HCQM Exam Sample Questions

Become familiar with the format of the certification examination by answering these multiple choice questions. At the end of the test, view the answers and compare with your selected choices. Some items are actual exam items that no longer appear on the exam.

1. Spurred by the Institute of Medicine reports on medical errors, a hospital's governing body demands a crash program to reduce medical errors. The chief executive officer orders the senior staff to immediately start nine patient safety projects. This decision will impede the likelihood of the organization lowering the rate of medical errors for which of the following reasons?
A. Information technology implementation is required to efficiently start patient safety projects
B. Involvement of the medical staff is critical in all patient safety projects
C. Projects should focus on medical errors
D. The quality assurance committee should direct all patient safety efforts
E. Resources are allocated to too many projects

2. A chief nursing officer pulls together a Quality Improvement team to improve the efficiency of transferring patients from the emergency department to the patient floors. To ensure that the newly designed process is efficiently implemented, who must be part of the team?
A. Chief information officer
B. Chief medical officer
C. Chief operating officer
D. Emergency department head nurse
E. President of the medical staff

3. Which of the following is a major complaint made by physicians against the use of information obtained from outcomes assessment?
A. Increased market share will not be realized by cooperating physicians
B. Information about internal costs and processes are not necessary for success
C. Information gained cannot be shifted to the point of service
D. The information is not statistically valid for individual physicians
E. Linking process to outcomes does not control quality or cost

4. Which of the following is the most likely root cause of medication errors in health care entities?
A. Carelessness of nurses
B. Illegible physician handwriting
C. Look-alike, sound-alike drugs
D. Manual medication delivery systems
E. Systems failure

5. A chief of surgery decides to address a quality problem among thoracic surgeons directly with staff. Who should participate in the meetings to address the problem?
A. Medical staff leadership
B. Nursing and risk management staff
C. Quality assurance committee
D. Relevant physicians, nurses and non-clinical staff
E. Thoracic surgeons only

6. A case manager discovers that a physical therapist is regularly billing one-hour sessions while providing 20 minutes of care. Which of the following actions of the case manager is most appropriate?
A. Documenting the discrepancy in the case notes
B. Notifying the patient of the discrepancy
C. Reporting the activity to the plan administrator
D. Visiting with the physical therapist to highlight the discrepancy
E. Doing nothing

7. Under which of the following conditions are physicians allowed to disclose confidential patient information?
A. Disclosure of the information is not likely to harm the patient
B. An insurance company assures the confidentiality of the information
C. A patient authorizes disclosure of the information
D. The patient’s guardian or proxy permits the disclosure

8. Each of the following is part of the hospital discharge process EXCEPT:
A. Assessment of the needs of a patient
B. Coordination of appropriate resources for a patient
C. Development of statistical profiling
D. Integration of the action of team members

9. Medical care for workers’ compensation claims is delivered primarily in which of the following settings?
A. Hospital
B. Nursing Home
C. Outpatient
D. Residential Facility

10. Which of the following is LEAST likely to be a basis of liability for a health maintenance organization (HMO)?
A. Administrative downsizing
B. Financial incentives encouraging underutilization
C. Improper selection of participating physicians
D. Negligent utilization review

11. Which of the following variables is used to determine which Diagnosis Related Group (DRG) is associated with an inpatient admission?
A. Principal diagnosis
B. Prior admission diagnosis
C. Secondary diagnosis
D. Total number of diagnoses

12. The National Practitioner Data Bank (NPDB) has been developed under which of the following regulations?
A. The Clinical Laboratory Improvement Act (CLIA)
B. The Consolidated Omnibus Budget Reconciliation Act (COBRA)
C. The Health Care Quality Improvement Act (HCQIA)
D. The Tax Equity and Fiscal Responsibility Act (TEFRA)

13. Which of the following reasons for removing a physician from a health maintenance organization (HMO) provider network requires a report to the National Practitioner Data Bank (NPDB)?
A. The physician hires an associate who has several member complaints and a liability suit pending to provide call coverage
B. The physician is a recovering alcoholic and peers worry that he might relapse
C. The physician’s medical license has been revoked
D. The physician performs more hysterectomies than any provider in the state
E. The physician’s provider profile shows that his charges are well in excess of his peers

14. Which of the following programs was established through the Tax Equity and Fiscal Responsibility Act (TEFRA) of 1982 to assure quality of care to Medicare recipients?
A. Continuing medical education
B. Medicaid
C. Civilian Health and Medical Program of the Uniformed Services (CHAMPUS)
D. Peer Review Organization (PRO)

15. One of the health care-related responsibilities of the Food and Drug Administration (FDA) is:
A. Assisting public health care providers in the provision of medical care
B. Enforcing foreign quarantine activities and regulations
C.Expanding clinical practice guidelines by evaluating their effect on the quality of health care
D. Monitoring the safety and effectiveness of medical devices for human use

16. Which of the following entities regulates the disposal of infectious waste?
A. Centers for Disease Control and Prevention (CDC)
B. Food and Drug Administration (FDA)
C. Occupational Safety and Health Administration (OSHA)
D. United States Public Health Service

Click and drag across the area directly below to reveal the answers to the questions above.
1 = E
2 = D
3 = D
4 = E
5 = D
6 = C
7 = C
8 = C
9 = C
10 = A
11 = A
12 = C
13 = C
14 = D
15 = D
16 = C