Deck 3: Health Policy and the Delivery System

Question 1

Health insurance plans, offered under the market place exchange program, must include which of the following features?

A)Low deductibles and low out-of-pocket costs
B)Birth control coverage
C)Dental coverage
D)Uniform monthly premiums for all persons

Answer 1

Birth control coverage

Question 2

Which of the following persons would be eligible to participate in the market place exchange program?

A)Individual covered by the Children's Health Insurance Program (CHIP)
B)An individual looking to shop for a better plan than what his employer provides
C)A newly unemployed individual who has lost his health care insurance
D)Anyone may participate in the Market Place Exchange Program

Answer 2

A newly unemployed individual who has lost his health care insurance

Question 3

An individual states that his family has insurance, but that paying for routine medical costs is very expensive because most routine services are paid for out of pocket.Which type of insurance plan does this individual most likely have?

A)High deductible health insurance plan (HDHP)
B)Point-of-service plan (POS)
C)Health maintenance organization (HMO)
D)Preferred provider organization (PPO)

Answer 3

High deductible health insurance plan (HDHP)

Question 4

The Health of the Nation is an annual report prepared by the US Department of Health and Human Services.Which of the following statements would accurately represent findings for the 2014 report?

A)Cancer is the number one cause of deaths, followed by heart disease.
B)Life expectancy has increased for women and remained static for men.
C)Suicide and drug-related deaths have decreased secondary to education programs.
D)Smoking for persons 18 years and over has dropped.

Question 5

The person known as the father of British and American public health is

A)Lillian Wald.
B)Edwin Chadwick.
C)Lemuel Shattuck.
D)Paul Ehrlich.

Question 6

Which form of managed care restricts providers to caring for individuals who are members of their organization?

A)Fee-for-service plan
B)Health maintenance organization (HMO)
C)Preferred provider organization (PPO)
D)Independent practice association (IPA)

Question 7

A community health nurse most effectively preserves the health of a person with tuberculosis (TB) and the community by

A)administering and reading the purified protein derivative (PPD) of all close contacts.
B)providing direct observed therapy (DOT) for the individual with TB.
C)isolating the person because it is likely drug resistant.
D)telling the person to wear a mask when leaving the home.

Question 8

Considering the provider and care recipient perspective, which of the following is the most autonomous form of insurance?

A)Fee-for-service plan
B)Health maintenance organization (HMO)
C)Preferred provider organization (PPO)
D)Independent practice association (IPA)

Question 9

A Medicare care recipient reports to the home care nurse that he is receiving care through an accountable care organization (ACO).Which of the following considerations should be made when delivering care to this individual?

A)The individual must see a primary care provider before being referred to a specialist.
B)The focus of care is prevention and management of individuals with chronic disease.
C)The individual has paid a membership fee to be part of this organization.
D)The focus of care is to conserve money in a health savings account.

Question 10

Two working adults do not have access to health insurance for their family via their respective employers and they do not meet the financial criteria for Medicaid.For which of the following federal programs may the children in this family be eligible?

A)Medicare
B)Civilian Health Medical Program for Uniformed Services (CHAMPUS)
C)State Children's Health Insurance Program (SCHIP)
D)Veteran's Administration Program

Question 11

Which nurse is at risk of making a medical error?

A)A nurse working overtime
B)A nurse who works in a hospital that advocates multidisciplinary care
C)A nurse caring for four care recipients during the shift
D)A nurse who attends regular continuing education programs

Question 12

Which of the following is a health plan consisting of hospitals and physician providers providing health care services to plan members (usually at discounted rates) in return for expedited claims payment?

A)Health maintenance organization (HMO)
B)Health savings account (HSA)
C)Preferred provider organization (PPO)
D)Independent practice association (IPA)

Question 13

Which of the following statements is correct concerning the Affordable Care Act (ACA), signed into law in March 2010?

A)Penalties are imposed for persons who fail to acquire health insurance
B)The ACA was challenged in 2012, requiring Supreme Court mandated revisions
C)It passed secondary to bipartisan support
D)All of the above statements are correct.

Question 14

Healthy People 2020 would be most concerned with which of the following healthcare issues?

A)Promoting reform regarding deaths from gun violence
B)Evaluating the merits of single-payer healthcare
C)Treating vulnerable populations
D)Eliminating healthcare fraud which consumes available funds

Question 15

A community planning committee is working on the development of a community nursing center.Which of the following essential components should be included in this center?

A)Physician as medical director
B)Interdisciplinary staff
C)Nurse as chief manager
D)Partnership with an academic institution

Question 16

Which of the following individuals is statistically the most likely to have a child who will succumb to a cause of infant mortality?

A)A 30-year-old teacher who insists on delivering her baby at home, with a midwife
B)A 17-year-old African American with credits toward her GED and in good health
C)An Asian woman who is having a C-section due to small pelvis
D)A 26-year-old accountant who quit smoking 18 months ago when she moved to NY

Question 17

Which addition to a community best demonstrates the concept of the Healthy People 2020 report?

A)New cardiothoracic intensive care unit at a major hospital
B)New rehabilitation center
C)New recreational health center
D)New children's hospital

Question 18

Which of the following statements is correct concerning Medicare Advantage plans?

A)They are plans which can be purchased in addition to traditional Medicare for greater coverage.
B)They are a substitute for the traditional Medicare program.
C)They are funded under the Affordable Care Act to improve availability of healthcare insurance.
D)They are available to persons who would not otherwise qualify for Medicare.

Question 19

Which could result in a change in a nurse practitioner's practice?

A)Holding a master's degree or higher
B)Moving to another state when she gets married
C)Caring for Medicare care recipients
D)Changing to another office within the same practice

Question 20

Which health care provider represents a primary care provider?

A)Psychiatric advanced practice nurse
B)Clinical nurse specialist
C)Pediatric nurse practitioner
D)Acute care nurse practitioner

Question 21

Which of the following statements about the financing of health care in the United States is accurate? (Select all that apply.)

A)Employee-sponsored health insurance premiums experienced minimal increases from 2001 to 2011.
B)State tax dollars must fund at least 50% of a state's Medicaid cost.
C)The largest percentage of health care dollars is spent on hospital care.
D)Most workers who have an employer-sponsored health insurance plan are enrolled in preferred provider organizations (PPOs).

Question 22

Adoption of a Canadian-style health care system in the United States has the potential to

A)decrease waiting times for tests and procedures.
B)create further health disparities.
C)increase the number of HMOs.
D)increase the amount of funding available for health care.

Question 23

A pregnant woman with two toddlers living at less than 135% of the federal poverty level would be eligible for

A)Medicare Part A.
B)Medicare Part B.
C)Medicaid.
D)State Children's Health Insurance Program (SCHIP).

Question 24

A community health nurse is presenting information about the current health of the nation to a local political action group in 2011.Which of the following information would be included in this presentation? (Select all that apply.)

A)Funding of public health programs has improved the health of the nation.
B)Provision of health care has improved the health of the nation.
C)Advances in technology have improved the health of the nation.
D)Consumer education has improved the health of the nation.

Question 25

Which person is at highest risk for being uninsured?

A)68-year-old retired mailman
B)48-year-old on renal dialysis
C)2-year-old whose parents work but do not have benefits through their employers
D)27-year-old who attends college and works part-time in a small pizza parlor

Question 26

The country with the highest life expectancy for women in 2011 was

A)France.
B)Germany.
C)Sweden.
D)the United States.

Question 27

The country with the lowest infant mortality rate in 2011 was

A)Canada.
B)Mexico.
C)Sweden.
D)the United States.

Question 28

Which of the following would be considered part of a vulnerable population? (Select all that apply.)

A)Deaf man
B)Cocaine-addicted teenage girl
C)Handicapped child
D)College graduate

Question 29

Which is a violation of the Health Insurance Portability and Accountability Act of 1996?

A)Nurse reporting a case of TB to the health department
B)Nurse reporting a case of child abuse to the Department of Human Services
C)Nurse discussing the person's case with his or her physician
D)Nurse discussing the person's case with his or her school nurse

Question 30

A nurse discussing the care of a person on the surgical unit following gastric bypass surgery with a friend is in violation of the

A)Patient Self-Determination Act.
B)Health Insurance Portability and Accountability Act of 1996.
C)Americans with Disabilities Act.
D)Civil Rights Act.

Question 31

Which nurse is functioning as a care manager?

A)A nurse working with a family to coordinate care for a child with multiple previous hospital admissions due to exacerbation of asthma
B)A nurse providing asthma education in an office setting to a child with moderate, persistent asthma
C)A nurse administering the appropriate anti-inflammatory medication to a child hospitalized for exacerbation of asthma
D)Nurse making a home visit to perform a respiratory assessment on a child discharged from the hospital following an admission for an asthma exacerbation

Question 32

A nurse complies with the Patient Self-Determination Act when asking

A)a person upon admission to the hospital if he or she has an advanced directive.
B)the family in the recovery room whether the care recipient has an advanced directive.
C)a person being discharged from the hospital if he or she has an advance directive.
D)the family about an advanced directive after the person has been intubated.

Question 33

A system used to evaluate the necessity, appropriateness, and efficiency of the use of the health care system, the purpose of which is to lower costs by discouraging unnecessary treatments, is known as

A)managed care.
B)gate keeping.
C)utilization review.
D)Capitation.