Chapter 11: The healthcare delivery system
Which six trends in health care reflect the Institute of Medicine's (IOM) focus?
"The system should be safe, effective, efficient, patient centered, timely, and equitable"
A nurse demonstrates understanding of Healthy People 2020: Understanding and Improving Health by supporting which statement?
A client's health is affected by social, economic, and political factors
An example of primary health care is?
A hearing screening in the school setting
The nurse is providing care to several clients. For which client should the nurse include secondary care in the nursing plan of care?
A middle-aged client who presents with new-onset angina
The growth in home health care is largely attributed to which factor?
Early discharge of clients from the hospital setting
When conducting an education program for a group preparing for retirement, the nurse would include information about applying for Social Security benefits and Medicare insurance. The nurse would include in the education that Medicare is a federally funded insurance program which bases the fee for payment on what?
A prospective payment plan based on a predetermined fixed cost
What is the most accurate definition of urgent care?
A type of ambulatory care that treats people who walk in with illnesses and minor trauma
A clinic-based nurse in a sparsely populated remote area far from a regional hospital is working with other local healthcare team members on a plan to improve client health and outcomes. The team has decided that which of the following healthcare delivery systems would best meet the population's needs?
APRN-run health clinic
Which is an emerging trend in health care delivery?
Active involvement of consumers
Which government policy addresses penalizing hospitals for readmissions of clients with certain diagnoses within 30 days of discharge?
Affordable care act
Medicare Part A is?
An insurance program that pays a set amount based on the diagnosis and approved care for in hospital services
Which scenario is using a prospective payment plan to reimburse for services?
An older adult client is admitted to the hospital and treated for pneumonia. The hospital is reimbursed based on a predetermined fixed price.
The nurse is providing care to several clients on a medical-surgical unit. For which client's plan of care should the nurse include information regarding extended care?
An older adult client who fell at home and required a hip replacement
Which statement accurately reflects the findings of the 1999 Institute of Medicine report, "To Err is Human"?
Anywhere from 44,000 to 98,000 people are estimated to die in U.S. hospitals each year as a result of preventable medical errors
Unlicensed Assistive Personnel (UAP) include which workers?
Certified nursing assistants, orderlies, attendants, and technicians
Nurses in various health care settings provide services to prevent the fragmentation of care that is occurring as a health care trend in today's society. What role of the nurse is most important in preventing this effect?
Coordinator of care
A nurse is caring for a client who has a PPO health care plan. What is the greatest advantage of this type of plan?
Cost effectiveness
One of the primary advantages of the managed care model is?
Economic, quality care
What role does the nurse assume when gathering information for a community assessment?
Epidemiologist
Occurs when multiple, specialized practitioners are involved in various aspects of a complex client's care
Fragmentation of care
The Nursing Agenda for Health Care Reform (American Nurses Association [ANA])
Health promotion
A nurse says, "We have so many drills and safety checks for everything. It is almost like we are preoccupied with the possibility of failure." How should the charge nurse respond to this statement?
Highly reliable organizations think about the possibility of failure and what to do to avoid it
Which is the acute care setting for people who are too ill to care for themselves at home, are severely injured, or require surgery?
Hospitals
The nurse understands that a diagnostic-related group is one of the reimbursement strategies in a prospective payment system. The diagnostic related group is a part of which health care delivery system?
Medicare
The implementation of diagnosis related groups (DRGs) by Medicare in 1983 affected hospitals in which way?
Medicare pays only the amount of money preassigned to a treatment for a diagnosis
A nurse is helping a client choose a new health care plan. The client states a preference being able to choose a physician. Which plan would be the best option for this client based on the stated preferences?
PPO
A nurse has very strong client education skills. In which health care setting would the nurse make best use of these skills?
Primary care center
In the 1980s, the nursing care delivery model shifted from a team nursing model to a ?
Primary nursing model
A client who is affluent and places a high priority on maintaining freedom to choose which physicians and health care services the client uses would most likely be served by which group plan?
Private insurance
Which statement regarding pay for performance is most accurate?
Quality of care is measured and used to evaluate hospitals and other providers and to award reimbursement
A nurse recommends palliative care for a client who is being discharged following a diagnosis of cancer. What is the chief focus of this type of care?
Relief from physical, mental, and spiritual distress
Which statement regarding health care reform trends is most accurate?
Systems are in place to pay for performance and penalize hospitals for excessive readmissions
Which statement is true when comparing home care with client care?
The nurse is the guest in the client's home
A home health nurse is scheduled to make a visit to a client who was discharged from the hospital yesterday following an appendectomy. The nurse understands that the scope of practice for a home health nurse allows the nurse to perform which psychomotor tasks
Wound care, medication administration, teaching, and ensuring a reasonably safe environment
