Chapter 11: The Health Care Delivery System (Exam Review, TB)
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?
"You will have surgery and go home that same day."
Which of the following clients is the most appropriate candidate for receiving outpatient care?
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 rural health center
What is one of the most significant trends in health care today?
Shift from hospitals to community-based care
Medicare reimburses in-hospital costs based on a set payment for a diagnostic related group (DRG). This means the hospital is reimbursed for a fixed amount based on the diagnosis and projected cost for care. As a result of this system the hospital can make a profit or a loss. Select the responses that describe when a profit for care of the client can be achieved.
All of the hospitalization charges are less than projected. The client is discharged before the approved discharge date.
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?
Ambulatory center
Medicare uses a prospective payment plan based on diagnosis-related groups (DRGs). What are DRGs?
Predetermined payment for services based on medical diagnoses
Long-term care is often needed for the elderly client. Select all the services that may be provided to the resident in a long-term care facility.
Assistance with activities of daily living Mental disability services Nonmedical care for chronic illness
The Public Health Service (PHS) is a federal agency of the U.S. Department of Health and Human Services. The professional nurse is aware that the services provided by the PHS include which of the following? Select all that apply.
Care to migrant workers Care in federal prisons Indian Health Services
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?
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.
Nurses who are employed in home care have a variety of responsibilities. Which of the following is one of those responsibilities?
Collaborate with other care providers
A nurse is making a visit to a client in the home. As a home health care nurse you may be expected to accomplish which of the following?
Complete an assessment on each visit. Provide support to the client and family. Administer treatments and medications. Document actions regarding patient, activities, and progress. Communicate and collaborate with other members of the health team.
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?
Controlling costs while maintaining quality of care
In providing nursing care, it is most important to perform which of the following actions?
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?
Crisis Management
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?
Preferred provider organization
What population do hospice nurses provide with care?
Dying persons and their loved ones
A nurse has been hired to work as an occupational health nurse. In this position as a registered nurse, what will this nurse provide?
Education and safety programs in industrial settings.
The nurse working in the hospital understands the changes that have resulted in shorter hospital stays, with a focus on acute care needs of the client. Which of the following factors influence shorter hospital stays? Select all that apply.
Federal regulations for health care reimbursement policies. Increased emphasis on preventive care. Improvement in treatment of illness.
Which of the following phrases best describes hospitals today?
Focus on acute care needs
What is the primary focus of health care today?
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?
Hospice
Health care costs are increasing as technology and related services increase. Patients interact with many health care providers, such as RNs, LPNs, physicians, physical therapists, medical technologists, radiation technologists, specialists, and others employed in health care. As a result of the complexity of care and multiple providers, health care is becoming fragmented. What are the major results of fragmented care?
Increased medication errors. Clients receive more specialized care. Lack of continuity of care.
Which of the following health care insurance programs is most suitable for a client 68 years of age?
Medicare
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?
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.
Should the uninsured person, who cannot pay for health care, receive the same care and services as someone who works and pays for insurance?
After a stroke, a client is having difficulty swallowing. The nurse may make a referral to what member of the health care team?
Speech therapist
What is one way in which nurses can help shape health care reform?
Support legislation to improve care
Who provides physicians with the authority to admit and provide care to clients requiring hospitalization?
The health care institution itself
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?
The hospice nurse continues to care for the client's family for up to one year.
A client has a private insurance policy that pays for most health care costs and services. Why is this plan called a third-party payer?
The insurance company pays all or most of the costs.
A grade school is preparing a series of classes on the dangers of smoking. Who would be most likely to teach the classes?
The school nurse
Health care is constantly changing and becoming more complex. Select the answers that describe clients as health care consumers today. Select all that apply.
They often have health information obtained from the Internet. They prefer to control the decisions made about their own health care. They express concern regarding access to care and the quality of service. They have helped develop clients' rights and cost-containment measures.
Which of the following is true of long-term care facilities?
They provide care to people of any age.
Nurses work with various members of the health team. The nurse understands that the role of the hospitalist is best described as:
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.