Exam 4 Flashcards

Question

Provisional Monitoring Visit | (step 2)

Answer 1

occurs as the first cohort is preparing to graduate

Answer 2

**occurs 18-24 months after initial accreditation provisional is granted** -will receive **accreditation-continued** if all standards are met

Answer 3

**given to an established program that has failed to keep up the standards** -temp 2 year status

Answer 4

validation visits every 10 years +/-

Answer 5

seeking accreditation-provisional but does not comply w/ standards

Answer 6

**loss of accreditation** -may pose risk to graduates of the program by not being able to gain licensure depending on the state

Answer 7

**PA profession certification body that provides reliable indicator that those certified have demonstrated/possess/maintain knowledge and skill to practice safely/effectively** -over 20 years -PA cert, re-cert and CME records (previously done by AAPA)

Answer 8

**certifies all states and DC** -must attend accredited school -must pass PANCE -100 CME hours every 2 years -PANRE every 10 years -certified w/in 6 years of graduation -up to 6 attempts on PANCE -maintenance of certification is digital

Answer 9

Arizona, California, Texas, Iowa, Massachusetts, Rhode Island, Utah

Answer 10

**allows new grads to work prior to sitting for their PANCE exam** -much more restrictive than full license

Answer 11

-let pt know your are going to log on -computer can enhance provider-pt relationship -maintain eye contact throughout computer use

Answer 12

1. **Honor golden minute**: remain technoology free the first minute 2. **Use triangle of trust**: allow u and pt to see screen 3. **Maximize pt interaction**: encourage pt to interact w/ graphs + trending tools 4. **Acquaint yourself w/ chart**: before entering pt room 5. **Nix the screen**: disengage from compiuter when discussing sensitive pt issues 6. **Let the pt look on**: see screen and follow actions 7. **Eye contact**: maintain as much eye contact as possible 8. **Value the computer**: discuss its benefits 9. **Explain what you're doing**: avoid long periods of silence 10. **Log off**: to ensure medical info is secure

Answer 13

**27 months** -24 months before integration of master's

Answer 14

-2,000 PCE hours -GPA = 3.56 -25 years old

Answer 15

-advocacy for PA education -founded in 1972 -oversight for CASPA

Answer 16

**360 multiple choice questions that assess medical and surgical knowledge** -6 attemps to pass within 6 years (3x in one year) -need 350 score out of 800 to pass -wait 90 days to retake if failed exam

Answer 17

recert after 10 years -computer based exam -240 multiple choice questions from NCCPA blueprint -passing score of 379 out of 800

Answer 18

**administered over 12 quarters in years 7-9** -added in 2022 to start Jan 2023 -final score based on best 8 quarters -25 questions each quarter w/ 5 minutes to answer each question -can use printed/online references -3 attempts to pass PANRE in year 10 if failed PANRE-LA -still need CME requirements

Answer 19

**100 hours every 2 years w/ NCCPA** -50 category 1 credits (medical conferences, training, journal reading w/ questions, grand rounds meeting) -remaining 50 credits can be category 1 or 2 -NCCPA fee of $180 to log CME

Answer 20

subcommittee of medical board formed ot deal w PA practice or state medical board that includes seats for PA representation

Answer 21

**states are trying to create PA licensing boards as a result of new PA practice acts that replace intial delegation amendments to medical practice acts** -composed of practicing PAs and physicians who employ/work with PAs -typically advisory to governmental agency (ultimate authority)

Answer 22

-communication -knowledgeable about diagnosis, prognosis and treatment -supportive space -speak without medical jargon -allow pt to process info (silence) -evaluate your reaction to pt's diagnosis

Answer 23

**hospice** -formal symptom assessment and treatment regarding disease processes shortening a pt's life -aid w/ decision making and goals of care -practical/moral support for pt/caregivers -collaborative models of care (team) for terminal illnesses | pts in U.S. spend < 1 week on hospice

Answer 24

**legally designated person to make decisions for a pt when they are unable to state their own wishes regarding medical treatment** -executes wishes via living will for resuscitation, antibiotics, feedings and other life sustaining treatment

Answer 25

**legal document stating pt's wishes regarding treatment if unable to speak** -resuscitation instructions -intubattion/mechanical vent instructions -treatment guidelines -future hospitalization and transfer -artificially administered fluids and nutrition -antibiotics -etc

Answer 26

**form used for pts who want to avoid or receive any or all life sustaining treatment; only authorized form in NYS documenting both nonhospital DNR/DNI orders** -pt who reside in long term care facility and/or may die within. a year -used in a variety of healthcare settings -legal checklists required concerning life-sustaining tretament -no checklist used = alternative method assuring strict adherance to legal requirements -witnesses to consent -renewed/discontinued after 90 days | bright pink paper

Answer 27

**conservations w pt, family and qualified health professional** -provider defines goals for care, reviews treatment options and ensures shared/informed medical decision making -provider MUST consult w/ all of the above personnel about diagnosis, prognosis, goals, treatment preferences, gain consent and sign orders derived from discussion

Answer 28

-**Page 1 (section A+B)**: resuscitation; pt/proxy/witnesses sign -**Section C:** signatures of physician -**Section D**: advanced directives -**Section E**: treatment guidelines, ventilation, future hospitalization/transfer, fluids, nutrition, antibiotics -"**Other" section**: dialysis, transfusion

Answer 29

**obtain good hx and physical exam** -pain: nociceptive, neuropathic, mixed-pain, psychosocially based pain

Answer 30

-underreporting of pain -multiple co-morbidities -side effects of meds to treat pain -changes in metabolism of meds due to age

Answer 31

NSAIDS, cognitive behacorial training, complementary modalities

Answer 32

low dose/low potency opioids, +/- NSAID, complementary modalities

Answer 33

potent opioids, PCA, neural blockage, spinal anesthesia, complementary modalities

Answer 34

1. 300 accredited programs as of Nov 2022 2. terminal degree = masters 3. average program length = 27 months 4. "minds on hands on" - short training 5. didactice + clinical phases 6. clincial experience during didactic 7. service in 1/3 programs to expose population health issues and cultural diversity

Answer 35

-21.9% 100k-125k -20.8% 75k-100k -14.5% 50k-75k

Answer 36

**May 2017 by AAPA** -direct reimbursement for all PA services -PA representation on state medical boards or separate PA regulatory boards -elimination of the requirement for written practice agreement to supervisory physician -PA scope of practice determined at the practice level (even though AAPA does not advocate for independent practice)

Answer 37

-AAPA -PAEA -NCCPA

Answer 38

**Code of Medical Ethics Opinion 2.1.1** -pts have right to receive information and ask questions about treatments to make well educated decisions -communication between pt and provider

Answer 39

-assess patient's ability to understand -pt's independent and voluntary decision -discuss diagnosis, purpose, risks/benefits, options, outcomes of refusal -documentation

Answer 40

**process of converting pt charts and clinical data to medical claims (submitted for reimbursement)** -data entered through EMR -applying procedure codes -ICD-10

Answer 41

January 1, 2021- outpatient E/M CPT 99202-99215 office visits have new guidelines to follow for assigning CPT code

Answer 42

-elimination of hx/PE as elements for code selection -providers choose to base documentation on medical decision making (MDM) or total time spent on encounter [office setting] -MDM or time (not both)

Answer 43

1. **time**: prep for visit, documentation, face to face time 2. **MDM**: 4 levels (straightforward, low, moderate, high), number and complexity of problems/data (tests, orders, review), risk of complications

Answer 44

1. **time**: prep for visit, documentation, face to face time 2. **MDM**: 4 levels (straightforward, low, moderate, high), number and complexity of problems/data (tests, orders, review), risk of complications

Answer 45

-3-7 characters in length -68,000 codes -first digit = letter -digits 2+3 = number -digits 4-7 = aplha or numeric -flexible for adding new codes -very specific -up to 12 codes on claim form

Answer 46

-bill for what you actually do -do not up code -do not commit fraud (medicare/medicaid investigation) -review / understand before clinical year

Answer 47

federal Medicare/Medicaid agency that oversees HIPAA administration -creates safety guidelines for facilities -penalizes facilities falling below standards by lowering reimbursement -monitors 30 day risk for unplanned readmissions -decubitus ulcers

Exam 4 Flashcards

(71 cards)