PHP0310 Exam #2 Question Bank

Expanding Medicaid...

A. will increase the number of hospitals in the long-term

B. causes specialists to flee from rural areas with low-income patients

C. is associated with a reduction in uncompensated care costs in hospitals

D. All of the above

C

Which is not one of the consequences of the high cost of healthcare in the US:

A. More uninsured Americans

B. More funding for education and other state programs

C. Stagnant wages

D. Growing federal deficit and debt

B

When patients have multiple health problems, this is called

A. Coaffliction

B. Comortality

C. Codependency

D. Comorbidity

D

True or False: In the long-run, the ACA will reduce the need for primary care providers

False

Primary care

A. Provides initial diagnosis

B. Is limited to illness episodes

C. Is focused and intense

D. Treats only comorbidities

A

True or False: There is wide variation in the quality of healthcare services across the United States

True

Which of the following is true about primary caring according to the Kerns and Willis' Harvard Business Review article?

A. By 2035, the Department of Health and Human Services estimates that the US will have enough PCPs to treat 380 million Americans

B. Nurse practitioners and physician assistants could deliver high quality primary care but are not being utilized effectively

C. Increasing use of the EHR will help decrease physician administrative work and increase patient panels by 30%

D. There are not enough PCPs to meet the demands of many urban areas in the US

E. More than one of the above

B

Which of the following medical professionals do not prescribe drugs or perform surgery?

A. Chiropractors

B. Osteopaths

C. Obstetricians

D. Podiatrists

A

The number of hospitalizations has _______ since 1981

A. Increased

B. Decreased

C. Stayed the same

D. More information is needed

B

In which of the following areas has the U.S malpractice system been successful?

A. Fairly compensating patients harmed by physician/hospital negligence

B. Settling cases quickly/cost effectively

C. Providing an incentive for providers to reduce mistakes and improve their quality of care

D. None of the above

D

Midlevel providers (MLPs) include which of the following

A. Osteopaths

B. Dentists

C. Physician assistants

D. Registered Nurses

C

According to the article by Kerns and Willis, why do some Americans not have access to primary care?

A. Many primary care offices are not open in the evenings and on weekends, which are the only times that work for some individuals

B. Not enough medical school graduates are choosing to enter primary care fields (insufficient supply of primary care doctors)

C. Payer aversion limits the number of private insurance patient primary care physicians accept

D. A and B

E. B and C

D

Why is the closing of hospitals in rural areas particularly problematic?

A. Increased travel time for patients urgently in need of medical care

B. Consolidation results in higher malpractice premiums

C. More children live in these areas

D. All of the above

A

The percentage of active primary care generalist physicians

A. Has decreased since 1949

B. Has increased since 1949

C. Has remained steady since 1949

D. Is unknown (this number has only been tracked since 1970)

A

What was the main argument Ezekiel Emanuel made in the NYT article "Are Hospitals Becoming Obsolete?"

A. Care is being shifted out of hospitals into cheaper, more effective settings

B. The only thing preventing hospitals from becoming obsolete are Washington lobbyists

C. The consolidation of hospitals is a detrimental trend that will cause healthcare inequalities

D. A and B

A

Why might hospital care become obsolete according to the NYT article by Ezekiel Emanuel?

A. The alarming rise of iatrogenic disease

B. Better alternative settings for care

C. Special interest lobbyists

D. A and B

D

Based on what three medical problems does Hospital Compare rank the quality of different hospitals?

A. Heart failure, musculoskeletal disorders, cancer

B. Pneumonia, cancer, heart rhythm

C. Acute heart attacks, heart failure, pneumonia

D. Senioritis, asthma, obesity

C

What does the Disproportionate Share Hospital program do?

A. Provides federal funds to compensate hospitals for caring for the uninsured

B. Provides state funds to compensate hospitals for caring for the uninsured

C. It is a charity program that compensates hospitals for caring for low-income patients

D. It is a federally funded program that provides funds to build hospitals in low-income areas

A

Countries whose health systems are oriented more toward primary care achieve

A. Higher satisfaction with health services among their populations

B. Higher expenditures in the overall delivery of care

C. Increased ED visits

D. Increased hospitalization rates

A

According to the article The Doctor's New Dilemma, taking the time to talk to patients can:

A. Help control blood pressure

B. Help relieve pain

C. Help relieve physician burnout

D. All of the above

D

According to the Institute of Medicine, primary care is "the provision of _____, accessible health care services by clinicians who are _______ for addressing a large majority of health care needs..."

A. efficient; well-compensated

B. efficient; accountable

C. integrated; trained

D. integrated; accountable

D

According to The Heroism of Incremental Care, which of the following is an advantage of primary care?

A. Having a primary care doctor increases patient willingness to seek care for severe symptoms

B. Primary care doctors use an empirical "big picture" approach to solving medical problems rather than a "rule out" strategy

C. Patients don't have to sit through diagnostic tests

D. A & B

D

Based on the article "Building Powerful Primary Care Teams," having a core team:

A. Helps the PCP give more attention to their patients because nurses also act as scribes

B. Medical assistants aid in setting the agenda, documenting history, and arranging follow-ups

C. Hiring additional medical assistants increased cost more than revenue

D. A and B

E. B and C

B

In the Gawande article entitled The Heroism of Incremental Care, which medical problem plagued Bill Haynes for nearly forty years?

A. Severe chronic migraines

B. Cancer

C. Hypertension

D. Diabetes

A

"Twitter Tailwinds" tells stories which highlight

A. The increasing importance of social media in medical treatments

B. The dissatisfaction of primary care doctors

C. the upsides of the medical profession

D. The rise of Twitter as the major political platform for physicians

C

What is the doctors "new dilemma" as articulated by Suzanne Koven?

A. Determining how to ration limited medications

B. Putting patient concerns above financial gain

C. Determining how to ration limited time among patients

D. Battling disparities in payment between primary care physicians and specialists

C

In Simon et al.'s study, "Exploring Attributes of High-Value Primary Care", which of the following were criteria for exclusion of primary care practices in the study?

A. Practice sites operated by large multi-state health care organizations

B. Practice sites that self-identified as only providing adult primary care

C. Practice sites with more than sixty patients

D. Practice sites with only one practitioner

E. A and D

F. B and D

G. All of the above

E

In Simon et al.'s study, "Exploring Attributes of High-Value Primary Care", which of the following attributes were included in the six that statistically distinguished high-value primary care sites?

A. Expanded access

B. Coordinated care

C. Shared decision-making

D. Shared workspaces

B

Many primary care physicians in the U.S face

A. Burnout

B. Feeling disillusioned with their careers

C. Emotional exhaustion

D. All of the above

D

Regions with more access to primary care physicians have:

A. Lower infant mortality

B. Fewer hospitalizations

C. Lower rates of general mortality

D. All of the above

D

According to The Lancet article, "Prioritising primary care in the USA":

A. High deductible health plans have helped increase insurance coverage, leading to an increase in primary care access

B.The broad definition of primary care includes nurse practitioners, OB/GYNs, psychologists, and social workers

C.Hospital systems and physicians are reluctant to adopt models, such as accountable care organizations and patient centered medical homes

D.More than one of the above

E.All of the above

D

The "headwinds/tailwinds asymmetry" refers to

A. High speed trade winds that blow throughout North America causing seasonal illnesses

B. The Hippocratic oath

C. A medical bias that leads patients to trust specialists more than primary care physicians

D. The tendency to focus on barriers and disadvantages

D

Which of the following is false about primary care teams according the article, "Building Powerful Primary Care Teams"?

A. Randomized control trials found that pharmacists and registered nurses manage diabetes care better than primary care physicians

B. Extended care teams help treat very common clinical conditions, such as hypertension and depression

C. The extended care team is responsible for all patients on a team while the core team manages three or four groups of patients

D. Seeing a physical therapist first may reduce cost than if seen after a referral from a PCP

E. Using teams could greatly expand primary care access without significantly increasing physician workload

C

The most prominent reason for the decline in the number of procedures performed in hospitals is

A. Most of these procedures were shifted to the outpatient setting

B. Most of these procedures were deemed outdated

C. Most of these procedures were unsafe

D. Most of these procedures used technology that was too expensive

A

What are some factors that might have contributed to Dr. Cromblin (a graduated medical school student from the NYT article) being constantly rejected from residency programs?

A. She didn't pass all of her exams

B. She graduated from medical school more than 3 years prior

C. She attended a foreign medical school

D. B and C

E. All of the above

D

In the KHN article by Blau, foreign-born physicians experienced:

A. Difficulty with re-entry into the U.S

B. Scrutiny at work

C. More respect from their patients compared to native physicians

D. A and B

D

Why are international medical students disproportionately not getting matched into residencies?

A. Many programs use the Electronic Residency Application Service software program to filter out international medical students

B. Studies show that international medical students are less capable than medical students that graduated in the U.S.

C. International medical students apply to less residency programs than do American medical students.

D. International medical students apply to more competitive residency programs than do American medical students.

A

Areas with more primary care physicians experience all of the following except:

A. Better medical outcomes

B. Lower health care spending

C. Better patient satisfaction

D. More emergency department visits

D

True or false: The increasing number of NPs and PAs is enough to fill the gap caused by the decreasing number of primary care physicians

False

Regions with a _________ ratio of population to primary care practitioners are designated as Primary Care Professional Shortage Areas

A. 2:1

B. 20:1

C. 200:1

D. 2000:1

D

According to Kevin B. O'Reilly in his AMA article, "How IMGs have changed the face of American medicine," how have IMGs benefited the American health system?

A. About one-third of IMGs work in outpatient settings

B. Almost two-thirds work in primary care, a specialty that is facing a shortage of physicians

C. They received their training in a different health system and can use this

D. A and B only

E. B and C only

E

The ratio of primary care providers to specialists in the U.S is ______, whereas in other high-income countries this ratio is ______

A. 70:30; 30:70

B. 50:50; 20:80

C. 35:65; 70:30

D. 80:20; 80:20

C

Which of the following is true about international medical graduates (IMGs), as stated by the AMA's webpage on IMGs impact on American medicine?

A. Almost all IMGs speak a language other than English

B. The majority of IMGs were born in the US but obtained their medical degree in another country

C. About a third of IMGs reside in the rural Midwest

D. Most IMGs practice in a group practice setting

A

In the Health Affairs blog, which of the following do Lazris, Roth, and Brownlee suggest as solutions to the "crisis" in primary care?

A. Political action through lobbying

B. Subsidies for primary care training

C. Direct primary care

D. B and C

D

RNs are poised to help fill the gap caused by primary care shortages in

A. Psychiatric care management

B. Pediatric care management

C. Chronic care management

D. Integrated care management

C

In the KHN article by Blau, which piece of government legislation enabled international student Garcia Manrique to attend medical school?

A. The Deferred Action for Childhood Arrivals Program (DACA)

B. The Affordable Care Act

C. Congressional Review Act

D. The Social Security Act

A

International medical graduates make up _____ of the primary care physician workforce

A. 25%

B. 30%

C. 45%

D. 60%

A

True or false: Under U.S immigration law, foreign-born doctors are required to practice in a medically underserved area for three years

True

The number of small primary care practices is

A. Increasing

B. Decreasing

C. Has remained virtually the same

D. Constantly fluctuating

B

Quality of care is ______ among NPs compared to primary care physicians and patient satisfaction is _______ among NPs compared to primary care physicians

A. Higher, the same

B. Lower, the same

C. The same, lower

D. The same; the same

D

Which of the following describes Bodenheimer & Bauer's vision for the scope of work for primary care physicians in the future?

A. Primary care doctors will become obsolete

B. Primary care doctors will probably focus more on complex patients while nurses and PAs take over other primary care responsibilities

C. Primary care doctors will probably work in hospitals, delivering care to high-income patients

D. Primary care doctors will probably participate in more fellowships in order to obtain a specialization

B

The residency match rate percentage for international medical students is ____ compared to ___ for American medical students:

A. 50%, 61%

B. 50%, 92%

C. 61%, 94%

D. 94%, 61%

C

Residency programs are increasingly training more

A. Primary care physicians

B. Specialists

C. Nurse practitioners

D. Rural physicians

B

According to Kevin B. O'Reilly in his AMA article, "How IMGs have changed the face of American medicine,"what support does the AMA provide to IMGs?

A. They help deal with issues of discrimination and racism against IMGs

B. They assist in bringing more qualified IMGs to the US through helping with immigration issues and advocating for the expansion of the J-1 visa waver program

C. They help place IMGs in residencies and programs in underserved areas of the country

D. More than one of the above

E. All of the above

D

According to Primary Care: Current Problems and Proposed Solutions, which of the following might solve the panel size problem for primary care physicians?

A. Increasing payment to primary care providers to attract more medical graduates into primary care

B. Task shift primary care duties to other members of the primary care team such as nursing practitioners and physician assistants

C. Allocate more medical education funds towards specialty training

D. A & B

D

Which of the following is a concern expressed by Bodenheimer & Bauer about the increasing role of nurses in primary care?

A. Nurses are generally unwilling to increase their clinical responsibilities

B. Training in nursing schools is focused on inpatient care rather than primary care

C. Increases in payment for nurses could bankrupt the health system

D. None of the above

B

According to Primary Care: Current Problems and Proposed Solutions, which of the following might solve the issue of difficulty with accessing primary care physicians?

A. Same day scheduling

B. Subsidizing prescription drugs

C. Discounts on primary care for older/sicker citizens

D. More medical devices

A

Which of the following are major problems in primary care as outlined by Lazris, Roth, and Brownlee in Health Affairs?

A. Lack of resources, cultural bias against PCPs, high medical school costs

B. Lack of resources, regulatory burden, unfair/inefficient payment schemes

C. Regulatory burden, high cost of living in PCP areas, lack of political will

D. Regulatory burden, lack of political will, high barriers to entry

B

Which of the following describes recent trends in retail clinic visits?

A. Retail clinic visits have increased substantially

B. Retail clinic visits have decreased substantially

C. Retail clinic visits have remained relatively stable

D. Retail clinic visits have only increased in major cities

A

Which of the following is NOT a typical setting for ambulatory care services?

A. Sports medicine clinics

B. Firehouse

C. Dialysis centers

D. Rehabilitation clinics

B

In the New Yorker article, "Medicine's Wellness Conundrum", which of the following are NOT cited as barriers to integrating wellness practices into hospitals?

A. Physician attitudes

B. Patient demand

C. Insurance coverage

D. Lack of concrete evidence to support them

B

A patient with special needs could expect to receive efficient, appropriate, team-approach care from which of the following?

A. Primary care

B. Patient-centered medical home

C. Community-oriented primary care

D. Outpatient care

B

Which is not one of the drivers of growth in convenient care options?

A. Demand for instant care (drop in visits, same-day appointments, etc.)

B. Lower overhead costs of convenient care options

C. Entrepreneurial spirit among convenient care providers

D. Better quality care in convenient care clinics

D

Why is the proliferation of convenient care options potentially concerning?

A. They increase utilization and spending

B. They decrease continuity of care

C. They increase financial pressure on primary care physicians

D. All of the above

D

How has the ER changed in the past 50 years?

A. Increased ability to treat a wider-range of health problems

B. More widespread use of community physicians

C. Ambulances became slower

D. Fewer patients with chronic conditions

A

According to Cassel's JAMA article, which of the following is NOT a concern about retail clinic growth:

A. Retail clinics may increase healthcare spending rather than being a substitution for more expensive care

B. Patient data collected by large retail clinics may be used as a product instead of focusing on creating lower cost, personalized medicine

C. There is an incentive for retail clinics to focus on profit rather than high quality care

D. Visits to non-physicians could disrupt continuity of care

E. Mixed results have been found when looking at the quality of care received at retail clinics

E

One reason women's health centers were created is:

A. Women have more money than men

B. Women seek care more often than men

C. Women have shorter lifespans than men

D. Women get sick more often than men

B

True or False: All ambulatory care is primary care?

False

True or False: According to the New Yorker article, "Medicine's Wellness Conundrum", the Flexner Report encouraged physicians to incorporate wellness practices into clinical care.

False

Convenient care options mainly provide care for:

A. Low-acuity conditions

B. High-acuity conditions

C. Athletes

D. Medicare patients

A

True or False: Hospital based emergency care is the only treatment to which Americans have a legal right, regardless of their ability to pay?

True

According to the Kellerman article entitled "The ER, 50 years and on" which is a reason for the increase in ER use?

A. Inaccessibility of primary care physicians on weekends, nights, and holidays

B. Increase in low-acuity conditions which require emergency care

C. Public perception of the ER as a place where one can receive care at all times

D. A and C

D

___________ is the tendency to attribute patient's symptoms to their mental illness.

A. Diagnostic overshadowing

B. Mental discrimination

C. Physician bias

D. Testing bias

A

What is the most significant reason for the mortality gap between severely mentally ill people and the general population?

A. Suicide

B. Accidents

C. Chronic diseases

D. Shortage of psychiatrists

C

The website, "Seizure the Awkward" recommends all of the following EXCEPT:

A. Diving straight into talking about mental health with a friend

B. Using a shared hobby to check-in

C. Sometimes breaking trust to help your friend get long-term help

D. Not making promises that you may not be able to keep

E. Finding other resources if your friend needs more help than you can provide

A

According to "Seizure the Awkward," when helping out a friend in need, you should:

A. Make sure to take care of yourself and set boundaries

B. Try not to take their comments or behavior too personally

C. Use statements that start with "you" and not "I"

D. A and B

E. A and C

D

According to the website "Seize the Awkward," what is a sign that someone might be struggling with their mental health?

A. Taking more risks than usual

B. Expressing feelings of hopelessness

C. Changing sleeping or eating habits

D. Social withdrawal

E. All of the above

E

Which mental illness did Amanda Lipp suffer from according to the KHN article by Jenny Gold?

A. Anxiety

B. Schizophrenia

C. OCD

D. Bipolar disorder

D

In the research article entitled "Prevalence and Predictors of Mental Health Diagnoses..." all of the following are true except:

A. Transgender students had a lower rate of suicidal ideation than ciswomen

B. Multiracial students were more likely to engage in suicidal ideation than white students

C. International students had a lower rate of suicidal ideation than domestic students

D. Transfer students were more likely to engage in suicidal ideation than non-transfers

A

What does the mental health parity law accomplish?

A. The law requires that insurers provide mental health benefits at the same level as any other medical condition

B. The law enables Medicare and Medicaid users to opt out of mental health care coverage

C. The law requires primary care physicians to screen all of their patients for severe mental illness

D. The law allows patients to seek mental health care from psychiatrists outside of the physician network at no extra cost

A

What does the CDC article on mental health during COVID suggest as intervention strategies to address the elevated prevalences of reported adverse mental and behavioral health conditions associated with the pandemic?

A. Expanded use of telehealth

B. Strengthening economic support to reduce financial strain

C. Harm reduction services targeting substance use

D. All of the above

E. A and B

D

True or False: Suicide is the leading cause of death amongst 15 to 24-year olds

False

According to the CDC findings on mental health during COVID, mental health conditions are disproportionately affecting all of the following populations except:

A. Unpaid caregivers

B. Hispanic and black persons

C. All females

D. Young adults

C

In her research, Cindy Liu discovered that _____ was strongly associated with suicidality and mental health diagnoses in college students

A. Relationship status

B. Fast food

C. Stress

D. Off-campus housing

C

What is the Jason Flatt Act?

A. A state mandate that required all teachers to complete suicide prevention and training.

B. A national mandate that required high school teachers to complete mental health awareness training.

C. A movement to raise awareness about depression in teens.

D. A law that requires businesses to offer mental health awareness training.

A

According to the NYT opinion piece, "I Don't Want Another Family to Lose a Child", a CDC survey in June 2020 found that what proportion of 18-24 year-olds had seriously considered suicide in the past 30 days?

A. 1 in 3

B. 1 in 4

C. 1 in 5

D. 1 in 10

B

What is the MAIN idea of the NYT opinion piece, "I Don't Want Another Family to Lose a Child"?

A. We need more pediatric psychiatric hospitals to address mental health issues in adolescents.

B. We need physicians to be better trained and equipped to notice signs of suicidal ideation in adolescents.

C. We need to enact better and more programs so that everyone can learn to support/recognize youth at risk of committing suicide.

D. The seatbelt law was a great example of an effective safety campaign.

C

Which of the following is a key issue with assessing patient capacity according to "Closing the Mortality Gap" by Lisa Rosenbaum?

A. Physicians usually don't have the time to assess patient capacity

B. Physicians fear having to coerce their patients who lack capacity

C. There is no objective way to assess patient capacity

D. All of the above

D

Inpatient care consists of

A. Services delivered by a hospital

B. Treatment of acute conditions

C. Health care delivered in conjunction with an overnight stay in a facility

D. Care delivered in a licensed facility

C

ALOS is an indicator of

A. Use of hospital capacity

B. Frequency of use

C. Severity of illness

D. Access to services

C

What is the major concern with increased consolidation among hospitals and health care systems according to Fulton?

A. Restricting consumer choice and autonomy

B. Lowering barriers to entry which could flood the health care market with unnecessary technology

C. Anticompetitive behavior which could lead to increased costs and lower quality care

D. There are no concerns with increased consolidation among hospitals and health care systems

C

To participate in Medicare and Medicaid, a health care facility must be

A. Conditioned

B. Accredited

C. Certified

D. Licensed

C

In the NYT article by Abelson, hospitals were consolidating with

A. Other hospitals

B. Private medical practices

C. Urgent care clinics

D. All of the above

E. A and B

E

According to the U.S law, nonprofit organizations

A. Can make only a limited amount of profit

B. Are tax exempt

C. Cannot have a governing body

D. Must pay taxes only if they are profitable

B

True or False: The affluent use hospital services more intensively than the poor

False

In the Fulton article, which tool was used to measure market concentration?

A. Herfindahl-Hirschman Index (HHI)

B. Gross Domestic Product (GDP)

C. Four-firm concentration ratio

D. Gini coefficient

A

After the Obama administration left, government attention to suppressing hospital consolidation

A. Increased

B. Decreased

C. Neither increased nor decreased

D. Shifted to suppressing hospital construction

A

The consolidation of hospitals ________ the cost of hospital care for patients

A. Decreases

B. Increases

C. Offsets

D. Subsidizes

B

True or False: By definition, a public hospital is one that is open to the general public

False

Which ownership group constitutes the largest group of hospitals and hospital beds in the United States?

A. Private for-profit

B. Federal

C. Private nonprofit

D. State and local government

C