173 TExES Health Science Technology Education 8 - 12 Exam Practice Questions

1. The Food and Drug Administration ensures the safety of:

A. Food
B. Kitchenware
C. Illegal drugs
D. All of the above

2. List the records required by The Safe Medical Device Act of 1990.

A. Patient responses
B. How many times a problem is reported
C. Cost of disposal
D. All of the above

3. Elder abuse can be:

A. A single act
B. Acceptable
C. Lack of love
D. All of the above

4. List specific activities that indicate elder abuse.

A. Laughing, feeding, and teasing
B. Hitting, pushing and kicking
C. Restricting access to entertainment
D. Encouraging exercise

5. Who can authorize an involuntary detention of a patient?

A. Lawyer
B. Family
C. Employer
D. All of the above

6. Reasons a person may be involuntarily detained include:

A. Annoying behavior
B. Refusing treatment
C. Homeless
D. Grave inability to provide basic needs

7. Bioethics considers issues arising from:

A. Biology
B. Relationships
C. Use of funds
D. Patient needs

8. Who will honor a "do not resuscitate" order?

A. Medical personnel
B. Family
C. Pharmacist
D. All of the above

9. What should be understood by a patient before giving informed consent?

A. Payment methods
B. Medical terminology
C. Probability of recovery
D. Possible outcomes of not agreeing

10. Name the different types of consent.

A. Special consent
B. Partial consent
C. General consent
D. All of the above

ANSWER KEY EXAM 173

1. Answer: A

The Food and Drug Administration (FDA) is an agency within the U.S. Department of Health and Human Services. Its purpose is to ensure the safety, effectiveness, manufacturing, packaging and labeling of food, medical and cosmetic products used and/or consumed by humans and food additives and drugs given to animals. The FDA has the power and authority to approve, ban and control the marketing and distribution of these products. The agency charges fees to the manufacturers who have applied for approval. In return, the FDA is required to meet specific "performance benchmarks" during the approval process. The FDA doesn't actually test products; that is the manufacturer's responsibility. The agency reviews and verifies information provided by the product's sponsor. The agency reviews data from clinical trials, manufacturing specifications, drug stability and labeling and packaging designs. The FDA accepts and approves the product (benefits outweigh risks), declares it "approvable" (minor problems need to be addressed before final approval) or declares the product "not approvable" because of concerns about the safety and/or effectiveness of the product.

2. Answer: B

The Safe Medical Device Act of 1990 was enacted to protect the public from dangerous devices that cause harm or do not do what the manufacturer claims they do. It requires users of medical devices to report to the manufacturer and the U.S. Department of Health and Human Services when the item has "caused or contributed to a death, illness or injury." It requires the DHHS to keep records of how many times a user reports a problem, manufacturers' responses and actions taken and cost of implementation. The act covers instruments and machines that deliver some kind of health care, i.e., anything that is not a drug or other consumable metabolized by the body. The law describes these devices as "any apparatus, implement, machine, implant or related article intended for use in diagnosing, treating, curing or preventing disease or intended to affect the body's function or structure." This is a broad definition that includes virtually all medical devices used in patient care and treatment.

3. Answer: A

Elder abuse is a single act, a pattern of actions or lack of attention that causes physical harm or psychological distress. Sometime the abuse is the continuation of a lifetime of domestic violence, starts after retirement or at the onset of a debilitating disease or chronic health problem.

According to the National Center on Elder Abuse:

• Suspicious bruises or other injuries; change in behavior; restriction or limitation of visitors are signs of physical and/or sexual abuse.
• The senior is agitated, withdrawn, unresponsive or exhibits uncharacteristic behavior could signal psychological abuse.
• Dehydration, malnutrition, weight loss, untreated medical conditions; poor and unsanitary living conditions, soiled or inadequate clothing, restricted access to eyeglasses, hearing aid, dentures, walker, wheelchair all suggest neglect.
• Unexplained bank withdrawals, unauthorized use of bankcards or credit cards, "lost" checks or checks written as "gifts" or "loans," abrupt changes in the will or power of attorney, odd investment decisions, transfer or disappearance of valuable assets all point to financial abuse.

4. Answer: B

• Physical Abuse: Hitting, punching, burning, pushing, kicking, restraining, inappropriate confinement, giving too much, not enough or the wrong medication <
• Psychological Abuse: Shouting, frightening, blaming, humiliating, manipulating, threatening, criticizing. Telling lies to and about the person; spreading malicious gossip and betraying confidences or threatening to; treating like a child; controlling access to and isolation from family and friends.
• Financial Abuse: Unauthorized use of or depriving or restricting access to monetary funds, real estate or personal property; changing the will or power of attorney, evicting them from their home.
• Sexual Abuse: Forcing the senior to participate in any sexual activity against their will.
• Neglect: Depriving the senior of food, water, heat, clothing, comfort and medication
• Rights Abuse: Denying the rights of a senior who has not been declared incompetent by a court
• Abandonment: Deserting a dependent senior or leaving them alone when it would endanger their health or welfare.

Note: Examples cited are not all inclusive.

5. Answer: B

Texas law specifies when, why and for how long a patient can be detained involuntarily and who has the authority to order the confinement. A police officer or licensed medical person can order a person held for seventy-two hours for testing and evaluation. If further confinement is warranted, the patient must either voluntarily sign himself in, his family must approve the admission or the primary care physician can order a second involuntary seventy-two hour hold. Even though the patient has been involuntarily confined, they have the same rights as a patient who voluntarily admits him/her self; they just cannot freely leave the facility. The patient is entitled to humane care without fear of neglect, abuse or discrimination. They can refuse medication unless he/she is a danger to him/her self or others or the court has ordered it because they are unable to make informed decisions. They can have visitors and private phone conversations, participate in religious services and have access to reading and writing materials. They have the right to speak to a Patient's Rights Advocate and their attorney.

6. Answer: D

Texas has broad definitions of who can be held involuntarily for seventy-two hours for testing and evaluation. The most common reasons for involuntary confinement stipulate the person must exhibit one of the following behaviors:

• Pose an immediate danger to him/her self, i.e., be suicidal
• Pose an immediate threat to others, i.e., he/she is holding someone against their will and threatening to harm them. Hearing voices "instructing" to do harm qualifies.
• Have a mental disorder that could lead to irrational acts that might harm him/her self or someone else. The person ordering the involuntary detention must be able to clearly identify and explain the reasons for the emergency confinement.
• Gravely disabled in ability to provide food, clothing and shelter for him/her self and no one can be found who is able or willing to help. The person can be an adult or a minor. This definition does not necessarily apply to a homeless person. Other conditions must be present.

7. Answer: C

Medical ethics began with the Hippocratic Oath and its admonishment to "do no harm." In 1846 the American Medical Association (AMA) adopted its Code of Ethics. The Nuremberg Code deals with the concept of informed consent from participants involved in any scientific or medical research study. During the 1970s there was an explosion of scientific breakthroughs in areas like genetic screening, fetal research and gene splicing that contributed to an increased interest in medical and scientific ethics. The International Association of Bioethics defines bioethics as "the study of the ethical, social, legal, philosophical and other related issues arising in health care and the biological sciences." Bioethics considers moral and ethical issues stemming from clinical practice, research, technology and the use of limited funds. Bioethicists consider questions and controversies about the type, availability and distribution of treatment, the authority of the patient, medical staff and other interested parties, the concept of confidentiality, the parameters of intervention and the consequences of genetic research and its potentially life-altering applications.

8. Answer: A

A "do not resuscitate" order (DNR) is a request not to have cardiopulmonary resuscitation (CPR) if the heart isn't beating or breathing stops. Medical personnel in all hospitals and attorneys and clergy honor a DNR order and consider it ethically appropriate in certain situations (FamilyDoctor.org).

The outcome of CPR depends on the patient's medical condition and while age is not a determining factor, in many cases, the older the patient, the more physical ailments are present, which means the success of CPR is problematic. If a patient is seriously ill or otherwise incapacitated, CPR may not work or may only partially work and can leave the patient in worse shape due to brain damage. Depending upon the patient's medical history and current health status, sometimes people prefer to have palliative care and do not want aggressive efforts taken to resuscitate them at the end of life. Any adult (or designated representative) can request a DNR order; a parent or legal guardian can request one for a dependent child.

9. Answer: D

Informed consent must be given freely, willingly and without fear of reprisal. It is only valid when the person is of sound mind, legal age and capable of comprehending the consequences of the agreement. Parents, guardians and those with medical power of attorney are legally allowed to give informed consent. Obtaining informed consent is a communication process between doctor and patient. It is vital the doctor talks to the patient; he shouldn't send someone else. He should discuss:

• The diagnosis
• The purpose, risks and benefits
• Available alternatives and their risks and benefits; no matter what the cost or whether health insurance covers the intervention
• The risks and benefits of not agreeing
• The patient must be given an opportunity to ask questions until they understand the nature of the intervention and all the potential risks and benefits of saying yes or no.

10. Answer: C

Express Consent means the physician has obtained the patient's permission beforehand to perform an examination, investigation, test or procedure, provide treatment and prescribe medication based on information about the purpose, benefits and risks. The patient should ask questions until they understand the consequences of the decision. Implied Consent is trickier. Just because a patient is on the table does not necessarily mean he is giving permission for an extensive or invasive examination. Non-verbal gestures and body language, as well as subtle forms of understanding and communication between doctor and patient can imply consent. It is always best, unless it is an emergency, to explain what the patient is going to experience before it happens. A General Medical Consent is written permission for a range of medical interventions authorizing the person in authority to either give consent for medical intervention or actually conduct the examination, order tests and provide appropriate treatment. It is valid and in force until the person who signed it revokes the permission in writing and sends the document to the appropriate person.