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InforMed Pennsylvania Physician Update

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Self-Assessment Answers for Section 1: 12 Hour Patient Safety Update

1 . Realization in the 1990s of the need for patient safety guidelines led to all of the following EXCEPT:

A.Creation of a discipline of patient safety with a body of knowledge

B.Global awareness of the risk of patient harm in hospitals

C.A single set of guidelines defining patient safety

D.Models of patient safety

2 . Which of the following is true regarding new thinking about patient safety?

A.The most prevalent errors result from physician error.

B.The focus has shifted to biologic systems in the individual patient.

C.Penalizing individuals for mistakes is an effective means of motivating others.

D.Outcomes can be affected by outside factors such as regulators, payers, suppliers.

3 . The first specialty to make substantial improvements using a systems approach to patient safety was

A.Anesthesiology

B.Cardiology

C.OB-Gyn

D.Surgery

4 . The “Achilles heel” of early efforts of implementing change in this area was

A.Poor relationship between physicians and other health care personnel

B.Lack of understanding of what caused errors

C.Demands for accountability

D.Rising health care costs

5 . A successful approach to patient safety is characterized by which one of the following?

A.Low risk interventions to maintain predictability

B.Culture of openness about adverse events when they occur

C.Culture of openness about adverse events when they occur

6 . Which of the following is true about designing a model of patient safety?

A.Measures exist in three main areas.

B.There is a “gold standard” based on research

C.The focus is on health care delivery more than medical issues.

7 . An ideal patient safety system includes which of the following?

A.Allows repeatability of an event to check reproducibility of a failure

B.Operator cannot perform a function improperly

C.Protocols allow for deviation

8 . This article proposes a definition of patient safety that includes four components, including all of the following EXCEPT:

A.People who receive health care

B.People who provide health care

C.Risk management specifications

D.Systems of therapeutic action

E.Methods within various domains

9 . Which of the following is correct regarding preprinted physician orders?

A.To be most effective they are confined to physician-to-physician communication.

B.Physician orders are the starting point for action and patient care.

C.A shortcoming of preprinted physician orders is the inability to change rapidly.

D.They can be difficult to implement.

10 . All of the following are important in assuring “best practices” in preprinted physician orders EXCEPT:

A.Controlling access to making changes in the preprinted orders

B.Limiting other services that are included on the preprinted orders

C.Keeping separate reimbursement and coding documentation

11 . To make the preprinted orders as clear as possible, formatting should do which of the following?

A.Use capitalization as a means of emphasis on certain words or abbreviations.

B.Use abbreviations and symbols as much as possible.

C.Number the medications to avoid confusion.

D.Print 2-sided pages.

12 . For effective use in promoting best practices, all of the following are recommended to be included EXCEPT:

A.Guidelines for infection control

B.Addition of reference material

C.Extensive additional resources

D.Referrals to other services

13 . For maintaining best practices, which of the following is recommended regarding preprinted physician orders?

A.Maintain at least 2 months supply of copies of the forms.

B.Have a single group responsible for developing order criteria.

C.Allow nurses or doctors to customize the form for their own preferences.

14 . All of the following are advantages of preprinted physician orders EXCEPT:

A.Ability to modify physician practice

B.Servers to guide patient care decisions

C.Requires little oversight

D.Is multidisciplinary

15 . In addition to being used for common interventions, preprinted patient orders can be used for which of the following?

A.Integrate safety alerts

B.Replace other information management functions

C.Reduce number of levels of care required

16 . All of the following statements are TRUE about race EXCEPT:

A.Any two human individuals are about 49.9% the same genetically.

B.Genetic variation can be used to predict geographic origin.

C."Race” and “ethnicity” are variable and fluid terms.

D.Race is primarily a social concept.

17 . Which of the following is LEAST LIKELY to explain the higher rates of diabetes among racial and ethnic minorities?

18 . There is little evidence that increasing the number of health professionals of diverse cultural backgrounds will improve public health.

A.True

B.False

19 . Which of the following statements is correct regarding race and culture with respect to the medical interview?

A.When patient and provider come from different cultural backgrounds, the medical history obtained may not be accurate.

B.Cross-cultural misunderstandings between a physician and patient rarely have an impact on clinical outcomes.

C.When recording the social history, definition of race can accurately be substituted for specifics.

D.Most physicians are not influenced by assumptions regarding certain types of patients

20 . All of the following statements are TRUE about the "Tuskegee Study of Untreated Syphilis in the Negro Male” EXCEPT

A.The American Medical Association called for stopping the study in 1969.

B.It was funded by the Public Health Service from 1932 to 1972.

C.Participants were denied access to penicillin in 1947.

D.The study led to the 1974 National Research Act.

21 . Which of the following is true regarding disparities in medical care across racial and ethnic groups?

A.When clinical factors such as stage of disease are taken into consideration, there is minimal difference in care.

B.When access to insurance coverage is accounted for, there is little difference in care.

C.Most physicians are aware of national health care disparities.

D.Disparity is widespread across a range of clinical settings.

22 . All of the following are examples of how physicians can help eliminate health disparities in their practice EXCEPT:

A.Request interpreter training and assessment of language skills for bilingual staff.

B.Request signage and patient brochures in most commonly used languages.

C.Work with community members to improve access to care.

D.Refuse to accept low-income or Medicaid patients.

23 . All of the following are effective means of monitoring and improving the provision of care to diverse groups in a physician’s practice EXCEPT:

A.Review patient records to identify areas of improvement.

B.Gain a better understanding of the patient population in the community.

C.Make presentations in the community on the importance of learning English.

D.Collaborate with community leaders to develop community-based health interventions.

24 . The term “diverse” means

A.Ethnocentrism

B.Typical behavior

C.Anyone who is not you

D.Established expectations

25 . All of the following describes an effective strategy for working with diverse patient populations EXCEPT:

A.Ask the patient to explain what he/she understands about what you said.

B.Presume knowledge about specific health disparities.

C.Change frame of reference in viewing the situation.

D.Ask the patient to identify barriers to change.

26 . Which of the following is a common perception held by all people?

A.Punctuality or clock-time centered

B.Communication styles

C.Individuality

D.Respect

27 . In contrast to disease, illness is:

A.Measurable.

B.What patients experience.

C.Discrete and reproducibly defined.

D.Rarely important in health care delivery.

28 . Which of the following is correct about stereotyping?

A.Originates from individuals’ self descriptions.

B.Is the same as hypotheses about affinity groups.

C.Reflects the individuality of the patient

D.Can result in blaming the patient.

29 . The language of stereotyping arises from all of the following EXCEPT:

A.Fear

B.Acculturation

C.Taught by families

D.Societal aspirations

30 . Which is correct about using pattern recognition for medical decision-making about patients or populations?

A.Is an effective means of avoiding stereotyping.

B.Leads to premature closure about patient information.

C.Provides valuable information when there are language barriers.

D.Avoids bias in clinical diagnostic reasoning.

31 . In accurately evaluating personal performance for giving quality healthcare, the best question a physician might ask her or himself is whether she/he:

A.makes patients take their medications.

B.achieves quality of care markers.

C.thinks he/she is doing a good job.

D.is liked by patients.

32 . The L-E-A-R-N, ETHNIC and Kleinman models of cross cultural communication have all the following in common EXCEPT:

A.Advocate negotiation with patient

B.Attention to racial characteristics

C.Inclusive of patient’s family

D.Patient-centeredness

33 . The L-E-A-R-N model of cross cultural communication incorporates all of the following EXCEPT:

34 . Which one of the following is LEAST LIKELY to be a useful source of updated information on health disparities?

A.The Centers for Disease control web site

B.A Textbook of Internal Medicine

C.The Commonwealth Fund newsletter

D.The Agency for Healthcare Research

35 . In the study by Schulman et al, in which physicians were asked to indicate which patients needed cardiac catheterization, which one of the following patients was LEAST likely to have cardiac catheterization recommended, given the same clinical indications?

A.A black woman

B.A black man

C.A white man

D.A white woman

36 . Which of the following is correct about creating cultural effectiveness in the health system?

A.Documentation of health care outcomes helps in adopting culturally effective practices.

B.Creating culturally specific health care settings has not been considered useful.

C.There is a “gold standard” that has been shown most effective.

D.Effectiveness is easy to achieve at the health system level.

37 . According to a recent review of the impact of patients’ limited English proficiency (LEP), all of the following are correct about the patients EXCEPT:

A.Are less likely to return for care

B.Have poorer health care outcomes

C.May go without care due to language barriers

D.Have the same health care interventions as other patients

38 . According to available studies, which one of the following is least likely to be a reason for under-utilization of professional interpreters for LEP patients in health care settings?

A.Refusal by patient

B.Increased time of encounter

C.High cost of professional interpretation

D.Failure to identify LEP patients by staff

39 . The CLAS (Culturally and Linguistically Appropriate Services) standards were developed by which one of the following?

A.Office of Minority Health of the Department of Health and Human Services

B.Joint Commission on Accreditation of Hospital Organizations

C.Liaison Committee on Medical Education

D.None of the above

40 . Which one of the following types of language interpreting is likely to be associated with the lowest patient satisfaction by LEP patients?

A.Videoconferencing

B.Family members as interpreters

C.Contracted telephone interpretation

D.Face-to-face professional interpretation

41 . When the physician is interviewing a patient with LEP using a professional interpreter, which of the following behaviors is NOT recommended?

A.Direct eye contact with the patient rather than the interpreter most of the time

B.Inviting a relative to be the interpreter to increase patient comfort

C.Correcting mistakes made by the interpreter

D.Seating in an equilateral triangle

42 . When interviewing or counseling a non-English-speaking patient through an interpreter, which one of the following techniques is most useful for verifying patient understanding of what is said?

A.Speaking more loudly to the patient

B.Repeating what has been said at least 3 times

C.Asking the patient to summarize what has been said

D.Asking the interpreter to repeat what the patient said

43 . All of the following describe self-directed learning (SDL) EXCEPT:

A.Learning is always done alone

B.Includes a wide variety of formats

C.Learner defines educational objectives

D.Learner selects the educational activity

44 . The primary emphasis of the Maintenance of Competence (MOC) program is on:

A.Expansion of number of CME credits required

B.Completion of certification examination

C.Continuous professional development

D.Creation of mentoring programs

45 . Many states are adding the requirement that CME include which of the following components?

A.Attendance at least one professional meeting per year.

B.Specific focus in the physician’s area of practice.

C.Patient satisfaction data.

D.Independent learning.

46 . Point of Care (PoC) learning is a CME format that makes use of which of the following resources?

A.Internet

B.Journal clubs

C.Patient consultation

D.Consultation with peers

47 . All of the following are characteristics of PoC EXCEPT:

A.Practice based

B.Reflective process

C.Individual directed

D.Specifically structured

48 . Directus serves as a CME tool for Internet searches by doing which of the following?

A.Providing a form for the learner to cut and paste URL sites visited

B.Tracking and documenting the search process

C.Creating a post-test for searches

D.Blocking commercial sites

49 . In order to claim a CME activity using Directus, the learner must do all of the following EXCEPT:

A.Identify the purpose of the search

B.Identify the outcome of the search

C.Complete the search in a single sitting

D.Evaluate the success of the search process

50 . When using Directus for CME credit the learner must:

A.Claim only the time calculated by the computer

B.Write a brief description of the learning plan

C.Deduct time of commercial sites visited

D.Visit a specified set of sites

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