Foundations-Midterm The Health Care Delivery System

1. The nurse is caring for a patient whose insurance coverage is Medicare. The nurse should consider which information when planning care for this patient? a. Capitation provides the hospital with a means of recovering variable charges. b. The hospital will be paid for the full cost of the patient’s hospitalization. c. Diagnosis-related groups (DRGs) provide a fixed reimbursement of cost. d. Medicare will pay the national average for the patient’s condition. ANS: C 2. A nurse is teaching the staff about managed care. Which information should the nurse include in the teaching session? a. Managed care insures full coverage of health care costs. b. Managed care only assumes the financial risk involved. c. Managed care allows providers to focus on illness care. d. Managed care causes providers to focus on prevention. ANS: D 3. A nurse is teaching a family about health care plans. Which information from the nurse indicates a correct understanding of the Affordable Care Act? a. A family can choose whether to have health insurance with no consequences. b. Primary care physician payments from Medicaid services can equal Medicare. c. Adult children up to age 26 are allowed coverage on the parent’s plan. d. Private insurance companies can deny coverage for any reason. ANS: C 4. A nurse is caring for a patient in the hospital. When should the nurse begin discharge planning? a. When the patient is ready b. Close to the time of discharge c. Upon admission to the hospital d. After an order is written/prescribed ANS: C 5. The nurse is applying for a position with a home care organization that specializes in spinal cord injury. In which type of health care facility does the nurse want to work? a. Secondary acute b. Continuing c. Restorative d. Tertiary ANS: C 6. A nurse provides immunization to children and adults through the public health department. Which type of health care is the nurse providing? a. Primary care b. Preventive care c. Restorative care d. Continuing care ANS: B 7. A nurse is following the PDSA cycle for quality improvement. Which action will the nurse take for the letter “A”? a. Act b. Alter c. Assess d. Approach ANS: A 8. The nurse is trying to determine how well a certain health plan compares with other health plans. To gather this type of data, which information will the nurse utilize? a. Pew Health Professions Commission b. Healthcare Effectiveness Data and Information Set (HEDIS) c. American Nurses Credentialing Center (ANCC) Magnet Recognition Program d. Hospital Consumer of Assessment of Healthcare Providers and Systems (HCAHPS) ANS: B 9. An older adult patient has extensive wound care needs after discharge from the hospital. Which facility should the nurse discuss with the patient? a. Hospice b. Respite care c. Assisted living d. Skilled nursing ANS: D 10. A nurse working in a community hospital’s emergency department provides care to a patient having chest pain. Which level of care is the nurse providing? a. Continuing care b. Restorative care c. Preventive care d. Tertiary care ANS: D 11. A nurse is teaching about the effects of globalization. Which information should the nurse include in the teaching session? a. Increased spread of communicable diseases b. Increased homogeneous mix of nursing staff c. Decreased poverty and increased “health tourism” d. Decreased urbanization as populations shift to the suburbs ANS: A 12. A nurse is using research findings to improve clinical practice. Which technique is the nurse using? a. Performance improvement b. Integrated delivery networks c. Nursing-sensitive outcomes d. Utilization review committees ANS: A 13. Which finding indicates the best quality improvement process? a. Staff identifies the wait time in the emergency department is too long. b. Administration identifies the design of the facility’s lobby increases patient stress. c. Director of the hospital identifies the payment schedule does not pay enough for overtime. d. Health care providers identify the inconsistencies of some of the facility’s policy and procedures. ANS: A 14. A nurse is providing home care to a home-bound patient treated with intravenous (IV) therapy and enteral nutrition. What is the home health nurse’s primary objective? a. Screening b. Education c. Dependence d. Counseling ANS: B 15. A nurse hears a co-worker state that anybody could be a nurse since it is so automated with infusion devices and electronic monitoring; technology is doing the work. What is the nurse’sbest response? a. “Technology use has to be combined with nursing judgment.” b. “The focus of effective nursing care is technology.” c. “If it’s so easy, why don’t you do it?” d. “That is true in the 20th century.” ANS: A 16. A nurse is completing a minimum data set. Which area is the nurse working? a. Nursing center b. Psychiatric facility c. Rehabilitation center d. Adult day care center ANS: A MULTIPLE RESPONSE 1. Which government-instituted programs should the nurse include in a teaching session about controlling health care costs? (Select all that apply.) a. Professional standards review organizations b. Prospective payment systems c. Diagnosis-related groups d. Third-party payers e. “Never events” ANS: A, B, C 2. A nurse is teaching the staff about the Institute of Medicine competencies. Which examples indicate the staff has a correct understanding of the teaching? (Select all that apply.) a. Use informatics. b. Use transparency. c. Apply globalization. d. Apply quality improvement. e. Use evidence-based practice. ANS: A, D, E 3. A nurse is evaluating care based upon the nursing quality indicators. Which areas should the nurse evaluate? (Select all that apply.) a. Patient satisfaction level b. Hospital readmission rates c. Nursing hours per patient day d. Patient falls/falls with injuries e. Value stream analysis for quality ANS: B, C, D 4. A nurse is working in a health care organization that has achieved Magnet status. Which components are indicators of this status? (Select all that apply.) a. Empirical quality results b. Structural empowerment c. Transformational leadership d. Exemplary professional practice e. Willingness to recommend the agency ANS: A, B, C, D