APEA 3P Exam Prep- Professional
Issues/Ethics Questions and
Answers with Explanations
A nurse practitioner has agreed to participate in the Medicare health insurance
program. Medicare paid 80% of the charges billed for a clinic visit. What can be
done about the other 20% that is owed?
The NP can bill the patient for a percentage of the remainder.
The NP is prohibited from billing the patient.
The NP can collect 90% if billed incident to the MD.
The NP can resubmit the bill for additional payment.
The NP is a “participating” provider because he agreed to accept assignments. An
assignment is an agreement between Medicare and the NP to accept the Medicare
Approved Amount (MAA) as payment in full and not charge Medicare recipients a
higher rate. The NP can bill the patient for a percentage of the remaining bill that
was not paid by Medicare. The NP may opt out of participating. The NP can be
reimbursed 100% if billed incident to the MD.
The name given to subjects in a research study who do not have the disease or
condition being studied, but who are included in the study for comparison are:
studied subjects.
controls.
case series.
cross sectionals.
Studied subjects are those members of a study who have a specific disease or
condition of interest or who are receiving a specific treatment. Case series may
refer to an observational study in which a group of patients with interesting
characteristics are studied. Cross sectional is a type of observational study in which
a particular characteristic is studied at one time rather than over time. Controls are
commonly employed in many types of research studies.
The research design that provides the strongest evidence for concluding causation
is:
, randomized controlled trials.
cohort studies.
case control studies.
prospective studies.
A randomized clinical trial (RCT) is the epitome of all research designs. Subjects are
randomly assigned to treatment groups. This type study provides the best evidence
that the results were due to the intervention and not something else. A RCT is an
experimental design, not an observational one.
An older adult male with moderately severe dementia presents with his caregiver
daughter. His BMI is 18. His clothes have food stains on them and he looks as
though he hasn’t been bathed in days. How should the nurse practitioner handle
this?
The NP should comment to the daughter about his poor care.
The NP should report this as potential elder abuse.
The patient should be asked about his care.
The daughter should be asked about the type of care he receives.
This patient presents as though he is being poorly cared for and mistreated. This
occurs in about 3-8% of the adult population in the United States. There is no
evidence that the patient has been physically abused, but he obviously suffers from
neglect. This is a form of elder abuse, just as physical, sexual, psychological, or
financial abuse is. Older adults with dementia often suffer abuse most frequently.
A nurse practitioner is working in a minor care area of an emergency department.
An illegal immigrant has a puncture wound caused by an unknown sharp object in a
trash container. A dirty needle is suspected. The nurse practitioner:
Should administer a tetanus injection only since the patient has no medical
insurance.
Should prescribe appropriate medications for HIV exposure even though the nurse
practitioner knows the patient can’t afford them.
Should not mention the possibility of HIV exposure from a dirty needle to the
patient.
Can offer to buy the HIV medications for $50 with their professional discount at the
pharmacy next door.
Issues/Ethics Questions and
Answers with Explanations
A nurse practitioner has agreed to participate in the Medicare health insurance
program. Medicare paid 80% of the charges billed for a clinic visit. What can be
done about the other 20% that is owed?
The NP can bill the patient for a percentage of the remainder.
The NP is prohibited from billing the patient.
The NP can collect 90% if billed incident to the MD.
The NP can resubmit the bill for additional payment.
The NP is a “participating” provider because he agreed to accept assignments. An
assignment is an agreement between Medicare and the NP to accept the Medicare
Approved Amount (MAA) as payment in full and not charge Medicare recipients a
higher rate. The NP can bill the patient for a percentage of the remaining bill that
was not paid by Medicare. The NP may opt out of participating. The NP can be
reimbursed 100% if billed incident to the MD.
The name given to subjects in a research study who do not have the disease or
condition being studied, but who are included in the study for comparison are:
studied subjects.
controls.
case series.
cross sectionals.
Studied subjects are those members of a study who have a specific disease or
condition of interest or who are receiving a specific treatment. Case series may
refer to an observational study in which a group of patients with interesting
characteristics are studied. Cross sectional is a type of observational study in which
a particular characteristic is studied at one time rather than over time. Controls are
commonly employed in many types of research studies.
The research design that provides the strongest evidence for concluding causation
is:
, randomized controlled trials.
cohort studies.
case control studies.
prospective studies.
A randomized clinical trial (RCT) is the epitome of all research designs. Subjects are
randomly assigned to treatment groups. This type study provides the best evidence
that the results were due to the intervention and not something else. A RCT is an
experimental design, not an observational one.
An older adult male with moderately severe dementia presents with his caregiver
daughter. His BMI is 18. His clothes have food stains on them and he looks as
though he hasn’t been bathed in days. How should the nurse practitioner handle
this?
The NP should comment to the daughter about his poor care.
The NP should report this as potential elder abuse.
The patient should be asked about his care.
The daughter should be asked about the type of care he receives.
This patient presents as though he is being poorly cared for and mistreated. This
occurs in about 3-8% of the adult population in the United States. There is no
evidence that the patient has been physically abused, but he obviously suffers from
neglect. This is a form of elder abuse, just as physical, sexual, psychological, or
financial abuse is. Older adults with dementia often suffer abuse most frequently.
A nurse practitioner is working in a minor care area of an emergency department.
An illegal immigrant has a puncture wound caused by an unknown sharp object in a
trash container. A dirty needle is suspected. The nurse practitioner:
Should administer a tetanus injection only since the patient has no medical
insurance.
Should prescribe appropriate medications for HIV exposure even though the nurse
practitioner knows the patient can’t afford them.
Should not mention the possibility of HIV exposure from a dirty needle to the
patient.
Can offer to buy the HIV medications for $50 with their professional discount at the
pharmacy next door.
