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Self-Assessment Answers for Section 1: Prescriber Education for Extended-Release and Long-Acting Opioid Analgesics
1 . Extended-release (ER) and Long-acting (LA) formulations of opioids should typically not be used for which of the following?
A.
B.
C.
D.
2 . If an organic pathology cannot be found to explain a patient’s pain, what should a clinician infer?
A.
B.
C.
D.
3 . Which of the following is the appropriate use of “universal precautions” as it applies to patients with chronic pain?
A.
B.
C.
D.
4 . The DIRE and the ORT are examples of which kind of assessment?
A.
B.
C.
D.
5 . All of the following need to be documented in writing as part of an overall therapeutic approach to managing chronic pain patients EXCEPT:
A.
B.
C.
D.
6 . All of the following are possible advantages of patient/provider agreements EXCEPT:
A.
B.
C.
D.
7 . All of the following are examples of functional goals EXCEPT:
A.
B.
C.
D.
8 . A fundamental part of ethical treatment for patients with chronic pain is:
A.
B.
C.
D.
9 . When opioid treatment is initiated, both the patient and clinician should view the commitment as:
A.
B.
C.
D.
10 . It can be particularly unsafe to combine opioids with which of the following other medicines?
A.
B.
C.
D.
11 . Which class of antidepressant medications has been shown to be effective in treating some neuropathic pain conditions?
A.
B.
C.
D.
12 . Combination products are those that include an opioid with which of the following elements?
A.
B.
C.
D.
13 . In general, the amount of opioids prescribed for acute pain should be limited to a ____ day supply:
A.
B.
C.
D.
14 . Uncomfortable or unpleasant side effects (aside from constipation) may potentially be reduced by which approach?
A.
B.
C.
D.
15 . All of the following are valid reasons to pursue opioid rotation EXCEPT:
A.
B.
C.
D.
16 . One reason that methadone must be prescribed with particular caution is that:
A.
B.
C.
D.
17 . Which of the following is not a potential benefit of urine drug testing?
A.
B.
C.
D.
18 . All of the following are of particular concern when prescribing an ER/LA opioid pain medication EXCEPT:
A.
B.
C.
D.
19 . In 2006, the FDA added a caution to the “black box” warning that methadone may cause which of the following serious adverse effects?
A.
B.
C.
D.
20 . Which of the following is the APS-AAPM guideline regarding the prescription of opioids to pregnant women?
A.
B.
C.
D.
Self-Assessment Answers for Section 2: Caring for Patients at the End of Life
21 . In the United States, what term is generally used for care of people who are not expected to live more than 6 months?
A.
B.
C.
D.
22 . Which statement is most true about pain relief at the end of life?
A.
B.
C.
D.
23 . In crafting goals of treatment, the values, beliefs, and priorities of which person should be primary?
A.
B.
C.
D.
24 . If a patient is not alert enough to communicate, what should be used to determine if he or she is experiencing pain?
A.
B.
C.
D.
25 . Which of the following questions is an example of the technique of reflective listening?
A.
B.
C.
D.
26 . Which of the following is a possible way to reduce the potential for GI bleeding with NSAIDs?
A.
B.
C.
D.
27 . In the absence of other indicators, which of the following would be the least effective indicator of depression in a patient with terminal cancer?
A.
B.
C.
D.
28 . What condition of a patient may be beneficial during the terminal phase of an illness?
A.
B.
C.
D.
29 . Which of the following is an example of how a clinician can show support for a bereaved relative or loved one?
A.
B.
C.
D.
30 . What is an example of a culturally-specific value that might surprise an American-trained physician?
A.
B.
C.
D.
Self-Assessment Answers for Section 3: Reducing Diagnostic Error In Medicine
31 . Approximately what percentage of U.S. adults seeking outpatient care will experience a diagnostic error each year?
A.
B.
C.
D.
32 . The phrase “next frontier in patient safety” has been applied to which topic of current interest in medicine?
A.
B.
C.
D.
33 . A key part of defining “diagnostic error” from a patient-centered perspective is ____________________.
A.
B.
C.
D.
34 . Before initiating any treatment for a patient’s health problem, a clinician must _______________________.
A.
B.
C.
D.
35 . Which of the following is a potential challenge to the performance of an accurate patient medical history?
A.
B.
C.
D.
36 . Which of the following phases in the “brain-to-brain loop model” of diagnostic testing is least susceptible to error?
A.
B.
C.
D.
37 . What type of diagnostic testing is growing rapidly and, thus, posing a challenge for clinicians?
A.
B.
C.
D.
38 . Which of the following is not a potential source of error when using medical imaging technology?
A.
B.
C.
D.
39 . Which of the following is a model for more closely involving pathologists and radiologists in the diagnostic process?
A.
B.
C.
D.
40 . A potential limitation of using an empiric treatment strategy is that _____________________.
A.
B.
C.
D.
41 . The current understanding of clinical reasoning is based on which theory of decision making?
A.
B.
C.
D.
42 . Which of the following is an example of a situation involving slow system 2 cognitive processing?
A.
B.
C.
D.
43 . What is the formal name for the universal tendency to believe that we know more than we actually do?
A.
B.
C.
D.
44 . Which type of cognitive processing typically performs best in highly reliable and predictable environments?
A.
B.
C.
D.
45 . What can be the result of a diagnostic process in which the outcomes of the decision-making process are unknown?
A.
B.
C.
D.
46 . Because of fatigue, a radiologist misses identifying a suspicious spot on a lung x-ray. When the attending physician reviews the x-ray, she notices the irregularity and consults with the radiologist, who recognizes his mistake. No harm occurred to the patient. What is the proper label for this kind of situation?
A.
B.
C.
D.
47 . Over-diagnosis is considered a form of diagnostic error.
A.
B.
48 . Which of the following is not a recommended motivation for instituting a system for measuring diagnostic error?
A.
B.
C.
D.
49 . Which of the following is not a method for estimating the incidence of diagnostic errors?
A.
B.
C.
D.
50 . __________________ was reported to reduce hospitalization time and costs, improve service provision, and enhance patient satisfaction, staff motivation, and team innovation in the United Kingdom’s National Health Service.
A.
B.
C.
D.
51 . Which group is considered to be at the center of the diagnostic process?
A.
B.
C.
D.
52 . _____________ can ensure communication and care coordination among diagnostic team members, monitor a patient over time to see if the patient’s course is consistent with a working diagnosis, and identify potential diagnostic errors.
A.
B.
C.
D.
53 . Accountable Care Organizations (ACOs) were created to address delivery system fragmentation and to align incentives to improve communication and collaboration among health care professionals.
A.
B.
54 . Morbidity and mortality conferences bring health care professionals from different disciplines together to consider the diagnosis and treatment of specific patients.
A.
B.
55 . A survey of low-income patients faced with major medical decisions found that ____ wanted to be very involved in the decision-making process.
A.
B.
C.
D.
56 . An identified problem with electronic health records is that _______________.
A.
B.
C.
D.
57 . Evidence shows that disclosing medical or diagnostic errors to patients and their families _______________________________.
A.
B.
C.
D.
58 . The phrase “heuristic failure” means _______________________.
A.
B.
C.
D.
59 . Which statement best describes the current state of diagnostic decision support tools?
A.
B.
C.
D.
60 . What fundamental change is recommended to increase the utility of health IT systems as they relate to improving diagnosis?
A.
B.
C.
D.
61 . What does “mHealth” stand for?
A.
B.
C.
D.
62 . What is one barrier to the use of postmortem examinations as a way of obtaining more accurate information about diagnostic errors?
A.
B.
C.
D.
63 . Which of the following is not a characteristic of effective feedback interventions to reduce diagnostic errors?
A.
B.
C.
D.
64 . Which statement is most true about the relationship between fee-for-service (FFS) reimbursement systems and efforts to improve diagnoses?
A.
B.
C.
D.
65 . What system has been proposed as a way to provide injured patients with expedited compensation decisions for certain types of medical errors?
A.
B.
C.
D.
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