Question 1

State statutes regarding peer review activities _____.

Accepted Answer

A) Are well defined to protect the activities of a peer review committee 
B) Cover the medical staff credentialing process in health care facilities 
C) Expressly protect peer review activities performed by HMOs in all states 
D) Protect peer review participants from liability unless they act in malice 
A) Are well defined to protect the activities of a peer review committee 
B) Cover the medical staff credentialing process in health care facilities 
C) Expressly protect peer review activities performed by HMOs in all states 
D) Protect peer review participants from liability unless they act in malice

Question 2

Which is an example of a utilization management function?

Accepted Answer

A) Emergency room triage 
B) Gatekeeping 
C) Preadmission testing 
D) Research protocol screening 
A) Emergency room triage 
B) Gatekeeping 
C) Preadmission testing 
D) Research protocol screening

Question 3

Which a nontechnical measure that might be employed to enhance security controls related to healthcare records access?

Accepted Answer

A) Educating employees about how to properly handle information 
B) Installing firewalls on all computers in the healthcare facility 
C) Requiring employees to change their password every 90 days 
D) Utilizing effective data mining techniques to access information 
A) Educating employees about how to properly handle information 
B) Installing firewalls on all computers in the healthcare facility 
C) Requiring employees to change their password every 90 days 
D) Utilizing effective data mining techniques to access information

Question 4

An adverse incident is defined as a(n) _____.

Accepted Answer

A) Event inconsistent with normal routine operations 
B) Medication error identified through quality review 
C) Unexpected event involving a visitor 
D) Unintended effect of a research protocol 
A) Event inconsistent with normal routine operations 
B) Medication error identified through quality review 
C) Unexpected event involving a visitor 
D) Unintended effect of a research protocol

Question 5

The Darling vs.Charleston Community Memorial Hospital case established the precedent that _____.

Accepted Answer

A) Abolished the doctrine of charitable immunity 
B) Hospitals are not liable for provider malpractice 
C) Medicaid patients cannot file negligence lawsuits 
D) Profit hospitals only are liable for employee negligence 
A) Abolished the doctrine of charitable immunity 
B) Hospitals are not liable for provider malpractice 
C) Medicaid patients cannot file negligence lawsuits 
D) Profit hospitals only are liable for employee negligence

Question 6

Utilization review is described as a(n) _____.

Accepted Answer

A) combination of activities aimed at loss prevention 
B) legally unenforceable system that increases lawsuits 
C) optional process to be implemented by healthcare facilities 
D) required component of Joint Commission accreditation 
A) combination of activities aimed at loss prevention 
B) legally unenforceable system that increases lawsuits 
C) optional process to be implemented by healthcare facilities 
D) required component of Joint Commission accreditation

Question 7

To protect an incident report from discovery, _____.

Accepted Answer

A) It needs to be part of the patient's permanent medical record 
B) Payers are required to have previously reviewed the incident report 
C) There must be an established attorney-client relationship 
D) Using the report during employee training and review is necessary 
A) It needs to be part of the patient's permanent medical record 
B) Payers are required to have previously reviewed the incident report 
C) There must be an established attorney-client relationship 
D) Using the report during employee training and review is necessary

Question 8

Charitable immunity is the _____.

Accepted Answer

A) ability for a nonprofit organization to avoid litigation for malpractice 
B) implementation of Good Samaritan laws in all states in the country 
C) shielding of health care institutions from liability for employee negligence 
D) way a health care facility manages its quality management programs 
A) ability for a nonprofit organization to avoid litigation for malpractice 
B) implementation of Good Samaritan laws in all states in the country 
C) shielding of health care institutions from liability for employee negligence 
D) way a health care facility manages its quality management programs

Question 9

The function of analyzing and evaluating all of the risks that affect an organization is called _____.

Accepted Answer

A) enterprise risk management 
B) litigation support 
C) quality review 
D) root-cause analysis 
A) enterprise risk management 
B) litigation support 
C) quality review 
D) root-cause analysis

Question 10

If an incident report is inadvertently released during the discovery process along with the medical record, _____ applies

Accepted Answer

A) attorney work product privilege 
B) Behringer Estate v.Medical Center at Princeton 
C) business record exceptions 
D) Federal Rule of Evidence 502 
A) attorney work product privilege 
B) Behringer Estate v.Medical Center at Princeton 
C) business record exceptions 
D) Federal Rule of Evidence 502

Question 11

Which is characteristic of an incident report?

Accepted Answer

A) Documents circumstances to assess for the possibility of impending litigation 
B) Guarantees that facility malpractice insurance premiums will be reasonable 
C) Provides a method of defense against liability for actions of facility employees 
D) Serves as a way to discipline the health care provider who perpetrated an error 
A) Documents circumstances to assess for the possibility of impending litigation 
B) Guarantees that facility malpractice insurance premiums will be reasonable 
C) Provides a method of defense against liability for actions of facility employees 
D) Serves as a way to discipline the health care provider who perpetrated an error

Question 12

Which is an obstacle to peer review activities?

Accepted Answer

A) Administrative feedback and input 
B) Fear of reprisals for candid criticism 
C) Participation by healthcare providers 
D) Resultant measures to improve care 
A) Administrative feedback and input 
B) Fear of reprisals for candid criticism 
C) Participation by healthcare providers 
D) Resultant measures to improve care

Question 13

Which incident would be reported to the risk manager?

Accepted Answer

A) A patient visitor getting lost on the way to the hospital 
B) Intravenous therapy resulting in reduced infections 
C) Patient refusing to consent for an elective procedure 
D) Surgical procedure performed on the wrong site 
A) A patient visitor getting lost on the way to the hospital 
B) Intravenous therapy resulting in reduced infections 
C) Patient refusing to consent for an elective procedure 
D) Surgical procedure performed on the wrong site

Question 14

Peer review committees serve to _____ as part of the quality management process?

Accepted Answer

A) Conduct audits of patient information to compare against established guidelines 
B) Evaluate, maintain, and monitor risk management functions of health care services 
C) Manage the organization's employees and providers credentialing process 
D) Prescribe disciplinary action against employees who violate policies and procedures 
A) Conduct audits of patient information to compare against established guidelines 
B) Evaluate, maintain, and monitor risk management functions of health care services 
C) Manage the organization's employees and providers credentialing process 
D) Prescribe disciplinary action against employees who violate policies and procedures

Question 15

Which involves a combination of planned functions directed toward prudent allocation of medical resources and the administration of appropriate treatment?

Accepted Answer

A) case management 
B) health information management 
C) quality management 
D) risk management 
A) case management 
B) health information management 
C) quality management 
D) risk management

Question 16

Which an investigation into a serious event, including clinical and administrative review?

Accepted Answer

A) Discovery process 
B) Incident reporting 
C) Root-cause analysis 
D) TPO procedures 
A) Discovery process 
B) Incident reporting 
C) Root-cause analysis 
D) TPO procedures

Exam 12: Risk Management, Quality Management, and Utilization Management

State statutes regarding peer review activities _____.

Which is an example of a utilization management function?

Which a nontechnical measure that might be employed to enhance security controls related to healthcare records access?

An adverse incident is defined as a(n) _____.

The Darling vs.Charleston Community Memorial Hospital case established the precedent that _____.

Utilization review is described as a(n) _____.

To protect an incident report from discovery, _____.

Charitable immunity is the _____.

The function of analyzing and evaluating all of the risks that affect an organization is called _____.

If an incident report is inadvertently released during the discovery process along with the medical record, _____ applies

Which is characteristic of an incident report?

Which is an obstacle to peer review activities?

Which incident would be reported to the risk manager?

Peer review committees serve to _____ as part of the quality management process?

Which involves a combination of planned functions directed toward prudent allocation of medical resources and the administration of appropriate treatment?

Which an investigation into a serious event, including clinical and administrative review?

Workings of the American Legal System

Workings of the American Legal System: Part A

Court Systems and Legal Procedures

Court Systems and Legal Procedures: Part A

Judicial Process of Health Information

Judicial Process of Health Information: Part A

Principles of Liability

Principles of Liability: Part A

Ethical Standards

Ethical Standards: Part A

Ethical Decisions and Challenges

Ethical Decisions and Challenges: Part A

Bioethical Issues

Bioethical Issues: Part A

Patient Record Requirements

Patient Record Requirements: Part A

Confidentiality and Informed Consent

Confidentiality and Informed Consent: Part A

Access to Health Information

Access to Health Information: Part A

Specialized Patient Records

Specialized Patient Records: Part A

Risk Management, Quality Management, and Utilization Management: Part A

Information Systems

Information Systems: Part A

Health-Care Fraud and Abuse

Health-Care Fraud and Abuse: Part A

Law and Ethics in the Workplace

Law and Ethics in the Workplace: Part A

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