Chapter 11, The Health Care Delivery System

Which of the following is true of long-term care facilities? A) They provide care only to older adults. B) They provide care for homeless adults. C) They provide care to people of any age. D) They provide care only for people with dementia.

C) They provide care to people of any age.

Which of the following clients is the most appropriate candidate for receiving outpatient care? A) A client whose complaints of irregular bowel movements have necessitated a colonoscopy B) A woman who has previously borne two children and is entering the second stage of labor C) A man who is receiving treatment for sepsis after his blood cultures came back positive D) A client with a history of depression who is currently expressing suicidal ideation

A) A client whose complaints of irregular bowel movements have necessitated a colonoscopy

After many years of advanced practice nursing, a nurse has recently enrolled in a nurse practitioner program. This nurse has been attracted to the program by the potential to provide primary care for clients after graduation, an opportunity that is most likely to exist in which of the following settings? A) A rural health center B) A long-term care facility C) A university hospital D) A community hospital

A) A rural health center

One of the newest concepts in providing long-term care is called aging in place. What is the best description of this type of care? A) Clients move to an independent living apartment or home, then have access to increasing health care services as needed, provided within the health care community where they live. B) Clients move into the nursing home, and access more and more services as required in the same facility. C) A long-term-care facility, associated with a hospital, that provides acute care services as needed so the client can return to long term care. D) Clients are maintained in their own homes with home health care.

A) Clients move to an independent living apartment or home, then have access to increasing health care services as needed, provided within the health care community where they live.

Who provides physicians with the authority to admit and provide care to clients requiring hospitalization? A) The health care institution itself B) Board of Healing Arts C) American Medical Association D) State Board of Nursing

A) The health care institution itself

A client has a private insurance policy that pays for most health care costs and services. Why is this plan called a thirdparty payer? A) The insurance company pays all or most of the costs. B) The family of the client is required to pay costs. C) The client gets the bill and pays out-of-pocket costs. D) Medicare and Medicaid will pay most of the costs.

A) The insurance company pays all or most of the costs

Nurses work with various members of the health team. The nurse understands that the role of the hospitalist is best described as: A) the doctor who admits the patient, assumes the management of the patient's care, and maintains communication with the primary physician while the patient is hospitalized. B) the physician who manages the patient's care in emergency and intensive care units only. C) the doctor who notifies the primary physician that their patient has been admitted to the hospital, and transfers care to a the referral specialist. D) the specialist who admits the patient to hospital, and returns care to the primary physician for all other referrals and services. Ans: A

A) the doctor who admits the patient, assumes the management of the patient's care, and maintains communication with the primary physician while the patient is hospitalized

A nurse and a client are discussing managed care. The nurse explains that the managed care model was designed for which of the following reasons? A) Increasing client satisfaction B) Controlling costs while maintaining quality of care ' C) Providing a distinct area of care D) Providing an all-RN staff

B) Controlling costs while maintaining quality of care '

A nurse has been hired to work as an occupational health nurse. In this position as a registered nurse, what will this nurse provide? A) Occupational therapy to schoolchildren. B) Education and safety programs in industrial settings. C) Assessment and motivation services to the unemployed. D) Activities to assist patients with ADLs in homeless shelters.

B) Education and safety programs in industrial settings

Which of the following phrases best describes hospitals today? A) Focus on chronic illnesses B) Focus on acute care needs C) Primary care centers D) Voluntary agencies

B) Focus on acute care needs

Which of the following health care insurance programs is most suitable for a client 68 years of age? A) Medicaid B) Medicare C) Capitation D) AmeriCare

B) Medicare

A person receiving health care insurance from his employer knows that he should check the approved list of contracted health care providers before seeking services, in order to receive them at a lower cost. What type of insurance is most likely involved? A) Medicaid B) Preferred provider organization C) Health maintenance organization D) Long-term care insurance

B) Preferred provider organization

What is one of the most significant trends in health care today? A) Increased length of hospital stays B) Shift from hospitals to community-based care C) Emphasis on disease management D) Narrowing of the areas for nursing practice

B) Shift from hospitals to community-based care

After a stroke, a client is having difficulty swallowing. The nurse may make a referral to what member of the health care team? A) Physical therapist B) Speech therapist C) Social worker D) Respiratory therapist

B) Speech therapist

Hospice nurses provide care in a variety of settings, including clients' homes, long-term-care facilities, and hospice residences. After the client dies, what happens next? A) The hospice services are provided to the families of the former residence clients only. B) The hospice services continue for family and friends during the bereavement period, up to one month after the death. C) The hospice nurse continues to care for the client's family for up to one year. D) Nurses assist the family to work through their grief during the period of mourning.

C) The hospice nurse continues to care for the client's family for up to one year.

A nurse in a walk-in health care setting provides technical services (e.g., administering medications), determines the priority of care needs, and provides client teaching on all aspects of care. Which of the following terms best describes this type of health care setting? A) Hospital B) Physician's office C) Ambulatory center D) Long-term care

C) Ambulatory center

What population do hospice nurses provide with care? A) Those requiring care to improve health B) Children with chronic illnesses C) Dying persons and their loved ones D) Older adults requiring long-term care

C) Dying persons and their loved ones

What is the primary focus of health care today? A) Care of acute illnesses B) Care of chronic illnesses C) Health promotion D) Health restoration

C) Health promotion

Nurses who assist clients to deal holistically with their health care needs at the end of their lives work primarily in which health care delivery system? A) Acute care B) Primary care C) Hospice D) Rehabilitation

C) Hospice

Medicare uses a prospective payment plan based on diagnosis-related groups (DRGs). What are DRGs? A) Locally supported health care financing, usually by donations B) A public assistance program for low-income individuals C) Predetermined payment for services based on medical diagnoses D) A private insurance plan for subscribers who pay a copayment

C) Predetermined payment for services based on medical diagnoses

What is one way in which nurses can help shape health care reform? A) Do their job and do it well B) Refuse to participate in organizations C) Support legislation to improve care D) Become a member of a support group

C) Support legislation to improve care

A man is scheduled for hospital outpatient surgery. He tells the nurse, "I don't know what that word, outpatient, means." How would the nurse respond? A) "It means you will have surgery in the hospital and stay for 2 days." B) "It means the surgeon will come to your home to do the surgery." C) "Why would you ask such a question? Don't worry about it." D) "You will have surgery and go home that same day."

D) "You will have surgery and go home that same day."

Nurses who are employed in home care have a variety of responsibilities. Which of the following is one of those responsibilities? A) Provide all care and services B) Maintain a clean home environment C) Advise clients on financial matters D) Collaborate with other care providers

D) Collaborate with other care providers

In providing nursing care, it is most important to perform which of the following actions? A) Administration of prescribed medications B) Implementation of physician's orders C) Evaluation of client's responses D) Coordination of care with the health care team

D) Coordination of care with the health care team

A nurse is caring for clients at an ambulatory care facility. Which care intervention is least likely to be provided by the nurse in this setting? A) Patient education B) Treatment of minor trauma C) Medication administration D) Crisis management

D) Crisis management

An elderly woman has total care of her husband, who suffers from debilitative rheumatoid arthritis. The couple voices concern over the pain and stress associated with the condition. What type of care might the nurse suggest to help the couple? A) Primary care B) Respite care C) Bereavement care D) Palliative care

D) Palliative care

The U.S. system of health care is based on an ability to pay for care, which leaves millions of people uninsured or underinsured, with inadequate access to health care. Nurses are often presented with ethical dilemmas when caring for patients and families. Which of the following is an example of an ethical dilemma? Select all that apply. A) All clients are entitled to care, whether they can pay or not, because health care is a right. B) You may have to pay higher insurance premiums to cover the cost of care because you smoke. C) There are free clinics and health programs to serve the poor; they should receive health care there. D) Should the uninsured person, who cannot pay for health care, receive the same care and services as someone who works and pays for insurance?

D) Should the uninsured person, who cannot pay for health care, receive the same care and services as someone who works and pays for insurance?

A grade school is preparing a series of classes on the dangers of smoking. Who would be most likely to teach the classes? A) A community health nurse B) An outside consultant C) A teacher D) The school nurse

D) The school nurse