2024 The Medical Necessity Series Part II: COPD and Pneumonia (36) – Post Test – Cyatl Courses

Quiz Summary

0 of 10 Questions completed

Questions:

You have already completed the quiz before. Hence you can not start it again.

Quiz is loading…

You must sign in or sign up to start the quiz.

You must first complete the following:

Results

Quiz complete. Results are being recorded.

Results

0 of 10 Questions answered correctly

You have reached 0 of 0 point(s), (0)

Sorry, but you have failed this post test. You can look at your answers below and review the material once again before retaking the post test. You’ll need a minimum of 70% to pass. You have a total of five attempts in which to score a passing grade of 70%.
Congratulations, you have passed this post test.

Current
Review
Answered
Correct
Incorrect

Question 1 of 10

1. Question
1. On day two of a hospital stay where the patient was admitted as inpatient for COPD exacerbation, what would help clinically further indicate this on day two? Select each correct condition:
- a. Occasional PACs on overnight monitor
- b. Noting a slight increased work of breathing on ambulation to the toilet (no accessory muscle use, no confusion, and RR 13) with room air saturation 96%.
- c. Continued shortness of breath (sat 97% off supplemental O2) at rest. RR12.
- d. Shortness of breath on ambulation with O2 saturation 85% in a patient not on home O2
Correct

Incorrect
Question 2 of 10

2. Question
2. Regarding screening tools for pneumonia, the following is true (select all that are correct):
- a. The CURB-65 score of >3 should lead one to consider hospitalization and inpatient care.
- b. The PSI score of >91 indicates a need to consider hospitalization and inpatient level of care.
- c. A SMART-COP score of 5-6 indicates a 33% risk of needing intensive respiratory or vasopressor support.
- d. CURB-65 is only to be used with patients 65 years of age and older.
Correct

Incorrect
Question 3 of 10

3. Question
3. CMS includes these conditions in their 30-day risk-standardized unplanned readmission measures to grade facilities. If excess readmissions are realized as compared to their peers, a reduction in payment can be applied. Which of the conditions below are used in this calculation (select all that are included)?
- a. Acute Myocardial Infarction (AMI)
- b. Chronic Obstructive Pulmonary Disease (COPD)
- c. Pneumonia
- d. Heart Failure
Correct

Incorrect
Question 4 of 10

4. Question
4. Which of the following is not true of respiratory failure?
- a. Documentation should include physical signs/symptoms of respiratory distress, clinical data such as ABG, pulse oximetry or capnography readings, and treatment.
- b. Linkage to an etiology is best practice, when possible (i.e., “due to LLL PNA”)
- c. Respiratory failure should be indicated if present on admission (POA status) and updated with documentation to show status of the condition (improved, resolved, etc.) during the stay and on the discharge summary.
- d. It is only documented if the patient has been intubated.
Correct

Incorrect
Question 5 of 10

5. Question
5. Evidence from various studies regarding Healthcare Associated Pneumonia (“HCAP”) show (select the ONE correct answer)
- a. Patients are at a high risk of multi-drug resistant pathogens with HCAP
- b. Hospitalizations are prolonged by more than one day with these infections.
- c. HCAP usually runs an uncomplicated course and is classified in the same category as Community Acquired Pneumonia (CAP, Simple PNAs).
- d. HCAP has a predilection for a younger population (40-60 years of age)
Correct

Incorrect
Question 6 of 10

6. Question
6. A 77-year-old male with a 60 pack-year smoking history and non-supplemental oxygen requiring COPD presents with SOB x 3d duration. Though not indicative of securing an inpatient status determination on admission, the following information would help in making that clinical decision: (choose all that are correct)
- a. Making reference to the last admission 2 months ago with a similar presentation that ended up with a prolonged hospital stay and a 2d mechanical ventilation complication
- b. Noting the O2 sat of 95% on RA in the PCP office 3 months ago and the sat of 85% on RA here
- c. Commenting on the labored breathing, accessory muscle use, and the “fatigued” look at presentation
- d. Noting the CXR finding of RLL with a new layering pleural effusion.
Correct

Incorrect
Question 7 of 10

7. Question
7. Which of the following COPD scenarios would most likely merit INPATIENT hospitalization from initial presentation?
- a. COPD patient with mild confusion exacerbation on day one
- b. COPD exacerbation with RR 15, cough w/ thick increased phlegm, sat 96% on RA
- c. COPD with 2 liters home O2, presents with sat 81% at which time the oxygen was increased to 4 liters. CXR showed LLL pneumonia. On 4 liters saturation is 91%.
- d. COPD with HF and BNP of 126.
Correct

Incorrect
Question 8 of 10

8. Question
8. Regarding patients with COPD exacerbation, which is true?
- a. Most COPD patients are admitted to a hospital with most exacerbations.
- b. Of those admitted, the length of stay ranges from 2.5 – 3.5 days per CMS GMLOS data available in 2024.
- c. O2 saturation < 95% merit admission to inpatient status.
- d. If the patient is not better on day 2, an inpatient admission is approved because of the length of stay.
Correct

Incorrect
Question 9 of 10

9. Question
9. Which of the following would NOT support continued hospital stay?
- a. Occasional PACs on overnight monitor
- b. Noting an increased work of breathing on ambulation to the toilet (noted access muscle use and RR 22) and associated worsening gait stability
- c. New hypoxia (sat 86% off supplemental O2) at rest
- d. Shortness of breath on ambulation with O2 saturation 89% in a patient not on home O2
Correct

Incorrect
Question 10 of 10

10. Question
10. The following COPD scenarios would merit hospitalization:
- a. Mild compensated diastolic heart failure
- b. Three-day URI symptoms with increased sputum production. Sat 96% on RA
- c. Pneumonia with a pleural effusion in a patient with new atrial fibrillation
- d. In a Type II diabetic with A1c of 9
Correct

Incorrect

2024 The Medical Necessity Series Part II: COPD and Pneumonia (36) – Post Test

2024 The Medical Necessity Series Part II: COPD and Pneumonia (36) – Post Test

Quiz Summary

Information

Results

Results

Categories

1. Question

2. Question

3. Question

4. Question

5. Question

6. Question

7. Question

8. Question

9. Question

10. Question