Case Closed Volume 2 (Second Edition) CME — test questions

Improper performance

1. With respect to physicians, negligence means failure to use ordinary care — that is, failure to do that which a physician of ordinary prudence would have done under similar circumstances or doing that which a physician of ordinary prudence would not have done under similar circumstances.

   1. true
   2. false
    
   
   

2. To avoid claims related to improper performance, it is recommended that physicians:

   1. delegate tasks such as explaining the risks and benefits of a procedure and obtaining informed consent to nursing staff
   2. maintain a complete, comprehensive medical record for each patient that includes the physician's rationale for treatment decisions
   3. minimize documentation — it could be used as incriminating evidence later
   4. make it clear to patients that seeking a second opinion from another physician would be a waste of time
    
   
   

3. When a patient is cared for my multiple physicians, some with differing opinions, it is advantageous for one physician to function as the primary coordinator with all of the information available.

   1. true
   2. false
    
   
   

Communication errors

4. When reporting test results to an ordering physician over the telephone, it is also advisable to fax or email a copy of the report directly to the physician.

   1. true
   2. false
    
   
   

5. An example of a communication error that can lead to litigation is:

   1. failure to inform the patient of the need for further testing
   2. failure to notify the referring physician when test results are abnormal
   3. making critical remarks about a patient's previous physician/treatment in front of the patient or in the medical record
   4. all of the above
    
   
   

6. Physicians who order tests or consults hold the responsibility to review those reports, and if necessary contact the consultant to obtain further information.

   1. true
   2. false
    
   
   

Medical record errors

7. After reviewing patient reports (lab, imaging, reports from consultants), physicians are encouraged to initial and date those reports to verify that they were indeed reviewed before being placed in the patient's medical record.

   1. true
   2. false
    
   
   

8. To avoid medical record errors, physicians can:

   1. review and "correct" the medical record after being served with a notice of claim
   2. have the patient or the patient's family members review the chart at the conclusion of each visit
   3. use electronic medical records
   4. confirm that test results are filed correctly in a patient's chart by verifying the name on the report
    
   
   

9. Which of the following is not true about medical record documentation:

   1. failure to document conversations with patients and family members on which important health care decisions are made can compromise a physician's defense
   2. documentation should be minimal; you can rely on memory if a malpractice claim occurs
   3. illegible documentation can lay the foundation to question the quality of care
   4. any recommendations for care and any refusal by the patient to obtain that care should be documented in detail in the medical record
    
   
   

Failure to follow up

10. Documenting a patient's noncompliant behavior in the medical record may help to defend physicians against claims alleging failure to follow up.

    1. true
    2. false
     
    
    

11. Taking steps to rule out potentially serious or life-threatening diagnoses can:

    1. be required only when the patient seeks treatment in the emergency department
    2. improve patient outcomes
    3. make physicians more defensible in the event of a claim
    4. b and c
     
    
    

12. "I don't have time to review all reports that are sent to my office" is an effective explanation for allegations of failure to follow up.

    1. true
    2. false
     
    
    

Diagnostic errors

13. When served with a notice of claim, many physicians may be tempted to add information to the medical record that they believe will assist in their defense. While this information may accurately reflect what occurred, the addition of such information after the event:

    1. is detrimental to the defense of the physician
    2. seriously jeopardizes the physician's credibility
    3. is acceptable only when the late entry is witnessed by other medical personnel
    4. a and b
     
    
    

14. Common allegations in claims involving diagnostic errors include:

    1. failure to fully evaluate the patient's symptoms
    2. failure to refer or obtain a consultation
    3. failure to follow up on test results
    4. all of the above
     
    
    

15. Patients with severe and continuous complaints of undetermined etiology may require:

    1. further diagnostic testing
    2. a referral or consult with the appropriate specialist
    3. admission to the hospital for observation or to rule out a serious condition
    4. all of the above
     
    
    

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Date: 02-09-2012

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