Health Law chapter 12
Referring to Case Study #2 on page 310, Bayshore Hospital is the ______ in this case. a. appellant b. appellee c. defendant d. plaintiff
C
A covered entity must act on a request for accounting disclosures no later than ________ days after its receipt and within ________ days of extension, as long as it notifies the individual in writing of the reasons for the delay and when the accounting will be made available?? a. 60,30 b. 45,30 c. 45,60 d. 30,60
A
A medical malpractice claim involving a wrong site surgery was heard in a higher court, which resulted in the health care facility's requirement to pay the plaintiff $1 million in damages. A similar case with similar elements was also heard in a lower court, and thus the lower court followed the lead of the higher court in deciding the outcome of the case. The term that most appropriately describes the action of the lower court is?? a. stare decisis b. res ipsa loquitor c. res judicata d. writ of certiorari
A
A valid authorization for the disclosure of health information should not be?? a. dated prior to discharge of the patient b. in writing c. addressed to the health care provider d. signed by the patient
A
A written consent from the patient is required from which of the following entities in order to learn a patient's HIV status?? a. insurance companies b. emergency medical personnel c. spouse or needle partner d. health care workers
A
All of the following require the patient to sign a consent form EXCEPT?? a. to release information to the emergency room physician b. to refuse treatment c. for the physician to perform an invasive procedure d. for the surgeon to perform surgery
A
An improper disclosure of patient information to unauthorized individuals, agencies, or news media may be considered a(n)?? a. invasion of privacy b. libel c. slander d. defamation
A
An interning medical student at the Goodwill Community Hospital accessed several patients' files to obtain their names, DOB, and social security numbers, which were used to impersonate patients and file claims with multiple insurance companies in hopes of receiving payment to cover the remaining tuition fees for medical school. This act can be best categorized as?? a. medical identity theft b. a negligent act c. spoliation d. defamation of character
A
Referring to Case Study #2 on page 310, what phase of the lawsuit are you involved in?? a. pretrial conference b. trial c. discovery d. appeal
C
Darling vs Charleston Community Memorial Hospital is considered one of the benchmark cases in health care because it was with this case that the doctrine of ________________ was eliminated for nonprofit hospitals. a. charitable immunity b. corporate negligence c. professional negligence d. contributory negligence
A
Dr. Sam Vineyard improperly performed a knee replacement surgery, which caused the patient to develop an infection that led to the amputation of the leg and thigh. The best term to describe the action performed is?? a. misfeasance b. malpractice c. nonfeasance d. malfeasance
A
HIPAA requires that certain covered entities provide every patient a Notice of Privacy Practices that sets forth all of the following EXCEPT?? a. covered entities provide every patient with its annual business report b. how covered entities may use and disclose PHI c. patient's rights regarding the covered entities' uses and disclosures d. covered entities' obligations for protecting the patient's PHI
A
In general, which of the following statements is correct?? a. When federal and state laws conflict, valid federal laws supersede state laws b. When federal and state laws conflict, valid state laws supersede federal laws c. When federal and state laws conflict, valid local laws supersede federal and state laws d. When federal and state laws conflict, valid corporate policies supersede federal and state laws
A
Mandatory reporting requirements for vital statistics generally?? a. do not require authorization by the patient b. require authorization by the physician c. required authorization by the payer d. do not apply to health care facilities
A
Many states have recognized a minor's right to seek treatment without parental consent in all of the following situations EXCEPT a(n)?? a. minor seeking treatment for breast reduction b. minor seeking treatment for a sexually transmitted disease c. minor seeking treatment for alcohol and substance abuse d. emancipated minor seeking treatment for breast enlargement
A
Ms. Johnson was a diabetic patient, and was placed on a strict diet by her primary care physician. However, Ms. Johnson enjoyed baking cakes, and most of all she enjoyed eating slices of her freshly baked German chocolate cakes on a weekly basis, and often neglected taking her medication. As result, Ms. Johnson suffered a diabetic coma and did not obtain consciousness for two months. She later filed a malpractice claim against her primary care physician. Which of the following is the most appropriate defense the primary care physician should raise in response to Ms. Johnson's claim?? a. assumption of risk b. contributory negligence c. comparative negligence d. charitable immunity
A
Ms. Juanita Smith has been hired as the new Health Information Management director at the Sunny Capital City Medical Health System. This organization was created by the merging of two smaller facilities that had hybrid medical records. One of Ms. Smith's first responsibilities is to define what constitutes a legal health record for the Sunny Capital City Medical Health System. All of the following should be considered in developing the definition for the legal health record EXCEPT?? a. the type of software application used for the electronic health record b. state and federal laws c. standards defining health record content d. purpose of the health records
A
One best practice to follow in order to establish safeguards for the security and confidentiality of a patient's information when a person makes a request for his or her records in person is to?? a. ask the requester for identification and the request in writing b. refuse the request c. refer the requester to the facility's attorney d. charge an exorbitant fee
A
Referring to Case Study #1 on page 307, the written statement by Dr. Roberts about Nurse Parrish's professional competence in the patient's medical record can constitute?? a. libel b. slander c. perjury d. defamation
A
Referring to Case Study #2 on page 310, the written answers to questions you have been asked to provide are known as a(n)?? a. interrogatory b. deposition c. physical and mental examination d. court order
A
When a health information professional (record custodian) brings the medical record to court in response to a subpoena duces recum, it is his or her responsibility to?? a. confirm whether or not the record is complete, accurate and made in the ordinary course of business b. present the case favorably for the patient involved c. leave the original record in the possession of the plaintiff's attorney d. explain details of the medical treatment given to the patient
A
Referring to Case Study #3 on page 312, which of the following can the attorney of the resident's family also use as a basis for the lawsuit, and why?? a. The doctrine of res ipsa loquitur because it allows the plaintiff to shift the burden of proof to the defendant because direct evidence is available b. The doctrine of charitable immunity because the nursing facility is a private institution and is shielded from liability for any torts committed on its property c. The Good Samaritan Statutes because they protect the director of nursing, an employee of the nursing facility, who was not present when the injury occurred d. The failure to warn theory because the doctor did not inform the resident's family that the resident was in danger at the nursing facility
A
The body of law founded on custom, natural justice and reason, and sanctioned by usage and judicial decision is known as?? a. common law b. lien law c. constitutional law d. statutory law
A
The failure to obtain the written consent of the patient before performing a surgical procedure may constitute?? a. battery b. contempt c. libel d. malpractice
A
The ownership of the information contained in the physical medical/health record is considered to belong to the?? a. patient b. hospital c. physician d. insurance company
A
When substituting a photocopy of the original record in response to legal process, which of the following can be helpful in convincing the court to accept the photocopy as a true and exact copy of the original?? a. certificate of authentication b. consent from the patient c. consent from the hospital administrator d. correspondence from the attending physician
A
Which of the following agencies is empowered to implement the law governing Medicare and Medicaid?? a. Centers for Medicare and Medicaid Services (CMS) formerly known as Health Care Financing Administration (HCFA) b. Joint Commission c. Institutes of Health d. Department of Health and Human Services
A
Which of the following is needed when a physician conducts an invasive procedure?? a. informed consent b. advanced directive c. general consent d. living will
A
Which of the following statements is correct regarding HIPAA preemption analysis?? a. If the state law recognizes a patient's right to health care information privacy is more stringent than the HIPAA federal rule, then the state law prevails b. State law regarding a patient's right to health care information privacy can never prevail over the HIPAA federal rule c. If a state law that recognizes a patient's right to health care information privacy is more stringent than the HIPAA federal rule, then the courts must decided which shall prevail d. Even if the state law that recognizes patient's right to health care information privacy is more stringent than the HIPAA federal rule, the HIPAA federal rule will still prevail
A
Which type of law is constituted by rules and principles determined by legislative bodies?? a. statutory law b. administrative law c. common law d. case law
A
Who decides whether all or portions of the medical record will be received in evidence in a court of law?? a. presiding judge/court b. subpoenaing attorney c. clerk of the court d. defendant
A
Who determines the retention period for health records?? a. state and federal governments b. medical staff c. city and state governments d. commercial storage vendors
A
The family of Mr. Kent filed a wronful death lawsuit against Pier Memorial Hospital 10 years after the procedure was performed. In order to avoid the risk of Mr. Kent's electronic medical record being destroyed, a ________________ was ordered by the court. a. subpoena duces tecum b. legal hold c. restitution waiver d. spoliation hold
B
Dr. Sanders performed a gastrectomy on Mr. Bean due to malignant tumors found on his stomach. Four days after the procedure, Mr. Beans complained of intensifying abdominal pain. A CAT scan revealed a foot long sponge left inside Mr. Bean's body. Which of the following negligence torts does this scenario depict?? a. malfeasance b. misfeasance c. nonfeasance d. defeasance
B
The ideal consent for medical treatment obtained by the physician is?? a. expressed b. informed c. implied d. verbal
B
The minimum record retention period for patients who are minors is?? a. age of majority b. age of majority plus the statute of limitations c. 5 years past treatment d. 2 years past treatment
B
A health care organization's compliance plans should not only focus on regulatory compliance, but also have a?? a. strong personnel component that reduces the rapid turnover of nursing personnel b. coding compliance program that prevents fraudulent coding and billing c. component that increases the security of medical records d. substantial program that increases the availability of clinical data
B
Adrienne, a disgruntled nurse was fired from East Care Hospital after it was discovered that she accessed a local celebrity's medical record. The celebrity was being treated for communicable disease at a satellite clinic under East Care's operational umbrella. In this scenario, Adrienne can best be described as an _______________ for East Care Hospital. a. external security threat b. internal security threat c. external privacy threat d. internal privacy threat
B
All of the following are areas in which electronically stored information for example, the electronic health record, differs from paper based information EXCEPT?? a. volume b. metadata c. variety of sources d. confidentiality
B
All of the following are elements of a contract EXCEPT?? a. offer/communication b. duty c. price/consideration d. acceptance
B
All of the following are examples of intentional torts EXCEPT?? a. medical abandonment b. failure to warn c. invasion of privacy d. breach of contract
B
Consent forms may be challenged on all the following grounds EXCEPT?? a. wording was too technical b. the treating physician obtained the patient's signature c. it is written in a language that the patient could not under stand d. the signature was not voluntary
B
In a negligence or malpractice case, all of the following elements must be present in order to shift the burden of proof onto the defendant EXCEPT the?? a. event would not normally have occurred in the absence of negligence b. health care facility does not have a risk management program c. defendant had exclusive control over the instrumentality that caused the injury d. plaintiff did not contribute to the injury
B
In electronic health records, authentication may be achieved by?? a. handwritten signature b. digital signature c. verbal statement d. all of the above
B
Medical record information may be exempt from the Freedom of Information Act requirements if the request for information meets the test of being an unwarranted invasion of personal privacy. Which of the following is NOT one of the conditions of the test?? a. The information must be contained in a personal, medical or similar file b. The information is generated from federally funded research conducted by a private health care organization c. Disclosure of the information constitutes an invasion of personal privacy d. The severity of the invasion must outweigh the public's interest in disclosure
B
One of the greatest threats to the confidentiality of health data is?? a. when medical information is reviewed as a part of quality assurance activities b. disclosure of information for purposes not authorized in writing by the patient c. lack of written authorization by the patient d. when medical information is used for research or education
B
Referring to Case Study #1 on page 307, the oral statement by Nurse Parrish about Dr. Robert's professional practices at the nurses' station can constitute?? a. libel b. slander c. perjury d. defamation
B
Referring to Case Study #2 on page 310, the sworn verbal testimony you are asked to provide is called a(n)?? a. interrogatory b. deposition c. physical and mental examination d. court order
B
The proper method for correcting a documentation error in a medical record is for the author to?? a. draw an "X" through the incorrect documentation b. draw a single line through the incorrect information, date, and initial the change c. white it out, date, and initial the change d. remove the form from the chart and add a revised form
B
Under traditional rules of evidence, a medical/health record is considered __________ and is __________ into evidence. a. hearsay; admissible b. hearsay; inadmissible c. reliable; admissible d. reliable; inadmissible
B
What advice should be given to a physician who has just informed you that she just discovered that a significant portion of a discharge summary she dictated last month was left out?? a. Squeeze in the information omitted by writing in available spaces such as the top, bottom, and side margins b. Dictate the portion omitted with the heading "Discharge Summary-- Addendum" and make a reference to the addendum with a note that is dated and signed on the initial Discharge Summary (e.g., "9/1/16--See Addendum to Discharge Summary" --Signature). c. Redictate the discharge summary and replace the old one with the new one d. Inform the physician that noting can be done about the situation
B
When a health care facility fails to investigate the qualifications of a physician hired to work as an independent contractor in the emergency room and is accused of negligence, the health care facility can be held liable under?? a. respondeat superior b. corporate negligence c. contributory negligence d. general negligence
B
Which of the following acts was passed to stimulate the development and use of standards for electronic transactions containing health care data and information of standards to facilitate electronic maintenance and transmission of health information?? a. Health Insurance for the Aged b. Health Insurance Portability and Accountability Act c. Conditions of Participation d. Hospital Survey and Construction Act
B
Which of the following is an example of the breach of confidentiality?? a. a nurse speaking with the physician in the patient's room b. staff members discussing patients in the elevator c. the admission clerk verifying over the phone that the patient is in house d. the hospital operator paging code blue in room 3 north
B
Who is legally responsible for obtaining the patient's informed consent for surgery?? a. the admissions clerk b. the surgeon performing the surgery c. the nurse d. medical records personnel
B
AHIMA and HIMSS recommend that organizations participating in HIE take all of the following steps to reduce the risk of unauthorized disclosures EXCEPT?? a. conduct a risk analysis to evaluate potential risks b. create a policy and procedure to manage HIE within the organization c. ensure tha all HIE participants have full access to patient information d. educate/train the workforce
C
According to HIPAA, a business associate contract should specify all of the following EXCEPT?? a. prohibit the business associate from using or disclosing the PHI for any purpose other that what is stated in the contract b. clarify that the business associate is responsible to report breaches of unsecured PHI c. state that subcontractors of the business associate are responsible for complying with HIPAA, but are not directly liable for the HIPAA violations because the business associate contract is in place d. establish how the covered entity would provide access to PHI to whom the information is about
C
According to the American Reinvestment Recovery Act, all of the following are elements of a compliance report with the exception of?? a. the number of complaints b. the number of complaints resolved informally c. the number of audits that are anticipated to be performed d. the number of compliance reviews conducted and the outcome
C
Dr. James, a surgeon with Sunnyhill Hospital, implanted a pacemaker into Mr. Tanner's heart to regulate his irregular heart rate. However, the pacemaker increased Mr. Tanner's heart rate by 30 percent. It was later discovered that the pacemaker implanted by Dr. James was faulty and a recall had been issued by the manufacturer. In order for Mr. Tanner to recover damages from the manufacturer, his claim should be based on which of the following?? a. respondent superior b. gross negligence c. strict liability d. ordinary negligence
C
Elements of a breach notification should include all of the following EXCEPT?? a. a description of what occurred, including the date of the breach and the date of the breach was discovered b. steps individuals should take in order to protect themselves c. the name of the individual within the entity responsible for the breach so that a civil claim can be filed against the individual d. what the entity is doing to investigate, mitigate, and prevent future occurrences
C
HIM personnel charged with the responsibility of bringing a medical record to court would ordinarily do so in answer to a?? a. personal subpoena b. deposition c. subpoena duces tecum d. judgment
C
Historically, individually identifiable information for deceased individuals regardless of the time of death was covered under the HIPAA privacy rule. However, under HITECH individually identifiable information for deceased individuals is no longer covered after __________ years?? a. 30 b. 40 c. 50 d. 60
C
In which of the following circumstances would release of information without the patient's authorization be permissible?? a. release to an attorney b. release to state workers' compensation agencies c. release to third party payers d. release to insurance companies
C
Laws that limit the period during which legal action may be brought against another part are known as?? a. cash law b. summons c. statutes of limitations d. common law
C
Ms. Jackie Jefferson sustained knee injuries in a car accident that required a visit to the local emergency room. The physician on duty performed a debridement procedure, which required him to remove glass particles from her right knee. However, in performing the procedure, Ms. Jefferson discovered that the emergency room doctor used an incorrect instrument to perform the procedure, which delayed the time frame for treatment. While there were no adverse effects suffered by the patient, Ms. Jefferson nonetheless later filed a negligent claim against the emergency room doctor, which was dismissed. Which of the following elements was not present in order for Ms. Jefferson to recover damages caused by negligence?? a. duty of care b. breach of the duty to care c. injury suffered d. physician's conduct/action caused harm
C
Spoliation is the term that refers to the wrongful destruction of evidence or the failure to preserve property, which addresses which of the following methods of discovery?? a. interrogatories b. deposition c. e-discovery d. request for admissions
C
The HITECH breach notification requirement is significant and different from any other requirements in the past because it?? a. required the entity responsible to pay monetary damages to those affected by the breach b. requires the CEO of the entity responsible to serve jail time c. places organizations on the radar of regulatory agencies and in the media spotlight d. suspends the responsible entity from being able to disclose PHI for a specific period of time
C
The doctrine that the decisions of the court should stand as precedents for future guidance is?? a. res ipsa loquitur b. respondeat superior c. stare decisis d. statute of limitaions
C
The extent to which the HIPAA privacy rule may regulate an individual's rights of access is not meant to preempt other existing federal laws and regulations. This means that if an individual's rights of access. a. are less under another existing federal law, HIPAA must follow the directions of that law b. are refused by a federal facility, HIPAA must also refuse the individual of the access c. are greater under another applicable federal law, the individual should be afforded the greater access d. are greater under another existing federal law, HIPAA can obstruct freedoms of the other federal law when using electronic health records
C
The legislation that required all federally funded facilities to inform patients of their rights under state law to accept or refused medical treatment is known as?? a. advance directives b. living wills c. Patient Self Determination Act d. durable power of attorney
C
Traditionally, the medical record is accepted as being the property of the?? a. patient's guardian b. court c. institution d. patient
C
Under which category of law would Marleana Harrison bring a cause of action against Dr. Billy Ray for disclosing information regarding her previous physical examination to his wife, Jane Ray, who is Ms. Harrison's hairstylist?? a. administrative law b. criminal law c. private law d. procedural law
C
Which of the following claims of negligence fits into the category of res ipsa loquitur?? a. incorrect administration of anesthesia b. failure to refer patient to a specialist c. leaving a foreign body inside a patient d. improper use of X-rays
C
Which of the following health care systems have to comply with the requirements of the Freedom of Information Act?? a. private hospitals b. physicians' offices c. veteran's hospitals d. single day surgery clinics
C
Which of the following is less likely to be considered a covered entity under the HIPAA Privacy Rule?? a. a primary physician in a local practice b. a managed care organization c. a locally family owned drug store d. a third party administrator that is responsible for transmitting medical claims
C
Which of the following would be an inappropriate procedure for the custodian of the medical record to perform prior to taking a medical record from a health care facility to court?? a. Number each page of the record in ink b. Document in the file folder the total number of pages in the record c. Remove any information that might prove detrimental to the hospital or physician d. Prepare an itemized list of sheets contained in the medical record
C
With regard to confidentiality, when HIM functions are outsourced (i.e., record copying, microfilming, or transcription), the HIM professional should confirm that the outside contractor's?? a. costs are not prohibitive, thus compromising confidentiality b. hours of operation permit easy access by all health care providers c. is contractually bound to handle confidential information appropriately by means of a signed business associate agreement d. is located in an easy to find place
C
What source or document is considered the "supreme law of the land"? a. Bill of Rights b. Supreme Court Decision c. Presidential Power d. Constitution of the United States
D
A valid authorization for release of information contains?? a. the name, agency, or institution to which the information is to be provided. b. the name of the hospital or provider who is releasing the medical information c. the date and signature of the patient or the patient's authorized representative d. All of these answer apply
D
A written authorization from the patient releasing copies of his or her medical records is required by all of the following EXCEPT?? a. the patient's attorney b. a physician requesting copies from another physician c. an insurance company d. the hospital attorney for the facility where the patient is treated
D
As a general rule, a person making a report in good faith and under statutory command (e.g., on child abuse, communicable diseases, births, deaths) is?? a. not protected from liability claims b. subject to penalties imposed by federal law c. subject to penalties imposed by state law d. protected
D
Centric Medical Center established a business associate agreement with Quenlinks Solutions to provide mobile devices for their physicians and nurses to enter patient information into the organization's EHR in real time. Which of the following should be considered as a best practice for the use of mobile technology in this given scenario?? a. identification of device ownership b. required authorization for mobile technology use c. safeguards and techniques for adequate protection of ePHI d. All of these answers apply
D
HIM professionals have a duty to maintain health information that complies with?? a. state statutes b. federal statutes c. accreditation standards d. All of these answers apply
D
In a court of law, Attorney A, the attorney for Sun City Hospital, introduces the medical record from the hospital as evidence. However, Attorney B, the attorney for the defendant, objects on the grounds that the medical record is subject to the hearsay rule, which prohibits its admission as evidence. Attorney B's objection is overridden. Why?? a. The medical record does not belong to the hospital; therefore, the hospital has no right to release the medical record as evidence b. It would violate physician-patient privilege, even though the patient signed a proper release of information form c. The doctrine of "res ipsa loquitur" prevails; therefore, reference to the medical record is moot d. The medical record may be admitted as business records or as an explicit exception hearsay rule
D
In which type of facility does the Privacy Act of 1974 permit patients to request amendments to their medical record?? a. private proprietary health care facility b. mental health and chemical dependency facility c. university based teaching facility d. Department of Defense health care facility
D
Internal disclosures of patient information for patient care purposes should not be granted?? a. to the facility's legal counsel b. to the attending physician c. on a need to know basis d. to a family member who is a registered nurse at the facility
D
Referring to Case Study #2 on page 310, Barbara Masters is the _________ in this case. a. appellant b. appellee c. defendant d. plaintiff
D
Referring to Case Study #3 on page 312, the resident's family brought legal action against the nursing facility for?? a. medical abandonment b. vicarious liability c. assault and battery d. negligence
D
Referring to Case Study #4 on page 316, given the emergency of the situation, who should the health care provide seek consent from in order to provide treatment to William?? a. the employer b. the parents c. the patients d. no consent is needed for emergency care
D
Referring to Case Study #4 on page 316, in order to release information to his employer, the hospital must receive a?? a. consent signed by the patient b. court order c. consent signed by the doctor d. consent signed by the patient's parent
D
Substance abuse records cannot be redisclosed by a receiving facility to another health care facility unless?? a. patient expires at the receiving facility b. charge nurse signs the release form c. physician signs the DNR form d. patient gives written consent
D
The privacy and protection of a patient's health information is addressed in each of the following EXCEPT?? a. Health Insurance Portability and Accountability Act b. Privacy Act c. Drug Abuse and Treatment Act d. US Patriot Act
D
What type of testimony is inappropriate for a health information manager serving as custodian of the record when he or she is called to be a witness in court?? a. whether the record is in the practitioner's possession b. to the attending physician c. on a need to know basis d. to a family member who is a registered nurse at the facility
D
When developing record retention policy, the HIM professionals should consider all of the following EXCEPT?? a. current storage space b. uses of and need for information c. all applicable statutes and regulations d. the thickness of the records
D
Which of the following is considered confidential information if the patient is seeking treatment in a substance abuse facility?? a. patient's name b. patient's address c. patient's diagnosis d. All of these answers apply
D
Which of the following measures should a health care facility incorporate into its institution-wide security plan to protect the confidentiality of the patient record?? a. verification of employee identification b. locked access to data processing and record areas c. use of unique computer passwords, key cares, or biometric identification d. All of these answers apply
D
Which of the following should be required to sign a confidentiality statement before having access to patients' medical information?? a. nursing students b. medical students c. HIM students d. All of these answers apply
D
Which two theories of negligence are used to hold health care facilities accountable for the actions of its employees?? a. assault and battery b. invasion of privacy and fraud c. defamation and fraud d. respondent superior and corporate negligence
D
While performing routine quantitative analysis of a record, a medical record employee finds an incident report in the record. The employee brings this to the attention of her supervisor. Which best practice should the supervisor follow to deal with this situation?? a. Remove the incident and send it to the patient b. Tell the employee to leave the report in the record c. Remove the incident report and have nursing personnel transfer all documentation from the report to the medical record d. Refer this record to the risk manager for further review and removal of the incident report
D
Willful disregard of a subpoena is considered?? a. breach of contract b. abuse of process c. contributory negligence d. contempt of court
D