Chapter 11: The Healthcare Delivery System

Which statement regarding health care reform trends is most accurate?

"Systems are in place to pay for performance and penalize hospitals for excessive readmissions."

Which six trends in health care reflect the Institute of Medicine's (IOM) focus?

"The system should be safe, effective, efficient, patient centered, timely, and equitable."

The nurse is caring for several clients with chronic conditions that need to be evaluated for long term care. After evaluating each client, the nurse determines which client is most appropriate to receive long-term care?

A client who suffered a stroke who has mobility issues and problems completing activities of daily living (ADLs).

A nurse demonstrates understanding of Healthy People 2030 by supporting which statement?

A client's health is affected by social, economic, and political factors

Which refers to a person's ability to find and to receive care from a health care provider?

Access to health care

Which government policy addresses penalizing hospitals for readmissions of clients with certain diagnosis within 30 days after discharge?

Affordable Care Act

The nurse is providing care to several clients on a medical-surgical unit. For which client's plan of cate should the nurse include information regarding extended care?

An older adult client who fell at home and required a hip replacement

A nurse working for a home health agency is scheduled to evaluate a client with worsening heart failure to determine whether the client is a candidate for the new "Hospital at Home" program. Which statement accurately reflects an outcome for this program?

Clients in the "Hospital at Home" program have been found to require shorter lengths of stay than when admitted to the acute care setting.

A new nurse is considering getting a job in either an acute care setting or a home care setting. Which statement about these care settings is most accurate?

Clients play a large role in helping themselves in the home care setting.

The growth in home health care is largely attributed to which factor?

Early discharge of clients from the hospital setting

Based on the Patient Protection and Affordable Care Act (ACA), nurses are to assume an important new role in health care. Which is an example of this new role?

Collaborating with all agencies to provide for the client's home health needs

Which is the main focus of care for a school nurse?

Community care

A nurse has an older adult home care client who lives alone with no family nearby. On a recent visit, the nurse notices that his clothes are very loose, and he has difficulty letting the nurse leave when the visit is ending. After talking with him, the nurse learns that he has not been cooking for himself and he can't get to the grocery store easily. What service could the nurse suggest as an immediate response until a long-term plan can be formed?

Enroll the client in Meals on Wheels.

A hospitalized client with advanced metastatic lung cancer states, "I want to go home. I don't have much time left. I want to be with my family." Which type of care referral by the nurse is most appropriate?

Hospice

Which is the acute care setting for people who are too ill to care for themselves at home, are severely injured, or require surgery?

Hospitals

Which are trends in health care in the twenty-first century? (Select all that apply.)

Increased funding for genetic engineering research Growing number of retiring baby boomers Rising number of outpatient and ambulatory clinics

A nurse recommends palliative care for a client who is being discharged following a diagnosis of cancer. What is the chief focus of this type of care?

Relief from physical, mental, and spiritual distress

During a home visit to a client, the caregiver tells the nurse, "My spouse has been sick for so long. All this care takes so much out of me. I am physically and emotionally drained." Assessment reveals that the client's status is unchanged from previous visits. Basked on the caregiver's statement, the nurse will likely make a referral for which service?

Respite care

Which statement is true when comparing home care with acute care?

The nurse is the guest in the client's home.

A home health nurse is scheduled to make a visit to a client who was discharged from the hospital yesterday following an appendectomy. The nurse understands that the scope of practice for a home health nurse allows the nurse to perform which psychomotor tasks?

Wound care, medication administration, teaching, and ensuring a reasonably safe environment