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1. Combining effective communication and patient-centeredness into care delivery has been demonstrated to improve patients’ health and health care.
A. True
B. False
2. Approximately what percentage of American adults identify as lesbian, gay, or bisexual?
A. 1%
B. 2.5%
C. 3.5%
D. 5%
3. Which of the following statements is true of the LGBT community according to this paper?
A. People in the LGBT community share all of the health concerns of the rest of the population.
B. People in the LGBT community face a number of significant health risks the rest of the population do not necessarily share.
C. Both of the above statements are true.
4. Some of the health and health care issues LGBT people experience include:
A. Less access to insurance and health care services, including preventive care (such as cancer screenings)
B. Lower overall health status
C. Higher risk for mental health illnesses, such as anxiety and depression
D. Higher rates of sexually transmitted diseases, including HIV infection
E. All of the above
5. LGBT patients face several barriers to equitable care. Which of the following is NOT one of these barriers?
A. Refusals of care
B. Delayed or substandard care
C. Inappropriate restrictions or limits on visitation
D. Inequitable policies and practices
E. Requirements for parental consent in order to receive care
6. The term LGBT defines a homogeneous community.
A. True
B. False
7. The term sexual orientation describes _____.
A. A person's basic sense of being male, female, or other gender
B. A person's appearance, personality, and behavior that our culture defines as masculine or feminine
C. A person whose gender identity or gender expression differs from their birth sex or prevailing ideas of masculinity and femininity
D. A person's physical and/or emotional attraction to the same and/or opposite gender
8. According to this paper, "transgender" is an umbrella term that includes people who cross-dress and people who otherwise express themselves in ways considered unconventional from their birth sex.
A. True
B. False
9. Which of the following statements is true according to this paper?
A. Leaders at every level of the organization set the tone for a culture that is inclusive and welcoming.
B. All it takes is the top level leaders supporting inclusiveness to ensure the hospital's culture is inclusive and welcoming to LBGT individuals.
C. Leaders craft the mission and vision for an organization and reinforce it through their behaviors.
D. All of the above
E. A and C above
10. Leadership must take the lead to ensure that the needs of LGBT populations are accounted for in their efforts to provide patient-centered and equitable care.
A. True
B. False
11. Almost every major American medical association has produced ethical rules that prohibit discrimination against LGBT people in the practice of medicine, recognizing that such discrimination is harmful to patients’ health.
A. True
B. False
12. Which of the following statements is NOT made in this paper?
A. If state laws and regulations do not include anti-discrimination protections for LGBT populations, hospitals in those states should not offer such protections either.
B. The Joint Commission requires that all hospitals prohibit discrimination based on personal characteristics, including sexual orientation and gender identity or expression.
C. Posting, disseminating, and publicizing the nondiscrimination policy will communicate that nondiscrimination is an organization policy, regardless of whether or not anti-discrimination protections are included in state laws and regulations.
D. Leaders must send the message that any discrimination is unethical, unacceptable, and will not be tolerated.
13. This paper identifies several areas of policy that leaders can focus on to help ensure equitable care for LGBT individuals. These include:
A. Develop or adopt a policy of non-discrimination based on personal characteristics, including sexual orientation and gender identity or expression
B. Develop or adopt a policy ensuring equal visitation
C. Develop or adopt a policy identifying the patients’ right to identify a support person of their choice
D. All of the above
E. A and C above
14. One area of policy this paper suggests leaders pay attention to is defining family to explicitly include
A. Only spouses
B. Only spouses of opposite or same sex
C. Any individual that plays a significant role in the patient’s life
15. According to this paper, it is ultimately the responsibility of leadership to bring the patient and family perspective directly into the planning, delivery, and evaluation of health care.
A. True
B. False
16. One thing this paper recommends to help ensure LGBT populations receive equitable health care is that leaders see that unique LGBT patient needs are integrated into their hospital's policies.
A. True
B. False
17. Leaders can demonstrate ongoing commitment to inclusivity for LGBT patients and families by developing policies and procedures to:
A. Monitor efforts to provide more culturally competent, patient- and family-centered care to LGBT patients, families, and communities
B. Provide clear mechanisms for reporting discrimination or disrespectful treatment.
C. Incorporate disciplinary processes that address intimidating, disrespectful, or discriminatory behavior toward LGBT patients or staff
D. Identify and support staff or physician champions who have special expertise or experience with LGBT issues
E. All of the above
18. Which of the following statements is true according to this paper?
A. Understanding a patient’s identity and behaviors can lead to more appropriate care, targeted risk-reduction counseling and screenings, and targeted treatment and referrals.
B. Care that is responsive to the unique needs of LGBT patients can enhance the patient–provider relationship and help ensure that patients seek routine and follow-up care.
C. It is best if hospitals make it clear they treat everyone the same.
D. All of the above.
E. A and B above.
19. Actions that create a welcoming environment for LGBT individuals can include:
A. Prominently posting the hospital’s nondiscrimination policy or patient bill of rights
B. Creating or designating unisex or single stall restrooms
C. Creating a welcoming environment in which all patients and families feel comfortable expressing love and support for one another
D. A and C above
E. All of the above
20. According to this paper, while it is usually easy to tell if an individual identifies as lesbian, gay, bisexual or transgender by his/her appearance, it is still important not to make assumptions.
A. True
B. False
21. There is an important difference between being treated fairly and without discrimination and having sexual orientation and gender identity will be taken into account, when appropriate, within the delivery of health care.
A. True
B. False
22. The paper cautions that hospital staff should "Recognize that self-identification and behaviors do not always align." Examples of this are:
A. A man who identifies as heterosexual and occasionally engages in sex with other men
B. A woman who identifies herself as a lesbian and who has had sexual relationships with men in the past
C. A man who identifies himself as gay and has never had a sexual relationship with a man
D. A and B above
E. All of the above
23. By knowing a patient's sexual orientation you also know a lot about his or her
A. Family relationships
B. Ability / disability
C. Socioeconomic status
D. Beliefs
E. None of the above
24. This paper recommends hospitals facilitate disclosure of sexual orientation and gender identity in several ways, including:
A. Having places on forms to check sexual orientation and gender identity
B. Having staff ask people outright about their sexual orientation and gender identity
C. Noticing the language patients use to describe sexual orientation, gender identity, partner(s), and relationships, and reflecting the choice of terminology when appropriate
25. A healthcare providers should be prepared to find himself or herself being the only confidant for an LGBT teen.
A. True
B. False
26. Transgender individuals may have experienced discrimination in the provision of care, treatment, and services which, according to this paper, often causes many transgender patients to
A. Be hostile and uncooperative with healthcare professionals
B. Be quick to sue healthcare professionals and institutions with little provocation
C. Delay or avoid necessary health care to the point of putting their overall health at risk
27. Part of any strategy to provide equitable healthcare for LGBT populations is to ensure that LGBT employees are treated in an inclusive and equitable manner.
A. True
B. False
28. The "Workforce" chapter describes strategies a hospital can use to develop a workforce that is prepared to provide the best possible care to lesbian, gay, bisexual, and transgender (LGBT) patients. Which of the following is NOT a goal of these strategies?
A. Ensuring that LGBT employees are treated in an inclusive and equitable manner
B. Ensuring LGBT patients get special treatment from employees
C. Ensure that all employees are able to provide equitable, competent, and welcoming care to LGBT patients and their families
29. Some of the issues LGBT employees face include:
A. Being carelessly or maliciously “outed”
B. Distribution and posting of material hostile to LGBT people
C. Harassment and/or ostracism
D. Denied and delayed promotions and pay increases
E. All of the above
30. This paper suggests that job notices that include a statement such as “This hospital does not discriminate on the basis of sexual orientation or gender identity/expression” demonstrate a commitment to supporting LGBT staff.
A. True
B. False
31. LGBT employees can face a variety of workplace challenges that might not be obvious except to LGBT individuals. The paper recommends which of the following to help remedy this?
A. Provide information about LGBT workplace concerns in all appropriate training materials
B. Ask LGBT staff members to share their challenges directly with their supervisors
C. Offer LGBT training to key audiences such as leadership, HR staff, managers and supervisors
D. All of the above
E. A and C above
32. Access to health care benefits for partners of LGBT employees is very highly valued by those employees, particularly in hospital settings, where the benefits of health care coverage are particularly evident.
A. True
B. False
33. Examples of benefits that may need reviewing for equity include:
A. Retirement benefits for spouses (for example, survivor and continuation benefits, postretirement health coverage)
B. Sick leave and family medical leave for care of an ill spouse or child
C. Policies prohibiting nepotism
D. All of the above
E. A and B above
34. Which of the following LGBT topics does this paper suggest should be covered in training?
A. LGBT history and background, particularly in the hospital’s service area
B. Stories of LGBT–related bias and substandard care
C. Systemic barriers to care for LGBT patients
D. LGBT health disparities and inequities
E. All of the above
35. This paper recommends developing a plan to address the unique needs of transgender employees, many of whom have experienced "extremely high levels of bias and discrimination."
A. True
B. False
36. This paper asserts that a hospital can do much—at little or no cost—to maximize LGBT employees’ inclusion, effectiveness, productivity, and success, and at the same time send a powerful message of equity and inclusion to LGBT patients, by:
A. Making sure all employees get training on LGBT issues
B. Marketing themselves as LGBT friendly
C. Promoting initiatives that create a welcoming workplace culture
37. Which of the following statements is/are true according to this paper?
A. Accurate data are helpful for informing policies and program development; evaluating the effectiveness of policies and programs.
B. Good data are necessary in developing marketing, research, quality improvement, and community outreach initiatives; and responding to the changing needs of patient populations.
C. Good data are necessary to ensure the overall health and well-being of all patients.
D. All of the above
E. None of the above
38. Data on which of these aspects of LGBT identity can help providers better understand the backgrounds, experiences, and health needs of their LGBT patients?
A. Relationship status
B. Sexual orientation
C. Sexual behaviors
D. Gender identity
E. All of the above
39. According to this paper the registration and admitting processes should identify ways to capture gender identity information, including indication of preferred name and gender pronoun, which may differ from those noted on the patient’s legal documentation.
A. True
B. False
40. Information regarding sexual orientation is usually provided in interactions between patients and providers, through physician or interview notes, or during a health history. Mechanisms to capture this information in the medical record may involve:
A. Taping these interactions
B. Using a written data gathering process for this type of information
C. Adding new fill-in fields or drop-down menus for healthcare providers to capture data elements
41. According to this paper which of the following is/are critical to collecting data on sexual orientation and gender identity information?
A. Disclosure of sexual orientation and gender identity information should always be voluntary
B. Privacy of sexual orientation and gender identity information should be safeguarded
C. Both A and B above
D. None of the above
42. Privacy of sexual orientation and gender identity information is a concern because in many states there are few or no legal protections against discrimination on the bases of this information.
A. True
B. False
43. According to this paper, sexual orientation and gender identity information can be used for a number of things, including
A. To develop or modify services, programs, or initiatives to meet patient population needs
B. To help determine the needs of the surrounding community
C. To assess the need for diversity in staffing
D. All of the above
E. A and B above
44. Reaching out to the LGBT community not only contributes to better patient care and it makes good business sense.
A. True
B. False
45. According to this paper, community support may be more significant for LGBT individuals and families in the context of LGBT health than for others within the hospital service area.
A. True
B. False
46. This paper recommends four ways of collecting feedback from LGBT patients and families and the surrounding LGBT community. Which of the following is NOT one of these recommendations?
A. Conduct confidential patient satisfaction surveys that include questions regarding sexual orientation and gender identity
B. Ask LGBT patients and families about staff responsiveness to their needs during care planning and treatment
C. Hire LGBT consultants to provide feedback on internal and external written material and policies to ensure that they are LGBT–inclusive
D. Establish a community advisory board
47. Hospitals can ensure that communications and community outreach activities reflect a commitment to the LGBT community by:
A. Publishing in LGBT media
B. Designating an individual or creating a committee to address LGBT community outreach activities
C. Conducting LGBT community outreach activities in partnerships with local community health centers and other hospitals
D. All of the above
E. B and C above
48. This paper suggests several potential topics for educational programs hospitals can put on. Which is NOT one of the recommendations?
A. Programs that support unique psychosocial, physical, and mental health needs of LGBT youth
B. Aging and end-of-life issues for LGBT seniors
C. Adoption by same-sex couples or LGBT individuals
D. Seminars or forums on legal issues for LGBT individuals
E. Forums on transgender care for clinicians and patients
49. Which of the following statements is/are true?
A. Appendix B presents existing standards and elements of performance related to effective communication, cultural competence, and patient- and family-centered care for all patients, including those who are LGBT.
B. There are standards and elements of performance in Appendix B that explicitly address LGBT issues.
C. Both A and B
D. Neither A or B
50. The Joint Commission Environment of Care standards address the physical safety of the environment for patients, staff, and visitors, and recognizes that the physical environment needs to support patient privacy and dignity, and foster ease of interaction.
A. True
B. False
51. In addition to standards for Environment of Care, Appendix B gives standards for seven other areas. Which of the follow is NOT one of those areas?
A. Human resources • “Record of Care, Treatment, and Services” (RC) • “Rights and Responsibilities of the Individual” (RI)
B. Information management
C. Leadership
D. Facilities management
E. Provision of care, treatment, and services
52. Advocates have filed complaints against hospitals with federal courts and administrative agencies using existing federal civil rights laws to protect the rights of lesbian, gay, bisexual, and transgender (LGBT) Americans.
A. True
B. False
53. This paper asserts that to avoid possible violation findings and the potential termination of federal financial assistance, hospitals should implement policies and procedures consistent with federal civil rights laws.
A. True
B. False
54. As health care professionals committed to providing culturally competent and patient- and family-centered care to all Americans, it is critical for hospital staff members to be aware of:
A. Federal laws that protect LGBT Americans' rights, since these laws usually super cede state and local laws
B. Federal, state, and local civil rights laws protecting LGBT Americans
C. Legal actions LGBT advocates are taking against hospitals
55. This paper suggests that by educating school staff and students, a health care organization can act as a leader and a catalyst in creating a school environment where LGBT youth face less bullying and abuse.
A. True
B. False
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