use and dosage of common medications
c) a provincial/territorial list of recommended retail cost of prescription drugs
d) a multi-discipline manual that describes the action, use, route of administration and recommended dose of medications
A
43
Which of the following statements about health card validation is true?
a) the red and white OHIP cards are no longer valid
b) in Ontario, claims submitted with an invalid version code will be rejected.
c) information about a client's health card can be obtained by calling the Ministry of health
d) Clients no longer have to show their health card each visit if their OHIP number is on file.
B
44
Which of the following statements is the best example of deregulation?
a) provincial plan covers in-patient physiotherapy
b) health insurance covers physician examination to investigate patients' symptoms
c) routine eye examinations have been removed from the provincial fee schedule
d) only medically necessary health services are covered by the provincial plan
C
45
Which of the following care services can be billed as physician encounters with the provincial care plans?
a) Sadie visits the office to get a back to school note for her daughter.
b) Susan has the nurse take her blood pressure and sees the doctor to have her medications renewed.
c) Charlie comes to the office to have the nurse change his dressing and assess his wound.
d) Martha comes to the office to have the nurse administer her monthly vitamin B6 ( pyridoxidine ) injection.
B
46
What should the AHP do, if unsure whether a service is insured by the provincial health plan?
a) ask the physician in charge
b) check with the office nurse
c) call another practice and check with their AHP
d) contact the health ministry regional information service
D
47
Is it necessary to have the patient sign a " permission to release information form" before submitting a billing claim which includes the required personal information?
Yes/No
No
48
In Ontario, what does the three number service code represent?
a) the type of assessment
b) the provider rendering the service
c) the assistant rendering the service
d) the type/complexity of the service rendered
D
49
The suffix in a service or billing code has a specific meaning in codes for diagnostic tests. What are the two insurable components related to diagnostic tests?
a) therapeutic and diagnostic
b) technical and professional
c) physician and assistant initiated
d) hospital or nursing home initiated
B
50
In which of the following circumstances must the AHP mark the MR field on the computer when submitting a claim?
a) When a hand-written hard copy of a claim is submitted
b) when a new client has been added to the practice
c) when a physician has examined a client without using any diagnostic technology
d) when a manual review of the claim is requested because the service provided contravenes the provincial billing guidelines
D
51
Which of the following methods of claims submission is the method of choice across Canada?
a) billing cards
b) electronic transfer
c) tape cartridge and disk
d) machine readable input/output
B
52
What does shadow billing refer to?
a) it is used in third party payment situations
b) it is the type of billing used for physicians opted out of OHIP
c) it is used in practices that have entered into primary care reform
d) it is a billing method used for doctors who offer services at more than one facility
C
53
Mr. Hank has suffered from COPD for a number of years. He has come to the office today to investigate a temperature of 38.5C , productive cough and SOB ( shortness of breath ) with chest discomfort. The doctor diagnosed pneumonia. What diagnosis would be used for the diagnostic code column on a claims submission form?
a) COPD
b) pneumonia
c) chest pain
d) either a or b
D
54
What is the remittance advice report?
a) a monthly statement from the Ministry of approved claims
b) the transmission of medical claims to the Ministry of Health
c) explanation of a payment to a provider of a lesser amount than that claimed
d) a message indicating what software is necessary to provide readable claims to Ministry computers
A
55
Medical records are making the transition from paper charts to electronic records. If a patient's chart is completely uploaded , how long does the College of Physicians and Surgeons across canada recommend keeping the paper version of the medical records?
a) one month
b) 6 months
c) one year
d) two years
B
56
What is the AHP's most important responsibility when a patient requests the transfer of their medical records to a new physician?
a) transfer the records immediately
b) transfer the complete, original medical health record
c) transfer the billing records from the provincial health care plan
d) have the client sign a consent and then transfer a copy of the medical record
D
57
Who owns a client's health information record in a group practice?
a) the client
b) the group practice
c) the health Ministry
d) the most responsible physician
D
58
Which Ontario statute requires the reporting of any misconduct on the part of a health-care provider?
a) The Aeronautics Act
b) the Regulated Health Professions Act
c) the Child and Family Services Act
d) the Health Protection and Promotion Act
B
59
Which of the following individuals would you typically report to in your role as clinical secretary?
a) the client
b) the physician
c) the clinical resource nurse
d) the personal support worker
C
60
Mr. Snider will require a portable Gomco suction when he returns to the hospital unit following his gastric surgery. Which of the following departments would you call to obtain that piece of equipment?
a) purchasing department
b) stores/materials management
c) environmental services/housekeeping
d) risk management/infection control
B
61
Mr. Lee has experienced a subdural hematoma. Which of the following hospital units would he most likely be admitted to?
a) neurology
b) nephrology
c) systemic therapy
d) psychiatric/mental health services
A
62
Dr. Jacob asks Martha, the clinical secretary, to slip down to Mr. Harvey's room and get the vital signs graph. Martha is in the process of transcribing orders. Which of the following would be Martha's best response?
a) I'm too busy right now.
b) I'm busy - someone else will have to get the graph.
c) That task is beyond my scope of practice and therefore I cannot get the graph.
d) I can go in a minute, Dr. Jacob. I am just about finished transcribing this order.
D
63
Which of the following would be the best response by the medical secretary when someone calls the unit wanting to know the condition of Mr. Jones, a patient?
a) I'm sorry but I am not qualified to give out that information.
b) Can I get you to hold for a minute while I go get Mr. Jones' nurse.
c) I heard them say at report that he has taken a turn for the worse.
d) I'm sorry , but if you want to know how he is, the best thing you could do is come for a visit.
B
64
Which of the following would you likely find in a clean utility room?
a) sterile dressing trays
b) sterile bed pan hoppers
c) housekeeping supplies
d) used but clean suction machines
A
65
The Universal Emergency Code " Blue" in Ontario alerts staff to which of the following?
a) fire
b) missing patient
c) cardiac arrest
d) violent/aggressive patient
C
66
The use of the term "client-care unit" is used to more accurately reflect the language used in the hospital and other health care facilities.
F
67
Routine hospital admissions are referred to as elective.
T
68
Often a patient admitted for surgery will be admitted the morning of surgery.
T
69
The Ontario health insurance plan ( OHIP) covers semi-private accommodation.
F
70
If Jeff has only standard accommodation coverage and he is admitted to a semi-private room because there is no other, Jeff will have to pay the difference
F
71
A patient admitted to hospital will have only one hospital number (MRN) which will remain the same for all admissions to that hospital.
T
72
The admission sheet will contain an account number that is the same number as the hospital number.
F
73
Never let anyone enter information on a form that is not labelled with the patient's name.
T
74
The head nurse on the unit is responsible for creating a patient's chart on admission and disassembling it on discharge.
F
75
Old paper charts are retrieved from Medical Records ( Health Records ) - Health Information Services.
T
76
The admission sheet records a patient's provisional diagnosis.
T
77
The provisional diagnosis may differ from the final diagnosis.
T
78
If you need to contact someone to make a decision about about the patient's medical care when the patient is unable to do so, you must contact the patient's next of kin.
F
79
The person assigned the "power of attorney relating to health care decisions " is the next-of-kin.
F
80
In a manual environment the care plan is called a kardex, and it is a separate entity from the chart.
T
81
DAR charting refers to Date, Assessment, and Revision.
F
82
Charting by Exception means that only essential information is charted.
T
83
Soap charting stands for Subjective , Objective, Assessment,Plan.
T
84
When using Voice Activation Software for transcribing dictated reports, a transcriptionist must edit the report before it is added to the chart.
T
85
In a manual environment, the administrative assistant would add an intake/output sheet( fluid balance sheet) to the post-operative chart.
T
86
Every time a chart leaves the floor (unit), it is the responsibility of the clinical secretary to keep a written record of where it went, using an outguiding system.
T
87
A patient transfer occurs whenever a patient is moved from one hospital to another facility.
F
88
A terminal cleaning of the bed and other furniture used by a patient is done 2x per week.
F
89
If a nurse calls in sick on a unit it may be the responsibility of the clinical secretary to find a replacement from a staffing list.
T
90
A hospital manual includes visiting hour policies and policies related to the use of electrical equipment.
T
91
The ability to process orders manually is no longer a necessary skill for the clinical secretary.
F
92
Medical orders are typically written by the hospitalist.
T
93
When checking a physician's orders which you are unsure about, it is better to deal with a grumpy physician than with an inaccurate order.
T
94
Orders related to assessments, treatments, and direct patient care are recorded in a kardex in a manual environment.
T
95
Vital signs include: temperature, pulse, respirations, and blood pressure.
T
96
Intake and output are automatically activated for any patient on parenteral therapy.
T
97
Occasionally an anaesthetist and a surgeon will both write orders for postoperative analgesics for the same patient. You should implement both sets of orders.
F
98
NPO means nil per os ( nothing by mouth).
T
99
A soft/surgical diet is one low in fibre
T
100
The suffix "ostomy" means creation of an artificial opening.
T
101
In medical terminology, "activities of daily living" include reading, watching TV, eating, and sleeping.
F
102
BR with BRP's means "up ad lib".
F
103
To prevent bedsores , patients who cannot move about in bed, must be turned or repositioned, every 4 to 6 hours.
F
104
When you are selecting an echart by entering the patient's last name and first initial, a number of possible names come up. What is the clinical secretary's responsibility at this point?
a) Ask the nurse to deal with the situation.
b) Pick the name that seems most reasonable.
c) Compare the client's date of birth and health number to the available selections.
d) Go to the patient's room and ask for identification to prove who they are.
C
105
Which of the following is the best way to describe the purpose of a " risk management program"?
a) It reduces the risk of visitors acquiring a severe infection.
b) It aims to improve staff and patient safety and reduce the risk of litigation.
c) It ensures that all patients will avoid the risk of having to stay in the hospital for longer than expected.
d) It requires the nursing staff to lift patients safely and be assigned two patients at a time.
B
106
Which of the following best describes a consultation report?
a) A report generated when the nurse consults with a physician.
b) A report generated when an internist consults with a cardiologist.
c) A report generated when the physiotherapist consults with an occupational therapist.
d) A report generated when all health professionals meet for a patient conference.
B
107
What would be the best response in the following situation? Dr. Jones wrote an order in the morning and signed the order sheet. You processed that order and sent the duplicate order sheet to the pharmacy. The Dr. came in again in the evening and wrote more orders, but just added them to the original order rather than sign again.
a) Ask the nurse to process the order.
b) Disregard the order as it has not been documented correctly.
c) Tell Dr. Jones that he should know better than that and that you intend to report him.
d) Report the discrepancy to the nurse who will follow up with the physician
D
108
Which of the following would you most likely find on the Kardex or patient intervention screen of a surgical patient under the heading of teaching and emotional support?
a) Diet as tolerated
b) Commode by bedside
c) Ambulate with assistance
d) Coughing and deep breathing q2hr.
D
109
Which of the following orders would you process first?
a) Daily FBS
b) Lasix 20 mg IV stat
c) Out of bed with assistance this evening
d) Demerol 50 mg, Atropine 0.6 mg, IM, one hour before surgery
B
110
Which of the following is the best interpretation of the statement " the IV went interstitial and it had to be removed".
a) The IV fluid bag went dry and had to be discontinued.
b) The needle dislodged from the vein and had to be removed.
c) Air invaded the closed intravenous system and the IV had to be removed.
d) The IV catheter became clogged with a clot and the system had to be discontinued.
B
111
Which of the following would be the best interpretation of the Doctor's order "flush saline lock q4 hrs".
a) Change the IV tubing every 4 hours
b) Run the IV at a faster rate every 4 hours.
c) Add medications to the intravenous bag every 4 hours.
d) Run normal saline through the IV catheter every 4 hours
D
112
Which of the following would be the best interpretation of the Doctor's order " IV D%W TKVO"?
a) Total vein obstruction has occurred.
b) Keep IV volume over the minimal amount.
c) Dextrose and water at a rate the client can tolerate
d) IV, five percent dextrose and water running at a minimal rate to keep the vein open.
D
113
Which of the following is the best description of how to record an IV solution in an electronic environment?
a) Write " copied" and your signature on the Doctor's order sheet.
b) Record the name of the intravenous solution to be infused on the paper MAR.
c) Click on the appropriate options from the IV management section on the PI screen.
d) Do not record anything on the PI screen. That is the nurse's responsibility.
C
114
Which of the following is an example of a good reason for having an implanted IV port?
a) It is ideal for continuous intravenous infusion.
b) It allows easy access for administering blood and blood products.
c) It allows for medication to be injected through the skin into a catheter.
d) It allows a catheter to be inserted less invasively than a peripheral angiocath.
C
115
Which of the following people/departments would you call if a patient on your unit did not receive a meal tray?
a) Admissions
b) The team leader
c) Nutritional services
d) The clinical coordinator
C
116
Which of the following is the best example of a high-fibre diet?
a) Meat,fish,eggs and milk
b) Fish, fried food, whole grains and meat
c) cabbage, lean meat, stewed fruit, and whole grains
d) pasta, white bread, boiled chicken, and well-cooked beef
C
117
Mr.Blair is booked for surgery and a general anaesthetic at 0800 tomorrow. At what time will the NPO order be implemented?
a) at 0400 tonight
b) at 1800 hours this evening
c) at 2200 hours this evening
d) from supper this evening until he goes to the OR
C
118
For which of the following patients is the Dr. most likely to order enteral foods post operatively?
a) A patient who is vomiting due to the flu.
b) A patient who has had abdominal surgery
c) A patient who has had a stroke and is dysphagic.
d) A patient who has been booked for a colonoscopy
C
119
Mr. Blair returned to the unit from the recovery room, where he was stabilized following bowel surgery. The post-op order says to carry out an abdominal assessment every shift until peristalsis returns. How will the nurse go about carrying out that order?
a) He will book an abdominal ultrasound once a week.
b) He will palpate the abdomen for distension once a shift.
c) He will listen to the patient's abdomen with a stethoscope once a shift
d) He will give the patient a drink and listen for the stomach to growl once a shift
C
120
Where would an order that reads " Gravol suppository 50 mg for nausea q4h prn" be transcribed?
a) The TPR graph.
b) The progress notes
c) The interdisciplinary notes
d) The MAR or cMAR and the Kardex.
D
121
Which of the following is the best description of what a hypotonic bladder is like?
a) The bladder is full of urine.
b) The bladder has lost its tone or strength.
c) The bladder has developed excess tone.
d) The bladder has residual urine of 50 ml
B
122
Mrs. Jones has a Doctor's order to obtain an MSU. Which of the following is the best description of a MSU?
a) Mrs. Jones will collect an early morning urine specimen.
b) Mrs. Jones will collect all her urine for a 24 hour period.
c) Mrs. Jones will urinate in a paper cup, then pour a small amount of the urine into a sterile container.
d) Using clean technique, Mrs. Jones will begin to void into the toilet , stop midstream, collect a sample in a sterile container and then finish voiding into the toilet
D
123
Which of the following tests would most likely be ordered to detect a residual urine?
a) A midstream urine to check the urinary sphincter.
b) A cystoscopy to see how much urine is in the bladder.
c) An abdominal xray to estimate whether bladder tone is lost.
d) A post-void catheterization to see how much urine is left in the bladder.
D
124
Which of the following is the best description of a continuous bladder irrigation?
a) A closed sterile irrigation system, usually using a 3-way catheter.
b) A straight catheter irrigated with normal saline four times a day.
c) An indwelling catheter to straight drainage placed in the bladder and irrigated every morning.
d) A bulb syringe is used to flush out the bladder and tubing PRN.
A
125
Which of the following therapies would a physiotherapist most likely be responsible for?
a) intravenous therapy
b) ventilation therapy
c) medication administration
d) coughing and deep breathing
D
126
Which of the following interventions require that a specific consent be signed?
a) Spirometry
b) Thoracentesis
c) Sputum specimen
d) Inhalation therapy
B
127
Dr. Attwood has written an order to suction Mr. Little PRN. What supplies would you order from Central Supply for the nurse to carry out this order?
a) A size 25 catheter
b) A tracheostomy tube
c) A sterile bundle for catheterization
d) A French-scale catheter, connecting tube, and a portable suction machine
D
128
Which of the following orders would you enter onto the Kardex or PI screen as preparation for a patient who has been booked for a cardiac catheterization on June 10th ?
a) NPO starting at 2200 June 9th. Groin prep early AM June 10th.
b) NPO starting at 1200 June 9th . Groin prep 1800 June 10th.
c) Clear fluids on June 9th. Bed rest June 9th and 10th. Groin prep PRN.
d) DAT June 8th and 9Th. Groin prep PRN. Bed rest June 10th.
A
129
What do nurses often do a half hour before they get a patient up post-surgery in order to reduce the discomfort?
a) Provide a warm bath to relax their muscles
b) Provide relaxing music for the patient to listen to.
c) Medicate the patient to make the experience more comfortable.
d) Discuss complications that have been experienced by patients who did not get up after surgery.
C
130
Which of the following is the best explanation for the standard procedure to reposition immobile patients at least every 2 hours.
a) Patients need the emotional stimulation of repositioning.
b) Repositioning prevents tissue hypoxia and breakdown.
c) Patients are more compliant to treatment if they are repositioned.
d) Family members will be more satisfied with the care the patient is receiving
B
131
Which of the following measurements must be reported when ordering a pair of anti-embolic stockings from Central Supply?
a) Height and weight.
b) Weight and any mobility issues.
c) The diameter of the leg and the client's height.
d) The diameter of the calf and thigh and the length of the legs
D
132
Which of the following is the best explanation of the use of a trapeze bar?
a) it keeps the patient from sliding down in bed
b) it lifts a patient who is too heavy out of bed into a chair
c) It is used for a patient to grab onto in order to exercise, position themselves and get up.
d) It is placed between the patient's legs post hip surgery to keep them apart
C
