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ASHRM Certified Professional in Health Care Risk Management (CPHRM) Sample Questions (Q20-Q25):
NEW QUESTION # 20
Per The Joint Commission and CMS patient visitation standards, a hospital may restrict an individual's ability to visit a patient if the visitor
- A. administered the patient an unknown drug via IV.
- B. is not the patient's immediate family member.
- C. is not the patient's designated healthcare surrogate.
- D. is known to be a drug seeker in the community.
Answer: A
Explanation:
According to Health Care Risk Management standards supported by ASHRM, CMS Conditions of Participation, and The Joint Commission patient visitation standards, hospitals must have written visitation policies that respect patient rights. Patients generally have the right to designate visitors of their choosing, including individuals who are not immediate family members. Visitation cannot be restricted based on non- clinical factors such as relationship status or surrogate designation.
However, facilities may impose clinically reasonable or safety-based restrictions. If a visitor administers an unknown drug intravenously to a patient, this presents a clear and immediate threat to patient safety. Such conduct justifies restricting visitation to protect the patient from harm, maintain clinical control of treatment, and prevent unsafe interference with care.
Being known as a drug seeker in the community, without evidence of disruptive or harmful behavior during the visit, does not alone justify restriction under patient rights standards. Similarly, visitation cannot be denied solely because the individual is not the designated healthcare surrogate.
Legal and regulatory objectives emphasize balancing patient rights with safety and security. Therefore, a hospital may restrict visitation when a visitor's actions pose a direct threat to patient safety.
NEW QUESTION # 21
A hospital risk manager has been called to the Neonatal Intensive Care Unit to discuss a 25-week premature infant whose parents are refusing a planned blood transfusion due to their religious beliefs. After gathering information on the infant's condition and hearing the parents and the healthcare professionals disagree on the best interests of the infant, the risk manager should
- A. prohibit the blood transfusion, respecting the parents' rights as substitute decision-makers for the infant.
- B. arrange for an ethics committee consultation to meet the parents and discuss the issue.
- C. advise the care team to proceed with the blood transfusion.
- D. contact legal counsel to arrange for an emergency court hearing to obtain a court order from the state to intervene.
Answer: D
Explanation:
According to Health Care Risk Management standards supported by ASHRM and the American Hospital Association Certification Center, while parents generally serve as surrogate decision-makers for minors, their authority is not absolute. When refusal of treatment places a child at significant risk of serious harm or death, healthcare providers have an ethical and legal obligation to act in the best interests of the child.
In cases involving life-sustaining treatment for a premature infant, refusal of a medically necessary blood transfusion may constitute potential medical neglect if it threatens the infant's survival. When disagreement persists after appropriate communication and ethics consultation, and the infant's life is at risk, the appropriate step is to seek judicial intervention. Contacting legal counsel to obtain an emergency court order allows the state to exercise its parens patriae authority to protect the child's welfare.
An ethics consultation may help clarify values and promote dialogue but does not override urgent medical necessity. Simply prohibiting or proceeding without legal authority exposes the organization to liability.
Legal and regulatory objectives emphasize protecting vulnerable patients while respecting due process.
Therefore, seeking an emergency court order through legal counsel is the appropriate action.
NEW QUESTION # 22
Which of the following is the MOST likely root cause of medication errors in healthcare entities?
- A. illegible physician handwriting
- B. manual medication delivery systems
- C. look-alike, sound-alike drugs
- D. system or process failure
Answer: D
Explanation:
According to Health Care Risk Management standards supported by ASHRM and patient safety principles endorsed by The Joint Commission, the most likely root cause of medication errors is system or process failure. Modern patient safety frameworks emphasize that errors rarely result from isolated individual mistakes. Instead, they typically arise from weaknesses in processes, workflow design, communication systems, technology integration, or inadequate safeguards.
Illegible handwriting, manual systems, and look-alike or sound-alike drugs are recognized contributing factors. However, these elements represent components within a broader system. For copyrightple, illegible handwriting becomes problematic when standardized order entry systems are lacking. Look-alike medications pose risks when storage, labeling, or verification processes are insufficient. Manual medication delivery systems increase risk when redundancy and double-check mechanisms are absent.
Root cause analysis methodologies consistently demonstrate that unsafe system design, poor communication processes, lack of standardized procedures, and inadequate training contribute to medication errors. A systems-based approach aligns with just culture principles and focuses on improving processes rather than assigning individual blame.
Clinical and patient safety objectives emphasize system redesign, standardization, and continuous quality improvement. Therefore, system or process failure is the most likely root cause of medication errors.
NEW QUESTION # 23
What are risk treatment strategies?
- A. Litigation, denial, delay
- B. Public relations, branding, advertising
- C. Risk avoidance, risk retention, risk transfer (and risk reduction/mitigation)
- D. Staff vacation scheduling
Answer: C
Explanation:
Core risk treatment strategies includeavoidance(stop the activity),reduction/mitigation(controls that reduce likelihood/severity),retention(accept risk within appetite and fund losses via reserves/self-insurance), and transfer(contracts/insurance shifting financial consequences). In healthcare, the highest priority is often mitigation for patient safety risks (standardization, technology, training), with financing mechanisms ensuring the organization can absorb residual loss without destabilizing operations. ERM aligns these strategies to enterprise objectives so leadership invests in the best mix of prevention and financing.
NEW QUESTION # 24
All of the following are valid reasons for performing risk management review of policies and procedures EXCEPT
- A. maintaining staff competency.
- B. identifying potential risk exposures.
- C. monitoring compliance with standards.
- D. ensuring consistency between practice and policy.
Answer: A
Explanation:
According to Health Care Risk Management standards supported by ASHRM and the American Hospital Association Certification Center, periodic review of policies and procedures is essential to ensure alignment with current laws, regulatory standards, accreditation requirements, and best practices. Reviewing policies helps ensure consistency between written procedures and actual clinical practice, thereby reducing liability exposure.
Policy review also supports identification of potential risk exposures by detecting outdated language, conflicting guidance, or gaps in processes that could lead to adverse events. Additionally, monitoring compliance with standards-such as federal regulations, state statutes, and accreditation requirements-is a central purpose of policy review, ensuring that organizational practices meet required benchmarks.
Maintaining staff competency, however, is primarily addressed through education, training programs, credentialing, and performance evaluation processes. While policies provide guidance for staff conduct, competency assessment is not the primary objective of policy review itself.
Health Care Operations objectives emphasize governance oversight, regulatory compliance, and risk mitigation through clear, current policies. Therefore, maintaining staff competency is not a direct reason for performing risk management review of policies and procedures, making it the correct exception.
NEW QUESTION # 25
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