PMR 12 - legal and ethics

Question 1

Which of the following is a federal program providing health insurance for people older than 65 years?
a. Medicare
b. Americans with Disabilities Act
c. Medicaid
d. Welfare

Answer 1

A) Medicare insurance provides coverage for people older than 65 years.

Question 2

Which of the following generally provides health insurance coverage for low-income patients and individuals with disabilities?
a. Medicare
b. Americans with Disabilities Act
c. Medicaid
d. Welfare

Answer 2

C) Medicaid provides insurance coverage for low-income patients and individuals with disabilities.

Question 3

Medicaid is primarily funded by which of the following?
a. Federal government
b. State government
c. Private companies
d. Split between Federal and State governments

Answer 3

D) Medicaid is jointly funded by the Federal and State governments.

Question 4

Medicare Part A primarily covers which of the following?
a. Outpatient physician visits
b. Yearly physicals
c. Inpatient hospitalizations
d. Outpatient surgical procedures

Answer 4

C) Medicare Part A primarily covers the cost of inpatient hospitalization.

Question 5

Medicare Part D primarily covers which of the following?
a. Inpatient hospitalization
b. Outpatient imaging studies
c. Outpatient physician visits
d. Prescription drugs

Answer 5

D) Medicare Part D primarily covers prescription drugs.

Question 6

Medicare pays for inpatient rehabilitation using which of the following payment systems?
a. Pay for fee service
b. Medicare does not pay for inpatient rehabilitation
c. Pay by outcome system
d. Prospective payment system (PPS)

Answer 6

Medicare pays for inpatient rehabilitation by using a PPS. A fixed amount of money is paid to the facility regardless of duration of hospitalization.

Question 7

Which of the following best describes autonomy?
a. Automatically making a decision for a patient
b. The right of an individual to make his or her own informed decision
c. Taking action that serves the best interest of the patient
d. Do not harm the patient

Answer 7

B) Autonomy is the right of an individual or patient to make his or her own informed decision.

Question 8

Which of the following best describes beneficence?
a. Automatically making a decision for a patient
b. The right of an individual to make his or her own informed decision
c. Taking action that serves the best interest of the patient
d. Do not harm the patient

Answer 8

C) Beneficence is taking action that serves the best interest of the patient.

Question 9

Which act allows eligible employees of covered employers to take unpaid, job-protected leave for specified family and medical reasons with continuation of group health insurance coverage under the same terms and conditions as if the employee had not taken leave?
a. Americans with Disabilities Act
b. Family Medical Leave Act (FMLA)
c. Maternity Leave Act
d. Stark Law

Answer 9

B) The FMLA protects eligible employees and allows them to take job protected leave while keeping group health insurance.

Question 10

Which act is best defined as a wide-ranging civil rights law that prohibits, under certain circumstances, discrimination based on disabilitv?
a. Americans with Disabilities Act (ADA)
b. Family Medical Leave Act
c. Maternity Leave Act
d. Stark Law

Answer 10

A) The ADA prohibits discrimination based on disability. It was signed into law in 1990.

Question 11

Which of the following governs physician self-referral for Medicare and Medicaid patients?
a. Americans with Disabilities Act
b. Family Medical Leave Act
c. Maternity Leave Act
d. Stark Law

Answer 11

D) The Stark Law governs physician self-, referral for Medicare and Medicaid patients. It limits the conditions under which a physician can refer to an entity in which he or she has a financial interest.

Question 12

Which of the following is best defined as
“a branch of philosophy dealing with values pertaining to human conduct, considering the rightness and wrongness of actions and the goodness or badness of the motives and ends of such actions.”?
a. Ethics
b. Tort
c. Stark
d. Hippocratic oath

Answer 12

A) Ethics is best defined as a branch of philosophy dealing with values pertaining to human conduct, considering the rightness and wrongness of actions and the goodness or badness of the motives and ends of such actions.

Question 13

What does HIPAA stand for?
a. Human Interference Protection and
Privacy Act
b. Health Insurance Portability and
Accountability Act
c. Home Insurance Portability and
Accountability Act
d. Health Income Potential and
Protection Act

Answer 13

B) HIPAA stands for Health Insurance
Portability and Accountability Act.

Question 14

Which of the following is best described as protection for the physician from civil punishment in an emergency?
a. Abandonment
b. Good Samaritan Law.
c. Health Insurance Portability and
Accountability Act (HIPAA)
d. Compliance

Answer 14

B) The Good Samaritan Law protects physicians from civil punishment when acting in an emergency situation. Emergency situations are defined differently by each respective state.

Question 15

Which of the following describes ending a physician-patient relationship when a patient is in need of treatment, without making certain they have continuing care?
a. Abandonment”
b. Good Samaritan Law
c. Health Insurance Portability and
Accountability Act (HIPAA)
d. Compliance)

Answer 15

A) Abandonment is best described by ending a physician-patient relationship when a patient is in need of treatment, without making certain they have continuing care.

Question 16

The degree to which a patient follows medical advice is best described as?
a. Abandonment
b. Good Samaritan Law
c. Health Insurance Portability and
Accountability Act (HIPAA)
d. Compliance

Answer 16

D) Compliance is the degree to which a patient follows medical advice.

Question 17

Which of the following is a unique 10-digit identification number issued to health care providers by centers for Medicare and Medicaid Services (CMS)?
a. Social security number
b. Drug Enforcement Agency (DEA) number
c. National Provider Identification
(NPI) number
d. State License number

Answer 17

C) NPI number is a unique 10-digit identification number issued to health care providers by CMS.

Question 18

Which of the following best describes informed consent according to the American Medical Association (AMA)?
a. Informing the patient you are going to perform a procedure
b. Informing the patient you made a mistake
c. Informing the parent of a minor
d. Informed consent is a process of communication between a patient and a physician that results in the patient’s authorization or agreement to undergo a specifi c medical intervention

Answer 18

D) Informed consent is a process of communication between a patient and a physician that results in the patient’s authorization or agreement to undergo a specific medical intervention.

Question 19

Which of the following best describes breach of confidentiality according to the American Medical Association (AMA)?
a. Not disclosing a breached fetal position to an expecting mother
b. Informing a patient of his or her test results
c. Disclosure of information to a third party without patient permission
d. Explaining risks and benefits of a procedure

Answer 19

C) A breach of confidentiality is a disclosure to a third party, without patient consent or court order, of private information that the physician has learned within the patient- physician relationship.

Question 20

Which of the following is/are appropriate step(s) that should be taken when ending a physician-patient relationship?
a. Providing the patient a written notice
b. Providing the patient an explanation
c. Providing resources to help find another physician
d. All of the above

Answer 20

D) According to American Medical Association (AMA) guidelines, appropriate steps to terminate a patient-physician relationship typically include giving the patient written notice, preferably by certified mail, return receipt requested; providing the patient with a brief explanation for terminating the relationship (this should be a valid reason, for instance, noncompliance, failure to keep appointments.); agreeing to continue to provide treatment and access to services for a L/reasonable period, such as 30 days, to allow a patient to secure care from another person (a physician mav want to extend the period for emergency services); providing resources and/or recommendations to help a patient locate another physician of like specialty; and offering to transfer records to a newly designated physician upon signed patient authorization to do so.

Question 21

Which of the following does not qualify for the Medicare 60% inpatient rule?
a. Stroke
b. Hip fracture
c. Knee replacement
d. Burns

Answer 21

C) The 60% rule (formerly the 75% rule) is a Medicare regulation stipulating that in order to be eligible for payments, 60% of an inpatient rehabilitation facility’s patients must fall within a specific list of qualifying conditions. Knee replacement does not qualify as part of the 60% rule. In order for a joint replacement to qualify, they must have other comorbidities (obesity, bilateral joint replacement, or older than 85 years).

Question 22

Medicare is funded by which of the following?
a. Federal government
b. State government
c. Private companies
d. Split between Federal and State governments

Answer 22

A) Medicare is funded by the Federal government. Medicaid is jointly funded by state and federal funds.

Question 23

Which best describes a legal document that allows you to convey your decisions about end-of-life care ahead of time?
a. Advanced directives
b. Health care proxy
c. Power of attorney
d. Palliative care

Answer 23

A) Advanced directives allow you to convey your decisions about end-of-life care ahead of time.

Question 24

Which of the following conveys your preferences regarding medical care intended to sustain life?
a. Health Insurance Portability and
Accountability Act (HIPAA)
b. Health care proxy
c. Living will
d. Palliative care

Answer 24

C) Living will conveys your preferences regarding medical care intended to sustain life. Examples are use of dialysis, artificial ventilation, tube feeding, and organ donation.

Question 25

Which of the following best describes the use of an appointed agent to make medical decisions in case the patient is unable to?
a. Health Insurance Portability and
Accountability Act (HIPAA)
b. Health care proxy
c. Living will
d. Palliative care

Answer 25

B) Health care proxy is an appointed agent that will make decisions if the primary person is unable to do so.

Question 26

Which of the following is a palliative care goal?
a. Treatment of the disease
b. Preventive care
c. Comfort and quality of life
d. Strict glucose control

Answer 26

C) Palliative care goals include comfort of the patient and improving quality of life

Question 27

Which of the following is best defined as a contract between physician and employer, preventing the physician from practicing in a geographic location?
a. Prospective payment
b. Health care proxy
c. Restrictive covenant
d. Palliative care

Answer 27

C) According to the American Medical Association (AMA), “a restrictive covenant is a contractual provision between a physician and his or her employer which prevents the physician from practicing in a specified geographic area for a given period of time if the physician’s employment terminates.”

Question 28

Which of the following best defines an action that produces two effects, one positive and 28. one negative?
a. Beneficence
b. Autonomy
C. Double effect
d. Euthanasia

Answer 28

C) Double effect is an action that produces two consequences, one positive and one negative. One example is giving morphine to a terminally sick patient. Morphine can have a positive effect in that it improves pain but can negatively impact the respiratory system.

Question 29

Which of the following is defined as intentionally ending a life to provide relief from pain and suffering?
a. Euthanasia
b. Double effect
c. Abortion
d. Advanced directive

Answer 29

A) Euthanasia is the act of intentionally ending a life to provide relief from pain and suffering.

Question 30

Which of the following is a form of insurance providing wage replacement and medical benefits to employees injured in the course of employment in exchange for mandatory relinquishment of the employee’s right to sue?
a. Workers’ compensation
b. Tort reform
c. Health Insurance Portability and
Accountability Act (HIPAA)
d. Americans with Disabilities Act

Answer 30

A) Workers’ compensation is a form of insurance providing wage replacement and medical benefits to employees injured in the course of employment in exchange for mandatory relinquishment of the emplovee’s right to sue the employer.

Question 31

Which of the following is an example of incentives provided by the government for industries that comply with the American with Disabilities Act?
a. The Targeted Jobs Tax Credit
b. The Revenue Reconciliation Act
c. Both A and B
d. None of the above

Answer 31

C) The Revenue Reconciliation Act of 1990 allows businesses to deduct a set amount of expenses used for making the workplace accessible for disabled individuals. The Targeted Jobs Tax Credit of 1978 allows a tax credit for industries that employ individuals with disabilities (for 1 year).

Question 32

What criteria must be considered when examining a patient on the medical floor/ICU and making recommendations for an acute versus subacute facility?
a. The patient must need the coordinated care of an interdisciplinary team of therapists, nurses, social workers, and physicians
b. The patient must be able to participate in and benefit from an intensive program in a reasonable time
c. The patient must be medically stable and require close medical supervision
d. All of the above

Answer 32

D) There are various rehabilitation settings including acute, subacute, day programs, outpatient, and home. The physiatrist must make the decision to determine the most appropriate disposition plan. When recommending an inpatient rehabilitation course, the following criteria must be evaluated: (a) Is the patient medically appropriate for admission? (b) Does the patient have attainable rehabilitation goals with an appropriate rehab discharge plan? (c)
Does the patient have rehabilitation potential in a reasonable time? (d) Does the patient require close medical management by a physician/nursing? (e) Does the patient require a comprehensive interdisciplinary team approach (physical therapy, occupational therapy, speech therapy, prosthetics, and orthotics)?

Question 33

Which of the following is the groundbreaking federal law that became the foundation for the American with Disabilities Act?
a. The National Housing Act Amendments
b. The Disability Act of 1970
c. Urban Mass Transportation Act
d. The Rehabilitation Act of 1973

Answer 33

D) The Rehabilitation Act of 1973 not only became landmark legislation that established antidiscrimination for disabled persons, but also provided a variety of federally funded benefits. The National Housing Act Amendments removed obstacles for housing by creating the Office of Independent Living.
The Urban Mass Transportation Act required mass transit to be accessible to disabled individuals.

Question 34

A letter of medical necessity should include:
a. The impact of the equipment on the patient’s functional abilities
b. The current functional limitations of the patient including activities of daily living (ADLs) and mobility
C. Description of the features and all required components of the equipment
d. All of the above

Answer 34

D) The treating physician may be asked for a letter of medical necessity to provide details of why recommended equipment is necessary to improve function. The letter should include appropriate documentation of the above items. The physician must show evidence that other lower cost options were considered, attempted and unsuccessful, or not appropriate. The letter is not only needed for equipment such as wheelchairs, but may also be requested for the prescription of assistive technology.

Question 35

Which of the following legislative acts prohibits discrimination based on disability?
a. Americans with Disabilities Act (ADA)
b. The Rehabilitation and Disability Amendment
c. The Federal Equality Bill
d. Justice in Emplovment Act

Answer 35

A) The ADA was passed in 1990 to protect the civil liberties of individuals with disabilities. It addresses issues ranging from employment to public
transportation/accommodations and telecommunications.

Question 36

What did the Individuals with Disabilities
Education Act (IDEA) establish?
a. Provides assistive technology services to school-aged children with disabilities who require them for their continued education
b. Provides transportation to and from school for children with disabilities
c. Provides early intervention for children before they start schooling if developmental milestones are delaved
d. All of the above

Answer 36

D) The IDEA established guidelines for children (from birth to the age of 21) with disabilities to participate in a special education program and receive additional services to meet their needs. It creates an individualized curriculum that involves teachers as well as parents that will benefit the child as he or she develops. It applies to states that receive federal funding. There have been a number of amendments to the IDEA over the years. These services and devices are provided at no additional cost to their families.

Question 37

Which of the following statements is false regarding the American with Disabilities
Act (ADA)?
a. Employers must make reasonable accommodations to allow disabled employees to perform their job
b. An able bodied individual with hum an immunodeficiency virus (HIV) is protected under the ADA
C. A preemployment physical is required to properly place the individual in the appropriate job
d. Employers cannot discriminate against individuals with impairments in the workplace

Answer 37

C) The ADA establishes civil liberties for individuals with disabilities. Disabled individuals cannot be discriminated against in the workplace as long as they can perform their job under reasonable accommodations.
Preemployment physicals are not allowed and can only be used after an individual has been hired. The list of acceptable diagnoses also includes conditions that can be perceived as disabilities (such as HIV).

Question 38

The Americans with Disabilities Act (ADA)
ensures equality in which of the following areas?
а. Education and employment opportunities
b. Employment, public accommodations/transportation, state/government services, telecommunications
c. Medical and legal services
d. Federal but not state services

Answer 38

B) The ADA was passed in 1990 to protect the civil liberties of individuals with disabilities. It addressed issues in five key issues: state and federal services, employment, public transportation/accommodations, and telecommunications.

Question 39

The Supreme Court case decision, the Daubert standard, established the following precedent:
a. Individuals with disabilities are entitled to a vocational rehabilitation program to maximize their employment potential
b. Information given as an expert testimony must be based on evidence-based medicine and widely accepted in the medical community
c. Public areas and buildings constructed with federal funds must be made accessible for disabled individuals
d. Handicapped children are provided a free, appropriate education

Answer 39

B) Physiatrists who will be giving expert testimony will be held to the Daubert standard. The information must be accepted by the medical community, published in the medical literature, have a scientific basis, and have a known error rate. If it does not meet these guidelines, then the testimony can be disqualified. The Comprehensive Employment Training Act of 1973 (CETA) provided training programs and public service jobs for individuals with disabilities. After 1982, this federally funded service was transferred to state level. Answer Choice C refers to the Architectural Barriers Act of 1968, and choice D refers to the Education for All Handicapped Children Act of 1975.

Question 40

Which of the following terms best describes malingering?
a. An exaggeration of symptoms for secondary gain
b. Multiple complaints regarding several organ systems
c. Deliberate production of symptoms
d. None of the above

Answer 40

A) The secondary gains may include financial compensation, avoiding
work/school, and legal incentives. All of these can be categorized as fraudulent activity.
Somatization disorder is characterized by multiple complaints resulting in the individual making numerous visits to the doctor. In factitious disorder, an individual also magnifies and even fabricates symptoms but without the intent of a secondary gain.

Question 41

Which of the following refers to the federal government’s effort to classify the potential functional ability of an individual with an amputation to determine the most appropriate prosthetic components he or she requires?
a. M-levels
b. L-levels
c. P-levels
d. K-levels

Answer 41

D) The K-level is based on the patient’s expected potential and not on his or her current level of activity. It establishes reimbursement for various components so that individuals will receive prosthetics that correlate with their level of function. For example, an active individual would receive a more advanced device. The levels range from o, where the individual cannot ambulate or transfer safely, to 4, where the individual participates in high-impact and energy activities.

Question 42

What does the acronym CARF stand for?
a. The Commission on Accreditation of Rehabilitation Facilities
b. The Committee on Amputation, Restoration, and Function
c. The Council for the Administration of Rehabilitation Facilities
d. The Central Agency for Regulating Function

Answer 42

A) CARF is an international, nonprofit organization that establishes standards for health care organizations, including medical rehabilitation, employment and community services, child and youth services, behavioral health, aging services, and business and service management. It was founded in 1966 and has provided accreditation to various providers in 18 countries. Its mission focuses on maintaining the highest quality of care and performance for individuals living with a disability.

Question 43

Which of the following diagnoses is not compliant with Medicare’s guidelines for medical conditions that require intensive acute rehabilitation services?
a. 87-year-old woman with a total hip replacement
b. 70-year-old man with coronary artery disease (CAD) who underwent coronary artery bypass graft (CABG)
c. 60-year-old man with polyneuropathy on EMG
d. 55-year-old woman with femur fracture after a fall

Answer 43

B) The remaining choices are one of the 13 compliant Medicare diagnoses, which include
(a) stroke, (b) spinal cord injury, (c) congenital deformity, (d) amputation, (e) major multiple trauma, (f) fracture of femur (long bones), (g) brain injury, (h) neurological disorders, including multiple sclerosis, motor neuron disease, polyneuropathy, muscular dystrophy, and Parkinson’s disease, (i) burns, () active, polyarticular rheumatoid arthritis, psoriatic arthritis, and seronegative arthropathies resulting in functional impairment of activities of daily living (ADL) or ambulation that has not improved from outpatient therapy with the potential to improve with a more aggressive course, (k) systemic vasculitides with joint inflammation resulting in a significant functional impairment, (I) severe osteoarthritis involving two or more major weight-bearing joints (not a prosthesis) with deformity, atrophy, and loss of range of motion that led to a functional decline, (m) bilateral joint replacement, unilateral joint replacement with body mass index (BMI) of 50 or above the age of 85.

Question 44

A patient with a joint replacement would qualify for acute rehabilitation if:
a. Above the age of 65
b. Body mass index (BMI) greater than
30
c. Unilateral hip replacement
d. Bilateral knee replacement

Answer 44

D) Under Medicare guidelines, a compliant diagnosis must be consistent with the following bilateral joint replacement, or unilateral joint replacement with BMI of 50, or above the age of 85..

Question 45

What percentage case mix of the compliant 13 diagnoses (also known as the compliance threshold) must be met by a unit to receive payment as an inpatient rehabilitation facility (IRF) according to Medicare?
a. 50%
b. 60%
c. 75%
d. 80%

Answer 45

B) As described in the Code of Federal Regulations (subpart B), IRFs can receive payment per discharge (prospective payment system) on the basis of distinct clinical characteristics as well as specific case and facility level adjustments. This minimal percentage, also known as the compliance threshold, was set at 75%. The Extension Act of 2007 lowered this percentage to 60% and is therefore referred to as the ‘60% rule.” It also established that comorbidities that met the criteria must be used to determine the total compliance threshold.

Question 46

Which of the following measures will rehabilitation facilities now be required to report to Medicare?
a. Cases of nosocomial respiratory infections
b. Cases of surgical site infections
c. Cases of Clostridium difficile
d. Cases of new pressure ulcers

Answer 46

D) Beginning in 2014, facilities will be required to report urinary catheter associated infections (CAUTI) and new or worsening pressure ulcers during the course of the hospitalization. Facilities that fail to comply will incur a 2% payment reduction.

Question 47

What is the name of the legislation that made the practice of physician self-referrals unlawful?
a. The Stark Law
b. The Disability Amendment
c. The Independent Business Act
d. The Rehabilitation Act

Answer 47

A) The Social Security Act or Stark Law prohibits physicians from making referrals to health services (payable by Medicare) in which they receive financial compensation including physical, occupational, and speech therapies, durable medical equipment, prosthetics, and orthotics among other services with a number of specific exceptions.

Question 48

Which of the following refers to a reimbursement model system that a group of health care providers and facilities provide coordinated high-quality care where cost-efficiency is used as a performance measure?
a. Coordinated Health Care System
b. Accountable Care Organization (ACO)
c. Quality Improvement Model
d. Clinical Excellence Measures

Answer 48

B) ACO consists of groups of physicians and hospitals that are held accountable for quality care provided to patients. This type of model system places a financial
responsibility upon the health care provider to minimize unnecessary and duplicated expenditures. As a result, the providers will benefit from the savings realized by Medicare. The payment system is based on different programs including a shared savings program and advance payment initiative.

Question 49

Which of the following are components of decision-making capacity?
a. Express a choice verbally
b. Seek the opinion of family members and friends
c. Understand the risks and benefits related to treatment decisions
d. All of the above

Answer 49

C) The process of decision making involves the ability to make a choice either verbally or nonverbally, understand information regarding treatment options, utilize this information in a logical manner as it relates to their condition, and make a decision that is reliable and uniform with their values.

Question 50

On the acute rehabilitation unit, which of the following can be a potential barrier to the principle of autonomy?
a. Feeling of being outnumbered by the interdisciplinary team
b. Reluctance to decline the recommendations of the team
c. Anxietv about new techniques
d. All of the above

Answer 50

D) All of the above can be potential obstacles to the self-determination of a patient.

Question 51

All of the following are required to obtain informed consent except:
a. Disclosure
b. Competency
C. Coercion
d. Understanding

Answer 51

C) In order for a patient to give his or her consent, he or she must have decision-making capacity. The individual obtaining the consent must fully disclose the risks and benefits and all treatment options,
establishing an understanding on the behalf of the patient who is free from intimidation or force.

Question 52

Who is the legally recognized proxy to make medical decisions for a patient with impaired decision-making capacity?
a. Health care provider
b. Next of kin
c. Court appointed guardian
d. Power of attorney

Answer 52

D) The designation of a proxy can vary from state to state, but the legally recognized proxy is the durable power of attorney assigned in advanced directives. The remaining choices are all examples of surrogate decision makers who could possibly be given that responsibility if one is not identified by the patient ahead of time.

Question 53

Informed consent is based on which principle?
a. Justice
b. Beneficence
c. Autonomy
d. Nonmaleficence

Answer 53

C) Autonomy is one of the core principles of ethics. It is the right of an individual to make an informed decision regarding his or her care and treatment even if it is in contrast with the recommendations of his or her health care provider. An informed consent allows one to practice autonomy after considering the risks/benefits and alternatives. The remaining principles are also critical in the study of ethics. Nonmaleficence is the philosophy of “first, do no harm”; beneficence is the idea of doing what is in the best interest of the patient; and justice is the act of being fair.

Question 54

The philosophy of “first, do no harm” is based on which principle?
a. Autonomy
b. Nonmaleficence
c. Dignity
d. Beneficence

Answer 54

B) Nonmaleficence is one of the four core ethical principles. It means that the first. objective is not to cause harm. in comparison, beneficence is the concept to “do good” first and foremost. Autonomy is the right of an individual to make an informed decision regarding his or her care. Beneficence is the idea of doing what is in the best interest of the patient. Justice is the act of being fair.
Dignity, although important, is not one of the four core ethical principles.

Question 55

Recommending a new medication from a pharmaceutical company in which the physician is a member of the Board of Directors is an example of which concept?
a. Communication
b. Bias
c. Conflict of interest
d. Principle of double effect

Answer 55

C) A conflict of interest occurs when a physician’s self-interest challenges the patient’s best interest. Therefore, he or she may potentially compromise clinical responsibilities and objectivity to benefit from a financial or other secondary gain.

Question 56

Which of the following statements is not true and in compliance with the Health Insurance Portability and Accountability
Act (HIPAA)?
a. A patient’s health care information can be shared with police for reporting purposes
b. Any violation should be addressed to the Office of Civil Rights
c. Health information is allowed to be shared with those health care professionals directly involved in a patient’s care “
d. A patient’s health information can be shared with his or her employer

Answer 56

D) The Privacy Rule outlines required guidelines to protect patient identifiable information. Designated organizations, referred to as covered entities including health care providers and health plans (e.g., insurance company, Medicare/Medicaid must follow these standards. Health information is allowed to be shared with those health care professionals directly involved in a patient’s care, and it can be used to protect the public’s health and reports to law enforcement. This information cannot be shared without authorization by the individual to family/friends, employers, or for marketing purposes. A patient has the right to see and receive a copy of his or her records. If any grievance occurs, the Office of Civil Rights works to ensure and enforce compliance of the Privacy Rule.

Question 57

Which of the following are ways in which the rehabilitation team can become more culturally competent?
a. A monthly journal club that discusses articles focused on cultural issues
b. The utilization of interpreter services during therapies and patient rounds
c. Attending an international conference
d. All of the above

Answer 57

D) There are various ways in which a physiatrist and his or her team can promote cultural awareness. Over time, the inpatient units have had a greater representation of minority patients. Therefore, it is vital to improve communication and understanding and ultimately care. The following four approaches are suggested: (a) Encourage education in cultural diversity. (b) Create the best individualized program with consideration of one’s values and belief and available resources in the community. (c)
Continue these practices on a consistent basis at administrative level. (d) Improve research and selfawareness

Question 58

Which of the following was achieved by the Lystedt Law?
a. Any individual who sustained an injury that resulted in tetraplegia will be approved to receive both a power and manual wheelchair for his or her mobility
b. Any individual with an injury or disability is eligible for acute rehabilitation if there is reason that he or she will benefit from the services
c. Any individual affected by traumatic or nontraumatic amputation is entitled to receive a prosthetic device
d. A young athlete can be removed from a sport if there is any suspicion of sustaining a concussion and he or she requires medical clearance to return to play

Answer 58

D) The Lystedt Law was passed in the state of Washington in 2009 and is named after a young athlete, Zachery Lystedt, who returned prematurely after sustaining a concussion during a middle school football game. As a result, he suffered from serious long-term consequences affecting his cognition and ability to function. Any athlete below the age of 18 who is suspected of having a concussion cannot return to play unless given written permission by a health care professional trained specially in the diagnosis and treatment of concussion. The law also requires athletes and their parents to review and sign an educational form on concussions.

Question 59

Which of the following is/are potential ethical challenge(s) to conducting research in the population treated by physiatrists?
a. Lack of decision-making capacity secondary to cognitive deficits from iniuries
b. Difficulty with timing of an injury and subiect recruitment
c. The misconception of equating a therapeutic intervention with a cure
d. All of the above

Answer 59

D) There are unique challenges that
L researchers face in conducting research in physical medicine and rehabilitation. Other concerns include overutilization of particular subjects in specialized populations, withholding standard of care practices in control groups, and the physician-patient relationship.