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NEW QUESTION # 82
Which of the following can be considered evidence in a malpractice claim?
* photographs of injuries
* thank you note from the patient to the physician
* patient journal of the hospital stay
* gift from the patient to a volunteer
Answer: A
Explanation:
According to Health Care Risk Management standards supported by ASHRM and the American Hospital Association Certification Center, evidence in a malpractice claim includes any relevant material that may help establish facts related to duty, breach, causation, or damages. Photographs of injuries are routinely admissible as demonstrative or documentary evidence to illustrate the nature and extent of harm. A thank you note from a patient to a physician may be introduced to reflect the patient's contemporaneous perception of care, credibility, or satisfaction at a particular time, depending on context. A patient's personal journal documenting experiences during hospitalization may also be considered evidence, particularly if it describes symptoms, interactions, or emotional distress relevant to damages.
A gift from a patient to a volunteer, however, is generally not probative of negligence or injury unless directly tied to issues of undue influence or misconduct. In typical malpractice litigation, such a gift does not establish standard of care, breach, or damages and would not ordinarily be considered relevant evidence.
Claims and litigation objectives emphasize careful documentation, preservation of relevant materials, and coordination with counsel regarding evidentiary matters. Therefore, photographs, written communications, and patient journals may be considered evidence in a malpractice claim.
NEW QUESTION # 83
A physician dies upon arrival to the emergency department from her home following a gunshot wound to the chest. The police report a history of domestic violence. The organization is required to notify the
Answer: C
Explanation:
According to Health Care Risk Management standards supported by ASHRM and the American Hospital Association Certification Center, deaths resulting from violent, traumatic, or suspicious circumstances are legally reportable to the appropriate medico-legal authority, typically the Office of the Medical Examiner or Coroner. A gunshot wound constitutes a violent and potentially criminal cause of death, triggering statutory reporting requirements.
When a patient is pronounced dead on arrival due to trauma, particularly with a history suggestive of domestic violence, the death falls within the jurisdiction of the medical examiner. The medical examiner has authority to determine cause and manner of death, order autopsy if indicated, and coordinate with law enforcement to preserve forensic evidence. Hospitals are required by state law to notify this office promptly.
The state Board of Medicine oversees professional licensure and discipline, not death investigation. The Department of Health and Family Services may have reporting roles for public health matters, but traumatic deaths are typically handled by the medical examiner. The public relations department may manage communications but is not a regulatory notification requirement.
Legal and regulatory objectives emphasize compliance with mandatory reporting statutes and preservation of evidence. Therefore, the appropriate entity to notify is the Office of the Medical Examiner.
NEW QUESTION # 84
Whenever possible, medication orders should be by:
Answer: C
Explanation:
Ordering by cleardose(with units, route, frequency, and indication when needed) reduces ambiguity and prevents common medication errors such as wrong concentration, wrong formulation, or misunderstood shorthand. Risk management objectives emphasize "closed-loop" medication communication: standardized ordering, read-back for limited verbal orders, and minimizing abbreviations that cause confusion (sound-alike drug names, numeric mishearing like 15 vs 50). Patient safety frameworks consistently identify unclear orders as a high-frequency contributor to adverse drug events; therefore, explicit dosing is a core reliability practice.
When dose is specified precisely and entered via CPOE (preferred), organizations reduce transcription errors, improve pharmacy verification, and enable automated safety checks. Clear dosing also supports legal defensibility by documenting rational prescribing aligned with standards of care.
NEW QUESTION # 85
Which of the following factors should be considered when setting or adjusting indemnity reserves?
* incurred medical expenses
* emotional pain and suffering
* medical expert witness costs
* future cost of medical care
Answer: C
Explanation:
According to Health Care Risk Management principles established by ASHRM and the American Hospital Association Certification Center, indemnity reserves represent the estimated amount the organization expects to pay in settlement or judgment to a claimant. Indemnity refers specifically to damages paid to compensate the injured party, not defense or administrative expenses.
Incurred medical expenses are a core component of economic damages and must be included in indemnity reserve calculations. Emotional pain and suffering fall under non-economic damages and are also considered when estimating potential settlement or verdict value. Future cost of medical care is another essential factor, particularly in cases involving long-term injury or disability, as it represents projected economic damages that may substantially increase exposure.
Medical expert witness costs, however, are categorized as defense expenses and are typically included in allocated loss adjustment expenses rather than indemnity reserves. These costs relate to the defense of the claim rather than compensation to the plaintiff.
Risk management objectives emphasize accurate differentiation between indemnity and expense reserves to ensure proper financial reporting and regulatory compliance. Therefore, incurred medical expenses, pain and suffering, and future medical costs should be considered when setting indemnity reserves, while expert witness costs should not.
NEW QUESTION # 86
A risk manager identifies a problem with the informed consent process in the organization. All of the following are appropriate interventions EXCEPT
Answer: B
Explanation:
According to Health Care Risk Management standards endorsed by ASHRM and the American Hospital Association Certification Center, system-level issues in the informed consent process should first be addressed through quality improvement and educational interventions rather than immediate punitive action.
Conducting a medical record audit is an appropriate first step to identify patterns of incomplete documentation and determine whether the problem is isolated or systemic. Reviewing and revising policies and procedures ensures alignment with current legal standards and clarifies responsibilities for obtaining and documenting consent. Providing targeted education to physicians, nurses, and office staff reinforces understanding of required elements, including discussion of risks, benefits, alternatives, and patient questions.
Reporting physicians with incomplete consent forms directly to peer review may be appropriate in cases of persistent noncompliance or willful disregard of standards. However, when a systemic process problem is identified, immediate referral to peer review is not the appropriate primary intervention and may undermine a just culture approach.
Clinical and patient safety objectives emphasize root cause identification, education, and process improvement before disciplinary escalation. Therefore, reporting physicians to peer review in this context represents the inappropriate intervention.
NEW QUESTION # 87
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