APEA 3P EXAM PREP 7 ETHICS PROFESSIONAL
ISSUES QUESTIONS AND CORRECT VERIFIED
ANSWERS WITH EXPANATIONS
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.
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:blank 1/27
, 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
about:blank 2/27
, 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.
The standard of care followed by the nurse practitioner
should not depend on whether the patient has insurance or
not. It is unethical to not properly inform the patient of risks
he may have been exposed to from the puncture wound.
Offering to buy the medications for the patient is noble but is
not a sustainable practice. The nurse practitioner should
prescribe the medications as for anyone with possible HIV
exposure and refer to social services or a community referral
agency that can help this patient acquire the appropriate
medications.
A nurse practitioner is working in a minor care clinic. She
realizes that a patient with a minor laceration does not have
insurance and is using his brother’s insurance information
today so that his visit will be covered. How should she
proceed?
She should let him know that she knows
what he is doing. She should ignore this
about:blank 3/27
ISSUES QUESTIONS AND CORRECT VERIFIED
ANSWERS WITH EXPANATIONS
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.
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:blank 1/27
, 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
about:blank 2/27
, 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.
The standard of care followed by the nurse practitioner
should not depend on whether the patient has insurance or
not. It is unethical to not properly inform the patient of risks
he may have been exposed to from the puncture wound.
Offering to buy the medications for the patient is noble but is
not a sustainable practice. The nurse practitioner should
prescribe the medications as for anyone with possible HIV
exposure and refer to social services or a community referral
agency that can help this patient acquire the appropriate
medications.
A nurse practitioner is working in a minor care clinic. She
realizes that a patient with a minor laceration does not have
insurance and is using his brother’s insurance information
today so that his visit will be covered. How should she
proceed?
She should let him know that she knows
what he is doing. She should ignore this
about:blank 3/27
