Questions 121-160

Question 1

In planning to purchase new equipment, a healthcare facility should always be sure:

1. to speak with all suppliers and ask for presentations by suppliers.
2. the purchase is part of the facility’s capital plan.
3. to take the lowest bid.
4. to take the recommendation of the medical director.

Answer 1

the purchase is part of the facility’s capital plan.

Question 2

The selection of a major item of equipment should be:

1. guided by a selection group composed of the users and maintainers of that equipment.
2. made by the medical director of the department.
3. the sole choice of the administrator.
4. the decision of the board of directors.

Answer 2

guided by a selection group composed of the users and maintainers of that equipment.

Question 3

An effective plan for equipment maintenance is:

1. ensured by having all replacement parts in stock.
2. determined when the equipment is installed and need not be changed.
3. based on manufacturer’s recommendations and facility experience with the equipment.
4. ensured by having a computer-based preventive maintenance system.

Answer 3

based on manufacturer’s recommendations and facility experience with the equipment.

Question 4

To assess the effectiveness of its maintenance program, a health facility should:

1. review the costs of maintenance activities.
2. send satisfaction questionnaires to user departments.
3. monitor an established set of performance measures on a periodic basis.
4. have an outside consultant review the program.

Answer 4

monitor an established set of performance measures on a periodic basis.

Question 5

The organization’s strategic plan, accreditation and licensing requirements and the need to improve functional efficiency may indicate the need for a building program. To develop a program that best meets these needs, the healthcare organization should:
1.
interview medical staff for suggestions.
2.
interview department managers regarding planned growth.
3.
interview board members.
4.
prepare a master facility plan

Answer 5

prepare a master facility plan.

Question 6

The master facility plan for development of a healthcare organization’s physical plant should be based on:
1.
the suggestions of medical staff for clinical service expansion.
2.
the facility’s strategic plan and volume projections.
3.
recommendations from licensing and accrediting bodies.
4.
the architect’s drawings.

Answer 6

the facility’s strategic plan and volume projections.

Question 7

A facility maintenance program will be most effective if:
1.
requests for service are satisfied promptly.
2.
reliability, safety and efficient operation guide the plan’s design.
3.
system failures occur very rarely.
4.
backup plans exist for every major system.

Answer 7

reliability, safety and efficient operation guide the plan’s design.

Question 8

The plan for maintenance of the physical plant should emphasize:
1.
customer satisfaction.
2.
minimal downtime for equipment.
3.
preventive maintenance.
4.
rapid response to problems.

Answer 8

preventive maintenance.

Question 9

One of the major elements of a master plan for information systems development in a healthcare organization is:

1. a request-for-proposal (RFP) from vendors.
2. a list of specifications for computer programs.
3. the setting of individual computer applications.
4. a list of specifications for computer hardware installation and maintenance.

Answer 9

the setting of individual computer applications.

Question 10

An information system contract for a healthcare organization should be drafted by:

1. an independent management consultant.
2. the vendor who will supply the system.
3. the organization’s legal counsel.
4. technical staff from the organization and the vendor working together.

Answer 10

the organization’s legal counsel.

Question 11

To compete for managed care contracts, healthcare providers must be able to provide data to managed care organizations on:

1. costs and quality of services provided.
2. medical technology employed in the delivery of care.
3. efficiency of internal operations.
4. number of personnel employed in the organization.

Answer 11

costs and quality of services provided.

Question 12

The chief information officer for a healthcare organization should supervise the following functions in the organization:

1. information systems and telecommunications.
2. mix of services provided.
3. utilization review and risk management.
4. clinical engineering programs.

Answer 12

information systems and telecommunications.

Question 13

An important management principle that should guide the planning, design and implementation of information systems for healthcare organizations is:

1. always buy the newest system available to avoid technical obsolescence.
2. leave all decisions about information technology to technical specialists.
3. employ consultants to set priorities for system development.
4. treat information as an essential institutional resource.

Answer 13

treat information as an essential institutional resource.

Question 14

Membership of the healthcare information systems steering committee should comprise:

1. the chief executive officer, chief information officer, selected major user departments and chair of the governing board.
2. representatives of administration, physician leadership, information systems management and major user departments.
3. the chief information officer and senior systems analysts.
4. the chief information officer and outside technical consultants.

Answer 14

representatives of administration, physician leadership, information systems management and major user departments.

Question 15

The most important factor influencing specifications for individual information systems in healthcare organizations should be:
1.
standard reports generated.
2.
user requirements.
3.
the cost of the systems.
4.
vendor service capabilities.

Answer 15

user requirements.

Question 16

Of the following, the most important task in evaluating vendor information system products is:
1.
reviewing technical journals.
2.
attending vendor product demonstrations.
3.
talking directly with others who have used the products you are considering.
4.
attending computer trade shows and conferences.

Answer 16

talking directly with others who have used the products you are considering.

Question 17

As healthcare networks develop, the level of information systems consolidation should be driven by:
1.
the desires and needs of managed care and other payors.
2.
the business, clinical and operating requirements of the emerging organization.
3.
the desires of the largest organizations in the network.
4.
plans to use common computer hardware throughout the network.

Answer 17

the business, clinical and operating requirements of the emerging organization.

Question 18

Information systems needed for financial planning and control in healthcare organizations include:
1.
patient registration, admissions, discharges and transfers.
2.
outpatient and emergency room scheduling.
3.
budgeting, cost accounting, case-mix analysis and financial modeling.
4.
order entry and results reporting.

Answer 18

budgeting, cost accounting, case-mix analysis and financial modeling.

Question 19

Outcomes assessment required by managed care will require more advanced clinical information systems, such as:
1.
computerized protocols to aid in diagnosis and treatment planning.
2.
computerized patient registration.
3.
entry of laboratory and radiology orders from computer terminals.
4.
processing of medical records abstracts.

Answer 19

computerized protocols to aid in diagnosis and treatment planning.

Question 20

With respect to the processes by which healthcare organizations maintain the confidentiality, security and integrity of the medical record, all of the following statements are true except:

1. the original medical record of a patient being transferred from one healthcare organization to another may accompany the patient to the new organization.
2. healthcare organizations must have a mechanism to preserve the confidentiality of data/information identified as sensitive.
3. the organization must have a mechanism to safeguard records against loss, destruction, tampering and unauthorized access or use.
4. written policies must require that medical records may be removed from the organization’s jurisdiction only in accordance with a court order, subpoena or statute.

Answer 20

the original medical record of a patient being transferred from one healthcare organization to another may accompany the patient to the new organization.

Question 21

All of the following are commonly recognized to be a right of each patient except the right to:

1. receive considerate and respectful care.
2. access protective services.
3. communicate with a caregiver in the language of the patient’s choosing.
4. be informed about and participate in decisions regarding their care.

Answer 21

communicate with a caregiver in the language of the patient’s choosing.

Question 22

All of the following statements about documentation in the medical record are true except:

1. verbal orders must be authorized by the practitioner within a time frame to be defined by the medical staff.
2. verbal orders can only be accepted by registered nurses.
3. authentication may be made by actual written signatures, initials, rubber stamp signatures, or computer “signatures.”
4. that entries must be authenticated by the actual author only.

Answer 22

verbal orders can only be accepted by registered nurses.

Question 23

Current Joint Commission guidelines regarding the design of new patient care processes include all of the following except:

1. the design is clinically up-to-date.
2. the design is based on the organization’s mission, vision, values and plans.
3. the design meets the needs and expectations of key constituents.
4. the design team includes physicians or their designees.

Answer 23

the design team includes physicians or their designees.

Question 24

Current Joint Commission guidelines regarding measurement (the collection of data) include all of the following except:

1. the data collection processes should be consistent with those of the Joint Commission’s “10-step method” for quality assessment.
2. the data should identify opportunities for possible improvement of existing processes.
3. the organization must collect data about the appropriateness of admissions and hospital stays.
4. the organization must collect data on patient care processes that are high risk, high volume and problem prone.

Answer 24

the data collection processes should be consistent with those of the Joint Commission’s “10-step method” for quality assessment.

Question 25

Which of the following is a false statement? Guidelines produced by the Agency for Health Care Policy and Research:

1. have been shown to decrease healthcare costs.
2. rarely need to be revised.
3. provide starting points for managing individual patients.
4. have been shown to improve the quality of care.

Answer 25

rarely need to be revised.

Question 26

Which of the following statements about the Malcolm Baldrige National Quality Award is true?

1. Service organizations have won the award as often as manufacturing organizations.
2. Healthcare organizations were able to receive the award beginning in 1996.
3. Each year, there are winners in the manufacturing, service and small business categories.
4. Regulatory compliance constitutes an essential prerequisite to winning the award.

Answer 26

Healthcare organizations were able to receive the award beginning in 1996.

Question 27

Which of the following statements most accurately describes the, Health Plan Employer Data and Information Set (HEDIS)?

1. HEDIS indicators can easily be adopted for use by acute-care hospitals.
2. HEDIS quality indicators evaluate preventive services, prenatal care, acute and chronic illness and mental health and substance abuse programs.
3. HEDIS was developed primarily to meet the needs of patients and their families.
4. financial performance has no bearing on HEDIS indicators.

Answer 27

HEDIS quality indicators evaluate preventive services, prenatal care, acute and chronic illness and mental health and substance abuse programs.

Question 28

The governing authority assures itself about the quality of care by:

1. holding the CEO of the health facility accountable.
2. making the president of the medical/professional staff an ex officio member of the governing authority.
3. approving the process and then following up regularly and continuously to see that it is being used.
4. reviewing tabulated results of incidence reports.

Answer 28

approving the process and then following up regularly and continuously to see that it is being used.

Question 29

A nonlegitimate reason to release information from a patient’s medical record is when:

1. subpoenaed by a court order.
2. requested by the spouse or next of kin.
3. the patient becomes incompetent.
4. reporting statistics for a research project.

Answer 29

requested by the spouse or next of kin.

Question 30

In the past, hospitals have been less effective in lobbying than physicians because:

1. legislators like physicians more.
2. physicians have better lobbyists.
3. the law prevents hospitals from lobbying.
4. hospitals don’t vote.

Answer 30

hospitals don’t vote.

Question 31

In general, courts exhibit what attitude regarding controversies over medical staff privileges?

1. Human lives are at stake and the courts must intervene to protect physicians’ rights to save those lives.
2. If the decision were supported by reasonable evidence, courts will not substitute their judgment for that of the hospital board.
3. Hospitals must not be permitted to interfere with the doctor-patient relationship.
4. Courts may not entertain suits regarding medical staff privileges.

Answer 31

If the decision were supported by reasonable evidence, courts will not substitute their judgment for that of the hospital board.

Question 32

Under federal law, whenever a patient comes to a hospital emergency department with an emergency condition:

1. with few exceptions, the patient’s ability to pay may be considered in determining whether to provide treatment.
2. with few exceptions, the patient’s condition must be stabilized before he/she is transferred or discharged.
3. a police officer may be asked to authorize treatment.
4. the hospital has no duty to treat the person if he/she is not a patient or a member of the medical staff.

Answer 32

with few exceptions, the patient’s condition must be stabilized before he/she is transferred or discharged.

Question 33

In considering applications for medical staff privileges, hospitals receive reports from a U.S. Government clearinghouse on malpractice payments and adverse medical staff and licensure actions. In general, these reports have had which effect?

1. Reports have rarely led hospitals to make privileging decisions they would not have made otherwise.
2. Reports have been timely and helpful and have reduced the complexity of the privileging process.
3. Had they not received the reports, most hospitals’ privileging decisions would usually have been different.
4. Hospitals usually receive significant information that neither the practitioner involved nor any other sources had provided.

Answer 33

Reports have rarely led hospitals to make privileging decisions they would not have made otherwise.

Question 34

Which of the following statements best summarizes the prevailing legal standard used to judge the actions of members of a nonprofit healthcare organization’s governing board?

1. They must act in good faith, with reasonable care, and with the best interests of the corporation in mind.
2. They must exercise the same high level of fiduciary duty as is applied to the trustees of a trust.
3. They must avoid gross negligence and willful misconduct.
4. They are immune from personal liability.

Answer 34

They must act in good faith, with reasonable care, and with the best interests of the corporation in mind.

Question 35

Which of the following is the clear trend regarding a hospital’s liability for the actions of members of its medical staff?

1. The hospital may be held liable for a physician’s negligence even though the physician is an “independent contractor.”
2. Hospitals are not liable for such actions because they are simply physical sites where patients receive treatment from privately retained physicians.
3. Courts are becoming more reluctant to impose liability on hospitals for the negligence of physicians who use their facilities.
4. The hospital is liable only if the physician is an employee.

Answer 35

The hospital may be held liable for a physician’s negligence even though the physician is an “independent contractor.”

Question 36

A joint venture laboratory owned by a hospital and physicians on its medical staff would probably be in violation of fraud and abuse laws if it were to:
1.
market its services to both investors and noninvestors.
2.
offer ownership shares at the same price to referrers and nonreferrers.
3.
require investors to refer business to it.
4.
base its profit distributions on the amount of capital contributed, not on referrals.

Answer 36

require investors to refer business to it.

Question 37

The principal reason for small and midsized employers to join buyers cooperatives is to enable them to:

1. drop coverage from existing insurers.
2. gain leverage to obtain prices similar to large employers.
3. negotiate directly with physicians and hospitals.
4. lobby government agencies for more protection from insurers

Answer 37

gain leverage to obtain prices similar to large employers.

Question 38

The development of preferred provider organizations was originally intended to:

1. guarantee that hospitals maintain their occupancies.
2. promote networks that would evolve into multihospital systems.
3. offer an alternative to the health maintenance organization.
4. force high-priced hospitals out of local markets via discounts.

Answer 38

offer an alternative to the health maintenance organization.

Question 39

An important reason for a hospital and its medical staff to explore the development of physician-hospital organizations is to:

1. permit contracting with plans that want to buy both hospital and physician services.
2. begin development of a hospital-based health maintenance organization.
3. eliminate poor-performing physicians from the organization.
4. provide a way to put all physicians on salary.

Answer 39

permit contracting with plans that want to buy both hospital and physician services.

Question 40

Insurance companies and other payors have introduced preadmission certification for elective hospital stays in order to:
1. cause physicians to reconsider need for service.
2. facilitate communication between hospitals and the attending physician.
3.
establish clinical necessity prior to service.
4.
encourage the patient to obtain a second opinion.

Answer 40

establish clinical necessity prior to service.