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NEW QUESTION # 37
A clear directive to a nurse is:
Answer: C
Explanation:
Clear directives are specific, measurable, and time-bound-reducing ambiguity and variability that drive frontline error. "Monitor every so often" becomes safer when translated into a defined interval (e.g., every 15 minutes for the first hour, then hourly), with documentation requirements and escalation triggers. Risk management objectives emphasize standard work and reliable monitoring for high-risk equipment such as infusion pumps because device malfunction or programming errors can rapidly cause harm. Clear directives also support accountability and defensibility: they demonstrate the organization defined expectations and trained staff accordingly. Vague instructions ("be careful") do not reliably change behavior or outcomes. In high-reliability care, clarity is a safety barrier: it reduces cognitive load, prevents missed steps, and improves handoffs between staff by making the plan visible and verifiable.
NEW QUESTION # 38
An organization's chief of orthopedics has scheduled an implant of a new artificial hip for the next day. The chief developed the artificial hip while working as a consultant for a medical device company. The device has not yet been approved by the FDA or the Institutional Review Board. The risk manager's best immediate course of action is to
Answer: B
Explanation:
Under Health Care Risk Management standards supported by ASHRM and the American Hospital Association Certification Center, the implantation of a medical device that lacks FDA approval and Institutional Review Board oversight presents significant legal and regulatory violations. Use of an unapproved device outside of an approved investigational protocol may violate federal regulations governing human subject research and medical device approval processes.
The risk manager's primary responsibility is to immediately mitigate regulatory and liability exposure.
Because the procedure is scheduled for the next day, urgent intervention is required. Contacting the FDA would not resolve the immediate risk. Verifying informed consent is insufficient, as patient consent cannot legitimize use of an unapproved device outside regulatory pathways. Calling a special IRB meeting would not retroactively authorize an unapproved device without appropriate investigational device exemption processes.
Escalating the issue to the chief of surgery to halt or cancel the procedure is the most appropriate immediate step. This ensures that organizational leadership addresses the compliance violation before patient harm occurs. Risk management objectives emphasize proactive prevention of regulatory breaches, protection of patient safety, and preservation of institutional integrity. Therefore, stopping the procedure is the correct and immediate action.
NEW QUESTION # 39
A hospital is a defendant in a recently filed lawsuit involving a child with seizures and flaccid paresis, allegedly arising from negligent care during delivery 10 years ago. The plaintiff is seeking $10 million. At the time of the alleged negligence, the hospital had first dollar coverage through a commercial carrier.
Which of the following steps should the risk manager take to determine coverage before discussion with the hospital CEO and CFO?
* Review the current policy and the policy in effect for the year the delivery occurred.
* Determine whether the applicable policy is occurrence or claims made.
* Identify co-defendants insurance coverage.
* Discuss the coverage issues with the defense lawyer.
Answer: B
Explanation:
According to Health Care Risk Management standards supported by ASHRM and the American Hospital Association Certification Center, determining coverage requires careful review of the applicable insurance policies and policy structure. Because the alleged negligence occurred 10 years earlier, the risk manager must first review both the current policy and the policy in effect at the time of the delivery. Coverage depends on the specific policy terms, limits, endorsements, and retroactive dates applicable during the relevant policy period.
It is also critical to determine whether the policy is written on an occurrence or claims-made basis. Under an occurrence policy, coverage is triggered by the date of the incident, regardless of when the claim is filed.
Under a claims-made policy, coverage depends on when the claim was reported and whether appropriate tail or extended reporting coverage exists.
Identifying co-defendants' coverage may be relevant to contribution or indemnification but does not determine the hospital's own coverage. Discussion with defense counsel may assist in strategy but should follow preliminary internal coverage analysis.
Risk financing objectives emphasize accurate policy review and understanding of trigger mechanisms before executive discussions. Therefore, reviewing the relevant policies and determining policy type are essential first steps.
NEW QUESTION # 40
If no specific OSHA standard applies to a given potential health hazard, then
Answer: A
Explanation:
According to Health Care Risk Management standards outlined by ASHRM and the American Hospital Association Certification Center, the Occupational Safety and Health Act includes a provision known as the General Duty Clause. This clause requires employers to furnish a workplace free from recognized hazards that are causing or are likely to cause death or serious physical harm, even when no specific OSHA standard addresses the hazard.
The General Duty Clause grants OSHA authority to cite employers for unsafe conditions not explicitly covered by a detailed regulation. To issue a citation under this clause, OSHA must demonstrate that a recognized hazard exists, that the hazard poses a risk of serious harm, and that feasible methods exist to correct or mitigate the hazard.
Therefore, OSHA retains enforcement authority even in the absence of a specific standard. The agency's jurisdiction does not disappear simply because no detailed regulation addresses the particular risk.
Legal and regulatory objectives in healthcare risk management emphasize maintaining compliance with federal occupational safety laws and proactively identifying workplace hazards. Accordingly, OSHA may govern the hazard under the General Duty Clause when no specific standard applies.
NEW QUESTION # 41
A claims manager needs to open a loss reserve and perform an investigation of an event. They review the patient demographics, the nature and extent of the injury, and other liability factors. Which of the following would be helpful to the claims manager in determining a loss reserve?
Answer: C
Explanation:
Within Health Care Risk Management practice as outlined by ASHRM and the American Hospital Association Certification Center, establishing an accurate loss reserve requires an estimation of the probable financial exposure associated with a claim. A loss reserve represents the anticipated cost to resolve a claim, including indemnity payments and defense expenses.
Comparable verdicts in the county are particularly useful because they reflect jurisdiction-specific jury tendencies, local legal climate, and historical award patterns. Venue significantly influences claim valuation, as jury awards can vary substantially between counties and states. Reviewing similar case outcomes allows the claims manager to benchmark potential settlement or verdict ranges based on injury severity and liability factors.
The surgery center's claims history may inform overall risk trends but does not directly determine the value of a specific claim. The patient's total medical bills are relevant but represent only one component of damages and do not account for non-economic damages such as pain and suffering. The insurance limit per occurrence defines maximum exposure but does not guide the realistic reserve estimate unless damages approach policy limits.
Therefore, analysis of comparable local verdicts is most helpful in establishing an appropriate and defensible loss reserve.
NEW QUESTION # 42
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