CPHRMテストガイドは、時間の無駄を避けるために、できるだけ早くこれらの資料を学習できることを保証できます。 Certified Professional in Health Care Risk Management (CPHRM) Study Questionは、不明瞭な概念を簡素化することにより、学習方法を最適化するのに役立ちます。 CPHRM試験問題は、アフターサービスを完璧にするための努力をspareしみません。
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質問 # 47
A root cause analysis of inpatient suicides would be most likely to discover problems with:
正解：B
解説：
Inpatient suicide prevention is a high-stakes patient safety domain where RCAs frequently identify environmental hazards-particularly ligature risks, blind spots, and unit design that limits observation. Joint Commission-style reviews and published analyses note that thephysical environmentis commonly
"incriminated" in inpatient suicides, emphasizing design/engineering controls alongside clinical monitoring.
Risk management objectives prioritize layered defenses: ligature-resistant fixtures, environmental rounding, safe room standards, removal control for risky items, and observation policies matched to patient risk.
Environmental mitigation is especially powerful because it reduces reliance on perfect human vigilance (which is not realistic). By treating suicide prevention as a systems problem-not an individual failure- organizations improve reliability and reduce recurrence. Environmental corrections also strengthen regulatory readiness and demonstrate that the facility addressed known hazards with sustainable controls.
質問 # 48
A 78-year-old patient in the ICU is unable to speak or swallow. The physician states that she is terminally ill and believes she lacks decision-making capacity. As such, he has deferred to her properly executed advance directive that clearly outlines her wishes for no life-prolonging treatment. The patient's three sons know of the directive, but insist that a PEG tube be placed to assist with feeding. The physician is opposed to placing the tube. The nurse calls the risk manager for advice. Which of the following should the risk manager advise?
正解：A
解説：
Under Health Care Risk Management principles recognized by ASHRM and the American Hospital Association Certification Center, a properly executed advance directive carries legal authority when a patient lacks decision-making capacity. The physician has assessed that the patient is terminally ill and lacks capacity, triggering activation of the advance directive. If the directive clearly states refusal of life-prolonging treatment, including artificial nutrition and hydration, those wishes must be honored in accordance with state law and the Patient Self-Determination Act framework.
Patient autonomy is a foundational ethical and legal principle in health care. Once capacity is lost, previously expressed wishes through a valid advance directive govern care decisions. Family members do not have authority to override a valid directive unless legal defects or ambiguity exist. Their disagreement does not negate the patient's documented preferences.
Although ethics consultation can be helpful in managing conflict, the directive here is described as properly executed and clear. Additional determination of capacity is unnecessary because the physician has already made that assessment.
Risk management objectives emphasize compliance with advance directive statutes, respect for patient autonomy, and reduction of liability through adherence to documented patient wishes. Therefore, the appropriate advice is to support the physician in honoring the advance directive.
質問 # 49
A healthcare entity has a large fleet of vehicles driven by employees. What is the minimum required documentation the entity should obtain for each driver on an annual basis?
正解：D
解説：
According to Health Care Risk Management principles supported by ASHRM and the American Hospital Association Certification Center, organizations operating vehicle fleets must implement structured fleet risk management controls to reduce liability exposure. One of the most fundamental annual requirements is verification of each driver's driving record, typically obtained through a motor vehicle record MVR review.
An annual driving record review allows the organization to confirm that drivers maintain valid licensure, identify traffic violations, detect patterns of unsafe driving behavior, and assess risk exposure. This proactive screening supports loss prevention, reduces the likelihood of negligent entrustment claims, and ensures compliance with organizational driving policies.
Mileage logs are operational tools used for tracking usage and reimbursement but do not assess driver eligibility or risk. Driver training is important for safety programs but is not the minimum required documentation to confirm driver qualification status. Proof of insurance may be required when employees use personal vehicles for business purposes, but it does not replace the need to review the driver's official record.
Health Care Operations objectives emphasize credential verification, regulatory compliance, and proactive liability mitigation. Therefore, obtaining and reviewing each driver's driving record annually is the minimum required documentation.
質問 # 50
In general, how many steps should an FMEA proceed in each direction (upstream/downstream) when mapping a process for failure analysis?
正解：D
解説：
A practical FMEA requires enough process context to capture upstream causes and downstream consequences without becoming unmanageably large. A common operational rule-of-thumb is to examine roughlytwo steps upstream and two steps downstreamfrom a target step to uncover handoffs, dependencies, and failure propagation. Risk management objectives focus on identifying failure modes that originate earlier (e.g., incorrect patient ID at registration leading to lab/specimen mismatch) and harms that emerge later (e.g., delayed result communication causing deterioration). The exact boundary depends on complexity and risk; high-hazard workflows (blood products, surgery, chemo) may require deeper mapping. The goal is usable granularity: map, identify failure modes, score (S-O-D), prioritize, implement controls, and reassess residual risk.
質問 # 51
When conducting an investigation of a liability claim, which of the following steps should be included?
* providing the RCA to the insurance company
* determining the applicable standard of care
* assessing the applicable legal principles
* obtaining an incident report from the claimant
正解：C
解説：
According to Health Care Risk Management standards established by ASHRM and the American Hospital Association Certification Center, investigation of a liability claim requires careful evaluation of both clinical and legal components. Determining the applicable standard of care is essential to assess whether the provider' s actions met accepted professional practice. This typically involves review of medical records, consultation with clinical experts, and comparison to established guidelines or customary practices within the specialty.
Assessing applicable legal principles is also critical. This includes analysis of duty, breach, causation, and damages, as well as jurisdiction-specific statutes of limitation, comparative negligence standards, and evidentiary considerations. Understanding the legal framework allows the risk manager to evaluate exposure and advise counsel appropriately.
Providing a root cause analysis to the insurance company may compromise privilege protections, depending on jurisdiction and policy structure. RCA documents are often protected under peer review or patient safety statutes and should not be disclosed without legal guidance. Obtaining an incident report from the claimant is not appropriate, as internal incident reports are generated by the organization and are not requested from claimants.
Claims and litigation objectives emphasize structured legal and clinical evaluation. Therefore, determining the standard of care and assessing applicable legal principles are required investigative steps.
質問 # 52
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