HCA 501 Unit1-4 MCQs

HCA 501
Health Care in America
Text: Delivering Health Care in America
Fourth Edition, 2008
ISBN-13: 9780763745127, ISBN-10:076374512X
Authors:
Leiyu Shi and Douglas A. Singh
Publisher:
Jones & Bartlett

Multiple Choice Questions (Enter your answers on the enclosed answer sheet)
1. Which of the following is a characteristic of a national health insurance system?
a. The government finances health care through general taxes
b. Health care is delivered by private providers
c. Both a and b
d. Neither a nor b
2. Which of the following is a characteristic of a socialized health insurance system?
a. Health care is financed through government-mandated contributions by employers and employees
b. Health care is delivered by government-employed providers
c. Both a and b
d. Neither a nor b
3. In 1984, Australia switched:
a. From the Medicare program to a universal national health care program
b. From a universal national health care program to a privately financed system
c. From a privately financed system to the Medicare program
d. None of the above
4. A free market in health care requires:
a. Adequate information for patients
b. Independent actions between buyers (patients) and sellers (providers)
c. Unencumbered interaction of the forces of supply and demand
d. All of the above
5. A multiple payer system is more cumbersome than a single payer system for all of the following reasons except:
a. There are numerous health plans, which is difficult for providers to handle
b. Payments are not standard ized across health plans
c. Some health care services are covered for people in the north, but not in the south
d. Government programs require extensive documentation proving services were provided before payi ng providers
6. Which of the following entities in the U,S, employs lobbyists?
a. Physicians
b. Insurance companies
c. Large employers
d. All of the above
7, The ownership of Canada’s health care system is best described as:
a. Private
b. Public
c. Combination of private and public
d. None of the above
8, Supplier-induced demand is created by:
a, Patients
b. Providers
c. Health insurance companies
d. The government
9. Which country spends the most in administrative health care costs?
B. United States
b. Germany
c. UK
d. Australia
10. Demand-side rationing IS the same thing as:
a. Nonprice rationing
b. Price rationing
c. Both a and b
d. Neither a nor b
11. Deontology asserts:
a. That no one has a duty to do what is right
b. That it is society’s duty to do what is right
c. That it is an individual’s duty to do what is right
d. None of the above

12. Utilitarianism emphasizes:
a. Happiness and welfare for the poor
b. Happiness and welfare for the deserving
c. Happiness and welfare for the most people possible
d. None of the above
13. Supply-side rationing is also referred to as:
a. Nonprice rationing
b. Price rationing
c. Planned rationing
d. Both a and c
14. The limitations of market justice include:
a. Social problems are not adequately addressed
b. Society is not always protected from the consequences of ill health
c. It leads to inequitable access to health care
d. All of the above
15. Prevalence is:
a. The number of new cases occurring during a specified period divided by the total population
b. The total number of cases at a specific point in time divided by the specified population
c. The number of new cases occurring during a specified period divided by the population at risk
d. The total number of cases at a specific point in time divided by the population at risk
16. Crude rates refer to:
a. A specific age group
b. A specific gender
c. The total population
d. None of the above
17. Holistic health adds which element to the World Health Organization definition of health?
a. Physical
b. Mental
c. Spiritual
d. Social
18. What was the main consequence of early proprietary medical schools, as opposed to state-sponsored schools, in the preindustrial era?
a. Standards were low.
b. The cost of medical education became too high.
c. Medical education became regulated.
d. Science and research became part of medical education.
19. Which of the following factors was particularly important in promoting the growth of office- based medical practice in the postindustrial period?
a. Urbanization
b. Educational reform
c. Science and technology
d. Dependency
20. When a profession’s services are generally accepted and are legitimized, they impart __ to the profession.
a. Specialization
b. Organ ized strength
c. Cohesiveness
d. Cu Itural authority
21. Cultural authority was conveyed to the medical profession mainly through
a. The development of the AMA
b. Advances in medical science
c. Patients’ dependency
d. Licensi ng
22. Development of the hospital and __ happened almost hand in hand in a symbiotic relationship between the two.
a. Dependency of patients
b. Growth of scientific knowledge
c. Professionalization of medical practice
d. Cohesiveness of the medical profession
23. Even though hospitals incurred frequent deaths in the early 1900s, their use was on the rise mainly because
a. Most people had poor living conditions in their homes
b. People had no other choice but use the hospitals
c. A large number of immigrants were settling in American cities
d. Technology was advancing at a rapid pace
24. Why did physicians remain independent of corporate settings even after the medical profession became well recognized?
a. Hospitals were unable to pay high enough salaries to physicians.
b. Physicians disliked salary arrangements.
c. Licensure laws had not yet been passed.
d. Physicians who took up practice in a corporate setting were castigated by the medical profession.
25. Organized medicine
a. Concerted activities of physicians through the American Medical Association
b. Affiliation of physicians with medical schools
c. Standardized practice of medicine
d. Unionization of physicians
e.

a.
Multiple Choice Questions (Enter your answers on the enclosed answer sheet)
1. Nonphysician practitioners (N PPs) i ncl ude:
a. Osteopaths
b. Dentists
c. Physician assistants
d. None of the above
2. Allied health professionals incl ude:
a. Osteopaths
b. Dentists
c. Physician assistants
d. None of the above
3. Physician maldistribution occurs by:
a. Specialty
b. Geography
c. Both a and b
d. Neither a nor b
4. Compared to metropolitan and suburban areas, there is a/an __ of physicians in rural areas.
a. Shortage
b. Surplus
C. Equal amount
d. Unknown number
5. The roles and responsibilities of health services administrators include:
a. Leadership and strategic direction
b. Departmental management
c. Program oversight
d. All of the above
6. Primary care is:
a. Longitudinal
b. The portal to the health care system
c. Holistic
d. All of the above
7. The principal source of funding for graduate medical education is:
a. Medicaid
b. Medicare
c. Private funds
d. State grant programs
8. Which of the following is a major criticism of managed care?
a. Qua I ity of care may be sacrificed
b. Managed care is inefficient
c. Utilization may increase
d. Managed care will worsen the physician oversupply
9. The percentage of active primary care generalist physicians has:
a. Decreased since 1949
b. Increased si nce 1949
c. Remained steady since 1949
d. Unknown: this number has only been tracked since 1970
10. Which of the following medical specialty earns the highest salary?
a. Emergency medicine
b. Radiology
c. Pediatrics
d. Obstetrics/Gynecology
11. This law was criticized for slowing down the introduction of new drugs.
a. Prescri ption Drug User Fee Act, 1992
b. Kefauver-Harris Drug Amendments, 1962
c. Food and Drug Administration Modernization Act, 1997
d. Food, Drug, and Cosmetic Act, 1938
12. This law provided incentives for pharmaceutical firms to develop new drugs for health
problems that affected a relatively small number of people.
a. Prescription Drug User Fee Act, 1992
b. Kefauver-Harris Drug Amendments, 1962
c. Orphan Drug Act, 1983
d. Food and Drug Administration Modernization Act, 1997

13. This made additional resources available to the FDA, and resulted in a shortened approval process for new drugs.
a. Kefauver-Harris Drug Amendments, 1962
b. Food and Drug Administration Modernization Act, 1997
c. Orphan Drug Act, 1983
d. Prescription Drug User Fee Act, 1992
14. The most stringent requirements of premarket approval regarding safety and effectiveness apply to __ devices.
a. Class I
b. Class II
c. Class III
d. Class IV
15. The Safe Medical Devices Act, 1990 requires:
a. That injuries, illness, or death from any device be reported
b. Premarket approval of devices
c. Safety testing of devices before and after they have been marketed
d. That all problems and potential problems be reported to the FDA
16. What was the purpose of certificate of need (CON) laws?
a. Monitor the diffusion of new technology
b. Control the flow of federal funds for private projects
c. Control new health service programs
d. Control new construction and modernization projects
17. Which department of the DHHS supports research on health care quality, cost, and access?
a. National Institutes of Health
b. Agency for Healthcare Research and Qual ity
c. Institute of Medicine
d. American Health Quality Association
18. What is the main function of the National Institutes of Health?
a. Conduct and support research on health care quality, cost, and access
b. Establish medical subspecialties in US medical schools
c. Provide specialized training for medical specialists
d. Conduct and support biomedical research
19. Which area of personal health expenditures has seen the greatest rise in recent years?
a. Long-term care
b. Hospital services
c. Prescription drugs
d. Durable medical equipment
20. According to the Institute of Medicine, the rise in prescription drug costs is mainly attributed to:
a. price inflation
b. increased use of existing drugs
c. research and development costs
d. replacement of older drugs by newer ones
21. Evaluation of the appropriateness of medical technology.
a. Cost -effectiveness
b. Health technology assessment
c. Clinical trial
d. Efficacy
22. In technology assessment, what role do clinical trials play?
a. They are used for experimentation with potentially useful drugs
b. They are used for establishing the rights of participants
c. They are used for determining cost-effectiveness
d. They are used for evaluating efficacy and safety
23. What is the role of an institutional review board (IRB)?
a. Establish guidelines for the method of conducting research
b. Verify the results of clinical trials
c. Approve and monitor research that involves human subjects
d. All of the above
24. Usefulness of a new technology.
a. Quality
b. Efficacy
c. Assessment
d. Appropriateness
25. Cost-efficiency evaluates marginal benefits in relation to:
a. Marginal safety
b. Marginal costs
c. Flat of the curve
d. Outcomes

Multiple Choice Questions (Enter your answers on the enclosed answer sheet)
1. What has been the effect of intense consolidation in certain hospital markets?
a. Increased competition
b. Better access
c. Dilution of competition
d. Improved quality
2. Who pioneered the transformation of nursing into a recognized profession?
a. Madame Curie
b. Florence Nightingale
c. Cicely Saunders
d. Sylvia Lack
3. The Hill-Burton Act was passed to
a. Make it mandatory for private insurers to cover hospital services
b. Rei ieve shortage of hospitals
c. Curtail the utilization of hospital beds
d. Have federal control over community hospitals
4. Under the Hospital Survey and Construction Act of 1946, the responsibility for hospital planning
a. Remained in the hands of the federal government
b. Was delegated to local county and city governments
c. Was given to the states
d. Was given to private insurers
5. Under the Hill-Burton Act, federal grants were given on the basis of
a. Bed-to-population ratios
b. Poverty ranking for each state
c. Number of hospital beds already in existence
d. Hospital size needed to adequately serve each community
6. Which factor was the most instrumental in the growth of nonprofit community hospitals in the United States?
a. Hill-Burton Act
b. Growth of private health insurance
c. Medical technology
d. Tax Equity and Fiscal Responsibility Act
7. Since 1980, the share of national health expenditures consumed by hospital care has
a. Increased
b. Declined
c. Remained the same
d. Remained unknown
8. Which factor had the most dramatic effect on hospital downsizing in the United States?
a. Increase in the number of uninsured Americans
b. Closing of rural hospitals
c. Managed care
d. Prospective reimbursement
9. Why are discharge statistics more accurate than admission statistics as a count of inpatients served by a hospital?
a. Deaths are not counted as discharges
b. Deaths are counted as discharges
c. Babies are born in hospitals
d. Some newborn infants need critical care
10. ALOS is an indicator of
a. use of hospital capacity
b. frequency of use
c. severity of illness
d. access
11. How is average length of stay calculated?
a. Days of care/d ischarges
b. By cumulating patient days
c. Inpatient days/capacity
d. Discharges X inpatient days
12. Average dai Iy census is a measure of a hospital’s
a. Daily capacity
b. Average admissions per day
c. Days of care
d. Number of patients served daily
13. The proportion of a hospital’s capacity that is actually utilized.
a. Days of care
b.ALOS
c. Average daily census
d. Occupancy rate
14. Which of these hospitals types is not likely to serve the general public?
a. County and city hospitals
b. Proprietary hospitals
c. Federal hospitals
d. Community hospitals
15. Which ownership type 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
16. For whose financial benefit are proprietary hospitals operated?
a. Stockholders
b. The American public
c. The local community
d. The governing body
17. In a hospital classified as short stay, the ALOS is less than
a. 5 days
b. 10 days
c. 15 days
d. 25 days
18. Which hospitals provide services to children in communities that do not have specialty children’s hospitals.
a. Rehabilitation hospitals
b. General hospitals
c. Long-term care hospitals
d. Specialized hospitals
19. To be classified as a community hospital, the hospital must be
a. A public hospital
b. A nonfederal hospital
c. A nonprofit hospital
d. A nongovernmental hospital
20. Which of the following cannot be classified as a community hospital?
a. Specialty hospital
b. Proprietary hospital
c. Long-stay hospital
d. Children’s hospital
21. To be classified as a Critical Access Hospital, the number of acute care beds should not exceed
a. 20
b.25
c.35
d. 50
22. What financial benefit does a small rural hospital reap by qualifying for the designation, Critical Access Hospital?
a. It can receive specific federal grants for serving vulnerable populations
b. It can use its beds for either acute care or long-term care as needed
c. It can increase its profitabi I ity by receivi ng special payments for emergency services
d. It can receive cost-plus reimbursement under Medicare Part A
23. Which hospital type is likely to emphasize holistic medicine?
a. Osteopathic hospital
b. General hospital
c. Specialty hospital
d. Rehabilitation hospital
24. According to US 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
25. Institutional theory predicts that
a. For-profit and nonprofit organizations will imitate each other when faced with similar regu latory and legal constrai nts
b. As an enterprise increases in size, its unit overhead costs would decrease
c. As a hospital increases in size, its economies of scale dissipate
d. In competitive markets, both for-profit and nonprofit organizations would deliver certain essential community benefits

Multiple Choice Questions (Enter your answers on the enclosed answer sheet)
l. All of the following are elements of the policy cycle, except:
a. Issue raising
b. Policy design
c. Policy implementation
d. Policy evaluation
2. What was the main purpose of the Kerr-Mills program (l960)?
a. Provision of federal grants to state government programs assisting the elderly
b. Provision of federal grants to state government programs assisting the poor
c. Provision of federal grants to state government programs assisting children
d. None of the above
3. Which piece of legislation had important implications for rural hospitals?
a. Rural Hospital Act of 1992
b. Omnibus Budget Reconciliation Act (OBRA) of 1986
c. Access to Ca re Act of 1988
d. Higgins-Branyan Act of 2004
4. For what is the National Health Planning and Resources Development Act of 1974 noted?
a. The shift from cost containment to improvement of quality as the principal theme in federal health policy
b. The shift from cost containment to improvement of access as the principal theme in federal health pol icy
c. The shift from improvement of access to cost containment as the principal theme in federal health policy
d. The shift from improvement of quality to cost containment as the principal theme in federal health policy
5. Which aspect of health care pol icy has received the most attention during the past several decades?
a. Quality improvement
b. Racial and ethnic disparities reduction
c. Cost containment
d. Access to car
6. What does “CON” stand for?
a. Certificate of Need
b. Certificate of Nursing
c. Certificate of Naturopathy
d. Certificate of Nationality
7. What is the mai n purpose of the Agency for Healthcare Research and Qual ity?
a. To regu late hospitals
b. To conduct and support research with respect to health care services and procedures
c. To evaluate the effectiveness and safety of pharmaceuticals
d. None of the above
8. In what way does research influence policymaking?
a. Prescription
b. Documentation
c. Analysis
d. All of the above
9. Which of the following is a health policy challenge faced by state governments?
a. Protecting public health
b. Subsidizing costs of caring for the uninsured
c. Financing health services for the poor
d. All of the above
10. All of the following were identified by the Institute of Medicine (Crossing the Quality Chasm, 2001) as areas for quality improvement, except:
a. Timeliness
b. Safety
c. Efficacy
d. Patient-centeredness
11. Which approach to national health care, if adopted, will make the most drastic changes in the US health care system?
a. Laissez-faire
b. Play or pay
c. Single payer
d. Managed competition
18. Which federal legislation has put severe constraints on the states to pass employer mandates that would require employers to pay for their employees’ health insurance?
a. Health Security Act
b. Trade Adjustment Assistance Act
c. Employee Retirement Income Security Act
d. Health Insurance Portability and Accountability Act
19. In former US Surgeon General, David Satcher’s proposal to increase investment in prevention, the ‘downstream’ level focuses on
a. The individual
b. The community
c. The state
d. The federal government
20. __ can benefit workers by furnishing them a larger set of skills.
a. Diversity training
b. Cross training
c. Multidisciplinary teamwork
d. Specialized training
21. Multi-skilled health practitioners (MHPs) are
a. Particularly useful in large teaching hospitals
b. Particularly useful in multidisciplinary teams
c. Cross-trained
d. Highly specialized
22. In a consumer-choice market, __ may be the best predictor of future success for a health care organization.
a. Continuum of services
b. Size
c. Market share
d. Client satisfaction

23. Extensive regulations imposed on health care organizations consume time and resources, which can impede
a. A focus on the consumer
b. Quality
c. Charity
d. Patient autonomy
24. Evidence-based medicine proposes to incorporate __ in medical care delivery.
a. Clinical trials
b. Best practices
c. Experimentation
d. Clinical review
25. Adherence to clinical guidelines is higher when they are based on
a. Experimentation
b. Clinical review
c. Small area variations
d. Clinical trials

Explanation & Answer

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