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NE Chiropractic Jurisprudence study materials
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NE Chiropractic Jurisprudence practice questions

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Question 1Chiropractic Practice and Patient Care

Under Nebraska chiropractic law, which record-keeping duty applies to a licensed chiropractor after a patient's course of care ends?

  1. Retain the clinical record for the period set by statute or board rule before destruction Correct answer.
  2. Transfer original records to the patient without retaining a copy
  3. Retain records only if the patient requests it in writing
  4. Destroy all records immediately at discharge to protect privacy

Explanation

Nebraska rules require a chiropractor to keep patient records for a defined retention period after the last treatment, and destruction must follow that timeline. Immediate destruction or release of originals without a retained copy conflicts with that duty.

Question 2Chiropractic Practice and Patient Care

A Nebraska chiropractor wants to advertise a discounted initial examination. Which approach best complies with the state's advertising rules for the profession?

  1. Present the offer truthfully and avoid misleading or deceptive claims about outcomes Correct answer.
  2. Omit any mention of fees to make the ad more appealing
  3. Use patient testimonials implying guaranteed results
  4. Guarantee that the adjustment will cure the patient's condition

Explanation

Chiropractic advertising must be truthful and must not be deceptive or create unjustified expectations of cure. Guarantees and outcome-implying testimonials cross into misleading territory, and concealing fees can itself mislead.

Question 3Chiropractic Practice and Patient Care

Which action is required before a Nebraska-licensed chiropractor may begin treating a new patient?

  1. Have the patient sign a blanket waiver of all liability
  2. Collect full payment in advance of the first visit
  3. Notify the board of each new patient encounter
  4. Obtain informed consent after explaining the proposed care and its risks Correct answer.

Explanation

Informed consent is an ethical and legal prerequisite to care; the chiropractor must explain the proposed treatment, alternatives, and material risks. Blanket liability waivers are generally unenforceable, and the board does not require notice of individual patient encounters.

Question 4Chiropractic Practice and Patient Care

A patient asks a Nebraska chiropractor to release copies of the treatment record to an attorney. What is the most appropriate response?

  1. Release the records only with a valid written authorization from the patient Correct answer.
  2. Refuse because chiropractic records are confidential to the clinic
  3. Release the records verbally to the attorney without documentation
  4. Send the records and bill the attorney without patient knowledge

Explanation

Patient records are confidential, and disclosure to a third party such as an attorney requires a valid written authorization unless a legal exception applies. Verbal release or disclosure without patient knowledge breaches confidentiality.

Question 5Chiropractic Practice and Patient Care

Which situation most clearly requires a Nebraska chiropractor to make a mandatory report to the appropriate authority?

  1. A patient who misses two scheduled appointments
  2. Reasonable suspicion that a patient's injury resulted from child abuse Correct answer.
  3. A patient who declines recommended spinal manipulation
  4. A patient who requests a copy of their own records

Explanation

Chiropractors are mandatory reporters when they have reasonable suspicion that a child's injury results from abuse or neglect. Declining care, requesting records, and missed appointments are ordinary clinical events with no reporting duty.

Question 6Chiropractic Practice and Patient Care

A Nebraska chiropractor's license has lapsed for nonpayment of renewal fees while the chiropractor continues to treat patients. This conduct is best characterized as:

  1. Practicing without a valid license, which is subject to disciplinary action Correct answer.
  2. Permissible if the patients are informed of the lapse
  3. A minor billing issue with no professional consequence
  4. Acceptable because the chiropractor was once licensed

Explanation

Practicing while a license is lapsed constitutes unlicensed practice and exposes the individual to disciplinary and legal consequences. Prior licensure or patient notification does not cure the lapse.

Question 7Chiropractic Practice and Patient Care

Which element is essential to a valid malpractice claim against a Nebraska chiropractor?

  1. Proof that the chiropractor charged above-average fees
  2. Proof that the chiropractor's breach of the standard of care caused the patient's injury Correct answer.
  3. Proof that the patient disliked the chiropractor's bedside manner
  4. Proof that the patient later saw another provider

Explanation

A malpractice claim requires duty, breach, causation, and damages; the patient must show the chiropractor fell below the standard of care and that this caused injury. Poor bedside manner, high fees, or seeking a second opinion do not by themselves establish negligence.

Question 8Chiropractic Practice and Patient Care

A Nebraska chiropractor wants to delegate a spinal adjustment to an unlicensed assistant. What is the correct position under state law?

  1. Spinal adjustment is a licensed act that cannot be delegated to an unlicensed assistant Correct answer.
  2. Any staff member may perform adjustments under direct supervision
  3. Delegation is allowed once the assistant completes a weekend course
  4. Delegation is allowed if the assistant signs a waiver

Explanation

Spinal adjustment is within the scope of chiropractic practice and may only be performed by a licensed chiropractor; unlicensed assistants cannot perform it even under supervision. Short courses or waivers do not create authority to perform a licensed act.

Question 9Chiropractic Practice and Patient Care

A Nebraska chiropractor suspects a colleague is impaired by alcohol while treating patients. What is the most appropriate professional response?

  1. Report the concern to the board or the appropriate authority consistent with duty to protect patients Correct answer.
  2. Confront the colleague publicly in front of patients
  3. Ignore the concern because it involves a fellow licensee
  4. Discuss the concern with other patients to gather opinions

Explanation

Professionals have a duty to protect patients, which includes reporting an impaired colleague to the licensing board or appropriate authority. Ignoring the issue endangers patients, and public confrontation or discussing it with patients is unprofessional and breaches confidentiality.

Question 10Chiropractic Practice and Patient Care

A Nebraska chiropractor moves to a new clinic and does not notify the board of the address change. Which statement is correct?

  1. Licensees must keep the board informed of current practice address and contact information Correct answer.
  2. Address changes are irrelevant to licensure
  3. Notification is optional if the chiropractor has a website
  4. Notification is required only at the next renewal in ten years

Explanation

Licensing boards require current practice address and contact information so they can reach licensees for official matters. Failing to update this information can itself be a violation and may cause missed notices.

Question 11Chiropractic Practice and Patient Care

During a treatment session, a Nebraska chiropractor wishes to use a technique for which they have limited training. What is the most appropriate action?

  1. Inform the patient that outcomes are unpredictable and proceed
  2. Delegate the technique to an assistant with no training
  3. Practice within demonstrated competence and refer or obtain additional training before using the technique Correct answer.
  4. Attempt the technique and learn from any mistakes during treatment

Explanation

Chiropractors must practice within their competence and obtain appropriate training or refer when a technique exceeds their skills. Experimenting on patients or delegating to untrained staff violates the standard of care.

Question 12Chiropractic Practice and Patient Care

A Nebraska chiropractor's patient discloses that they intend to harm a specific identifiable person. Which response best reflects the chiropractor's legal and ethical obligations?

  1. Report the disclosure only if the patient consents
  2. Maintain absolute confidentiality regardless of the threat
  3. Take reasonable steps to protect the identifiable potential victim, which may include warning or notifying authorities Correct answer.
  4. Post the disclosure in the patient's public record

Explanation

When a patient makes a credible threat against an identifiable victim, the duty to protect may permit or require warning the victim or notifying law enforcement. Absolute confidentiality yields to this public-safety exception, and consent is not required in that situation.

Question 13Chiropractic Practice and Patient Care

A Nebraska chiropractor is asked to sign a lien agreement so an attorney will pay for treatment after a personal injury settlement. Which statement is most accurate?

  1. Liens are prohibited in all circumstances
  2. Liens are permissible if properly documented, but the chiropractor remains responsible for accurate billing and records Correct answer.
  3. A lien permits billing for services not rendered
  4. A lien eliminates the need to keep treatment records

Explanation

Treatment liens can be used in personal injury cases when properly documented, but they do not relax requirements for accurate records and billing. Fraudulent billing under a lien remains a violation.

Question 14Chiropractic Practice and Patient Care

Which best describes the chiropractor's duty when a Nebraska patient's condition falls outside the chiropractic scope of practice?

  1. Refer the patient to an appropriate licensed provider while continuing supportive care as indicated Correct answer.
  2. Continue treating the condition indefinitely within the clinic
  3. Treat the condition using any method the patient requests
  4. Discharge the patient without explanation

Explanation

When a condition requires care beyond the chiropractic scope, the chiropractor should refer to an appropriate provider and coordinate care. Continuing out-of-scope treatment or abandoning the patient without explanation is inappropriate.

Question 15Chiropractic Practice and Patient Care

A Nebraska chiropractor documents a treatment note days after the visit from memory. Which practice best supports record integrity?

  1. Note the actual date of entry and identify it as a late entry Correct answer.
  2. Backdate the note to the date of service
  3. Ask the patient to write the note instead
  4. Leave the note undated to avoid confusion

Explanation

Records should be accurate and contemporaneous; when an entry is made later, it should show the actual date and be identified as a late entry. Backdating falsifies the record, and undated or patient-authored notes undermine reliability.

Question 16Chiropractic Practice and Patient Care

A Nebraska chiropractor receives a subpoena for a patient's records in litigation. What is the most appropriate first step?

  1. Verify the subpoena's validity and confirm that patient authorization or a court order supports release Correct answer.
  2. Ignore the subpoena because records are confidential
  3. Immediately mail all records to the requesting attorney
  4. Destroy the records to avoid disclosure

Explanation

A subpoena does not by itself override confidentiality; the chiropractor should confirm it is valid and that authorization or a court order permits release. Immediate disclosure, ignoring the subpoena, or destroying records can each create legal exposure.

Question 17Chiropractic Practice and Patient Care

Which action by a Nebraska chiropractor would most likely constitute fee splitting prohibited by professional rules?

  1. Paying a portion of a treatment fee to an unlicensed marketer for each referred patient Correct answer.
  2. Referring a patient to a specialist without payment
  3. Charging a standard fee for an office visit
  4. Providing a receipt for services rendered

Explanation

Paying a share of professional fees to an unlicensed person for patient referrals is an improper fee split that can also violate referral prohibitions. Standard fees, receipts, and unpaid referrals are ordinary and permissible.

Question 18Chiropractic Practice and Patient Care

A Nebraska chiropractor is retiring and plans to dispose of patient records. Which approach best complies with professional obligations?

  1. Keep records indefinitely in an unsecured storage unit
  2. Sell the records to another clinic without patient consent
  3. Follow the retention schedule and provide patients notice or a means to obtain their records before lawful destruction Correct answer.
  4. Discard records in the regular trash without notice

Explanation

Record disposal must respect retention requirements and protect confidentiality, which typically includes notifying patients and offering a way to obtain records before lawful destruction. Trashing, selling, or storing records insecurely breaches those duties.

Question 19Chiropractic Practice and Patient Care

A Nebraska chiropractor's continuing education cycle requires completion of specified hours. Which statement best reflects the obligation?

  1. Hours may be carried over indefinitely without limit
  2. Only online courses count toward the requirement
  3. The licensee must complete the required hours, including any mandated subject areas, by the deadline Correct answer.
  4. Continuing education is optional for experienced licensees

Explanation

License renewal depends on completing the required continuing education hours, including any specified subject areas, within the cycle. It is not optional, carryover is limited by rule, and acceptable formats are defined by the board.

Question 20Chiropractic Practice and Patient Care

A Nebraska chiropractor is considering a romantic relationship with a current patient. Which statement best reflects professional boundaries?

  1. The relationship is acceptable if the patient initiates it
  2. The relationship is acceptable after the first adjustment
  3. The relationship is acceptable if documented in the chart
  4. Entering a romantic relationship with a current patient is prohibited as a boundary violation Correct answer.

Explanation

Sexual or romantic relationships with current patients are prohibited because of the inherent power imbalance and risk of exploitation. Who initiates the relationship or chart documentation does not make it permissible.

Question 21Chiropractic Practice and Patient Care

A Nebraska chiropractor is employed by a clinic that pressures staff to upcode visits to increase insurance reimbursement. What is the chiropractor's most appropriate response?

  1. Bill the higher codes only for patients with insurance
  2. Refuse to submit inaccurate claims and report the pressure through appropriate compliance channels Correct answer.
  3. Submit the codes but document the pressure in the chart
  4. Comply because the employer directs billing practices

Explanation

Submitting knowingly inaccurate claims is insurance fraud; the chiropractor must refuse and use compliance or reporting channels. Employer direction, chart notes, or insurance status do not justify false billing.

Question 22Chiropractic Practice and Patient Care

A Nebraska chiropractor treats a minor brought in by a grandparent who lacks documentation of guardianship. What is the most prudent course?

  1. Treat the minor without any consent because a relative brought them
  2. Confirm that the accompanying adult has legal authority to consent before providing non-emergency care Correct answer.
  3. Refuse all care to minors in every circumstance
  4. Obtain consent from the minor's school nurse

Explanation

Non-emergency care of a minor requires consent from a parent or a person with legal authority, so the chiropractor should verify that authority. Treating on a relative's word alone or refusing all minors is inappropriate, and a school nurse generally cannot consent.

Question 23Chiropractic Practice and Patient Care

A Nebraska chiropractor learns during a peer review meeting that a colleague made a documentation error. Which action best reflects the confidentiality obligations of peer review?

  1. Discuss the error with patients as a cautionary tale
  2. Report the colleague to the board without any factual basis
  3. Share the details with the clinic's social media followers
  4. Keep peer review proceedings confidential and address the issue through the review process Correct answer.

Explanation

Peer review proceedings are confidential and designed to improve care through a protected process. Publicizing the information or making baseless board reports violates confidentiality and professional obligations.

Question 24Chiropractic Practice and Patient Care

A Nebraska chiropractor is asked by an insurance carrier to provide records for a utilization review. Which response best complies with confidentiality rules?

  1. Release only the records necessary for the review under the applicable authorization or contractual/legal basis Correct answer.
  2. Release records to any carrier employee who calls
  3. Refuse all requests from insurers as a matter of policy
  4. Release the entire chart including unrelated mental health notes without review

Explanation

Disclosures to insurers should be limited to the minimum necessary information and supported by authorization or a legal/contractual basis. Releasing unrelated sensitive notes, blanket refusal, or releasing to any caller violates confidentiality.

Question 25Chiropractic Practice and Patient Care

A Nebraska chiropractor plans to use a new device for which the manufacturer claims clinical benefits but provides no peer-reviewed evidence. Which approach best reflects the standard of care?

  1. Delegate device use to unlicensed staff without training
  2. Adopt the device immediately based on marketing claims
  3. Use the device only on patients who cannot complain
  4. Evaluate the evidence and obtain appropriate training before adopting the device in patient care Correct answer.

Explanation

Adopting new technology requires critical evaluation of evidence and adequate training; marketing claims alone are insufficient. Immediate adoption, targeting vulnerable patients, or untrained delegation falls below the standard of care.

Question 26Chiropractic Practice and Patient Care

Under Nebraska law, which individual is authorized to perform a chiropractic adjustment?

  1. A certified chiropractic assistant after 40 hours of training
  2. A physical therapist with a manual therapy endorsement
  3. A student enrolled in a chiropractic college under direct supervision
  4. A licensed chiropractor acting within scope of practice Correct answer.

Explanation

Nebraska law reserves the performance of chiropractic adjustments to licensed chiropractors. Assistants, physical therapists, and students are not licensed to perform adjustments independently, even with training or supervision. Only a licensed chiropractor may legally perform an adjustment.

Question 27Chiropractic Practice and Patient Care

A Nebraska chiropractor is establishing a new practice and must display their license. Where should the license be displayed?

  1. In a locked file cabinet accessible to staff
  2. In a conspicuous place in the primary office Correct answer.
  3. At the chiropractor's residence
  4. Only at the corporate headquarters

Explanation

Nebraska regulations require that a chiropractor's license be displayed conspicuously in the office where the chiropractor practices. Keeping it at home, at a corporate office, or in a file cabinet does not satisfy the public notice requirement.

Question 28Chiropractic Practice and Patient Care

A Nebraska chiropractor is treating a patient with low back pain. Which action best demonstrates compliance with informed consent?

  1. Explaining the proposed treatment, risks, and alternatives, and documenting the patient's agreement Correct answer.
  2. Assuming consent because the patient scheduled the appointment
  3. Providing a general brochure about chiropractic care at the front desk
  4. Obtaining a signed consent form without discussion

Explanation

Informed consent requires a discussion of the nature of the treatment, its risks and benefits, and reasonable alternatives, followed by the patient's agreement. Simply providing a brochure, obtaining a signature without discussion, or assuming consent from scheduling does not satisfy the requirement.

Question 29Chiropractic Practice and Patient Care

A Nebraska chiropractor is treating a patient who is also seeing a medical doctor for the same condition. What is the chiropractor's responsibility regarding coordination of care?

  1. Refer the patient exclusively to their own care
  2. Continue treatment without informing the patient
  3. Avoid contact with the medical doctor to prevent interference
  4. Communicate with the other provider as necessary for the patient's welfare Correct answer.

Explanation

Chiropractors should coordinate care with other health care providers when it serves the patient's best interest. Avoiding communication, keeping the patient uninformed, or insisting on exclusive care can compromise safety and continuity. Communication is a professional responsibility.

Question 30Chiropractic Practice and Patient Care

A Nebraska chiropractor is retiring and must notify the board. Which action is required regarding patient records?

  1. Destroy all records immediately
  2. Arrange for secure retention or transfer according to law and notify patients Correct answer.
  3. Leave records in the office for anyone to access
  4. Take records home without notifying patients

Explanation

When closing a practice, chiropractors must ensure patient records are retained or transferred in compliance with legal requirements and that patients are notified so they can obtain copies. Immediate destruction, removal without notice, or leaving records accessible violates confidentiality and recordkeeping rules.

Question 31Chiropractic Practice and Patient Care

A Nebraska chiropractor is treating a patient who has a condition that is outside the chiropractic scope of practice. What is the most appropriate action?

  1. Refer the patient to an appropriate health care provider Correct answer.
  2. Continue treatment and monitor for improvement
  3. Tell the patient no treatment is needed
  4. Treat the condition anyway with chiropractic techniques

Explanation

Chiropractors must practice within their scope and refer patients when a condition requires care outside that scope. Treating an out-of-scope condition, dismissing the patient without referral, or continuing ineffective care is inappropriate and may constitute unprofessional conduct.

Question 32Chiropractic Practice and Patient Care

A Nebraska chiropractor is asked to provide a patient's records to the patient. What is the chiropractor's obligation?

  1. Provide copies promptly upon proper request and payment of reasonable fees Correct answer.
  2. Require the patient to obtain a court order
  3. Provide records only if the patient sues
  4. Refuse because records belong to the chiropractor

Explanation

Patients have a right to access their medical records. Chiropractors must provide copies in a timely manner, though they may charge a reasonable fee for copying. Refusing, conditioning on litigation, or requiring a court order is improper.

Question 33Chiropractic Practice and Patient Care

A Nebraska chiropractor is treating a patient who is a minor. Who may consent to treatment?

  1. A parent or legal guardian Correct answer.
  2. Any adult accompanying the minor
  3. The minor's teacher
  4. The minor if they are 16 years old

Explanation

For minors, consent must be obtained from a parent or legal guardian unless a specific legal exception applies. An unrelated adult, a teacher, or the minor themselves generally cannot provide valid consent.

Question 34Chiropractic Practice and Patient Care

A Nebraska chiropractor discovers that a patient has been receiving duplicate chiropractic treatment from another provider without disclosure. What is the most appropriate response?

  1. Confront the other provider aggressively
  2. Ignore the issue and continue treatment
  3. Discuss the situation with the patient and document the findings Correct answer.
  4. Terminate care immediately without explanation

Explanation

When a chiropractor learns of undisclosed duplicate treatment, the appropriate response is to discuss it with the patient, assess the impact on care, and document the conversation. Aggressive confrontation, abrupt termination without explanation, or ignoring the issue is unprofessional and may compromise patient safety.

Question 35Chiropractic Practice and Patient Care

A Nebraska chiropractor is asked by a patient to alter a treatment note to reflect a different date of injury for insurance purposes. What should the chiropractor do?

  1. Make the change because the patient requested it
  2. Change the date but note the alteration in a separate file
  3. Ask the patient to sign a waiver
  4. Refuse to alter the record and document the request Correct answer.

Explanation

Falsifying a medical record is unethical and illegal. The chiropractor must refuse to alter the note and should document the patient's request. Making the change, even with a note elsewhere, or obtaining a waiver does not make the alteration permissible.

Question 36Chiropractic Practice and Patient Care

A Nebraska chiropractor wants to advertise a new treatment as 'guaranteed to cure back pain.' Which statement best reflects the advertising rules?

  1. It is allowed if the treatment is FDA-approved
  2. It is allowed with a disclaimer
  3. Such advertising is prohibited because it is misleading Correct answer.
  4. It is allowed if the chiropractor believes it is true

Explanation

Chiropractic advertising must be truthful and not misleading. Claiming a guaranteed cure is deceptive and prohibited, regardless of the chiropractor's belief, a disclaimer, or FDA status. Professional regulations prohibit false or exaggerated claims.

Question 37Chiropractic Practice and Patient Care

A Nebraska chiropractor is treating a patient with acute neck pain and suspects a fracture. What is the most appropriate action?

  1. Refer for immediate medical evaluation Correct answer.
  2. Perform a high-velocity adjustment
  3. Schedule a follow-up in one week
  4. Apply traction and monitor

Explanation

When a fracture is suspected, the chiropractor must refer the patient for immediate medical evaluation. Adjusting, applying traction, or delaying care could worsen the injury and is outside the chiropractic scope for such a condition.

Question 38Chiropractic Practice and Patient Care

A Nebraska chiropractor is asked to participate in a health fair by providing free spinal screenings. What is the primary professional obligation?

  1. Diagnose conditions on the spot and prescribe treatment
  2. Sell supplements to all participants
  3. Ensure screenings are conducted within scope and do not constitute diagnosis without follow-up Correct answer.
  4. Collect insurance information from all attendees

Explanation

Spinal screenings at health fairs must be conducted within the chiropractor's scope, and any findings should prompt appropriate referral or follow-up rather than immediate diagnosis or treatment. Diagnosing on the spot, selling products, or collecting insurance information is inappropriate.

Question 39Chiropractic Practice and Patient Care

A Nebraska chiropractor is treating a patient who requests a treatment that is not clinically indicated. How should the chiropractor respond?

  1. Provide the treatment because the patient requested it
  2. Refuse to see the patient again
  3. Provide the treatment but document the patient's request
  4. Explain why the treatment is not indicated and offer appropriate alternatives Correct answer.

Explanation

Chiropractors should not provide unnecessary treatment even if requested. The appropriate response is to explain the lack of indication and discuss clinically appropriate alternatives. Providing unnecessary care, dismissing the patient, or documenting the request does not justify inappropriate treatment.

Question 40Chiropractic Practice and Patient Care

A Nebraska chiropractor is considering hiring a billing service that offers to increase revenue by 'optimizing' codes. What is the chiropractor's responsibility?

  1. Delegate all responsibility to the billing service
  2. Use the service only for Medicare patients
  3. Ensure billing practices comply with laws and accurately reflect services provided Correct answer.
  4. Accept the service's recommendations without review

Explanation

Chiropractors are ultimately responsible for the accuracy of billing submitted under their name. They must ensure compliance with laws and that codes reflect actual services. Delegating responsibility, blindly accepting recommendations, or limiting to certain payers does not absolve the chiropractor.

Question 41Chiropractic Practice and Patient Care

A Nebraska chiropractor is treating a patient who discloses that they are HIV-positive. What is the chiropractor's obligation regarding confidentiality?

  1. Disclose to the patient's employer
  2. Report the status to the health department
  3. Maintain confidentiality unless disclosure is required by law Correct answer.
  4. Inform the patient's spouse without consent

Explanation

HIV status is highly confidential and may not be disclosed without the patient's consent unless a specific legal exception applies. Informing a spouse, reporting to the health department, or notifying an employer without legal authority violates confidentiality.

Question 42Chiropractic Practice and Patient Care

A Nebraska chiropractor is asked to provide expert testimony in a malpractice case. What is the chiropractor's primary ethical obligation?

  1. Testify based on the attorney's instructions
  2. Provide testimony that is truthful and within the area of expertise Correct answer.
  3. Testify only for the side that hired them
  4. Avoid testimony to prevent conflict

Explanation

Expert testimony must be truthful, objective, and confined to the expert's area of knowledge. Testifying only for one side, avoiding testimony, or following attorney instructions compromises integrity and violates ethical standards.

Question 43Chiropractic Practice and Patient Care

A Nebraska chiropractor is treating a patient who is a known drug seeker and requests opioids. What is the chiropractor's appropriate response?

  1. Prescribe a limited supply
  2. Provide a referral to a pain clinic without evaluation
  3. Dismiss the patient from the practice
  4. Explain that opioids are outside chiropractic scope and refer as needed Correct answer.

Explanation

Chiropractors do not prescribe opioids; they should explain the scope limitation and refer the patient for appropriate medical evaluation if needed. Prescribing, referring without evaluation, or dismissing the patient without appropriate referral is not appropriate.

Question 44Chiropractic Practice and Patient Care

A Nebraska chiropractor is treating a patient who has a history of stroke. What is the most important consideration before cervical manipulation?

  1. Refer the patient to a surgeon immediately
  2. Proceed with manipulation regardless of history
  3. Avoid all manual therapy
  4. Screen for contraindications and obtain informed consent regarding risks Correct answer.

Explanation

Before cervical manipulation, chiropractors must screen for contraindications such as vascular risk factors and obtain informed consent that includes discussion of rare but serious risks. Proceeding regardless, avoiding all manual therapy, or immediate surgical referral is not appropriate without evaluation.

Question 45Chiropractic Practice and Patient Care

A Nebraska chiropractor is treating a patient who is involved in litigation related to their injury. The patient asks the chiropractor to exaggerate symptoms in the record. What is the chiropractor's best response?

  1. Exaggerate slightly to support the patient's case
  2. Refer the patient to another chiropractor
  3. Record the patient's subjective complaints without comment
  4. Refuse and explain that records must be accurate Correct answer.

Explanation

Chiropractors must maintain accurate records and cannot falsify findings, even at a patient's request. Refusing and explaining the ethical and legal obligation is required. Exaggerating, recording false subjective complaints, or referring solely for this reason is inappropriate.

Question 46Chiropractic Practice and Patient Care

A Nebraska chiropractor is asked to serve as a peer reviewer for an insurance company. Which action would be most appropriate to maintain objectivity?

  1. Deny all claims to save the company money
  2. Review the case based on clinical guidelines and disclose any conflicts of interest Correct answer.
  3. Review only cases involving friends
  4. Approve all claims to support colleagues

Explanation

Peer reviewers must be objective, follow clinical guidelines, and disclose conflicts of interest. Denying or approving claims based on financial or collegial bias, or reviewing only friends' cases, undermines the integrity of the process.

Question 47Chiropractic Practice and Patient Care

A Nebraska chiropractor is treating a patient who has a communicable disease and refuses to disclose it to a sexual partner. What is the chiropractor's legal obligation?

  1. Report the patient to the police
  2. Follow state law regarding disclosure and encourage the patient to inform partners Correct answer.
  3. Immediately inform all past partners
  4. Disclose the information to the patient's employer

Explanation

Chiropractors must follow state-specific laws on communicable disease reporting and partner notification while maintaining confidentiality. Informing partners directly, reporting to police, or notifying an employer without legal authority violates privacy and may be unlawful.

Question 48Chiropractic Practice and Patient Care

A Nebraska chiropractor is asked to provide care to a patient who is terminally ill and requests aggressive chiropractic treatment for pain. What is the most appropriate approach?

  1. Refuse to treat because the patient is terminally ill
  2. Refer the patient to hospice and discontinue all care
  3. Provide any treatment the patient requests
  4. Provide palliative care within scope and coordinate with the patient's medical team Correct answer.

Explanation

Chiropractors may provide palliative care within their scope and should coordinate with the patient's medical team to ensure comprehensive care. Refusing treatment, providing any requested treatment without evaluation, or discontinuing care entirely is not in the patient's best interest.

Question 49Chiropractic Practice and Patient Care

A Nebraska chiropractor is treating a patient who is a colleague. What is the most appropriate action to avoid ethical issues?

  1. Treat the colleague as any other patient and maintain professional boundaries Correct answer.
  2. Avoid documenting the treatment
  3. Discuss the colleague's care with other colleagues
  4. Provide free treatment indefinitely

Explanation

When treating a colleague, the chiropractor should maintain the same professional standards as with any patient, including documentation and boundaries. Providing indefinite free treatment, discussing care with others, or avoiding documentation is unethical and unprofessional.

Question 50Chiropractic Practice and Patient Care

A Nebraska chiropractor has been treating a patient for several weeks and believes the patient's condition has plateaued. The chiropractor decides to end the professional relationship. Which action best reflects the chiropractor's ethical and legal obligation when terminating care?

  1. Notify the patient in writing, explain the reason, and allow reasonable time to arrange continued care or transfer of records Correct answer.
  2. Stop scheduling appointments immediately and take no further action, because a provider may end care at any time
  3. Continue treating the patient indefinitely until the patient decides to stop coming to the office
  4. Tell the patient verbally that treatment is over and discard the chart to protect the patient's privacy

Explanation

Ending care is a patient-care decision governed by the duty to avoid abandonment: the chiropractor must give the patient notice, a clinical rationale, and enough time to secure another provider or obtain records. Simply walking away, or continuing futile care indefinitely, both breach that duty. Records must be retained and transferred on request, never discarded.