Passbook Tips Flashcards
1
Q
4Which of the following is the definition of “credentialing” according to the Joint Commission?
A
The process of obtaining, verifying, and assessing the qualifications of practitioners seeking to provide care.
2
Q
The most important reason for credentialing is
A
ensuring patient safety
3
Q
The Medicare Conditions of Participation or COP’s are a part of the code of
A
federal
4
Q
The reason behind getting accredited is
A
improving the quality of care, meeting the Medicare requirements, ensuring quality of care
5
Q
The item reviewed during the physician and dentist credentialing process includes
A
education and work history, prior disciplinary actions and terminations, board certification
6
Q
According to legal terminology, _______ is defined as the level at which an average healthcare provider in a community should practice.
A
standard of care
7
Q
Which of the following certifications assesses whether medical students from outside the United States are ready to be a part of residency programs in the United States?
A
ECFMG
8
Q
______ can be defined as a professional opinion about the applicant’s abilities, character or talents.
A
Peer references
9
Q
Which of the following authorizes the verification of an applicant’s credentials and experience?
A
Consent and release statements
10
Q
The _____ defines a practitioner’s scope of practice in any organization
A
Clinical Privilege Delineation
11
Q
The staff’s structure of governance is defined by the
A
bylaws
12
Q
The Current Procedural Terminology is a widely accepted system which is used to report medical procedures and services to the _____ programs developed by the AMA.
A
health insurance
13
Q
_______ is a legal claim against any organization when it fails to perform its duty and ensure clinical competencies.
A
Negligent Credentialing
14
Q
_______ is the authority granted to an accrediting organization by the CMS once it is ensured that the organization meets the Federal Standards.
A
Deeming
15
Q
Which of the following is an accreditor with deemed status?
A
Joint Commission, URAC, AAAHC
16
Q
A _________ practitioner is legally permitted to provide care within the specified scope, even in the absence of supervision.
A
licensed independent
17
Q
In medical terminology, an unexpected event linked with death or a serious injury is known as a ______ event.
A
sentinel
18
Q
The function of an MSO is to
A
provide patient care, evaluate the quality of care, maintain the MSO
19
Q
The organization XYZ has regularly participated in the development, implementation, and assessment of rules and regulations, procedures, etc. and has ensured its cooperation with the accreditation regulatory standards. Such behavior may be termed as
A
compliance
20
Q
How should a medical staff act and interact in the hospital’s activities?
A
In accordance with its bylaws
21
Q
The bylaws should be reviewed at least
A
biennially (twice a year)
22
Q
Why is it important for MSP’s to be familiar with the accreditation standards which apply to their organization?
A
To ensure compliance with these regulations and standards
23
Q
The MCO’s use ______ instead of bylaws to delineate the required functions.
A
policies and procedures
24
Q
Which of the following is TRUE when considering informed consent or medical negligence?
A
The parents may give consent on behalf of their children
25
A prominent legal case of 1988, known as _____ led to the development of HCQIA
Patrick v Burget
26
Credentialing standards apply to ______ providing care
licensed or group of practitioners
27
A practitioner who practices exclusively within an inpatient setting must be credentialed.
False
28
The basic criteria for appointing an individual to medical staff is
education and training, competence and health status, licensure
29
______ is a system published by Medicare in 1992 according to which the service payments to physicians are determined by the resource costs for their provision.
CPCS, RBRSS, CPMSM - ******NONE OF THE ABOVE*****
30
The requirements which are set forth by organizations and certifying bodies like TJC and NCQA are called ______ criteria.
external
31
The _____ criteria includes factors defined by a hospital's staff or board.
internal
32
Independent practitioners can include individuals from many walks of life such as doctors, dentists, or psychologists, depending on the ____ laws.
state
33
If the medical staff wishes to recommend appointment by the governing body, then in accordance with the Medicare requirements, the
bylaws must describe the required qualifications of the candidate
34
______ is a private nonprofit organization which was established in 1981 to evaluate the United States residency programs.
ACGMW (accreditation council for graduate medical education)
35
The _____ board works with member boards for setting up standards for certifications of expertise.
American Board of Medical Specialties
36
The legal case popularly known as Elam v. College Park hospital case is associated with
negligent credentialing
37
_____ has proposed a bureaucratic structure including division of labor and a chain of command.
Weber
38
According to Maslow's hierarchy of needs, individuals are motivated by
lowest level needs
39
According to _______, the methods of working should be based on statistical quality control rather than the manager's opinion.
Taylor
40
A popular tool for organizing tasks in projects is
PERT chart
41
One of the most widely accepted systems of nomenclature, developed by the AMA, which is used to report procedures to insurance programs is
CPT
42
The _____ is used to identify a medical provider's scope of practice in any institute.
clinical privilege delineation
43
______ is a time limited evaluation of a practitioner's performance when new privileges are granted or concerns are raise about his performance.
FPPE
44
Traditionally, there are five functions of management. These include planning, staffing, directing, controlling, and
organizing
45
Many research proposals include a ______ which shows the anticipated time for completion of tasks and the project.
Gantt chart
46
A popularly used diagram for root cause analysis, showing cause and effect is
fishbone diagram
47
The maximum number of individuals which a manager can efficiently overlook is called
span of supervision
48
______ had proposed the seven deadly sins and the fourteen points, which were originally shunned in America.
Deming
49
According to the national patient safety goals, patients should be included in the preprocedure verification whenever possible.
False
50
According to CMS, all Medicare beneficiaries, who are inpatients, must provide an IM from Medicare within ____ days of checking in.
two (2); The IM informs hospitalized inpatient beneficiaries of their hospital discharge appeal rights.
51
Office of ______ is the agency responsible for ensuring privacy and safety of patients, as stated by HIPAA laws.
Civil rights
52
Which of the following is a type of lawsuit linked with defamation because of incorrect allegations broadcasted through the internet?
Libel
53
Under the HCQIA rules, the adverse action reports should be submitted to state licensing boards within ____ days following the decision.
15
54
Once the adverse action reports have been submitted, the state licensing board must report to the NPDB within the next _____ days.
15
55
The Fourteenth Amendment and Section 1983 fail to provide relief for an individual's private conduct.
True
56
Which of the following is an INCORRECT way of disposing of data related to the applicatn?
Placing in dumpster
57
____ Health Information refers to any information which can be used to identify an individual and determine appropriate care. It may also be used in research studies.
Protected
58
The national provider identifier was defined under the HIPAA Act of
1996
59
Physicians with hospital privileges must participate in what the HIPAA privacy rules describe as _____ so they may import information for healthcare activities without violating or entering any agreements.
OHCA; organized health care arrangement
60
____ refers to the document prepared by an attorney for appear in a case.
Brief
61
According to the Safe Medical Devices Act of 1990, the staff must report device-related death to the FDA and the
device manufacturer
62
ECFMG stands for the Electronic Commission for
Foreign Medical Graduates
63
According to HIPAA, the _____ entities includes those providers who conduct their transactions electronically.
covered
64
HIPAA was established in the year _____, following approval by Congress.
1996
65
The _______ code is made up of 10 numbers and helps facilitate billing digitally.
Taxonomy
66
HIPDB started accepting reports in ____
1999
67
Since the year _____, NPDB has allowed practitioners to add their own statements to their reports and these may be disclosed to queries.
2004
68
The U.S. Constitution passed in 1789 has been amended ____ times.
27
69
A ______ law is the one passed by Congress.
statutory
70
It is important to inform inpatients and outpatients of their rights.
True
71
Which of the following is NOT to be included in the hospital's written notice to the patient in response to grievances?
Corrective action against employees
72
According to CMS, a time frame of ____ days is considered appropriate for responding to a patient's grievances.
7
73
The responsibility of addressing grievances with responsibility falls on the
governing body
74
The quality assessment and performance improvement program must be updated with patient complaints and the data collected in this regard.\
True
75
The complaint of a patient rises to the level of a grievance when it is
not resolved by the staff, postponed for later, made in writing
76
______ law is a type of civil law, an example of its violation could be medical negligence.
Tort
77
In which of the following cases was an organization excused for negligent credentialing as the state granted immunity to nonprofit health.
Harrel v Total Health Care (1989)
78
______ oversees the Institutional Review Boards
FDA
79
In accordance with the ADA Law of _____, individuals with disabilities must be granted access to public places.
1990
80
_____ was designed with the aim of preventing hospitals from refusing to treat patients simply based on the source of their payment.
EMTALA; Emergency Medical Treatment and Labor Act
81
The NPDB querying and reporting requirements apply to
dentists, physicians, licensed practitioners
82
Which of the following may NOT query at the NPDB?
Medical malpractice payers
83
______ is an updated version of CFR and an editorial compilation of its material. It is updated on a regular basis
e-CFR
84
The NPDB-HIPDB allows self-query by applicants even in the absence of a signed and notarized paper copy submitted to the data banks.
False
85
Hospitals are not required to query more than once every _____ years on a continuous staff practitioner.
2
86
The ____ processes the information as submitted by the reporting entity to the NPDB.
IQRS; Integrated Querying and Reporting Service
87
According to the NPDB research statistics, the number of adverse action reports in the U.S. between 2002 and 2012 is around
350,000
88
The ____ act was passed in 1946 and provides subsidies for expansion of hospitals in exchange for the provision of free care.
Hill Burton
89
The pre-employment medical examinations have been prohibited by the Americans with Disabilities Act of
1990
90
____ is a federal law which requires healthcare facilities receiving state funds to provide information about advanced directives to patients in the form of written material.
PSDA; The PSDA protects patients' rights to self-determination and allows them to make decisions about their medical care
91
An amendment to the Social Security Act in 1965 led to the establishment of
Medicare
92
The URAC accreditation program is four phased. These include the application building, desktop review, onsite review, and ____ review.
committee
93
In 2013, in response to the ACA mandate for consumer friendly health plan data, URAC constructed the URAC _____ system.
star data
94
_____ 1986, is a federal law which was enacted to create a national tracking system of physicians with records of malpractice.
HCQIA
95
HCQIA provides immunity from civil money damages in peer review cases, but an exception to this is the damages related to
those who misreport to the review body, those who provide false information, civil rights action
96
EMTALA is also known as
COBRA and Patient Anti-dumping law
97
EMTALA does not apply to the transfer of stable patients.
True
98
CMS and OIG have powers regarding violation of EMTALA and these can include hospital fines up to
$50,000
99
In 2014, a chair of AAAHC, _____ has been selected to represent AAAHC on the Affordable Care Act advisory panels.
Karren Conolly
100
An organizations, emergency management plan, according to the Joint Commission, must include
civil disasters, criminal acts, biological disaster
101
Which of the following patients must seek an accreditation certificate before choosing the health care center?
A 40 year old man anticipating a surgical procedure of the appendix, A 25 year old mother seeking a pediatrician for her newborn, A 50 year old woman suffering from heart problems
102
An accredited hospital has the authority to
participate in benchmarking studies
103
"Achieving Accreditation" is a quarterly educational program organized by
AAAHC
104
According to the AAAHC rules and regulations, which of the following is the CORRECT sequence of steps for accreditation?
Obtain a copy of the AAAHC handbook, conduct self-assessment; submit application; prepare organization; AAAHC conducts survey; get the final decision from AAAHC
105
It is recommended to involve healthcare professionals and administrators to conduct accreditation surveys.
True
106
Accreditation is awarded to those organizations which demonstrate ____ with the accreditation standards and adhere to the policies
substantial compliance
107
Compliance of organizations with the accreditation rules and regulations are assessed through one of these means; documented evidence, answers to questions about implementation, and
on site observations, interviews
108
The 2014 health plan standards took effect from
January 1, 2014
109
Which of the following must get accredited?
Surgery centers, Retail clinics, dental group practices
110
In the year 2013, AAAHC was approved as the accreditor for Qualified Health Plans at the federal and _____ levels.
state
111
The term ____ is used by the federal government as a way to recognize private accreditation organizations.
deemed status
112
In accordance with CMS policies, it takes approximately ___ days to get an NPI number.
10
113
Organizations such as AAAHC have the authority to conduct a "deemed status" survey.
True
114
CMA has established an internet-based system known as ____ as an alternative to the paper enrollment process (CMS-855)
PECOS
115
Section 301 of the No Fear Act requires each federal agency to post summary ____ data pertaining to complaints of employment discrimination filed against it by employees, former employees and applicants for employment under 29 CFR (Code of Federal Regulations) Part 1614
statistical
116
According to the Medicaid and CHIP April 2014 enrollment data reports, the total number of individuals enrolled is approximately ___ million.
65
117
In response to the growing number of advisory committees, Congress enacted the ____ which established the guidelines under which all Federal advisory committees must operate.
FACA; Federal Advisory Committee Act
118
____ refers to any employee who, by agency regulation, instruction, or other issuance, has been delegated authority to make any determination, give any approval, or take any other action required or permitted by this part with respect to another employee.
Agency designee
119
As required by Sections 2638.201 and 2638.202 (b) of CMS guidelines, each agency has a designated ____ who, on the agency's behalf, is responsible for coordinating and managing the agency's ethics program, as well as an alternate.
agency ethics official
120
In accordance with CMS guidelines, an employee shall not accept a gift, directly or indirectly, if it is from a _____ source, or given because of the employee's official position.
prohibited
121
_____ is defined as "any reference to an individual's substance abuse problem or a condition which results from such abuse which is made for the purpose of treatment."
diagnosis
122
____ means a "communication of patient identifying information or the communication of information from the record of an identified patient".
diagnosis, informant, program, *****NONE OF THE ABOVE*****
123
In case of a patient who is incapable of managing his own health care decisions, a guardian authorized under the _____ law may act on his behalf.
state
124
For disclosures with the patient's consent, the written form must contain the
name of the person making the disclosure, date of signing the consent, date on which the consent expires
-*****all of the above*****
125
For the purpose of preventing multiple enrollments in maintenance treatment programs, which of the following is the CORRECT definition of the term "Central Registry".
The patient identifying information from various sources
126
_____ are the minimum health and safety requirements for operation of Medicare certified ASC's.
Conditions for coverage
127
According to the recent CMS updates, those members of Medicare program who applied before _____ must revalidate their enrollment under the new criteria of the Affordable Care Act.
March 25, 2011
128
Organizations are now required to design an appropriate emergency equipment plan based on the procedures performed and
populations served
129
The Medicare enrollment application is also called CMS-
855B
130
If an ASC is denied the Medicare certification, it must request the CMS _____ for a written authorization if it wishes an organization with a deemed status to conduct a survey.
regional office
131
The state licensure inspections are different from Medicare surveys and are conducted according to the
state requirements
132
For a Medicare certified organization, acquisition of deemed status is
voluntary
133
The deemed status is not a permanent one, rather it only remains throughout the
accreditation term
134
The ____ determines the effective date of Medicare certification
CMS
135
According to CMS policies, the deemed status survey is
unannounced
136
For the acquisition of a deemed status, each ASC is allowed up to _____ blackout dates.
5
137
Health net federal services is a subsidiary of Health Net which was awarded in May 2014 _____ re-accreditation under the health network standards from URAC
full
138
The latest version of URAC accreditation program is version ____ which includes measures which fully address the requirements of the Affordable Act 2010.
7
139
URAC's Health Plan Accreditation Program with measures incorporates key market trends, addresses relevant policy issues, and aligns with the ____ components for accrediting health plans as outlined in the ACA Section 1311 requirements for state exchanges.
nine
140
Alex is an employee of the Mapping Agency and has been invited by the XYZ Association of Environmental Management to give a lecture about his agency's role in the protection of the environment. At the conclusion of his speech, the association presents Alex with a framed map with a market value of $18 and a book about the history of mapping with a market value of $15. Which of these gifts can Alex accept, according to the CMS ethical rules and regulations?
He may accept the map or the book but not both
141
The Deficit Reduction Act (DRA) was signed into law on February 8, _____ This legislation affects many aspects of domestic entitlement programs, including both Medicare and Medicaid.
2006
142
The Deficit Reduction Act requires that the Comprehensive Medicaid Integrity Plan must be revised every _____ year cycles.
5
143
The ___ is the first comprehensive Federal strategy to prevent and reduce provider fraud, waste, and abuse in the $300 billion per year Medicaid program.
MIP; The Medicaid Integrity Program (MIP) is a federal program that aims to reduce fraud, waste, and abuse in Medicaid
144
Under the Medicaid Integrity Program, the CMS has two broad responsibilities. Firstly, to hire contractors for reviewing Medicaid activities. Secondly, to provide assistance to ______ in their efforts to combat Medicaid fraud.
states
145
CMS is also required to report to Congress ____ on the effectiveness of the use of funds appropriated for the MIP
Annually
146
The criminal penalty for violation of laws regarding privacy of patient information generally is not more than $500 for first-time offenders and ____ for second time or subsequent offenses.
$5,000
147
An _____ organization is one which provides services to a program such as finance management or laboratory and has entered into a written agreement with the program.
qualified services
148
A _____ payer is the person who pays for a patient's treatment or diagnosis on the basis of a contract with the patient or patient's family. Or on the basis of the patient's eligibility for federal, local or state benefits.
third party
149
_____ agent is a law officer who gets enrolled in a program to investigate any violation of law.
Undercover
150
An institution cannot participate in Medicare unless it meets each and every condition or attains substantial compliance with requirements for
SNF's and NF's (Skilled Nursing Facility/Nursing Facility)
151
CAHPS is the acronym for Consumer Assessment of
Health Providers and Systems
152
Which of the following is a key issue stated in the ACA requirements?
Care coordination, mental health parity, reward quality
153
In 2014, URAC has launched a new publication called _____ as an updated to its previous publication Medical Home Today.
The Pulse on Clinical Integration
154
URAC is a national accreditation leader, offering over ____ highly regarded accreditation programs that span the healthcare spectrum.
30
155
An _______ in an independent third-party medical review resource that provides objective medical determinations based on evidence that includes medical reports, health plan guidelines, and evidence-based criteria.
independent review organization
156
There are three steps in the appeal process. A first level internal appeal, second level internal appeal, and a third level _____ appeal.
external
157
According to Section ______ of NAIC's Uniform Health Carrier External Review Model Act, the IRO's and reviewers are not liable for their determinations.
14
158
_______ is individually identifiable health information, in any form that is held by a covered entity, provider or business associate about health status, provision or payment for health care.
Protected health information
159
Incomplete documentation can result in a number of outcomes that are less than optimal for health plans, including
a slower review process, increased administrative costs, increased likelihood of legal action by the consumer
160
______ is a process by which a scholarly work is checked by a group of experts from that field to make sure that it meets the expected standards.
Peer review
161
After receiving the request for external review, the IRO (Independent Review Organization) will provide written notice on its decision within ____ days.
45
162
In case of an expedited review, the IRO will provide written notice on its decision within ____ hours.
72
163
In case of grandfathered self-insured reviews under the Department of Labor ERISA claims, IRO's have _____ days to render a determination.
60
164
Clinical reviewers must have clinical experience of ____ years to be qualified as an independent review expert.
3, 5 or 10 ****All of the above*****
165
Primarily, it is the responsibility of the ____ to combat Medicaid fraud.
states
166
The State Medicaid Director provides contact information for State Medicaid Directors for each state, the District of Columbia, and the U.S. Territories
State Medicaid Director
167
The punishment for a first offense of failure to pay child support includes fine or _____ months in prison, or both.
6
168
Currently, the Medicaid Fraud Control Unit operates in the District of Columbia and ____ states.
49
169
CMS employees are allowed to take any type of retaliatory action against any entity raising a complaint, question, or concern.
False
170
All CMS regulations are subject to the ____ which requires agencies to minimize regulatory burden on small businesses and other small entities.
Regulatory Flexibility Act (RFA)
171
CORF's is the acronym for ____ Rehabilitation Facilities.
Comprehensive Outpatient
172
The Social Security Amendments of 1972 amended the Medicaid Statute to allow the states the option of covering inpatient psychiatric hospitals services for individuals under the age of
21
173
In 1984, Congress amended 1905 (b), removing the requirement for _____ accreditation and adding the requirement that providers of the psych under 21 benefit meet the definition of a psychiatric hospital under the Medicare program.
JCAHO; Joint Commission on Accreditation of Healthcare Organizations
174
The term _____ is used for any non-hospital facility with a provider agreement with a State Medicaid Agency to provide the inpatient services benefit to Medicaid-eligible individuals of the psych under 21 benefit program.
PRTF; Psychiatric Residential Treatment Facility
175
The ____ is ultimately responsible for administration of Medicaid program.
State Medicaid Agency
176
The ____ Pricing Program enables covered entities to stretch scarce Federal resources as far as possible, reaching more eligible patients and providing more comprehensive services.
340B
177
The Title V Maternal and Child Health Program was enacted in the ____ as a part of the Social Security Act and continues to be the nation's oldest Federal/State partnership.
1930's
178
According to future-trending reports, specialty drugs will account for the majority of new drug approvals in the coming years, and they will consume approximately ____ percent of a health plan's drug spending by 2020.
40
179
____ is the term used for medicinal products made from living organisms.
Biologics
180
A specialty drug is one which
has its usage initiated by a specialist, requires special handling and requires a high degree of patient management (all of the above)
181
Up to 69 percent of medication-related hospital admissions are caused by _____, at a cost of more than $100 billion a year.
poor medication adherence
182
_____ is a systemic approach to the collection and verification of a provider's professional qualifications.
Provider credentialing
183
The top three results that health plans want their specialty pharmacies to achieve are: a decrease in inappropriate utilization, a reduction in drug acquisition costs, and
adherence to persistency
184
A recent study from the University of California, Davis, found that three cornerstone elements of the medical home model-comprehensive care, patient-centeredness, and extended office hours-correlate with _____ among patients.
a longer lifespan
185
Recent surveys total the number of uninsured individuals in America around approximately _____ million.
35
186
Nearly 40% of U.S. deaths arise from four preventable issues: unhealthy eating, physical inactivity, smoking, and
alcohol use
187
There were five accredited Comprehensive Wellness (CW) organizations submitting data in 2010, nine accredited CW organizations in 2011, and ____ CW companies in 2012.
six
188
______ is the coordination of patient care across conditions, providers, settings, and time to achieve care that is safe, effective, efficient, and patient focused.
Clinical integration
189
There are a total of _____ NCQA certification levels which CVO's can earn based on their performance.
two
190
The administrative simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA, Title II) require the Department of Health and Human Services (HHS) to adopt national standards for electronic health care transactions and national identifiers for providers, health plans, and
employers
191
Section 1886 (d) of the Social Security Act sets forth a system of payment for the operating costs of acute care hospital inpatient stays under Medicare Part A (Hospital insurance) based on prospectively set rates. This payment system is referred to as the
IPPS; Inpatient Prospective Payment System
192
The base payment rate is divided into a labor-related and ____ share.
non-labor
193
If a hospital treats a high percentage of low-income patients, it receives a percentage add-on payment applied to the ____ adjusted base payment rate.
DRG; Diagnosis Related Group
194
Medicare Part A claims processing contractors, called FI's and MAC's had ____ acute care inpatient hospital claim review responsibility.
no
195
The primary review responsibility of RAc's is
identifying past Medicare FFS improper payments
196
_____ has the responsibility of maintaining death report information provided by the RO
CMS-CO
197
Survey protocols and interpretive guidelines are established to provide guidance to
individuals conducting surveys
198
To certify an SNF or NF, a state surveyor completes at least a _____ survey and a standard survey.
life safety code
199
A sample size is defined as
then act of choosing the number of observations or replicates to include in a statistical sample
200
Between 2002 and 2008, the likelihood that a nursing home would receive at least one health deficiency on a survey increased steadily, from 2009 to 2011, this trend has
reversed
201
Some organizations addresses the credentialing and privileging of Advanced Practice Professionals in their
bylaws
202
The proportion of ambulatory surgical centers which currently require board certification for privileging is
unknown
203
Board ____ is an evaluation which is administered by physician specialty boards; it can also be defined as a metric for calculating the competence of physicians.
certification
204
Several recent studies have found a positive association between certification and
quality of care
205
Originally, the board certification consisted of a single examination. But in the 1970's, certain specialty boards moved toward _____ certificates.
time limited
206
Today, all American Board of Medicine Specialties (ABMS) issue only _____ certificates.
time limited
207
In the year 2000, about 24 members of the ABMS approved the plan for moving towards a much more comprehensive assessment for certification. This new plan came to be known as
MOC; Maintenance of Certification
208
Most of the current research on credentialing and privileging is limited to ___ and health plans.
hospitals
209
MOC evaluated the physician competencies in six main areas which include: patient care, medical knowledge, professionalism, interpersonal skills, knowledge and
practice
210
Credentialing is usually considered an expensive process as an average practitioner application may cost the organization an estimated $60 to
$400
211
Research shows that small hospitals are ____ likely than large hospitals to require board certification
less
212
Board certification has many ______ over the other available measures of competence.
advantages
213
Certification is static, just like residency and fellowship training.
False
214
Certification does not include which of the following?
Physician's cognitive expertise
215
_____ is an important source for verification of information
Federation of State Medical Boards, American Board of Medical Specialties, American Medical Association ****All of the above****
216
For each billing code, CMS calculates a weighted average sales price using the Average Sales Price (ASP) data submitted by manufacturers. The manufacturers submit ASP data at the _____ digit National Drug Code (NDC) level.
11
217
The Physician Referral Law forbids physicians from referring patients to an entity for a ______ in case the physician or a member of his or her immediate family has a financial relationship with the entity, except in certain exceptional cases.
designated health service
218
Section IV B.2. a. of the SRDP defines the ____ period as the time during which the disclosing party may not have been in compliance with the Physician Self-referral Law.
look back
219
A "_______ practice" is a medical practice which comprises two or more physicians who organize to provide patient care services.
physician
220
If an individual has only Medicare Part B, he is not considered to have minimum essential coverage.
True
221
Which of the following is a condition which fulfills the term "appropriate transfer"
The patient has been treated and stabilized at the transferring hospital as far as the limits of its capabilities, the weighing process is described in writing by a physician, the receiving hospital has been contacted and it approves the transfer, *****All of the above******
222
EMTALA applies only to people without insurance.
False
223
The National Committee for Quality Assurance is a _____, not for profit organization which has dedicated itself to improving health care quality.
private
224
Many preventive screening tests, such as colonoscopies, have been shown to _______ disease morbidity and mortality.
reduce
225
In 2014, the Affordable Care Act will extent Medicaid eligibility to nearly all residents under the age of
55, 75, 85, *****none of the above******
226
Physicians who score in the top quartile of credentialing examination are _____ likely to utilize experience-based practices than others.
more
227
Board certified physicians are at _____ risk of disciplinary action by a state medical board than their counterparts.
lower
228
A 2003 National Gallup Poll of the general public showed that board certification is _____ to patients.
important
229
______ has been defined as the minimum level of skill, knowledge, and/or expertise, derived through training and experience, required to safely and proficiently perform a task or procedure.
Clinical competency
230
When assessing a physician's endoscopic competence, which of the following should be evaluated?
The physician uses appropriate sedation, the physician obtains tissue properly, the physician discusses his findings with patients or thier families, ****All of the above*****
231
_____ includes verifying that the practitioner has documentation of appropriate licensure, education, training, and experience.
Credentialing
232
Board certificates and medical licenses are sufficient on their own for documenting completion of training.
False
233
Re-credentialing is an interval assessment of
competence
234
Studies have demonstrated that low procedural volume can be associated with _____ incomplete procedure and complication rates.
higher
235
The Joint Commission has mandated that endoscopic privileges must be renewed at least every _____ years for hospital-based endoscopy centers.
2 (two)
236
The Joint Commission has mandated that ambulatory endoscopy and surgical centers require renewal at least every _____ years unless state law provides otherwise.
3 (three)
237
In the event that minimal competence cannot be assured, there are several mechanisms available to a privileging body to ensure high-quality medical care, such as
including proctoring, continuing medical education, limitation of privileges, ****All of the above*****
238
According to CMS, credentials alone are _____ for privileging.
insufficient
239
All states do not recognize accreditation as meeting their state health facility licensing regulator requirements.
True
240
_____ Guides are health plan specific versions of the HIPAA-adopted standard implementation Guides which define the requirements of the health plans for different situational data elements, and also provide special instructions about how the health plan is interpreting the HIPAA implementation Guides.
Companion
241
The deadline for upgrading to Versions 5010 and D.0 was January 1
2012
242
The date of _____ is considered as the date for determining the codes which depend on service data for their validity, in the case of inpatient claims which span multiple service dates.
discharge
243
In the case of outpatient claims, the date of ____ is considered with the service item at the line level, and is utilized to determine the codes.
rendering services
244
_____ HIPAA operating rules are present which address spend down amounts for Medicaid agencies.
Three, Five, Seven, ****None of the Above****
245
The Council for Affordable Quality Healthcare (CAQH) Committee on Operating Rules for Information Exchange (CORE) acts as the operating rules authoring entity for non-retail _____ related eligibility for a health plan and health care claim status standard transactions.
pharmacy
246
An estimated 17 million low-income people are expected to become newly covered under Medicaid by
2020
247
Beginning in _____ all U.S. citizens and legal residents will be required to maintain minimum coverage or face a penalty.
2014
248
The U.S. Bureau of Primary Health Care is the agency that oversees all federally qualified health centers.
Primary Health Care
249
The agency mentioned above is paying for technical assistance and application fees for 500 health centers to achieve medical home recognition through the
NCQA
250
In the Multi-Payer Advanced Primary Care Initiative, Medicare has joined Medicaid and private insurers in multi-payer medical home initiatives in ____ states.
eight
251
Legally, the ____ is responsible for the conduct of the hospital as an institution.
hospital
252
Privileged physicians are ____ to become members of the medical staff.
eligible
253
According to the CMS, apart from doctors or physicians, the medical staff can also include those practitioners who are appointed by the
governing body
254
The IRA Form CP575 is a letter generated by the Internal Revenue Service which is delivered by the IRS and grants individuals their
employer identification number
255
The CMS condition of participation on "Medical Staff" at Section 482.22, concerns the organization and ___ of the hospital medical staff.
accountability
256
CMS first adopted the term "medical staff" in ____ when it began using the term at Section 482.22 in place of "physicians"
1980's
257
One of the requirements of the Joint Commission is that the institutions must have a policy guiding referrals for ____ peer review.
external
258
The National Practitioner Data Bank (NPDB) was established by the Health Care Quality Improvement Act and implemented in
1990
259
Federal Law requires hospitals to seek information from the NPDB when a physician applies for membership and at least _____ after that.
yearly
260
There is ____ data on how the information from NPDB is used for credentialing and peer review activities.
no
261
The DSM-V was released in May
2013
262
DSM-IV and DSM-V are HIPAA adopted code sets.
False
263
The ____ edits always consist of pairs of HCPCS codes and are arranged in two tables.
Correct Coding Initiative
264
A _____ is a unit of service (UOS) edit for a Healthcare Common Procedure Coding System (HCPCS) Current Procedural Terminology (CPT) code for services rendered by a single provider/supplier to a single beneficiary on the same date of service.
Medically Unlikely Edit
265
The Clinical Laboratory Improvement Amendments of _____ (CLIA) established quality standards for all laboratory testing to confirm the accuracy and reliability of patient test results regardless of the location where the test was performed.
1988
266
If the beneficiary requires medical necessary hospital care that is expected to span ______ or more midnights, then inpatient admission is generally appropriate.
2 (two)
267
Claims at or above ______ where the beneficiary's therapy services have exceeded have the threshold cap for the year will require manual medical review.
$3,700
268
Generally, if the physician cannot conclude whether the patient's diagnosis and treatment plan will involve an anticipated length of stay covering 2 or more midnights, the physician will have to continue to treat the beneficiary as
outpatient
269
_____ are congressionally-mandated financial limitations on various items such as outpatient occupational therapy or physical therapy but exclude the services provided in the hospital outpatient setting.
Therapy caps
270
On January 2, 2013, President Obama signed into law the American Taxpayer Relief Act of
2012
271
Since 2000, the number of uninsured Americans has increased by more than 20 percent. It reached approximately ____ million in 2006.
50
272
Costs of insurance administration are the ____ growing component of U.S. National health expenditures.
fastest
273
Estimates of the American "hidden tax" range from 8.5 percent of premiums nationally to up to 10.6 percent in
California
274
In the United States, 89 percent of total national health spending is concentrated among the sickest _____ percent of the population.
30
275
_____ is the sixth leading cause of death in the U.S., mainly due to the complexity of its treatment.
Diabetes
276
ICD-9 CM procedure codes were named as the HIPAA standard code set for ____ hospital procedures.
inpatient
277
A health care provider may apply for an NPI in a total of _____ alternative ways.
three (3)
278
_____ may be described as a series of a situational data element, combined with three data elements. Another characteristic is that their match can be found in the electronic remittance advice or ERA.
TRN segment
279
The Medicare Contracting Reform will affect the Medicare Advantage as well as the prescription drug benefit.
False
280
There are two ways of calculating the number of admissions in ED for measures associated with meaningful use objectives. These include the observation services method and the _____ method.
all ED visits
281
Since the year _____, an EP must have access to Certified EHR Technology at a location to be able to decide whether to include patients seen in locations 50% threshold or not and whether they are eligible for the EHR Incentive Program.
2013
282
There is no overall prerequisite under the Medicare and Medicaid EHR Incentive Programs which compels providers to contribute some maximum amount for the EHR technology that they are utlizing.
True
283
For the satisfactory reporting of the 2013 PQRS incentive eligibility, the PQRS _____ % performance rule is applicable.
0
284
A minimum of _____ denominator-eligible patients must be Medicare Part B Fee-For-Service (FFS) beneficiaries in case the eligible professionals decide to report measures group via the registry method.
11
285
_____ refers to a known set of identifiers used by either the states or the federal government for the purpose of identifying service providers before the National Provider Identifiers (NPI's) arrive.
LPI; Legacy Provider Identifier; which refers to a unique provider identification number used before the standardized NPI system was implemented
286
For identifying pregnant women in the Medicaid Analytic Extract Data, ____ ways are available.
no
287
The number of Medicaid Covered Inpatient Days are set as ____ for the dual claims for Medicaid as well as Medicare payments. These claims are also known as the IP crossover records.
zero
288
For those IP records whose Medicaid Covered Inpatient Days data element value is more than ____, the data element value is set as 365.
365
289
Which of the following is NOT a state participating in the Recovery Audit Prepayment Review Demonstration?
Mississippi
290
There are _____ legal requirements for issuance of an Advanced Beneficiary Notice.
two, three, four, ******None of the above******
291
Before the ATRA, the original Medicare claims for therapy services which were unable to qualify for a coverage exception were rejected as a benefit category denial, and the beneficiary was financially accountable for the ____ services.
non-covered
292
Section 1867 of the ____ Act levies certain responsibilities on Medicare-participating hospitals that provide emergency services. This includes the provision of medical screening examinations (MSE) when a request is made for examination or treatment of an emergency medical condition.
Social Security
293
EMTALA applies only to participating hospitals or hospitals which have entered into _____ contracts according to which they may receive payment from CMS under the Medicare program.
provider
294
The term _____ in medical terminology, in the case of emergency medical conditions, refers to the fact that there are no chances of any material determination of the patient's condition as a result of the transfer or which may occur during the transfer.
stabilized
295
According to the census of primary care workforce in the U.S., the number of physicians was greater than _____ million in 2010.
two
296
Is the usage of ANCC and NCCPA board certification as proof of achieving the highest level of education for nurse practitioners and physician assistants an acceptable act?
Yes, if the organization can obtain written confirmation from ANCC or NCCPA
297
Does the NCQA anticipate the participatory organization to issue peer-related information?
Up to the organization
298
According to the HEDIS 2013 report, during the initiation of AOD treatment indicator, the term "within 14 days of the IESD (inclusive) has been used". What do you suppose is meant by the term "inclusive" used in this statement? That IESD is
1 day
299
Unlike core elements, elements include requirements that must be met even if the organization delegates 100% of its functions.
structural
300
Patient-Centered Medical Homes transform primary care into what patients want it to be. This includes
enhanced access to care, care continuity, self-management resources, ****All of the above*****
301
The AAAHC has organized a number of clinical studies on the cataract and lens operations since 1999. The procedure usually involved adults over the age of
40
302
Almost _____ % of colonoscopies, particularly those for detecting colorectal cancer, are conducted in an ambulatory setting.
60
303
Accreditation may be described as a "voluntary" regulatory requirement.
True
304
Which of the following is a major accrediting organization for hospitals and surgery centers?
AAAHC, AAAASF, JCAHO, *****All of the above******
305
Which of the following explains the benefit of accreditation?
It increases efficiency, it reduces cost, it helps motivate staff members, ****All of the above*****
306
When was the AAAHC formed?
1979
307
The term "ambulatory" in AAAHC covers which of the following?
Ambulatory surgery centers, Community health centers, HMO's, ****All of the above****
308
Organizations which apply at AAAHC may receive any one of the ____ total rankings.
five
309
The ____ rank at AAAHC shows that the facility does not meet the standards currently but is allowed to re-apply after a period of 6 months has elapsed.
Deferred
310
The AAAASF accredits ______ which are owned or operated by the American Board of Medical Specialties.
single specialty & multi-specialty
311
For the purpose of accreditation, the facilities must be _____ compliant with an organization's set of standards.
100%
312
The accreditation program at AAAASF addresses a total of ______ aspects of the outpatient surgery center.
nine
313
Costs of accreditation depends on
the sized of the facility applying for accreditation & the number of specialties
314
The Joint Commission grants one of the total _____ accreditation levels to its applicants.
six
315
Medicaid and CHIP cover more than ____ million children.
31
316
Medicare Part A covers which of the following?
Hospitalization cost
317
Medicare Part C covers which of the following?
Medicare Advantage Plan
318
This monthly income limit is $993 for individuals and $1331 for couples in all states except Alaska and
Hawaii
319
A national minimum eligibility standard of ______ has been created by the ACA for the federal poverty level.
133%
320
_____ is included in eligibility groups for Medicaid.
Medically needed, breast cancer prevention, TB patients, *****Al of the above*****
321
Operating Department Practitioners work with
surgeons, nurses, anesthetists, *****All of the above****
322
HFAP was conceived in 1943 and began surveying hospitals in the year
1945
323
"Clinical Invasive Ventilation" refers to standards offered by
HQAA; The Healthcare Quality Association on Accreditation (HQAA) is a not-for-profit organization that accredits home medical equipment (HME) providers
324
Section 302 of the Medicare Modernization Act requires the formation of new competitive bidding programs for which of the following?
Prosthetics
325
Medtronic has recently decided to buy Covidien on a value of approximately _____ billion.
40
326
______ at the Joint Commission shows the decision that there exists justification to deny accreditation as it failed to show satisfactory compliance but the decision is subject to review.
Preliminary denial
327
When a facility meets only a subset of standards during the preliminary evaluation and it must undergo a full survey after 6 months, it is termed _____ by the Joint Commission.
Provisional accreditation
328
_____ accreditation at the Joint Commission signifies that an organization has failed to demonstrate its compliance in multiple areas and it must achieve compliance within a given time.
Preliminary denial
329
JCAHO has been accrediting ambulatory surgical centers since
1975
330
About 50% of the JCAHO standards are linked with
safety
331
_____ is recognized by Medicare and has a deemed status.
JCAHO, AAAHC, AAAASF - ****All of the above****
332
____ accreditation is originally referred to as a deemed status.
Medicare
333
The survey process for a Medicare survey depends on the chosen AO.
False
334
When are Medicare surveys announced?
One week before the survey, one month before the survey, six months before the survey ***** none of the above****
335
The survey period for Medicare survey is a ____ day span.
90
336
It is expected by Medicare that the ASC shall provide information to patients at least _____ day (s) ahead of the scheduled procedure, about the ASC's ownership interests and information about patient rights or advanced directives.
1
337
A unique aspect of the Medicare accreditation process is that once a survey is completed, the ASC is presented with a statement of ____, which details its findings.
deficiencies
338
The governing body of any ASC can establish its own minimum qualifications, as in terms of education, based on the national standards and ____ requirements.
state
339
Title 18 of the Social Security Amendments established Medicare for Americans over the age of
65
340
The Physician Quality Reporting System provides incentive payment to practices identified with
national provider identifier & tax identification number
341
_____ refers to the prescriber's ability of electronically sending prescriptions to the pharmacy from his point of care.
E-prescribing
342
____ may be described as the use of web services for health care.
E-health
343
A difference between Medicare and Medicaid HER incentive program is
Medicare program is run by the State Medicaid Agency while Medicaid is run by CMS
344
Medicaid HER Incentive program involves payments over ____ years which do not have to be consecutive.
six
345
Which of the following BEST describes URAC?
Non-profit
346
According to a recent report by the CDC, approximately ____ of the U.S. population suffers from diabetes.
9%
347
This year the Joint Commission international is celebrating ____ years of global impact on health care.
20
348
The total number of registered hospitals in the U.S. is approximately
6,000; As of 2024, there were 6,120 hospitals in the United States.
349
_____ is a way of preventing mistakes when serving clients or customers.
Quality assurance
350
According to a new CMS proposal, Medicare shall make reasonable effort to render a decision on prior authorization requests within ____ days.
ten (10)
351
Medicare and Medicaid were direct outgrowths of ____ program.
Beer-Mills
352
Between 2011 and 2012, teen birth rates have decreased by approximately
5%
353
In October 2006, Jay Schindler won his case when the defendant's motion for summary judgement under HCQIA was
denied
354
_____ is the process through which a professional review body considers whether a practitioner's membership will be negatively impacted by his competence or conduct.
Peer review
355
The National Practitioner Data Bank was actually promulgated by the _____ of 1986.
HCQIA
356
The information on the NPDB is available to which of the following?
General public, practitioners, patients ****none of the above****
357
It was reported by almost ____ of hospitals in the leapfrog survey of 2008 that they had adopted a no bill policy for adverse events.
60%
358
According to the NPDB research statistics, the population of America in 2013 was approximately
300,000,000
359
In the year 2012, NPDB expanded its website to provide statistical data of ____ years in tabular and graphical form.
10
360
According to the Title IV of Public Law 99-660, there has been a _____ occurrence of medical malpractice.
increasing
361
HCQIA required the reporters of NPDB submit any information related to malpractice payments which were taken on or after the year
1990
362
Under the Nurse Licensure Compact, the ____ was developed to allow any reporting of the actions against the privilege to practice for a nurse.
Nurse Multi-State Privilege Adverse Action Classification Codes
363
A payment made at which of the following cannot be reported?
Low end payment under high-low agreement
364
The denial of the licensure renewal of any physician cannot be reported to the NPDB.
False
365
URAC is the acronym for _________ Accreditation Commission
Utilization Review
366
Credentialing can be helpful for an organization by
setting standards & maintaining quality of care
367
The inclusion of PA's in the credentialing process is important for maintaining quality of care and its costs.
True
368
The term _____ is used to describe populations according their size, structure, and distribution.
demographics
369
The "Doorway Thoughts" is a tool which provides general considerations for _____ groups to facilitate conversations between clinicians and older adults.
ethnic
370
URAC is currently run by over _____ committee volunteers and paid staff.
500
371
Which of the following is an appropriate credentialing organization for radiologists?
AART; American Registry Of Radiologic Technologists
372
Credentialing is based on
objectivity
373
_____ is established by law and is implemented at a state level.
Licensure
374
Which of the following is an example of primary care setting?
Treatment of diabetes
375
Which of the following is an example of tertiary care setting?
Neurosurgery
376
In 2014 the Secretary for Health and Human Services is
Sylvia Burwell
377
In 2014, CMS announced that it shall fill two new leaders, a permanent marketplace CEO and a new permanent marketplace
CTO; Chief Technical Officer
378
The most popular plan type in the marketplace, according to HHS, is the _____ plan.
silver
379
On an average, consumers can select from a total of five health insurers and _____ marketplace plans.
47
380
In the year 2012, about ______ consumers got refunds amounting to half a billion dollars.
8.5 million
381
Which of the following refers to the Healthcare Quality Improvement Act of 1986?
Title 42 of the United States Code
382
The Omnibus Budget Reconciliation Act of ____ introduced the requirement of state medical boards reporting any negative action or finding.
1991
383
EMTALA was originally known as a ____ advisory group.
technical
384
According to Section 945 of the MMA, EMTALA was to be composed of ___ members.
19;
MMA= Medicare Modernization Act of 2003
385
Which of the following is the first touch point for those suspecting Medicaid fraud?
State Medicaid Agency
386
When reporting fraud, the pertinent information must include which of the following?
Medicaid card number of client, date of service, amount of money paid, ****All of the above****
387
The beneficiary card sharing tool kit is related to the issues associated with _____ cards.
Medicaid
388
_______ care involves highly specialized equipment and expertise.
Tertiary
389
When distance medicine is facilitated with the use of computers and internet, it is termed
cyber medicine
390
The process of attestation at the data bank allows the accounting for professionals not included in the ____ most queried professions.
12
391
An organization may have more than one DBID
True in the case of organizations with multiple departments
392
Which of the following cannot query the NPDB at any time?
Medical Malpractice payers
393
Hospitals are discouraged to query the data bank more than once every ____ years about a continuous staff practitioner.
2 (two)
394
The HIPDB cannot accept reports with dates of action before which of the following?
1996
395
The term "health plan" may include which of the following?
U.S. Dept. of Defense, U.S. Dept. of Veterans Affairs, Medicare, *****All of the above****
396
If an organization wants to request its members to act as observers during the survey process, according to JC regulations, it must obtain written consent at least _____ days before the survey.
5
397
Internet-based PECOS can be used for which of the following purposes?
Submitting initial Medicare enrollment application, Tracking your application, withdrawing from the Medicare program, *****all of the above*****
398
"The conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients." This is the definition for which of the following?
Evidence-based medicine
399
The current Medicare application fee is
$532
400
In November 2006, CMS approved ____ accreditation organizations. These were given the responsibility of accrediting DMEPOS under Medicare Part B.
10
401
The Social Security Act (the Act) mandates the establishment of minimum health and safety and CLIA standards that must be met by providers and suppliers participating in which programs?
Medicare and Medicaid
402
What percentage of all health care expenditures are estimated as annual losses due to health care fraud?
3-10%
403
According to the legislation for HIPDB, there should be
privacy protection, regular monthly reports, procedures to manage disputes, ****** all of the above*****
404
Which of the following is NOT a function of the states for CMS under the Social Security Act?
Training employees
405
If the provider refuses to permit examination, the CMS may take action for
termination
406
According to Medicare terminology, which of the following is a supplier?
Ambulatory surgery center
407
The term "alcohol abuse" refers to the use of any alcoholic beverage which impairs the user's
physical health, emotional health, social wellbeing, *****all of the above*****
408
There are a number of methods for monitoring medical audits, as suggested by Harrison. Which of the following is one such method that is based on the concept of acquiring knowledge from mistakes?
Peer review
409
In every hospital, much significance is given to laboratory and diagnostic services. Which of the following BEST explains the reason for this statement?
They receive patients and brief them about investigations
410
Net death rate is based on which of the following?
the deaths after 24 hours of hospital admissions
411
For hospitals and health care management, many different research models are in use. Which of the following models can be used for management of resources?
Linear programming model
412
Which of the following actors must be considered when studying the existing hospital facilities while planning a hospital?
Physical conditions of existing facilities
413
Which of the following is a certificate that an organization or hospital meets the nationally recognized standards?
AAAHC
414
A data collection will have to be arranged for which of the following patients?
A 50-year old woman who qualifies for Medicaid disability insurance suffers from diabetes and requires drug monitoring.
415
Which of the following cannot usually be assigned discharge planning responsibilities?
Family member
416
Discharge planning is not required for outpatients.
True
417
The types of institutions participating solely in Medicaid include
unskilled nursing facilities, psychiatric residential treatment facilities, intermediate care facilities for the mentally retarded, *****all of the above***
418
In accordance with the statement of deficiencies, an institution is given _____ calendar days, during which it must respond with a plan of correction. Failing this, the state agency certifies noncompliance.
10
419
When Medicaid nursing facilities wish to participate as Medicare skilled nursing facilities, the state must conduct a new survey.
False
420
For a long-term nursing facility, the requirements include provision of licensed nursing 24 hours a day as well as provision of registered nurses for 8 hours a day. Under which of the following conditions can the state grant a waiver of these requirements?
If the facility is able to demonstrate that it has made sincere efforts to fulfill the requirements but has been unable to do so.
421
______ have been established to provide assistance to the personnel conducting surveys.
Survey protocols & Interpretive guidelines
422
The CMS regularly sponsors the "open door forums" with the aim of providing opportunity for dialogue between the CMS and the
stakeholder community at large
423
The first part of the interpretive guidelines include
survey tag number
424
EMTALA was enacted by Congress in the year ______ as a part of the Consolidated Omnibus Budget Reconciliation Act or COBRA.
1986
425
Which of the following is an "administrative" aspect of what AAAHC looks for when surveying any organization?
Are the policies in use appropriate for all?
426
Which of the following is NOT a part of the hospital discharge planning process for patients?
Managing the hospital resources
427
Medicaid required that the nursing facilities meet the same requirements as the
skilled nursing facilities participating in Medicare
428
Under the agreements between the State and the Secretary, the state survey agencies are allowed to enforce the standards for
CLIA and Medicaid
429
A ______ nursing facility has in effect a transfer agreement which meets the requirements of Sections 1861 (1), 1866, and 1819 of the Act.
skilled
430
Interpretive guidelines have been established to provide guidance to the individuals conducting surveys. These interpretive guidelines include _____ parts.
3 (three)
431
The concerns of which of the following are addressed by low-income health access open door forum?
beneficiary advocates, providers, information intermediaries, ***all of the above****
432
______ is also known as COBRA or the patient anti-dumping law.
EMTALA
433
______ is a nationally recognized accreditation organization which meets or exceeds the CMS standards to provide accreditation to hospitals and other healthcare centers.
HFAP
434
The Joint Commission accredits more than _____ healthcare organizations in the U.S.
20,000
435
The MOST stringent form of health care regulation is
licensure
436
Clinical guidelines
consider the continuous provision of care as an important part of patient safety
437
Medication _____ refers to the situation when clinical care is not executed properly and a wrong drug is administered or the drug is administered in an incorrect way.
error
438
To which of the following organizations is the CVO certification available?
Organizations that are conducting credentials verification, organizations which report credentialing information to clients, organizations which maintain confidentiality of information, *****All of the above****
439
The certification level(s) that a Credentials Verification Organization can achieve include
certification or denial of certification
440
Which of the following is the United States of America's oldest accreditation organization?
The Joint Commission on Accreditation of Healthcare Organization
441
The life expectancy of a terminally ill patient is
six months or less
442
In the year ______, President Obama's healthcare reforms, known as the "Patient Protection" and the "Affordable Care Act" became a law
2010
443
Traditionally in the U.S. health insurance has been seen to be less common among young adults. This includes all males and females between the ages of 20 and 29. The reason(s) for this may include the lack of
awareness in this age group, opportunities available to this age group, media involvement in the issue, *****all of the above*****
444
The target year for complete conversion to Electronic Health Records systems was set by President Obama as _____, following which organizations that fail to undergo this transition shall face payment penalties.
2016
445
The concept of population based healthcare quality is mainly based on
measurement of community's health status
446
According to the URAC policies, what is a measurement year?
The first calendar year following the year in which an organization receives URAC accreditation
447
The three levels of management are
strategic, tactical, and operational, top level, middle level and first line management
448
The primary healthcare is ______ for the community, as compared to other levels of healthcare.
less expensive
449
It is the _________ job to manage procedural changes which are related to safety of patients in the hospital.
every manager's
450
The accreditation credentialing standards can be traced back to the 1970's with the _____ program.
National Home School Accreditation of America
451
Which of the following is a common requirement to obtain certification?
Giving an oral exam
452
Which of the following is a reason that BEST demonstrates the importance of accreditation?
It shows the values the clients attach to provide services of the state of the art standards
453
The Joint Commission requires the verification of licensure at foru different instances. Three of these include the stage of initial granting, the renewal, and the revision of privileges. Which is the fourth one?
If the organization intends to make administration changes
454
Which of the following options shows the CORRECT sequence of events in processing of applications by the Joint Commission? If the provider refuses to permit examination, the CMS may take action for
receive application; verifying contents; processing; review by chief; review and recommendations to the board of trustees; approval; notifying applicant
455
In what way is the credentialing process of HFAP different from that of the Joint Commission?
The chief/chair cannot make recommendations
456
Privileging is different from credentialing as the former involves
the authority given to a clinician
457
By applying for the credentialing process, the applicant demonstrates his _____ to appear for interviews regarding the application or credentialing process.
excuse
458
The document a candidate may have to provide for primary source verification may include a photocopy of
medical school diploma
459
A self-designation is designed to accommodate those applications who wish to establish their core credentials but have not yet
chosen an entity to receive their profile
460
Every state licensing authority will not have its own application for licensure.
False
461
To verify a physician's medical license, the primary source verifiers will check with the physician licensing board in their
state
462
The Association of American Medical Colleges, Federation of State Medical Boards and American Academy of Physician Assistants are some of the internet resources available for verification of
credentials
463
For the verification of an MD's board certification, the ABMS certified doctor verification program is an unacceptable source because it is
solely intended for consumer reference
464
According to the Joint Commission, the hospital must query the National Practitioner Data Bank at three times. Which of the following is NOT included in these three instances?
Requesting withdrawal of privileges
465
A physician's self-query to the NPDB is sufficient to fulfill the Joint Commission's requirements.
False
466
According to the NCQA, an organization can verify the sanctions on licensure in any state where the practitioner
provides care
467
The organization with which NCQA allows verification to be done includes FSMB, NPDB and
HIPDB
468
Jill works in a small practice and for some modalities she has problems meeting the continuing experience through primary interpretation. Another way to meet the requirement for her is by
an alternative peer review program
469
According to the Joint Commission, the information which must be included in peer recommendation includes medical knowledge, professionalism, skills and
clinical judgement
470
Ongoing monitoring of sanctions to Medicare and Medicaid must be one on a monthly basis or within _____ days.
30
471
A credential which must be tracked on an ongoing basis due to the need to keep it current is
state licensure
472
The NCQA uses the date of _____ as the official date of the application.
date on the letter or report
473
The Joint Commission states that the ____ can grant temporary privileges
Trustees
474
The Federation of State Medical Boards is an acceptable source for ____ source verification for sanction activity against physicians.
primary
475
A motivating benefit of board certification for applicants is
reduced cost to practice, enhanced salary, demonstrate the value attached to national standards, *****all of the above*****
476
A medical staff services association was established by Cochrane and Covell Carpenter in California in the year 1971 and this evolved into a national organization in 1976. The organization is known as ______ and provides education and other resources to its members.
NAMSS
477
The _______ examination has been created particularly for practitioner credentialing in the arena of managed care.
CPCS
478
The difference between a DO and MD is the
DO is an osteopathic physician while an MD is a medical doctor
479
The U.S. Congress passed in 1984 the National Organ Transplant Act, according to which the transplantation network is operated by a non-profit organization which is under the _____ contract.
federal
480
The _____ is based in Richmond and administers the Organ Procurement and Transplantation Network under contract with the HRSA
United Network for Organ Sharing
481
_____ allows the patient to communicate his preferences in terms of health care in case he becomes unable to make his own decisions.
Advanced Directive
482
A ____ year period for certification has been established by the Commission on Certification
5
483
Primary source verification can be done electronically by mail, fax, or telephone in certain circumstances.
True
484
A document which an applicant provides directly, rather than by primary or secondary source is
non-acceptable
485
The American Academy of Nurse Practitioners currently charges $40 for verification of national certification. The charge for verification provided State Boards of Nursing is
free of cost
486
According to Section 1921 of the Social Security Act, the state must provide the _____ or his designated member with access to documents of authority.
secretary
487
In accordance with the 1996 Amendments in the electronic Freedom of Information Act, a publicly accessible ____ has to be established by the HRSA.
electronic reading room
488
The Freedom of Information Act places requesters in three categories for free purposes. Which of the following is NOT included in these three categories?
Education institute or media, commercial use requesters, scientific institutes, ****none of the above****
489
About 120 million Americans, or 70% of the total health plan members are covered by _____ health plans.
NCQA
490
The ____ survey is for the new plans to NCQA and leads to a 3-year accreditation.
first
491
NCQA standards involve a number of categories including Utilization Management. One example of Utilization Managemetn is
does the plan use evidence-based guidelines in decision making
492
According to the Affordable Care Act, qualified health plans should participate in ____ to report on quality measures.
exchanges
493
HFAP has adopted the ____ safe practices which were provided in 2009 by the National Quality Forum.
34
494
The members of HFAP survey team include three surveyors: a physician, a nurse and a
hospital administrator
495
According to the National Practitioner Data Bank's report for years 2002-2012, the total medical malpractice payments in the United States are around
$150,000
496
The difference between laboratory developed tests and the FDA's authority is the premarket clearance and approval method of
FDA to assess the validity of a system in greater depth
497
The ____ regional office has the responsibility for approval and certification that ensures that the Regional Nonmedical Health Care Institution meets all conditions of coverage and participation.
Boston
498
According to CMS, which of the following is not a type of organ transplant program?
Brain
499
Individuals practicing outside the U.S. are exempt from having to enroll in a peer review program.
True, until the time they come back to the U.S.
500
The official accrediting body for programs in nursing is the
National League for Nursing (NLN)
501
The MIMIMUM formal education that would be required for the position of Assistant Director of Nursing, Intensive Care Unit, is normally
M.S.
502
Which of the following is NOT a typical legal liability affecting nursing practice?
Larceny
503
Each of the following is considered to be an advantage associated with associate nursing degree programs EXCEPT
preparation for administrative roles
504
Which of the following would be considered grounds for false imprisonment charges to be filed against a nurse?
Restraining a patient
505
The National Council Licensure Examination, or NCLEX, examines a candidate's knowledge of client needs along each of the following dimensions EXCEPT
effective treatment plan
506
All of the following may be used as reasons for revoking a nursing license EXCEPT
emotional problems
507
What is the term used to designate the curriculum track followed by students in a baccalaureate program who have received their basic education through an AD or diploma program?
Articulated
508
What is the MIMIMUM format education that would usually be required for the position of Oncology Nursing Coordinator?
M.P.H. with B.S. in nursing
509
R.N.s who return to school for a B.S.N. or M.S.N. degree should consider all of the following factors EXCEPT
present ability to supervise and evaluate
510
Formal recognition of a nurse's demonstration of competency by professional organizations or institutions (and not by state or federal boards) is termed
certification
511
Professional nursing practice requires, as a minimum level of education, a(n)
baccalaureate degree
512
What is the MINIMUM formal education that would be required for the position of Nursing Instructor, Associate Degree Program?
M.S. in psychiatric or medical-surgical nursing
513
Candidates who plan to take either the SAT or ACT should register AT LEAST ______ in advance.
six weeks.
514
For purposes of litigation, standard of care is determined by all of the following EXCEPT
emergency room statistics
515
Which of the following is NOT a designation given by the American Nurses' Association?
R.N., F.A.A.N
516
Of the following, an ADVANTAGE associated with nursing diploma programs is
accelerated level of patient contact
517
What is the MINIMUM formal education that would usually be required for the position of Clinical Specialist?
M.S. in field of specialty
518
In choosing a nursing school, it is desirable to select a program affiliated with hospitals that have been approved by the
JCAHO
519
The legal concept describing commonly accepted measures of competence and action on the part of medical professionals is termed
standard of care
520
What is the MINIMUM formal education that would usually be required for the position of Clinical Nursing Coordinator?
B.S.N. with five years' related clinical experience
521
The legal term for failure to act in a thoughtful manner, which results in harm to another, is
negligence
522
In which of the following organizations is membership composed of both nurses and non-nurses?
NLN; National League for Nursing
523
Each of the following is an advantage associated with baccalaureate nursing programs EXCEPT
lower relative cost
524
In order to avoid litigation, verbal or telephone orders from a physician should be signed within _____ hours.
24
525
What is the MIMIMUM formal education that would usually be required for the position of Director, School of Nursing (baccalaureate)?
Ph.D.
526
Of the following terms used in recognizing a nurse's demonstration of competency, _____ is MOST commonly applied in nursing.
credentialing
527
Currently, MOST nurses obtain R.N. status through completion of a(n)
associate degree
528
Which of the following is NOT one of the fifteen areas of nursing practice that is offered certification by the American Nurses' Association?
Clinical specialist in community health nursing
529
A student in a master's program must USUALLY complete ____ units of academic study, in addition to 8 units of graduate professional work.
30-36
530
The MIMIMUM formal education that would usually be required for the position of Director, Home Health Agency, is the
M.P.H.
531
What is the legal term GENERALLY used to describe any form of professional misconduct?
Malpractice
532
A candidate in an R.N. diploma program will USUALLY take ___ years to complete requirements.
2-3
533
Technical nursing practice requires a(n) ____ as a MINIMUM level of education.
associate degree
534
Which of the following mechanisms for controlling the quality of professional practice has NO legal status?
Certification
535
A candidate who takes the College Level Examination Program (CLEP) General Examination can eliminate some tuition costs by earning as many as ____ semester hours of undergraduate credit.
30
536
In legal terms, a written communication that damages a person's reputation is specifically known as
libel
537
Each of the following is considered to be a disadvantage associated with practical nursing programs EXCEPT
relative difficulty in qualifying for hospital work
538
What is the MINIMUM formal education that would be required for the position of Visiting Staff Nurse?
B.S.N.
539
Which of the following types of nursing practice does NOT require completion of either a nursing diploma or an associate degree?
L.P.N.
540
All of the following are considered to be grounds for filing assault and battery charges against a nurse EXCEPT
detaining a patient in an institution
541
The MINIMUM formal education that would be required for the position of Head Nurse CCU is
B.S.N.
542
Which of the following is considered to be a disadvantage associated with baccalaureate nursing programs?
Initial cost
543
Which of the following mechanisms for controlling the quality of professional practice is implemented through the use of state board examinations and state-approved schools of nursing?
Licensure
544
For purposes of litigation, the standard of care might be determined by
expert witnesses
545
From the time a student graduates from a school of nursing until he or she becomes licensed, the nurse works in the capacity of
a graduate nurse under a state-issued permit
546
Of the following, one of the fifteen areas of nursing practice that is offered certification by the American Nurses' Association is
family nurse practitioner
547
The National Council Licensure Examination, or NCLEX, identifies all of the following as the five main behaviors that make up the nursing process EXCEPT
prescribing
548
The MINIMUM formal education that would be required for the position of Visiting Nurse Clinical Specialist is the
M.S.
549
Affirmation that a school of nursing has requested evaluation and successfully met criteria established by the state board of registered nursing is termed
accreditation
550
A person with incomplete staff privileges who is in the transition from provisional active status is termed
associate
551
Which of the following is an advantage associated with the use of a prime vendor in hospital materials management?
Lower in-hospital inventory levels
552
Which of the following is NOT typically a function of a hospital CEO?
Functioning in a judgmental or deliberative fashion
553
Hospital finance documents may occasionally provide for a basket, which is a(n)
minimum level of debt that can be incurred without the need of meeting any financial performance tests
554
Medicare's Preferred Provider System (PPS) applies to
adult acute-care hospitals
555
Generally, the most basic function of a management services organization (MSO) is to act as a vehicle for
managed care contracting
556
The _____ committee(s is (are) mandated at all hospitals by the Joint Commission on the Accreditation of Health Care Organizations (JCAHO)
executive
557
Which of the following general statements about the work force in United States hospitals is FALSE?
highly integrated by function and occupation
558
In the average United States hospital, the Medicare program accounts for about _____ % of all revenues.
60
559
In inpatient community hospitals, which of the following utilization trends has increased over the past few years?
inpatient admissions
560
Each of the following was a characteristic of the health care industry at the turn of the 20th century EXCEPT
nursing glut; A "nursing glut" is the opposite of a "nursing shortage," meaning there is an excess supply of nurses in a particular area, where the number of available nurses significantly exceeds the demand for their services, essentially creating a surplus of qualified nurses with not enough jobs to fill.
561
The FIRST step in a hospital's attempt to contain labor costs should most likely be to
reduce the demand for particular services
562
Which of the following is NOT a typical subsystem associated with hospital food service systems?
Safety
563
In multi-provider systems, the MAIN advantage to using the corporate structure in governance is that
the lines of authority are clear
564
In a typical hospital organization, which of the following departments serves as the foundation for medical records?
Admitting/Patient Access Services
565
In productivity improvement, which of the following procedures is typically performed first?
Management orientation
566
The most traditional - and generally least effective - means of distributing hospital materials is through
requisitions
567
Factors to consider in developing the range of testing performed by a hospital laboratory fall into four general categories. Which of the following is NOT one of these?
Patient flow
568
Which of the following is an external input stakeholder in a hospital?
Third-party payers
569
Medicare's PPS payments are made on a _____ basis.
per-discharge
570
The strategic planning process at a hospital often begins with a plan to plan. Which of the steps in this process is typically performed FIRST?
Assessing internal and external environments.
571
Medicare's DRG payment rates represent full payment to a hospital for all inpatient hospital costs EXCEPT
capital related costs
572
Which of the following has been a trend in hospital care since 1980?
10% decline in both hospitals and beds
573
Factors which inhibit the vertical integration of multihospital systems involve each of the following EXCEPT
administrative costs
574
Approximately what percentage of a hospital's budget is related to materials, equipment, and purchased services?
30-50
575
Of the following, which area represents the greatest difference between the operations of free-standing hospitals and multi-provider systems?
Financial management
576
The medical record of a hospital patient
is the property of the hospital, which has the obligation to safeguard it from unauthorized use, loss or destruction
577
Which of the following types of tests is subject to the federal regulations regarding clinical laboratories?
Testing in physician office laboratories
578
Currently, outpatient service accounts for an average of about _____ % of a hospital's total revenue.
30
579
What type of medical record emphasizes chronological entry?
Integrated
580
The rapid growth of ambulatory services, and the accompanying movement toward free-standing and independently owned facilities, has been driven by each of the following factors EXCEPT
outdated inpatient facilities
581
In a typical hospital pharmacy department, drug expenditures generally account for about _____ % of the operating budget.
70
582
A significant advantage to the team approach to hospital design and construction is that
planning and construction times are minimized
583
In a hospital's administrative structure, a span of control of about _____ in a given functional area is normal to achieve optimal effectiveness.
5-10
584
The largest portion of financing for nonprofit hospitals generally comes from _____ bonds.
tax-exempt state agency
585
In a hospital, the easiest and least costly fire prevention/safety provision that can be made is to
eliminate the cause of fire occurences
586
In the past two decades, which of the following has done the most to diminish horizontal integration strategies among multi provider systems?
The implementation of PPS; A Prospective Payment System (PPS) is a method of reimbursement in which Medicare payment is made based on a predetermined, fixed amount.
587
Which of the following is NOT a significant factor in the changing reimbursement policies of United States hospitals?
Expanded referral bases
588
The quality improvement process
is designed to realign processes
589
The driving force behind strategic thinking, planning, and managing in hospitals should always be the
hospital's mission
590
_____ costs are excluded from Medicare's diagnostic related group (DRG) payment rates.
Pass-through; A "pass-through cost" is a cost incurred by a company on behalf of a client, which is then directly billed to the client without any markup, essentially meaning the company acts as a middleman simply passing the exact cost they paid to the client, with no additional profit added on; it's a reimbursable expense tied to a specific project or service provided to the client.
591
Which of the following is a financing instrument that provides a mechanism for consolidating the credit of the participating corporations, and for developing a legal framework for the future borrowings of each department?
Master indenture
592
The ultimate purpose of general cost-finding is to
determine the full costs of operating the revenue-producing centers of the hospital
593
Which of the following was a common characteristic on the internal environment of United States hospitals prior to 1965?
Increasing personnel specialization
594
In writing job descriptions, a human resources staff member should generally adhere to each of the following guidelines EXCEPT
use qualitative rather than quantitative words when possible
595
A hospital can improve its return on assets (ROA) by
increasing profit margin, increasing asset turnover, decreasing asset commitments
596
In a typical hospital organization, which of the following is part of the ancillary services department?
Pharmacy
597
The PRIMARY advantage associated with a pooled hospital financing program is that
a hospital may participate in financing that has already been structured
598
A hospital learns that its employees have initiated the unionization process. Under federal law, the hospital is prohibited from
granting wage increases or Special concessions during the election
599
For a public hospital, an investment-interests safe harbor can exist if
the investment represents the purchase of a federally-registered security
600
Which of the following is most widely accepted as the required academic preparation for health administration?
Master's degree
601
Management engineering in hospitals can be used for each of the following purposes EXCEPT
structuring job evaluation procedures according to productivity measures
602
Approximately what percentage of all energy consumed by a hospital is used in the heating, ventilating, and air conditioning (HVAC) systems?
60
603
In the general physical planning of a health care facility, certain interdepartmental relationships should be considered. Which of the following is generally the most important relationship to preserve in the facility's design?
Laboratory/Emergency
604
Typically, the clinical information department in a hospital is responsible for transcribing
autopsy protocols, interpretations of graphic data (EEC, EKG, etc.), discharge summaries, x-ray reports
605
In forming a nonprofit foundation, which of the following is typically done FIRST?
Appraising physician compensation
606
In the job analysis process in hospitals, which of the following is LEAST likely to be used as a means of obtaining information about jobs?
Published abstracts of job content at similar institutions
607
The ambulatory patient grouping (APG) system of reimbursement is based on the payment unit of the
outpatient visit
608
In which of the following radiology divisions is central scheduling likely to be LEAST effective?
Angiography
609
In hospital management engineering, the primary objective of layout and equipment studies is to
reduce walking distances and total labor input
610
Which of the following agencies is responsible for issuing certification documents or waivers for testing done at clinical laboratories?
Health Care Finance Administration (HCFA)
611
Which of the following is a process-of-care measure of quality for a hospital?
Communication between clinical staff
612
In the most widely accepted model for strategic stakeholder management in hospitals, which of the following steps should be performed FIRST?
Diagnosing each stakeholder in terms of potential for threat and potential for cooperation
613
The most common reimbursement method in managed care plans is
fee-for-service
614
At what level of a hospital's medical staff membership is a person who does not frequently admit patients and who does not have the full obligations of active staff membership?
Courtesy
615
In the development of a new health care facility, of of an addition to an existing facility, which of the following procedures in the implementation process is typically performed FIRST?
CON development; CON development" in a hospital refers to the process of applying for a "Certificate of Need" (CON), which is a legal document required by many states before a hospital can construct a new facility, expand existing services, acquire major medical equipment, or make significant changes to operations, essentially proving that the community needs the proposed development and it won't lead to unnecessary duplication of services; it acts as a regulatory mechanism to control healthcare resource allocation within a region.
616
Which of the following is an advantage associated with the use of consignment buying in hospital materials management?
Improved cash flow
617
In general, hospitals today are least likely to offer which of the following benefits to their employees?
Vision-coverage
618
In a hospital's cost finding process, which of the following would be counted as a direct cost?
Laboratory
619
Performance evaluations of hospital employees should generally include each of the following EXCEPT
a measurement of the employee's performance against the performance of other employees in the same department
620
What is considered to be the basic functional unit in a clinical laboratory?
Workstation
621
What is the term for the account group used to record the transactions involving the hospital's investments is land, buildings, and equipment?
Plant fund
622
The most notable example of a closed medical staff within a hospital is in the ____ department.
radiology; A "closed medical staff" refers to a hospital or healthcare facility where only a limited number of pre-selected physicians are allowed to practice, meaning they do not accept applications for new medical staff members unless there is a vacancy, essentially restricting access to the facility to a specific group of doctors; in contrast to an "open medical staff" which actively accepts applications from new physicians.
623
Which of the following is an advantage associated with the formation of a management services organization (MSO)?
Lower per physician costs
624
Under Medicare regulations, which of the following is eligible for reimbursement as a direct general medical education (GME) cost?
Faculty salary
625
All of the following are generally accepted moral values basic to clinical nursing practice EXCEPT
countertransference; In clinical nursing, "countertransference" refers to the unconscious transfer of a nurse's own personal feelings, emotions, and experiences onto a patient
626
Values clarification is a process by which individuals find their own answers (values) to situations. Valuing is composed of seven processes, that can be placed in which of the following groups?
Prizing one's beliefs and behaviors, choosing one's beliefs and behaviors, acting on one's beliefs, ****All of the above****
627
Behavior must be consistent over a period of time in order to reflect a value. It is important for nurses to do all of the following EXCEPT
confront the patient with their values
628
Which of the following is NOT an advantage of values clarification?
It sets limits on the type of nursing activities that can be undertaken
629
Values change from time to time as situations change. Reasons for identifying a patient's value system do not include
controlling patient behaviors through value manipulation
630
All of the following are means of learning a patient's values EXCEPT
trying to adopt an authoritative role in patient's thought process
631
Different patients exhibit different behaviors. Behaviors that may indicate unclear values include all of the following EXCEPT
prior history of cooperation and consistent behavior
632
An ethical or moral dilemma is a situation involving a choice between equally satisfactory or unsatisfactory alternatives or a difficult problem that seems to have no satisfactory solution. According to Thompson and Thompson, for a situation to be a moral dilemma, it MUST fulfill which of the following criteria?
Awareness of different options
633
Nursing codes of ethics
provide a means by which professional standards of practice are established, maintained and improved
634
Purposes of ethical nursing codes include all of the following EXCEPT
Nurses do not assume responsibility and accountability for individual nursing judgements and actions
635
In addressing the issue of risk versus responsibility to patients, the American Nurses Association presents fundamental criteria to differentiate the nurse's moral duty from the moral option to care for a patient, namely whether
the patient is at significant risk of harm, loss or damage if the nurse does not assist, the nurse's intervention or care is directly relevant to preventing harm, the benefit the patient will gain outweighs any harm the nurse might incur and does not present more than minimal risks to the health care provider, ****All of the above*****
636
All of the following statements about the Canadian Nurses Association Code of Ethics for Nursing are correct EXCEPT the nurse
is not obliged to hold confidential all information regarding a patient learned in the health care setting
637
The withdrawal of equipment from a patient whose life is being sustained by artificial means is a highly complex issue. The Hastings Center has prepared guidelines for the termination of life-sustaining treatment, which are governed by all of the following values EXCEPT
the nurses' autonomy
- the patient's well being, integrity of the health professional, justice or equity
638
Although codes of ethics offer general guidelines for decision-making, more specific guidelines are necessary in many cases to resolve the ethical dilemmas encountered by nurses in practice settings. Suggested guidelines for nurses to resolve these dilemmas include:
establishing a sound data base
639
Nurses need to gather as much information as possible about a situation. Aroskar suggests that nurses get answers to all of the following EXCEPT what
diagnostic workup the nurse has to perform for a particular case
640
Nursing practice is governed by many legal concepts. Knowledge of laws that regulate and affect nursing practice are needed to
ensure that the nurse's decisions and actions are consistent with current legal principles, protect the nurse from liability
641
Functions of law in nursing do NOT include
protecting nurses from culpability for their errors
642
The Constitutions of the United States and Canada include due process and equal protection clauses. The due process clause applies to state or provincial and local agencies, including public hospitals, and to actions that deprive a person of life, liberty or property. This includes which of the following primary elements?
The rules being applied must be reasonable, fair procedures must be followed when enforcing the rules, the rules being applied must not be vague; ****All of the above****
643
Laws govern the relationships of private individuals with the government and with each other. All of the following are types of law EXCEPT
contact
644
Our system of law rests upon all of the following principles EXCEPT:
Law is characterized by resistance to change
645
Licenses are legal permits granted by a government agency for the practice of a profession and the use of a particular title. In order for a profession or occupation to need or hold a license, its members must GENERALLY meet which of the following criteria?
The occupation is clearly delineated as a separate and distinct area of work.
646
The ANA has enumerated the principles of credentialing. These principles reflect the belief that credentialing exists PRIMARILY to protect and benefit the public and includes
accountability as an essential component of any credentialing process, professional identity and responsibility evolving from the credentialing process, an effective system of role delineation, ****all of the above*****
647
In the United States, nurses are issued a license by the State Board of Nursing or by an administrative governmental agency. Licenses are issued to all of the following registered nurses EXCEPT nurses who have
completed three years of basic training in a private or governmental hospital
648
There are two types of licensure/registration: mandatory and permissive. Under mandatory licensure, all nursing practice must be licensed EXCEPT practice
in an emergency, by nursing students as part of their education, by nurses employed by the federal government, ****All of the above****
649
A contract is an agreement between two or more competent persons, upon sufficient consideration, to do or not to do some lawful act. Contract law requires all of the following elements be met in order to make a contract valid EXCEPT
there must be no compensation for the service to be provided
650
Nurses have three separate, interdependent legal roles, each with its own rights and associated responsibilities. These roles include
provider of service, employee or contractor for service, citizen, ****All of the above*****
651
While working in the capacity of employee or contractor for service, a nurse has all of the following legal rights EXCEPT the right to
adequate and qualified assistance as necessary
652
Most jurisdictions of the country have statutes that impose a duty to report certain confidential information. Major reporting categories include all of the following EXCEPT
cancer and other serious conditions
653
A tort is a civil wrong committed against a person or a person's property. All of the following statements are unintentional torts EXCEPT
the act in question is willful and deliberate
654
Obtaining informed consent is the responsibility of a physician. The nurse's responsibility is often to witness the giving of informed consent and involves
witnessing the exchange between the patient and the physician
655
Northrop describes major elements of informed consent as including all of the following EXCEPT that
in order to give consent, the patient must feel coerced.
656
The American Heart Association has issued standards and guidelines for cardiopulmonary resuscitation and emergency cardiac care, outlining the medicolegal considerations and offering recommendations about DNR orders for physicians. The implications of the American Heart Association code standards means that a nurse must do all of the following EXCEPT
even if the agency does not have a well established procedure, do not seek a legal opinion
657
Clinical guidelines for the legal precautions that a nurse should adopt include
observe and monitor the patient accurately, build and maintain good rapport with patients, protect patients from falls and preventable injuries, ****All of the above****
658
Abortion laws provide specific guidelines for nurses about what is legally permissible. The results of Supreme Court rulings do NOT include which of the following statements?
During the second trimester of pregnancy, the mother's privacy rights override any restrictions designed to protect the health and safety of the mother.
659
Nurses are expected to know basic information about procedures and medications ordered by a physician. Becker outlines all of the following orders that nurses must question in order to protect themselves legally EXCEPT to question
any order if the patient's condition remains the same
660
Nursing students are responsible for their actions and are liable for their acts of negligence committed during the course of clinical experience. In order to fulfill their responsibilities to patients and to minimize chances for liability, nursing students need to do all of the following EXCEPT
not ask for additional help or supervision
661
A will is a declaration by a person about how the person's property is to be disposed of after death. In order for a will to be valid, which of the following conditions must be met?
The person making the will must be of sound mind.
662
In the past, health care facilities have been influenced largely by the needs of the people providing the services. As a result, preventive health care facilities have been slow to develop. This delay can be attributed in great part to the fact that
the nurse's role as the chief provider of preventive health care and health promotion has been slow to evolve
663
The health delivery system is very much affected by a country's total economic status. Correct statements about economic influences include all of the following EXCEPT:
The United States spends more on health care than it does on defense
664
Funding for personal health care can come from a variety of sources. Major sources include all of the following EXCEPT
private organizations
665
Primary care agencies are the point of entry into the health care system and the point at which initial health care is given. The major purpose of primary care centers is to provide all of the following EXCEPT
treatment of permanent malfunctioning that does not require hospitilization
666
Ambulatory care centers are being used more frequently in many communities. These centers have all of the following advantages EXCEPT they
permit patients to live in a controlled environment while obtaining needed health care
667
An HMO is a group health care agency that provides basic and supplemental health maintenance and treatment services to voluntary enrollees. To be federally qualified, an HMO company must meet certain requirements which include offering all of the following EXCEPT
preventive dental services for children over 12 years of age
668
The preferred provider organization (PPO) has emerged as another alternative health delivery system. Major sponsors of PPOs include all of the following EXCEPT
individual patients
669
In 1987, the Congress of the United States passed the Omnibus Budget Reconciliation Act (OBRA) to bring a measure of quality assurance to the nursing home industry. One of the provisions of OBRA that concerns nursing is the requirement for nursing aide training. Specific requirements include
a registry for nurse's aides
670
Nursing implications of this 1987 OBRA provision include
concerns about which state agency is to be responsible for implementing the requirements, that the training requirements may not be sufficient to prepare aides to carry out routine care for nursing home patients who have complex problems, the evaluation requirement necessitates job analysis and the development of standard criteria at the state level, ***All of the above****
671
The American Hospital Association published A Patient's Bill of Rights in an effort to promote the rights of hospitalized clients. The nursing implications of the patient's bill of rights are that the patient has the right to
considerate and respectful care, refuse treatment to the extent permitted by law, expect reasonable continuity of care, ****All of the above****
672
The problem of financing health illness services is increasingly severe. Major reasons for increased costs include all of the following EXCEPT
the relative number of people who provide health illness services has decreased
673
The number of homeless people in towns and cities continues to grow. Reasons for this increase include all of the following EXCEPT
an increase in federal subsidies for low-income housing
674
Which of the following is NOT a goal associated with the use of critical pathways in medical care
establish standards of practice for health care professionals
675
The organization largely responsible for the voluntary accreditation of nursing education programs in the United States is the
National League for Nursing (NLN)
676
Which of the following is NOT generally considered to be a goal of the contemporary health care system?
Return of health care professionals to more generalized education and practice
677
Nurses who want to ensure their autonomy in the workplace generally seek
administrative positions
678
Each of the following was a feature of Florence Nightingale's original nursing program at St. Thomas Hospital EXCEPT that
the program was financially linked to the hospital
679
The earliest mode of nursing care in use was
the case method; The case method is a teaching and problem-solving technique that involves analyzing real-world situations to develop solutions. It's a participatory approach that encourages students to actively engage with the material and develop critical thinking skills.
680
The body of law that defines and enforces duties and rights among private individuals that are not based on contractual agreements is ____ law.
tort
681
According to Miller, the degree to which a nurse functions as a professional is reflected in each of the following behaviors EXCEPT
accepting, promoting, and maintaining the independence of nursing research from nursing practice
682
If a nurse is inequitably assigned to a shift or weekend work, the category of collective bargaining that has been breached is
contract violations
683
Immediately after World War II, the United States experienced a dire shortage of civilian nurses. The primary reason for this was
low pay and poor working conditions for civilian nurses as opposed to nurses in military service
684
In the United States, the system of law rests on four basic principles. Which of the following is NOT one of these?
Law is based on a concern for the distribution of material wealth and the opportunity to acquire it.
685
As a general rule, professional codes of ethics are
typically more demanding than legal standards
686
The ____ approach to nursing research is also known as the literary or critical approach.
historical
687
Which of the following promoted the facilitation of the body's reparative processes by manipulating a patient's environment?
Nightingale
688
If a nurse makes a documentation error while charting a patient, the nurse should ______, write error in charting above the incorrect section, and initial the changes.
cross out the error with a single line
689
The ANA recommends that each of the following questions be part of the nursing admission assessment regarding advanced directives EXCEPT
Is the client preparing for a procedure for which an advance care directive might be applicable?
690
The amount of autonomy a professional group possesses depends primarily on its effectiveness at
governing its members
691
The hospice movement in the United States gathered most of its momentum in the
1970's
692
Analysis is a feature of the ______ phase of the nursing process.
diagnosing
693
When documenting care and observations in a patient record
approved medical terms and abbreviations can be used
694
Which of the following is LEAST likely to factor in nurses' ethical decision-making?
Legal principles
695
In order to protect themselves legally, nurses must question each of the following types of orders from physicians EXCEPT
those that differ in any way from those conventionally encountered in similar situations
696
The professional organization for nurses in the United States is the
American Nursing Association (ANA)
697
Which of the following is an example of a secondary health care service?
Surgery
698
Today, the most significant effect of advances in technology and knowledge in the health care industry has been to
change the profile of the hospital client
699
Each of the following is a category used to define different clinical specialties for nursing EXCEPT
teaching
700
In 1945,
New York became the only state to have mandatory licensure laws for practical nurses
701
A nurse becomes _____ by the process of learning the ways of the nursing culture, and becoming a functioning participant in this group.
socialized
702
Each of the following is a burden of proof required for nursing negligence and malpractice EXCEPT a
willful breach of the nurse's duty to the client
703
Which of the following is a typical research function of a nurse at the baccalaureate level?
Identifying nursing problems that need to be investigated and participates in the implementation of specific studies
704
Which of the following is NOT a typical characteristic of an Independent Practice Association (IPA)?
At the end of a fiscal year, any surplus money is divided among the provider and the IPA.
705
Nursing ______ includes knowledge obtained through nursing research.
science
706
Which of the following is an example of constitutional law affecting nurses?
Due process
707
Of the following, which moral framework is based on relationships, rather than on the concept of justice?
The ethic of caring
708
A novice is a nurse
who enters a clinical setting with no experience
709
Each of the following is a basic rule for a nurse to follow in charting a patient EXCEPT
mark each block of a charting or entry with one's initials
710
In what year had all states passed licensure laws affecting practical/vocational nurse training?
1955
711
The main DISADVANTAGE associated with the functional mode of nursing care delivery is
fragmentation of care
712
Which of the following is an example of a major tertiary care provider?
Home health care agency
713
Which of the following is a characteristic that most clearly distinguishes a profession from other kinds of occupations?
An orientation of the individual toward service, either to a community or to an organization
714
Each of the following is a reason why preventive health care facilities have been slow to develop in the United States EXCEPT
preventive health costs are not covered by most private insurers
715
When developing a definition of health, one should consider that health is
a condition of physical, mental and social well-being and absence of disease
716
In what year was the Patient Self-Determination Act passed by the United States government?
1991
717
Which of the following is NOT a purpose generally served by nursing ethics committees?
participate in disciplinary actions involving nurses who have proven to be in violation of the agency's code of ethics
718
The listing of a nurse's name and other information on an official roster of a governmental or nongovernmental agency is a process known as
registration
719
As the nursing process method first came into accepted use, most practitioner's attention was focused on
assessing
720
Which of the following states uses a Title Act, rather than a practice act, to regulate nursing licensure?
Texas
721
The ANA's Human Rights Guideline for Nurses in Clinical and other Research attempts to specify each of the following EXCEPT the
type of research activities appropriate for nurses at differing educational levels
722
In 1973, the
Health Maintenance Organization Act was passed
723
Which of the following is NOT a type of critical pathway variance?
Treatment
-System
-Provider
-Client
724
The three elements of the nursing situation are patient behavior, nurse reaction, and nurse action.
Orem
725
A nurse's goal is to be kind and caring but also intelligent, competent, and technically well-prepared to provide service to individuals, families and society.
Rogers
726
The goal of nursing is to use conservation activities aimed at optimal use of a patient's resources.
Rogers
727
Caring is assisting persons in performing activities they would accomplish independently given the necessary resources.
Levine
728
The goal of nursing is to maintain and promote health, prevent illness, and care for and rehabilitate ill and disabled patients through the humanistic science of nursing
King
729
The interpersonal process is viewed as a human-to-human relationship formed during an illness or experience of suffering
King
730
The focus of nursing is on humanity as a living unity, and its qualitative participation with health experience. Health is a continual, open process, rather than a state of well-being or an absence of disease.
Orem
731
Nursing is defined as a process of action, reaction, and interaction whereby nurse and client share information about their perceptions in the nursing situation, leading to goal attainment.
Rogers
732
The goal of nursing is to provide care consistent with nursing's emerging science and knowledge, with care as the central focus.
Levine
733
Stress reduction is the goal of the systems model of nursing.
King
734
Caring is an interpersonal process comprising interventions that result in meeting human needs.
Rogers
735
In 1965, the American Nurses Association published a position paper outlining its beliefs about the nursing profession. Which of the following was NOT a belief included in this paper?
Nursing assistants should have preservice programs in vocational education, rather than on-the-job trianing.
736
Those acts that are permitted to be performed or prohibited from being performed by a prudent person working within the parameters of his/her training, license, and experience, and the conditions existing at the time, are defined broadly as
the nurse practice act
737
Documentation is part of the _____ phases of the nursing process.
assessment
738
Nursing's first professional code of ethics was adopted in
1953
739
Mrs. Yardley is a hospital patient with congestive heart failure. She is a bit forgetful and unsteady on her feet. In the past, she has fallen several times, and the nursing staff is concerned for her safety. After some consideration, Mrs. Yardley is provided with a safety reminder device when the nurse cannot be in attendance. The necessary action for Mrs. Yardley's protection interferes, out of necessity, with her ability or tendency to function independently. This situation becomes a potential threat to her
autonomy
740
The ANA's Patient's Bill of Rights includes each of the following elements EXCEPT
the client's right to refuse a treatment or particular plan of care.
- a hospital must ask the client about any advance directive before certain procedures are begun
- if a client lacks decision-making capacity for any reason, the rights will be exercised on their behalf at the discretion of the physician who is currently treating or caring for the client
- confidentiality of all records and communications regarding a client's care
741
A nurse _______ provides bedside or direct care in a specialty area
clinician
742
Which of the following is an example of statutory law affecting nurses?
Nurse practice acts
743
Which of the following is NOT a type of primary health care agency?
Hospital
- Industrial clinic
- Ambulatory care Center
- Physician's office
744
A profession is considered to be autonomous if it(s)
regulates itself and sets standards for its members
745
A nurse, committed to the sanctity of life, wants a client to have artificial nutrition and hydration. However, the nurse also knows that tube-feedings are prolonging the client's pain and suffering, and this makes the nurse want to discontinue the feedings. This is an example of
a decision=focused ethical problem
746
_____ nursing research approach organizes narrative or words to discover themes and relationships among concepts in a non-numerical way.
Qualitative
747
In what year did Florence Nightingale begin the transformation of nursing from occupation to profession by establishing the nursing school at St. Thomas Hospital in London?
1860
748
A nurse has reached a level of professionalism categorized as proficient when he or she
perceives a situation as a whole, rather than just its individual aspects
749
A nurse's separate but interdependent legal roles are generally defined as each of the following EXCEPT
guardian
750
Administrative law is written within the scope of the authority granted by the
legislative body
751
In 1992, the American Organization of Nursing Executives published its recommendations for effective health care reform in the United States. Which of the following was NOT an element of these recommendations?
Finance health care through an increasing reliance on public-sector funding
752
What is the term for the ongoing process of behaving in ways that lead to improved health, or a subjective perception of balance, harmony, and vitality?
Wellness
753
The adaptive model of nursing was developed by
Roy
754
The Voluntary practice of establishing that an individual nurse has met his/her minimum standards of nursing competence in specialized areas is known as
certification
755
According to Peplau, the first phase to develop in a nurse-patient relationship is
orientation
756
The purpose of a nurse's professional code of ethics is, in its most general sense, to
provide standards of conduct for the practice of nursing
757
A rehabilitation process typically has each of the following broad objectives EXCEPT to
strengthen existing abilities in order to compensate for the loss of others
- assist the client to use his or her abilities
- return affected abilities to the highest possible level of function
- prevent further disability
758
Persons who perform emergency care in a reasonable and prudent manner, without appropriate equipment and supplies, are protected from legal action in most states by
Good Samaritan laws
759
The central concept of _____ is improving or maintaining the quality of life, rather than saving life or curing illness.
hospice services
760
The purpose of conscience clauses in state abortion legislation is to
grant hospitals the right to deny admission to abortion clients
761
Each of the following is true of intentional torts EXCEPT
the wrong results from failure to use due care
762
In which of the following states would a nursing program use the term vocational nursing instead of practical nursing?
California
763
Which of the following modes of nursing care was developed in response to the shortage of personnel experienced in World War II?
The functional method
764
Most jurisdictions in the United States have statues that impose a duty on health care professionals to report certain confidential information. Which of the following is NOT a type of information generally included in these statutes?
Requested medication
765
In most states, advanced directives
must be witnessed by two people but do not require review by attorney
766
The changing nature of the American health care system has involved many implications for nursing practice. Which of the following is NOT one of these?
Decreased need for nurses to function in primary care
767
Nursing interventions that are based on the instructions or written orders of another professional are classified as
dependent
768
A _______ can, under certain circumstances, provide informed consent.
minor
769
Which of the following organizations receives and manages funds and trusts that contribute to the advancement of nursing?
International Council of Nurses (ICN)
770
Which of the following is NOT an example of a primary health care service?
Restoring clients to useful function in some or all areas of their lives
- illness prevention programs
-referring clients to specialists
-explaining a client's overall health problem
771
A health care professional's duty to do no harm is known as the principle of
nonmaleficence
772
The legal term for touching another's body without consent is
battery
773
The MAIN difference between a Preferred Provider Organization (PPO) and a Preferred Provider Arrangement (PPA) involves
whether services are offered to the insurer at a discounted rate
774
The term for a mental image or classification of things and events in terms of similarities is
theory
775
Which of the following is NOT a type of advanced medical directive?
Health care proxy
776
A patient has signed a consent for a perineal surgical procedure. Consent will be most clearly indicated by the patient's statement that
he is in so much pain, he'll sign anything
777
By the end of the nineteenth century, there were three nursing schools established in the United States. Which of the following was NOT one of these?
Bellevue Hospital School of Nursing
778
Nursing ______ is the term for the way in which nursing knowledge is expressed by a practitioner.
science
779
The time period of a civil litigation procedure is LEAST likely to be affected by
the attorneys for both sides
780
Which of the following is a characteristic that most clearly distinguishes a profession from other kinds of occupations?
Its requirement of prolonged specialized training to acquire a body of knowledge pertinent to the role to be performed.
781
_____ is covered under Medicare.
Examinations to prescribe eyeglasses
782
The giving of nursing care is an element of the _____ phase of the nursing process.
implementing
783
Of the following, the first to offer a definition of nursing process was
King
784
What type of nursing research has proven to be most difficult to carry out in hospital settings?
Experimental
785
Each of the following is a general approach to moral theory involved in medical practice EXCEPT
bioethics
786
_____ is a system in which one nurse is responsible for total care of a number of clients 24 hours a day, seven days a week.
Primary nursing
787
The purpose of the prospective payment system (PPS) legislation passed by the federal government in 1983 was primarily to
limit the amount of money paid to hospitals that are reimbursed by Medicare
788
When performing aggregation, a nurse's FIRST step is to
collect and summarize clinical interventions
789
The most common malpractice situations involved in nursing care are
medication errors
790
A patient's health records are
concise legal records of all care given and responses
791
Each of the following is a service or agency that has been added to some hospitals as a result of the changing nature of the health care delivery system EXCEPT
hospice services
792
An LPN is working as a staff member at a nursing home. One of the patients, Mr. Thompson, a 90-year old, is restless and has spent the last few nights wandering about, unable to sleep. The LPN is told in report by Ms. Barkley, a fellow nurse, that Ms. Barkley borrowed a Darvocet from another patient and gave it to Mr. Thompson to calm him down. After the LPN discusses the problem with Ms. Barkley and reports the error to the physician, the next appropriate action would be to
bring the issue to the organization's ethics committee
793
The regulation of nursing is a function of
state law
794
In order to resolve ethical dilemmas, a nursing staff should establish a sound database that will address each of the following questions EXCEPT
What is the patient's religious affiliation?
795
In 1914,
the Mississippi State legislature was the first political body to pass license laws controlling practical nurses
796
When collecting data during the nursing process, a tertiary source of data would be
the patients record
797
Which of the following is an example of public law affecting nurses?
Sexual assault
798
The CHIEF goal of a nurse in the role of care provider is to
convey understanding of about what is important, and to provide support
799
Each of the following is characteristic of the process for developing critical pathways in a medical care facility EXCEPT
the process for developing a pathway is created independent of the agency
800
For legal purposes, the standards of care for nursing practice are most clearly defined by the
state nurse practice act
801
Which of the following is a typical research function of a nurse at the associate degree level?
Assisting in data collection within an established, structured format
802
According to the International Council of Nurses, the nurse's fundamental ethical responsibilities include the following EXCEPT to
sustain a cooperative relationship
803
A nurse who demonstrates marginally accepted performance is professionally categorized as
an advanced beginner
804
A resident physician instructs nurses to order a complete blood count and urinalysis on all clients admitted to the emergency room and to get the results before calling him down. The nurses feel this is unethical; it is wasteful and causes discomfort and possible risks for the clients. Without having the authority to change the situation, however, they order the tests, feel guilty, and upset. This is an example of
an action-focused ethical problem
805
Each of the following has contributed to the professional nurse's increased role as a teacher EXCEPT
increased client awareness
806
According to Miller, the critical aspects of professionalism in nursing do NOT include
gaining a science orientation at the hospital level in nursing
807
When the American Society of Superintendents of Training Schools of Nursing was established in 1894, its primary goal was
the establishment of educational standards for nursing
808
The general term for an expected standard of behavior for specific group members is
norm
809
It is NOT a purpose of nursing codes of ethics to
give direction for actions to take in specific cases
810
______ stimuli are most immediate to a patient, and precipitate certain observed behaviors.
Focal
811
Since 1965, health care costs in the United States have increased by approximately
400%
812
Before a civil trial, written answers to written questions, known as _______, are submitted by all parties.
interrogatories
813
In what year were the Medicare amendments to the Social Security Act adopted?
1965
814
Which of the following is a type of therapeutic intervention?
Educating
815
Which of the following is NOT typically involved in a nurse's responsibility as a witness to a client's informed consent?
Securing the approval of a patient's living relation
816
Of the following, which patient value is most threatened by health care situations?
Autonomy
817
Which of the following is a secondary health care agency?
Hospital
818
Which of the following is NOT an important priority of data collection during the assessment phase of the nursing process?
Arranging results in a way easily retrievable by future researchers
819
Which of the following was the creator of nursing's four conservation principles?
Levine
820
Which of the following is not an essential element of nursing diagnosis?
Representing an opinion
821
Each of the following is a recommendation offered by the ANA regarding do not resuscitate (DNR) orders EXCEPT
the wishes of the client's spouse and family must always take precedence.
822
The scientific method is useful in nursing research for
to find answers to clinical problems
