DPT 612: Legal and Ethical Issues in Physical Therapy Flashcards

1
Q

The APTA code of ethics delineates which of the following obligations of all PTs as determined by the House Delegates of the APTA?

a. Ethical
b. Legal and Moral
c. Moral
d. Ethical, Legal, and Moral
e. None of the above

A

A

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2
Q

How many basic principles are set forth in the APTA Code of Ethics?

a. 8
b. 5
c. 6
d. 7

A

A

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3
Q

As physical therapists in Kansas we must adhere to the Kansas State Practice Act and the rules and regulations. These are examples of what type of law?

a. Common Law
b. Constitutional Law
c. Statutory Law
d. Administrative Law

A

C

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4
Q

The Kansas Board of Healing Arts (KSBHA) is responsible for which for the following acts?

a. KSBHA actions may include fines, renewal of license, and promote and protect the professional welfare of Kansas PTs
b. KSBHA actions may include license suspension, license granting, and fines
c. KSBHA actions may include granting temporary licenses, tracking continuing education hours, and fines
d. KSBHA actions may include license suspensions, license granting and lobbying for profession

A

B

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5
Q

The Kansas Physical Therapy Association represents all of the following except:

a. Patients
b. PTAs
c. PTs
d. SPTs

A

A

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6
Q

An 18 year old male is being seen in your clinic for wound care of a non-healing Achilles tendon repair wound. The patient has been seen by you two times prior for wound care and given consent to participate/allow wound care in each prior session, however, today, he states that he doesn’t want to do the wound care because it’s too painful. The patient’s mother has just called you, stating she wants you to complete the wound care ‘no matter what’ your patient says, because, ‘he doesn’t know what’s good for himself at this age.’ Based on this information which of the following best describes how you would proceed?

a. attempt to convince the patient multiple times to undergo the wound care, ignoring his escalating anger and refusal
b. complete the wound care, as the patient’s mother has the right to make his medical decisions
c. call the patient’s mother and have her discuss the issue with her son while in your clinic
d. discuss with the patient his options, and honor his autonomy and decision to decline wound care

A

D

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7
Q

As an outpatient therapist, you are seeing a new patient for the treatment of a rotator cuff tear repair. The patient has demonstrated sufficient voluntariness and competence, and you have provided information as follows: ‘I will provide an examination of your shoulder as well as your physical abilities. We will then go through an evaluation process that will help define your diagnosis and prognosis, and then come up with a plan for treatment/intervention. This will ideally help get you back to functioning as you need and want to for your job. Some of the risks may include increased pain, swelling, or damage to your surgical repair.’
What other information needs to be included, according to the WCPT?

a. Anticipated costs of alternative therapies, risks of alternative therapies, anticipated time frames
b. Alternatives to treatment, anticipated costs, anticipated time frames
c. Alternative treatments and risks of those treatments, anticipated costs, anticipated time frames
d. Whom will be treating the patient, anticipated time frame of each treatment, risks of alternative therapies

A

B

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8
Q

According to the legal standards when guardians must render decisions, when is non-compliance of the decision permitted?

a. When the guardian has a limited knowledge of the history of the patient’s decision making
b. When care is contrary to accepted standards or goes against the HCP’s conscience
c. When the health-care providers conclusions is unaffected by the directive
d. When the conscience of the health care-provider is in agreement with the directive

A

B

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9
Q

You and your PTA have been treating a 48 year-old patient s/p TKR. The orders on his original prescription stated “Ambulation with TTWB”. This patient is scheduled with the PTA for his patient today and presents a new prescription form the doctor that states “Ambulation with WBAT”. Which of the following statements best describes how this situation should be handled?

a. The PTA treats the patient for the scheduled for that scheduled visit advancing him to WBAT status and then ensures the patient is scheduled with the PT for his next visit
b. The PTA cancels the patient’s appointment for the day and tells him he will have to reschedule with the PT
c. The PTA treats the patient for that scheduled visit maintaining the original TTWB status and then ensures this patient is scheduled with the PT for his next visit

A

C

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10
Q

What is the maximum number of PTAs a PT may have working concurrently under his/her discretion in the state of Kansas?

a. 2
b. 3
c. 4
d. 5

A

C

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11
Q

You are a PT working in a public school based setting. You are working with a little girl of African American descent to help decrease tone in her legs. Her mother approaches you after school one day and talks with you that she believes her daughter and her daughters friend are being forced to be the last people in line for recess each day because they are black. You walk with this parent about the Civil Rights Act of 1964 and referred to which Title Act that prevent this kind discrimination?

a. Title VI
b. Title VII
c. Title IX
d. Title XI

A

A

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12
Q

You are working with a middle school aged girl in your therapy clinic to rehab her knee following ACL repair. During casual conversation you ask what other activities she is interested in besides volleyball where she injured her knee. She tells you she is also in debate and science club. She mentions that she wanted to be on the student council but she was not allowed because that position is always filled by guys. You talk with her about the Civil Rights Act of 1964 and referred to which Title Act that prevents this kind of discrimination?

a. Title VI
b. Title VII
c. Title IX
d. Title XI

A

C

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13
Q

While working with a male pt in your outpatient clinic, you get on the subject of yearly calendars. He mentions to you that he works in an office complex in a cubical. He comments about she has a NYC firemans calendar and how most of the images are of very scantily clad men which is not something he prefers to see on a daily basis. You talk with him about the Civil Right Act of 1964 and referred to which Title act that prevents this kind of discrimination?

a. Title VI
b. Title VII
c. Title IX
d. Title XI

A

B

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14
Q

According to the Family Education Rights and Privacy Act of 1974

a. Educational Institutions must retain official school records for at least 3 years after the student graduates
b. Educational institutions are allowed to share official school records with potential employers
c. Students have the right to access their official school records and the right to challenge the accuracy of that information
d. Clinical affiliation reports are not considered official school records and therefore do not have to be retained.

A

C

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15
Q

Of the following described individuals, who MOST APPROPRIATELY could be helped by the IDEA

a. A 25 y/o boy with cystic fibrosis confined to a w/c with mental disabilities
b. An 8 y/o girl with a diagnosis of CP with the inability to walk and delayed mental status
c. A 16 y/o boy with a drug and alcohol problem with multiple juvenile criminal offenses
d. A 12 y/o girl that speaks Spanish as her first language

A

B

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16
Q

Which of the following BEST describes the considerations a PT should make before delegating and intervention or treatment to a PTA according to KSBHA Rules and Regs?

a. The PTA’s education, experience, and professional affiliation
b. The PTA’s specialty certifications, attitude, and education
c. The PTA’s education, expertise, and professional judgment
d. The PTA’s education, case load, and track record

A

C

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17
Q

Jakes Aunt Martha was placed in the ICU for congestive heart failure. Prior to becoming ill, Aunt Martha had created legal documents spelling out what type of care she desired in times of critical illness, as well as appointed Jake as her medical power of attorney. Aunta Martha’s physicians are now asking Jake if he would like to withdraw life support. If Jake follows the directives as created by Aunt Martha, he would be applying what legal standard?

a. Substituted judgment
b. Religious Decision making
c. Acting in the best interest of patient
d. pure autonomy

A

D

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18
Q

You are working in an outpatient clinic and 63 y/o female comes into your clinic for patient self-referral for an ankle sprain she suffered over the weekend at her co-ed softball tournament. She reports 9/10 pain. You eval her and determine she is grossly 4/5 MMT in all planes of ankle strength on the injured side and 5/5 MMT on her uninjured side. You note her gait as antalgic with decreased stance on her injured side and normal on her uninjured side. After 15 business days and 9 treatments she still c/o of 9/10 pain, is able to demonstrate 4+/5 MMT in all planes on her uninjured side, and still walks with an antalgic gait, but has improved stance and push-off technique. What is the MOST appropriate course of action?

a. Refer her to her physician as she has not made significant improvements in pain control and therefore could have an ankle fracture
b. Continue with treatment under the patient self-referral statue in KS as she has made objective improvements
c. Refer her to her physician as she has not yet made objective improvements and therefore you are not able to continue to treat her under the patient-self referral statues in KS in the allowed time frame
d. Continue with treatment under the patient self-referral statue in KS as she has not been seen for the allowed 30 calendar days or 15 visits

A

B

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19
Q

When someone turns 18, autonomy is not a given right, rather, it is something that is earned

a. True
b. False

A

FALSE

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20
Q

As a new therapist, you have encountered a patient that seems hesitant to work with you. He asks how long you’ve been a therapist and if you know what you are doing. What is an approach that could be used to respond?

a. Suggest that the pt find another PT
b. Attempt to establish trustworthiness by providing current literature to support the treatment regimen you have proposed
c. Establish overidentification, as this may help your pt feel more comfortable
d. Respond with your age and length of employment, as the pt has a right to know

A

B

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21
Q

You are seeing a 28 y/o male pt in your clinic for an ankle sprain. You are a member of Mother Against Drunk Driving (MADD). Somehow during casual conversation with your pt during treatments you discover that he has a Breathalyzer on his care because of 10 DUIs. In light of this new information you decide to talk with you clinic scheduler and have him moved to another PT. What type of ethics have you applied to make your decision?

a. Normative Ethics
b. Descriptive Ethics
c. Ethical Egoism
d. Teleological

A

B

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22
Q

Your pt a 55 y/o female was in a car accident and fractured her humerus. She has been hospitalized for a week due to a surgical repair and some other minor complications. Her physician has referred her to PT for balance and gait assessment as wee as PROM of the extremity with the repaired fracture. When you bring her to her room, you notice that she reminds you of your favorite aunt, so you find a way to spend a little more time with her. This is an example of:

a. Poor time management
b. Countertransference
c. Transference
d. Overfamiliarity

A

B

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23
Q

As a PT working in a hospital you have 2 hours left of your work day and 8 new evals just came in through the printer. You still have 2 total joint pts to see and you were scheduled to see 5 other general medical pts for today. 3 of the 5 general medicine pts haven’t been seen since 4 days ago because the PT departments has been full. You want to see the general medical patients because they haven’t been seen in multiple days, you know the new evals need to be seen also. What type of ethical situation does this represent?

a. Ethical Dilemma
b. Ethical Disagreement
c. Ethical Distress
d. Ethical Disability

A

C

24
Q

A PTA you supervise is treating an established pt in rehab. the pt has suffered a TBI. Your established POC indicates “stretching, strengthening, sitting balance training, hot/cold packs prn”. The pt has been progressing well and the PT and PTA have been talking about progressing the pt to standing balance, but the PT has not had a chance to see the pt and formally assess his readiness to progress. The PTA performs all the sitting balance exercises with the pt this date and he is able to demonstrate perfect sitting balance with all activities. The PTA decides to initiate standing balance in the // bars with the pt. and the pt. falls during the treatment: Which is the MOST responsible party?

a. The PTA for progressing the pt outside of the established POC
b. Both the PT and PTA as they are both responsible for the care of this pt
c. The pt for falling

A

A

25
Q

The KSBHA offers reciprocity and temporary licenses

a. True
b. False

A

True

26
Q

The APTA code of ethics was established in order to:

a. Clarify legal, ethical, and moral boundaries of the PT profession
b. Clarify the obligations of PTs in many roles, including administrator, consultant, educator, practitioner, and researcher
c. Delineate the ethical obligations of PT as determined by the House of Delegates of the APTA
d. Clarify the legal and ethical obligations of the PT

A

C

27
Q

A PT is instructed by the director of rehab to continue to provide treatment for a pt who is no longer showing any objective improvement because this pt is related to a wealthy donor. The PT knows that under Medicare guidelines this pt should be discharged from treatment and that it would not be appropriate to continue with treatment. What type of ethical situation does this represent?

a. Ethical Disagreement
b. Ethical Distress
c. Ethical Dilemma
d. Ethical Disability

A

B

28
Q

Providing ROM to pts shoulder is permissible, in spite of them protesting or saying “no”

a. No, as this could violate their autonomy and be considered coercion
b. No, because this would be considered pressuring the patient
c. Yes, because the pt is a grumpy old codger…
d. Yes, because the patient is old and likely incompetent to make his own decisions

A

A

29
Q

According to the World Confederation of PT, when seeking info consent with your pt for knee replacement rehab, it is necessary to include which of the following?

a. Anticipated cost, which therapist(s) will be treating the patient, and how long each session will be
b. Expected exam, intervention, risks, and outcomes
c. Expected exam, benefits, and opportunities to be a research participant
d. Anticipated cost, which therapist(s) will be treating the patient, and how long each session will be
e. Expected exam, intervention, risks, and outcomes
f. Expected risks, benefits, and opportunities to be a research participant
g. Alternative interventions and risks of the alternatives, as well as cost of the alternative treatments

A

B

30
Q

A woman in her late 60s is being seen in your clinic for wound care. Her adult daughter, who is the patients guardian, accompanies your pt to each session. After the third session, she asks you not to do wound care anymore because it takes away from her going to the gym and shopping. Would it be permissible to continue wound care, in spite of the patients’ guardian statement?

a. No – the guardian and the patient have to be in agreement about the decision
b. Yes – as you are willing to give the pt a ride to and from the clinic yourself if need be
c. No – the guardian has the final say in the patients treatment
d. Yes – as the decision by the guardian conflicts with your conscience and it is contrary to standard of care

A

D

31
Q

A PT requested a PTA to perform US to the shoulder of a pt. The use of modalities was included in the patients POC established by the PT previously. During the treatment session, the pt experiences electrical shock. The PT would be responsible for an injury to the pt if it was a result of:

a. The PT having instructed the PTA to use a device that had malfunctioned the previous day
b. A faulty circuitry in the US machine
c. The PT touching the US during treatment
d. The PTA failure to continuously move the US on the pts shoulder

A

A

32
Q

Upon entering our program and in each course syllabus are the Honor Code and the Academic Dishonesty Policy of which all our DPT students agree to abide… You make the appropriate decision not to utilize alternative information presented to you as to not jeopardize your future in the program and to stay true to the Honor Code and the Academic Dishonesty Policy. What type of Ethics have you applied to make your decision?

a. Ethical Egoism
b. Teleological Ethics
c. Descriptive Ethics
d. Normative Ethics

A

D

33
Q

The KSBHA requires all licensed practicing PT to complete 40 hours of CEU within 2 years

a. True
b. False

A

True

34
Q

The APTA bylaws, positions, standards, guidelines, policies, procedures, are passed by APTA House of Delegates and the Board of Directors

a. True
b. False

A

True

35
Q

The shift away from the ‘medical paternalism’ began in the 1960s as a result of the women right activities

a. True
b. False

A

False

36
Q

You are working with a pt under pt self referral in KS for a R frozen shoulder. At her initial evaluation you measure her shoulder flexion 0-90° and make a goal for 0-120° as well as for her to be able to reach her arms overhead. You are assessing her today on her 10th treatment in 10 days and you measure her shoulder flexion as 0-85°. She states that her shoulder is sore from her treatment yesterday where you manually stretched her aggressively. While having her perform an overhead reaching exercise in the gym during your reassessment you notice continued shoulder hiking and poor overall shoulder mechanics, strength, and endurance. What is the appropriate course of action?

a. Continue treatment under the pt self-referral statue in KS as she has made objective improvements
b. Refer her to her physician as she has not made objective improvements and therefore you are not able to continue to treat her under the pt self-referral statues in KS
c. Continue treatment under the patient self-referral statue in KS because even though she has been seen for 10 visits, she has not been seen for the allowed 15 business days
d. Continue with treatment under the patient self-referral act in KS as she has not been seen for the allowed 30 calendar days or 15 visits (Medicare rule – not direct access rule)

A

B

37
Q

While on your PT pediatric clinical, you have developed a favorite patient, whom you see three days a week. She is a 6 year old girl with down syndrome. You are seeing her for spin stabilizing exercises and general strengthening. Midway into your pts 8 week course, you find that her mother is terminally ill. The thought of your patient losing her mother is all that you can think about each and every day. You’ve even caught yourself tearing up at the thought of the loss your pt is going to experience. The emotional boundary that has been compromised is:

a. Empathy has turned to sympathy
b. Enmeshment, as there are no boundaries anymore between you and your patient
c. Sympathy has turned to pity
d. Overidentification is clouding your judgment

A

C

38
Q

You are treating a self-employed salesman in your clinic for patellar femoral pain syndrome. He pays privately for his insurance. You determine he would benefit from biofeedback e-stim application. His insurance will not cover this modality and he is unable to personally pay for the cost. What type of ethical situation does this represent?

a. Ethical Disability
b. Ethical Disagreement
c. Ethical Dilemma
d. Ethical Distress

A

D

39
Q

You are working at a PT site following a massive train wreck. You are trying to free a patient who is stuck in the rubble and then you hear the ER crews telling everyone who evacuated because the train will explode within the next 5 minutes. You notice a tent full of 20 injured people still in the explosion path, so you decide to go to help move the people from the tent to a safer place. What type of ethics have you applied to make your decision?

a. Descriptive
b. Normative
c. Ethical Egoism
d. Teleological

A

D

40
Q

The KSBHA requests al licensed, practicing therapists to maintain liability insurance

a. True
b. False

A

True

41
Q

Your patient says to you “you look so much like my son! You talk like him too! I bet you were quite an athlete like he was” these statements are examples of which of the following?

a. Overidentification
b. Countertransference
c. Transference
d. Enmeshment

A

C

42
Q

If a patient gives a gift to you, it is important to know your employers gift receiving policy. If no policy is present, what guidelines might you use to decide whether or not to keep the gift?

a. One should always accept the gift to avoid hurting the patients feelings
b. The State Practice Act
c. The rule of proportionality
d. The AMAs rule on gift receiving

A

C

43
Q

While asking your patient to sign their intake form at your clinic, which included informed consent, your pt refuses, as he wants his “attorney son to look over it” the clinic director says to go ahead and see the patient. After requesting the pt to participate in the evaluation several times, he complies. The patient is never seen again for another visit but you are welcomed to a legal notice charging you with battery and assault, among other things. How can this be?

a. The patients competence must be questioned, as during the eval, you only moved his arms through full ROM
b. You opted to see the patients surrogate decision maker, as he seemed confused about all the medical jargon you were using to describe his therapy needs
c. The patients attorney suggests that coercion, deceit, and pressuring occurred, especially since no informed consent was signed
d. The patient only needs to be asked 3 times to participate and he finally did

A

C

44
Q

As the PT are interested in starting a research project to help advance the field of PT in the state of KS where you currently live and practice. You know your research might be applied more nationally, but you are interested in first looking at an analysis of needs for rural PT clinics or if larger, urban based PT clinics are better able to meet the needs of the rural citizen. What organization would you contact that helps to maintain and promote standards for PT practice, education, and research in an area you are interested in researching?

a. KSBHA
b. APTA
c. The education section of APTA
d. KPTA

A

D

45
Q

The APTA code of ethics was primarily revised in order to address the multitude of practice scenarios and challenges for PT in clinical setting

a. True
b. False

A

B

46
Q

Can a PT accept a referral from an optometrist?

A

YES!

47
Q

Can a PT accept a referral from a chiropractor?

A

YES!

48
Q

Can a PT accept a referral from a dentist?

A

YES!

49
Q

Can a PT accept a referral from a physician assistant?

A

YES!

50
Q

Can a PT accept a referral from a physician?

A

YES!

51
Q

Can a PT accept a referral from an advanced registered nurse?

A

YES!

52
Q

Can a PT accept a referral from a podiatrist?

A

YES!

53
Q

Can a PT accept a referral from an acupuncturist?

A

HELL NO!

54
Q

Can a PT accept a referral from a psychologist?

A

HELL NO!

55
Q

Can a PT accept a referral from a pharmacist?

A

HELL NO!

56
Q

Can a PT accept a referral from a dietitian?

A

HELL NO!

57
Q

Can a PT accept a referral from a psychiatrist?

A

HELL NO!