AHIP AHM-540 問題集

質問 1：
Nilay Sharma suffered a small wound while working in his yard and was taken to a local hospital for treatment. A triage nurse at the hospital evaluated Mr. Sharma's condition and directed him to an outpatient unit in the hospital where a physician assistant examined, cleaned, and sutured the wound. Mr. Sharma returned home following treatment. The care Mr. Sharma received at the hospital is an example of the type of care known as
A. emergency care
B. specialty referral
C. urgent care
D. primary prevention
正解：C

質問 2：
Health plans that choose to contract with external organizations for pharmacy services typically contract with pharmacy benefit managers (PBMs). Functions that a PBM typically performs for a health plan include
1.Managing the costs of prescription drugs
2.Promoting efficient and safe drug use
3.Determining the health plan's internal management responsibilities for pharmacy services
A. 1 and 2 only
B. 2 and 3 only
C. 1 only
D. All of the above
正解：A

質問 3：
The case management team at the Hightower Health Plan reviewed the medical records of the following two plan members to determine the type of care each one needs and the most appropriate setting for that care:
Ira Morton was hospitalized for a severe stroke. Although his medical condition is stable, the stroke left him partially paralyzed and he will require extensive rehabilitation and 24hour medical care.
Theresa Finley is recovering from a total hip replacement and is in need of short-term physical therapy and twice-weekly visits from a licensed nurse to check her blood pressure and the healing of her incision.
From the answer choices below, select the response that correctly identifies the level of care that would be most appropriate for Mr. Morton and Ms. Finley.
A. Mr. Morton-palliative care Ms. Finley-acute care
B. Mr. Morton-skilled care Ms. Finley-palliative care
C. Mr. Morton-subacute care Ms. Finley-skilled care
D. Mr. Morton-acute care Ms. Finley-subacute care
正解：C

質問 4：
Elaine Newman suffered an acute asthma attack and was taken to a hospital emergency department for treatment. Because Ms. Newman's condition had not improved enough following treatment to warrant immediate release, she was transferred to an observation care unit. Transferring Ms. Newman to the observation care unit most likely
A. gave Ms. Newman access to more effective and efficient treatment than she could have obtained from other providers in the same region
B. allowed clinical staff an opportunity to determine whether Ms. Newman required hospitalization without actually admitting her
C. resulted in unnecessarily expensive charges for treatment
D. prevented Ms. Newman from receiving immediate attention for her condition
正解：B

質問 5：
Health plans that offer healthcare programs for Medicare beneficiaries have a strong financial incentive for identifying high-risk seniors as early as possible. The identification of high-risk seniors is typically accomplished through the use of
A. intervention identification
B. geriatric evaluation and management (GEM)
C. case management
D. interdisciplinary home care (IHC)
正解：A

質問 6：
Acute care refers to healthcare services for medical problems that
A. are expected to continue for a minimum of 30 days
B. require low utilization of resources
C. are typically treated in a provider's office or outpatient facility
D. require prompt, intensive treatment by healthcare providers
正解：D