BCPA STUDY TEST QUESTIONS Flashcards

Question

Advocates respect each client’s right to privacy and abide by: A. All relevant laws and regulations as they pertain to the confidentiality of personal information and personally identifiable information. B. Insurance requirements C. The rules of the facility D. Their own policies

Answer 1

A. All relevant laws and regulations as they pertain to the confidentiality of personal information and personally identifiable information. Rationale: board-certified patient advocates respect each client’s right to privacy and abide by all relevant laws and regulations as they pertain to the confidentiality of personal information and personally identifiable information.

Answer 2

C. A strong working relationship and productive advocacy. Rationale: being clear on expectations will help build a strong working relationship and a productive outcome.

Answer 3

A. Some state laws offer additional protection Rationale: HIPAA standards represent a uniform, federal for privacy protections for consumers across the country. State laws provide additional protections to consumers. California has enacted legislation that penalize hospitals and healthcare organizations that fail to protect patient information.

Answer 4

A. Help clients access resources Rationale: advocate refrain from diagnosing or prescribing any medical/mental health treatment for clients, even if the advocate has additional licensure or training.

Answer 5

B. Using PHI to assess quality of services Rationale: HIPAA does allow some exceptions to PHI protections. These include: using PHI to assess the quality of services through outcome evaluations.

Answer 6

D. Refer the client to a professional mediator Rationale: if a client needs assistance in an area in which an advocate does not have sufficient knowledge or training, the advocate is a black obligated to refer the client on appropriate system or resource for assistance. An example would be if the situation warrants advanced skills and conflict management or professional mediation, it is outside of your scope of practice to perform this.

Answer 7

D. Medical providers cannot treat patients without their consent unless there is a court order. Rationale: medical providers cannot treat patients without their consent except in emergencies or under court order when patients are incompetent or minors.

Answer 8

C. Commercialized medicine Rationale: private physicians who are paid fee-for-service can increase profits by raising fees or providing more services. Healthcare in the US is organized as a business as positions and patience are organized into a relationship that can be financially exploited.

Answer 9

D. Empowering patients Rationale: before clients can be engaged, they must be empowered. Providing information as part of empowering patients. Self-determination happens after clients feel empowered.

Answer 10

C. Legal surrogate Rationale: a surrogate is an adult who is appointed to make healthcare decisions for a person when a person is unable to make decisions for themselves.

Answer 11

B. Healthcare reform began with Massachusetts in 2006 Rationale: the first efforts at healthcare reform began with Theodore Roosevelt in 1912. As a US entered World War I, interest in healthcare reform wind. Harry Truman made another attempt in 1944 with the ‘economic bill of rights’ which included the right to medical care and good health. To provide healthcare for the elderly, Medicare and Medicaid for incorporated into the Social Security act in 1965. Massachusetts was the inspiration for the affordable care act, but it was not the beginning of healthcare reform.

Answer 12

A. Durable power of attorney Rationale: a durable power of attorney (POA) enables a person to appoint an “agent”, such as a trusted relative, friend, or attorney to handle specific health, legal, and financial responsibilities

Answer 13

B. Treat clients fairly regardless of age, race, religious/spiritual practice, culture, ethnicity, sexual orientation or gender identity, and immigration status. Rationale: the board-certified patient after treats all clients fairly regardless of age, race, religious/spiritual practice, culture, listening, sexual orientation or gender identity, and immigration status.

Answer 14

C. Advance directives Rationale: advanced directives are legally executed documents that detailing individuals healthcare related wishes and decisions for end of life.

Answer 15

A. It is what allows entry into the healthcare system Rationale: coverage is a persons ticket into the healthcare system.

Answer 16

A. Timely delivery of appropriate care can help reduce mortality and morbidity for chronic conditions Rationale: timely delivery of appropriate care can help reduce mortality and morbidity for chronic conditions, such as kidney disease.

Answer 17

D. Autonomy, beneficence, nonmaleficence and Justice Rationale: known as the big four, they are autonomy, beneficence, nonmaleficence, and justice.

Answer 18

D. Offering an evening or Saturday appointment for screening tests Rationale: By offering a more convenient time for the screening, Anne may be able to fit this into her busy life. If Anne asks for help, every effort should be made to help her cope with the situation.

Answer 19

A. The time we use a personal health services to achieve the best health outcomes Rationale: access to healthcare means having the timely use of personal health services to achieve the best health outcomes. Access to healthcare consists of four components.

Answer 20

D. Justice Justice is maintaining what is right and fair; making decisions that are good for a person.

Answer 21

C. Workforce, coverage, timeliness, and service Rationale: the four components of access our coverage, service, timeliness, and workforce.

Answer 22

C. Uninsured Rationale: The uninsured or less likely to receive medical care and more likely to have poor health status.

Answer 23

D. African-American women Rationale: everyone is at risk; however, the population of African-American women, is included into vulnerable populations: women and African-Americans.

Answer 24

C. Promote equitable access to appropriate and safe healthcare and treatment Rationale: the board-certified patient advocate promotes equitable access to appropriate and safe health care and treatment.

Answer 25

D. Autonomy Rationale: the term autonomy refers to the right of self determination. By law, patients have a right to make choices independently. Informed consent was also be present for biomedical research. The ultimate responsibility for discussing treatment options, plan of care, and obtaining informed consent rests with the physician. This includes, but is not limited to, advanced directives. Evidence must appear in the client’s record.

Answer 26

B. Hospice bill of rights Rationale: The hospice Bill of Rights allows the client to request a change in caregiver without reprisal or discrimination.

Answer 27

A. As soon as she is able to ensure her memory of the meeting remains accurate. Rationale: document as soon after the fact as you can; while it is happening is best.

Answer 28

B. Active listening Rationale: active listening can help provide you with greater clarity about a situation

Answer 29

D. They may have a general distrust or fear of government that can extend healthcare Rationale: migrants who have fled the country store escape persecution, violence, or war may have general distrust her fear of government they can extend it to Healthcare.

Answer 30

A. Limited English speaking persons Rationale: limited English speaking people are less likely to have a usual source of care, utilize for your preventative services, or more likely to experience home from an adverse event, and tend to be less satisfied.

Answer 31

C. Create an atmosphere of acceptance Rationale: create an atmosphere where clients who lack understanding of key information do not feel belittled or ashamed.

Answer 32

A. Teach back or show me Rationale: using tactics such as teach back or show me to evaluate understand it can be very helpful. Teach back as a method of explaining information to the client and asking the client to restate the information. It has been demonstrated to be an effective method for client teaching.

Answer 33

D. Call, cause, cope, concerns Rationale: the forces of culture or call, clause, cope and concerns

Answer 34

D. Voicing concerns to all staff who will listen Rationale: Influencing the level of conflict, avoidance and shared collective interests are always to manage conflict.

Answer 35

C. Getting involved in social movements Rationale: strategies to expand a persons networking include increasing visibility, seeking inclusion in decision-making bodies, cultivating mentors, obtaining access to informal groups and developing links with social movements.

Answer 36

A. Inform the nurse of her role as a board-certified patient advocate Rationale: some staff may not understand the advocate role. As this is a relatively new role, the patient advocate may need to help to inform staff of the advocate role, as misunderstanding can sometimes create conflict.

Answer 37

B. The client Rationale: documentation belongs to the client. However, you should keep copies for your records.

Answer 38

C. Establish a goal and timeframe for completion with the client Rationale: establishing a goal and timeframe for completion with a client is the first step in the planning process.

Answer 39

A. Alleviate suffering, promote health, promote safe care, encourage well-being whenever and wherever possible. Rationale: Ford certified patient advocates have four main tenants to alleviate suffering, promote health, promote safe care, and encourage well-being whenever and wherever possible.

Answer 40

D. The plan is client centered and client directed Rationale: advocacy planning must begin and end with the expressed needs, interests, or preference of the client.

Answer 41

B. The client Rationale: first advocacy planning must begin and end with the expressed needs, interests, or preference of the client.

Answer 42

B. Mr. Earl is responsible for the entire bill. As his advocate, I will explore eligibility for Medicaid. Rationale: as long as Mr. ours an observation status, he is responsible for the entire bill since he doesn’t have Medicare part B. He has missed the enrollment. To get part B now and will have to wait until next year. However, he may qualify for Medicaid, which is retroactive three months. We don’t know if he has Medicare advantage or not.

Answer 43

C. TRICARE Rationale: TRICARE is a department of defense program that provides care to the dependence of active duty military members and military retirees and their dependence. There are several options for TRICARE, such as an HMO type plan, a PPO type plan, and a fee for service plan.

Answer 44

A. Medicare

Answer 45

D. Medicaid Rationale: Medicaid covers pregnant women

Answer 46

D. Medicaid Rationale: due to her unemployment, she will most likely qualify for Medicaid. We don’t know if she’s Native American and she does not qualify for Medicare that we know of.

Answer 47

B. Joint commission Rationale: the joint commission link can be used to report for medical care, safety concerns, and Hospital acquired infections

Answer 48

A. Employment sponsored insurance Rationale: employment sponsored insurance (ESI) has become the predominant method of obtaining insurance in the US

Answer 49

B. Managed care organization Rationale: as the name implies, managed-care organizations take a more active role in managing the care of their beneficiaries receive, and thus the cost incurred, rather than focusing solely on premiums and reimbursements

Answer 50

D. Post acute care Rationale: there are thousands of facilities are also providing patient care. These facilities known as post acute care I have experience rapid growth in the past 20 years and are increasing area of concern from Medicare spending and quality improvement.

Answer 51

B. Part C Rationale: Medicare part C is also called Medicare advantage, it allows beneficiaries to enroll in a private insurance plan, like an outside HMO, which will cover all regular Medicare benefits and may cover more or require reduced co-pays and deductibles. Medicare pays these private insurers a fixed amount per month, per beneficiary.

Answer 52

C. Inform her parents Rationale: while Susan can inform school personnel, this will not empower the parents. Informing the parents and supporting them in the next steps is the better answer.

Answer 53

B. Vertical network Rationale: a vertical network contains different kinds of services. An example is Kaiser Permanente, a network of organizations that function variously as an insurer, and a lot of hospitals and outpatient centers, and an employer of physicians. These are sometimes referred to as integrated care as well.

Answer 54

D. Part D Rationale: part do you is voluntary and operates through contracted private insurers. The program is subsidized, particularly for low income beneficiaries. Previously there existed a donut hole, causing certain beneficiaries to lose coverage of most of their prescriptions, but the affordable care act closes the gap through subsidies and rebates.

Answer 55

A. Medicare Rationale: to be eligible for Medicare coverage, a person must be at least 65 years old, has been a US citizen or permanent resident for more than five years, and have or have a spouse, who has paid Medicare taxes for at least 10 years; be under age 65, be permanently disabled, and have receive Social Security disability benefits for at least the previous two years; be under age 65 and receive Social Security disability benefits for amyotrophic lateral sclerosis, ALS or Lou Gehrig’s disease; be under age 65 and a continuous dialysis or kidney transplant; or be under age 65 and have developed health conditions following environmental hazard exposure in an emergency declaration area after June 17, 2009.

Answer 56

D. Commonwealth fund ranked the US health system fifth out of seven countries Rationale: the most recent major international comparison by the Commonwealth fun ranked our system seventh - which isn’t so bad until you realize that the study only included in seven countries.

Answer 57

A. Medicaid Rationale: Nancy would qualify for Medicaid due to her pregnancy and most likely meet income requirements with her unemployment.

Answer 58

A. Inpatient and outpatient

Answer 59

A. Steering patients to generics and cheaper drugs by selling a lower copayment Rationale: PBMs and insurance plans try to keep their costs low by steering patients take generics and other cheaper drugs, so they sent lower patient copayments; the system of classifying drugs by co-pay is known as a “tiered formulary”.

Answer 60

C. For profit hospitals Rationale: private corporations earn for profit hospitals, and some of the hospitals profit is giving the shareholders, as opposed to all of it reinvested into operations. I’m like not for profit hospitals, these organizations pay taxes. As of 2013, do US had over 260 physician owned hospitals. The majority are for profit institutions. These hospitals can be of any type that are more likely to be single specialty hospitals, especially orthopedics, Oncology, or Cardiology.

Answer 61

B. Primary care doctors Rationale: less than 40% of physicians practice in primary care, due to this they have a huge workload: do you university researchers estimate that, given the typical patient load and the current guidelines for care, a PCP should be spending 7.4 hours per day on preventive care, 10.6 hours on managing chronic diseases, and 4.6 hours on handling acute illness - totaling 22.6 hours a day.

Answer 62

C. Discharge planning Rationale: studies have shown that improvements in a hospital discharge planning can dramatically improve the outcome for patients as they move to the next level of care.

Answer 63

C. Criminal act of fraudulently reporting an incorrect diagnosis in order to profit Rationale: upcoding is the criminal act of fraudulently reporting an incorrect diagnosis in order to profit.

Answer 64

A. Value based purchasing (VBP) Rationale: VBP involves birthday quality reporting system and a payment modifier, penalizing those providing below average care and providing bonuses to those providing above average care.

Answer 65

B. Single specialty group practices Rationale: the simplest form of horizontal integration is a single specialty group practice. These organizations can be a varying sizes and are composed of Physicians with the common specialty, although in the modern era of subspecialization, related specialties may be aggregated into one organization. For example, non-invasive cardiologist, interventional cardiologist, and electrophysiologists work together in a single specialty cardiology group.

Answer 66

B. Medication related Rationale: the average number of medication errors in the hospital is one error per patient per day

Answer 67

B. Population health Rationale: the population health approach describes a shift in our healthcare system from a narrow model of acute care targeted at the individual patient, to win the focuses on the health and overall wellness of the broader population it serves.

Answer 68

B. Alzheimer’s disease Rationale: Alzheimer’s disease is the most common type of dementia.

Answer 69

D. Depression Rationale: patients with another chronic illness or 1.5 to 2 times more likely to have depression and have poorer outcomes.

Answer 70

C. Decreased worker/employer share Rationale: work/employer share has increased.

Answer 71

A. A recent study found that electronica health records miss 33% of medication errors Rationale: researchers at University of Utah health, Harvard university and Brigham and women’s hospital discovered EHRs didn’t detect up to 33% of medical errors in studies simulations. The systems are supposed to issue warnings to doctors if their orders for medication could result in allergic reactions, adverse drug interactions, excessive doses or other potentially harmful effects.

Answer 72

A. Late life depression Rationale: late life depression is a common psychiatric disorder and people over 65 years of age, occurring in about 15% of that population. Predictors of poorer outcomes include adverse childhood events, age of one set, limited education, number of previous recurrences, and length of untreated episodes. Biological risk factors for late life depression include old age, female sex, family history of mood disorders, poor physical health, medications such as benzodiazepines and frailty. Psychosocial risk factors include a loss of purpose, lower level of education, being single, loneliness, lack of social supports, stressful life events, and poverty.

Answer 73

B. Lung function and detect COPD Rationale: a simple test, called spirometry, can be used to measure pulmonary - or lung - function and detect COPD and anyone with breathing problems.

Answer 74

B. Carcinoma Rationale: a carcinoma begins in the skin or the tissue that covers the surface of internal organs and glands. Carson is usually form solid tumors. They are the most common type of cancer. Examples of carcinomas include prostate cancer, breast cancer, lung cancer, and colorectal cancer.

Answer 75

C. Asthma Rationale: the asthma client needs to have a written action plan and rescue medications on hand. The client should know how to avoid triggers.

Answer 76

B. Coronary artery disease Rationale: coronary artery disease, CAD, is the most common type of heart disease, killing over 370,000 people annually.

Answer 77

D. Within Rationale: ending means within, or inside of, endoscopy is an example.

Answer 78

C. They are was multi factorial with multiple causes Rationale: medication errors are really caused by failure of a single element or the foot of a single practitioner. Because medication errors are often multi factorial, analysis of errors should always identify weaknesses in the system and correct of plans should include risk reduction strategies that span multiple processes.

Answer 79

D. Physician hospital organization Rationale: physician hospital organizations, PHO’s, such as Advocate health system in Chicago, or a form of physician hospital integration, although a loser one then certain other models such as medical foundations. PHO’s entail a formal partnership between hospitals and all or some of their affiliated positions for the purposes of contracting with water more health plans.

Answer 80

A. Availability heuristic or bias Rationale: availability heuristic or bias is the diagnosis of current patient biased by experience with past cases.

Answer 81

A. Anxiety Rationale: according to a recent study, 44% of cancer patients reported some anxiety and 23% reported significant anxiety. Anxiety is an emotional and physiological response to a perceived threat with an increase in alertness, tension, and sympathetic nervous system response. Anxiety is a normal response to stressful situations such as a cancer diagnosis or caring for someone with cancer.

Answer 82

D. Osteoarthritis National: asked you arthritis is the most common form of arthritis and disability in the US.

Answer 83

A. Stroke Rationale: acting F. A. S. T. Can help stroke patients get the treatments they desperately need.

Answer 84

C. Arm Rationale: brachi/o means arm, and example is brachialgia

Answer 85

C. CAPABLE Rationale: Community Aging in Place - Advancing Better Living for Elders (CAPABLE) helps older adults remain at home. Based on financial need, this program helps people who have a hard time completing daily tasks, like taking a bath or cooking a meal. The CAPABLE team includes a nurse, occupational therapist, and Handyman. These helpers visit the home and take care of individual needs. The CAPABLE team works closely with the client to identify goals. CAPABLE is currently available in nine states.

Answer 86

D. A second opinion Rationale: clients should trust their intuition and keep searching if they don’t think the physicians are right.

Answer 87

C. Heart disease Rationale: heart disease is the leading cause of death for both men and women.

Answer 88

C. Ask Mr. Doe if he’s thinking about killing himself Rationale: ASK: “Are you thinking about killing yourself?” It’s not an easy question, but studies show that asking at risk individuals if they are suicidal does not increase suicide or suicidal thoughts.

Answer 89

C. Obesity Rationale: obesity is linked to many other product conditions such as type two diabetes, coronary artery disease, heart failure, hyperlipidemia, hypertension, osteoarthritis, obstructive sleep apnea and depression.

Answer 90

A. I store everything in a HIPAA compliant cloud and use an encrypted computer Rationale: always keep all client records secured at all times. Use a HIPAA compliant cloud and a computer that is encrypted, hardcopy records should be kept in a locked file cabinet.

Answer 91

C. Disclosing any potential conflicts of interest Rationale: an advocate shall not start or continue to provide services to a client with a conflict of interest exists, unless both of the following apply: - the advocate will be able to provide competent and diligent services to the client, and - the client is informed consent, confirmed in writing.

Answer 92

A. Transparency Rationale: board-certified patient advocates shut at all times be transparent with clients, disclosing credentials, work experience, pricing structure, and any financial relationships they hold with other professionals, businesses, or institutions.

Answer 93

C. Sign up to receive notices and newsletters from government and other reputable organizations Rationale: this is the only choice that would be the most likely to provide credible information.

Answer 94

C. Asking clients to subscribe to the advocate’s monthly newsletter for a fee Rationale: advocates shall not except compensation for making referrals to other providers or services, north your clients to products or services from which the advocates will profit financially or earn a commission. Advocates shall not except a paid advertising on their websites for products or other service providers. Advocates shall not require a client to purchase or subscribe to any outside service in order to benefit from the advocate’s services.

Answer 95

A. Obtain 30 continuing education credits within the next three years Rationale: see the PACB CE handbook

Answer 96

B. Errors and omissions insurance Rationale: independent advocates need work insurance commonly called errors and omissions insurance or E and O. This insurance covers the advocate if a mistake is made or something is not done that should have been.

Answer 97

D. The advocate Rationale: the advocate is responsible for setting and maintaining boundaries.

Answer 98

A. All of these Rationale: advocates participate in the continued learning other colleagues by sharing information and resources for the benefit of the profession and the public. And example might be teaching a class for other healthcare professionals are creating a list of community resources and sharing with other healthcare professionals.

Answer 99

D. Business insurance Rationale: business insurance covers your business property, such as computers, office furniture, and other equipment.

Answer 100

C. Obtaining EOM Insurance Rationale: board-certified patient at the kids participate and then continued learning of their colleagues by sharing information and resources for the benefit of the profession and the public. And example might be teaching a class for other healthcare professionals or creating a list of community resources and sharing with other healthcare professionals. We are applicable, advocates Shelton continuing education credits as dictated by professional license and regulatory/credentialing bodies. Advocates shall consult with colleagues regarding challenging client situations and view it as an opportunity to learn. To foster the development of the advocacy profession and junior colleagues, advocates will participate in the professional development of other patient advocates by mentoring or participating in professional education programs, as appropriate.

Answer 101

C. Benefit the profession and the Public Rationale: Advocates participate in the continued learning of their colleagues by sharing information and resources for the benefit of the profession and the public.

Answer 102

A. Let me see if I can find someone who can come in and clean for your mom and if it is covered in her benefits Rationale: Susan wants to be careful that she does not set an expectation that she will always do housework.

Answer 103

C. Business insurance Rationale: business insurance covers your business property such as computers, office furniture and other equipment. It does not cover liability.

Answer 104

A. Use one pharmacy Rationale: clients and caregivers can be educated to use one pharmacy. One pharmacy is safer because if all medications are in one place, the pharmacy can quickly check for interactions. It is always a good idea to have interactions chat anytime a new prescription is added.

Answer 105

B. Advocate role and avoidance of impropriety Rationale: advocate role - advocates cannot recommend specific treatment choices, provide clinical opinion, or perform medical care of any type, even if they possess the Clinical credentials. Avoidance of impropriety - ever gets cannot except compensation for referring clients to other providers or services, nor can they steal clients to products or services in which the advocate will profit. This applies to paid advertising for Products or other service providers on the advocates website. Additionally, advocates cannot require a client to purchase or subscribe to any outside service to benefit from the advocate’s service.

Answer 106

B. Affordable care act Rationale: the overarching goals of the ACA are to make healthcare affordable, improve quality and safety, and extend the life of Medicare.

Answer 107

B. Provide all patients with written information about advance directives Rationale: PSDA requires all healthcare institutions receiving Medicare or Medicaid reimbursement to ask patients that they admit if they have an advance directive. If the patient does not, institution is required to provide written information about advance directives.

Answer 108

A. Malpractice litigation Reform Rationale: malpractice litigation reform deals with limits on attorney fees and limits on liability and capitation set for pain and suffering.

Answer 109

D. Allowing her client to buy her dinner, valued at $37.50 Rationale: advocates cannot except compensation for referring clients to other providers or services, nor can they steer clients to products or services in which the advocate will profit. This applies to paid advertising for products or other service providers or the advocates website. Additionally, advocates cannot require a client to purchase or subscribe to any outside service in order to benefit from the advocate service. An advocate may except a gift from a client that is not of substantial value, but may not except multiple gifts with a combined value that is substantial. The patient advocacy certification board considers anything valued over $75 as substantial.

Answer 110

B. African-American Rationale: African-Americans are more likely to visit but leave the emergency department without being seen, compared to whites, and African-Americans wait longer to be seen than any other groups. African Americans were 30% more likely than whites to die prematurely from heart disease and 2010, and African-American men are twice as likely as whites to die prematurely from stroke. African-Americans, Asians, American Indians/Alaska native, and Hispanics continue to lag behind whites in the percentage of the population over 50 who receive colon cancer screening, and this gap has widened in recent years.

Answer 111

C. Horizontal network Rationale: a horizontal network is a conglomeration of multiple institutions of the same type. And example is Shriners hospital.

Answer 112

D. Advocate role, transparency and honest disclosure, provision of competent services, and fostering autonomy Rationale: the advocate roll speaks to Roberts role as a facilitator guide which provide clients with information to make informed choices. Transparency and honesty disclosure speaks to the mandate for Robert to maintain integrity and the conduct of his practice. Provision of confidence Services requires that Robert refrain from offering opinions about the skills or attitude of other healthcare professionals. Fostering autonomy requires that Robert respect Mr. Green’s ability to choose, provided Mr. Green has a complete and accurate information.

Answer 113

D. 60 million Americans living in a primary care shortage area Rationale: there is a shortage of primary care physicians, resulting in 60 million Americans living in a primary care shortage area. Areas with higher ratio is a primary care physicians to population have much lower total healthcare costs and other regions, adding to healthcare disparity.

Answer 114

B. The color black Rationale: melan/o means the color black, and example is melanoma

Answer 115

B. The three midnight rule Rationale: skilled nursing facility SNF is covered if it follows within 30 days of a hospital stay in which the person was inpatient for three days or more and is deemed medically necessary

Answer 116

C. Why Rationale: avoid questions that begin with why because they require the client to provide a reason. Not only do some people find it difficult to explain their actions, but they also may simply feel providing reasons is an invasion of privacy and intrusive. Why questions can also seem accusatory to some people, as if the advocate is finding fault with your actions or choices.

Answer 117

C. Community-based program Rationale: a community-based hospice has no facility, just an office, and home care is the focus.

Answer 118

B. Jane’s informed consent in writing Rationale: in the event of a conflict of interest, the average cannot start or continue services with a client unless both of the following are true: 1) The advocate will be able to provide competent and diligent services to the client, and 2) the client gives informed consent in writing.

Answer 119

B. Advocate that the ribbon stays on Miguel’s wrist Rationale: in the Mexican culture, jewelry may have religious or spiritual meaning. (advocate that the stay on the client or at least with the client).

Answer 120

B. Day treatment programs Rationale: this is the only choice it will expose Betty to other people her own age and help with social isolation

Answer 121

B. Susan is a silent partner in Ann’s doctor’s practice Rationale: the patient advocate board defines conflict of interest as a situation with the potential to undermine the impartiality of a person because of the possibility of a clash between the persons self interest and professional interest or public interest. C is not correct because we do not know the Ann has breast cancer and or that Herceptin would be one of the treatments. A is not correct, because this does not mean that Susan will not still be impartial and D has no bearing on the situation

Answer 122

C. Refusing difficult patient’s due to inexperience Rationale: in order to keep pace with rapid changes in healthcare, keep knowledge and skills current, and develop professionally, advocates are committed to lifelong learning. When patient advocates are faced with challenging clients situations, they consult with colleagues in order to learn from them. Advocates foster development of the advocacy profession and novice colleagues by contributing to the professional development of them by mentoring or participating in professional development programs.

Answer 123

A. Concierge practice Rationale: boutique/concierge practice: these clinics focus on patients who would like a high level of service (e.g. short wait times, extended appointments, and Physicians were available 24/7) and are willing to pay for it. Boutique or concierge practice is typically charge an annual membership fee, sometimes along with separate appointment fees, and can therefore, afford to keep the total patient load low and have more time for each patient.

Answer 124

A. Resume and references Rationale: independent advocates who provide a service for a fee have an obligation to disclose their fees, training, education, experience, and credentials. They must provide their curriculums vitae or resume and references upon request. Additionally, they must disclose any existing contractual relationships with manufacturers, distributors of products or providers of services they use to assist clients. The contract was also outlined the projected length and scope of the relationship, as well as criteria for termination of the agreement.

Answer 125

B. 22.6 Rationale: do you conversely researchers estimate that: given the typical patient load and the current guidelines for care, a PCP should be spending 7.4 hours per day on preventive care, 10.6 hours on managing chronic diseases, and 4.6 hours on handling acute illness - totaling 22.6 hours a day. When your clients wonder why appointments or short or there is a long wait time, this is part of the reason why. Another contributor is the primary care physician shortage.

Answer 126

D. Learn about preferences and consider those when helping the client Rationale: when an advocate is unfamiliar with clients ethnic or cultural background, the advocate will work to understand preferences and include that regard in to provision of the client’s healthcare.

Answer 127

C. Autonomy Rationale: the term autonomy refers to the right of self determination.

Answer 128

A. Caregiver skills matched to patient needs Rationale: general characteristics of care delivery includes caregiver skills matched to patient needs, caregiver role is defined and assignment of work based on competencies

Answer 129

A. Secular Rationale: secular hospitals are not for profit hospitals that are owned and operated by non-religious civic organizations. They are governed by a Board of Directors composed of locally prominent citizens.

Answer 130

A. Confining to the client that he, like the client, has an unfaithful spouse, so he understands the client’s stress Rationale: as an advocate you’ll be dealing with very personal aspect of the client’s life, it is easy for lines to blur between what is personal and what is business. Clients can become very dependent on you and often dependency breeze familiarity. As the advocate, you need to make sure boundaries don’t get across. As long as the business relationship exists keep business and personal separate.

Answer 131

D. Having a relative translate treatment options for a Spanish-speaking client Rationale: by providing complete an accurate information, advocates work to ensure that clients are cognizant off and understand all care and treatment options, including the potential risk and benefits, and available alternatives. Interpreters must be specially trained and certified in medical translation to ensure that information is translated accurately.

Answer 132

B. Advocates shall not provide clinical opinions unless they are licensed to do so Rationale: board-certified patient advocates who are licensed medical professionals cannot provide clinical opinions or perform medical care of any kind. This role is maintained at all times that the title board-certified patient advocate disease regardless of the relationship status with the client

Answer 133

C. Suggest remedies without being overly directive Rationale: with an audience of experts such as physicians, the advocate should be careful not to be excessively directive and suggesting solutions for the client. The tone of communication is essential in medical settings were power disparities exist. Citing guidelines can certainly be a part of this, but it needs to be done in a collaborative manner.

Answer 134

C. Remind the physician that best practice and joint commission standards act provide a professional healthcare interpreter Rationale: advocates can cite shared collective interests to improve the care of clients

Answer 135

D. Nothing, Susan cannot share any information with the legal surrogate without consent from Betty Rationale: similar to a medical power of attorney, illegal surrogate is often named as part of the LivingWell or advanced directive. Just because Betty has a legal surrogate does not mean that the Legal circuit has become a decision maker. When the legal surrogate becomes a decision maker, that would be the time for Susan to convey any personal conversations she had with Betty regarding her wishes. In the meantime, Susan will need Betty’s permission to share any information with the legal surrogate.

Answer 136

B. Advocate role and avoidance of impropriety Rationale: advocate roll - advocates cannot recommend specific treatment choices, provide clinical opinion is, or perform medical care of any type, even if they possess the Clinical credentials. Avoidance of impropriety - advocates cannot except compensation for referring clients to other providers or services, Newark and they said your clients to products or services in which the advocate will profit. This applies to paid advertising for Products or other service providers on their advocates website. Additionally, advocates cannot require a client to purchase or subscribe to any outside service in order to benefit from the Advocate service. Susan would not violate transparency if she disclosed her relationship with John to her clients.

Answer 137

B. Persuasion Rationale: persuasion is not an active listening skill. Clarification and questioning, reflection, and summarization or active listening skills.

Answer 138

C. Help Mrs. Wright achieve her goals Rationale: the purpose of health coaching or wellness coaching is to help clients achieve their goals

Answer 139

A. Withdrawal and disturbed sleep Rationale: older people may show clinical signs of depression, such as: with drawl, sleep disturbances, hopelessness, and possibly suicidal thoughts

Answer 140

A. Per diem Rationale: Perdiem is a reimbursement at a fixed amount per day, regardless of the services provided

Answer 141

A. Avoiding practices that will harm the client Rationale: The four ethical principles guiding advocacy practice are: autonomy nonmaleficence, beneficence, and justice. Autonomy is self determination, helping clients determine the right course of action. Nonmaleficence is do no harm. Beneficence is assisting clients in determining the benefits against the risk. Justice is the distribution of resources fairly.

Answer 142

B. Symptom management Rationale: palliative care is intended for clients you need to improve the quality of life by managing symptoms, including pain management. Palliative care can begin at any time during an illness and is unrelated to the diagnosis or life expectancy. Clients can continue to receive curative treatments. Clients with life-threatening diseases can begin with palliative care to control pain and other symptoms and then may progressed to hospice care as the disease progresses.

Answer 143

D. The ADA and FMLA apply only to employers with more than 15 and 50 employees, respectively. Rationale: because Mary works for a small business owner with fewer than 15 employees, she is not protected at the workplace by ADA and the FMLA. The Americans With Disabilities Act (ADA) applies to employers with 15 or more workers. The family and medical leave act (FMLA) applies to our government employers (local, state and federal) and to private businesses with 50 or more workers within 75 miles (with some exceptions). She would not win a suit against her employer given these conditions. She would not qualify for long-term disability since she is no longer employed. She should apply for Medicaid, for which she qualifies.

Answer 144

D. Assisting with obtaining information Rationale: assisting with gathering of information is appropriate at the stage.

Answer 145

D. Description of information to be disclosed as described, date, and signature of authorized person Rationale: the authorization must include: a description of the information to be disclosed; the authorization last name specific persons or entities that can receive the information; it must include a date or event after when the authorization expires; the patient has a right to revoke authorization at any time

Answer 146

A. Obtain 30 continuing education credits within the next three years Rationale: see the PACB CE handbook

Answer 147

A. 4020 Rationale: in 2020, once a person has reached $4020 (includes with the patient and the plan has paid) in drug costs, they are responsible for 25% of the cost of their drugs. For example, if a drug cost $100 and the patient previously paid a co-pay of $20 during the initial coverage period (up to the $4020), the patient will now pay $25.25 percent of $100 during the coverage gap (after $4020 has been reached).

Answer 148

A. Client centered care Rationale: this is the world health organization definition of person centered care, another name for client centered care.

Answer 149

D. Are 3 to 7 times more likely to die of cancer than those with high annual incomes Rationale: people with low incomes are 3 to 7 times more likely to die of cancer than those with high annual incomes

Answer 150

C. When medications are administered and during transitions Rationale: the most dangerous times for patients are when medications are administered and during transitions. Remember a change of shift is just another type of transition in that it is a transition from one care team to another, so both choices in D are essentially the same. Medical errors occur on average of one per patient per day and most errors occur station. This along with any type of transitions are dangerous times for patients.

Answer 151

A. Seek out colleagues, mentors or other experts Rationale: board-certified patient advocates take the initiative to seek out colleagues, mentors, and other experts regarding challenging client situations.

Answer 152

D. Mr. Green will need to pay the 20% copayment for all the tests and medications he received in the hospital and there is no limit to the out-of-pocket expenses he may have to pay. Rationale: the MOON form is a standardize notice to inform beneficiaries that they are an outpatient receiving observation services and are not an inpatient of the hospital. With that means is that Medicare treats Mr. Green as if you were still at the clinic, even though he spent the night. That means that Mr. Green needs to pay the 20% copayment for all the tests and medications he received in the hospital and there is no limit to the out-of-pocket expenses he may have to pay.

Answer 153

D. Restore dosha Rationale: Shirodhara is a method to restore dosha . In the traditional Hindu culture, it makes a Food, minerals, and herbs may restore the balance between the three dosha or elements which relate to the different functions: air (respiratory system), fire (digestive system), and water (bodily fluids).

Answer 154

B. Point of service plan (POS) Rationale: the POS is a hybrid that combines features of HMOs and PPOs. This hybrid allows the client to choose a physician is either in network or out of network. The clients PCP oversees referrals to out of network providers. In contrast to a PPO, when the services are obtained out of network, the beneficiary has a higher deductible, higher coinsurance, and higher copayments to make. To receive services, the beneficiary must first pay the deductible and the co-pay.