Ethical, Legal, & Cultural Considerations

Question 1

Health Care Delivery
Healthy People -1-
> Continuance of Healthy People -2-, by -3-
> Objectives relate to -4-, availability, cost, -5-, etc.

Answer 1

1. 2030
2. 2000 and 2020
3. the US DHHS
4. equal access
5. quality of care

Question 2

Health Care Delivery
-1–2-: Require practioners to -1- specific health-related informatoin; vary form state to state but commonly involve the following:
> -3- and injury from a -4-

Answer 2

1. Report/-ing
2. statutes
3. Criminal acts
4. dangerous weapon (police)

Question 3

Health Care Delivery
Reporting Statutes
> In most states, the NP must notify -2- of:
>> Gonorrhea
>> Chlamydia (-5-)
>> -6-
>> -7-
>> TB
>> COVID-19

Answer 3

2. the DHHS
3. less universal
4. Syphilis
5. HIV

Question 4

Health Care Delivery
Reporting Statutes
> In -1-, the NP must notify the DHHS of:
>> -3-
>> -4- (less universal)
>> Syphilis
>> HIV
>> -8-
>> -9-

Answer 4

1. most states
2. Gonorrhea
3. Chlamydia
4. TB
5. COVID-19

Question 5

Health Care Delivery
Reporting Statutes
> -1- -2- (-1- -3-; subsidiary of the -4-)

Answer 5

1. Animal
2. Bites
3. Control
4. DHHS

Question 6

Health Care Delivery
Reporting Statutes
> -1- child or elder -2- (-3-; police via -4- who is -5-)

Answer 6

1. Suspected or actual
2. abuse
3. not domestic violence
4. social services
5. our point of contact

Question 7

Health Care Delivery
Health Care Financing
> -1-: evaluation and management (E/M) -1- identify the -2- provided
» -1- -3- of service provided to the -4- of the -5-

Answer 7

1. Codes/Coding
2. level of care (1-5)
3. match the level
4. complexity
5. presenting pt problem

Question 8

Health Care Delivery
Health Care Financing
> -1-
> -2- payers (-3- sets the standard for -1- which -4- follow)

Answer 8

1. Reimbursement
2. third-party
3. CMS
4. CIIs, HMOs, and Businesses/Schools

Question 9

Health Care Delivery
Incident-to Billing: Services billed under the -1- to receive the -2- given the following rule(s):
> The -3- whose -4- the bill is submitted must be the individual present in the office suite when the service is provided

Answer 9

1. physician’s provider number
2. full physician fee (100%)
3. physician/other provider under
4. name and number

Question 10

Health Care Delivery
QA/QI/CPI
> A management process of -1- review, and -2- in providing -3-

Answer 10

1. monitoring, evaluating, continuous
2. improving the quality
3. health care

Question 11

Health Care Delivery
QA/QI/CPI
> Used to -1-, -2-, and -3- care provided to patients

Answer 11

1. assess
2. monitor
3. improve

Question 12

Health Care Delivery
QA/QI/CPI
> Components include -1- of care, care -2-, -3- of care, -4- of care, self-regulation, and -5- to ensure compliance to care standards

Answer 12

1. monitoring quality
2. appropriateness
3. effectiveness
4. cost
5. peer review

Question 13

Health Care Delivery
QA/QI/CPI
> Case Mgmt: -1- resources a pt -2- of illness while -3-

Answer 13

1. mobilize, monitor, & modulate
2. uses in a course
3. balanceing quality & cost

Question 14

Health Care Delivery
QA/QI/CPI
> Steps of CQI/QA (JCAHO)
>> Quality -1-
>> -2- care
>> -3- data
>> -4- when thresholds are reached
>> -5- information

Answer 14

1. planning
2. delineate scope of
3. collect and organize
4. evaluate care
5. communicate relevant

Question 15

Provider Roles
> Ancillary staff, patient, parents/caregivers may -1-
> Provider must -2-
>> supports -3-
>>> needed to comply with -4- audits
>> cannot -5-

Answer 15

1. complete ROS, PMH
2. complete HPI
3. evaluation/management reporting
4. criteria for billing/coding
5. be co-signed

Question 16

Serology results of -1- indicate immunity to hepatitis A and -2- to be reported to any state or local authorities; however, persons with acute -3- and -4- serology, have to be reported.

Answer 16

1. anti-HAV and IgG
2. do not have
3. hepatitis A, anti-HAV
4. IgM

Question 17

HIPAA Privacy Rule establishes standards for -1- and protection of -2-. While meeting these essential standards, -3- is also important to providing -4- patient care.

Answer 17

1. patient privacy rights
2. health information
3. timely provider-to-provider communication
4. collaborative and integrated

Question 18

There are often perceived, -1- about the exchange of clinical information among -2- due to misconceptions of the HIPAA Privacy Rule. In most cases, pertinent -3- information can be -4- with members of the current treatment team -5- authorization.

Answer 18

1. unnecessary barriers
2. care team providers
3. mental health treatment
4. released to/discussed
5. without written disclosure

Question 19

As long as both -1- in the treatment or consultation of -2-, relevant protected health information can be -3- or caregiver consent. Written psychotherapy notes and -4- treatment records maintained by a licensed -4- program are two exceptions that -5- authorization.

Answer 19

1. providers are involved
2. a mutual patient
3. disclosed without patient
4. substance abuse
5. require written disclosure

Question 20

HIPAA
It is important to note that -1- may impose additional restrictions that -2- and healthcare providers need to be familiar with -3- where they practice.

Answer 20

1. individual state laws
2. supersede HIPAA rules
3. variations in states

Question 21

For children with special healthcare needs, much of their day-to-day -1- of the medical setting. It is important that providers are familiar with the -2- resources that are available to these children and their families.

Answer 21

1. care occurs outside

2. nonmedical and community

Question 22

The school setting -1-, developmental, and psychosocial -2-, and providers need to be prepared to help parents -3- these -2-. For school-age children, the -4- Plans can both help ensure they -5- needed to optimize their educational experience.

Answer 22

1. provides many educational
2. support services
3. access and utilize
4. IEP and 504
5. receive services

Question 23

The -1- between IEP & 504 plans can make it difficult to determine which is -2- for a child’s specific needs. Eligibility for both plans requires -3-. For a 504 Plan, this can be any -4- disorder which “substantially limits” the individual’s learning.

Answer 23

1. overlap
2. most appropriate
3. a medical diagnosis
4. psychologic or physical

Question 24

Children with a 504 Plan can follow the -1- but -2- in the school setting. This may include conditions such as ADHD, diabetes, or migraines. In order to be eligible for an IEP, a child has to also have a medical diagnosis, but that diagnosis must -3- as a -4- that -5- and, therefore, cannot follow a -1-.

Answer 24

1. curriculum without modification
2. may require assistance
3. specifically meet criteria
4. qualifying disability
5. seriously affects learning/behavior

Question 25

Both a 504 and an IEP -1-, although for an IEP, it is more formalized and is typically completed by a -2-. Both an IEP and a 504 plan will include -3-. There are no legal requirements for -4- in a 504 plan and there is no mandated re-evaluation.

Answer 25

1. require evaluation 2. team of professionals 3. a written plan 4. what is included

Question 26

An IEP has -1- and must describe the specific learning problems, detail -2-, set annual goals and define -3-. -4- every 3 years.

Answer 26

1. very specific criteria 2. provision of services 3. progress metrics 4. Re-evaluation is mandated

Question 27

Hispanic Cultural Considerations > Often believe it is -1- pharmacotherapy once -2- >> Especailly problematic for -3- in which ongoing medication is required

Answer 27

1. unnecessary to continue 2. symptoms abate 3. diabetics

Question 28

Hispanic Cultural Considerations | > Esteem the -1-, especially from the -2-, as the -3- of -4-

Answer 28

1. mother or grandmother 2. husband 3. primary decision-maker 4. health-related issues

Question 29

Hispanic Cultural Considerations > Balance of -1- is -2- >> Both -3- and -4- have these properties >>> And an -3- of one is requires a -4- of the other >> May also believe in a balance of -5-

Answer 29

1. hot and cold 2. essential 3. illness 4. medicine 5. wet & dry

Question 30

``` Hispanic Cultural Considerations > Illness may be caused by -1- >> healthcare workers can inadvertently -2- > Strong -3- with state of health >> Health is a -4- and a reward for -5- ```

Answer 30

1. mal de ojo (the evil eye) 2. give this look 3. religious association 4. gift from God 5. good behavior

Question 31

Hispanic Cultural Considerations | > Big proponents of -1-: Eating -2-, working -3-, wearing -4- and sleeping with -5-

Answer 31

1. illness prevention strategies 2. the proper foods 3. the proper duration (siestas) 4. religious medals 5. relics

Question 32

Hispanic Cultural Considerations > Use of -1- may be common in some communities >> Treat with a variety of -2-, visits to shrines, -3-, -4-, and promises to God to change behavior

Answer 32

1. curanderas (holistic healers) 2. herbs and teas 3. medals 4. candles

Question 33

Hispanic Cultural Considerations > Often concerned about the -1- when taking medications for -2- > May expect -3- as a -4- of effective treatment for disease >> -5- may be viewed as a less effective treatment

Answer 33

1. risk for addiction 2. prolonged durations 3. injections 4. necessary component 5. taking oral medications

Question 34

In some Mexican cultures, it is customary to -1- while complimenting him or her to neutralize -2-. These cultures believe that -3- are weak and susceptible to the power of an -4-; giving compliments can be seen as giving -2-.

Answer 34

1. touch a baby 2. the "evil eye" 3. babies 4. envious glance

Question 35

Termination of a Provider-Patient Relationship Although specific referral to a -1- is often made, it is not required. However, patients must receive -2- from the nurse practitioner so as to allow sufficient time to -3-. An admission of -4- or the -5-, usually based on the amount of hours already worked, are permissible reasons for terminating a patient relationship.

Answer 35

1. different nurse practitioner 2. reasonable notice 3. make other arrangements 4. lack of competence 5. refusal of assignment