Legal and Ethical Issues in Health Care
Textbook Exam Questions
Course Introduction
This course provides an in-depth examination of the legal and ethical principles governing health care delivery. Students will explore the regulatory framework affecting health care professionals, patients rights, confidentiality, informed consent, malpractice, and end-of-life decision-making. Through case studies and contemporary issues, the course highlights the complex interplay between law, ethics, and the ever-evolving landscape of modern medicine, equipping students with the knowledge to navigate ethical dilemmas and comply with legal standards in health care settings.
Recommended Textbook
Legal and Ethical Aspects of Health Information Management 3rd Edition by Dana C. McWay
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2
Chapter 1: Workings of the American Legal System
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Q1) Under stare decisis, _____.
A)U.S.courts of appeal are bound by trial court decisions of U.S.district courts in other jurisdictions
B)U.S.district courts are bound by decisions of U.S.courts of appeal within the same jurisdiction
C)U.S.supreme court is bound by decisions of all U.S.courts of appeal within different jurisdictions
D)U.S.supreme court is obligated to follow precedent, regardless of decisions in courts of appeal or district courts
Answer: B
Q2) Public law _____.
A)excludes regulatory statutes, penal law, and other laws of public order
B)includes the law of contracts or torts and the law of obligations
C)involves relationships between individuals
D)is subdivided into administrative, constitutional and criminal law
Answer: D
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3
Chapter 1: Workings of the American Legal System: Part A
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Q1) The burden of proof as a "preponderance of the evidence found" is associated with _____ law.
A)civil
B)criminal
C)intellectual property
D)public
Answer: A
Q2) Laws passed at the local level are called:
A)felonies
B)misdemeanors
C)ordinances
D)regulations
Answer: C
Q3) Separation of powers as it pertains to the branches of federal government is in place:
A)as a way to increase the number of jobs created in the country.
B)if the president is unable to fulfill his duties and responsibilities.
C)so that no one particular branch overpowers the other branches.
D)to prevent any interaction between factions of political parties.
Answer: C
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Chapter 2: Court Systems and Legal Procedures
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Sample Questions
Q1) The written document that describes the grounds of jurisdiction, plaintiff's claim, and demand for relief is called the _____.
A)appeal
B)complaint
C)decision
D)interrogatory
Answer: B
Q2) Diversity jurisdiction includes is a form of subject-matter jurisdiction whereby US district courts (e.g., trial courts of general jurisdiction in the federal judiciary) have the power to hear a _____ case where the parties are "diverse" in citizenship, indicating that they are citizens of different states or non-U.S.citizens.
A)civil
B)contract
C)criminal
D)customs
Answer: A
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Page 5
Chapter 2: Court Systems and Legal Procedures: Part A
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Q1) Which is the name of the process used by the defendant (or plaintiff) to obtain facts and information about the case from the plaintiff (or defendant)?
A)appeal
B)discovery
C)legal process
D)trial
Q2) The stages through which a lawsuit passes is called the _____ process.
A)appeal
B)complaint
C)interrogatory
D)legal
Q3) The answer to a complaint that is made by the defendant is called the _____.
A)appeal
B)decision
C)interrogatory
D)written response
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6
Chapter 3: Judicial Process of Health Information
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Q1) An approved method to challenge the validity of a subpoena duces tecum called a
A)litigation hold
B)motion to quash
C)order to deny
D)response to interrogation
Q2) The legal right to keep certain information private and confidential and protect it from subpoena, discovery, or admission into evidence is called the _____.
A)foundation requirement
B)privilege doctrine
C)release of information process
D)trustworthiness requirement
Q3) Which is a concept that describes the requirement to anticipate the need for data in a court action?
A)duty to preserve
B)litigation hold
C)order of preservsation
D)notice of preservation
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Chapter 3: Judicial Process of Health Information: Part A
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Q1) A court order is signed by the _____.
A)court clerk
B)defendant's attorney
C)judge
D)plaintiff's attorney
Q2) A litigation response plan is a _____.
A)motion to quash
B)subpoena commanding the testimony of a witness
C)subpoena duces tecum commanding the production of documents
D)tool consisting of policies and procedures that addresses how to respond to the legal process requests
Q3) When information concerning HIV/AIDS, mental health, and substance abuse is released to a third party, a _____ prohibits sharing the information with yet another third party unless the patient signs an authorization to release the information.
A)motion to quash
B)prevention of spoliation
C)redisclosure statement
D)subpoena duces tecum
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Chapter 4: Principles of Liability
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Q1) Under the theory of failure to warn the psychotherapist _____.
A)can warn an intended victim if the patient expresses the intent to do harm
B)has an ethical obligation only, not a legal one, which means a warning is optional
C)may not reveal a patient's intentions to harm a third party due to confidentiality issues
D)should alert the authorities only to the possibility that the patient may harm another
Q2) The anti-dumping law is abbreviated as _____.
A)COBRA
B)EMTALA
C)HIPAA
D)TEFRA
Q3) Respondeat superior is associated with _____.
A)comparative negligence
B)corporate liability
C)professional negligence
D)vicarious liability
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Chapter 4: Principles of Liability: Part A
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Q1) Failure of a health care organization to provide entrusted care and treatment to a patient is:
A)corporate negligence.
B)failure to warn.
C)often awarded punitive damages.
D)treated as res ipsa loquitur.
Q2) Which is an obligation to behave in a certain way, such as the expectation by the medical profession that physicians will act or practice medicine in a reasonably prudent manner?
A)Duty to care
B)EMTALA
C)Expressed contract
D)Vicarious liability
Q3) When a patient is voluntarily admitted to a hospital:
A)a relationship is established between the patient and the hospital.
B)and the patient signs admission forms, an implied contract is created.
C)EMTALA applies to hospitals and physicians who participate in Medicaid.
D)the hospital is required to treat the patient, regardless of diagnosis.
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Chapter 5: Ethical Standards
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Q1) Which includes concepts that give meaning to an individual's life and serve as the framework for decision making?
A)Ethics
B)Etiquette
C)Morals
D)Values
Q2) In the healthcare context, the distributive justice criterion of contribution refers to the _____.
A)An amount the health insurance provider is expected to reimburse
B)How much money the client pays for the health care service rendered
C)The healthcare provider's write-off amount for the services provided
D)What a person might be expected to contribute to society at a later date
Q3) Autonomy is viewed as a freedom unless it _____.
A)Annoys health providers
B)Causes financial stress
C)Interferes with another's rights
D)Disputes religious beliefs
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Page 11
Chapter 5: Ethical Standards: Part A
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Q1) Which ethical concept applies to a legal situation when someone else must decide for an individual because that individual cannot make the decision due to competence?
A)best-interest standard
B)cost-benefit analysis
C)double-effect principle
D)nonmaleficence-beneficence
Q2) How human beings relate under certain circumstances is called _____.
A)autonomy
B)ethics
C)etiquette
D)morals
Q3) The just claim or entitlement that may be based on law, ethics or morality that others are obliged to respect is associated with a(n) _____.
A)consequentialism
B)justice
C)right
D)utilitarianism
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Chapter 6: Ethical Decisions and Challenges
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Q1) Which is true of ARRA?
A)ARRA provisions specify that patients are to receive a paper-based printout of all information transmitted in an electronic health record format.
B)ARRA reinforces a patient's right to access to their own healthcare information when the patient record is in stored in a paper-based format.
C)ARRA restricts the transmission of healthcare information to the patient if the information was originally received in a manual format.
D)ARRA states that patients have the right to require a covered entity to electronically re-transmit information to an entity designated by the patient.
Q2) Which would create an ethical concern?
A)Altering statistics to meet accreditation requirements.
B)Documenting late entries as such in a patient's record.
C)Revealing conflicts of interests to hospital administration
D)Televising press conferences at the health care facility.
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Chapter 6: Ethical Decisions and Challenges: Part A
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Q1) Which is an ethical part of the problem when faced with health care challenges?
A)conflicts of interest demonstrated by physicians
B)extending inpatient stays due to payer influence
C)research involving consenting human subjects
D)use of public information for private financial gain
Q2) When monitoring of employee conduct is performed as a role of ethics in supervision, the supervisor is _____.
A)accepting responsibility for mistakes made by employees and setting a good example for others to follow
B)establishing a system of checks and balances to determine nonconformity with standards of performance
C)regularly communicating policies and procedures, which include ethical guidelines, to the employees.
D)using rewards for ethical behavior demonstrated by employees and punishment for unethical behavior.
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14
Chapter 7: Bioethical Issues
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Q1) Nonhuman and animal tissues used for transplant _____.
A)Are not compatible with human transplantation of any form
B)Have an effective long-term use, regardless of type
C)Provide additional time until a suitable allograft is available
D)Usually result in automatic rejection of transplanted tissue
Q2) Which controversy is associated with the use of stem cells?
A)Embryonic harvesting
B)Euthanasia
C)Genetic engineering
D)Mutation into specialized cells
Q3) An ethical concern related to HIV-infected persons involves _____.
A)Best-interest standard
B)Double effect principle
C)Right to privacy
D)Veracity
Q4) GINA stands for:
A)Genetics in Native Americans
B)Genetic Information Nondiscrimination Act
C)Government in Nursing Association
D)Government Information Nondisclosure Agreement
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Chapter 7: Bioethical Issues: Part A
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Q1) What refers to the termination of a pregnancy before the viability of the fetus?
A)abortion
B)eugenics
C)genetic screening
D)perinatal testing
Q2) Stem cells that do not yet have a specific function _____.
A)are available only from embryos, and their use is viewed as unethical
B)can renew themselves and then change into needed specialized cells
C)genetically mutate by altering organisms to treat or prevent disease
D)to map the genes of human DNA to create the human genome
Q3) Prenatal testing can cause _____.
A)defective genes
B)genetic abnormalities
C)risk to the fetus
D)the control of hereditary factors
Q4) The Human Genome Project _____.
A)addresses the concern over confidentiality of genetic information
B)genetically alters organisms treat or prevent disease and conditions
C)maps the genes in human DNA, which consists of 46 human chromosomes
D)notifies employers of the genetic predisposition of a potential employee
Page 16
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Chapter 8: Patient Record Requirements
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Sample Questions
Q1) The release of health records from drug and alcohol abuse programs is governed by _____ regulations.
A)County
B)Federal
C)Municipal
D)State
Q2) Record retention policies address _____,
A)The length of time a record is maintained
B)When the record can be released to the patient
C)Whether a patient's record warrants storage
D)Which records can be provided pursuant to court order
Q3) Which is an example of a nonclinical use of the health record?
A)Billing to and reimbursement by third-party payers
B)Chronological documentation of patient care
C)Public health monitoring to determine flu outbreaks
D)Quality improvement activities, such as infection control
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Chapter 8: Patient Record Requirements: Part A
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Q1) Which is a possible consequence of the if it wasn't documented, it wasn't done concept?
A)Deficiencies found in the health record are corrected by responsible providers.
B)Patients are notified by the risk manager that they are eligible bring a lawsuit.
C)The responsible provider is automatically suspended from the medical staff.
D)Third-party payer review of the health record can result in payment denials.
Q2) Enterprise content and record management (ECRM) aids in combating potential increased costs associated with the discovery process.An example of an enterprise management principle is _____.
A)creating both digital and analog records for use in the facility
B)differentiating between clinical and nonclinical health record content
C)policies established about how long to save emails and text files
D)streamlining the process of responding to discovery requests
Q3) Health data and health records are the property of the ____.
A)centers for medicare and medicaid
B)owner of the health care facility
C)patient (or patient's next of kin)
D)state in which the facility operates
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Chapter 9: Confidentiality and Informed Consent
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Q1) Prior to the development of the informed consent doctrine, which theory would have been used to hold a physician accountable for his actions?
A)Autonomy
B)Battery
C)Charitable immunity
D)Good Samaritan
Q2) Which recognizes the patient's right to bring a lawsuit for damages or relief against someone who obtains, releases, or uses protected health information (PHI) inappropriately?
A)AMA ethical guidelines
B)Common law basis
C)Freedom of Information Act
D)Informed consent
Q3) Good Samaritan laws provide legal protection for _____ treatment.
A)elective
B)healthcare
C)negligent
D)unauthorized
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19
Chapter 9: Confidentiality and Informed Consent: Part A
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Q1) The focus of confidentiality is on the _____ relationship.
A)federal-state
B)patient-patient
C)patient-provider
D)provider-provider
Q2) Which provides instruction about the medical care to be administered or removed in the event of the patient's incapacitation?
A)living will
B)notice of privacy practice
C)power of attorney
D)redisclosure statement
Q3) State _____ statutes apply to malpractice cases when evidence is introduced during a trial.
A)closed record
B)open record
C)physician-patient privilege
D)privacy and security
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Chapter 10: Access to Health Information
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Q1) An emancipated minor is one who is _____.
A)Actively serving in the US armed forces
B)Engaged to be married
C)Not living with his or her parents
D)Quitting high school
Q2) Authority for release of information can be granted by a(n) _____.
A)executor of an estate
B)mentally disabled 18-year-old
C)minor child
D)plaintiff's attorney
Q3) A redisclosure notice _____.
A)Allows information released by a facility to be submitted to RHIO agencies.
B)Is optional when the patient information pertains to drug and alcohol abuse treatment.
C)Protects information from the patient record from being shared with a third party.
D)Prohibits information from being only for the stated purpose included on ROI form.
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21
Chapter 10: Access to Health Information: Part A
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Q1) HIPAA requires _____ inform patients about the use of their health record, such as that provided for continuing care, education, fund raising, marketing, or research?
A)business associates
B)covered entities
C)departments of health
D)health record banks
Q2) Today, the _____ owns the physical record, and the _____ owns the information within it.
A)patient, patient
B)patient, provider
C)provider, patient
D)provider, provider
Q3) The National Commission for the Protection of Human Subjects in Biomedical and Behavior Research published the Belmont Report, which contains principles that require respect for persons, _____, and justice.
A)autonomy
B)beneficence
C)maleficence
D)veracity
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Page 22
Chapter 11: Specialized Patient Records
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Q1) Two main differences between mental health records and general health records include _____.
A)Accurate provider documentation as well as timely entries are stricter for mental health records as compared with general health records
B)Additional requirements for patient record content and more stringent privacy requirements are associated with mental health records
C)Medical record retention regulations and policies as well as issues related to timely entries are more stringent for general health records
D)The accuracy of entries in both types of patient records as well as consents required for the release of information are subject to HIPAA regulations
Q2) A substance abuse treatment release of information is invalid if it fails to include the _____.
A)Automatic expiration date
B)Consent of legal counsel
C)Provider's signature
D)Purpose of disclosure
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Chapter 11: Specialized Patient Records: Part A
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Q1) Audit activities performed by qualified organizations and individuals do not require written patient authorization when access is provided to:
A)a research scientist who writes an article that includes case studies about a limited number of patients with a rare disease, all of whom live in the same town.
B)individuals who are professionally qualified to conduct research studies but who have not yet been determined as qualified by the treatment program director.
C)members of the staff at federal, state, and local governmental agencies.
D)persons who work for quality information organizations (QIOs), third-party payers, or private organizations that provide financial assistance.
Q2) More stringent privacy restrictions for mental health (psychiatric) records are mandated by _____ laws.
A)federal
B)Medicare CoP
C)HIPAA
D)state
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24
Chapter 12: Risk Management, Quality Management, and Utilization Management
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Q1) Which is a legal consideration that applies to the retention of health care records?
A)Available storage and methods of destruction
B)Decision made by the health information committee
C)Length of time required by statute and regulation
D)Policy established by the health care institution
Q2) Medicare's inpatient prospective payment system _____.
A)Changed reimbursement per diem rates to predetermined rates
B)Defined APCs, APGs, DRGs, MS-DRGs, RBRVS, and RUGs
C)Established minimum reimbursement amounts for hospital stays
D)Provided payment to facilities in advance of inpatient admission
Q3) Which is an obstacle to peer review activities?
A)Administrative feedback and input
B)Fear of reprisals for candid criticism
C)Participation by healthcare providers
D)Resultant measures to improve care
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25
Chapter 12:
Risk Management, Quality Management, and Utilization Management: Part A
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Q1) The analysis and evaluation of all sentinel events that might be encountered by a health care organization is called _____.
A)enterprise risk management
B)medical staff disciplinary process
C)peer review analysis
D)traditional trending
Q2) Which force influences the growth of risk management?
A)Decreased medical malpractice lawsuits resulted in high damage awards.
B)Implementation of the doctrine of charitable immunity via court decisions.
C)Joint Commission required hospitals to implement risk management programs.
D)State legislatures established no requirements for risk management programs.
Q3) Patient record documentation proves what did or didn't happen regarding patient care, and it establishes whether the _____ of care was met.
A)continuity
B)duty
C)network
D)standard
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Page 26
Chapter 13: Information Systems
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Q1) A printout of the patient record, which has been maintained in an electronic medium is _____.
A)Considered inadmissible because it is not the actual patient record
B)Entered into evidence with testimony by the custodian of health records
C)Not required to meet foundation, trustworthiness, or accuracy requirements
D)Paper-based, which means it was generated manually by providers
Q2) Which is an Institute of Medicine core functionality that constitutes an electronic health record?
A)Clinical decision support
B)Dictation and transcription
C)Enforcement of collections
D)Gatekeeping for patients
Q3) The health-care provider should consider improved controls, including the establishment of written policies and procedures covering the loan and use of _____ and whether ePHI should even be maintained on these media/devices at all
A)Computer devices that are portable
B)Electronic surveillance equipment
C)Mainframe and archived computers
D)Off-site storage of paper records
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Chapter 13: Information Systems: Part A
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Q1) The use of electronic communications and information technologies to provide or support clinical care at a distance is called _____.
A)digital imaging
B)electronic indexing
C)email communication
D)telemedicine
Q2) When the electronic health record (EHR) is admitted into evidence during a medical malpractice lawsuit means the health record will _____.
A)be used by plaintiff's attorney only in court
B)facilitate credentialing of medical staff physicians
C)improve computerized processes using the EHR
D)serve as proof of the quality of patient care
Q3) Providers are authorized to operate and practice medicine _____.
A)accreditation organizations
B)county health departments
C)professional associations
D)state licensing agencies
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28
Chapter 14: Health-Care Fraud and Abuse
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Q1) When employees have password access to medical records, _____.
A)Employee have a responsibility to allow the truth to be shared with the public
B)It is acceptable to review a celebrity's chart because of their implied consent
C)Released information is limited to that which has been authorized by the patient
D)The employer has implied that employees have control over release of records
Q2) The Deficit Reduction Act requires _____.
A)Actions of employees to be protected under nolo contendre so that the government is not a risk of being sued in a court of law
B)Compliance programs to shield hospitals from liability for unintentional fraud and abuse on the part of its employees
C)Facilities that receive more than $5 million in Medicaid reimbursement to have in place written policies and handbooks to educate staff
D)That only the entity may be prosecuted for fraud and abuse, exempting individual providers and other healthcare professionals
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Chapter 14: Health-Care Fraud and Abuse: Part A
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Q1) Which is the penalty for felony violation of mail and wire fraud statutes?
A)$1,000 fine and/or 5-year prison term
B)$5,000 fine and/or 1-year prison term
C)$10,000 fine and/or 5-year prison term
D)$50,000 fine and/or 10-year prison term
Q2) Efforts to establish a culture that promotes prevention, detection, and resolution of instances of conduct that do not conform to application local, state, and federal laws is called _____.
A)compliance
B)fraud
C)quit tam
D)regulation
Q3) Match the type of facility or service with the appropriate law. Occupational and physical therapy practices
A)Stark I
B)Stark II
Q4) Match the type of facility or service with the appropriate law.
Home health agencies
A)Stark I
B)Stark II
Page 30
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Chapter 15: Law and Ethics in the Workplace
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Q1) The government agency that establishes and oversees collective bargaining procedures is the _____.
A)ERISA
B)FLSA
C)FMLA
D)NLRB
Q2) Which legislation bans discrimination in compensation, terms, and conditions of employment based on race, religion, color, sex, or national origin?
A)Equity Pay Act
B)ERISA
C)Fair Labor Standards Act
D)Title VII
Q3) An employer is obligated to verify the _____ of employees who are hired to work.
A)Age, gender, and disability status
B)Employment authorization and identity
C)Independent contractor status
D)Medical ability and competency
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Chapter
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Q1) Match the appropriate term with its characteristic or definition. Persons, business or organizations that provide work, engage services or labor, and pay for work performed.
A)Employment
B)Employers
C)Employees
Q2) Match the Federal legislation with its definition. Regulates employee pensions by establishing minimum standards and for pension and health/life insurance plans.
A)Consumer Credit Protection Act
B)Employee Retirement Income Security Act
C)Federal Labor Standards Act
D)Genetic Information Nondiscrimination Act
E)Occupational Safety and Health Act
Q3) Match the appropriate term with its characteristic or definition. Individuals who perform work and work-related services.
A)Employment
B)Employers
C)Employees
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