Medical Law and Ethics practice questions

Answer: B) A POLST, a set of portable medical orders for life-sustaining treatment

A POLST is a portable set of signed medical orders that records a seriously ill patient's current wishes about life-sustaining treatment. Unlike an advance directive, it is an actual medical order that emergency personnel can follow.

• AIncorrect. A living will is an advance directive in which a person states general future wishes. It is not a set of medical orders signed by a clinician that emergency personnel act on directly.
• BCorrect. A POLST (Physician Orders for Life-Sustaining Treatment) is a signed medical order form for seriously ill or frail patients. It records current treatment wishes so that emergency personnel can follow them.
• CIncorrect. A health care power of attorney names a person to make decisions if the patient cannot. It does not give treatment orders.
• DIncorrect. A HIPAA authorization permits disclosure of protected health information. It does not address life-sustaining treatment.

Answer: C) Until adulthood plus the statute of limitations

• AIncorrect. That's too short.
• BIncorrect. That's too short.
• CCorrect. State law varies.
• DIncorrect. They must be kept.

Answer: A) Invasion of privacy, an unauthorized disclosure of private information

Sharing a patient's photo without consent is invasion of privacy. When healthcare staff do it, it can also be a HIPAA violation, because full-face photos are identifiers.

• ACorrect. Making a patient's image public without consent is invasion of privacy. Because a workforce member of a covered entity posted it, it may also violate HIPAA, which lists full-face photographs as identifiers.
• BIncorrect. Battery requires unwanted physical contact, and no one touched the patient.
• CIncorrect. Assault involves a threat or attempt that makes someone fear harm. Posting a photo is not a threat.
• DIncorrect. Abandonment means ending the provider-patient relationship without notice. Care was not ended here.

Answer: A) The physician must sign the written request; the MA may sign the delivery receipt as the physician's designee.

Federal rules (21 CFR 203.31) require the licensed practitioner to sign the written request for drug samples. The practitioner or a designee, such as the MA, may sign the receipt when the samples are delivered to the office.

• ACorrect. Under 21 CFR 203.31, the written request for samples must be signed by the licensed practitioner. When samples are delivered to the practitioner's address, the receipt may be signed by the practitioner or the practitioner's designee.
• BIncorrect. A designee may sign only the receipt. The written request must be signed by the licensed practitioner who is asking for the samples.
• CIncorrect. Free prescription drug samples are exactly what the federal sample rules cover. A signed written request and a signed receipt are both required.
• DIncorrect. The representative cannot sign for the practitioner. The licensed practitioner must sign the request, and verbal approval does not replace that signature.

Answer: C) They keep the assistant's knowledge current and maintain the certification each cycle

Continuing education under AMT's CCP keeps a medical assistant's knowledge current and, together with annual fees, keeps the certification active each three-year cycle. It does not expand scope of practice.

• AIncorrect. Continuing education does not change a medical assistant's legal scope of practice. Diagnosis is still the provider's job.
• BIncorrect. AMT requires both recorded CCP points and payment of annual fees to advance into the next cycle.
• CCorrect. CCP activities must enhance job performance or broaden healthcare knowledge, and completing the points every three-year cycle keeps the credential active.
• DIncorrect. AMT accepts several categories, including professional education such as seminars and CPR training, authorship, presentations, and committee work, not just college courses.

Answer: B) The Anti-Kickback Statute

The Anti-Kickback Statute makes it a crime for anyone to offer, pay, solicit or receive anything of value in return for federal health care program referrals. The Stark Law applies only to referrals by physicians.

• AIncorrect. The Stark Law bars physicians from referring Medicare patients for designated health services to entities where the physician or an immediate family member has a financial relationship. The office manager is not a physician.
• BCorrect. The Anti-Kickback Statute makes it a felony for anyone to knowingly and willfully offer, pay, solicit or receive remuneration in return for referrals paid for by federal health care programs such as Medicare.
• CIncorrect. The HIPAA Privacy Rule protects patients' health information. It does not cover payments made in exchange for referrals.
• DIncorrect. CLIA sets quality standards for laboratory testing. It does not address payments for referrals.

Answer: B) Respect the rights of patients and protect the confidentiality of their health care information

The AMT Standards of Practice include respecting patients' rights and protecting the confidentiality of health information. They also include valuing the attending practitioner's judgment, not diagnosing unless licensed or authorized, and reporting professional abuse.

• AIncorrect. The standards say the AMT professional observes and values the judgment of the attending licensed practitioner. Deference does not depend on whether the professional agrees.
• BCorrect. One AMT standard is to respect the rights of patients and fellow health care providers and to protect the confidentiality of health care information.
• CIncorrect. The standards say not to diagnose or give medical advice unless properly licensed or authorized. Experience alone is not enough.
• DIncorrect. The standards make the professional responsible for reporting knowledge of professional abuse or unlawful behavior. That duty does not wait for a patient complaint.

Answer: B) Measles in an unvaccinated child

Each state sets by law which diseases are reportable, and providers and laboratories must report diagnosed cases to public health departments. Serious communicable diseases such as measles are notifiable; individual cases of minor contagious conditions are not.

• AIncorrect. Head lice spread from person to person, but individual cases are not on the national notifiable conditions list and are handled through the medical record and school policies.
• BCorrect. Measles is a notifiable communicable disease. Providers and laboratories must tell public health departments when a patient is diagnosed, and the cases are shared with CDC through NNDSS.
• CIncorrect. Viral conjunctivitis is contagious, but individual cases are not on the notifiable disease list and are not reported to the health department.
• DIncorrect. A cold is infectious, but individual cases are not notifiable and are recorded only in the medical record.

Answer: B) The nature of the procedure, its risks and benefits, and reasonable alternatives

Informed consent is a communication process: the clinician explains the nature of the procedure, its risks and benefits, and reasonable alternatives, and confirms that the patient understands them.

• AIncorrect. Scheduling and cost details may be useful, but they are not the core elements of informed consent. Risks, benefits, and alternatives are missing.
• BCorrect. Informed consent requires that the patient understand the nature of the intervention, its risks and benefits, and reasonable alternatives (including their risks and benefits).
• CIncorrect. Credentials, accreditation, and billing codes are not the disclosures that make consent informed.
• DIncorrect. Telling the patient only the benefits and preparation steps leaves out the risks and the alternatives, so the consent would not be informed.

Answer: A) AMT certification

• ACorrect. Only those certified by AMT may use the RMA (AMT) credential.
• BIncorrect. Certification is required.
• CIncorrect. Certification is required.
• DIncorrect. Certification is required.