ESTUDYR
HESI LPN–ADN MOBILITY EXAM (PROFESSIONAL ISSUES
AND LEADERSHIP) MOST TESTED QUESTIONS AND
ANSWERS GRADED A+ WITH RATIONALES
Which of the following lists correctly states the five elements of evidence-based practice
(EBP)?
A. Research evidence; insurance policy; patient age; local tradition; clinician mood
B. Research evidence; integrated with practice; client preferences/values; practitioners’
expertise; making clinical decisions
C. Research evidence; integrated with practice; client preferences and values; practitioners’
expertise; making clinical decisions.
D. Research evidence; employer goals; productivity targets; client preferences; practitioner age
Rationale: EBP combines best current research, clinician expertise, and patient values to guide
clinical decisions.
ASHA’s formal definition of evidence-based practice states that EBP refers to:
A. Using only randomized controlled trials for therapy decisions.
B. Integrating current, high-quality research evidence with practitioner expertise and client
preferences/values in clinical decision-making.
C. Following insurance company guidelines exclusively.
D. Applying only long-standing clinical tradition.
Rationale: ASHA emphasizes the three pillars: evidence, clinician skill, and patient values.
Which of the following is NOT typically listed as a scope-of-practice issue?
A. Expansion and contraction of services
B. Technological advances
C. Multi-skilling and encroachment
D. Personal hobbies of clinicians
Rationale: Scope issues focus on service boundaries, training, tech, staffing and recognition —
not clinicians’ hobbies.
Under what legislation were outpatient therapy “caps” instituted?
A. Medicare Modernization Act of 2003
B. Affordable Care Act of 2010
C. The Balanced Budget Act of 1997.
D. Social Security Act of 1965
Rationale: Therapy caps originated from the Balanced Budget Act as a cost-control measure.
What was the primary policy purpose of therapy caps?
A. Improve clinical outcomes
B. Promote telepractice
C. A cost-control mechanism to limit Medicare outpatient therapy expenditures.
,ESTUDYR
D. Increase clinician reimbursement
Rationale: Caps were intended to limit spending, not necessarily to align with clinical need.
Which agency administers Medicare therapy caps and related policies?
A. FDA
B. CDC
C. Centers for Medicare & Medicaid Services (CMS).
D. NIH
Rationale: CMS oversees Medicare policy, payment, and exceptions.
Medicare Part B primarily covers which of the following for beneficiaries?
A. Inpatient room and board
B. Outpatient services, including outpatient therapy (SLP/PT/OT).
C. Long-term nursing home custodial care
D. Vision correction surgery
Rationale: Part B covers outpatient/physician services and outpatient therapy.
SLP and PT began sharing a combined therapy cap on October 1, 2012. What was the
shared cap amount at that time (approx.)?
A. $1,000
B. $2,500
C. $3,700.
D. $5,000
Rationale: The combined annual cap for PT + SLP services was set around $3,700 (historical
figure).
If a patient’s therapy needs exceed the therapy cap, what process can potentially allow
additional payment?
A. There is no option — services denied automatically
B. Judicial review only
C. An exception process (e.g., manual medical review/exception).
D. Self-pay only
Rationale: An exceptions or manual medical review route could permit additional coverage
when clinically justified.
Why were therapy caps criticized and largely viewed as ineffective?
A. They increased administrative simplicity.
B. They improved patient access.
C. They denied adequate services to many patients by limiting necessary care.
D. They reduced fraud entirely.
Rationale: Caps sometimes forced premature discharge or limited clinically indicated therapy.
Which major health reform bill targeted broad health-care reform in 2010?
A. Balanced Budget Act
,ESTUDYR
B. The Patient Protection and Affordable Care Act (ACA) of 2010.
C. HIPAA
D. Medicare Modernization Act
Rationale: The ACA (Obamacare) addressed coverage, quality, coordination, and fraud
reduction.
Which of the following is NOT one of the ACA’s primary goals as summarized in your notes?
A. Increasing coverage and accessibility
B. Improving quality of care
C. Coordinating care more effectively through ACOs
D. Eliminating clinician licensure
Rationale: The ACA did not abolish licensure; it focused on coverage, quality, coordination, and
fraud reduction.
Under the ACA, what mechanism was emphasized to improve care quality over fee-for-
service?
A. Better marketing campaigns
B. Longer hospital stays
C. Value-based purchasing and physician quality reporting (PQRS).
D. Removing clinical guidelines
Rationale: The ACA promoted value-based reimbursement tied to quality metrics.
What does “fee-for-service” mean?
A. Payment only for successful outcomes
B. Paying for each service provided, regardless of outcome.
C. Bundled payment per episode of care
D. Capitation payment method
Rationale: Fee-for-service reimburses volume of services, not value.
Which outcome measure system is commonly used by SLPs for reporting
quality/performance?
A. ICD-10 codes only
B. PROMIS exclusively
C. NOMS (National Outcomes Measurement System).
D. SF-36 only
Rationale: NOMS was developed for SLP outcome reporting.
How did the ACA propose to coordinate care more effectively among professionals?
A. Single-payer national clinician assignment
B. Through Accountable Care Organizations (ACOs) encouraging coordination.
C. Eliminating referrals
D. Independent solo practice only
Rationale: ACOs provide incentives for coordinated care and shared savings.
, ESTUDYR
Which of the following services are explicitly considered an Essential Health Benefit (EHB)
relevant to SLPs under the ACA?
A. Cosmetic surgery only
B. Rehabilitation and habilitation services (covered as EHBs).
C. Electoral assistance services
D. Nonmedical household chores
Rationale: Rehab/habilitation services fall under EHB definitions in many state benchmark
plans.
Which of the following best defines “habilitation services”?
A. Services that restore previously lost skills only
B. Services that help a person keep, learn, or improve skills and functioning for daily living
(may be lifelong).
C. Public health vaccination programs
D. Short recreational activities only
Rationale: Habilitation focuses on learning or maintaining skills not previously acquired.
Which future trend was NOT listed as a cross-setting issue for SLPs?
A. Shorter courses of treatment
B. Increased caregiver/parent as therapist roles
C. Expanded use of AAC and telepractice
D. Decreasing caseloads across the board
Rationale: The trend is toward higher caseloads, not decreases.
ASHA’s definition of telepractice states it is:
A. Only email correspondence about therapy
B. Use of telecommunications technology to deliver professional services at a distance linking
clinician to client or clinician to clinician for assessment, intervention, consultation.
C. Telephone triage only
D. Social media support groups only
Rationale: Telepractice involves synchronous/asynchronous tech-enabled clinical services.
Telepractice services must conform to:
A. Only client preferences
B. Professional standards, including ASHA’s Code of Ethics and applicable laws.
C. Employer policy only
D. No rules if international
Rationale: Telepractice is regulated by professional and legal standards.
According to ASHA Code of Ethics, Principle I Rule K: “clinical services may not be provided
solely by ____.”
A. teleconference
B. correspondence.
C. interns
HESI LPN–ADN MOBILITY EXAM (PROFESSIONAL ISSUES
AND LEADERSHIP) MOST TESTED QUESTIONS AND
ANSWERS GRADED A+ WITH RATIONALES
Which of the following lists correctly states the five elements of evidence-based practice
(EBP)?
A. Research evidence; insurance policy; patient age; local tradition; clinician mood
B. Research evidence; integrated with practice; client preferences/values; practitioners’
expertise; making clinical decisions
C. Research evidence; integrated with practice; client preferences and values; practitioners’
expertise; making clinical decisions.
D. Research evidence; employer goals; productivity targets; client preferences; practitioner age
Rationale: EBP combines best current research, clinician expertise, and patient values to guide
clinical decisions.
ASHA’s formal definition of evidence-based practice states that EBP refers to:
A. Using only randomized controlled trials for therapy decisions.
B. Integrating current, high-quality research evidence with practitioner expertise and client
preferences/values in clinical decision-making.
C. Following insurance company guidelines exclusively.
D. Applying only long-standing clinical tradition.
Rationale: ASHA emphasizes the three pillars: evidence, clinician skill, and patient values.
Which of the following is NOT typically listed as a scope-of-practice issue?
A. Expansion and contraction of services
B. Technological advances
C. Multi-skilling and encroachment
D. Personal hobbies of clinicians
Rationale: Scope issues focus on service boundaries, training, tech, staffing and recognition —
not clinicians’ hobbies.
Under what legislation were outpatient therapy “caps” instituted?
A. Medicare Modernization Act of 2003
B. Affordable Care Act of 2010
C. The Balanced Budget Act of 1997.
D. Social Security Act of 1965
Rationale: Therapy caps originated from the Balanced Budget Act as a cost-control measure.
What was the primary policy purpose of therapy caps?
A. Improve clinical outcomes
B. Promote telepractice
C. A cost-control mechanism to limit Medicare outpatient therapy expenditures.
,ESTUDYR
D. Increase clinician reimbursement
Rationale: Caps were intended to limit spending, not necessarily to align with clinical need.
Which agency administers Medicare therapy caps and related policies?
A. FDA
B. CDC
C. Centers for Medicare & Medicaid Services (CMS).
D. NIH
Rationale: CMS oversees Medicare policy, payment, and exceptions.
Medicare Part B primarily covers which of the following for beneficiaries?
A. Inpatient room and board
B. Outpatient services, including outpatient therapy (SLP/PT/OT).
C. Long-term nursing home custodial care
D. Vision correction surgery
Rationale: Part B covers outpatient/physician services and outpatient therapy.
SLP and PT began sharing a combined therapy cap on October 1, 2012. What was the
shared cap amount at that time (approx.)?
A. $1,000
B. $2,500
C. $3,700.
D. $5,000
Rationale: The combined annual cap for PT + SLP services was set around $3,700 (historical
figure).
If a patient’s therapy needs exceed the therapy cap, what process can potentially allow
additional payment?
A. There is no option — services denied automatically
B. Judicial review only
C. An exception process (e.g., manual medical review/exception).
D. Self-pay only
Rationale: An exceptions or manual medical review route could permit additional coverage
when clinically justified.
Why were therapy caps criticized and largely viewed as ineffective?
A. They increased administrative simplicity.
B. They improved patient access.
C. They denied adequate services to many patients by limiting necessary care.
D. They reduced fraud entirely.
Rationale: Caps sometimes forced premature discharge or limited clinically indicated therapy.
Which major health reform bill targeted broad health-care reform in 2010?
A. Balanced Budget Act
,ESTUDYR
B. The Patient Protection and Affordable Care Act (ACA) of 2010.
C. HIPAA
D. Medicare Modernization Act
Rationale: The ACA (Obamacare) addressed coverage, quality, coordination, and fraud
reduction.
Which of the following is NOT one of the ACA’s primary goals as summarized in your notes?
A. Increasing coverage and accessibility
B. Improving quality of care
C. Coordinating care more effectively through ACOs
D. Eliminating clinician licensure
Rationale: The ACA did not abolish licensure; it focused on coverage, quality, coordination, and
fraud reduction.
Under the ACA, what mechanism was emphasized to improve care quality over fee-for-
service?
A. Better marketing campaigns
B. Longer hospital stays
C. Value-based purchasing and physician quality reporting (PQRS).
D. Removing clinical guidelines
Rationale: The ACA promoted value-based reimbursement tied to quality metrics.
What does “fee-for-service” mean?
A. Payment only for successful outcomes
B. Paying for each service provided, regardless of outcome.
C. Bundled payment per episode of care
D. Capitation payment method
Rationale: Fee-for-service reimburses volume of services, not value.
Which outcome measure system is commonly used by SLPs for reporting
quality/performance?
A. ICD-10 codes only
B. PROMIS exclusively
C. NOMS (National Outcomes Measurement System).
D. SF-36 only
Rationale: NOMS was developed for SLP outcome reporting.
How did the ACA propose to coordinate care more effectively among professionals?
A. Single-payer national clinician assignment
B. Through Accountable Care Organizations (ACOs) encouraging coordination.
C. Eliminating referrals
D. Independent solo practice only
Rationale: ACOs provide incentives for coordinated care and shared savings.
, ESTUDYR
Which of the following services are explicitly considered an Essential Health Benefit (EHB)
relevant to SLPs under the ACA?
A. Cosmetic surgery only
B. Rehabilitation and habilitation services (covered as EHBs).
C. Electoral assistance services
D. Nonmedical household chores
Rationale: Rehab/habilitation services fall under EHB definitions in many state benchmark
plans.
Which of the following best defines “habilitation services”?
A. Services that restore previously lost skills only
B. Services that help a person keep, learn, or improve skills and functioning for daily living
(may be lifelong).
C. Public health vaccination programs
D. Short recreational activities only
Rationale: Habilitation focuses on learning or maintaining skills not previously acquired.
Which future trend was NOT listed as a cross-setting issue for SLPs?
A. Shorter courses of treatment
B. Increased caregiver/parent as therapist roles
C. Expanded use of AAC and telepractice
D. Decreasing caseloads across the board
Rationale: The trend is toward higher caseloads, not decreases.
ASHA’s definition of telepractice states it is:
A. Only email correspondence about therapy
B. Use of telecommunications technology to deliver professional services at a distance linking
clinician to client or clinician to clinician for assessment, intervention, consultation.
C. Telephone triage only
D. Social media support groups only
Rationale: Telepractice involves synchronous/asynchronous tech-enabled clinical services.
Telepractice services must conform to:
A. Only client preferences
B. Professional standards, including ASHA’s Code of Ethics and applicable laws.
C. Employer policy only
D. No rules if international
Rationale: Telepractice is regulated by professional and legal standards.
According to ASHA Code of Ethics, Principle I Rule K: “clinical services may not be provided
solely by ____.”
A. teleconference
B. correspondence.
C. interns
