SOLVED QUESTIONS GRADED A+
◉ False. Answer: A consent to admission documents a patient's consent
for all medical treatment including procedures and surgeries to be
completed during the current admission.
◉ True. Answer: A consultation includes the examination of a patient by
a specialist, who also provides an opinion or advice
◉ True. Answer: A delinquent record can result in a suspension of a
physician's medical staff privileges.
◉ True. Answer: A discharge progress note can be documented in a
patient record instead of a discharge summary if a patient had an
uncomplicated hospital stay of less than 48 hours
◉ True. Answer: A licensed nurse is required to have a public license to
deliver care to patients
,◉ True. Answer: A living will is a written document that informs a
health care provider of a patient's desires regarding life-sustaining
treatment
◉ Comorbidity. Answer: A patient is admitted for congestive heart
failure and hypertension. During the admission, the patient is also
treated for uncontrolled diabetes. The uncontrolled diabetes is a:
◉ History and Physical examination. Answer: A patient was admitted
with chronic obstructive pulmonary disease (COPD) on April 15 (this
year). The patient has an exacerbation of COPD and was readmitted on
June 1 (this year). The physician needs to document a(n):
◉ Discharge order. Answer: A patient's record contains the following
order, "Mary Black is stable and has no complaint of pain. Wound is
healing. No fever or chills. No medications given and no restrictions.
She can be release home in the morning. To be seen in my office in two
weeks." This is an example of a:
◉ Comorbidity. Answer: A preexisting condition that causes an increase
in the patient's length of stay by at least one day in 75% of the cases is
known as a:
◉ True. Answer: A principal procedure is performed for definitive or
therapeutic reasons.
, ◉ True. Answer: All ancillary reports should be filed in the patient's
record within 24 hours after interpretation of test results.
◉ True. Answer: All orders must be authenticated by the responsible
provider.
◉ True. Answer: American Osteopathic Association (AOA)
requirements state that a patient record must be maintained for each
patient treated in the emergency department.
◉ Newborn record. Answer: An APGAR score is documented in the:
◉ False. Answer: An admission note documented by the attending
physician can replace a dictated history and physical examination .
◉ False. Answer: An advance directive and an informed consent are
considered clinical data.
◉ Review of Systems (ROS). Answer: An inventory of body systems to
reveal subjective symptoms stated by the patient is called the
__________.
◉ state departments of health or offices of vital statistics. Answer: Birth
certificate information is usually submitted to the ______ within 10 days
of birth.