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ASHRM Certified Professional in Health Care Risk Management (CPHRM) Sample Questions (Q60-Q65):
NEW QUESTION # 60
When considering the proper insurance to purchase for an organization and its practitioners, a risk manager should understand which of the following about specific types of coverage?
- A. With claims-made coverage, the retroactive date does not impact the coverage of the insured.
- B. Occurrence coverage provides coverage for incidents that occur prior to initiation date of the policy as long as the event is reported to the insurer before signing.
- C. Occurrence coverage provides coverage for incidents that occur while the policy is in effect.
- D. With claims-made coverage, the nose period has no significance to the coverage of the insured.
Answer: C
Explanation:
According to Health Care Risk Management standards supported by ASHRM and the American Hospital Association Certification Center, occurrence coverage provides protection for incidents that occur during the policy period, regardless of when the claim is reported. The triggering event is the date of the occurrence. As long as the alleged act or omission took place while the policy was in force, coverage applies even if the claim is filed years later.
Option A is incorrect because occurrence coverage does not extend to incidents that occur prior to the policy's effective date. Coverage is strictly tied to the policy period.
Option C is incorrect because in claims-made coverage, the retroactive date is critical. Coverage applies only to claims made during the policy period for incidents that occurred on or after the retroactive date.
Option D is incorrect because the "nose" period, also known as prior acts coverage, is highly significant in claims-made policies. It determines whether earlier acts are covered when switching carriers.
Risk financing objectives emphasize understanding policy triggers, retroactive dates, and reporting requirements. Therefore, occurrence coverage applies to incidents that occur while the policy is in effect.
NEW QUESTION # 61
For a liability claim to succeed, the claimant must establish duty owed, duty breached, proximate cause, and
- A. punitive damages.
- B. gross negligence.
- C. contributory negligence.
- D. injury sustained.
Answer: D
Explanation:
Under Health Care Risk Management principles outlined by ASHRM and the American Hospital Association Certification Center, a successful negligence claim requires proof of four essential legal elements: duty, breach of duty, causation, and damages. Duty refers to the legal obligation owed by the healthcare provider to the patient. Breach occurs when the provider fails to meet the applicable standard of care. Proximate cause establishes the direct link between the breach and the harm suffered.
The final required element is actual injury or damages sustained by the claimant. Without demonstrable harm, a negligence claim cannot succeed, even if duty and breach are proven. The injury may include physical harm, emotional distress, or financial loss, but it must be measurable and attributable to the breach.
Contributory negligence is a defense that may reduce or bar recovery but is not an element the claimant must prove. Punitive damages are awarded in exceptional cases involving egregious misconduct and are not required to establish liability. Gross negligence represents a higher degree of negligence but is not a required element in standard malpractice claims.
Therefore, proof of injury sustained is essential for a liability claim to succeed.
NEW QUESTION # 62
A hospital has opted to open an anticoagulation clinic. As this is a high-risk medication, a risk manager wants to conduct a risk assessment before opening the clinic. The BEST tool to use would be a
- A. root cause analysis RCA.
- B. cause and effect diagram.
- C. scatter diagram.
- D. failure mode and effects analysis FMEA.
Answer: D
Explanation:
Failure Mode and Effects Analysis FMEA is the most appropriate tool in this scenario because it is a proactive risk assessment methodology designed to identify and mitigate potential failures before harm occurs. According to Health Care Risk Management principles outlined by ASHRM and the American Hospital Association Certification Center, FMEA is specifically used when introducing new processes, services, or high-risk clinical operations, such as an anticoagulation clinic involving medications with narrow therapeutic indices and significant bleeding risks.
FMEA systematically evaluates each step in a proposed process, identifies possible failure modes, analyzes their causes and effects, and prioritizes risks using severity, occurrence, and detectability scoring. This structured approach aligns with patient safety objectives by reducing preventable adverse events before implementation.
In contrast, Root Cause Analysis RCA is a retrospective tool used after an adverse event has occurred. A cause and effect diagram is a component often used within RCA or FMEA but is not a comprehensive risk assessment tool on its own. A scatter diagram is primarily used for statistical correlation analysis and does not evaluate process failures.
Therefore, for proactive risk identification and mitigation prior to clinic opening, FMEA is the best and most appropriate tool.
NEW QUESTION # 63
For a risk management program to be effective, it needs:
- A. Only insurance coverage
- B. Only incident reporting software
- C. Only a policy manual
- D. Organizational commitment, visibility/access, and physician engagement
Answer: D
Explanation:
Effective risk management requires more than tools-it needs organizational commitment (tone at the top), operational visibility (access to events, leaders, data), and physician engagement because many high-severity risks involve medical decision-making and clinical leadership. Risk management objectives include preventing harm (patient safety), reducing financial loss (claims and insurance costs), ensuring compliance, and building a learning culture. Without executive and board support, corrective actions stall; without visibility, emerging risks are missed; without physician buy-in, clinical process redesign fails. Successful programs integrate with quality, patient safety, compliance, legal, and operations, and they use structured methods (RCA/FMEA, audits, claims trend analysis) to drive measurable improvement. This also strengthens defensibility: it shows governance, action, and continuous improvement-key elements in regulatory review and litigation.
NEW QUESTION # 64
An appropriate way to complete the verification read-back of a complete order, as required by The Joint Commission National Patient Safety Goals, is to have the person receiving the order
- A. immediately repeat the information.
- B. have a witness verify that the information is repeated back correctly.
- C. document the date and time the order was received.
- D. write the information down before reading it back.
Answer: D
Explanation:
According to Health Care Risk Management standards supported by ASHRM and The Joint Commission National Patient Safety Goals, the read-back process is designed to ensure accurate communication of verbal or telephone orders. The correct process requires the person receiving the order to first write down the complete order and then read it back to the prescribing practitioner for verification.
Writing the order down before reading it back reduces reliance on memory and decreases the risk of omission or transcription errors. The practitioner who gave the order must then confirm that the read-back is accurate.
This closed-loop communication process enhances patient safety and reduces medication and treatment errors associated with miscommunication.
Immediately repeating the information without documenting it does not meet the full verification requirement, as the written record must be confirmed. A witness is not required under the standard. Documenting the date and time is necessary for proper charting but does not constitute completion of the read-back verification itself.
Clinical and patient safety objectives emphasize clear, structured communication processes. Therefore, writing the information down before reading it back is the appropriate method to complete the verification process.
NEW QUESTION # 65
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