Multiple Choice Questions MCQ

Question 147# Print Question

Your patient is moving to another province and requests transfer of his medical records.

Which one of the following is true regarding this patient’s request?

A. The medical record should be released only with written permission from a patient or legal representative

B. Although it is kept by the physician, the actual medical record is the property of the patient

C. A physician may withhold medical record information that could cause undue stress to a patient

D. In spite of a patient request, the physician may withhold information from a third party

E. A physician has the right to withhold the medical record until medical bills are paid in full

Question 146# A pregnant 20-year-old female is diagnosed with a Chlamydia infection. She is treated and the infection is cured, but she tests positive again at a follow-up visit. In this situation, contacting her sexual partners is considered a reasonable breach of confidentiality because:
A. There is a public health risk
B. There is a risk to the fetus
C. The patient’s Chlamydia infection has become resistant to antibiotics
D. There is a risk of pelvic inflammatory disease
Correct Answer A: There are three situations when a breach of confidentiality is justified: abuse of a vulnerable person (child or elderly), a public health risk (communicable disease), or substantial danger to the patient or others. While Chlamydia is not usually considered life-threatening or dangerous, it is communicable. Contacting sexual partners to notify and treat them to stem the spread of disease is recommended.

Question 148# During a routine office visit, a 19-year-old patient requests contraception. After discussing options, you prescribe an oral contraceptive. Several days later her father calls, asking if you prescribed oral contraceptives for his daughter. Your response is best guided by which of the following principles?
A. Honesty
B. Beneficence
C. Confidentiality
D. Informed consent
E. Justice
Correct Answer C: Confidentiality (choice C) means that a patient has the right to make decisions about her own care and to decide to whom these decisions and her medical information are communicated. → Honesty (choice A) means that the patient is given complete and truthful information about her condition. → Beneficence (choice B) is the obligation to promote the wellbeing of others. → Informed consent (choice D) can be defined as the willing acceptance of a medical intervention after adequate disclosure by the physician. → Justice (choice E) is the right of individuals to claim what is due them based on certain personal properties or characteristics.

Question 149# A patient diagnosed as having a fetus with trisomy 18 asks that you do not share this finding with her family. You may discuss her tests with:
A. Her husband
B. Her mother
C. Her father
D. Her son
E. No one
Correct Answer E: This question covers the ethical concept of confidentiality. Even though her husband is the father of the affected child, the patient has the right to request that you do not disclose this information to him.

Question 150# Which one of the following is the best definition of specificity?
A. The true positive rate of a test
B. The false positive rate of a test
C. The true negative rate of a test
D. The false negative rate of a test
E. None of the above
Correct Answer C: The specificity of a test is the true-negative rate, or how well the test correctly identifies patients without disease. That is, it measures the proportion of negatives which are correctly identified. The sensitivity of a test is the true-positive rate of the test. It measures the proportion of actual positives which are correctly identified as such (e.g. the percentage of sick people who are correctly identified as having the condition).

Question 147# Your patient is moving to another province and requests transfer of his medical records. Which one of the following is true regarding this patient’s request?
A. The medical record should be released only with written permission from a patient or legal representative
B. Although it is kept by the physician, the actual medical record is the property of the patient
C. A physician may withhold medical record information that could cause undue stress to a patient
D. In spite of a patient request, the physician may withhold information from a third party
E. A physician has the right to withhold the medical record until medical bills are paid in full
Correct Answer A: Permission for the release of patient information should always be in writing. Although the actual medical record is the property of the physician, the information in the chart is the property of the patient. Ethically and legally, patients have a right to the information in their medical records, and it cannot be withheld from the patient or a third party (at the request of the patient), even if medical bills are unpaid or the physician is concerned about the patient.