Multiple Choice Questions in Management and Hospital Administration

“Nise Dominus Frustra”

“Without God we can do nothing”

Multiple Choice Questions in Management and Hospital Administration Shakti Kumar Gupta MBBS MHA (AIIMS) FAMS FIHE FAHA

Head, Department of Hospital Administration and Medical Superintendent All India Institute of Medical Sciences (AIIMS) Dr RP Centre for Ophthalmic Sciences New Delhi, India

Col Sunil Kant, VSM MBBS DCE MNAMS MBA MHA (AIIMS)

Professor Department of Hospital Administration AFMC, Pune, Maharashtra, India

Prashant Rampal MBBS DA PGDHHM MHA (AIIMS)

Practicing Physician and Consultant Hospital Administration Yol, Himachal Pradesh, India

®

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Multiple Choice Questions in Management and Hospital Administration © 2010, Jaypee Brothers Medical Publishers All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the authors and the publisher. This book has been published in good faith that the material provided by the authors is original. Every effort is made to ensure accuracy of material, but the publisher, printer and the authors will not be held responsible for any inadvertent error (s). In case of any dispute, all legal matters are to be settled under Delhi jurisdiction only. First Edition: 2010 ISBN 978-93-80704-41-8 Typeset at JPBMP typesetting unit Printed at ....................

To My parents for their guidance and moral support to my students past, present and future and teachers who always inspired me for academic excellence to my beautiful and brilliant wife, Madhu who provides me with unwavering love and support and our affectionate daughter, Shilpa for her undaunting patience and understanding while I pursued my dreams —Shakti Kumar Gupta To My lovable wife, Sheeba for being my steady anchor and omnipresent sublime loec Our delightful daughter, Dakshita for her radiant presence Memory of my Father, mother and brother —Sunil

Kant

To Lt Gen PK Rampal and Shashi Rampal my parents My teachers Sheetal Rampal my euphemistic wife and our angel Shubhika —Prashant

Rampal

Preface

Multiple Choice Questions (MCQs) have become a frequent method of assessment as a screening tool in competitive examinations. Apart from this, they may also be utilized as a means of formative exercises during conduct of teaching modules, as summative assessment to make judgment on students’ performances, or for ascertaining knowledge gap of students at the beginning of a module or for progress through a module. There is at present non-availability of a comprehensive and updated book on MCQs in the speciality of General Management, Hospital Administration and its related specialties. It is to fulfill this felt requirement that the present book is being published. The book has MCQs related to the specialties of Hospital Administration, Health Care Administration, Community Medicine, Forensic Medicine and General Management. The book has the following Sections: 1. Multiple Choice Questions – An Overview 2. Management and its Applications 3. Community Medicine and Health Care Administration 4. Hospital Administration 5. Clinical Care Services 6. Supportive and Utility Services 7. Ready Reckoner The book has 91 chapters which contain all types of MCQs including single best response type, true/false type, relation analysis type, matching type and case history type. The MCQs which are incorporated in the book are to test various domains viz knowledge, comprehension, analysis, applications, synthesis and evaluation. The book will be a useful guide to: • Students preparing for entrance examinations of PG courses in Hospital Administration, Health Care Administration, Community Medicine, Forensic Medicine, Management, Business Administration, etc. • Students pursuing the above-mentioned courses. • Paper setters for examinations in the above-mentioned courses. • Teachers as a means for assessment of students. We hope, the book proves to be valuable to those for whom it is intended. Communication of suggestions and omissions from our esteemed readers will be of immense help in incorporating the same in the subsequent editions. We sincerely appreciate the valuable contribution to the well-knit team of M/s Jaypee Brothers Medical Publishers (P) Ltd. Our special thanks to Shri Jitendar P Vij (Chairman and Managing Director) and Mr Tarun Duneja (Director– Publishing) for their cooperation, professionalism, and dedication. Their invaluable contribution in the timely completion of the book is gratefully acknowledged. Authors

Contents SECTION 1—MULTIPLE CHOICE QUESTIONS Chapter 1.

Multiple Choice Questions—An Overview ................................................................................. 3

SECTION 2—MANAGEMENT AND ITS APPLICATIONS Chapter 2. Chapter 3.

Management Science .................................................................................................................. 9 Planning ..................................................................................................................................... 16

Chapter 4.

Organising .................................................................................................................................. 21

Chapter 5 Chapter 6. Chapter 7. Chapter 8. Chapter 9. Chapter 10. Chapter 11. Chapter 12. Chapter 13. Chapter 14. Chapter 15. Chapter 16. Chapter 17. Chapter 18. Chapter 19. Chapter 20. Chapter 21. Chapter 22.

Informal Organisation ................................................................................................................ 33 Staffing ....................................................................................................................................... 37 Communication .......................................................................................................................... 41 Leadership .................................................................................................................................. 45 Motivation ................................................................................................................................... 50 Transactional Analysis .............................................................................................................. 55 Management Control ................................................................................................................. 57 Change and Conflict Management ........................................................................................... 61 Personnel Counselling .............................................................................................................. 65 Human Resource Development ................................................................................................ 67 Labor Laws ................................................................................................................................. 70 Industrial Relations ................................................................................................................... 71 Accountancy and Economics ................................................................................................... 72 Social Sciences and Management ............................................................................................ 85 Re-engineering ........................................................................................................................... 87 Decision-Making ........................................................................................................................ 89 Project Management .................................................................................................................. 90 Case Studies .............................................................................................................................. 93

SECTION 3—COMMUNITY MEDICINE AND HEALTH CARE ADMINISTRATION Chapter 23. Chapter 24.

Epidemiology ............................................................................................................................. 97 Demography and Family Planning ......................................................................................... 120

Chapter 25. Chapter 26.

Preventive Medicine in Obstetrics, Paediatrics and Geriatrics ............................................ 123 Occupational Health ................................................................................................................ 125

Chapter 27. Chapter 28.

Health Committees .................................................................................................................. 127 Environment ............................................................................................................................. 130

Chapter 29. Chapter 30.

National Health Programmes .................................................................................................. 134 Nutrition .................................................................................................................................... 145

Chapter 31.

Communicable Diseases ......................................................................................................... 154

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MCQs in Management and Hospital Administration

Chapter 32. Chapter 33. Chapter 34.

Non-Communicable Diseases ................................................................................................. 166 Immunisation ........................................................................................................................... 171 Managed Care .......................................................................................................................... 175

Chapter 35. Chapter 36.

Indian Public Health Standards .............................................................................................. 176 National Rural Health Mission ................................................................................................ 179

Chapter 37. Chapter 38. Chapter 39.

National Health Policy ............................................................................................................. 182 Health Care Delivery ................................................................................................................ 187 Janani Suraksha Yojana .......................................................................................................... 189

Chapter 40. Chapter 41.

Pradhan Mantri Swasthya Suraksha Yojana ........................................................................... 194 Current Health Care Scenario ................................................................................................. 195

Chapter 42.

General Questions ................................................................................................................... 206

SECTION 4—HOSPITAL ADMINISTRATION Chapter 43. Chapter 44. Chapter 45. Chapter 46. Chapter 47. Chapter 48. Chapter 49. Chapter 50. Chapter 51. Chapter 52. Chapter 53. Chapter 54. Chapter 55. Chapter 56. Chapter 57.

History of Hospitals ................................................................................................................. Legal Aspects in Hospital Administration ............................................................................. Forensic Medicine and Toxicology ......................................................................................... Organ Transplantation Act ...................................................................................................... Right to Information Act and Consumer Protection Act ....................................................... Quality Assurance ................................................................................................................... Medical Audit ........................................................................................................................... Hospital Accreditation ............................................................................................................. Public Relations in Hospital .................................................................................................... Medical Ethics .......................................................................................................................... Hospital Acquired Infections .................................................................................................. Hospital Hazards ...................................................................................................................... Biological Hazards ................................................................................................................... Hospital Engineering Services ............................................................................................... Hospital Equipment Planning .................................................................................................

211 212 232 242 245 247 257 259 260 261 265 267 269 271 281

Chapter 58. Chapter 59. Chapter 60. Chapter 61. Chapter 62.

Hospital Information System .................................................................................................. Hospital Transport System ...................................................................................................... Operations Research ............................................................................................................... Biostatistics ............................................................................................................................. Materials Management in Hospitals .......................................................................................

283 285 286 292 314

Chapter 63.

Financial Management in Hospitals ....................................................................................... 321

Chapter 64. Chapter 65. Chapter 66. Chapter 67.

Resource Mobilisation in Hospitals ........................................................................................ Personnel Management in Hospitals ...................................................................................... Central Civil Services (Classification, Control and Appeal) Rules ....................................... Marketing of Hospital Services ...............................................................................................

Chapter 68. Chapter 69.

Barrier Free Environment ........................................................................................................ 334 Health Insurance ...................................................................................................................... 338

Chapter 70.

Hospital Environment Management ....................................................................................... 343

323 324 331 333

Contents Chapter 71. Chapter 72.

xi

Planning and Designing Considerations for Hospitals ........................................................ 352 Case Studies ............................................................................................................................ 356

SECTION 5—CLINICAL CARE SERVICES Chapter 73. Chapter 74.

Emergency Services ................................................................................................................ 361 Out Patient Department ........................................................................................................... 364

Chapter 75. Chapter 76. Chapter 77.

Operation Theatre .................................................................................................................... 368 Intensive Care Unit .................................................................................................................. 374 Nursing Services ..................................................................................................................... 377

Chapter 78.

Day Care Services .................................................................................................................... 381

SECTION 6—SUPPORTIVE AND UTILITY SERVICES Chapter 79. Chapter 80. Chapter 81. Chapter 82. Chapter 83. Chapter 84. Chapter 85. Chapter 86. Chapter 87. Chapter 88. Chapter 89. Chapter 90.

Medical Records ...................................................................................................................... Laboratory Services ................................................................................................................ Radioimaging Services and Radiation Hazards .................................................................... Linen and Laundry Services ................................................................................................... Blood Bank ............................................................................................................................... Central Sterile and Supply Department ................................................................................. Dietary Services ....................................................................................................................... Housekeeping Services ........................................................................................................... Medical Waste Management .................................................................................................... Manifold Services .................................................................................................................... Pharmacy Services .................................................................................................................. Mortuary Services ....................................................................................................................

385 389 393 397 399 402 405 407 409 416 420 422

SECTION 7—READY RECKONER Chapter 91.

Ready Reckoner ....................................................................................................................... 427

Section 1 Multiple Choice Questions Chapter 1

Multiple Choice Questions–An Overview

Chapter

1

Multiple Choice Questions —An Overview

Multiple Choice Questions (MCQs) are questions where choice has to be made from a list of possible answers. Selection is done of the correct or best answer from a given list. Uses of MCQs MCQs may be utilized for the following: a. Summative assessment: These are done to make judgement on a student’s performance at the end of a semester/module/course. MCQs could form a part or whole of summative assessment. b. Formative exercises: These normally take place during the conduct of a teaching module. The purpose is development. This could take the form of regular self assessment exercises with feedback and are particularly useful for revision/assessment. c. Assessment: They may be utilized for screening/ selection assessment of various examinations. d. MCQs may also be utilized as a means of ascertaining knowledge gaps of students at the beginning of a module or unit and or progress throughout a module or unit through analysis of results. Component of MCQs Each MCQ is know as an item. An item has the following components: a. Direction: It states how the examinee has to answer/ respond, e.g. Select the most appropriate answer. b. Stem: The problem is called the stem. It may be stated in the form of a fact/description/diagram/direct question/ incomplete statement/case history/fill in the blank. c. Alternatives/Responses: Choices given in the answer are called alternatives. There are two subtypes of alternatives. i. Key/Key option: This is the correct answer. ii. Distractors: These are the other remaining options. These are the wrong choices. Example: Select the most appropriate answer. The standardized mortality rate is a method of: A. Direct standardization

B. Indirect standardization C. Estimating crude death rate D. Calculating age specific death rate In the above example “select the most appropriate answer” is the direction. The problem i.e. “ The standardized mortality rate” is the stem. Answer B is the correct answer or the key. The options given in A, C and D are the distracters. Types of MCQs Various types of MCQs are: a. Single Best Response Type. b. True/False Type. c. Multiple True/False Type. d. Relationship Analysis Type. e. Matching Type. f. Case history Type. Single Best Response Type Their characteristics are: 1. They have a stem and four or five alternatives of which there is one and only one predetermined correct answer. Question: Select the most appropriate answer. All the following occupationally hazardous chemicals can be found in urine except: A. Arsenic B. Lead C. Mercury D. Cadmium E. Benzene 2. They mainly test the recall capability. In formulation of such types of MCQs the following should be ensured: a. Clues that may suggest the correct answer are avoided. b. Plausible distracters should be used. c. The distracters and the key responses should possess homogencity i.e. they should be fairly similar in contents.