practice questions

A nurse working on a postpartum unit of a large urban hospital has received a grant to begin a "Baby-friendly Hospital Initiative" developed by WHO. When explaining the major premises of the initiative to her unit manager, the nurse should stress which of the following?

"Improving nutrition by promoting breast feeding of newborns through age four months is what this program is all about."

The Patient Self-Determination Act requires health care facilities to have which of the following?

-Policies and procedures for advance directives -Documentation of individual decisions about life-sustaining treatment -Available education about advance directives

The nurse working at a crisis hotline center assesses that which of the following callers is most at risk for suicide?

A 16-year-old girl who broke up with her boyfriend An 80-year-old male in constant pain from metastatic cancer

medicare

A federal health insurance program that finances medical care for people over 65, disabled individuals who are entitled to Social Security benefits, and people with end-stage renal disease requiring dialysis or a kidney transplant.

Accountable care organizations (ACOs)

A health care organization characterized by a payment and care delivery model that seeks to tie provider reimbursements to quality metrics and reductions in the total cost of care for an assigned population of patients.

point-of-service (POS)

A health care plan in which members decide how to receive services at the time of service; it combines HMO and indemnity features. As with HMOs, providers are paid through a capitation or risk-based system and, as with preferred provider organizations, individuals can choose a non-plan provider by paying extra.

High-deductible health insurance plans (HDHPs)

A health insurance plan with lower premiums and higher deductibles than a traditional health plan.

Preferred provider organizations (PPOs)

A network of providers who agree to deliver services for a discounted fee. The provider generally incurs no financial risk; the financial burden is on the client rather than the provider.

Nursing Centers are nurse-managed health centers, often situated in medically underserved rural and urban areas, which primarily serve vulnerable populations in the provision of primary care to individuals and families. What are the key components of a nursing center?

A nurse as chief manager A nursing staff that is accountable and responsible for care and professional practice Nurses as the primary providers of care

Gatekeeper

A physician or APN who provides primary care and who makes referrals for emergency services or specialty care.

hospitalist

A physician whose professional focus is caring for the hospitalized individual.

non maleficence

A principle that enjoins people not to harm other people.

Health insurance exchanges

A set of state-regulated and standardized health care plans in the United States, from which individuals may purchase health insurance eligible for federal subsidies.

Indemnity insurance plan

A type of medical plan that reimburses the patient and/or provider as expenses are incurred.

Concierge care

A type of primary care medical practice in which physicians charge individual clients a membership fee (on average of $1500 to $1900 per year; range reported as $60 to $15,000 per year) in return for enhanced health care services or amenities.

Which of the following statements are true regarding Advanced Practice Nurses (APNs)?

APNs typically practice in the roles of nurse practitioners, clinical nurse specialists, nurse midwives, or nurse anesthetists. APNs serve economically disadvantaged and vulnerable populations. APNs have specialized clinical knowledge and skills at the masters or doctoral level.

Which of the following statements best supports the ethical principle of justice?

Access to health care should be provided for all people.

Which of the following patients seen in a clinic has an increased risk of experiencing interpersonal violence?

An 8-year-old male who has witnessed his mother being verbally abused by her boyfriend Correct A 14-year-old female whose parents are problem drinkers Correct A 10-year-old boy who has difficulty making friends Correct A 16-year-old girl who is 70 pounds overweight and concerned about her weight Correct

World Health Organization (WHO)

An international agency founded after World War II to promote health around the world.

Which information about anthrax is correct?

Anthrax can cause skin lesions or pneumonia.

What is the role of the gatekeeper in a managed care health plan?

Coordinate and oversee an individual's care.

maleficence

Deliberate harm and harm caused by indifferent of incompetent decision-making.

Justice

Ethical principle that claims that equals should be treated equally and those who are unequal should be treated differently according to their differences.

descriptive theories

Ethics based on observations of human behavior over time and in a variety of settings. They are not directive—they merely tell us how people act toward each other and their environment, what they seem to believe are "good" or moral actions.

In the private sector, which organization provides health care insurance that includes independent prepayment plans?

Health Maintenance Organizations (HMO)

Primary care provider (PCP)

Health care providers who provide care in the managed care arena. They can be physicians or midlevel practitioners (physicians' assistants, nurse practitioners, or nurse midwives) who provide basic health care services.

health savings account (HSAs)

Health care reimbursement accounts established for the employee.

Fee-for-service

Individual health care payment arrangement in which the person pays for each visit.

insurance

Individual payment to a fund to provide protection for each contributor against financial losses resulting from an unlikely, but possible, occurrence.

In health-promotion activities, which of the following statements is accurate regarding respect for autonomy?

Individuals must be given the information they need to make choices. Correct **NOT**Choices are autonomous when public policy dictates the action. Incorrect Autonomous choices are made when the person can understand the risks and benefits of the choices. Correct **NOT**Autonomous choices are acceptable even when mental capacity is questionable. Incorrect Choices are considered autonomous in the absence of coercive influence. Correct

Which of the following indicators is one of the most important determinants of the health of a nation?

Infant mortality rates

Why do infants in developed countries have better outcomes in natural disasters?

Most infants in developed countries are breastfed.

Which of the following statements accurately describe ethical theories?

Normative theories are concerned with ensuring good actions. Consequentialist theories hold that decisions should take into account all knowable potential consequences. Religions and duty-based theories assert that certain duties will produce good outcomes.

According to the Institute of Medicine, nurses can play a key role in helping realize the objectives set forth in the 2010 Affordable Care Act. What are the key roles?

Nurses should practice to the full extent of their education and training. Effective workforce planning and policy making require better data collection and an improved information infrastructure. Improved education systems should promote seamless academic progression.

Advanced practice nurses (APNs)

Nurses with advanced education beyond the baccalaureate degree who are prepared to manage and deliver health care services to individuals, families, groups, communities, and populations; includes clinical nurse specialists, nurse practitioners, nurse midwives, nurse anesthetists, and others.

What are some of the definitions that support using the term profession to denote the status of nursing?

Nursing is considered a profession because it provides a service to society. Correct ***NOT****Nursing is considered a profession because of the stable employment opportunities. Incorrect Nursing is self-governing. Correct Members of the nursing profession are accountable for their actions. Correct Members of a profession abide by a code of ethics. Correct

Which of the following interventions will be most helpful in preventing premature death in children under the age of 5?

Nutritional supplements

Which of the following components are included in the World Health Organization's (WHO) definition of malnutrition? (select all that apply)

Obesity Correct Inadequate intake of vitamins/minerals Correct Inadequate protein intake Correct **NOT** Inadequate fluid intake Incorrect

Advocate

One who pleads the cause of another

According to the IOM report Keeping Patients Safe: Transforming the Work Environment of Nurses, what are the four main problem areas in nurses' work environments?

Organizational management *NOT*Time management Incorrect Workforce management Work design Organizational culture

Independent practice associations (IPAs)

Organizations composed of independent physicians in solo or group practices who provide health care services to members of an HMO in their private offices, eliminating the expense of the staff model HMO, which furnished and owned the facility in which care was provided.

Which statement about smallpox is correct?

People who received the smallpox vaccine 50 years ago may still be protected from the disease.

applied ethics

Philosophical examination, from a moral standpoint, of particular issues in private and public life that are matters of moral judgment.

Which nursing intervention would be based upon utilitarian theory?

Preparing a 52-year-old woman with uterine cancer for a hysterectomy

The Institute of Medicine has made recommendations for promoting safety within the health care system. Which of the following are accurate reflections of the recommended practices?

Promote health literacy. Improve transparency in the reporting of health information technology. Nurses demonstrate an understanding of the environment they work in.

Capitation rate

Rate paid to a physician or group of physicians that is a set amount for each enrolled person assigned to them, per period of time, whether or not that person seeks care.

Which of the following projects fall under the guidance of WHO collaborating nutrition centers?

Research related to preserving the freshness of foods Correct Educational seminars related to nutritional requirements Correct Comparison of the effectiveness of vitamin pills versus fresh fruit and vegetables Correct Research related to BMI and cardiovascular disease Correct

Affordable Care Act (ACA)

The comprehensive health care reform law enacted in March 2010. The law was enacted in two parts: The Patient Protection and Affordable Care Act was signed into law on March 23, 2010 and was amended by the Health Care and Education Reconciliation Act on March 30, 2010. The name "Affordable Care Act" is used to refer to the final, amended version of the law.

Which statement supports the principle of beneficence that overrides a person's autonomy?

The nurse instructs parents that their newborn must be placed in a car seat that faces the back of the seat in the back seat of the car.

HMOs

The prototypical managed care structure that encompasses two possibilities: (1) a health plan in which providers assume some of the financial risk and (2) a health plan that uses primary care providers as gatekeepers.

beneficence

The quality or state of doing or producing good.

Autonomy

The right to determine what treatments or interventions one will accept.

Duty-based theories

Theories that depend more on adherence to duties than on good consequences.

medicaid

Title XIX Social Security Amendment (1965), a combined federal and state program. The program provides access to care for the poor and medically needy of all ages.

The primary federal agency charged with providing health services to the public is the

United States Department of Health and Human Services (USDHHS).

When a nurse utilizes aggressive action on behalf of a care recipient, he or she is considered to be practicing:

advocacy.

Veracity

devotion to the truth

The nurse participates in the process of ethical inquiry in health promotion to:

facilitate in-depth data gathering. Correct resolve all ethical problems related to health promotion. understand what is expected of the health-promotion agent viewed as a moral agent. Correct gain clarity on actual or potential issues regarding health-promotion endeavors. Correct **NOT**foresee all possible consequences of ethical issues related to health promotion. Incorrect permit the uncovering of hidden agendas and interests. Correct focus on salient aspects of problems, thus enhancing professional judgment. Correct

The school nurse has been asked to present a workshop on community-associated methicillin resistant Staphylococcus aureus (CA-MRSA) for high school teachers. The nurse should stress that CA-MRSA is a:

potentially fatal skin infection that is difficult to treat

In health promotion settings, individual autonomy may be limited by:

the duty of protecting the health and safety of society.

The nurse recognizes that the American Nurses Association (ANA) Code of Ethics identifies expectations of ethical behavior through statements regarding:

the primary goals, values, and obligations of the profession.