Fundamentals Success Healthcare Delivery

A patient is told that pre-authorization is required before surgery can be performed. The patient asks the nurse, "What does pre-authorization mean?" Which is an accurate response to the patient's question? 1. "Third-party payers have approved the surgery and the facility will be reimbursed for costs." 2. "The preoperative checklist has been completed and verified by a nurse." 3. "Required preoperative diagnostic tests have been performed." 4. "You have signed the legal consent form for the surgery."

1. "Third-party payers have approved the surgery and the facility will be reimbursed for costs."

Which health-care professional is best prepared to track a patient's progress through the health-care system? 1. Case manager 2. Primary nurse 3. Nurse manager 4. Home-care nurse

1. Case manager

Identify which of the following individuals are nursing team members. Select all that apply. 1. Client 2. Hospice nurse 3. Registered nurse 4. Nursing assistant 5. Licensed practical nurse

1. Client 2. Hospice nurse 3. Registered nurse 4. Nursing assistant 5. Licensed practical nurse

A home health-care nurse is functioning as a case manager for a patient recently discharged from the hospital. Which is the primary role of the nurse when functioning as a case manager? 1. Coordinator 2. Counselor 3. Provider 4. Teacher

1. Coordinator

Three hospitals agree to work collectively to provide a full range of health-care services in their neighborhoods. Which type of relationship has been entered into by these hospitals? 1. Integrated health-care service network 2. Third-party reimbursement system 3. Health Maintenance Organization 4. Diagnosis Related Groups

1. Integrated health-care service network

A nurse case manager is counseling an older adult patient about resources available to assist with the cost of health care. The nurse should inform the patient which organization provides the majority of the health-care costs for people older than 65 years of age? 1. Medicare 2. Medicaid 3. Blue Cross 4. Blue Shield

1. Medicare

A patient is discharged from the hospital 3 days after abdominal surgery because of the influence of Diagnosis Related Groups (DRGs). Which should the nurse performing the discharge teaching be most concerned about? 1. Providing for continuity of care 2. Ordering equipment to be used in the home 3. Accepting discharge by the patient and family 4. Verifying that the client has insurance to cover hospital costs

1. Providing for continuity of care

A nurse is explaining mammography screening to a patient. Which level of healthcare delivery service does this diagnostic test reflect? 1. Secondary 2. Tertiary 3. Primary 4. Acute

1. Secondary

Which factor that is increasing and that is associated with older adults has an impact on the delivery of health care to this population within the United States? Select all that apply. 1. accidental falls 2. misuse of alcohol 3. presence of cognitive deficits 4. number of persons living longer 5. existence of multiple health problems

1. accidental falls 2. misuse of alcohol 3. presence of cognitive deficits 4. number of persons living longer 5. existence of multiple health problems

Which setting is the organizational center of the United States health-care system? 1. Clinic setting 2. Acute care setting 3. Community setting 4. Long-term care setting

2. Acute care setting

A nurse is planning actions that address a patient's health-care needs. Which statement is important for the nurse to consider? 1. Health and illness clearly are separated at the middle of the health-illness continuum. 2. Demographics of the population of the United States are changing drastically. 3. External factors mainly are the cause of most illnesses. 4. Most people view health as the absence of disease.

2. Demographics of the population of the United States are changing drastically.

Which is the best example of an inpatient care setting where nursing care is delivered? 1. Ambulatory care center 2. Extended-care facility 3. Day-care center 4. Hospice

2. Extended-care facility

Which does critical pathways in health care refer to? 1. Educational career ladders for health-care professionals 2. Multidisciplinary plans with predetermined patient outcomes 3. Times during life when certain health problems are more likely to occur 4. Organizations that provide services that progress from acute care to long-term

2. Multidisciplinary plans with predetermined patient outcomes

Which nursing activities reflect care on the primary level of health-care delivery? Select all that apply. 1. Arranging for hospice services 2. Presenting a class on a healthy diet 3. Providing emergency care at a local hospital 4. Encouraging attendance at a Smoke Enders' meeting 5. Administering immunizations to prevent childhood diseases

2. Presenting a class on a healthy diet 4. Encouraging attendance at a Smoke Enders' meeting 5. Administering immunizations to prevent childhood diseases

At the end of a shift the nurse in charge must evaluate each patient in relation to the agency's patient classification system. Which is the purpose of this patient classification system? 1. Document resource needs for the purpose of establishing reimbursement. 2. Provide data about patient acuity to help assign nursing staff. 3. Establish that quality standards have been met. 4. Identify standardized expected outcomes.

2. Provide data about patient acuity to help assign nursing staff.

Which change identified by the nurse will most affect health-care delivery in the United States in the future? 1. Less emphasis will be placed on prolonging life. 2. The proportion of older adults in society will increase. 3. More people will seek health care in an acute care setting. 4. Genetic counseling will dramatically decrease the number of ill infants born.

2. The proportion of older adults in society will increase.

Which is an example of an official agency? Select all that apply. 1. American Cancer Society 2. Veterans Affairs Hospital 3. American Heart Association 4. National League for Nursing 5. Nonprofit community hospital

2. Veterans Affairs Hospital

Which is the cornerstone of Nursing's Agenda for Health Care Reform? 1. a standardized package of healthcare services must be provided by organizations within the federal government 2. healthcare services should be provided in environments that are accessible, familiar, and friendly 3. advanced practice nurses should play a prominent role in the provision of primary health care 4. nursing must provide for the central focus of the healthcare delivery system

2. healthcare services should be provided in environments that are accessible, familiar, and friendly

A client with an infection receives medical intervention and nursing care in a hospital setting. Which level health-care has been provided in this situation? 1. emergency 2. secondary 3. teritary 4. primary

2. secondary

A patient asks the nurse, "What is the difference between Medicare and Medicaid?" Which response by the nurse describes the Medicaid program? 1. "A retrospective health-care reimbursement program that pays for costs incurred by health-care agencies for the care of the indigent" 2. "A state program requiring primary health-care providers to deliver care to people living below the designated poverty level" 3. "A federally funded health insurance program for individuals with minimal incomes" 4. "A federally funded health insurance program for people aged 65 years or older"

3. "A federally funded health insurance program for individuals with minimal incomes"

A nurse is reviewing a variety of surveys regarding the delivery of health care within the United States. Which statement reflects a significant change in the thinking of the general public about concepts related to health-care delivery? 1. "Institutional-based care will have to be increased as baby boomers age." 2. "More services must address the secondary health-care needs of the community." 3. "Individuals can influence their own health through behavior and lifestyle changes." 4. "Health-care providers should be primarily responsible to provide appropriate health-care services."

3. "Individuals can influence their own health through behavior and lifestyle changes."

Which characteristic is unique to the nurse-patient relationship? 1. Patient's needs are satisfied. 2. There is a social component. 3. Both are working toward a common goal. 4. The nurse is the leader of the health team.

3. Both are working toward a common goal.

A recently licensed Registered Nurse is working the night shift on an active medical unit in a hospital. Which is the best way that this nurse can prevent professional burnout? 1. Challenge the how and why of one's role. 2. Get adequate sleep and exercise each day. 3. Clarify expectations, strengths, and limitations. 4. Seek a balance among seriousness, humor, and aloofness.

3. Clarify expectations, strengths, and limitations.

Which is the major factor that limits the overhaul of the health-care delivery system of the United States? 1. Elected officials who do not respond to the pressure of their political constituencies 2. Explosion of technical advances within the profession of medicine 3. Complexity of the problems associated with health-care reform 4. Resistance of physicians to reform

3. Complexity of the problems associated with health-care reform

Which intervention is most likely to have the greatest impact on decreasing the nursing shortage? 1. Providing stress reduction programs to address needs of nurses experiencing burnout 2. Offering bonuses to entice nurses close to retirement to work longer 3. Developing initiatives to fund the education of nursing faculty 4. Increasing the recruitment of foreign registered nurses

3. Developing initiatives to fund the education of nursing faculty

Which action is common to the majority of Registered Nurse positions in different settings in which nurses work? 1. Assisting a primary health-care provider 2. Serving in an administrative capacity 3. Developing patient plans of care 4. Providing direct physical care

3. Developing patient plans of care

Which is emphasized in the traditional health-care delivery system in the United States? 1. Health promotion 2. Illness prevention 3. Diagnosis and treatment 4. Rehabilitation and long-term care

3. Diagnosis and treatment

When should a nurse begin a patient's rehabilitative care? 1. When the patient is conscious 2. Once the patient begins walking 3. Once the medical diagnosis is made 4. Just before discharge from the hospital

3. Once the medical diagnosis is made

A nurse is functioning as a patient advocate. Which words best describe this nursing role? Select all that apply. 1. Provider 2. Nurturer 3. Protector 4. Evaluate 5. Supporter

3. Protector 5. Supporter

Which should a nurse conclude is the main cause of the shift of healthcare delivery from the hospital to the home? 1. use of resource utilization groups to categorize needs of clients 2. need for hospital beds to be available for the acutely ill 3. limits on length of stay by reimbursement sources 4. shortage of qualified licensed nurses

3. limits on length of stay by reimbursement sources

Together the nurse and patient are setting a goal during health-care planning. Which factor generates the most anxiety for a patient with this process? 1. Role 2. Values 3. Beliefs 4. Change

4. Change

Diagnosis Related Groups (DRGs) were instituted by the federal government mainly to reduce which of the following? 1. Number of professionals working in hospitals 2. Focus on illness and place it on prevention 3. Fragmentation of care 4. Cost of health care

4. Cost of health care

Which health-care team member can provide independent health care with third-party reimbursement in the emerging health-care delivery system in the United States? 1. Licensed Registered Nurse 2. Clinical Nurse Specialist 3. Physician's Assistant 4. Nurse Practitioner

4. Nurse Practitioner

A nurse is planning a community outreach program about the variety of health-care professionals and the services they provide. Which members of the health-care team should the nurse indicate are the largest group of health-care personnel in the United States? 1. Social workers 2. Nurse aides 3. Physicians 4. Nurses

4. Nurses

A patient is to return from the post anesthesia care unit to a semiprivate room. Which is the most significant factor concerning the postoperative patient's potential roommate that will influence the nurse's decision to transfer the postoperative patient to this room? 1. Emotionally fragile 2. Able to communicate 3. In the bed by the window 4. Physiologically compatible

4. Physiologically compatible

Which result of re-engineering in hospital settings has raised the greatest concerns for patient safety? 1. Decreased hospital occupancy rates 2. Increased acuity of hospitalized patients 3. Hospitals merging with larger institutions 4. Substitution of less skilled workers for nurses

4. Substitution of less skilled workers for nurses