Deck 1: The Health Care System

Question 1

A 76-year-old man,who is hospitalized for treatment after a stroke,asks the nurse how long he can expect Medicare to cover his treatment.The nurse's most informative response is:

A) "Your Part B will cover your hospital care as long as is necessary."
B) "Your health care provider will determine how long your Medicare coverage will be in effect."
C) "You are allowed 50 days of inpatient care annually."
D) "You can receive skilled care for up to 100 days."

Answer 1

"You can receive skilled care for up to 100 days."

Question 2

The nurse clarifies to the patient who is applying for Medicaid that the receipt of benefits requires:

A) Following a supervised health maintenance plan
B) Enrolling in the Medicare-Preferred Drug Plan
C) Qualifying for the food stamp program
D) Having an annual income of less than $10,000

Answer 2

Enrolling in the Medicare-Preferred Drug Plan

Question 3

Which is true concerning proprietary agencies?

A) They are organized to be nonprofit operations.
B) They are organized to make a profit on their operation.
C) Any profit they make is immediately used to purchase better equipment and services.
D) They must participate in Medicare.

Answer 3

They are organized to make a profit on their operation.

Question 4

Which patient would the nurse recognize as eligible for a referral to Medicaid?

A) Military automobile mechanic with severe asthma
B) Pregnant unmarried young woman employed at a discount retail store for 3 years
C) College student on scholarship who works part-time at the college library and who needs medication for arthritis
D) Unemployed young mother on welfare who needs diabetic medication for one of her children

Question 5

An 89-year-old man,who was recently discharged from a rehabilitation hospital because of an inability to concentrate and frequent memory lapses,cannot be left alone while his family works.What options can the discharge planning team suggest that will satisfy safety concerns and give the greatest quality of life to the patient?

A) Placement in a day care center from 8 AM to 5 PM daily
B) Placement in a long-term psychiatric facility
C) Placement in a high-security nursing home
D) Admission to a general hospital for evaluation

Question 6

A nurse could best refer an unemployed 42-year-old patient with renal failure who has lost his job-related private insurance to which health care plan for his medical care?

A) Medicare
B) Medicaid
C) Public health facility
D) Community-based outpatient clinic

Question 7

The nurse clarifies the difference between a health maintenance organization (HMO)and a fee-for-service plan by pointing out that an HMO:

A) Requires a set fee from each client.
B) Allows clients to select their own health care provider.
C) Permits admission to any inpatient facility.
D) Offers limited referral options.
E) Provides both inpatient and outpatient care.

Question 8

A resident in a long-term care facility has difficulty swallowing and frequently chokes on food and liquids.Because of the threat of aspiration,the nurse initiates a referral for a swallowing evaluation to a:

A) Physician who specializes in throat disorders
B) Dietitian
C) Nutritionist
D) Speech therapist

Question 9

The Balanced Budget Act of 1997 was the cause of closures of many proprietary home health care agencies because the Act:

A) Specified that all care be given by registered nurses (RNs).
B) Listed specific diagnoses that could qualify a patient for home health care.
C) Limited the amount of money that could be spent on a patient.
D) Increased the criteria for patient eligibility for home care.

Question 10

A voluntary health care agency is one that:

A) Is supported by tax dollars.
B) Is governed by boards made up of community members.
C) Receives no fee for its services.
D) Uses volunteers as health care providers.

Question 11

A 42-year-old patient admitted yesterday with a diagnosis-related group (DRG)diagnosis of abdominal pain of an unknown cause is being discharged this afternoon because all diagnostic tests have been negative.This scenario is an example of:

A) Effective laboratory response
B) Medicare guidelines limiting hospital stay
C) Cost containment related to a DRG diagnosis
D) Patient who should not have been admitted in the first place

Question 12

A 66-year-old hospitalized patient is anxious about how the physician will be paid now that he is on Medicare-Parts A and B,instead of his previous privately funded insurance plan.The nurse explains that the physician will be paid by:

A) Previous privately funded insurance plan
B) Medicare Part A
C) Medicare Part B
D) Patient or patient's family

Question 13

The nurse clarifies that health care benefits supported by both federal and state funding are exemplified in:

A) Cost-containment prospective funding
B) Department of Health and Human Services (DHHS) Social Security benefits for dentures
C) Centers for Disease Control and Prevention (CDC) surveillance of persons at risk for acquired immunodeficiency syndrome (AIDS)
D) Medicaid provision for skilled care in the home

Question 14

In discussing the discharge to a transitional subacute facility with a 72-year-old patient with diabetes who has had both legs amputated,the nurse informs the patient that his stay in the new facility will be limited to:

A) 25 days
B) 50 days
C) 75 days
D) Is totally unlimited

Question 15

A 2003 report from the Institute of Medicine (IOM),"Health Professions Education: A Bridge to Quality," outlined:

A) Specific software technology to increase efficiency in health care
B) Evaluation tool to evaluate the quality of health care
C) Recommendations for curriculum changes in professional health care schools
D) Five core competencies for health care professionals

Question 16

The nurse explains that skilled nursing facilities are mandated to staff their facility with:

A) Licensed health professionals around the clock
B) RN in charge on each shift
C) RNs to supervise the patient care given by aides
D) Only RNs to provide complex care

Question 17

The person who is considered the forerunner of modern public health nursing in the United States is:

A) Vincent DePaul
B) William Rathbone
C) Florence Nightingale
D) Lillian Wald

Question 18

The nurse assessing a 65-year-old patient who is scheduled for outpatient surgery for the removal of cataracts in 10 days will stress the need to:

A) Have adequate insurance
B) Provide adequate postoperative care at home
C) Acquire specialized glasses
D) Preserve and protect his vision

Question 19

The purpose of a long-term care facility is to:

A) Rehabilitate patients to their former level of functioning.
B) Restore patients to their optimal level of independence.
C) Offer care to patients who do not need hospitalization but cannot care for themselves.
D) Exclusively care for patients with dementia.

Question 20

A 50-year-old woman with terminal lung cancer with extensive metastasis is requesting a hospice transfer.The requirements for this transfer include which criteria?

A) Patient requests and agrees to the guidelines of hospice care without requiring a physician's order.
B) Physician confirms that the patient has 6 months or less of life remaining and has provided a written order for hospice care.
C) Proof confirms that the family can no longer care for the patient at home.
D) Patient's specific diagnosis is included on a list of accepted diseases that qualifies the patient for hospice care.

Question 21

The nurse explains that the mission of the Public Health Service (PHS)is to:(select all that applay)

A) Ensure safety of foods and cosmetics.
B) Provide access to health care services for low-income individuals.
C) Support medical research.
D) Support substance abuse prevention and treatment.
E) Monitor and prevent disease outbreaks.

Question 22

The DHHS is administered by:

A) PHS
B) Administration for Children and Families
C) Administration on Aging
D) American Medical Association
E) Centers for Medicare and Medicaid

Question 23

The nurse assures the parents of a newborn with a congenital heart defect that the home care for their child is eased and supported by:

A) Availability of smaller and more compact equipment
B) Specialized DRGs for home care of children
C) Medicaid-funded home care services
D) Home care services funded by private insurance
E) Grants and stipends from various drug manufacturers

Question 24

The nurse explains that physicians prefer to use e-prescription systems to:

A) Process drug request more efficiently.
B) Prevent drug duplications.
C) Use less expensive drugs.
D) Identify contraindications for a drug.
E) Label both the generic and trade names.

Question 25

The nurse clarifies that the insurance plan that pays the physician in advance each month for each enrolled patient,whether or not the patient is treated by the physician,is a strategy known as ____________________.

Question 26

The nurse outlines the benefits of using a home health aide for the ability to assist a home-bound patient with:

A) Bathing
B) Doing laundry
C) Shopping for groceries
D) Administering medications
E) Ambulating

Question 27

The nurse explains that the Medicare Prescription Drug Plan will:

A) Be included in Medicare, Part A.
B) Charge a $250 deductible.
C) Pay approximately 25% of prescription drug expenses.
D) Cover only prescriptions written by a medical physician.
E) Reimburse 95% of out-of-pocket expenses over $3600.

Question 28

When the patient inquires about eligibility for home health care,the nurse states that the criteria for skilled home health care are:

A) Annual income less than $20,000
B) Need for physical or speech therapy
C) Nonavailability of transportation
D) Must be homebound
E) Need for wound dressing changes