Legal and Ethical Issues practice questions

Answer: B) Vital statistics records

Births and deaths are reported to state vital registration offices as vital statistics. The CDC's National Vital Statistics System compiles this data nationally.

• AIncorrect. Notifiable disease reports cover specific communicable or reportable conditions, such as measles or tuberculosis, not every birth and death.
• BCorrect. Births, deaths, and fetal deaths are registered as vital records in each jurisdiction. The states then supply this data to the CDC's National Vital Statistics System.
• CIncorrect. Cancer registries collect data on diagnosed cancer cases, not on all births and deaths.
• DIncorrect. Incident reports are internal risk-management documents about unusual events. They are not filed with the state as birth or death records.

Answer: A) Implied

• ACorrect. Emergency care proceeds under implied consent.
• BIncorrect. Emergency exceptions exist.
• CIncorrect. Delay could harm the patient.
• DIncorrect. Insurers don't consent.

Answer: B) Producing specified records, such as the patient's medical chart

A subpoena duces tecum orders the recipient to produce specified documents or records, such as a patient's chart. A subpoena that only requires someone to appear and testify is a subpoena ad testificandum.

• AIncorrect. This describes a subpoena for testimony only (subpoena ad testificandum). A subpoena duces tecum adds an order to produce specified documents.
• BCorrect. A subpoena duces tecum ('bring with you') orders the person to produce specified documents, papers or other records, such as medical records.
• CIncorrect. Interrogatories are written questions exchanged between the parties during discovery. They are not a subpoena ordering records to be produced.
• DIncorrect. Expert witnesses are usually hired by a party to give opinions. A subpoena duces tecum orders specified records to be produced; it does not appoint an expert.

Answer: A) Justice

• ACorrect. It's about fair allocation.
• BIncorrect. That's truthfulness.
• CIncorrect. That's keeping promises.
• DIncorrect. That's self-determination.

Answer: B) Battery

• AIncorrect. Assault is the threat.
• BCorrect. Battery is unauthorized physical contact.
• CIncorrect. This is written defamation.
• DIncorrect. This is ending care improperly.

Answer: A) Deposition

• ACorrect. Depositions are sworn, recorded testimony.
• BIncorrect. This orders someone to appear.
• CIncorrect. This is the decision.
• DIncorrect. This notifies of a lawsuit.

Answer: A) A provider's medical order that CPR not be performed if the patient's breathing or heartbeat stops

A DNR is a medical order written by a provider that applies only to CPR. It is one part of advance care planning, not a complete advance directive.

• ACorrect. MedlinePlus defines a DNR as a medical order written by a health care provider telling providers not to do CPR if the patient's breathing or heart stops.
• BIncorrect. Naming a health care agent is done through advance care planning documents such as a health care power of attorney. A DNR is a provider's order about CPR.
• CIncorrect. A DNR covers CPR only. It does not apply to other treatments such as medicines or nutrition.
• DIncorrect. A provider writes the DNR order after discussing the patient's wishes with the patient, proxy, or family, and records it in the chart.

Answer: C) Thank the patient sincerely, politely decline, and follow the office's gift policy

Expensive gifts from patients threaten professional boundaries, so the medical assistant should thank the patient, politely decline, and follow office policy, in keeping with the profession's ethical principles.

• AIncorrect. Worry about the patient's feelings doesn't override professional boundaries. Keeping an expensive gift can look like favoritism or create a sense of obligation.
• BIncorrect. Accepting a valuable gift for the whole office still creates a boundary and conflict-of-interest problem, and it skips the office gift policy.
• CCorrect. Thanking the patient while declining protects both the relationship and professional boundaries, and the office policy sets out how gifts are handled.
• DIncorrect. Taking a valuable gift before checking the policy is already a boundary problem. Expensive personal gifts should be declined when they are offered.

Answer: A) Send a certified letter giving the end date and offering care for a reasonable period, such as 30 days

To avoid a patient-abandonment claim, dismiss the patient with written notice (typically certified mail with return receipt) that states the end date and offers continued care for a reasonable period, often 30 days. Release records once the patient authorizes it.

• ACorrect. Abandonment means ending the relationship without reasonable notice. A written termination letter sent by certified mail with return receipt, stating the end date and that the clinician stays available for about 30 days, gives the patient time to find new care and documents the notice.
• BIncorrect. This ends care with no notice and no period of continued availability, which is exactly what makes up abandonment.
• CIncorrect. Notice should be in writing, typically by certified mail, and should give an end date and a period of continued care. A phone call alone gives no proof of notice and no transition time.
• DIncorrect. Records should be released to a new provider once the patient authorizes it. Sending them without authorization does not replace proper written notice.

Answer: B) Document the symptoms, explain that the provider must assess them, and relay the call to the provider

Diagnosing and recommending treatment are outside a medical assistant's scope of practice. The CMA should document the symptoms and refer the patient to the provider.

• AIncorrect. Naming a likely condition is diagnosing, and suggesting treatment is giving medical advice. Both are outside a medical assistant's scope of practice.
• BCorrect. Medical assistants work under the supervision of a provider and do not diagnose. Recording the symptoms accurately and passing them to the provider stays within scope and gets the patient a proper evaluation.
• CIncorrect. Using a reference doesn't change anything: telling the patient a likely diagnosis is still interpreting clinical findings, which a medical assistant may not do.
• DIncorrect. Recommending a medication based on the symptoms is treatment advice that requires a provider's clinical judgment. A medical assistant cannot do this on their own.