Deck 23: Economic and Legal Issues

Question 1

The wife of an older man who has diabetes mellitus brings him to primary care.He has severe bilateral infections forming black rings around each ankle.He tells the nurse it is caused by tight shoes.Which intervention should the nurse implement first to investigate this individual's health care regimen?

A) Examine his health insurance coverage.
B) Question the man without the wife present.
C) Consult with social services about neglect.
D) Analyze his glycosylated hemoglobin level.

Answer 1

Analyze his glycosylated hemoglobin level.

Question 2

An older woman is resisting her son's help to make her money last longer.He wants to have her declared incapacitated so he can manage her finances.Which nursing assessment can be used by the court to declare incapacitation?

A) Prepares very few meals and avoids cleaning the house.
B) Ambulates around her local community without difficulty.
C) Balances her checkbook weekly and pays her bills on time.
D) Resists medical advice to remove a stage I malignant tumor.

Answer 2

Resists medical advice to remove a stage I malignant tumor.

Question 3

An older woman is brain dead,and the attorney-in-fact or surrogate named in her DPA is opposed to organ donation; the law in the state allows a surrogate with a DPA to make end-of-life decisions.Although she failed to document it,her family states that she wanted to donate her organs.Given the law about a DPA,what does the nurse expect the surrogate to do?

A) Deny consent.
B) Provide consent.
C) Refuse to decide.
D) Get a second opinion.

Answer 3

Provide consent.

Question 4

The nurse understands which of the following indicator(s)describe(s)the profile of an elder abuser?

A) Does not have a history of abuse.
B) Has mental health problems.
C) Has substance abuse problems.
D) Is stressed with the caregiving role.

Question 5

Which of the following statements describes one of the standards of case management during hospitalization?

A) Begin discharge planning on the first day of hospitalization.
B) Keep an older adult in the hospital as long as necessary.
C) Accept the hospital discharge planner's (HDP) proposal for discharge.
D) Assist hospital personnel to focus on the admission complaint.

Question 6

Managed care systems are most effective for an older adult who does which of the following?

A) Avoids using the system until it is really needed in an emergency.
B) Avoids seeing generalists and seeks health care only from specialists.
C) Uses high-tech treatments to reduce expenses over the long term.
D) Seeks regular primary care and preventive strategies to maintain health.

Question 7

The older adult wants to appoint an attorney-in-fact with DPA for a specific period around a forthcoming surgery.Which should the nurse implement?

A) Help the patient find a qualified attorney.
B) Explain the legal rights and responsibilities of an attorney-in-fact with a DPA.
C) Suggest using a guardian for the surgical period.
D) Offer to act as the patient's guardian during surgery.

Question 8

Which of the following statements is true about health care costs for older adults in the United States?

A) Older adults become eligible for full Social Security benefits upon reaching the age of 65 years.
B) Medicare, Part A, covers physician visits, whereas Part B covers prescription drugs.
C) Health maintenance organizations (HMOs) can obtain an exemption from Medicare's per capita spending limit.
D) Older adults pay a fixed premium and low out-of-pocket costs in a preferred provider organization (PPO).

Question 9

When an older adult is considering long-term care insurance (LTCI),which is an important consideration?

A) Carefully scrutinize all exclusions before enrolling.
B) Apply at the oldest age possible for lower rates.
C) Avoid purchasing LTCI through a group policy.
D) Delay application until the government sponsors LTCI.

Question 10

Which is the fundamental difference between Medicare Part A and Medicare Part B?

A) Hospice care
B) Health care setting
C) Home care services
D) Invasive procedures

Question 11

The nurse distrusts the male caregiver,the son of an older woman,and collaborates with social services about potential resources for abused older adults.Which characteristics of the caregiver does the nurse report to social services as indicators of potential elder abuse?

A) Collects unemployment benefits.
B) Finds fault with any nursing care.
C) Takes frequent breaks for smoking.
D) Lives in the same house as his mother.
E) Makes demands on assistive personnel.
F)Sits at his mother's bedside for hours daily.

Question 12

Which of the following statements is true about conservators?

A) A conservatorship entails control over property, whereas a guardianship entails control over the person.
B) The most legally restricting way individuals and property can be handled are through conservatorships and guardianships.
C) Conservators cannot be members of the conservatee's (patient's) family.
D) Because a conservatorship is the least restrictive alternative, a court hearing is not required.

Question 13

Which of the following statements is true about case management and care management for older adults?

A) A case manager works for a health care system to save time and money.
B) Care managers are usually paid from public agencies such as the Area Agency on Aging (AAA).
C) One nurse can only perform care management.
D) The Outcomes-Based Quality Improvement system is designed to evaluate the expected benefit of a procedure.

Question 14

The nurse understands which of the following indicator(s)describe(s)the profile of an abused older adult?

A) Resides in safe housing.
B) Is from a lower socioeducational level.
C) Is a woman who lives with an abuser and is socially isolated.
D) Has nonwhite ethnicity.

Question 15

A health care provider asks the nurse about an older man's durable power of attorney (DPA)because consent is needed for a medically necessary invasive procedure.The patient has end-stage disease,is intubated,and is on mechanical ventilation.Which steps should the nurse implement?

A) Refer to the patient's advance directive for a name.
B) Assist with obtaining informed consent from the patient.
C) Use the oral trail-making test to measure cognitive function.
D) Apply the Confusion Assessment Method for critical care.