NU 180 EXAM 3 REVIEW QUESTIONS AND ANSWERS
Premium - CORRECT ANSWER✅✅Monthly fee paid for health insurance coverage.
Deductible - CORRECT ANSWER✅✅Annual out-of-pocket amount paid before insurance covers
expenses.
Copayment - CORRECT ANSWER✅✅Set fee paid at the time of service (office visit, medication).
Coinsurance - CORRECT ANSWER✅✅Percentage of bill paid by the insured after deductible is met.
Capitation - CORRECT ANSWER✅✅A set monthly fee charged per patient for defined services (cost-
containment model).
Fee-for-service - CORRECT ANSWER✅✅Traditional model where providers are paid for each service.
Medicare - CORRECT ANSWER✅✅Federal program for those 65+ or with qualifying disabilities.
Medicare Part A - CORRECT ANSWER✅✅Covers hospital and inpatient care.
Medicare Part B - CORRECT ANSWER✅✅Covers physician and outpatient care.
Medicaid - CORRECT ANSWER✅✅State & federally funded program based on income need, helping
low-income families, pregnant women, and disabled individuals.
Diagnosis-Related Groups (DRGs) - CORRECT ANSWER✅✅Predetermined payment amounts for
diagnoses, encouraging shorter hospital stays.
Prospective Payment System - CORRECT ANSWER✅✅Hospital knows in advance what it will be paid,
creating an incentive to discharge early.
, Continuous Quality Improvement (CQI) - CORRECT ANSWER✅✅Ongoing monitoring to improve safety,
processes, and patient outcomes.
Cost-Containment Nursing Actions - CORRECT ANSWER✅✅Actions include documenting accurately for
reimbursement, managing time efficiently, using supplies wisely, and preventing complications.
Primary Care - CORRECT ANSWER✅✅First entry into the healthcare system (referring MD, NP,
ambulatory clinic).
Ambulatory/Urgent Care Centers - CORRECT ANSWER✅✅Walk-in services for non-emergencies.
Acute Care Hospitals - CORRECT ANSWER✅✅Short-term, intensive treatment facilities.
Skilled Nursing Facility (SNF) - CORRECT ANSWER✅✅Long-term care for patients needing daily
medical/nursing services.
Assisted Living - CORRECT ANSWER✅✅Help with ADLs but not 24/7 medical care.
Hospice - CORRECT ANSWER✅✅Comfort-focused, end-of-life care at home or facility, includes respite
care.
U.S. Public Health Service (USPHS) - CORRECT ANSWER✅✅Funded by tax money, includes CDC, NIH,
FDA, and Alcohol, Drug Abuse, and Mental Health Administration.
American Heart Association - CORRECT ANSWER✅✅Voluntary agency focused on research and
education.
Visiting Nurse Association - CORRECT ANSWER✅✅Public, voluntary agency providing home health care.
Premium - CORRECT ANSWER✅✅Monthly fee paid for health insurance coverage.
Deductible - CORRECT ANSWER✅✅Annual out-of-pocket amount paid before insurance covers
expenses.
Copayment - CORRECT ANSWER✅✅Set fee paid at the time of service (office visit, medication).
Coinsurance - CORRECT ANSWER✅✅Percentage of bill paid by the insured after deductible is met.
Capitation - CORRECT ANSWER✅✅A set monthly fee charged per patient for defined services (cost-
containment model).
Fee-for-service - CORRECT ANSWER✅✅Traditional model where providers are paid for each service.
Medicare - CORRECT ANSWER✅✅Federal program for those 65+ or with qualifying disabilities.
Medicare Part A - CORRECT ANSWER✅✅Covers hospital and inpatient care.
Medicare Part B - CORRECT ANSWER✅✅Covers physician and outpatient care.
Medicaid - CORRECT ANSWER✅✅State & federally funded program based on income need, helping
low-income families, pregnant women, and disabled individuals.
Diagnosis-Related Groups (DRGs) - CORRECT ANSWER✅✅Predetermined payment amounts for
diagnoses, encouraging shorter hospital stays.
Prospective Payment System - CORRECT ANSWER✅✅Hospital knows in advance what it will be paid,
creating an incentive to discharge early.
, Continuous Quality Improvement (CQI) - CORRECT ANSWER✅✅Ongoing monitoring to improve safety,
processes, and patient outcomes.
Cost-Containment Nursing Actions - CORRECT ANSWER✅✅Actions include documenting accurately for
reimbursement, managing time efficiently, using supplies wisely, and preventing complications.
Primary Care - CORRECT ANSWER✅✅First entry into the healthcare system (referring MD, NP,
ambulatory clinic).
Ambulatory/Urgent Care Centers - CORRECT ANSWER✅✅Walk-in services for non-emergencies.
Acute Care Hospitals - CORRECT ANSWER✅✅Short-term, intensive treatment facilities.
Skilled Nursing Facility (SNF) - CORRECT ANSWER✅✅Long-term care for patients needing daily
medical/nursing services.
Assisted Living - CORRECT ANSWER✅✅Help with ADLs but not 24/7 medical care.
Hospice - CORRECT ANSWER✅✅Comfort-focused, end-of-life care at home or facility, includes respite
care.
U.S. Public Health Service (USPHS) - CORRECT ANSWER✅✅Funded by tax money, includes CDC, NIH,
FDA, and Alcohol, Drug Abuse, and Mental Health Administration.
American Heart Association - CORRECT ANSWER✅✅Voluntary agency focused on research and
education.
Visiting Nurse Association - CORRECT ANSWER✅✅Public, voluntary agency providing home health care.
