Patient Care Ethical and Legal Aspects

Which of the following is a possible sanction from the ARRT if a tech repeatedly violates the Standards of Ethics?

1. Imposition of a fine

2. Loss of state licensure

3. Revocation of certification and registration

4. No standard punishment

Revocation of certification and registration

According to the American Hospital Association (AHA) Patient Care Partnership, which two of the following are within the rights of the patient?

1. To choose the floor where they are to be admitted

2. To know if a student is performing their radiographic examinations

3. To refuse payment if unhappy with their care

4. To know the financial consequences of choosing out of network care

1. To know if a student is performing their radiographic examinations

1. To know the financial consequences of choosing out of network care

Which two of the following may be used to identify a two month old infant for a portable radiographic examination?

1. Asking the nurse to verify the patient’s identity

2. Comparing the MRN on the wristband to the xray order

3. Asking a parent or legal guardian to verify their identity

4. Comparing the name on the wristband with the name on the xray order

1. Comparing the MRN on the wristband to the xray order

1. Comparing the name on the wristband with the name on the xray order

A technologist is performing a chest xray on a patient who has refused the procedure. The technologist proceeds with the exam without the patient’s consent. What ethical principle is the technologist violating?

Autonomy

In which two of the following situations could a technologist be found guilty of medical tort?

1. Posting an xray image on social media without removing patient identifiers

2. Radiating a pediatric patient with a parent of legal guardian present

3. Using immobilization devices without consent

4. Shredding de-identified patient order requisitions

5. Obtaining a professional interpreter when the patient does not speak English

1. Posting an xray image on social media without removing patient identifiers

1. Using immobilization devices without consent

Mandatory standards that specify the minimally acceptable professional conduct of radiographers are found in

ARRT Standard of Ethics

If a technologist notices that a restraint was used on a patient without a clear indication or documentation, what is the most appropriate action to take?

Report the use of restraint to the supervisor or department manager

Regarding a healthcare proxy, what is the most important for a technologist to understand?

1. Proxy has total control over the patient’s financial decisions

2. Proxy can override the patient’s wishes at any time

3. Proxy’s decisions are advisory and not binding on medical personnel

4. Proxy is authorized to make medical decisions if the patient is unable to

1. Proxy is authorized to make medical decisions if the patient is unable to

A technologist is preparing a patient for an abdominal xray. The patient asks about the procedure’s purpose and potential risks. According to the AHA Patient Care Partnership, what is the best response?

1. Proceed with the procedure without providing details

2. Answer the patient and address all questions and concerns

3. Tell the patient to ask their referring physician

4. Assure the patient that all procedures are safe and there’s no need for concern

1. Answer the patient and address all questions and concerns

Which three of the following are considered protected health information under the HIPAA Privacy Act?

1. Cell phone number

2. MRN

3. State of residence

4. Medical device identifier

5. Year of birth

1. Cell phone number

1. MRN

1. Medical device identifier

If a technologist touches a patient without asking first, they may be accused of

Battery

(T/F) Failure to include HIPAA training as part of a technologist’s new employee orientation is considered a HIPAA violation.

True

A technologist who refuses to perform exams on patients who are of a particular race of culture may be guilty of

Professional ethics violation

Where must paper medical records be stored to avoid violating HIPAA?

1. In airtight storage filing cabinets

2. In locked rooms or file cabinets

3. In off campus locations

4. In publicly accessible locations

1. In locked rooms or file cabinets

(T/F) Electronic medical records must be password protected.

True

What is the most accurate way for a technologist to verify patient identification?

Use two identifiers, such as full name and date of birth

If a technologist is involved in a lawsuit, it will normally fall under which kind of law?

Civil Law

(T/F) Manipulating images to hide errors compromises patient care and violates ethical standards.

True

The hospice concept involves family centered care with an emphasis on what type of treatment?

Palliative (comfort and pain relief)

Which of the following acts would fall under the legal doctrine of res ipsa loquitur?

1. A patient believes he has suffered discrimination

2. Excessive fluoroscopy causes a radiation-induced skin burn

3. Restraints are applied without a physician’s order

4. The physician is sued for a negligent act committed by a healthcare worker

1. Excessive fluoroscopy causes a radiation-induced skin burn

What does the term res ipsa loquitur stand for?

The thing speaks for itself (no need for further explanation)

A technologist is documenting a change to a radiographic procedure order. What is the most critical aspect to include in the documentation?

1. Reason for the change, who authorized it, and when it was made

2. The technologist’s opinion on whether the change was necessary

3. A detailed explanation of the procedure performed

4. The outcome of the procedure and the patient’s response to the change

1. Reason for the change, who authorized it, and when it was made

Which three of the following are considered patient’s rights?

1. Right to confidentiality

2. Right to decline payment of medical bills

3. Right to confidentiality

4. Right to refuse treatment

1. Right to confidentiality

2. Right to confidentiality

3. Right to refuse treatment

You witness a coworker completing an exam on the incorrect patient. You approach her regarding the situation, and she asks you not to say anything to anyone. She said that she has already been disciplined this year, and one more incident could lead to the loss of her job. What is the most appropriate action to take regarding the situation?

Notify department supervisor and director immediately

Which two of the following circumstances would constitute legal and informed consent?

1. Patient is 16 years of age and signs form on their own behalf

2. Form is signed by a witness, typically the person explaining the procedure to the patient

3. Procedure is explained in a language understood by the patient, by a hospital interpreter

4. Procedure is performed by a different physician than the one who explained it to the patient

1. Form is signed by a witness, typically the person explaining the procedure to the patient

2. Procedure is explained in a language understood by the patient, by a hospital interpreter

If a radiologist instructs you to inject a patient with radiographic contrast and the patient collapses from anaphylactic shock, you may be protected from litigation under the doctrine of

Respondeat superior

What does the term respondeat superior stand for?

The master speaks for the servant (physician/facility is responsible for negligent acts of employees)

Which three of the following must be included in every patient’s EMR?

1. Billing information

2. Family history

3. Informed consent forms

4. Medical history

5. Procedure orders

1. Informed consent forms

2. Medical history

3. Procedure orders

If a technologist performs an IVU on a patient who was supposed to have has a lumbar spine series, the technologist may be charged with

Battery

What is the intentional touching that is harmful or offensive without the consent of the victim or the unlawful use of force upon a person called?

Battery

What is written or printed material that is made with malicious intent to defame another’s reputation?

Libel

What term refers to threats or threatening behavior against another, placing that person in fear of bodily harm?

Assault

What is the action or crime of making a false spoken statement that is damaging to a person’s reputation?

Slander

A technologist receives an order requisition for a patient in the ER for a right ankle, lower leg, and femur. However, the patient states that they injured their left leg, which is visibly swollen. What is the best course of action for the technologist?

1. Check the order with the ER physician

2. Check the order with the patient’s nurse

3. Xray the right ankle, lower leg, and femur as the requisition orders

4. Xray the left leg because that is where the patient’s pain is

1. Check the order with the ER physician

Which hospital affiliation created a document mandating that a patient has the right to review their medical records and have access to information to ensure everything is correct and complete?

1. American Hospital Association (AHA)

2. American Medical Association (AMA)

3. U.S. Department of Health and Human Services (HHS)

4. The Joint Commission (TJC)

1. American Hospital Association (AHA)

A technologist returns to the xray room to find a pediatric patient, whom they had left alone on the radiographic table, lying on the floor, crying in pain. In this situation, the technologist may be accused of

Negligence

What is the failure to use such care as a reasonably prudent person would use under similar circumstances called?

Negligence

What term means to do no harm?

Nonmaleficence

Which three of the following are considered protected health information according to HIPAA?

1. Billing and payment for care received

2. Employment status and employer

3. Highest level of education received

4. Patient health conditions

5. Treatment received for health conditions

1. Billing and payment for care received

1. Patient health conditions

2. Treatment received for health conditions

What law serves to protect patient data from inappropriate disclosure or use, and safeguards patient information systems from unauthorized access?

1. Health Information Technology and Clinical Health (HITECH) Act

2. Privacy Act of 1974

3. Federal Education Right to Privacy Act (FERPA)

4. Health Insurance Portability and Accountability Act (HIPAA)

1. Health Insurance Portability and Accountability Act (HIPAA)

What law was enacted because of an ever-increasing amount of electronic information about patients and requires safeguards to protect patient security and confidentiality?

Health Insurance Portability and Accountability Act (HIPAA)

As a technologist, you must not promise patients results that you cannot achieve. This refers to the ethical principle of

Fidelity

What term refers to the obligation to tell the truth?

Veracity

What term means respecting the independence of others?

Autonomy

What is the obligation to treat all with equity?

Justice

What term means goodness and actions that bring about good are right actions?

Beneficence

What is the obligation to be loyal or faithful, including the observance of promises or duties?

Fidelity

A patient arrives for an upper GI study and appears confused about the procedure, despite having previously given verbal consent. What should the technologist do next?

1. Proceed with the procedure, assuming the initial consent is still valid

2. Cancel the procedure until a family member can provide consent

3. Re-explain the procedure and risks to ensure informed consent is obtained

4. Transfer the patient back to their room without performing the exam

1. Re-explain the procedure and risks to ensure informed consent is obtained

What involves using physical force to keep a patient still without consent?

Retraining

What involves keeping a patient still with consent?

Immobilizing

What is the appropriate course of action if you overhear someone discussing specific questions that were on the ARRT examination?

1. Do nothing

2. It is acceptable to discuss the exam with other potential examinees

3. Notify the ARRT in writing about the violation of the Standard of Ethics

4. Notify the radiography program director about the violation of the ARRT Standard of Ethics

1. Notify the ARRT in writing about the violation of the Standard of Ethics

Discussing a patient’s examination results in the hospital elevator is a violation of

Health Insurance Portability and Accountability Act (HIPAA)

A technologist forgets to use their lead marker on the PA image of the chest, and the marker ended up outside the collimated area on the image of the lateral chest. Rather than repeating the images to include their marker, the technologist applies an electronic marker to the images and sends them to the radiologist. Which two of the following are legal concerns in this scenario?

1. Images could be marked incorrectly

2. There is no problem; post processing markers are provided by the system and acceptable to use when needed

3. This is considered manipulation of electronic data

4. Images might get assigned to the wrong patient

1. Images could be marked incorrectly

2. This is considered manipulation of electronic data

(T/F) Electronic markers are acceptable in a legal case.

False

A patient arrives to the imaging department for a routine examination of the right hip. The technologist mistakenly obtains radiographs of the left hip, instead. This mistake may be considered

Battery

Refusing to let a patient leave the examination room after they requested or using restraints without the order of a physician is called?

False Imprisonment

What term includes sharing detailed patient information with a third party through verbal, electronic, or other means?

Invasion of privacy

A technologist notices that a colleague frequently skips cleaning the equipment between patients, potentially exposing patients to infections. What ethical principle requires the technologist to address this behavior?

Beneficence

What term involves promoting the well-being of patients and ensuring that they are not exposed to harm?

Beneficence