Health Care Regulation and Reform

A nurse is caring for a 43-year-old woman with type 2 diabetes in a nurse-led clinic. Which factors must the nurse consider for a wellness approach to providing care? Select all that apply. 1. Insulin affordability 2. Nutrition and exercise 3. Encouraging working at home 4. Coping with having diabetes 5. Beginning Medicare application

1. Insulin affordability 2. Nutrition and exercise 4. Coping with having diabetes

Health care reform is in a state of flux. Which examples support the quadruple aim of quality, safety, cost, and burden? Select all that apply. 1. CMS state waivers 2. Staffing decreases 3. Medicaid expansion 4. Increased insurance coverage 5. The Affordable Care Act (ACA)

1. CMS state waivers 3. Medicaid expansion 5. The Affordable Care Act (ACA)

Wellness models are holistic and focus on an individual's self needs. Which represent components of Substance Abuse and Mental Health Services Administration's (SAMHSA) wellness model? Select all that apply. 1. Coping with life 2. Managing finances 3. Balancing work and home 4. Monitoring community drug use 5. Managing church calendar

1. Coping with life 2. Managing finances 3. Balancing work and home

Match the characteristic with the type of health insurance it describes.

1. Greatest freedom of provider selection- Preferred Provider 2. Federal program for children in low-income families- SCHIP 3. Federal program for adults managed by each state- Medicaid 4. Health insurance system to manage cost and utilization- Managed Care

Which responses are accurate comparisons of Medicaid and Medicare?

1. Medicare is federally run, whereas Medicaid is state run 2. Medicaid assists low-income families, whereas Medicare assists older individuals 3. Medicare payments are deducted from Social Security, whereas Medicaid requires no payment.

The current United States health care system functions more on a business model than a service model. Which factors contribute to rising health care costs? Select all that apply. 1. Provider burden 2. Health care fraud 3. Institute of Medicine (IOM) 4. Increased health insurance coverage 5. Increased health insurance premiums

1. Provider burden 2. Health care fraud 5. Increased health insurance premiums

Match the wellness dimension with its definition 1. Understanding our surroundings 2. Expanding knowledge 3. Balancing home and work 4. Understanding one's purpose in life

1. Understanding our surroundings- Environmental 2. Expanding knowledge- Intellectual 3. Balancing home and work- Occupational 4. Understanding one's purpose in life- Spiritual

Which responses describe reasons for health care cost increases? Select all that apply. 1.An aging population 2. Increase in adolescent population 3. New diagnostic testing technology 4. Passage of Medicare and Medicaid 5. Fewer enrollments in health insurance plans

1. an aging population 3. new diagnostic testing technology 5. fewer enrollments in health insurance plans

Which factors supported the necessity of health care reform in the United States? Select all that apply. 1. To improve patient care 2. To cut back on health care fraud 3. To allow more people to obtain health insurance 4. To ration health care only to people with insurance 5. To maintain health care costs above other countries

1. to improve patient care 2. to cut back on health care fraud 3. to allow more people to obtain health insurance

Which health care regulation or reform increased access to care while reducing health insurance costs? 1. Medicare 2. Affordable Care Act 3. National Quality Forum 4. The Institute of Medicine

2. Affordable Care Act

Which responses describe federal health insurance plans? Select all that apply. 1. Health insurance only for long-term care 2. Health insurance for worst-case hardships 3. Health insurance for individuals who work 4. Health insurance for very low-income individuals 5. Health insurance for individuals over 65 years old

2. Health insurance for worst-case scenario 4. Health insurance for very low-income individuals 5. Health insurance for individuals over 65 years old

Rising health care costs justify the need for health care reform. Which key elements of reform, based on the Institute of Medicine's (IOM's) recommendations, need to be addressed? Select all that apply. 1. Utilization review 2. Medication errors 3. Housekeeping staff 4. Provider job satisfaction 5. Patient-centered outcomes

2. Medication errors 4. Provider job satisfaction 5. Patient-centered outcomes

Employers generally offer health care insurance options. Which examples are employer generated health care plans? Select all that apply. 1. Medicare 2. Medicaid 3. Managed care 4. Preferred provider 5. Children's Health Insurance Program (CHIP)

3. Managed care 4. Preferred provider

The nurse verifies that the patient is receiving the correct medication as prescribed by the provider before administering the medication. The nurse understands that this action aligns with which of the quadruple aims of overhauling health care? 1. Cost 2. Quality 3. Safety 4. Burden

3. Safety

The nurse is caring for a child with pneumonia from an impoverished, unemployed family. Which health care plan would assist this family to care for their child? 1. Medicare 2. Managed care 3. Preferred provider 4. State Children's Health Insurance Program (SCHIP)

4. State Children's Health Insurance Program

The nurse is caring for an 11-year-old child with cystic fibrosis whose parents do not qualify for Medicaid. Which type of insurance coverage can help this family pay for patient care costs? 1. Medicare 2. Catastrophic insurance 3. Long-term care insurance 4. State Children's Health Insurance Program (SCHIP)

4. State Children's Health Insurance Program

Which is a main factor for focusing health care on wellness? 1. Wellness is only for the young. 2. Wellness is a good way to lose weight. 3. Wellness is exercise and not counseling. 4. Wellness reduces health care costs and increases longevity.

4. Wellness reduces health care costs and increases longevity

Life expectancy is affected by an increased focus on wellness. In many nations it is higher than the United States, where the life expectancy is years

78.7

Wellness is gaining support for patient care. Which is not a construct of the wellness model? 1. Wellness is just for patients. 2. Wellness helps health literacy. 3. Wellness may add to a patient's longevity. 4. Wellness is adopted in academic institutions.

Wellness is just for patients