CHAPTER 10: FISCAL PLANNING

C HAPTER 10: F ISCAL P LANNING

1. The manager is using a dec ision package to set funding priorities for a
hospital unit. What type of budgeting is the manager most likel y using?
a. Flexible
b. Operating
c. Capital
d. Zero based



ANS: D



Feedback:



Managers must re-justify their program or needs every budgeting cycle
in zero-based budgeting. Using a decision package to set funding
priorities is a key feature of onl y zero -based budgeting, not flexible,
operating, or capital budgets.



PTS: 1 DIF: Easy REF: Page: 249 OBJ: 2 | 5 NAT:
Client Needs: Safe and Effective Care Environm ent: Management
of Care TOP: Chapter Number: 10: Title: Zero -Based
Budgeting KEY: Integrated Process: Nursing Process BLM:
Cognitive Level: Understand NOT: Multiple Choice



2. The nurse is caring for a client who has health insurance that is a form of
managed care. What are likel y characteristics of this client’s health -care
plan? Select all that apply.
a. Clients as gatekeepers of their health -care services

, b. A focus on prevention of illness
c. Decreased emphasis on inpatient hospital care
d. Capitation
e. Unlimited choice of health -care providers



ANS: B, C, D



Feedback:



Key principles of managed care include the use of primary care
providers as gatekeepers, a focus on prevention, a decreased emphasis
on inpatient hospital care, the use of clinical practice guideline s for
providers, selective contracting, capitation, utilization review, the use
of formularies to manage pharmacy care, and continuous quality
monitoring and improvement. The client’s choice of health -care
providers is often limited.



PTS: 1 DIF: Moderate REF: Page: 254 OBJ: 9
NAT: Client Needs: Safe and Effective Care Environment:
Management of Care TOP: Chapter Number: 10: Title:
Managed Care KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Anal yze NOT: Multiple
Selection



3. What aspect of a client’s care is most likely to be influenced by the
Patient Protection and Affordable Care Act (PPACA)?
a. The number of health insurance plans that the client can choose
between
b. The likelihood that the client will have to seek out -of-state
treatment

, c. The client’s abilit y to act as the “gatekeeper” of his or her own care
d. The client’s abilit y to qualify for Medicaid



ANS: A



Feedback:



The Affordable Care Act was aimed at increasing consumers’ options
for obtaining health insurance. It did not alter the cr iteria for
Medicaid. In most forms of managed care, the client does not act as the
“gatekeeper” for his or her own care. Out-of-state treatment was not a
focus of the PPACA.



PTS: 1 DIF: Moderate REF: Page: 260 OBJ: 12 | 13
NAT: Client Needs: Safe and Eff ective Care Environment:
Management of Care TOP: Chapter Number: 10: Title:
Health-Care Reform Efforts: The Patient Protection and
Affordable Care Act. What Comes Next? KEY: Integrated
Process: Nursing Process BLM: Cognitive Level: Anal yze
NOT: Multiple C hoice



4. A client belongs to an HMO that is a preferred provider organization
(PPO). When requiring health care, this client will most likel y:
a. prove that he or she has received preventive care from a provider at
some point.
b. pay out of pocket for care and the n submit for reimbursement.
c. be assessed by a nurse before being referred to a physician.
d. choose between the health -care providers that are in the PPO.



ANS: D