ATI Fundamentals
Examples of Regulatory Agencies - ANS--US Department of Health and Human Services
-US Food and Drug Administration (FDA)
-State and local public health agencies
-State licensing boards
-The Joint Commission (TJC)
-Professional Standards Review Organizations (PSROs)
-Utilization review committees
What is the purpose of state licensing boards? - ANS-To ensure that health care providers and
agencies comply with state regulations
What is the purpose of The Joint Commission? - ANS-to set quality standards for accreditation
of health care facilities
What is the purpose of utilization review committees? - ANS-to monitor for appropriate
diagnosis and treatment of hospitalized clients
Medicare - ANS-65+ years old and those with permanent disabilities
Medicaid - ANS-clients with low incomes
federally funded
individual states determine eligibility requirements
Managed Care Organizations (MCOs) - ANS-primary care providers oversee comprehensive
care for enrolled clients and focus on prevention and health promotion
Preferred provider organizations (PPOs) - ANS-clients choose from a list of contracted
providers; using noncontracted providers increases the out-of-pocket costs
Exclusive provider organizations (EPOs) - ANS-clients choose from a list of providers within a
contracted organization
Purpose of long-term care insurance - ANS-provides for long-term care expenses that Medicare
does not cover
Traditional insurance reimburses for services on a... - ANS-fee-for-service basis
, Primary Health Care - ANS--emphasizes health promotion and includes prenatal and well-baby
care, nutrition counseling, and disease control
-a sustained partnership between clients and providers
-examples: office or clinic visits, scheduled school or work-centered screening for vision,
hearing, obesity, etc
Secondary Health Care - ANS--includes diagnosis and treatment of acute illness and injury
-examples: care in hospital settings like inpatient and emergency departments, diagnostic
centers, and emergent care centers
Tertiary Health Care - ANS--provision of specialized and highly technical care
-examples: intensive care, oncology centers, and burn centers
Restorative Health Care - ANS--involves intermediate follow-up care for restoring health
-examples: home health care, rehabilitation centers, and skilled nursing facilities
What is QSEN? - ANS-Quality and Safety Education for Nurses
It assists nursing programs in preparing nurses to provide safe, high-quality care
Which of the following are health care regulatory agencies? (select all that apply)
A. American Nurses Association
B. The Joint Commission
C. State Boards of Nursing
D. National League for Nursing (NLN)
E. Food and Drug Administration (FDA) - ANS-B: the joint commission
C: state boards of nursing
E: FDA
Which of the following health care financing mechanisms are federally funded? (select all that
apply)
A. Preferred provider organization (PPO)
B. Medicare
C. Long-term care insurance
D. Exclusive provider organization
E. Medicaid - ANS-B. Medicare
E. Medicaid
A hospital is conducting a community blood pressure screening in its lobby. This is an examples
of which of the following levels of care?
A. preventive
B. primary
C. secondary
D. tertiary - ANS-B. primary
Examples of Regulatory Agencies - ANS--US Department of Health and Human Services
-US Food and Drug Administration (FDA)
-State and local public health agencies
-State licensing boards
-The Joint Commission (TJC)
-Professional Standards Review Organizations (PSROs)
-Utilization review committees
What is the purpose of state licensing boards? - ANS-To ensure that health care providers and
agencies comply with state regulations
What is the purpose of The Joint Commission? - ANS-to set quality standards for accreditation
of health care facilities
What is the purpose of utilization review committees? - ANS-to monitor for appropriate
diagnosis and treatment of hospitalized clients
Medicare - ANS-65+ years old and those with permanent disabilities
Medicaid - ANS-clients with low incomes
federally funded
individual states determine eligibility requirements
Managed Care Organizations (MCOs) - ANS-primary care providers oversee comprehensive
care for enrolled clients and focus on prevention and health promotion
Preferred provider organizations (PPOs) - ANS-clients choose from a list of contracted
providers; using noncontracted providers increases the out-of-pocket costs
Exclusive provider organizations (EPOs) - ANS-clients choose from a list of providers within a
contracted organization
Purpose of long-term care insurance - ANS-provides for long-term care expenses that Medicare
does not cover
Traditional insurance reimburses for services on a... - ANS-fee-for-service basis
, Primary Health Care - ANS--emphasizes health promotion and includes prenatal and well-baby
care, nutrition counseling, and disease control
-a sustained partnership between clients and providers
-examples: office or clinic visits, scheduled school or work-centered screening for vision,
hearing, obesity, etc
Secondary Health Care - ANS--includes diagnosis and treatment of acute illness and injury
-examples: care in hospital settings like inpatient and emergency departments, diagnostic
centers, and emergent care centers
Tertiary Health Care - ANS--provision of specialized and highly technical care
-examples: intensive care, oncology centers, and burn centers
Restorative Health Care - ANS--involves intermediate follow-up care for restoring health
-examples: home health care, rehabilitation centers, and skilled nursing facilities
What is QSEN? - ANS-Quality and Safety Education for Nurses
It assists nursing programs in preparing nurses to provide safe, high-quality care
Which of the following are health care regulatory agencies? (select all that apply)
A. American Nurses Association
B. The Joint Commission
C. State Boards of Nursing
D. National League for Nursing (NLN)
E. Food and Drug Administration (FDA) - ANS-B: the joint commission
C: state boards of nursing
E: FDA
Which of the following health care financing mechanisms are federally funded? (select all that
apply)
A. Preferred provider organization (PPO)
B. Medicare
C. Long-term care insurance
D. Exclusive provider organization
E. Medicaid - ANS-B. Medicare
E. Medicaid
A hospital is conducting a community blood pressure screening in its lobby. This is an examples
of which of the following levels of care?
A. preventive
B. primary
C. secondary
D. tertiary - ANS-B. primary
