3 Y R O TA D N A M E R O C
Relias
R Healthcare Education & Competency Platform
EST. 2012
IMPROVING LIVES THROUGH BETTER KNOWLEDGE.
Relias Prophecy — Core Mandatory Part 3
A B US E · W O R K P L AC E V I O L E N C E · R E ST RA I N TS · PA I N · A DVA N C E D I R E CT I V E S
INSTITUTION Relias COURSE Relias Prophecy Core Mandatory
Part 3
CATEGORY Healthcare Compliance & Patient TOTAL QUESTIONS 35 Questions
Safety
FORMAT Multiple Choice — Select the ACCREDITATION Joint Commission · CMS · OSHA
Single Best Answer Standards
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each multiple-choice question.
▸ Content covers advance directives, abuse identification and reporting, sexual harassment, workplace
violence, restraints, and pain management.
▸ Correct answers and clinical rationales appear below each question for board review purposes.
▸ All data reflects current federal and state regulations, Joint Commission standards, and evidence-based
practice.
, CORE MANDATORY EXAMINATION Questions 1 – 35
1. Which statement is accurate concerning the portability of advance healthcare directives?
A. An AHD written in one state is valid in all 50 states automatically
B. In some cases, if laws are similar, a state will accept an AHD written in another state
C. Advance directives are never valid across state lines
D. Only federal advance directives are portable
CORRECT ANSWER B — In some cases, if laws are similar, a state will accept an AHD written in
another state.
RATIONALE Advance healthcare directive (AHD) portability varies by state. While there is no
universal automatic recognition of out-of-state AHDs, many states have
reciprocity provisions — they will honor an AHD executed in another state if it
complies with that state's laws OR if it substantially complies with the receiving
state's requirements. Some states explicitly recognize valid out-of-state directives
by statute. However, healthcare providers should be aware of their specific state's
laws. The key point: AHDs are NOT automatically valid in all 50 states, but many
states do accept them when laws are similar. Emergency medical technicians
(EMTs) generally cannot honor AHDs in the field — they must resuscitate and
transport unless a valid DNR order is presented. AHDs are important for
EVERYONE, even those who are healthy.
,2. Which of the following statements is NOT accurate regarding signs of abuse?
A. Victims may have injuries inconsistent with the explanation given
B. Victims of physical abuse will always have visible cuts or bruises
C. Psychological abuse may leave no visible signs
D. Abuse victims may display behavioral changes such as withdrawal or fear
CORRECT ANSWER B — Victims of physical abuse will always have visible cuts or bruises.
RATIONALE This statement is FALSE and dangerously inaccurate. Physical abuse does NOT
always leave visible marks. Abusers may use techniques specifically designed to
avoid leaving visible evidence: strangulation (may leave minimal external marks
but cause serious internal injury), suffocation, forced ingestion of harmful
substances, or inflicting pain in areas covered by clothing. Victims may also hide
injuries out of shame or fear. The absence of visible cuts or bruises does NOT rule
out physical abuse. Healthcare workers must also assess for: injuries inconsistent
with the explanation, delay in seeking treatment, frequent emergency
department visits, behavioral changes (anxiety, depression, withdrawal, fear of
partner/caregiver), and pattern injuries (bruises in various stages of healing).
Psychological abuse involves intimidating, ridiculing, or degrading someone.
, 3. Hostile work environment sexual harassment involves harassment by:
A. Only a direct supervisor
B. Only a coworker at the same level
C. All of the above — direct supervisor, vendor, subordinate
D. Only someone of the opposite gender
CORRECT ANSWER C — All of the above: direct supervisor, vendor, subordinate.
RATIONALE Hostile work environment sexual harassment can be perpetrated by ANYONE in
the workplace — a direct supervisor, a coworker, a subordinate, a vendor, a
contractor, a patient, or a patient's family member. The harasser does NOT need
to be in a position of authority over the victim. The legal standard: unwelcome
conduct of a sexual nature that is sufficiently severe or pervasive to create an
intimidating, hostile, or offensive work environment that unreasonably interferes
with an individual's work performance. This is distinct from quid pro quo
harassment (demanding sexual favors in exchange for job benefits, which
requires authority). Sexual harassment in the workplace involves uninvited and
unwelcome verbal or physical conduct directed at an employee because of their
sex. Gender harassment (the most common type) involves unwelcome obscene
jokes or comments. Victims should keep a record of harassment incidents.
Relias
R Healthcare Education & Competency Platform
EST. 2012
IMPROVING LIVES THROUGH BETTER KNOWLEDGE.
Relias Prophecy — Core Mandatory Part 3
A B US E · W O R K P L AC E V I O L E N C E · R E ST RA I N TS · PA I N · A DVA N C E D I R E CT I V E S
INSTITUTION Relias COURSE Relias Prophecy Core Mandatory
Part 3
CATEGORY Healthcare Compliance & Patient TOTAL QUESTIONS 35 Questions
Safety
FORMAT Multiple Choice — Select the ACCREDITATION Joint Commission · CMS · OSHA
Single Best Answer Standards
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each multiple-choice question.
▸ Content covers advance directives, abuse identification and reporting, sexual harassment, workplace
violence, restraints, and pain management.
▸ Correct answers and clinical rationales appear below each question for board review purposes.
▸ All data reflects current federal and state regulations, Joint Commission standards, and evidence-based
practice.
, CORE MANDATORY EXAMINATION Questions 1 – 35
1. Which statement is accurate concerning the portability of advance healthcare directives?
A. An AHD written in one state is valid in all 50 states automatically
B. In some cases, if laws are similar, a state will accept an AHD written in another state
C. Advance directives are never valid across state lines
D. Only federal advance directives are portable
CORRECT ANSWER B — In some cases, if laws are similar, a state will accept an AHD written in
another state.
RATIONALE Advance healthcare directive (AHD) portability varies by state. While there is no
universal automatic recognition of out-of-state AHDs, many states have
reciprocity provisions — they will honor an AHD executed in another state if it
complies with that state's laws OR if it substantially complies with the receiving
state's requirements. Some states explicitly recognize valid out-of-state directives
by statute. However, healthcare providers should be aware of their specific state's
laws. The key point: AHDs are NOT automatically valid in all 50 states, but many
states do accept them when laws are similar. Emergency medical technicians
(EMTs) generally cannot honor AHDs in the field — they must resuscitate and
transport unless a valid DNR order is presented. AHDs are important for
EVERYONE, even those who are healthy.
,2. Which of the following statements is NOT accurate regarding signs of abuse?
A. Victims may have injuries inconsistent with the explanation given
B. Victims of physical abuse will always have visible cuts or bruises
C. Psychological abuse may leave no visible signs
D. Abuse victims may display behavioral changes such as withdrawal or fear
CORRECT ANSWER B — Victims of physical abuse will always have visible cuts or bruises.
RATIONALE This statement is FALSE and dangerously inaccurate. Physical abuse does NOT
always leave visible marks. Abusers may use techniques specifically designed to
avoid leaving visible evidence: strangulation (may leave minimal external marks
but cause serious internal injury), suffocation, forced ingestion of harmful
substances, or inflicting pain in areas covered by clothing. Victims may also hide
injuries out of shame or fear. The absence of visible cuts or bruises does NOT rule
out physical abuse. Healthcare workers must also assess for: injuries inconsistent
with the explanation, delay in seeking treatment, frequent emergency
department visits, behavioral changes (anxiety, depression, withdrawal, fear of
partner/caregiver), and pattern injuries (bruises in various stages of healing).
Psychological abuse involves intimidating, ridiculing, or degrading someone.
, 3. Hostile work environment sexual harassment involves harassment by:
A. Only a direct supervisor
B. Only a coworker at the same level
C. All of the above — direct supervisor, vendor, subordinate
D. Only someone of the opposite gender
CORRECT ANSWER C — All of the above: direct supervisor, vendor, subordinate.
RATIONALE Hostile work environment sexual harassment can be perpetrated by ANYONE in
the workplace — a direct supervisor, a coworker, a subordinate, a vendor, a
contractor, a patient, or a patient's family member. The harasser does NOT need
to be in a position of authority over the victim. The legal standard: unwelcome
conduct of a sexual nature that is sufficiently severe or pervasive to create an
intimidating, hostile, or offensive work environment that unreasonably interferes
with an individual's work performance. This is distinct from quid pro quo
harassment (demanding sexual favors in exchange for job benefits, which
requires authority). Sexual harassment in the workplace involves uninvited and
unwelcome verbal or physical conduct directed at an employee because of their
sex. Gender harassment (the most common type) involves unwelcome obscene
jokes or comments. Victims should keep a record of harassment incidents.
