Ethics & Legal

Question 1

Beneficence

Answer 1

obligation to help people in need

Question 2

Nonmaleficence

Answer 2

do no harm whether with or without intention

Question 3

Autonomy

Answer 3

self-determination, independence, and freedom

Question 4

Justice

Answer 4

all people are to be treated equally

Question 5

Utilitarianism

Answer 5

Allocation of resources so that the best is done for the greatest number

Question 6

Veracity

Answer 6

provider should be honest and give full disclosure to pt, abstain from misrepresentation or deception, and report known lapses of standards of care

Question 7

Cultural Awareness

Answer 7

developing sensitivity and understanding of another ethnicity, internal changes such as attitude

Question 8

Cultural sensitivity

Answer 8

awareness that cultural differences exist

Question 9

Malpractice

Answer 9

failure of healthcare professional to exercise such care as would a reasonably prudent professional under same/similar conditions

Question 10

Components of Malpractice

Answer 10

There must be a violation of standards of care (breach of duty)

There must also be actual physical or emotional damages that have occurred

Question 11

Occurrence based insurance

Answer 11

Covers injuries that occur during the period the policy was active, regardless of whether the policy is renewed or continues to be in effect

Question 12

Claims-made policy

Answer 12

Covers the clinician only if the injury occurs within the policy period, and if the claim is filed during the period the policy is in effect

Question 13

Schedule I drugs

Answer 13

Illegal for prescription

Heroin, MDMA, PCP

Question 14

Schedule II drugs

Answer 14

Legal to prescribe but significant abuse potential

MSO4, fentanyl, methadone, oxy, anabolic steroids, methylphenidate

Question 15

Schedule III drugs

Answer 15

Less abuse potential

Compunds with limited quantities of opioids such as hydrocodone, codeine and others in combination with other drug such as acetaminophen (Percocet, Vicodin, Tylenol #3)

Question 16

Schedule IV drugs

Answer 16

Meds with low potential for abuse

sleep aids (Ambien, short-acting benzos), Benzos, appetite control (sibutramine, phentermine)

Question 17

Schedule V drugs

Answer 17

Lowest potential for abuse

anti-tussive and anti-diarrheals

Question 18

Incident to billing

Answer 18

Services furnished by NP, PA, other, as integral, although incidental, part of the physician’s personal professional services in the course of diagnosis of treatment of an injury and illness

If an NP and a physician work together to provide physician services, the services can be billed under the physician’s provider number, in order to get the full physician fee (100% of Medicare rate, as opposed to 85% of rate reimbursed to NPs), under the Medicare provision for “incident-to billing.”

Question 19

Medicare

Answer 19

Federally sponsored health insurance for the following:

• Age => 65 years
• Age <= 65 years with certain disabilities
• People of any age with End-Stage Renal Disease (ESRD) (permanent kidney failure requiring dialysis or a kidney transplant)

Question 20

Medicare Part A

Answer 20

Medicare
• Part A
- Hospital services, some post-hospital, some home health, hospice, others
- Religiously associated facilities, such as Christian Science nursing facilities (Religious Nonmedical Health Care Institutions in Medicare terms)

Question 21

Medicare Part B

Answer 21

Supplemental insurance -Outpatient services, home health -NPs can be reimbursed under
-NPs can be reimbursed under Medicare Part B as long as services are physician-like services, not RN services

Question 22

Medicare Advantage

Answer 22

Sometimes called “Part C” or “MA Plans”

• Offered by private companies that are approved by Medicare.
• Provide PPO or HMO services, provide Part A (Hospital Insurance) and Part B (Medical Insurance) coverage, usually a prescription drug benefit

Question 23

Medicare Part D

Answer 23

Prescription drug coverage

• Must have part A and B in order to qualify for part D
• A premium is charged.

Question 24

Medicaid

Answer 24

Provides medical benefits to low- income people who have no medical insurance or have inadequate medical insurance.
• Specific eligibility requirements to receive Medicaid benefits, as well as the type and scope of services provided, are determined by each individual state.
• The federal government establishes general guidelines for the administration of Medicaid benefits.
Must go through all medicare money before going to medicaid
Enrollee characteristics: blind, disabled, pregnancy, have child with disability

Question 25

Components of Competency

Answer 25

Communicate a choice
Understand info
Appreciate consequences
Reason about treatment choices

Question 26

Parental consent is not necessary when talking to a minor regarding

Answer 26

Treatments regarding contraceptives, STDs, alcohol abuse, drug abuse, and cigarettes

Question 27

Asian culture

Answer 27

hesitancy to make eye contact

healthcare professionals expected to make decisions

Question 28

Incident to billing

Answer 28

NP is an extension of the MD
MD must see patient on first visit
Allows for 100% reimbursement

Question 29

Who determines competency?

Who determines ability to consent?

Answer 29

Court

Provider

Question 30

Determining competency

Answer 30

Knowledge of diagnosis
understands purpose of procedure
understands risks/benefits/side effects
Understands alternatives

Question 31

Duty

Answer 31

relationship exists between patient and provider

Question 32

Proximate Cause

Answer 32

plaintiff establishes relationship between breach and the injuries

Question 33

Damages

Answer 33

must be permanent, substantial damages as a result of malpractice