Deck 3: The Health Care Delivery System

Question 1

A retired high school teacher has been admitted to the hospital with complications of diabetes.To ensure the patient is discharged home with the right care,at the right time,and without duplication,which health care reform system was developed?

A) The Joint Commission
B) National Priorities Partnership
C) Accountable Care Organization
D) Managed Care

Answer 1

Accountable Care Organization

Question 2

Which patient is most in need of discharge planning by the nurse?

A) A 29-year-old mother with strong family support who has a healthy newborn
B) A 59-year-old patient with an active lifestyle who has had an appendectomy
C) A 64-year-old patient with heart failure who has a limited income
D) A 56-year-old patient with a supporting spouse who has had a hysterectomy

Answer 2

A 64-year-old patient with heart failure who has a limited income

Question 3

A patient who needs nursing and rehabilitation after a stroke would benefit most by receiving care at which center?

A) Primary care center
B) Restorative care center
C) Assisted living center
D) Respite center

Answer 3

Restorative care center

Question 4

A nurse is asked the most frequently cited reason for death in the world.How should the nurse reply?

A) Technological advances
B) Old age
C) Cancer
D) Poverty

Question 5

A patient states that he or she cannot afford health care insurance for the family because of a low income.What is the best form of insurance available for this patient?

A) Medicaid
B) Medicare
C) Private insurance
D) A managed care organization

Question 6

A patient who experienced a stroke 4 days ago has been discharged from the hospital and will be undergoing outpatient rehabilitation.How should the nurse prepare the patient for this level of care?

A) The patient will be admitted to the rehabilitative unit of the hospital.
B) The patient will have scheduled appointment times for therapy.
C) The patient will have home visits from all members of the multidisciplinary team.
D) The patient will be at home for all of the treatments ordered by the primary health care provider.

Question 7

A 74-year-old patient was admitted to the hospital with diabetic ketoacidosis.How will the hospital be reimbursed by Medicare?

A) Based upon the diagnostic-related group
B) Based upon the cost of care
C) Based upon the actual length of stay
D) Based upon the number of medications

Question 8

Which patient is in the most expensive place to deliver care per day?

A) A patient in a rehabilitation unit
B) A patient in a long-term care facility
C) A patient in an intensive care unit
D) A patient in a private hospital room

Question 9

What is the most appropriate time for the nurse to begin discharge planning with a patient?

A) The day of patient discharge from the health care agency
B) As soon as the insurance provider has been identified
C) When the health care provider writes the discharge order
D) When the patient is admitted to the health care agency

Question 10

A 17-year-old patient was seriously injured in a motor vehicle accident and has been transferred from an acute care hospital to a rehabilitation/restorative facility.Which action should the nurse take to ensure the best outcome for this patient?

A) Make sure that the patient gets enough rest.
B) Push the patient beyond his or her limits.
C) Request that nobody visit for the first few days.
D) Involve the family early in the rehabilitation process.

Question 11

A nurse is teaching the staff about the Prospective Payment System (PPS).Which information should the nurse include in the teaching session?

A) PPS establishes cost-based reimbursement for health care.
B) PPS provides reimbursement for every service the patient receives.
C) PPS establishes reimbursement rates based upon diagnosis-related groups (DRGs).
D) PPS provides money to the patient for health promotion use.

Question 12

A college student with severe depression was recently admitted to the psychiatric ward of a local hospital.The family is concerned about the student finishing the college term.Which is the best information for the nurse to give regarding how long psychiatric patients are typically hospitalized?

A) A relatively short inpatient stay is followed by outpatient treatment.
B) A long inpatient hospitalization is normal for the majority of patients.
C) Patients with emotional or behavioral problems generally are not hospitalized.
D) Most are automatically placed in a long-term care facility.

Question 13

A nurse is teaching the importance of breast self-examination to a group of 20-year-old women.The nurse is promoting which type of care?

A) Primary
B) Secondary
C) Tertiary
D) Restorative

Question 14

A nurse admits an older adult patient who states that he or she has no living relatives and only two close friends.Upon admission to the hospital,which action should the nurse initiate first?

A) Implement a process of payment.
B) Implement a discharge plan.
C) Implement a visit with the family.
D) Implement a resource utilization group.

Question 15

A patient tells the nurse that he or she does not understand the purpose of capitation.What is the nurse's best response?

A) To provide high-quality care at the highest cost to the hospital, not the patient
B) To provide the least expensive care for patients regardless of outcomes
C) To build a payment plan that includes the best standards of care at the lowest cost
D) To ensure that all patients receive the same care for the same cost in all hospitals

Question 16

A grocery store clerk does not have a family health care provider.The clerk has had a sore throat for the past week and recently began running a fever.The clerk goes to the local community hospital's emergency room for treatment.Which level of care did the clerk use?

A) Continuing care
B) Restorative care
C) Primary care
D) Tertiary care

Question 17

A nurse is teaching the staff about managed care.Which information should the nurse include?

A) Managed care focuses on long-term care services for skilled nursing.
B) Managed care focuses on hospital admissions and illnesses for a group of people.
C) Managed care focuses on control over primary health services for a defined population.
D) Managed care focuses on decreased access to care while increasing costs.

Question 18

A small business owner has consulted with an occupational health nurse regarding health promotion activities for the employees.The registered nurse explores the possibility of providing an area outside the new office complex where employees can walk during their breaks.Which level of care did the nurse use?

A) Continuing care
B) Restorative care
C) Primary care
D) Tertiary care

Question 19

A registered nurse working as a school nurse for a small poor rural school district has noticed an increase in children arriving at school without having eaten breakfast.The nurse has discussed this issue with the school principal and is working on a proposal to ask the school district to explore a school breakfast program.Which level of care did the nurse use?

A) Primary care
B) Continuing care
C) Restorative care
D) Tertiary care

Question 20

A single mother with three children uses the public health department services in the county to immunize her children.Which level of health care did the mother use?

A) Continuing care
B) Preventative care
C) Secondary acute care
D) Restorative care

Question 21

Which patient is most suitable for admission into hospice?

A) A 63-year-old man with a fractured femur
B) A 45-year-old woman with terminal end-stage renal failure
C) A 14-year-old patient with leukemia that is in remission
D) A 78-year-old patient with dementia that wanders

Question 22

Which other term can the nurse use to describe the Omnibus Budget Reconciliation Act of 1987?

A) Medicaid Act
B) Nursing Home Reform Act
C) Diagnostic Related Group Act
D) Magnet Recognition Act

Question 23

A new registered nurse who recently began working in a nursing center has been asked to complete a Resident Assessment Instrument (RAI)on a newly admitted resident.What is the primary purpose of this instrument?

A) To provide a database to better understand the health care needs of this population
B) To provide the nursing staff with an overall physical assessment of the resident
C) To provide statistical evidence to support a universal health care policy
D) To provide medications for the residents to take on a daily basis

Question 24

A registered nurse working in a restorative care setting will focus on which areas? (Select all that apply.)

A) Providing extensive supportive care
B) Providing one-on-one care to patients
C) Promoting patient self-care
D) Promoting independence
E) Promoting dying at home

Question 25

An 81-year-old widow with mild dementia has self-care capabilities.The widow recently moved in with her daughter,a 46-year-old working mother with three children.In considering how to have care for her mother when she is working,what is the most appropriate option the nurse should suggest?

A) A rehabilitation center
B) A nursing center
C) An adult day care center
D) A hospice center

Question 26

A registered nurse has been working for an oncology unit for the past year and has a passion for caring for oncology patients undergoing chemotherapy.Whose responsibility is it for the nurse to become competent in administering chemotherapy?

A) The hospital where the nurse is employed
B) The charge nurse
C) The nurse herself or himself
D) The oncologist who admits patients to the unit

Question 27

A nurse wants to practice using the Institute of Medicine Competencies.Which competencies should the nurse use? (Select all that apply.)

A) Working in interdisciplinary teams
B) Using informatics
C) Providing physical comfort
D) Offering access to care
E) Preventing catheter-associated urinary tract infections

Question 28

A 78-year-old widow needs assistance with medications,housekeeping,and laundry,and would like to maintain independence.Which is the best option for the nurse to suggest?

A) Assisted living
B) Respite care
C) Nursing center
D) Rehabilitation center