BioMedicine Boards Prep

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					                     BioMedicine Boards Prep – Ethics, Legal and Patient Mgmt Stuff

Question                                                                                                  Answer
What is the consequence of overinflating the lungs during CPR?                                              C
  a) Increase of blood pressure
  b) Decrease of blood pressure
  c) Air going to stomach and causing vomiting
  d) Coughing of phlegm

When assisting an infant with ventilation you should                                                        C
  a) Overinflate the lungs for best result
  b) Turn the head sideways to help exhale
  c) Puff air from your cheeks, not your lungs
  d) Give the infant your fullest, deepest breath

What is the essence of CPR?                                                                                 D
  a) Allows the victims to help themselves if they are alone
  b) Will always save the victim‟s life if performed properly
  c) Is an ancient healing technique
  d) Serves as an artificial heartbeat and an artificial respirator

The American Heart Association recommends Child CPR for                                                     D
   a) Infants and children
   b) Any small-framed adult
   c) Adolescents
   d) Children under the age of 8 but not for infants

Your patient feels faint during an interview. You feel the carotid artery and you feel a pulse beating.     D
You call 911. What should you do while waiting?
   a) Shake her
   b) Take her to the ER at a nearby hospital
   c) Needle GV 26 (ren zhong)
   d) Begin chest compression

In giving CPR to an adult who needs assisted breathing, what should you do after counting aloud for         C
30 compressions?
    a) Lift the victim to sitting position
    b) Stop and wait for help to arrive
    c) Give 2 breaths
    d) Move the head side to side

What should you do if an adult victim remains unresponsive?                                                 A
  a) Dial 911 before starting CPR
  b) Wait to see if the victim regains consciousness
  c) Shake him much harder
  d) Start CPR before dialing 911

What should you remember when administering compressions to a child?                                        A
  a) 1 hand/ 2 inches
  b) 2 hands/ 1 inch
  c) 1 hand/ 3 inches
  d) 2 hands/ 2 inches
                                             Biomed Prep Test A – Pg 1 of 24
How do you check for an adult victim responsiveness?                                D
     a) Tickling his feet
     b) Using smelling salts
     c) Pouring cold water on his face
     d) Shaking him and shouting, “Are you okay?”
In infant CPR you use                                                               C
     a) 1 hand, 2 inches
     b) 2 fingers, 2 inches
     c) 2 fingers, 1 ½ inches
     d) 2 hands, 2 inches

What is the technique to clear a victim‟s airway?                                   C
  a) Push chin down, tilt head forward
  b) Gently turn head from side to side
  c) Lift chin up, tilt head back
  d) Lift chin up, turn head sideways

When giving breaths to an infant you should                                         B
  a) Have each breath last 10 seconds
  b) Puff air from your cheeks, not your lungs
  c) Give breaths in spurts
  d) Lift the head up and support with a small pillow

What should you do when assistang an adult or child with breathing?                 D
  a) Push on the victim‟s abdomen
  b) Let the victim‟s chin drop
  c) Force all of you air into the victim
  d) Pinch the victim‟s nose closed

If you are alone with a child or an infant and he/she is unresponsive youshould     C
     a) Turn the child or infant‟s head to the side
     b) Dial 911 before starting CPR
     c) Start CPR before dialing 911
     d) Perform CPR and do not dial 911

Overinflating the victim‟s lungs may                                                A
   a) Lead to air being forced into stomach and cause vomiting
   b) Make the skin tone turn red
   c) Dangerously elevate blood pressure
   d) Have no effect

How do you check for infant responsiveness?                                         B
  a) Slapping his face lightly
  b) Patting his feet and shoulders
  c) Sprinkling water on his face
  d) Shaking him and shouting

The „2 hands, 2 inches‟ rule means                                                  A
   a) With your 2 hands interlaced, compress chest to only 2 inches
   b) Holding the victim‟s head with 2 hands, turn head 2 inches to each side
   c) Never use only one hand to compress 2 inches
   d) 2 hands width plus 2 inches from clavicle locates best compression location

                                            Biomed Prep Test A – Pg 2 of 24
What should you do when giving adult chest compressions?                                           D
  a) Hands are both flat along side of ribs
  b) Position one hand below diaphragm
  c) Hands are in fists, thumbs side up
  d) Position your hands just above the junction of the xyphoid and sternum in the lower half of
      the sternum
Compressions on an infant must be administered more carefully than with an adult because:          D
  a) There is no difference
  b) An infant‟s body can heal faster
  c) The bones of infants are more flexible
  d) An infant‟s delicate ribcage is especially susceptible to damage

If 2 people are administering adult CPR, what is the ratio of compression to ventilation?          C
     a) 5 to 1
     b) 15 to 2
     c) 30 to 2
     d) 10 to 1

The American Heart Association recommends Infant CPR for                                           A
   a) Children under the age of 12 months
   b) Children under the age of 6 months
   c) Children under the age of 24 months
   d) Children under the age of 18 months

What should you do when assisting an infant with ventilation?                                      A
  a) Cover his nose/mouth with your mouth
  b) Let the chin drop
  c) Pinch the nose closed
  d) Hold the head with both hands

What is the first step in CPR?                                                                     B
  a) Determine if the patient is breathing
  b) Determine if the patient is unresponsive
  c) Determine if the patient has a pulse
  d) Determine if there are any bodily injuries

What is the most common cuase of airway obstruction?                                               D
  a) Chewing gum
  b) Foreign objects
  c) Food
  d) Tongue

In the 2010 CPR guidelines, the CAB system stands for:                                             C
    a) Circulation – air – breathing
    b) Cardio – air – breathing
    c) Compression – airway – breathing
    d) Cardio – airway – breathing

                                            Biomed Prep Test A – Pg 3 of 24
You are performing adult CPR and have finished giving 30 compressions on the chest. What is the          a
next thing to do?
   a) Give 2 breaths
   b) Give the 2nd round of 15 compressions
   c) Call 911
   d) Wait for a response before proceeding

A patient you are interviewing collapses to the floor. He has a pulse, but no respiration. What is the   C
first thing to be done?
     a) Open the mouth
     b) Shake him
     c) Call 911
     d) Give 2 rescue breaths

What should you remember when administering compressions to an infant?                                   B
  a) 1 hand, 2 inches
  b) 2 fingers, 1.5 inches
  c) 2 hands, 1 inch
  d) 2 fingers (1/2 hand), 2 inches

What is the breath to compression ratio in child CPR?                                                    C
  a) 1 to 20
  b) 1 to 5
  c) 2 to 30
  d) 2 to 10

What should you do after giving the adult or child victim 2 full breaths?                                C
  a) Immediately give 3 more rapid breaths
  b) Turn the head to the side
  c) Allow the victim to exhale on his own
  d) Ask the victim his/her name

In adult CPR the 2 hands and 2 inches rule means                                                         B
    a) Lift 2 hands 2 inches between compressions
    b) With 2 hands interlaced compress the chest no more than 2 inches
    c) Always use 2 hands 2 inches apart
    d) Use 2 hands compressing the chest every 2 inches.

In child CPR which is correct in giving compressions?                                                    D
    a) 2 hands, 1 inch
    b) 1 hand, 3 inches
    c) 2 hands, 2 inches
    d) 1 hand, 2 inches

What should you do to check if the victim is breathing?                                                  A
  a) Look, listen and feel for exhaled air
  b) Cover the mouth and nose for 5 seconds
  c) Notice if face color has turned blue
  d) Place a mirror under the nose.

                                             Biomed Prep Test A – Pg 4 of 24
How is responsiveness checked for in an infant?                                                       A
  a) Patting feet/shoulders
  b) Shaking shoulders
  c) Blowing air on face
  d) Slightly slapping cheeks

What is the breaths to compresson ratio for an adult, child, or infant?                               C
  a) 2 breaths for every 20 compressions
  b) 1 breath for every 15 compressions
  c) 2 breaths for every 30 compressions
  d) 2 breaths for every 15 compressions

Which of the following is a patient‟s fundamental right under HIPAA?                                  A
   a) All of these answers
   b) The right to receive a notice about your privacy policies
   c) The right to access their medical information
   d) The right to limite the uses/disclosures of medical information

A patient consent agreement regarding their protected health information (PHI) must be                D
   a) Verbal
   b) Witnessed by a 3rd party
   c) Digital
   d) Written

The patient‟s written permission to disclose information for uses outside of treatment, payment and   D
health operations is
   a) Acknowledgment
   b) Privacy report
   c) Disclosure
   d) Authorization

An authorization o release protected health information can be revoked                                D
   a) Only within 60 days of signed authorization
   b) By telephone request
   c) It cannot be revoked under any circumstances
   d) If the requested action has not already taken place

When should a medical office‟s privacy policies and procedures be reviewed?                           C
  a) Before a new employee is hired
  b) When HIPAA regulations are amended
  c) Every year
  d) Every other year

A copy of an authorization to release protected health information is acceptable if                   A
   a) All of the required elements are included
   b) It is notarized
   c) It is legible
   d) Never acceptable

                                             Biomed Prep Test A – Pg 5 of 24
A patient request to amend their medical record can be done by                                            A
   a) Adding additional notes
   b) Crossing out certain information
   c) No changes can be done
   d) Changing medical entries

A medical practice can respond to a patient‟s request to amend a record                                   B
   a) When the physician has time
   b) Within 60 days
   c) Within 30 days
   d) Only if it does not affect patient care

The patient‟s written statement that he/she has received the notice of your privacy policies and          C
procedures is
   a) A privacy report
   b) A disclosure
   c) An acknowledgment
   d) An authorization

A patient consent agreement regarding their protected health information (PHI) must be signed             C
   a) After the health care provider‟s intake interview
   b) Within 10 days
   c) Before providing any service
   d) Within 60 days

If a patient requests a restriction on disclosing their PHI                                               D
     a) It must be notarized
     b) The health care provider must agree to it
     c) The patient cannot restrict disclosure
     d) It must be in writing

Which of the following is TRUE?                                                                           D
   a) A minor may obtain health care services without the consent of an adult
   b) A medical practice must require that personal representatives (parents/guardians) of minors
      comply with the same privacy rules as individuals do
   c) The personal representative (parent/guardian) can consent to an agreement of confidentiality
      between the minor and the medical practice
   d) All of these answers

The release, transfer, provision of access to or divulging in any manner information outside the entity   A
holding the information is
    a) Disclosure
    b) Authorization
    c) Acknowledgment
    d) Privacy report

When a patient requests copies of their medical records                                                   C
  a) Any amount can be charged
  b) $1 per copy can be charged
  c) A reasonable cost based fee for copying can be charged
  d) Retrieval fees and copying fees can be charged

                                              Biomed Prep Test A – Pg 6 of 24
A medical practice can refuse a patient‟s request to amend their medical record                         B
   a) If unrelated to patient care
   b) Under specific circumstances
   c) Only if insurance coverage is not affected
   d) Under no circumstances

Components of informed consent form include all of the following EXCEPT:                                C
  a) Alternative treatments for the patient
  b) The type of treatment for which informed consent is required
  c) Insurance provider
  d) The risk of treatment

Which of the following is a patient‟s fundamental right under HIPAA?                                    A
   a) all of these
   b) the right to request amendments to the medical record
   c) the right to revoke or limit authorization
   d) the right to get an accounting of PHI (protected health info) disclosures

When a patient requests access to their medical records which of the following statements is FALSE      A
  a) the original medical record must always be provided
  b) a copy of the record can be provided
  c) a fee must be agreed to in advance
  d) a summary can be provided if the record is too difficult to interpret

A patient consent agreement regarding their PHI must be                                                 B
   a) given to the patient
   b) filed in the patient‟s medical record
   c) filed in a separate file with all other patient‟s consent agreements
   d) notarized

A patient‟s consent to use and disclose their protected health information for the purpose of           C
treatment, payment, and health care operations needs to be obtained
    a) every year
    b) at the beginning of treatment and when patient is discharged
    c) once
    d) only when the patient authorizes release of their medical information

Penalties for disclosing PHI such as accidentally leaving a patient‟s chart on the reception desk for   B
others to see if reported are
   a) $10k per occurrence
   b) $100 or less per occurrence
   c) $100,000 per occurrence
   d) $1000 per occurrence

Individually Identifiable Health Information (IIHI) includes                                            B
    a) Diagnoses, procedures, symptoms
    b) All of these
    c) Name, address, phone number, email
    d) Insurance information such as employer or carrier

                                             Biomed Prep Test A – Pg 7 of 24
Which of the following statemtns is true regarding a deceased patient‟s PHI (protected health info)   A
   a) Subject to the same rules as all living patients
   b) Can be made public 100 years after death
   c) Can be made part of the public record
   d) Subject only to HIPAA citation 164.508

A doctor can speak directly about health and treatment information to any of the following EXCEPT     A
   a) To any family member
   b) Only to immediate family members unless the patient has explicitly indicated the contrary
   c) Only to a spouse unless the patient has explicitly indicted the contrary
   d) Referring physician

A deceased patient‟s PHI consent agreement expires                                                    C
   a) Depends on each state‟s regulations
   b) Twenty years after death
   c) Never
   d) At the time of death

Who is authorized to access or remove medical records?                                                A
  a) Only individuals whose job description states they may need access to medical records
  b) Staff members that the patient has agreed to in the consent form agreement
  c) Only the physician
  d) Nurse and physician

All privacy breaches to PHI must be                                                                   D
    a) Documented w/ the FPPA (Federal Privacy Protection Agency)
    b) Reported to the patient
    c) Reported to state regulators
    d) Documented and followed up on

Which statement is false about employee privacy training?                                             D
   a) New employees should be trained during orientation (effective 4/14/2003)
   b) Employee privacy training must be documented in the employees personnel file
   c) Employees are to receive training whenever a change in the privacy law will have an effect
      upon the performance of their job
   d) Employee privacy training must be repeated every year

The medical practice should document and maintain records of all disclosures of PHI for reasons       D
other than treatment, payment and health care operations (TPO) for a period of
   a) Three months
   b) Unto perpetuity
   c) Until the death of the patient
   d) At least 6 years

Who does HIPAA require to address and respond to a pt‟s request regarding PHI?                        C
  a) Lawyer
  b) Advocacy group
  c) Trained staff member
  d) Only the physician

                                            Biomed Prep Test A – Pg 8 of 24
The medical practice must have a process for using and disclosing PHI based on                     A
   a) HIPAAs consent and authorization agreements requirements
   b) The physician‟s lawyer recommendations
   c) The American medical association regulations
   d) State and local regulations

When should the medical practice review or update its privacy policies/procedures?                 B
  a) Only when HIPAA has made additions or changes to the regulations
  b) Every year
  c) Only when the medical office institutes a change to it‟s policy
  d) Every 3 years

Which statement is true about the medical practice personnel, such as the assistants and nurses,   C
having access to PHI?
   a) They have access to all patient‟s PHI
   b) There is no regulation
   c) They have access to the minimum PHI necessary to perform treatment
   d) They have access only to those portions of PHI that the patient has agreed to

Which of the following is the most accurate about PHI?                                             D
   a) Past, present or future payment information
   b) Dates for office visits, birth, admission, discharge, death
   c) Past, present or future physical or mental conditions
   d) Any information that may be used to identify a patient
   e) Name, address, social security number, phone, email

A notice of Privacy Practices outlining how PHI may be used must be made available upon request    C
   a) To patients and doctors
   b) Only to patients
   c) To patients and non-patients
   d) To any office staff which comes in contact with PHI

Criminal penalties for improperly disclosing patient health information can be as high as          B
   a) $500,000 and up to 5 years in prison
   b) $250,000 and up to 10 years in prison
   c) Varies from state to state
   d) 5 years in prison

Which statement is true?                                                                           A
   a) State privacy/security laws supercede HIPAA if state laws are stricter
   b) Which law takes precedence is still under appeal
   c) Whether state laws supercede HIPAA varies from state to state
   d) HIPAA laws always take precedence

A signed Business Associate contract is required with only                                         A
    a) Third party vendors who have access to PHI
    b) Transcription services
    c) Offsite disposal record storage or disposable storage
    d) Billing services and collection agencies

                                            Biomed Prep Test A – Pg 9 of 24
From all of the following about HIPAA, there are 3 which are recommendations and one which is a          B
HIPAA regulation/law. Choose the law
   a) The identity of the patients who call via telephone requesting scheduling, billing requests, lab
      results, etc. must be verified via patient provided confirming info such as DOB, SSN,
      mother‟s maiden name or other unique identifier.
   b) Only permit office personnel to view PHI whose job description states needed access to
      medical records
   c) All staff should log out of all programs containing PHI prior to leaving a computer unattended
   d) Protected health info must be rendered unreadable when it is destroyed

The following are HIPAA recommends except one which is a HIPAA regulation/law. Choose the law.           D
   a) When a privacy breach has occurred, a medical practice must put appropriate measure to
        prevent similar occurrences
   b) The medical practice should have policies to authenticate the recipients and senders of e-
        mail containing PHI
   c) Except in emergencies related to patient care, health care providers should not take medical
        records out of the practice.
   d) The practice should have a business associate contract with third party vendors who have
        access t PHI

The following are HIPAA recommends except one which is a HIPAA regulation/law. Choose the law.           C
   a) Appointment schedules should be placed out of sight from patients and other non-authorized
   b) A private area should be available for staff to discuss PHI with patients
   c) A Notice of Privacy Practices must be made easily visible in the office.
   d) Computer screens shd be facing away from pts or have screens that allow only straight on

The following are HIPAA recommends except one which is a HIPAA regulation/law. Choose the law.           B
   a) Exam room doors shd b closed while a provider is examining a patient or discussing PHI with
        a patient.
   b) Only PHI that is necessary for carrying out TPO (treatment, payment, health care operations)
        shd b transported to office satellite locations
   c) All phone calls that include a discussion of PHI must take place in a private area.
   d) All discussion and dictation of PHI should take place in a private area.

The following are HIPAA recommends except one which is a HIPAA regulation/law. Choose the law.           B
   a) To protect confidentiality, medical practices shd avoid using both first and last names
        together when calling pts back for treatment.
   b) A pt privacy consent form must be signed prior to providing any service.
   c) Patients should sign a consent allowing for answering machine/voice mail messages and
        other forms of contact.
   d) Correspondence to pts shd be labeled “Personal and Confidential” and if possible shd not
        identify the nature of the practice

The following are HIPAA recommends except one which is a HIPAA regulation/law. Choose the law.           A
   a) All medical records must be kept private and secure.
   b) Health care providers should not take phone calls pertaining to patients while in an exam
        room with another patient.
   c) All lab logs, X-ray folders or lab requests should be secured when not in use.
   d) All lab logs, X-ray folders or lab requests should be stored in areas that are not visible or
        accessible to non-authorized personnel.

                                           Biomed Prep Test A – Pg 10 of 24
The following are HIPAA recommends except one which is a HIPAA regulation/law. Choose the law.        D
   a) Only parties authorized to receive PHI under applicable law and the medical practice‟s
        privacy policies should receive PHI via a fax.
   b) All fax numbers should be confirmed prior to dialing.
   c) Fax machines should be located away from areas where patients or non-authorized persons
        may have visual access.
   d) Except otherwise authorized by law, a written authorization from the patient must be obtained
        prior to the release of PHI for purposes other than TPO (treatment, payment, health care

After the age of 40 how often do certain health organizations recommend prostate cancer               A
    a) Every year
    b) Every 2 years
    c) Every 6 months
    d) Every month

The daily recommended allowance (RDA) for sodium is:                                                  A
   a) 2400 mg per day
   b) 3000 mg per day
   c) 1000 mg per day
   d) 1500 mg per day

What is the most common cancer in the US?                                                             A
  a) Squamous cell and basal cell carcinomas
  b) Leukemia
  c) Colon cancer
  d) Lung cancer

What should you do when a fmale pt admits to being abused by her husband?                             B
  a) Tell her to bring her husband w/her at the next appt
  b) Offer info on safe shelters and counseling centers
  c) Call her husband and reprimand him
  d) Tell her to stand up for herself

Healthy weight has a BMI (body mass index) between                                                    D
   a) 15 and 18
   b) 26 and 35
   c) 20 and 26
   d) 19 and 25

Between the ages of 20 and 30 how often does the American Cancer Society recommend a clinical         A
breast exam?
   a) Every 3 years
   b) Every 6 monhts
   c) Every year
   d) Every 2 years

                                          Biomed Prep Test A – Pg 11 of 24
What is the lowest SPF (sun protection factor) recommended to protect against UV-B?   A
  a) 15
  b) 30
  c) 10
  d) 35

The 2nd most prevalent form of cancer is                                              D
   a) Leukemia
   b) Skin
   c) Lung
   d) Colorectal

When does the American Cancer Society recommend that clinical breast exams start?     C
  a) 35 years old
  b) 30 years old
  c) 20 years old
  d) 25 years old

The desired goal for a patient‟s LDL cholesterol level depends on:                    B
   a) Presence of smoking
   b) Risk factors
   c) Hypertension
   d) Familial history

The recommended blood pressure screening for healthy adults is generally:             C
   a) Every 6 months
   b) Once a year
   c) Once every 2 years
   d) Every month

Hepatitis A symptoms occur approximately how long after exposure?                     A
   a) 30 days
   b) 1 day
   c) 1 week
   d) 6 months

The leading cause of blindness for African Americans is                               A
   a) Glaucoma
   b) Diabetes
   c) Macular degeneration
   d) Smoking

When should testicular self-examination start?                                        C
  a) 40 years old
  b) 50 years old
  c) 15 years old
  d) 35 years old

                                           Biomed Prep Test A – Pg 12 of 24
The American Cancer Socity recommends clinician screening of the skin for persons 20-39 every       A
   a) Three years
   b) Year
   c) Five years
   d) Month

How long after smoking cessation do the disease risks from smoking drop significantly?              B
  a) 2 years
  b) 1 year
  c) 6 months
  d) 1 month

When should pap smear screenings start?                                                             D
  a) 40 years old
  b) 50 years old
  c) 35 years old
  d) 18 years old

Over the age of 50 colorectal screening is recommended                                              A
   a) every year
   b) every 3 years
   c) every 6 months
   d) every 2 years

From what age does the risk for prostate cancer increase?                                           C
   a) As men approach 60
   b) As men approach 30
   c) As men approach 50
   d) As men approach 40

What is the percentage of adults infected with Hep B that are asymptomatic?                         A
  a) 10%
  b) 40%
  c) 3%
  d) 25%

Do state licensing bodies have a right to medical records to assess charting and care?              C
   a) False in all states
   b) True in all states
   c) True in some states
   d) Determined on a case by case basis

Does the patient employer have the right to the patient‟s chart in a worker‟s compensation claim?   D
   a) Determined on a case by case basis
   b) True in all states
   c) False in all states
   d) True in some states

                                           Biomed Prep Test A – Pg 13 of 24
You are treating a famous rock star for substance abuse. The National Enquirer calls you to confirm    D
whether she is a patient being treated for substance abuse. What would you do?
   a) deny that she is a patient
   b) confirm that she is a patient being treated for a cocaine problem
   c) state that she is a patient but cannot divulge the reasons for seeing you
   d) refuse to deny or confirm that the person is a patient

A patient you treated for alopecia with 7star needles sues you for becoming infected with Hepatitis.   B
You are not at fault because you have sterilized the re-usable 7 star needles hammer through
boiling. What is correct?
    a) you are responsible because you did not autoclave
    b) you are responsible because the boiling water is not an acceptable method for sterilization
    c) you are not responsible because you have used sterilization after each treatment
    d) you are not responsible because none of your other patients have Hep B

You received a subpoena for the release of a patient‟s medical records. Which action is correct?       D
   a) Contact an attorney
   b) Release the information without a patient waiver
   c) Even with subpoena portions of the record can be protected
   d) A and C

Which is not true in regards to medical records                                                        D
   a) Records should be returned or destroyed after they have served their purpose
   b) Information about the pt given by phone should have a signed pt release and verification of
       the recipient
   c) Info regarding release of records should be maintained in the pts file
   d) Information about the patient can be sent thru email

Other providers in your clinic have a legitimate need to access a patient‟s chart. Which of the        A
following is correct
     a) Can be shared without patient waiver and no fee charged
     b) Can be shared without patient waiver and a fee should be charged
     c) Can be shared only with patient waiver
     d) Cannot be shared without patient waiver

An insurance company calls you to request one of your patient‟s medical records in order to            A
determine whether coverage should be extended. What would you do?
    a) Only disclose records if the insurance company gives you a written request from the patient
    b) Send the insurance company the records and charge no fee
    c) Do not give any information about your patient
    d) Send the insurance company the records and charge a fee

You make an error in your written medical notes. How should you correct it?                            C
   a) Write over the error and sign your signature
   b) Cross out the error and make a new entry
   c) Cross out the error, make a new entry, and sign your signature next to the change
   d) Erase the error

                                            Biomed Prep Test A – Pg 14 of 24
An agent from the Homeland Security requests one of your patient‟s medical records because your      A
patient has a criminal record. What would you do?
    a) Provide the medical records only if the agent has a written consent from your patient
    b) Do not give any information about your patient
    c) Provide the medical records
    d) Only share general contact information

One of your patients makes an explicit seductive move towards you. What should you do?               C
   a) Tactfully confront the patient and refuse
   b) Tell them it is inappropriate in the clinic but that you will see them outside of the clinic
   c) Tactfully confront the patient and make a note on the patient‟s record
   d) Tell them that you feel flattered

How long is an employer required to maintain confidential medical records?                           C
  a) Duration of employment + 10 years
  b) Duration of employment + 5 years
  c) Duration of employment + 30 yrs
  d) Duration of employment + 1 yr

When does the confidentiality of medical records end?                                                C
  a) After 50 years
  b) After 100 years
  c) It does not end
  d) After the death of the patient

Who can sign your medical notes?                                                                     C
  a) You or your assistant
  b) Anyone you give permission to
  c) Only you
  d) The nurse

When should medical records be written?                                                              A
  a) After treatment
  b) Within 48 hours
  c) Within 24 hours
  d) Within 36 hours

How long is the NCCAOM certification valid?                                                          A
  a) 4 years
  b) 2 years
  c) 3 years
  d) 1 year

What is the max time limit to comply with the auth to release med rec‟s?                             A
  a) 90 days
  b) 45 days
  c) 30 days
  d) 7 days

                                             Biomed Prep Test A – Pg 15 of 24
Which of the following is part of a standard release form?                                        D
   a) Pt‟s dated signature/auth for release
   b) Addressed to the acupuncturist and identity of patient
   c) What information is to be released and who is to receive the info
   d) A, B and C

What agency req‟s the employer to provide the Hep vaccine to all health professional employees?   D
  a) CDC
  b) FDA
  c) WHO
  d) OSHA

What is the length of time that medical records must be maintained?                               A
  a) Varies from state to state
  b) 5 years
  c) 15 years
  d) 7 years

You have made an error in recording your medical notes. Who can make corrections?                 D
   a) Nurse
   b) You or assistant
   c) Anyone you give permission to
   d) Only you

The owner of the NCCAOM certificate is                                                            C
   a) State regulating agencies
   b) Federal regulating agencies
   c) NCCAOM
   d) The certificate holder

What is the best way of disposing of medical records?                                             C
  a) Return them to the patient
  b) Have them picked up by a recycling company
  c) Shred or burn
  d) Throw them into a garbage can

Who does the medical record belong to?                                                            D
  a) The patient
  b) The doctor
  c) The state
  d) The health care provider

In the US a TCM college is accredited by                                                          B
    a) Federal office of education
    b) ACAOM
    c) AAAOM
    d) NCCAOM

                                           Biomed Prep Test A – Pg 16 of 24
Your patient‟s medical record states that he has a sexually transmitted disease. The state licensing     C
board of your state has the legal right to request this pt‟s medical records to evaluate a complaint
against you. What do you do?
   a) Refuse on the basis of confidentiality
   b) Send a copy of the records
   c) Call your lawyer and get specific consent from your patient
   d) Send the original records.

You have sold your acupuncture practice to another practitioner. What is the correct procedure for       A
transferring medical records?
    a) Notify former patients of the transfer of their records by letter
    b) No need to contact former patients about the transfer of their records
    c) Put a notice in the local newspaper
    d) Former patients need to approve the transfer of their medical records

From the time a stroke starts, how much time do emergency medical personnel have to mitigate the         C
fx of the stroke by using clot busting meds?
    a) 6 hours
    b) 1 hour
    c) 3 hours
    d) 12 hours

Mary‟s asthma has worsened in the past 3 days after catching a cold. All of the following indicate a     D
possible emergency except
   a) bluish lips
   b) hunched shoulders, sitting or standing up to breathe more easily
   c) use of bronchodilator every hour with little relief
   d) frequent wheezing/coughing
   e) breathlessness while lying down

A patient has a fever over 103 degrees F. Which of the following requires an immediate emergency         B
    a) Fever comes and goes, night sweats, swollen lymph nodes
    b) Severe headache, stiff neck, drowsiness, vomiting, eyes sensitive to light
    c) Short of breath, cough produces yellow, green or tan mucus
    d) Rash that is red, tender, and warm or a red streak on the arm/leg.

In a patient with a hx of hypertension, what is the baseline blood pressure value that can precipitate   D
hypertensive crisis requiring immediate medical attention?
    a) 200/140
    b) 210/150
    c) 160/100
    d) 180/120

A patient has developed calf pain after falling down and bruising her leg. The pain increases when       A
walking. There is swelling in the calf with redness on the spot. As of yesterday she began to have
dyspnea. What course of action would you take?
   a) Referral to ER
   b) Treat with Tuina for congealed blood
   c) Treat with acupuncture for stagnant blood
   d) Advise patient to see family doctor within the month

                                            Biomed Prep Test A – Pg 17 of 24
A hypertensive patient has shortness of breath, nausea, dizziness. Which type of pulse would             D
require an immediate emergency referral?                                                               (indic
   a) Irregular pulse at 90 bpm                                                                         vfib)
   b) Regular slow pulse at 50bpm lasting 30-60 min
   c) Regular fast pulse at 100 bpm lasting 20-30 min
   d) Irregular fast pulse at 200+bpm

Any of the following can be an indication of stroke except                                               A
   a) Inability to breathe
   b) Inability to smile
   c) Inability to say a complete sentence
   d) Inability to raise either arm or leg

All are cardinal symptoms of heart failure except:                                                       B
    a) Fatigue
    b) Chest pain
    c) Dyspnea
    d) Fluid retention

All of the following are neurological sx requiring a red flag referral except:                           C
    a) Acute and progressive diplopia
    b) Acute and progressive ataxia
    c) Acute and progressive sciatica
    d) Acute and progressive foot drop

In a patient with chest pain which would prompt you to make an immediate emergency referral?             B
    a) Chest pain from the breastbone increases with deep breaths, touch, movement
    b) Chest pain last longer than 4 minutes with sweating and feelings of dread
    c) Chest pain not worse with exertion, but worse swallowing very hot or cold substances
    d) Chest pain that burns and is worse lying down.

In a back pain pt which would prompt you to make an immediate emergency referral?                        B
    a) Back pain with leg weakness
    b) Back pain with bladder incontinence and saddle anaesthesia
    c) Back pain with numbness and tingling in the feet
    d) Sharp back pain with coughing/sneezing

A 27 y.o. medical student rec‟d acupuncture therapy for a right levator scapular muscle spasm. The       C
pt later calls the practitioner to say he does not feel right. He has chest pain, dyspnea and a non-
productive cough. What should the practitioner ask the pt to do?
     a) Make an appt with the family doctor
     b) Schedule an appointment to see practitioner tomorrow
     c) Go to the ER
     d) Don‟t worry, it will heal itself

A pt complains of sudden onset dyspnea. He has no hx of panic attx. Which of the following warrant       A
immediate emergency referral?
   a) Pt can‟t speak more than 2 words at a time
   b) Pt has weak inhalation, strong exhalation
   c) Pt has dyspnea after going up a flight of stairs
   d) Pt has strong inhalation, weak exhalation

                                             Biomed Prep Test A – Pg 18 of 24
Which of the following requires an emergency referral?                                                      D
   a) Migraine with aura that they‟ve never had before
   b) Migraine without aura
   c) Cluster headaches
   d) Severe sudden headache they‟ve never had before

Mary is a 32 year old female who just returned from China. Her flight was delayed multiple times.           D
She was in good health until coming home when she experienced a sharp left-sided chest pain and
SOB. Pain is worse with motion, deep breathing and is getting progressively worse. Now has left
shoulder pain, SOB and is apprehensive about dying. No cough, fever, sputum or hemoptysis. She
is married, is on OCP since the birth of the 3 year old. She smokes ½ pack of cigs/day. She should
be referred to the ER because she likely has:
    a) Aortic stenosis
    b) Myocardial infarction
    c) Tension pneumothorax
    d) Pulmonary embolism

A pt has sinusitis. Which requires an urgent ENT referral?                                                  B
   a) Pain is worse on bending forward
   b) Periorbital edema, diplopia, persistent fever
   c) Nonspecific pain radiating to the top of the head
   d) Purulent yellow or green nasal discharge

After a BM, visible blood is found on the toilet tissue of a 40 yo male. His family doc dx‟d internal and   C
external hemorrhoids. All of the following are possible complications of this except:
    a) Ulceration
    b) Anemia
    c) Constipation
    d) Thrombosis

Pt has a cough. Which of the following is the most immediate life threatening emergency?                    A
    a) Coughing frothy pink sputum, SOB, noisy bubbling breath
    b) Unintentional weight loss, SOB, cough, wheeze
    c) Cough that produces green mucus
    d) Fever, chills, night sweats + chest pain w/coughing or deep breaths

All of the following are causes of gross hematuria except:                                                  A
    a) Excessive use of ibuprofen
    b) Prostate cancer
    c) Vaginal trauma
    d) Renal lithiasis

Which type of headache can be a warning sign of potentially life-threatening conditions?                    D
   a) Chronic paroxysmal hemicrania
   b) Cluster headache
   c) Basilar migraine
   d) Thunderclap headache

                                            Biomed Prep Test A – Pg 19 of 24
A pt has epistaxis. Which of the following needs an urgent ENT referral (within 1-8 hours)                     D
   a) Blood out the left nostril
   b) Blood out the right nostril
   c) Bleeding won‟t stop with direct pressure after 2 minutes
   d) Blood going down the back of the throat.

Pt has excessive menstrual bleeding. Which of the following would require an immediate emergency               C
    a) Night sweats, dry throat, hypersomnia
    b) Nausea, hyperesthesia, migraine
    c) Diaphoresis, pallor, tachycardia
    d) Dyspnea, cough, shoulder pain

Pt has low grade fever and right lower quadrant abdominal pain. Which of the following would tend              A
to indicate a possible appendicitis?
     a) Asking patient to cough results in stabbing in lower right abdomen
     b) Pain started LLQ and moved to RLQ
     c) WBC count is 9000
     d) Pain started in RLQ and stayed in RLQ

Pt has severe ab pain with tense distended abdomen. There is tenderness to pressure, coughing,                 B
and body movements. Physical exam reveals an almost silent abdomen. What is the course of
    a) First treat with acupuncture then refer immediately
    b) Immediate emergency referral
    c) Refer within 1-3 days
    d) Wait 24 hours, reassess.

Pt has worsening flu. Which of the following requires an urgent med referral within 1-8 hours?                 A
    a) Fever with shaking chills, chest pain, labored breathing, thick mucus, fatigue, confusion
    b) Muscle aches, chills, sore throat, runny nose, cough, malaise
    c) Cough with sputum, lips/skin appear bluish sometimes, swollen legs or ankles, neck veins
    d) Pt is underweight, appears thin, breathes with pursed lips, increased respiratory rate w/
       hypertension, increased redness to skin

                            (above – a=pneumonia, b=flu sx, c=COPD blue bloater, d=COPD pink puffer
Pt has severe constant ab pain. All of the following are emergencies except:                                   B
    a) Pregnant woman with vaginal bleeding
    b) Pain in right abdomen, shifts to back, worses with fatty meals
    c) unremitting sharp pain starts in back near ribs and moves down to groin
    d) fever, right lower ab pain with superficial and deep tenderness.

                          (above a=ectopic preg/miscarry, b=gallstaones, c=ki stone/bl infx, d=appendicitis)
Patient has epistaxis. All of the following raise concern except:                                              D
    a) Signs of petechia or purpura
    b) Hypertension
    c) Bleeding not stopped by direct pressure
    d) Drying of mucosa due to cold weather
    e) Use of aspirin/ibuprofen

                                                 Biomed Prep Test A – Pg 20 of 24
Which of the following can indicate pneumothorax?                                                        A
   a) Sharp pain on 1 side of the chest when taking a deep breath
   b) SOB when physically active
   c) Bk pain that radiates around to the front of chst
   d) SOB and numbness around lips, hands, feet

The most common communication probs that pts complain about their health care prac include all of        A
the following except:
    a) Poor eye contact/low speaking voice
    b) Talking down to or over the pts head
    c) Interruptions or not listening
    d) Not answering q‟s or not spending enough time.

How long should appointment logs be kept?                                                                A
  a) They should be kept just beyond the statute of limitations
  b) They should be kept for a year
  c) They should be kept for 5 years
  d) They should be kept as long as the person remains a patient

Which of the following would you NOT use to establish rapport w/ a teenager?                             B
   a) Use transitional statements letting them know what you will ask about and do before you ask
      or do it.
   b) Use strategic silence to get them to talk.
   c) Start with specific directed questions
   d) Focus on them rather than the problem
   e) Summarize the pt‟s story in the course of the interview

What is the critical factor for patients filing malpractice claims?                                      D
  a) News reports
  b) Iatrogenic injury
  c) Clinical error
  d) The patient or patient‟s family

If a patient comes to you via a referral from their medical doctor, which of the following should you    C
     a) Be clear about how your malpractice insurance will handle the situation if there is litigation
     b) Treat based on their western dx
     c) Find out the purpose of the referral
     d) Do a TCM evaluation

You receive a medical request for the HIV status of one of your patients. Which of the following         D
statements is true?
    a) Release the info as it is a sexually transmitted ds that needs to be federally doc‟d
    b) Fulfill the request as the pt has already signed an informed consent release
    c) You need to consult w/ your lawyer before releasing such sensitive information
    d) Patients must consent separately to the release of information regarding HIV status

                                              Biomed Prep Test A – Pg 21 of 24
You disagree with an entry into the medical record made by another member of the health care team     D
but that person stands by their entry. Which of the following actions would you take?
    a) File an incident report in the medical record
    b) Make a note in the medical record that you disagree
    c) No longer personally continue to treat the pt or let other members of the team follow up
    d) Discuss and resolve the issue verbally and personally w/ him/her or in a peer review setting

A physician you have referred your patient to asks for the medical records. Which of the following    D
actions would you not take?
    a) log into the chart what, when, and to whom the records were provided
    b) get the pt‟s written permission
    c) make a copy of the records to give to the physician
    d) transfer or loan the original record to the physician

Which of the following is false about medical records?                                                A
   a) Medical records are primarily a legal document
   b) Medical records document treatment for payment purposes
   c) Medical records are a source of information about communicable diseases
   d) Medical records document quality of care

How long should medical records and other forms of documentation be kept?                             D
  a) 10 years
  b) 5 years
  c) Indefinitely
  d) Varies from state to state

You use a transcription service for your dictated medical records. Which of the following actions     C
should you take?
   a) Write dictated but not read
   b) Stamp the document as read
   c) Review, initial, and date the document
   d) No other action is necessary

Informed consent is not required in an emergency situation if all of the following apply except:      A
    a) The treating physician can receive permission from the pt‟s primary care physician
    b) No close family member is available to give consent on behalf of the pt
    c) The physician has no evidence to suggest that the pt would oppose treatment
    d) Delay in tx would be life threatening

If it is your first DUI, as an NCCAOM diplomate                                                       C
      a) You need not report it unless there was an injury or loss of life
      b) You need to report to the NCCAOM only if it involves your state regulatory agency
      c) You need to report it to the NCCAOM
      d) You need not report it to NCCAOM as it si non-practice related

According to NCCAOM code of ethics how much time must elapse after the pt-prac relationship           B
ends before a practitioner can have a sexual relationship w/ a former patient?
   a) one year
   b) six months
   c) two years
   d) never

                                            Biomed Prep Test A – Pg 22 of 24
A state regulatory agency has sanctioned an acupuncturist. The acupuncturist then voluntarily         D
forfeits their NCCAOM certificate to avoid the NCCAOM sanctioning process. Which of the following
statements is true?
    a) she can still be sanctioned by the NCCAOM but not have her name published
    b) the NCCAOM can sanction her only within 30 days after the state issues their finding
    c) the NCCAOM cannot sanction someone who has forfeited their certificate
    d) she will be sanctioned by the NCCAOM and have her name published

You refer a pt to another practitioner. After a year this practitioner is sued by the pt for sexual   A
misconduct. Which of the following statements is correct?
   a) It has the possibility of negligent referral
   b) You are not responsible as too much tie has elapsed between the referral and the charge
   c) You are not responsible as the pt has become the responsibility of the other practitioner
   d) You are responsible for the behavior of the practitioners you refer to.

the NCCAOM professional discipline governs                                                            C
    a) Personal behavior relating to practicing acupuncture
    b) Competency
    c) Character and competency
    d) Character

When does the doc/pt relationship begin?                                                              C
  a) During the intake
  b) After they sign the consent form
  c) As soon as you give advice
  d) When the appointment is made

For which of the following sanctions will the NCCAOM not publish the person‟s name?                   B
   a) Suspension
   b) Letter of reprimand
   c) Probation
   d) Letter of censure

What would you say to a persistently seductive patient?                                               C
  a) I can only have a sexual relationship with you after our treatments are over
  b) We can only have a casual relationship outside of our treatment
  c) I can no longer treat you b/c you cannot acknowledge that I cannot be anything more than
      your practitioner
  d) I cannot have a romantic relationship with you

A practitioner has rec‟d an NCCAOM letter of censure. Which of the following will NCCAOM not do?      A
   a) Notify malpractice carriers
   b) Notify state regulatory agencies
   c) Publish the name on its‟ website
   d) Publish the name in its‟ newspapers

                                            Biomed Prep Test A – Pg 23 of 24
An acupuncturist rec‟d a complaint from their state regulatory agency that is later dismissed. Which   D
of the following statements is true?
    a) Need not be reported b/c NCCAOM and state regulatory agencies operate as independent
    b) State agency will report complaint and dismissal to NCCAOM
    c) As the complaint was dismissed it needs not be reported to NCCAOM
    d) You will be sanctioned by the NCCAOM if you don‟t report it to them.

An acupuncture student, a non- NCCAOM diplomate, needles a friend outside of clinical supervision      B
and does not ask for payment for treatment. Has the acupuncturist endangered their future
NCCAOM certification?
   a) No – no money has changed hands
   b) Yes – violation of the code of ethics prior to cert is not a defense.
   c) No – they weren‟t NCCAOM certified at the time
   d) No – it was between friends

What does a letter terminating the doc/pt relationship need not include?                               A
  a) The exact reason why you cannot provide care
  b) State that you can no longer provide effective service
  c) Provide referrals
  d) Keep whatever appointment is already there

If you are in a probation with both a state and the NCCAOM and the probation period is over:           D
     a) The state removes your name, but NCCAOM doesn‟t
     b) NCCAOM will remove your name after a 1 year period
     c) Both NCCAOM and the state remove your name
     d) NCCAOM removes your name, the state doesn‟t

If you are subject to an ongoing NCCAOM investigation no outside individual can inquire about it.

                                           Biomed Prep Test A – Pg 24 of 24

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