Actual Exam 2026/2027 – Complete Exam-Style
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Section A: Administrative & Financial Challenges
Question 1
What is identified as the primary administrative challenge in merging Ceder Bend
Medical Center and Western View Children's Hospital?
A) Integrating two distinct and incompatible Electronic Health Record (EHR)
systems.
B) Aligning a hierarchical, board-led governance structure with a decentralized,
trust-based model.
C) Reconciling significant differences in the patient demographic profiles.
D) Managing a substantial staff reduction to eliminate redundancies.
Answer: B
Rationale: The main administrative hurdle is the clash between Ceder Bend's
hierarchical framework and Western View's decentralized approach. This
misalignment can cause decision-making bottlenecks and role ambiguity .
Question 2
What is the primary financial challenge encountered during this merger?
A) Decreasing reimbursement rates from Medicare and Medicaid.
B) The high cost and technical complexity of integrating proprietary and cloud-
based EHR systems.
C) An increase in malpractice insurance premiums for the merged entity.
D) The different profit statuses of the organizations (for-profit vs. non-profit).
,Answer: B
Rationale: The primary financial challenge is the integration of Ceder Bend's
proprietary EHR with Western View's cloud-based EHR. This is a costly process that
carries significant data migration and security risks .
Question 3
Which of the following is a potential consequence of failing to align the
governance structures of the two organizations?
A) Improved decision-making speed and efficiency.
B) Enhanced staff morale due to increased autonomy.
C) Role ambiguity, delayed decision-making, and diminished organizational
efficiency.
D) Automatic compliance with all regulatory requirements.
Answer: C
Rationale: Failing to harmonize the hierarchical and decentralized approaches can
lead to confusion over responsibilities, slower decisions, and a less effective
organization overall .
Question 4
Which of the following is a financial risk of merging the two EHR systems?
A) No financial risk, as EHR integration is purely a technical issue.
B) A potential for automatic cost savings due to economies of scale.
C) High integration costs and a risk of data breaches.
D) Simplified billing processes from day one.
Answer: C
Rationale: Merging EHRs requires significant financial investment. It also carries
the risk of a data breach during the complex data migration process, which would
add regulatory fines and reputational costs .
,Question 5
What patient population does Ceder Bend Medical Center primarily serve?
A) Children and families from low-income backgrounds.
B) Primarily an aging/elderly population.
C) Only veterans.
D) Only emergency room patients.
Answer: B
Rationale: The case study identifies Ceder Bend Medical Center as having a
particular focus on serving an aging patient population .
Question 6
What patient population does Western View Children's Hospital primarily serve?
A) Only surgical patients.
B) Primarily an aging/elderly population.
C) Children and families from low-income backgrounds.
D) Only emergency patients.
Answer: C
Rationale: Western View Children's Hospital specializes in pediatric care and
primarily serves children and families from low-income backgrounds .
Section B: Ethical Concerns
Question 7
An ethical concern arising from the governance alignment challenge is:
A) The potential for increased profitability for the merged entity.
B) Power imbalances and a lack of fair representation for all stakeholders.
C) A reduction in staffing needs leading to job losses.
D) Faster decision-making processes.
Answer: B
Rationale: If one hospital's leadership model dominates, it can create an ethical
, issue of equity and justice. The power imbalance can sideline the interests and
mission of the other organization, affecting staff and patient care .
Question 8
What is the ethical obligation regarding patient data security during the EHR
integration?
A) There is no ethical obligation beyond what is legally required.
B) Keeping patients informed about data transfers and obtaining their consent as
needed.
C) Deleting all patient records prior to migration to ensure complete privacy.
D) Allowing all staff from both hospitals to access all patient records.
Answer: B
Rationale: Ethically, the merged entity must maintain transparency with patients
about how their sensitive health information is being handled during the EHR
migration, which is also a core requirement of patient autonomy .
Question 9
How could the financial integration of the two hospitals threaten Western View's
mission?
A) By increasing funding for its pediatric programs.
B) By shifting the organization's focus to profit-driven services over its community
health mission.
C) By eliminating the need for its pediatric specialty services.
D) By reducing its patient volume.
Answer: B
Rationale: An ethical concern is the potential "mission drift" where the for-profit
model of Ceder Bend overshadows the non-profit mission of Western View, leading
to a prioritization of profitable services over care for underserved populations .