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1)Annual U

Health Science

1)Annual U.S. healthcare expenditures far outstrip those of twelve other developed nations. In relationship with expenditures, U.S. health population status ranking on critical indicators in comparison with other developed nations is:





  1. The ACA will provide new access to health care for millions of Americans. However, health services researchers caution about overstating the link between insurance and health. The basis for their caution is


  1. Problems of the healthcare delivery system are historically rooted in balancing cost, quality, and access. These problems generated competition between the government and private sectors in the 1990s, best characterized by which of the following?:


  1. In the past, patient behaviors were formed from the authoritarian positions of better-educated providers who expected patients to be compliant and grateful. Today, healthcare providers and consumers:


  1. In the natural history of a disease, the pre-pathogenesis period refers to:


  1. Of the levels of prevention associated with the natural history of disease, primary prevention refers to:


  1. The natural history of disease is best described as:


  1. Secondary prevention describes:


  1. Tertiary prevention describes:









Quiz #2

  1. In its early origins in colonial America, the patient/physician relationship can be best characterized as:
  2. As early as the 1800s, some Americans carried "health insurance" through employers, fraternal orders, guilds, trade unions, or commercial insurance companies. However, unlike the health insurance of today, these insurance policies only provided for:
  3. Blue Cross Hospital Insurance, the predominant form of health insurance for decades, was modeled after:
  4. The American Medical Association's initial reaction to Blue Cross hospital insurance plans suggested that the plans:
  5. Following WWII, the federal government excluded health insurance benefits from wage and price controls and excluded workers' contributions to health insurance from taxable income. These measures had which one of the following effects?
  6. The most significant social legislation passed by any Congress in the history of the United States was the:
  7. The major health care advances of the second half of the 1900s were in the area of:
  8. The primary purpose of Medicare as enacted in 1965 was to:
  9. The primary purpose of Medicaid as enacted in 1965 was to:
  10. The explosion of science and technology in the 1970s resulted in which of the following?


Quiz #3

  1. Three organization elements essential for successful health information systems implementation are:
  2. Most electronic health records (EHRs) are not designed to share patient health information between systems and institutions. A solution for overcoming this limitation in current EHR design has been the development of:
  3. The federated model of health information exchange architecture is best described as a model in which:
  4. A computerized decision support system (CDSS) is best described as an electronic system that:
  5. The single most important factor in accelerating health information technology adoption since 2008 has been:
  6. All of the following describe a personal health record (PHR) except:
  7. Information blocking is:
  8. Regional health information organizations (RHIOs) do all of the following except:
  9. The monolithic model of health information exchange:



Quiz #4

  1. In colonial America, the primary functions of hospitals were to:
  2. The development that contributed most significantly to the decline of the social mission of voluntary hospitals was the:
  3. The ultimate responsibility for a hospital’s quality of care, including the medical care provided, rests with a hospital’s:
  4. A major obligation of physicians when obtaining informed consent for a medical procedure is to:
  5. Until the mid-1980s, hospitals were reimbursed for whatever they charged on a “retrospective” basis. Now they are paid a certain amount for each patient’s care on a predetermined “prospective” basis. The amount they are paid is based on:
  6. Through discharge planning, hospitals help assure that safe and appropriate post-hospital care is arranged for each patient. Medicare patients may appeal what they believe to be a premature or inappropriate discharge by petitioning which of the following organizations?:
  7. In health care, which of the following terms refers to a system that includes several service components with each addressing one or more dimensions of a population’s healthcare needs?:


  1. For many years, the standard for assessing hospital quality of care was peer review using physician audits of selected patient records to judge “the degree of conformity with preset standards.” Which of the following was not a reason for the ineffectiveness of such audits?:



  1. “Hospitals can no longer live in a four-walls, brick-and-mortar world.” This statement refers to which encompassing principle of healthcare reform?:



Quiz #5

  1. Ambulatory care is best defined as:
  2. Technological and clinical advances that allow many surgical procedures to be safely performed on an ambulatory basis had what corollary effect on hospitals?:
  3. In the 1990s, ambulatory care facilities of all types proliferated. Reasons for this proliferation include which of the following?:
  4. The primary organizational mode of medical care in the United States, in terms of volume of services delivered, is:
  5. Which of the following is not a principle of a patient-centered medical home?:
  6. In today’s hospitals, outpatient clinics frequently provide:
  7. Beginning in the 1980s, a significant advance in the provision of hospital emergency department services occurred with the introduction of:
  8. Clinical observation units (COUs) may be best described as hospital units associated with emergency departments which:
  9.  “Urgent Care” is best described as care:
  10. The predominant services of local public health departments today are:


Quiz #6

  1. In colonial America, the primary mode of medical education was
  2. Medical societies were first established for the primary purpose of:
  3. In 1905, the American Medical Association, with support from the Carnegie Foundation, commissioned a study of U.S. medical schools in response to decades of concern about the quality of medical education and training. The resulting Flexner Report is considered a benchmark in the history of medical education because it:
  4. Academic Health Centers may be best described as:
  5. Teaching hospitals in the United States:
  6. To provide direct patient care, physicians are required to do all of the following except:
  7. Which of the following organizations is responsible for approving the content of post-medical school residency training?:
  8. The U.S. imbalance between specialty physicians and primary care physicians has its origins in many factors. Which of the following does not contribute to physicians’ attraction to specialty medicine over primary care?:
  9. Physician employment by hospitals continues on a pathway of steady growth. One reason why physicians are leaving private practice for hospital employment is:
  10. Healthcare reforms will change the emphasis in medical practice from treating illness in individual patients to maintaining wellness in community populations. This shift poses major challenges to the medical education process because:


Quiz #7

  1. Healthcare system changes, including advancing technology, will likely result in new, more highly specialized health occupations. Which of the following is not one of the expected effects of this development?:
  2. States try to protect the public from incompetent care by licensing certain health professions. Certification differs from licensing, in that certification:
  3. A physician residency training program is best described as:
  4. At the outset of the nurse practitioner movement, educational requirements were often limited to relatively short certificate programs. Today, it is generally accepted that nurse practitioners should be registered nurses with:
  5. Unlike medicine, dentistry essentially remains a “cottage industry,” primarily serving only those with dental insurance or who can afford to pay out-of-pocket. For this reason:
  6. The category of allied health professionals, “therapeutic science practitioners” concerned with the treatment and rehabilitation of patients with all types of diseases and injuries, includes which of the following professions?:
  7. Complementary medicine differs from alternative medicine in that complementary medicine:
  8. The widespread use and popularity of complementary medicine in the U.S. resulted in which of the following developments?:


Quiz #8

  1. Although the ACA will enact sweeping U.S. healthcare system reforms, one fundamental element of the system that will remain unchanged is:
  2. The primary reason why the number of uninsured Americans dropped by over one million in 2011 was:
  3. The highest personal care expenditure in the United States is for:
  4. Despite U.S. healthcare spending exceeding by far the expenditures of 12 other

developed nations, U.S. health outcomes lag far behind. Extensive research has concluded that reasons for high U.S. high expenditures are:

  1. Major drivers of U.S. health expenditures include:
  2. The basic concept of health insurance is antithetical to the premise on which personal or property insurance was historically defined because:
  3. The establishment of Blue Cross for hospital care and shortly thereafter, Blue Shield for physicians’ services signaled a new era in healthcare delivery and financing. Which of the following was not among Blue Cross and Blue Shield major impacts?:
  4. The 1973 HMO legislation responded to which of the following national concerns?:
  5. By focusing on insured populations rather than individuals, managed care organizations project health services use and costs by analyzing:
  6. The managed care concept called “capitation” refers to:


Quiz #9

  1. Long-term care is best described as:
  2. Which of the following societal factors increases the need for formal long-term care services?:
  3. The U.S. history of institutional long-term care began with:
  4. The development of formal home care services, such as those provided by the Visiting Nurses Association, originated as:
  5. Long-term care and nursing-home reform legislation of the 1970s occurred as a response to which of the following?:
  6. The enactment of Medicare and Medicaid in 1965 affected the long-term care industry in many ways. Which of the following was not an effect of Medicare and Medicaid enactment on the long-term care industry?:
  7. The major distinction between skilled-nursing and assisted-living facilities is that skilled nursing facilities:
  8. Which of the following was not a driver of expanded home care services during the 1980s through the 1990s?:
  9. The hospice movement is concerned with care for terminally ill patients. Which of the following is not a major goal of hospice care?:
  10. Which of the following best describes the informal long-term care system?:


Quiz #10

  1. In colonial America, mental health treatment consisted of:
  2. National awareness of the needs of the mentally ill rose sharply in the aftermath of WWI because:
  3. At the end of WWII (1945), the federal government became active in the mental health field. Which of the following was the most significant development for mental health at this time?: 4. During the 1960s, one factor that enabled mentally ill persons to move from large institutions to community settings was:


Quiz #11

  1. The term “non-parity,” as it applies to insurance coverage for mental health services, is best defined as:
  2. The World Health Organization ranking of the leading causes of disability in the U.S. in terms of the total number of years lost to illness, disability, or premature death places neuropsychiatric disorders at what level?:
  3. An individual’s diagnosis with two or more illnesses diagnosed at the same time is termed:
  4. The ACA continues to have significant positive effects for the mentally ill, with the exception of which one of the following?
  5. Many factors are associated with barriers to access for mental health care. One reason why fewer than 50% of Americans in need of mental health services actually receive them is:
  6. Which of the following is not a reason why access to adequate mental health treatment for children and adolescents is problematic?:


Quiz #12

  1. Clinical research focuses primarily on:
  2. The careers of all nurse practitioners who graduated in 2007 are being tracked to determine the appropriateness of their education to their subsequent work role. This is an example of:
  3. Research studies may be observational or experimental. The essential difference between experimental and observational studies is that in experimental investigations:
  4. In conducting experimental studies, ethical issues may arise about:
  5. The Agency for Healthcare Research and Quality (AHRQ) is a federal agency charged with:
  6. In evaluating the quality of health care, explicit standards differ from implicit standards in that:
  7. Empirical standards for assessing the quality of healthcare practices (also known as “performance report cards”) rely upon:
  8. In contrast to traditional, randomized controlled studies, outcomes research evaluates results of healthcare processes by:
  9. A goal of comparative effectiveness research is to:
  10. Which of the following is a meta-analysis of several high-quality randomized, controlled clinical trials?


Quiz #13

  1. Attempts at healthcare system reforms of the basic problems of cost, quality, and access have consistently demonstrated which of the following results?:
  2. A paradox of the U.S. healthcare system may be described as:
  3. Reasons why improvements in healthcare quality have been slow to occur despite well-documented research on the scope and seriousness of quality problems include:
  4. Continuing efforts to achieve system-wide improvements in healthcare quality include which of the following?:
  5. The ACA and MACRA are attempting to address long-standing problems of variations in quality and rising costs principally through:
  6. Which of the following does not represent a continuing challenge of implementing health information technology in the delivery system?
  7. Hospital consolidations through mergers and acquisitions are predicted to continue. Concerns about this trend include:
  8. Recent legislation that may help reduce severe workforce shortages in the home care industry is the:
  9. Changes in the healthcare delivery system are resulting in two new, emerging roles for physicians. These are:
  10. A major trend in employer-sponsored health insurance coverage is:



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