ABFM Safety and Compliance 3 — Questions and Answers
Question 1: A child is brought in with bruises in various stages of healing in unusual locations. After reporting suspected abuse to child protective services, what is the physician's obligation if the family demands the report be withdrawn?
- Withdraw the report to maintain the therapeutic relationship
- Explain that mandatory reporting laws require the report to stand (Correct answer)
- Contact CPS to place the report on hold pending investigation
- Refer the family to an attorney before proceeding
Correct answer: Explain that mandatory reporting laws require the report to stand
Mandatory reporting laws require physicians to report suspected child abuse, and these reports cannot be withdrawn at the request of the family.
Question 2: Which of the following best describes 'never events' in patient safety?
- Adverse events that occur less than 1% of the time
- Serious, largely preventable patient safety events that should never occur (Correct answer)
- Events that are not covered by malpractice insurance
- Medication errors that cause temporary harm only
Correct answer: Serious, largely preventable patient safety events that should never occur
Never events are serious, preventable adverse events such as wrong-site surgery or retained surgical instruments that should never occur with proper safety protocols.
Question 3: A patient with HIV requests that their diagnosis not be shared with their sexual partner. The physician should:
- Always honor the patient's confidentiality request unconditionally
- Report the partner to public health authorities without the patient's knowledge
- Counsel the patient on partner notification and follow state law on duty to warn (Correct answer)
- Discharge the patient from the practice for noncompliance
Correct answer: Counsel the patient on partner notification and follow state law on duty to warn
Physicians must balance patient confidentiality with the duty to protect third parties, counseling on partner notification and following state-specific duty-to-warn laws.
Question 4: In the context of medication safety, what does the 'five rights' framework include?
- Right patient, right drug, right dose, right route, right time (Correct answer)
- Right provider, right hospital, right formulary, right payer, right dose
- Right diagnosis, right drug, right insurance, right pharmacist, right patient
- Right lab, right drug, right follow-up, right dose, right route
Correct answer: Right patient, right drug, right dose, right route, right time
The five rights of medication administration are: right patient, right drug, right dose, right route, and right time.
Question 5: Under CLIA (Clinical Laboratory Improvement Amendments), which test complexity level requires the least stringent quality control in a physician office laboratory?
- High complexity
- Moderate complexity
- Waived tests (Correct answer)
- Provider-performed microscopy
Correct answer: Waived tests
Waived tests under CLIA have the simplest quality control requirements because they use simple, cleared methodologies with minimal risk of error.
Question 6: A physician suspects a colleague is impaired by substance use during clinical duties. The most appropriate first action is to:
- Ignore the suspicion to preserve professional relationships
- Immediately report to state medical board without further steps
- Address patient safety and follow institutional protocol for reporting impaired physicians (Correct answer)
- Confront the colleague publicly in front of staff
Correct answer: Address patient safety and follow institutional protocol for reporting impaired physicians
When a colleague may be impaired, immediate patient safety must be addressed first, followed by reporting through proper institutional and state physician health program channels.
Question 7: Which type of informed consent is generally sufficient for routine physical examinations in outpatient family medicine?
- Written informed consent with a signed form
- Implied consent from the patient's actions (Correct answer)
- Court-ordered consent
- Proxy consent from a family member
Correct answer: Implied consent from the patient's actions
Implied consent is generally accepted for routine examinations; patients indicate consent through their actions of scheduling and attending the appointment.
ABFM Safety and Compliance 3
A child is brought in with bruises in various stages of healing in unusual locations.
After reporting suspected abuse to child protective services, what is the physician's obligation if the family demands the report be withdrawn?