November 2003, Volume 5, Number 11
Which of the following are appropriate statements in a discussion with
a patient who has just learned she is HIV-positive:
- It is important that you notify your sexual partner(s) that they should also be tested for HIV. You should do this when you feel comfortable; as your physician I will never reveal your HIV-status to anyone.
- I understand that it is extremely difficult to notify your sexual partners of your HIV-status but you have to do it; it is the responsible and loving thing to do.
- You may be legally liable if you continue to have sex with your partner without informing him or her that you are HIV-positive.
- It is imperative that I know your partners have been informed of your status. Let's discuss ways of talking to them about the importance of getting tested.
- A and B
- B, C, and D
2. Flu vaccine is recommended for which of the following categories of patients:
- All children who are younger than 1 year old.
- Patients between 10 and 40 years old who are HIV-positive.
- Women who are in their first trimester of pregnancy during flu season
- Patients who live in nursing homes.
- A and B
- B, C, and D
3. All states allow parents medical and religious exemptions to having their children vaccinated.
4. In their article "The Unbearable Rightness of Beside Rationing: Physician Duties in a Climate of Cost Containment" Ubel and Arnold propose all of the following about bedside rationing except
- Physicians should make resource allocation decisions based solely on medical costs and benefits
- Physicians should ration only services that are marginally beneficial.
- Physicians should be trained in cost-effective analysis.
- Physicians are obligated to explain to their patients why and how rationing decisions are made.
- Physicians should compare the cost of all treatments to the cost of alternative treatment options.
5. In cases where a physician suspects that a patient is being abused by spouse or partner the physician should:
- Never involve legal or public health authorities; the patient will contact the police herself if she wants them involved.
- Try to elicit the patient's voluntary disclosure but if the patient is unwilling disclose and it is likely her life is endanger, the abuse should be reported to protect her.
- Approach the patient in a nonjudgmental and supportive manner to elicit voluntary disclosure of abuse and offer legal, health care, and other resources on violence.
- The physician should encourage the patient to get out of the abusive relationship, but if the patient refuses, the physician should stop inquiring about the situation.
- A and D.
6. The AMA has not found concierge medical practices to be inconsistent with a pluralistic means of health care delivery but has identified ethical
concerns that warrant careful attention.
7. According to Upshur, all of the following are part of the 4 criteria that must be met before quarantine can be ethically justified except:
- Knowledge of how the disease is spread.
- Less restrictive means for controlling the spread of infections have been considered insufficient to protect the public.
- Plan for social support of those who are quarantined
- Knowledge of the effectiveness of quarantine in preventing the spread of the particular disease at hand.
- Transparency in communication with the public
8. Williams offers which of the following as a reason why physicians should engage in brief behavioral counseling:
- It is an important part of offering patients their full treatment options.
- Patients may not realize the extent to which their behaviors endanger their health.
- They can have great impact on the burden of disease caused by behaviors like smoking, overeating, and excessive alcohol consumption.
- All of the above.
- A and C.
9. In the Grimes v Kennedy-Kreiger case, the court suggested that the researchers were legally liable for which of the following:
- Not including in the informed consent form the foreseeable risk that the children in the study might have increased lead levels in their blood.
- Not informing the study's participants when they found dangerously high levels of lead in their blood.
- Involving children in a nontherapeutic study.
- All the above.
- A and B.
10. Which of the following may be an obstacle to the successful integration of genomics into health care:
- Low genetic literacy of the public.
- Low genetic literacy of health professionals.
- Genetic technology that improves health but is not available to all patients.
- All of the above.
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