Physician Assistant General Information 5 — Questions and Answers
Question 1: A PA is asked to perform a procedure they have not been trained to do. The most appropriate response is to:
- Attempt the procedure to avoid inconveniencing the patient
- Decline and refer the patient to a qualified provider (Correct answer)
- Ask a nurse to assist and proceed
- Perform the procedure with the patient's verbal consent only
Correct answer: Decline and refer the patient to a qualified provider
PAs are ethically and legally obligated to practice within their competency and should decline procedures they are not trained to perform, ensuring patient safety.
Question 2: Which type of PA practice agreement or document outlines the specific clinical duties and prescribing authority of a PA at a given practice site?
- Delegation of Services Agreement (DSA) (Correct answer)
- National Provider Agreement
- HIPAA Business Associate Agreement
- Medicare Enrollment Form 855I
Correct answer: Delegation of Services Agreement (DSA)
A Delegation of Services Agreement (also called a practice agreement or scope of practice document) defines the PA's authorized clinical activities and prescriptive authority at a specific site.
Question 3: What is the primary purpose of the AAPA's 'PA Scope of Practice' policy statement?
- To set mandatory salary ranges for PAs
- To advocate for the broadest possible PA practice authority supported by evidence (Correct answer)
- To restrict PAs from practicing in rural areas
- To require PAs to obtain board certification in a specialty
Correct answer: To advocate for the broadest possible PA practice authority supported by evidence
The AAPA's scope of practice policy advocates for PAs to be allowed to practice to the full extent of their education and training without unnecessary restrictions.
Question 4: A PA who discloses a patient's HIV status to the patient's employer without consent has violated which principle?
- Non-maleficence
- Veracity
- Confidentiality (Correct answer)
- Autonomy
Correct answer: Confidentiality
Unauthorized disclosure of protected health information violates the ethical and legal principle of confidentiality, as well as HIPAA.
Question 5: Which historical figure is credited with founding the PA profession in the United States?
- Harvey Cushing
- Eugene Stead (Correct answer)
- William Osler
- Paul Beeson
Correct answer: Eugene Stead
Dr. Eugene Stead at Duke University is widely credited with establishing the first PA program in 1965, founding the modern PA profession.
Question 6: Under HIPAA, a PA may share a patient's protected health information (PHI) with another provider without patient authorization when:
- The patient is a public figure
- It is for treatment, payment, or healthcare operations (TPO) (Correct answer)
- The information is more than 10 years old
- The patient verbally consented in a prior visit
Correct answer: It is for treatment, payment, or healthcare operations (TPO)
HIPAA permits disclosure of PHI without explicit patient authorization for treatment, payment, and healthcare operations (TPO) purposes.
Question 7: What is the significance of the 'learned intermediary doctrine' for PA prescribing practice?
- It holds pharmaceutical companies liable for all drug side effects
- It shifts duty to warn about drug risks from the manufacturer to the prescribing provider (Correct answer)
- It requires PAs to consult a pharmacist before prescribing any new drug
- It prohibits PAs from prescribing brand-name medications
Correct answer: It shifts duty to warn about drug risks from the manufacturer to the prescribing provider
The learned intermediary doctrine holds that a drug manufacturer fulfills its duty to warn by informing the prescribing clinician, who then assumes the duty to warn the patient.
Physician Assistant General Information 5
A PA is asked to perform a procedure they have not been trained to do.
The most appropriate response is to: