Final Flashcards
(269 cards)
1
Q
A fixed payment plan of health insurance offers coverage for…
A
Complete medical care
2
Q
Third-party payers are…
A
Insurance companies
3
Q
The purpose of the gatekeeper is to…
A
Approve all non emergency services, approve hospitalization, and approve tests before they are given
4
Q
In a managed care organization, financial risk is shared by….
A
Organizations, hospitals, and physicians
5
Q
A gag clause, considered illegal in contracts between physicians and managed care organizations…
A
Prohibits the physician from discussing financial incentives given by the organizations.
6
Q
Managed care organizations may attempt to limit a patient’s…
A
Choice of hospitals, referrals to specialists, length of stays in a hospital.
7
Q
A health maintenance organization provides
A
Healthcare services available for a predetermined fee per member by a limited group of providers.
8
Q
Capitation is
A
A fixed monthly fee paid to the healthcare provider for providing patient services.
9
Q
Medicare is a federal program of
A
Healthcare coverage in which rationing of care might occur in the future and coverage for the elderly and disabled.
10
Q
Medicaid is a
A
Federal program of care for the poor implemented by the states
11
Q
A medicare-instituted method of hospital payment is
A
DRG(Diagnosis-related groups)
12
Q
Diagnosis related groups refer to
A
The classification of patients of illness by diagnosis
13
Q
Those persons most likely to receive the best care under a managed care system are
A
Those who understand the system
14
Q
Medicare and Medicaid prohibit physicians from
A
Referring to services they own
15
Q
Different methods of medical practice, such as partnership and corporations, are the result of
A
Increased insurance coverage costs, a desire to better serve patients’ needs, and increased patient-initiated malpractice lawsuits.
16
Q
A practice in which the physician employs other physicians and pays them a salary is called
A
Sole proprietorship
17
Q
An associate practice is a legal agreement in which the physicians
A
Share a facility and staff
18
Q
A business operation of a medical practice in which two or more physicians are responsible for the actions of each, including debts, is called…
A
Partnership
19
Q
A medical practice consisting of three or more physicians who practice the same specialty and share expenses and income is a
A
Group practice
20
Q
The members of a professional corporation are known as
A
Shareholders
21
Q
Benefits of a corporation include all of the following except…
A
Protection from the lawsuits for the corporation
22
Q
Which form of medical practice ends with the death of the owner?
A
A solo practice
23
Q
Fee splitting occurs when
A
One physician pays another physician for the referral of patients.
24
Q
Allied health professionals who are certified include all of the following except
A
Pharmacists
25
A person with the appropriate education who practices as a doctor of medicine or doctor of osteopathy is called a
Physician
26
Decision based on emotion
Gut feeling
27
Medical etiquette
Standards of professional behavior
28
R/O
Rule out diagnosis
29
Ethics
Branch of philosophy
30
Applied ethics
Practical application of moral standards
31
Laws
Binding rules determined by an authority
32
Medical ethics
Moral conduct to regulate behavior of medical professionals
33
Beneficence
Principle of doing good
34
Veil of ignorance
Justice based
35
Three step ethics model
Kenneth Blanchard and Norman Vincent Peale’s approach to ethics
36
When you are trying to solve an ethical dilemma, it is necessary to?
Use logic to determine the solution
37
An illegal act is almost always
Unethical
38
An utilitarian approach to solving ethical dilemmas might be used when?
Allocating a limited supply of donor organs
39
Three step approach to solving ethical dilemmas is based on what?
Asking ourselves how our decision would make us feel if we had to explain our actions to a loved one, asking ourselves if the intended action results in a balance decision, asking ourselves if the intended action is legal
40
How can embezzlement be prevented?
Checks and balances
41
Order for a person or document to appear in court?
Subpoena
42
Person who is being sued
Defendant
43
Give up the right to something
Waive
44
Law that covers harm to another person
Tort
45
Earlier ruling applied to present case
President
46
Failure
Breach
47
Person who sues another party
Plaintiff
48
Less serious crime such as a traffic violation
Misdemeanor
49
Oral testimony to be used in court
Deposition
50
Serious crime such practicing medicine w/out a license
Felony
51
Subpoena duces tecum means?
“Under penalty, take with you”
52
Stare decisis means?
“Let the decision stand”
53
A threat of doing bodily harm to your patient by stating, “if you won’t allow us to continue the procedure, we will have to tie your hands” is...
Assault
54
A patient comes in for an exam, they remove their clothing and put on a gown. This would be?
Implied consent
55
Endorsement
Sanction
56
Guardian ad liter
Court appointed representative
57
Revoked
Medical license taken away
58
Respondeat superior
Let the master answer
59
Statute of limitations
Period of time that patient has to file a lawsuit
60
Discovery rule
Begins at the time the injury is noticed or should have been noticed
61
Reciprocity
One state granting a license to a physician in another state
62
Standard of care
Ordinary skill that medical practitioners use
63
Good Samaritan law
Law to protect the healthcare professional
64
Nonrenewal of license
Practicing medicine without a license
65
According to the Medical Patients Rights Act, patient information
Can never be given out to a third party
66
The term used for a court appointed person to represent a minor or unborn child in litigation is?
Guardian ad litem
67
The prudent person rule refers to?
The information that a reasonable patient would need
68
When the Physician places an ambiguous order, you the healthcare professional...
Can decline to carry out the order and should immediately notify the physician
69
Physicians and employees are?
Liable in a lawsuit, have the same responsibility to protect patient’s confidentiality, operate under a standard of care, and must be trained to perform a procedure before attempting it
70
What does JCAHO mean?
Joint Commission of Accreditation of Healthcare Organization
71
The contract for services with a physician includes...
An agreement to pay for services for as long as they are received by the patient, truthful disclosure of conditions by the patient, and an agreement to provide services by the doctor
72
Physicians may...
Refuse to treat patients, except emergencies, and withdraw from a contract if the patient is uncooperative
73
An increase in malpractice insurance premiums has caused
Physicians to charge more for services than in the past
74
A physician can turn away patients that
They have not agreed to treat.
75
An indigent patient is one who
Is unable to pay for medical care
76
Abandonment can be avoided by
Giving formal notice of withdrawal from a case.
77
The physician, by law, must report to the state any person who...
Is HIV or AIDS positive
78
The physician who believes that his or her AIDS patient may place the health of others in jeopardy has an ethical obligation to...
Persuade the patient to inform his or her partners
79
Testing for HIV first requires
The patient’s informed consent.
80
A report of HIV or AIDS diagnosis must be completed by the
Physician
81
Patient confidentiality does not apply in the case of
The life or safety of the patient.
82
Medical ethicists currently encourage healthcare providers to
Focus on the consequences of an action while protecting the patient and apply the principles of justice
83
The patient has a right to
Deny any treatment, give informed consent for any treatment, and expect the appropriate standards of care
84
Minor children may receive life-saving treatment
Even though the parents refuse
85
A breach of confidentiality is considered unethical and illegal, and is prohibited by
HIPAA
86
Confidential information that has been told to a physician by the patient is called
Privileged communication
87
A statement of the patient’s intentions for healthcare-related decisions is called
An advanced directive
88
A patient request to either use or not use life-sustaining treatments and artificial nutritional support is known as
A living will
89
The authority of a healthcare agent to act on behalf of the patient
Continues even if the patient is physically or mentally incapacitated
90
A minor is one who
Is less tha 18 and is not considered competent to give consent for most treatments
91
The patients signature on an informed consent form indicates
Understanding of treatment options, expressed consent, understanding of the limits or risks in the pending treatment
92
Patients who indicate by their behavior that they will accept a procedure are providing
Implied consent
93
Exceptions to obtaining consent may include
Commonly known risks
94
Refusal for medical or surgical treatment by the patient must be honored if
The patient is concerned about the success of the procedure, the patient is not confident in physician, religious beliefs against the procedure are expressed.
95
One of the best ways to prevent medical errors is for the patient to
Be a better informed consumer of medical services
96
Failure to perform an action that a reasonable person would have performed in a similar situation is
Negligence
97
Performing a wrong and illegal act is considered
Malfeasance
98
Professional misconduct or demonstration of an unreasonable lack of skill with the result of injury, loss or damage to the patient is
Malpractice
99
Negligence is composed of four elements
Duty, dereliction of duty, direct or proximate cause, and damages
100
The reasonable person standard refers to
Duty of due care
101
The standard of care for physicians and other healthcare professionals is determined by
What members of the same profession would do in a similar situation within the same geographic area
102
To prove dereliction of duty, a patient would have to prove the physician
Did not conform to the acceptable standard of care
103
The the things that speaks for itself applies to the law of negligence and is the doctoring of
Res Pisa loquitur
104
Monetary awards by a court to a person who has been harmed in an especially malicious or willful way are
Punitive damages
105
To win a wrongful death case, the plaintiff must prove
Negligence
106
The most common defense provided by the defendant in a medical malpractice case is called
Denial defense
107
Assumption of risk the legal defense
That prevents the plaintiff from recovering damages if he or she accepts a risk associated with the activity
108
When an employer lends an employee to someone else, this is called
The borrowed servant doctrine
109
The statute of limitations for a case begins to run
When the injury is discovered
110
Deliberate concealment of the facts from a patient is
Fraud
111
Res judicata means
The thing has been decided
112
The legal relationship formed between two people when one person agrees to perform work for another person is called
The law of agency
113
Protection for the physician/employer by the healthcare professional is best accomplished by
Having a job description with clearly defined responsibilities, duties, and necessary skills, using extremes care when performing his or her job, and carrying out only those procedures for which he or she is trained
114
Responsibility for action in employment is ultimately assigned to the
Employer
115
A contact by which one person promises to compensate or reimburse another if he or she suffers a loss form a specific cause or a negligent act is
Liability insurance
116
Coverage of the insured party for all injuries and incidents that occurred while the policy was in effect, regardless of when they are reported is
Occurrence insured
117
A general liability policy that covers any negligence on the part of the physician’s staff would include
A rider of the malpractice policy
118
Submitting a dispute to a person other than a judge is called
Arbitration
119
An important reason for arbitration of civil cases is to save
Time and money
120
The only health professional who not usually employed by the physician is the
Pharmacist
121
Data, such as birth and death dates, are used by the government to
Determine population trends and needs
122
Public duties for the physician include reporting
Births and still births, deaths and injuries, and communicable illnesses or diseases,
123
The live birth certificate must be signed by the
Physician who delivered the child and person in attendance in a home birth
124
A death certificate must include the
Date and time of death, name of the parents of the deceased, and location of the place of death.
125
A coroner or medical examiner must sign the death certificate of the deceased when
No physician was present at the time of death, a violent death occurred, and the death occurred when the deceased was in jail or or prison
126
A medical examiner is a
Physician
127
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Which of the following is not a reportable communicable disease:
Tetanus
Tuberculosis
Chicken pox
Gonorrhea
```
Chicken pox
128
Which of the following is/are required by the National Childhood Vaccine Injury Act of 1986?
The polio virus vaccine, live and the measles, mumps, and rubella vaccine
129
A physician reporting possible child abuse
May not be sued by the parents of the child for defamation and may file an initial oral report followed by a written report.
130
Failure to report a suspected case of child abuse may result in a charge of
Misdemeanor
131
Elder abuse may legally include all of the following except
Verbal abuse
132
Injuries, fractures, pain in the genital area, and weight loss may be signs of
Physical abuse
133
Evidence gathered in an abuse case may include
Pictures of bruises or injuries, urine specimens, and clothing
134
Chain of evidence refers to all of the following except
Clothing evidence that is clean and dry
135
Conditions such as cancer, epilepsy, and congenital disorders of the newborn are often reported to government agencies in order to
Maintain accurate public health statistics
136
Enforcement of drugs sales an distribution is through the
Food and Drug Administration
137
The purpose of the DEA is to
Regulate the Controlled Substances Act of 1970
138
Registration for physicians who administer controlled substances must be renewed every
3 years
139
The proper method of destroying a controlled substance that needs to be disposed of “disposed of or wasted” is to
Flush it down a toilet as advised by the manufacturer.
140
The penalty for violation of the Controlled Substances Act is
A fine, loss of license to practice medicine, and a jail sentence.
141
DEA registration numbers are available to
Physicians
142
Prescriptions for Schedule 2 controlled substances can
Not be refilled
143
A program of management-financed and confidential counseling and referral service designed to help employees and/or their family members assess a problem is the
EAP
144
It is estimated that personal problems related to alcohol and/or drug abuse cost the U.S. economy more than_______ of it $70 billion budget yearly.
%50
145
Hazardous medical waste includes
Infectious waste from body fluid contract and radioactive waste.
146
Laws regulating employment relationships, recruitment, placement, pay plans, benefits, penalties and terminations are based primarily on
Job performance
147
Employment-at-will allows the
Employee to quit at any time, and employer to terminate the employee at any time
148
Discrimination in the form of unfair treatment in employment based on race, color, religion, sex or national origin is covered through
Title VII
149
Medicare and Medicaid forbid discrimination in
patient-care institutions
150
Sexual harassment includes
Unwelcome sexual advances, requests for sexual favors, and verbal or physical conduct of a sexual nature
151
The Civil Rights ACT of 1991 permits the court to award _______ to mistreated employees
Compensatory and punitive damages
152
The Age Discrimination in Employment Act of 1967 protects persons _______ or older against employment discrimination.
40 years
153
The Americans with Disabilities Act of 1990 requires the employer to make
Reasonable accommodations for disabled employees
154
OSHA represents the
Occupation Safety and Health Act
155
Rules to protect healthcare workers from blood borne pathogens are regulated by the
OSHA
156
The Health Maintenance Organization Act of 1973 requires that any company with 25 employees must provide
An HMO alternative to regular group insurance
157
COBRA of 1985 provides that a company with 20 or more employees must provide extended healthcare insurance to terminated employees fo up to
18 months, usually athe employee’s expense.
158
Through the Drug-Free Workplace Act, employers contracting to provide good or services to the federal government must certify that
A drug-free workplace is maintained
159
The Failr Labor Standards Act of 1938 regulates employee benefits such as
Minimum wage, payment for overtime work, and hours that are worked.
160
The origin of the current unemployment insurance program for employees who are unable to work through no fault of their own is the
Social Security Act
161
The Equal Pay Act of 1963 makes it illegal for an employer to discriminate on the basis of
Gender
162
A fine imposed by the federal gov’t for employers not contributing to Social Security for their employees is mandated by the
Federal Insurance Contribution Act
163
The Workers’ Compensation Act protects workers and their families from financial problems resulting from
Employment-related injury, disease, or death
164
The Family and medical Leave Act of 1994 allows
The mom and dad to take a leave of absence of up to 12 weeks in any 12-month period when a baby is born and an unpaid medical leave for up to 12 weeks of leave for their own or a family member’s medical or family related situation
165
Guidelines for use of an individual’s credit information are stablished by the
Fair Credit Reporting Act of 1971
166
The fAir Debt Collection Practices Act prohibits phone calls for the purpose of debt collection
Before 8 am
167
The portion of a paycheck that may be paid directly to an employee’s creditors is established by the
Federal Wages Garnishment Law
168
Under the Family and Medical Leave Act, the employee
Must be returned to the same or equivalent position when he or she returns.
169
The Emergency Treatment and Active Labor Act relates to
Patient “dumping”
170
An unfair dislike or preference against someone is called
Bias
171
A private or public healthcare entity that facilitates the processing of nonstandard electronic transactions into HIPAA transactions is...
Clearinghouse
172
A healthcare organization covered under HIPAA regulations is
Covered entity
173
A number assigned to an employer for purposes of identification is the
Employer ID number
174
The individual or group that provides or pays for the patient’s medical care is the
Healthcare plan
175
A national source of reports of actions taken against healthcare providers, practitioners, and vendors who are in noncompliance or performing fraudulent activities is the...
Healthcare Integrity and Protection Data Bank
176
The use of communication and information in medical practice, research, and education is called
Medical informatics
177
the reasonable effort that a healthcare provider uses to limit disclosure of patient information is referred to as
The minimum necessary standard
178
The objective of the Health Insurance Portability and Accountability Act of 1998 is to
Combat fraud, abuse, and waste in healthcare, promote medical savings accounts, and simplify the administration of health insurance
179
The federal office that investigates violations of HIPAA is the
Healthcare Integrity and Protection Data Bank
180
Which title of HIPAA most affects confidentiality issues for healthcare providers?
Title 2: Administrative simplification
181
The privacy rule is meant o ensure that there are
Security of electronic transfer of information and disclosure of only the necessary information
182
Protected health information relates to
Past, present, and future individually identifiable health information
183
Those who would be covered under HIPAA include
Life insurers, information system vendors, universities
184
Healthcare fraud alerts are issued by the
Inspector General of the HHS
185
REsearchers who wish to obtain individually identifiable medical information must...
Obtain a patient authorization that complies with the rules set by HIPAA
186
An exception to the release of information policy under HIPAA would allow information to be released to
The police investigating a crime
187
Violation of HIPAA is a
Federal criminal offense
188
The original intent of HIPAA was to
Protect computerized medical records and billing and provide easier access of medical records for the patient
189
HIPAA allows all of the following except
Complete disclosure of patient information by an EMT
190
HIPAA law stipulates that the patient...
May sue over privacy violations and may register a complaint to the gov’t
191
Suggestions for physician and physician groups when implementing HIPAA include
Appointing and training a privacy officer, adopting procedures for handling patient requests, and implementing a notice of privacy practices.
192
Signed authorizations and any agreements with patient restricting disclosure of PHI should be retained for a period of
6 years
193
Wireless local area networks are used by physicians and nurses to
Access patient records from central databases and add patient observations and assessments to databases
194
The application of communication and information to medical practice, research, and education is called
Informatics
195
The use of communications and information technologies to provide healthcare services to people at a distance is known as
Telemedicine.
196
Branch of philosophy relating to morals or moral principles is
Ethics
197
Applied ethics relates to
Healthcare professionals
198
Issues discussed in the context of advanced medical technology are called
Bioethics
199
Illegal acts are
Usually unethical
200
The code of ethics dealings with experimentation on human subjects is
The Nuremberg code
201
The father of medicine, who wrote a statement of principles for his medical students to follow
Hippocrates
202
The issue of a warning or censure by the American medical Association to a physician occurs when the physician
Is accused of unethical behavior or conduct
203
An allegation of a criminal act by a physician requires that the
Act be reported to the state licensing aboard or gov’tal agency
204
The loss of a physician’s license is called
Revocation
205
The concern for the human subject in medical experimentation is the result of the
Nuremberg Code
206
The AAMA has developed a code of ethics for the
Medical assistant
207
The thick committees of a hospital serves ina n advisory capacity to patients, families, and staff to
Decide who gets donated organs, review difficult ethical issues, determine when care will be discontinued.
208
The Uniform Anatomical Gift Act
Permits competent adults to allow posthumous use of their organs through a written document
209
Giving organs to patients who will benefit the most is called
Social utility
210
The National Organ Transplant Law of 1984
Forbids the sale of organs
211
Allocating organs for transplants is handled through
The United Network for Organ Sharing
212
An employee should state a preference for not wishing to be involved in assisting with a procedure
Before being hired
213
Research that will not directly benefit the research subjects is
Nontherapeutic
214
An institutional review board in a hospital or university receiving federal research funds
Oversees any human research in the facility
215
Medical research that may directly benefit the research subject is
Therapeutic
216
Placing the researcher’s interests above the patient’s interests is considered
A conflict of interest
217
In a double-blind test
Neither the experimenter nor the patient knows who is getting the research treatment
218
Standards of professional behavior practice by physicians in their relationship or conduct with other physicians is called
Medical etiquette
219
A decision model for helping resolve ethical issues include asking
Who do we know? Who is involved? Where and when does the situation occur?
220
The administration of a lethal agent by another person to a patient for the purpose of relieving intolerable and incurable suffering is
Euthanasia
221
In the stage of human development between the 2nd and 12th week, the developing life is
An embryo
222
The gestational period is the
Time from conception to birth
223
AIDS is the same as
Artificial insemination donor
224
The most common legal and ethical concern related to AIDS is
Legitimacy of the child and its support
225
AIDS records are
Confidential, not a public record, handled the same as adoption papers
226
In vitro fertilization occurs as a result of
Growth of the fertilized ovum in the lab and implantation of the fertilized ovum in the uterus.
227
Surrogate motherhood allows the
Surrogate mother to be paid for medical expenses
228
The use of fertility drugs
Increases the chance of multiple births
229
Any action taken to prevent pregnancy from occurring is
Contraception
230
A woman’s right to privacy, including the right to an abortion, is guaranteed by
Roe vs. Wade
231
The process of medically altering reproductive organs to prevent the possibility of producing children is
Sterilization
232
Sterilization requires
Written consent and a mentally competent adult
233
Voluntary sterilization of unmarried minors is
Forbidden in many states and allowed with authorization of the minor and parent or guardian in some states
234
Eugenic sterilization is
Considered unethical by many people
235
Castration or sterilization of another person without legal permission is considered to be
Assault and battery
236
The termination of a pregnancy before the fetus is viable is called
Induced and spontaneous abortion
237
Initially, Roe v. Wade said that during the third trimester of pregnancy, the state
May prohibit abortions except to save the life of the mother
238
Recommendations from Roe v. Wade decision included all of the following except
Viability of the fetus in not required
239
A person appointed by the court to speak on behalf of an incapacitated party is called the
Guardian ad litem
240
Pro-choice advocates believe that
Women have the right to choose what to do with their bodies, legalized abortions are safer for the woman, and a woman has the right to an abortion when she is the victim of rape or incest.
241
Right-to-life advocates argue all of the following except
The right of the unborn child take precedence over the right of the mother
242
The conscience clause refers to
Hospitals not choosing to perform sterilization procedures and physicians and hospital personnel not being required to participate in sterilization
243
The study of heredity and its variations was discovered by
Gregor Mendel
244
A means to detect couples who are at risk of passing on a genetic disease to their offspring is called
Genetic counseling
245
Criteria or standards that assist in the determination of death include
A significant drop of body temp and rigor Morris
246
A legal death is a
Cardiac death
247
Prolonged absence of oxygen can result in
Neurological damage, brain death, and cardiac death
248
According to the brain-oriented death definition, death occurs when
There is irreversible cessation of all brain functions
249
Discontinuing ventilation support for a patient who is brain dead will result in
Cardiac death
250
Most widely accepted legal definition of death in US?
Multi-organ death
251
Irreversible coma include all of the following criteria except
Spontaneous movement or breathing
252
Which action is considered active euthanasia
Intentionally foregoing life-sustaining treatment
253
Ethical considerations of the terminally ill patient include
Withdrawing versus withholding treatment, active vs. passive euthanasia, and ordinary vs extraordinary means
254
Withdrawing life-sustaining treatment refers to
Discontinuing artificial methods of maintaining life
255
Patients have the legal right to
Refuse treatment, food, and fluids
256
The intentional killing of the terminally ill is called
Active euthanasia
257
Justifications for euthanasia include
Individuals should have the right to determine the outcome of their lives
258
Active euthanasia
Is illegal and violates the medical profession’s ethics
259
Advice regarding the course of action taken for a dying loved one can be given by
The physician
260
The double-effect doctrine recognizes that an action may have
Two consequences: one desired, one undesired
261
A treatment or procedure that is morally required is considered
Ordinary and appropriate
262
Dr. Elisabeth Kubler-Ross is known for her study of
Stages of death and dying
263
A facility with a homelike atmosphere where terminally ill patients find comfort until death is called a
Hospice
264
The focus of hospice care is
Comfort measure, emotional support, relief from pain
265
The total care of patients whose disease is no longer responsive to curative therapy is
Palliative care
266
Viatical settlement allow terminally ill persons to
Obtain money from their life insurance policies
267
Healthcare facilities, in order to receive Medicare or Medicaid funding, must ask patients if they have
An advance directive
268
Persons who cannot exercise the fundamental right to self-determination include
Persons who suffer irreversible brain damage, such as those who Alzheimer’s disease
269
A DNR order can be place don the medical chart of a patient by the
Physician
