AMA Journal of Ethics®

Illuminating the art of medicine

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AMA Journal of Ethics®

Illuminating the art of medicine

Virtual Mentor. June 2004, Volume 6, Number 6.

Test Questions

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Test Questions: The Ethics of Quality Care

1.

According to Dr. Michael Suk, which of the following should be considered when evaluating the difficult question of residency work hours:

A. What safeguards does the hospital have to create a safe and reasonable working environment?
B. Is there adequate coverage for the service by residents and attendings?
C. What clinical intervention is required and what is its level of difficulty?
D. Subjectively, how tired is the resident?
E. All of the above.
F. A, B, and C.

2.

According to Dr. Robert Phillips, if a patient's only reason for refusing pill splitting is personal preference, then the physician should:

A. Refuse to treat the patient.
B. Explain to the patient that he or she has a responsibility to be cognizant of the costs associated with health care and try to use medical resources judiciously, then allow the patient to decide.
C. Explain to the patient that the physician's practice is experiencing pressure from managed care insurance companies to be more cost-efficient, so the physician has to prescribe the higher dose.
D. None of the above.

3.

When patients request or demand tests that are, in the physician's clinical judgment unnecessary, the physician should:

A. Find out what fears the patient thinks the test results will allay.
B. Determine who is to pay for the desired tests.
C. Explain the risks associated with the test and why the test will not provide the information the patient wants, and then order the test if the patient insists.
D. All of the above.
E. A and B.

4.

All of the following are "red flags" for ordering neuroimaging for a patient with a nonacute headache except:

A. Numbness
B. Paralysis
C. Dizziness
D. Papilledema
E. Stiff neck

5.

According to the Steven Woolf article reviewed in the journal discussion, what should be done to improve quality of health care in the US?

A. We should apply resources to the programs and activities that will result in the greatest improvement in patient health—not emphasize improvements only in patient safety.
B. We should apply most resources toward making improvements in patient safety and medical error.
C. We should apply resources to reducing the problem of the uninsured.
D. We should apply resources to create a prescription drug benefit program.

6.

According to Dr. Hibbard, there are several ways that physicians can assist patients in contributing to their own health care. All of the following are suggested methods except:

A. Physicians can provide support and information to enable consumers to participate more fully.
B. Physicians can provide reinforcement and sanctioning for patients who take on greater informed roles in their health care.
C. Physicians can diagnose patient capabilities for self-management and help them to increase their skills and knowledge.
D. Physicians can model key behaviors for their patients.
E. Physicians can instruct patients on what choices to make with their insurance plans.

7.

According to Dr. LaFarge, a major aspect often omitted from arguments for expanding the scope of practice of nonphysicians is:

A. Specific details of the didactic education and the clinical training that would be required in order to assure both competence and safety for the public.
B. Access issues faced by patients.
C. Questions of patient satisfaction with care by nonphysicians.
D. Effect of expanding the scope of practice on the particular area of medicine.

8.

The best physician report cards of the next 5 years will probably be:

A. Regional or local in scope.
B. National in scope.
C. Nonpunitive in nature.
D. Include clinical and managerial data.
E. All of the above.
F. A, C and D.

9.

When the University of Connecticut Medical School introduced a curriculum in quality improvement and patient safety, students:

A. Disliked the course, saying it was time-consuming, came too early in their medical education, and expected them to critique their practice sites.
B. Were barred from many of the clinical sites they sought to audit.
C. Recommended that the course, first offered as an elective, be made mandatory.
D. Saw no improvement in quality measures in the sites following their audits.

10.

In a claim brought by a group of anesthesiologists against a hospital that closed their department and contracted for anesthesiology services with an outside company:

A. The anesthesiologists claimed that the hospital had terminated their right to practice without due process.
B. The hospital claimed that it closed the Anesthesiology Department as a means of getting rid of the particular physicians who brought the suit.
C. The appeals court found the hospital guilty of violating the anesthesiologists' civil rights, breach of contract, defamation, and civil conspiracy.
D. All of the above.

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