FINAL EXAM QUESTIONS AND ANSWERS LATEST UPDATE 2022/2023 BEST EXAM SOLUTION WITH SATISFACT, Exams of Nursing

Download FINAL EXAM QUESTIONS AND ANSWERS LATEST UPDATE 2022/2023 BEST EXAM SOLUTION WITH SATISFACT and more Exams Nursing in PDF only on Docsity! 1/18 3 Marks: 1 FINAL EXAM QUESTIONS AND ANSWERS LATEST UPDATE 2022/2023 BEST EXAM SOLUTION WITH SATISFACTORY SUCCESS RATED A+ Medicare Course Home Final Exam - Attempt 1 1 Marks: 1 Agent Higgins helps Mrs. O'Malley to enroll in AB Medicare Advantage (MA) plan during the Annual Open Enrollment Period. Mrs. O'Malley's effective enrollment date is January 1st. Subsequently, Mrs. O'Malley disenrolls on February 12th following a move outside the plan's service area. What impact will this have on Agent Higgins compensation? Choose one a. Agent Higgins entire compensation must be recouped because Mrs. O’Malley has answer. disenrolled within 3 months of enrollment. b. AB MA plan must recoup a pro rata amount of Agent Higgins’ compensation if Mrs. O’Malley subsequently enrolls in Original Medicare and Part D c. AB MA plan does not have to recoup Agent Higgins’ compensation because she has moved away from its service area. d. AB MA plan must recoup a pro rata amount of Agent Higgins’ compensation and pay him only for the month of January. 2 Marks: 1 Mrs. Mulcahy is concerned that she may not qualify for enrollment in a Medicare prescription drug plan because, although she is entitled to Part A, she is not enrolled under Medicare Part B. What should you tell her? Choose one a. Everyone who is entitled to Part A or enrolled under Part B is eligible to enroll in a answer. Medicare prescription drug plan. As long as Mrs. Mulcahy is entitled to Part A, she does not need to enroll under Part B before enrolling in a prescription drug plan. b. To qualify for enrollment into a Medicare prescription drug plan, Mrs. Mulcahy must be entitled to Part A and enrolled under Part B. She should contact her local Social Security office and make arrangements to enroll in Part B prior to selecting a prescription drug plan. c. Like all Medicare beneficiaries, Mrs. Mulcahy will be automatically enrolled in a Medicare prescription drug plan when she turns 65. She will have a six-month window during which she can select a plan other than the one into which she has been automatically enrolled. d. As long as Mrs. Mulcahy is 65, eligibility for a Medicare prescription drug plan is not dependent on entitlement to Part A or enrollment under Part B, so she should not be concerned. 2/18 Alice is enrolled in a MA-PD plan. She makes a permanent move across the country and wonders what her options are for continuing MA-PD coverage. What would you say to her in regard to a special enrollment period (SEP)? Choose one a. She is unlikely to qualify for a SEP but will be automatically covered by Original answer.Medicare and a standalone Part D prescription drug plan. b. She is likely to qualify for a SEP. She can choose an effective date of up to six months after the month in which the enrollment form is received by the new plan, but the effective date may not be earlier than 30 days prior to the date of her move. c. She is unlikely to qualify for a SEP and should remain on her current plan, relying on her current plan’s out-of-network benefits. d. She is likely to qualify for a SEP. She can choose an effective date of up to three months after the month in which the enrollment form is received by the new plan, but the effective date may not be earlier than the date of her permanent move. 4 Marks: 1 Mrs. Walters is entitled to Part A and has medical coverage without drug coverage through an employer retiree plan. She is not enrolled in Part B. Since the employer plan does not cover prescription drugs, she wants to enroll in a Medicare prescription drug plan. Will she be able to? Choose one a. Yes, but Mrs. Walters must drop the employer coverage prior to enrolling in a answer. Medicare prescription drug plan. b. No. Mrs. Walters will have to enroll in Part B in order to qualify for enrollment into the Medicare prescription drug program. c. Yes. Mrs. Walters must be entitled to Part A or enrolled in Part B to be eligible for coverage under the Medicare prescription drug program. d. No. As long as her employer offers coverage that is equivalent to that available through Medicare, Mrs. Walters cannot enroll in a Medicare prescription drug plan. 5 Marks: 1 Ms. Lopez is an independent agent under contract with MarketCo, a third-party marketing organization. MarketCo has a contract with BestCare health plan, a Medicare Advantage (MA) organization, to offer marketing services through its contracted agents and agencies. Ms. Lopez returns calls to individuals who contact MarketCo in response to its mailers promoting BestCare health plan. Which of the following best describes the responsibilities of Ms. Lopez? Choose one a. Ms. Lopez is considered a marketing representative of BestCare and thus is answer. obligated to comply with CMS marketing requirements, including those regarding using only approved call scripts. b. Ms. Lopez no longer needs to be concerned about state licensure since she is marketing an MA product subject to federal rules. c. Ms. Lopez is considered a marketing representative of BestCare but is exempt from the marketing rules regarding approved call scripts because she works directly for MarketCo. d. Ms. Lopez needs to maintain state licensure, but because she is working for a third- party marketing organization she is exempt from CMS training 5/18 9 Marks: 1 For which of the following individuals would a Cost Plan be most appropriate? Choose one a. Mr. Charles who is enrolled in Medicare Part A but does not want to enroll in Part B. answer. b. Ms. Darwin who is enrolled in Medicare Parts A and B who also is enrolled in a Medicare Supplement (Medigap) and is unwilling to pay any additional plan premiums. c. Ms. Baker who is enrolled in Medicare Part B and is willing to continue paying Part B premiums plus any plan premiums. d. Mr. Able who has retiree health insurance but relatively modest prescription drug benefits. 10 Marks: 1 You have set up an appointment for an in-home sales presentation with Mrs. Fernandez, who expressed interest in the Medicare plans you represent. In preparation for the sales presentation, what must you do? Choose one a. Prior to conducting the presentation, obtain, and document having obtained her answer. permission to visit, along with her interest in the specific products you will present. b. Seven days prior to the appointment, you must notify the company(s) you represent regarding which products you will be presenting, so they can report the nature of your meeting to the Medicare agency. c. At the time you arrive for the appointment, let her know which products you will be going over. d. Prior to arriving at her home, request approval from CMS to use special materials that you developed to explain the plan benefits instead of the plan’s materials, which you think are confusing. 11 Marks: 1 Ms. Stuart has heard about a special needs plan (SNP) that one of her friends is enrolled in and is interested in that product. She wants to be sure she also has coverage for prescription drugs. Would she be able to obtain drug coverage if she enrolled in the SNP? Choose one a. Maybe. Some SNPs offer Part D coverage for prescription drugs and some do not. answer. b. Yes, but only if she qualifies for Part D prescription drug coverage under her state Medicaid program. c. Yes. All SNPs are required to provide Part D coverage for prescription drugs. d. No. Medicare beneficiaries who enroll in an SNP must always obtain their drug coverage through a stand-alone Part D Medicare prescription drug plan that they sign up for independent of their enrollment in the SNP. 6/18 12 Marks: 1 Mr. McTaggert notes that a Private Fee-for-Service (PFFS) plan available in his area has an attractive premium. He wants to know what makes them different from an HMO or a PPO. What should you tell him? Choose one a. If offered, beneficiaries can select a stand-alone Part D prescription drug plan answer. (PDP) with an HMO or a PPO, but not with a PFFS plan. b. Enrollees in a PFFS plan can obtain care from any provider in the U.S. who accepts Original Medicare, as long as the provider has a reasonable opportunity to access the plan’s terms and conditions and agrees to accept them. c. PFFS plans are the same as Medicare supplement plans and he may obtain care from any provider in the U.S. d. If a PFFS enrollee shows his/her card when obtaining services from a provider who participates in Original Medicare, then that provider is required to accept the plan’s terms and conditions. 13 Marks: 1 Mrs. Peňa is 66 years old, has coverage under an employer plan and will retire next year. She heard she must enroll in Part B at the beginning of the year to ensure no gap in coverage. What can you tell her? Choose one a. She may only enroll in Part B during the general enrollment period whether she is answer. retired or not. b. She may enroll at any time while she is covered under her employer plan, but she will have a special eight-month enrollment period that differs from the standard general enrollment period, during which she may enroll in Medicare Part B. c. She must wait at least 30 days after her employment terminates before she may enroll in Medicare Part B. d. She may not enroll in Part B while covered under an employer group health plan and must wait until the standard general enrollment period after she retires. 14 Marks: 1 Mrs. Duarte is enrolled in Original Medicare Parts A and B. She has recently reviewed her Medicare Summary Notice (MSN) and disagrees with a determination that partially denied one of her claims for services. What advice would you give her? Choose one a. Mrs. Duarte has no right to appeal this determination since her claim has been answer. partially paid. b. Mrs. Duarte should file an appeal of this initial determination within 90 days of the date she received the MSN in the mail. If she still disagrees with Medicare Administrative Contractor's (MAC's) further decision she should request a reconsideration by a qualified independent party within 10 days. c. Mrs. Duarte should request a reconsideration of the decision by a qualified independent party within 60 days of the date she received the MSN in the mail. d. Mrs. Duarte should file an appeal of this initial determination within 120 7/18 days of the date she received the MSN in the mail. 10/18 18 Marks: 1 Dr. Elizabeth Brennan does not contract with the PFFS plan but accepts the plan’s terms and conditions for payment. Mary Rodgers sees Dr. Brennan for treatment. How much may Dr. Brennan charge? Choose one a. Dr. Brennan can charge Mary Rogers no more than the cost sharing specified in the answer. PFFS plan’s terms and condition of payment which may include balance billing up to 15 percent of the Medicare rate. b. Dr. Brennan can charge Mary Rodgers more than the cost sharing specified in the PFFS plan’s terms and conditions as long as she treats all beneficiaries the same. c. Dr. Brennan can charge the beneficiary the same costsharing as Original Medicare as long as she sends the claim to Medicare and not the plan. d. Dr. Brennan can charge Mary no more than the cost sharing specified in the PFFS plan’s terms and conditions of payment which may include balance billing up to 25 percent of the Medicare rate. 19 Marks: 1 Ms. Hernandez has marketed several different types of insurance products in her home state and has typically sought approval of her materials from her State Department of Insurance. What would you advise her regarding seeking such approval for materials she uses to market Medicare Advantage plans? Choose one a. States often volunteer to review marketing materials on behalf of the Medicare answer. agency. She should check with her Department of Insurance to see if such a review is available and would satisfy CMS requirements. b. Materials for marketing Medicare health plans to individuals are subject to Medicare’s uniform national requirements. They do not need to be reviewed by the state, but the company she represents must obtain approval from the Medicare agency (CMS) for any materials she uses. c. Materials need only be reviewed and approved by the company(s) she represents. d. Obtaining approval of her materials from the State Department of Insurance is a good practice and she should continue it with materials for the Medicare health plans she represents. 20 Marks: 1 Mr. Shultz was still working when he first qualified for Medicare. At that time, he had employer group coverage that was creditable. During his initial Part D eligibility period, he decided not to enroll because he was satisfied with his drug coverage. It is now a year later and Mr. Shultz has lost his employer group coverage within the last two weeks. How would you advise him? Choose one a. Mr. Schultz should enroll in a Part D plan before he has a 63-day break in coverage answer. in order to avoid a premium penalty. b. Mr. Schultz should immediately enroll in a Part D plan but he can 11/18 expect to pay a premium penalty because he failed to enroll when first eligible. c. Mr. Schultz should seek to continue employer group coverage through COBRA 12/18 because it is likely to have superior benefits at a more reasonable price. d. Mr. Schultz can wait up to 180 days after the loss of his creditable employer group coverage before enrolling in a Part D plan without worrying payment a premium penalty. 21 Marks: 1 Mr. Moreno invited his neighbor, Agent Tom Smith, to discuss Medicare Advantage (MA) and Part D plans that Agent Smith sells at the regular Tuesday brunch the neighbors have for senior citizens. What should Agent Tom Smith tell Mr. Moreno about the kinds of food that can be provided to potential enrollees who attend the sales presentation? Choose one a. Any meal is allowed, as long as it is valued at less than $15. answer. b. Any type of meal or food is allowed, as long as it is available to the general public and not just those who are eligible to enroll in the plans. c. Nothing may be provided to eat or drink during the sales presentation. d. A meal cannot be provided, but light snacks would be permitted. 22 Marks: 1 Mr. Chen has heard about a Medical Savings Account (MSA), but wants to know if it is just about saving money, or if he will get insurance coverage for his health care expenditures as well. What should you tell him? Choose one a. Under the Medicare Advantage program, the MSA is only an account to help him answer. pay for IRS-allowed health expenditures he may have. It does not involve health insurance of any kind. b. Under the Medicare Advantage program, the MSA plan is a form of prescription drug coverage. c. Under the Medicare Advantage program, a MSA plan involves the combination of a high deductible health plan and a savings account for health expenses. Medicare will make contributions to this savings account to help him pay his health care expenses while in the deductible. d. Under the Medicare Advantage program, the MSA is funded by money he sets aside each year. If he does not use it all on IRS allowable health care expenditures then he will lose the money the following year. 23 Marks: 1 Mr. Decaro has looked at Medicare prescription drug plans available in his area and noted a wide range in premiums. He thought that all the drug plans were required to offer the same standard benefits and would like you to explain why there is such a range in premiums. What should you tell him? Choose one a. Medicare permits plans that have the highest quality services to reduce their answer. premiums below the standard amount in order to increase their market share. This 15/18 him? 16/18 Choose one a. The POS option is only to allow him to visit in-network specialists without a referral. answer. He will have no coverage if he goes out-of-network. b. The POS option will allow him to visit out-of-network providers and generally the plan must provide the same level of cost sharing as if he went to in-network providers. c. The POS option refers to a method of processing claims in real time so that Mr. Polanski will be able to finalize his bill at the point of service with the provider, rather than waiting for the plan to mail him statements several weeks later. It does not have anything to do with his ability to access out-of-network providers. d. The POS option might be a good solution for him as it will allow him to visit out-of- network providers, generally without prior approval. However, he should be aware that it is likely he will have to pay higher cost-sharing for services from out-of-network providers. 27 Marks: 1 Julia Harris is turning 66 in July, at which time she will retire. She has contacted your office and requested a meeting so that she can learn about Medicare and the products you represent. How should you respond? Choose one a. Tell Julia that she must first complete a questionnaire providing her health history so answer. that you can recommend an appropriate product before submitting an enrollment application, since she qualifies for a special enrollment period. b. Tell Julia that you will meet with her at a time of her convenience within the next week, when you can accept a completed enrollment application to be submitted after October 15th. c. Tell Julia that you are happy to meet with her once this year’s open enrollment begins on October 15th. d. Tell Julia that you will meet with her to explain Medicare and should she be interested you can accept and submit an enrollment request, since this is an initial enrollment qualifying her for a special enrollment period. 28 Marks: 1 Mrs. Disraeli is enrolled in Original Medicare (Parts A and B) and a standalone Part D prescription drug plan. She has recently developed diabetes and has suffered from heart disease for several years. She has also recently learned that her area is served by a SNP for individuals suffering from such a combination of chronic diseases (C-SNP). Mrs. Disraeli is concerned however, that she will have few rights or protections if she enrolls in a C-SNP. How would you respond? Choose one a. Enrollees, while able to select their primary care provider (PCP), do have answer. substantial restrictions and financial responsibilities regarding emergency care whether obtained at in-network or out-of-network facilities. b. Enrollees in SNPs must have access to provider networks that include enough doctors, specialists, and hospitals to provide all covered services necessary to meet enrollee needs within reasonable travel time. c. The SNP would select her primary care provider (PCP) but she could file a grievance within 90 days if the PCP proved incapable. d. Mrs. Disraeli would have substantial restrictions on obtaining emergency care and must use network facilities or be responsible for most emergency care costs. 17/18 20/18 likes, so long as that provider participates in Original Medicare. 32 Marks: 1 Another agent working for your agency claims that because you are not employed by the Medicare Advantage plans that you represent, you are not subject to the same requirements as the plans themselves. How should you respond to such a statement? Choose one a. Your coworker is correct because employed agents have to follow a stricter set of answer. rules than do independent agents, such as yourself. b. Your coworker is correct. You may use any marketing techniques that do not involve providing misinformation to potential enrollees. c. Your coworker is correct. You are subject only to requirements issued by your state department of insurance. d. Your coworker is not correct. Marketing on behalf of a plan is considered marketing by the plan and requires that all contracted and employed agents comply with all Medicare marketing rules. 33 Marks: 1 Mr. Wendt suffers from diabetes which has gotten progressively worse during the last year. He is currently enrolled in Original Medicare (Parts A and B) and a Part D prescription drug plan and did not enroll in a Medicare Advantage (MA) plan during the last annual open enrollment period (AEP) which has just closed. Mr. Wendt has heard that there are certain MA plans that might provide him with more specialized coverage for his diabetes and wants to know if he must wait until the next annual open enrollment period (AEP) before enrolling in such a plan. What should you tell him? Choose one a. Mr. Wendt must wait until the next annual open enrollment period (AEP) before he answer. can enroll in a special needs plan (SNP). b. As long as there is a special needs plan (SNP) specializing in diabetes within 500 miles of Mr. Wendt’s residence, he can enroll in the SNP at any time under a special enrollment period (SEP). c. If there is a special needs plan (SNP) in Mr. Wendt’s area that specializes in caring for individuals with diabetes, he may enroll in the SNP at any time under a special enrollment period (SEP). d. If there is a special needs plan (SNP) in Mr. Wendt’s area that specializes in caring for individuals with diabetes, he may enroll in the SNP during the MA Open Enrollment Period which takes place between January 1 and March 31. 34 Marks: 1 Able, Baker, and Charles are engaged in the marketing to and enrollment of beneficiaries into Medicare health plans. Mr. Able is an independent agent paid directly by a health plan. Ms. Baker is an independent agent paid through a field marketing organization (FMO). Mr. Charles is an independent agent paid for his work by a third- party marketing organization (TMO). How do the CMS compensation rules apply to these three agents? 21/18 22/18 Choose one a. Able is subject to CMS compensation rules because he is paid directly by a health answer. plan. Agents Baker and Charles are not because they are paid by third parties. b. All three are treated as independent agents under CMS compensation rules. c. Baker and Charles are subject to CMS compensation rules because they are paid by third parties. Able is not because he is paid directly by a health plan. d. Charles is subject to CMS compliance rules because he works for a TMO and CMS applies an extra layer of scrutiny to such organizations. Able and Baker are not. 35 Marks: 1 Mr. Jackson just turned 65. He has been seeing the same general practitioner for annual check-ups for the past 15 years, likes these yearly visits, and would like to continue obtaining these services as a Medicare beneficiary. What should you tell him about annual check-ups? Choose one a. Physical exams, in the absence of readily observable illness or injury, are never answer. covered under any circumstances. b. He can have as many preventive physical exams as he feels that he needs. They will all be covered by Medicare. c. Medicare will cover an annual wellness visit, even if he has no illnesses or injuries. d. Medicare will cover only a one-time “Welcome to Medicare” wellness visit. 36 Marks: 1 Eleanor takes several high-cost prescription drugs. She would like to enroll in a standalone Part D prescription drug plan that is available in her area. In what type of Medicare Health Plan can she enroll if she also wishes to enroll in the standalone Part D plan? Choose one a. A Cost Plan that does not offer drug coverage or a Cost Plan that does offer drug answer. coverage if she chooses not to enroll in it. b. A MA PPO plan that offers drug coverage if she chooses not to enroll in it. c. A Cost Plan only if it does not offer drug coverage. d. A MA PPO plan only if it does not offer drug coverage. 37 Marks: 1 Ms. Gardner is currently enrolled in an MA-PD plan. However, she wants to disenroll from the MA- PD plan and instead enroll in a Part D only plan and go back to Original Medicare. According to Medicare's enrollment guidelines, when could she do this? Choose one a. She may make such a change during the Annual Election Period that runs from Oct. answer. 15 to December 7, or during the MA Open Enrollment Period which takes place from January 1- March 31 of each year (beginning in 2019). 25/18 Choose one a. The extra help is available to beneficiaries whose income and assets do not exceed answer. annual limits specified by the government. b. He must apply for the extra help at the same time he applies for enrollment in a Part D plan. If he missed this opportunity, he will not be able to apply for the extra help again until the next annual enrollment period. c. The extra help is available only to Medicare beneficiaries who are enrolled in Medicaid. He should apply for coverage under his state’s Medicaid program to access the extra help with his drug costs. d. The government pays a per-beneficiary dollar amount to the Medicare Part D prescription drug plans, to offset premiums for their low-income enrollees in accordance with the plan’s set criteria. Mr. Shapiro should check with his plan to see if he qualifies. 41 Marks: 1 Mrs. Patterson is a new enrollee in the HealthBest Medicare Advantage (MA-PD) plan. She is new to this type of coverage and asks you what materials, if any, she should expect to receive. How would you reply? Choose one a. She should expect to receive a hard copy of the provider directory in and a separate answer. notice describing where she can find monthly periodic updates online and how to request hardcopies. b. She should expect to receive Evidence of Coverage (EOC) within 21 days of confirmation of enrollment. c. She should expect either the pharmacy directory in hard copy or a distinct and separate notice (in hard copy) describing where she can find the pharmacy directory online and how to request a hard copy. d. She should expect to receive hard copies of both the provider and pharmacy directories automatically within 30 days of confirmation of enrollment. 42 Marks: 1 Which of the following is a correct statement about state laws as they pertain to marketing representatives? Choose one a. Plan sponsors can use any marketing representative, as long as they are licensed answer. in at least one state. b. State licensure laws are pre-empted and do not apply to marketing representatives marketing MA and Part D plans c. Medicare health plans must comply with requests for information from state insurance departments investigating complaints about a marketing representative. d. Plans must contract only with marketing representatives who reside in the state where they intend to work. 43 Marks: 1 Mrs. Goodman enrolled in an MA-PD plan during the Annual Election Period. In mid-January of the 26/18 following year, she wants to switch back to Original Medicare and enroll in a stand-alone prescription drug plan. What 27/18 should you tell her? Choose one a. During the MA Open Enrollment Period, from January 1 – March 31, she may only answer. add or drop Part D coverage, so she cannot switch back to Original Medicare. b. During the MA Open Enrollment Period, from January 1 – March 31, she may disenroll from the MA-PD plan into Original Medicare and also may add a stand-alone prescription drug plan. c. During the MA Open Enrollment Period, from January 1 – March 31, she may drop a MA or MA-PD plan and go back to Original Medicare, but she may only enroll in a stand-alone prescription drug plan if she also purchases a Medigap policy. d. During the MA Open Enrollment Period, from January 1 – March 31, she may only disenroll from a MA or MA-PD plan, but cannot enroll in a stand- alone Part D plan. 44 Marks: 1 You are scheduled to give a sales presentation at a local senior center. At the beginning of the presentation, which of the following must you do? Choose one a. Determine whether the beneficiaries present are healthy enough for the plan. answer. b. Make sure that those present provide leads. c. Explain, in your own words, how the plan you represent compares to other companies’ plans. d. Clearly state that no obligation exists to enroll if a gift or prize is being provided. 45 Marks: 1 Who is most likely to be eligible to enroll in a Part D prescription drug plan? Choose one a. Ms. Adams, a healthy early retiree who has just begun to collect Social Security at answer.age 62. b. Ms. Davis who recently turned age 65 and is eligible for Part A and has just enrolled in Part B. c. Ms. Bradley is currently living abroad for a multi-year job assignment. d. Mr. Charles, an undocumented immigrant, entered the country illegally. 46 Marks: 1 Mr. Jenkins is interested in enrolling in a Medicare cost plan and has sought your advice. What would you tell him? Choose one a. Cost plans are required to be open to enrollment at least 30 days per year, and answer. many are open for enrollment all year. So open enrollment will be dependent on the 30/18 Submit all and finish 31/18 Mrs. Kelly, age 65, is entitled to Part A but has not yet enrolled in Part B. She is considering enrollment in a Medicare health plan (Part C). What should you advise her to do before she will be able to enroll in a Medicare health plan? Choose one a. In order to join a Medicare health plan, she must be enrolled in Parts A, B, and D. answer. b. In order to join a Medicare health plan, she also must enroll in Part B. c. Since she is age 65 she may enroll in any Medicare health plan, regardless of whether she is entitled to Part A or Part B coverage. d. To enroll in a Medicare health plan, she need only be entitled to Part A, so she does not need to take any further steps. 50 Marks: 1 Which of the following statements is correct about the appeal and grievance processes? I. Enrollees have a right to obtain a review (appeal) of certain decisions about prescription drug coverage. II. The grievance process is used for reviews of coverage decisions on plan benefits. III. Plans must provide a link to the Medicare.gov website where an enrollee can enter a complaint. IV.Enrollees have a right to file complaints (sometimes called grievances) about the quality of their care. Choose one a. I and II only answer. b. II and IV only c. I, III, and IV only d. I and III only