HIPAA Practice Questions

Question 1

A 42-year-old woman presents to the physician with symptoms of vague abdominal pain and bloating for several months. Test results indicate that she has ovarian cancer. Her physician attempts to reach her by phone multiple times but cannot reach her. Next of kin numbers are in her chart. According to HIPAA regulations, who should be the primary person the doctor discusses this information with?

Accepted Answer

The patient

Answer

The patient's brother

Answer

The patient's husband

Answer

The patient's daughter

Answer

All of the options

Question 2

A 19-year-old man presents to an orthopedic surgeon to discuss repair of his torn anterior cruciate ligament. He suffered the injury during a college basketball game 1 week ago and has been using a knee immobilizer since the accident. His past medical history is significant for an emergency appendectomy when he was 12 years of age. At that time, he said that he never wanted to have surgery again. At this visit, the physician explains the procedure to him in detail including potential risks and complications. The patient acknowledges and communicates his understanding of both the diagnosis as well as the surgery and decides to proceed with the surgery in 3 weeks. Afterward, he signs a form giving consent for the operation. Which of the following statements is true about this patient?

Accepted Answer

He has the right to revoke his consent at any time

Answer

He cannot provide consent because he lacks capacity

Answer

His parents also need to give consent to this operation

Answer

He did not need to provide consent for this procedure since it is obviously beneficial

Answer

His consent is invalid because his decision is not stable over time

Question 3

A 28-year-old woman dies shortly after receiving a blood transfusion. Autopsy reveals widespread intravascular hemolysis and acute renal failure. Investigation reveals that she received type A blood, but her medical record indicates she was type O. In a malpractice lawsuit, which of the following elements must be proven?

Accepted Answer

Duty, breach, causation, and damages

Answer

Only duty and breach

Answer

Only breach and causation

Answer

Duty, breach, and damages

Question 4

A 75-year-old nursing home resident presents with multiple unexplained bruises in various stages of healing on the upper arms and inner thighs. The patient appears withdrawn and anxious when staff members enter the room. Which of the following is the most appropriate next step?

Accepted Answer

Report suspected abuse to adult protective services

Answer

Request psychiatric consultation

Answer

Prescribe anti-anxiety medication

Answer

Schedule follow-up in one week

Question 5

A 28-year-old male presents to his primary care physician with complaints of intermittent abdominal pain and alternating bouts of constipation and diarrhea. His medical chart is not significant for any past medical problems or prior surgeries. He is not prescribed any current medications. Which of the following questions would be the most useful next question in eliciting further history from this patient?

Accepted Answer

"Can you tell me more about the symptoms you have been experiencing?"

Answer

"Does the diarrhea typically precede the constipation, or vice-versa?"

Answer

"Is the diarrhea foul-smelling?"

Answer

"Please rate your abdominal pain on a scale of 1-10, with 10 being the worst pain of your life"

Answer

"Are the symptoms worse in the morning or at night?"

Question 6

A 65-year-old man is admitted to the hospital because of a 1-month history of fatigue, intermittent fever, and weakness. Results from a peripheral blood smear taken during his evaluation are indicative of possible acute myeloid leukemia. Bone marrow aspiration and subsequent cytogenetic studies confirm the diagnosis. The physician sets aside an appointed time-slot and arranges a meeting in a quiet office to inform him about the diagnosis and discuss his options. He has been encouraged to bring someone along to the appointment if he wanted. He comes to your office at the appointed time with his daughter. He appears relaxed, with a full range of affect. Which of the following is the most appropriate opening statement in this situation?

Accepted Answer

What is your understanding of the reasons we did bone marrow aspiration and cytogenetic studies?

Answer

Your lab reports show that you have an acute myeloid leukemia

Answer

You must be curious and maybe even anxious about the results of your tests.

Answer

I may need to refer you to a blood cancer specialist because of your diagnosis. You may need chemotherapy or radiotherapy, which we are not equipped for.

Answer

Would you like to know all the details of your diagnosis, or would you prefer I just explain to you what our options are?

Question 7

A 23-year-old woman presents to the emergency department with acute alcohol intoxication. Her blood alcohol level is 280 mg/dL. She becomes increasingly agitated and attempts to leave against medical advice. Which of the following determines her capacity to refuse treatment?

Accepted Answer

Understanding of risks and benefits

Answer

Age of the patient

Answer

Family's wishes

Answer

Blood alcohol level

Question 8

A 34-year-old man presents to the local clinic with a 2 month history of midsternal chest pain following meals. He has a past medical history of hypertension. The patient takes lisinopril daily. He drinks 4–5 cans of 12 ounce beer daily, and chews 2 tins of smokeless tobacco every day. The vital signs are currently stable. Physical examination shows a patient who is alert and oriented to person, place, and time. Palpation of the epigastric region elicits mild tenderness. Percussion is normoresonant in all 4 quadrants. Murphy’s sign is negative. Electrocardiogram shows sinus rhythm with no acute ST segment or T wave changes. The physician decides to initiate a trial of omeprazole to treat the patient’s gastroesophageal reflux disease. How can the physician most effectively assure that this patient will adhere to the medication regimen?

Accepted Answer

Have the patient repeat back to the physician the name of the medication, dosage, and frequency

Answer

Instruct the patient to purchase a weekly pill organizer

Answer

Provide the patient with details of the medication on a print-out

Answer

Contact the pharmacist because they can explain the details more thoroughly

Answer

Tell the patient to write the medication name, dosage, and frequency on their calendar at home

Question 9

A 68-year-old man comes to the emergency department because of sudden onset abdominal pain for 6 hours. On a 10-point scale, he rates the pain as a 8 to 9. The abdominal pain is worst in the right upper quadrant. He has atrial fibrillation and hyperlipidemia. His temperature is 38.7° C (101.7°F), pulse is 110/min, and blood pressure is 146/86 mm Hg. The patient appears acutely ill. Physical examination shows a distended abdomen and tenderness to palpation in all quadrants with guarding, but no rebound. Murphy's sign is positive. Right upper quadrant ultrasound shows thickening of the gallbladder wall, sludging in the gallbladder, and pericolic fat stranding. He is admitted for acute cholecystitis and grants permission for cholecystectomy. His wife is his healthcare power of attorney (POA), but she is out of town on a business trip. He is accompanied today by his brother. After induction and anesthesia, the surgeon removes the gallbladder but also finds a portion of the small intestine is necrotic due to a large thromboembolism occluding a branch of the superior mesenteric artery. The treatment is additional surgery with small bowel resection and thromboendarterectomy. Which of the following is the most appropriate next step in management?

Accepted Answer

Proceed with additional surgery without obtaining consent

Answer

Decrease the patient's sedation until he is able to give consent

Answer

Contact the patient's healthcare POA to consent

Answer

Ask the patient's brother in the waiting room to consent

Answer

Close the patient and obtain re-consent for a second operation

Question 10

An 11-month-old girl presents to a pediatrician with her mother who is concerned about a red discoloration with a rectangular shape over the child’s left buttock presenting since the previous night. The mother also mentions that her daughter has been crying excessively. There is no history of decreased breast feeding, fever, joint swelling, vomiting, decreased urine output, or change in color of urine or stools. The mother denies any history of injury. However, she mentions that the infant had suffered from a self-limiting upper respiratory infection three weeks before. There is no history of bruising or bleeding in the past. The mother informs the doctor that she has a brother (the patient’s maternal uncle) with hemophilia A. On physical examination, the girl’s temperature is 37.0°C (98.6°F), pulse rate is 160/min, and respiratory rate is 38/min. The lesion presents over the left buttock and is tender on palpation. What is the most likely diagnosis?

Accepted Answer

Abusive bruise

Answer

Erythema multiforme minor

Answer

Hemophilia

Answer

Idiopathic thrombocytopenic purpura

Answer

Diaper dermatitis

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