Question 1

A nurse is trying to maximize the quality of life of her clients while reducing health care costs.Which of the following actions would most likely be completed by the nurse?&#10;A) Assisting in cast application for a client who was injured in a skateboard incident&#10;B) Irrigating the eyes of a client splashed with chemicals&#10;C) Restoring a normal cardiac rhythm following cardiopulmonary resuscitation of a client with a heart condition&#10;D) Teaching a high school boy about sexually transmitted infections and proper condom application

Accepted Answer

Education is primary health care prevention.A proactive investment in disease prevention and health promotion targeted at improving health behaviors and lifestyle has the potential to improve health status and reduce health care costs.Assisting in a cast application,irrigating a client's eyes,and restoring a normal cardiac rhythm are all tertiary prevention methods as a condition has already occurred and the nurse if focusing on restoring health.In order to maximize quality while reducing health care costs,the nurse should focus on primary prevention strategies.

Question 2

Which person is most likely to be uninsured?&#10;A) An 82-year-old woman with chronic medical problems&#10;B) A 2-year-old whose mother is on welfare&#10;C) A 50-year-old business man who works for a large corporation&#10;D) A 24-year-old man who works part-time at a small business

Accepted Answer

Young adults (ages 19 to 25 years)account for a disproportionately large share of the uninsured,largely due to their low incomes.The elderly person would be eligible for Medicare,and the 2-year-old is probably eligible for Medicaid.The man who works at the large corporation probably has health insurance,because most large businesses provide it.

Question 3

A Medicare recipient has elected to pay a monthly premium for Medicare that will cover expenses such as laboratory services and equipment.Which of the following best describes this part of Medicare?&#10;A) Part A&#10;B) Part B&#10;C) Part C&#10;D) Part D

Accepted Answer

Medicare Part B is a supplemental (voluntary)program; it provides coverage for services that are not covered by Part A,such as laboratory services,ambulance transportation,prostheses,equipment,and some supplies.Medicare Part A covers hospital care,home care,and skilled nursing care.Medicare Part C plans are coordinated care plans that include health maintenance organizations,private fee-for-service plans,and medical savings accounts.Medicare Part D provides prescription drug coverage.

Question 4

A client expresses concern that health care coverage based on capitation may have negative side effects.Which of the following would most likely be a consequence of capitation?&#10;A) Coercing clients to attend health promotion education classes&#10;B) Encouraging clients to seek care elsewhere&#10;C) Increasing the number of interventions to maximize payment&#10;D) Neglecting to order certain tests or treatment to minimize cost to the provider

Accepted Answer

In capitated arrangements,physicians and other practitioners are paid a set amount to provide care to a given client for a set period of time and amount of money.Thus,neglecting to order certain tests or treatment would be a way for the provider to maximize the amount of money received to provide care to members of this group.In a capitated arrangement,the provider would most likely not increase the number of interventions used or coerce clients to attend health promotion classes as both of these strategies would cost the provider more money,and the provider will be receiving a set amount of money to provide care for a given client for a set period of time.It is unlikely that the provider would encourage clients to seek care elsewhere,rather the provider would be consciencious about the number of tests and treatments that are ordered in order to try to contain costs.

Question 5

Which of the following criterion is now used for deciding the amount of the reimbursement before care is provided?&#10;A) A proportion of actual cost arbitrarily decided by the Medicare panel&#10;B) The federal budget constraints for the current fiscal year&#10;C) Hospital and health care provider feedback and political persuasion&#10;D) Prospective payment scale based on the medical diagnosis

Accepted Answer

As a result of rising health costs,Congress passed a law in 1983 that mandated an end to cost-plus reimbursement and instituted a prospective payment system (PPS)for inpatient hospital services to shift the cost incentives away from the providing of more care and toward more efficient services.The basis for prospective reimbursement is the 468 diagnosis-related groups (DRGs).There is not a Medicare panel that determines the actual cost of services.Payments are determined in advance based on DRGs and are not determined by the budget of the federal government.Hospital and health care provider feedback do not influence the prospective reimbursement,rather,the third-party payer establishes the amount of money that will be paid for the delivery of a particular service before offering the services to the client.

Question 6

Which of the following best explains how the government unintentionally encourages low-income persons to use emergency departments as their primary-care provider?&#10;A) A huge amount of paperwork is required when Medicaid clients go to a physician's office.&#10;B) Government regulations require Medicaid clients to use emergency departments when their primary health care provider is unavailable.&#10;C) Legally, emergency departments must see clients even if clients can't pay.&#10;D) Physicians' limited office hours make them unavailable during evenings and weekends.

Accepted Answer

People on Medicaid frequently have no primary-care provider and may not be able to pay for their care.Although physicians can choose clients based on their ability to pay,emergency departments are required by law to evaluate every client regardless of ability to pay.Emergency department copayments are modest and are frequently waived if the client is unable to pay.Thus,low out-of-pocket costs provide incentives for Medicaid clients and the uninsured to use emergency departments for primary-care services.Limited physician office hours over the weekend does make it difficult for low-income persons to access care through a primary care provider; however,this is not influenced by a government decision.The government does not require Medicaid clients to use the emergency department when their primary care provider is unavailable,rather the policies of the emergency department to see all clients regardless of ability to pay may inadvertently encourage them to use this service.The paperwork at a physician's office that needs to be completed by a Medicaid client is not any different than any other client receiving care at the office.

Question 7

Which of the following caused health care providers to begin to focus on individual infections and trauma in the 1900s in the United States?&#10;A) Education of health care providers moved into universities.&#10;B) People finally had enough money to pay for medical care.&#10;C) The improved outcomes of hospital care were recognized.&#10;D) Advances were made in sewage disposal, and water and milk quality.

Accepted Answer

Environmental conditions influencing health began to improve with major advances in water purity,sanitary sewage disposal,milk quality,and urban housing quality.The health problems of this era were no longer mass epidemics but individual acute infections or traumatic episodes.The education of health care providers did move into universities during this time period; however,this is not the reason why there was an increased focus on infections and trauma.Health care was paid for primarily by individuals during this time period so there was not an increase in the amount of money available to pay for health care.The outcomes of hospital care improved because of the advances that were being made in technology,not because health care providers were focusing more on infections and trauma.

Question 8

A nurse is discussing how health care rationing occurs in the United States.Which of the following would most likely be discussed as the criterion that is used to ration health care?&#10;A) Clinic operating hours&#10;B) Ability to pay for services&#10;C) Availability of local provider services&#10;D) Transportation availability

Accepted Answer

Because there are not enough health care services available to provide desired services to everyone,the focus has been on reducing costs by controlling the use of services.All of the factors listed affect health care access and therefore affect health care rationing (either directly or indirectly).The primary determinant,however,is the ability to pay for services.Without this ability,services are denied; therefore,those without insurance that is accepted by a provider or institution or who do not have the money to pay out of pocket are unable to obtain services.

Question 9

Of the four main factors that affect health,which is the least important?&#10;A) Environment&#10;B) Human biology&#10;C) Lifestyle choices&#10;D) Health care system

Accepted Answer

The four major factors that affect health are lifestyle,environment,human biology,and the health care system.However,the health care system (medical services)has the least effect on health.Of the four major factors that affect health - personal behavior (or lifestyle),environmental factors (including physical,social,and economic environments),human biology,and the health care system - medical services are said to have the least effect.Behavior (lifestyle)has been shown to have the greatest effect,but environment and biology account for the greatest effect on the development of all illnesses.

Question 10

Which of the following demographic factors is expected to have the greatest influence on national health care spending?&#10;A) The aging population&#10;B) Use of diagnosis-related groups to determine reimbursement&#10;C) Insurance reform&#10;D) An increasing number of people without health insurance

Accepted Answer

The aging population is expected to affect health services more than any other demographic factor.The majority of older adults rely on publicly funded programs.As the Baby Boom generation ages and retires,federal expenses for Social Security and health care will increase.The use of diagnosis-related groups to determine reimbursement started in 1983 and is not expected to have a great influence on national health care spending at this time.Insurance reform is not a demographic factor.Due to the Affordable Care Act,the number of people without health insurance is decreasing.

Question 11

A nurse is providing care to a child whose parents do not receive health insurance as an employee benefit and who do not have the financial resources to pay for health care out of pocket.Which of the following resources should the nurse recommend to the family?

A) A managed care organization
B) An emergency department
C) Medicaid
D) Medicare

Accepted Answer

The answer of A nurse is providing care to a...

Question 12

Which of the following accurately describes a challenge that will be faced by health care providers in the 21st century?&#10;A) Lack of available space to provide care for clients in hospitals&#10;B) Emergence of new and old communicable and infectious diseases&#10;C) New guidelines for chronic disease management&#10;D) Increased use of technology leading to a decreased need for health care workers

Accepted Answer

The answer of Which of the following accurately describes a...

Question 13

Which of the following services would be covered under Medicare Part A?&#10;A) Blood draw to assess PT/INR&#10;B) Physical therapy visit&#10;C) Stay in skilled nursing facility&#10;D) Transportation by an ambulance

Accepted Answer

The answer of Which of the following services would be...

Question 14

Which of the following groups pays the largest amount for health care in the United States today?&#10;A) Consumers&#10;B) Federal and state government&#10;C) Insurance companies and other third-party payers&#10;D) Hospitals and health care providers

Accepted Answer

The answer of Which of the following groups pays the...

Question 15

A pregnant teenager has approached a nurse asking about ways to improve the health outcomes for her and her unborn child.Which of the following statements would be most appropriate for the nurse to make?

A) "Don't drop out of school."
B) "Sign up for childbirth classes."
C) "Sign up for the WIC program."
D) "Take your prenatal vitamins daily."

Accepted Answer

The answer of A pregnant teenager has approached a nurse...

Question 16

Which of the following is most closely correlated with poor health?&#10;A) Age and gender (i.e., older males)&#10;B) Low socioeconomic status&#10;C) Minority race status&#10;D) High-risk lifestyle behaviors

Accepted Answer

The answer of Which of the following is most closely...

Question 17

Which of the following payment systems tries to keep clients healthy through education and health promotion,with the goal of reducing the need for professional health care intervention and therefore also lowering cost?

A) Managed care plan
B) Fee-for-service payment
C) Prospective reimbursement
D) Retrospective reimbursement

Accepted Answer

The answer of Which of the following payment systems tries...

Question 18

Which of the following must a nurse be knowledgeable about to make decisions regarding the most cost-effective way to allocate health care resources?&#10;A) Insurance resources&#10;B) Health care rationing&#10;C) Health economics&#10;D) Medical technology

Accepted Answer

The answer of Which of the following must a nurse...

Question 19

Which of the following terms describes when a nurse practitioner receives a set monthly payment to take care of a group of clients regardless of the services needed and provided?&#10;A) Capitation&#10;B) Fee for service&#10;C) Rationing&#10;D) Retrospective reimbursement

Accepted Answer

The answer of Which of the following terms describes when...

Question 20

Which of the following individuals would most likely experience a barrier when accessing health care?&#10;A) A 40-year-old female who speaks English&#10;B) A 25-year-old female with health insurance&#10;C) A 50-year-old male with hypertension&#10;D) A 30-year-old male who is unemployed

Accepted Answer

The answer of Which of the following individuals would most...

Question 21

In which of the following situations would the federal government provide money through tax relief for private enterprise?&#10;A) A business pays for part of health insurance premiums for its employees&#10;B) A business purchases gifts for its employees to award them for their service&#10;C) An employer provides health screenings and immunizations&#10;D) An employer requests reimbursement for employee transportation costs

Accepted Answer

The answer of In which of the following situations would...

Question 22

Which of the following are some major differences in health care today,as compared with the first half of the 20th century?&#10;A) Consumers are influenced by advertising for specific health care agents or procedures.&#10;B) The emphasis is on the continued expansion of health care facilities, especially acute care hospitals.&#10;C) Education and specialization of personnel have increased.&#10;D) The need to create new ways to pay for health care is a central focus.

Accepted Answer

The answer of Which of the following are some major...

Question 23

Which of the following best explains why clients who have Medicaid have poor health outcomes?&#10;A) Clients may have preexisting conditions not covered by insurance.&#10;B) Many physicians won't accept Medicaid clients.&#10;C) Medicaid won't pay for certain medical interventions.&#10;D) Medicaid recipients are noncompliant with their health care providers' recommendations.

Accepted Answer

The answer of Which of the following best explains why...

Question 24

A public health nurse is counseling a client who is trying to determine if a health maintenance organization (HMO)or preferred provider organization (PPO)will provide the better health care coverage.Which of the following best describes one main difference between these two types of coverage?

A) HMOs provide comprehensive care to members for a fixed fee.
B) PPOs designate providers that members can choose.
C) PPOs provide one model of care delivery.
D) HMOs provide financial incentives to encourage members to select HMO providers.

Accepted Answer

The answer of A public health nurse is counseling a...

Question 25

A nurse is implementing a primary prevention strategy focusing on economics within the community.Which of the following interventions is the nurse most likely completing?&#10;A) Applying for a grant to establish a daycare center to serve dependent older adult clients living with working families&#10;B) Persuading legislators to pass a bill offering health care financial aid to families at risk&#10;C) Screening cocaine addicts for financial assistance eligibility for drug treatment&#10;D) Referring clients with renal failure to apply for Medicare

Accepted Answer

The answer of A nurse is implementing a primary prevention...

Question 26

A nurse would like to help members of the community focus on receiving primary preventive health care services.Which of the following interventions should be implemented by the nurse?&#10;A) Publicize data on success of health promotion efforts, including cost savings.&#10;B) Lobby for decreased reimbursement for secondary and tertiary care services.&#10;C) Establish standards for appropriate screenings at specific intervals.&#10;D) Encourage members of the military service to engage in appropriate healthy lifestyle behaviors.

Accepted Answer

The answer of A nurse would like to help members...

Deck 8: Economic Influences