PNR 140
TEST BANK FOR SUCCESS IN PRACTICAL
VOCATIONAL NURSING 9TH EDITION BY KNECHT
LATEST UPDATE
Chapter 16: The Health Care
System: Financing, Issues, and
Trends
MULTIPLE CHOICE
1. When the nurse is asked by a patient, “Why is it necessary to have deductibles and copayments when I
already have health insurance?” The best response would be:
a. “They are a way to improve the margin of profit in the fee-for-service method of paying for
health care.”
b. “They prevent health care agencies from having huge deficits associated with uncompensated
care.”
c. “They were developed to save health care dollars at the time Medicare introduced DRGs.”
d. “They are part of the incremental changes designed to provide more universal care.”
ANS: A
Deductibles and copayments require the patient to pay an increased share of the cost of treatment,
thus improving the profit margin for the insurer. They benefit the insurer more than the agency.
Deductibles and copayments were not developed to save health care dollars at the time Medicare
introduced DRGs. Deductibles and copayments are not part of the incremental changes designed to
provide more universal care.
DIF: Cognitive Level: Application REF: p. 223 OBJ: 2
TOP: Deductibles and copayments KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment
2. A patient tells the nurse, “I didn’t sign up for health care insurance at my job because I’m young and
healthy and can use the money in other ways.” The response that best explains the advantage of health
insurance would be
a. “With insurance a fiscal middleman pays your health care bills.”
b. “With insurance your individual contributions go directly to paying your personal expenses.”
c. “With insurance you can borrow money for unexpected health care expenses at a very low
interest rate.”
, d. “With insurance you are spreading the risk in case you have a serious health event, such as cancer
or major trauma.”
ANS: D
Health insurance, like any insurance, spreads risk. The risk that is spread in health insurance is
that the young and the healthy generally subsidize (support financially) the sick and older persons
in the health insurance group. Individual contributions are pooled for the protection of individuals
from financial disaster due to health care bills. A fiscal middleman does pay health care bills, but
this does not address the best explanation of the advantage of health insurance. The remaining
options are not factual statements.
DIF: Cognitive Level: Analysis REF: p. 223 OBJ: 2
TOP: Advantage of health insurance KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment
3. A patient asks the nurse, “What do health maintenance organizations (HMOs) do to reduce health care
costs?” The response giving the best example of an HMO cost-containment method would be:
a. “HMOs pool individual contributions for use in catastrophic illness.”
b. “HMOs provide supplemental coverage for items not covered by Medicare.”
c. “HMOs use a retrospective payment system.”
d. “HMOs provide services aimed at keeping members healthy.”
ANS: D
HMOs attempt to reduce costs by providing services aimed at keeping members healthy, such as
smoking cessation classes and weight loss programs. The other options are not factual statements.
DIF: Cognitive Level: Analysis REF: p. 224 OBJ: 3
TOP: HMOs KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment
4. Which of the following constitutes a problem that affects data collected by the nurse interviewing a
chronically ill older adult patient? Many older adults who are covered only by Medicare Parts A and B
find it difficult to pay the cost of
a. hospital care for an acute short-term illness.
b. prescription drugs while living at home.
c. post-hospitalization rehabilitation services in a skilled nursing facility.
d. doctor’s office visits, Pap smears, and mammography.
ANS: B
Data collection should include medications prescribed for the patient and whether the patient is
medication compliant. Often patients are without medication when funds are limited. The other costs
mentioned in the remaining options are covered by Medicare Parts A and B.
DIF: Cognitive Level: Application REF: p. 225 OBJ: 3
TOP: Medicare coverage KEY: Nursing Process Step: Assessment (Data Collection)
MSC: NCLEX: Health Promotion and Maintenance
5. When involved with discharge planning for a patient recovering from a mild cerebrovascular accident,
the nurse should understand that Medicare provides
TEST BANK FOR SUCCESS IN PRACTICAL
VOCATIONAL NURSING 9TH EDITION BY KNECHT
LATEST UPDATE
Chapter 16: The Health Care
System: Financing, Issues, and
Trends
MULTIPLE CHOICE
1. When the nurse is asked by a patient, “Why is it necessary to have deductibles and copayments when I
already have health insurance?” The best response would be:
a. “They are a way to improve the margin of profit in the fee-for-service method of paying for
health care.”
b. “They prevent health care agencies from having huge deficits associated with uncompensated
care.”
c. “They were developed to save health care dollars at the time Medicare introduced DRGs.”
d. “They are part of the incremental changes designed to provide more universal care.”
ANS: A
Deductibles and copayments require the patient to pay an increased share of the cost of treatment,
thus improving the profit margin for the insurer. They benefit the insurer more than the agency.
Deductibles and copayments were not developed to save health care dollars at the time Medicare
introduced DRGs. Deductibles and copayments are not part of the incremental changes designed to
provide more universal care.
DIF: Cognitive Level: Application REF: p. 223 OBJ: 2
TOP: Deductibles and copayments KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment
2. A patient tells the nurse, “I didn’t sign up for health care insurance at my job because I’m young and
healthy and can use the money in other ways.” The response that best explains the advantage of health
insurance would be
a. “With insurance a fiscal middleman pays your health care bills.”
b. “With insurance your individual contributions go directly to paying your personal expenses.”
c. “With insurance you can borrow money for unexpected health care expenses at a very low
interest rate.”
, d. “With insurance you are spreading the risk in case you have a serious health event, such as cancer
or major trauma.”
ANS: D
Health insurance, like any insurance, spreads risk. The risk that is spread in health insurance is
that the young and the healthy generally subsidize (support financially) the sick and older persons
in the health insurance group. Individual contributions are pooled for the protection of individuals
from financial disaster due to health care bills. A fiscal middleman does pay health care bills, but
this does not address the best explanation of the advantage of health insurance. The remaining
options are not factual statements.
DIF: Cognitive Level: Analysis REF: p. 223 OBJ: 2
TOP: Advantage of health insurance KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment
3. A patient asks the nurse, “What do health maintenance organizations (HMOs) do to reduce health care
costs?” The response giving the best example of an HMO cost-containment method would be:
a. “HMOs pool individual contributions for use in catastrophic illness.”
b. “HMOs provide supplemental coverage for items not covered by Medicare.”
c. “HMOs use a retrospective payment system.”
d. “HMOs provide services aimed at keeping members healthy.”
ANS: D
HMOs attempt to reduce costs by providing services aimed at keeping members healthy, such as
smoking cessation classes and weight loss programs. The other options are not factual statements.
DIF: Cognitive Level: Analysis REF: p. 224 OBJ: 3
TOP: HMOs KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment
4. Which of the following constitutes a problem that affects data collected by the nurse interviewing a
chronically ill older adult patient? Many older adults who are covered only by Medicare Parts A and B
find it difficult to pay the cost of
a. hospital care for an acute short-term illness.
b. prescription drugs while living at home.
c. post-hospitalization rehabilitation services in a skilled nursing facility.
d. doctor’s office visits, Pap smears, and mammography.
ANS: B
Data collection should include medications prescribed for the patient and whether the patient is
medication compliant. Often patients are without medication when funds are limited. The other costs
mentioned in the remaining options are covered by Medicare Parts A and B.
DIF: Cognitive Level: Application REF: p. 225 OBJ: 3
TOP: Medicare coverage KEY: Nursing Process Step: Assessment (Data Collection)
MSC: NCLEX: Health Promotion and Maintenance
5. When involved with discharge planning for a patient recovering from a mild cerebrovascular accident,
the nurse should understand that Medicare provides
