Deck 2: The Health Care Delivery System

Question 1

When the nurse first meets the patient,it is important to establish a dialogue if possible; patient-centered care stresses that it is important for the nurse to recognize that

A) Patients usually want to rely on the nurse for patient care.
B) Patients usually want to keep their fears and concerns to themselves.
C) It is important to identify patient expectations.
D) Patients usually have insurance and do not worry about finances.

Answer 1

It is important to identify patient expectations.

Question 2

The nurse is applying for a position with a home care organization that specializes in spinal cord injury.In doing so,the nurse is applying for a position in _____care.

A) Secondary acute
B) Tertiary
C) Continuing
D) Restorative

Answer 2

Restorative

Question 3

In today's society,the nurse is facing more and different challenges.Central to some of these challenges is the concept of globalization,because it has led to

A) A more homogeneous mix of nursing staff.
B) Decreased poverty and increased diseases of affluence.
C) Decreased urbanization as populations shift to the suburbs.
D) Increased spread of communicable diseases.

Answer 3

Increased spread of communicable diseases.

Question 4

The nurse is serving on the hospital's Quality Improvement Committee.As the nursing representative,the nurse focuses quality improvement measures on

A) Outcomes unrelated to patient satisfaction.
B) Desired health outcomes.
C) Factors solely affecting inpatients.
D) Increasing patient-to-nurse ratios.

Question 5

The student nurse is reporting to her group in post-conference about her observational rotation in the intensive care unit.The student states that "it seems so much easier than floor nursing because everything is automated.There are machines that take vital signs and regulate IVs." The instructor's best response is to

A) Agree with the student's evaluation of ICU nursing.
B) Agree that IV pumps have made IV therapy totally safe.
C) Disagree, stressing the importance of taking vital signs themselves.
D) Disagree, stressing the importance of the nurse's judgment.

Question 6

The nurse is feeling overwhelmed by the constant changes that are part of nursing and the health care system in general.Understanding that changes are necessary,the nurse needs to be aware that

A) The nurse has no control over the changes, but needs to accept them.
B) Quality improvement depends on active participation of nurses.
C) Belonging to nursing organizations will help bring the right changes.
D) Active participation in nursing organizations will have no effect on change.

Question 7

The nurse is evaluating the Falls Program instituted on the medical unit to decrease the number of falls.The number of falls has decreased in the last month.The nurse realizes that

A) The program has been successful and can be terminated.
B) Policies for the program need to be developed or evaluated further.
C) The program evaluation is a nursing-sensitive outcome that can enhance safety.
D) The program results need to be reported to the QI Committee only.

Question 8

A major outcome of managed care is that managed care organizations such as hospitals

A) Assume financial risk, as well as provide care.
B) Focus more on individual illness.
C) Decrease discharge planning activities.
D) Have increased lengths of stay.

Question 9

The patient is to be discharged home from a tertiary care center later in the week; therefore,the nurse

A) Coordinates referral of patients to services provided by other disciplines.
B) Monitors the patient's progress through discharge.
C) Cares for patients after discharge.
D) Anticipates and identifies patient needs.

Question 10

Primary health care focus includes

A) Individual health screenings.
B) Community health promotion programs.
C) Development of health policies.
D) Disease prevention in communities.
E) Discharge planning for individual patients.

Question 11

The nurse is caring for a patient who is on Medicare.Because the patient is on Medicare,the nurse is aware that

A) The hospital will be paid for the full cost of the patient's hospitalization.
B) Capitation provides the hospital with a means of recovering variable charges.
C) Diagnosis-related groups (DRGs) provide a fixed reimbursement of cost.
D) Medicare will pay the national average for the patient's condition.

Question 12

The advent of diagnosis-related groups (DRGs)and capitation has brought about many changes in how health care is provided and paid for.Because of these changes,the nurse is aware that today's managed care system has

A) Insured full coverage of health care costs.
B) Assumed all of the financial risk involved.
C) Allowed providers to focus on illness care.
D) Caused providers to focus on illness prevention.

Question 13

Government-instituted programs designed to control health care costs include

A) Professional standards review organizations (PSROs).
B) Prospective payment systems (PPSs).
C) Diagnosis-related groups (DRGs).
D) "Never events."
E) Third-party payers.

Question 14

Which of the following,established by Congress in 1983,eliminated cost-based reimbursement for patients who received Medicare benefits?

A) Prospective payment system (PPS)
B) Professional standards review organizations (PSROs)
C) Utilization review (UR) committees
D) Capitation

Question 15

The setting of health care services that includes blood pressure and cancer screening is _____ care.

A) Secondary acute
B) Preventive
C) Tertiary
D) Restorative

Question 16

Nurses who work in a skilled nursing facility need nursing expertise in which of the following areas?

A) Gerontological nursing
B) IV fluid management
C) Ventilator management
D) Depression/violent behavior management
E) Wound care management

Question 17

The nurse is trying to determine how well a certain health plan compares with other health plans.To gather this type of information,the nurse utilizes the

A) Healthcare Effectiveness Data and Information Set (HEDIS).
B) Centers for Medicaid and Medicare Services (CMS) standards.
C) Pew Health Professions Commission Report.
D) American Nurses Credentialing Center (ANCC) Magnet Recognition Program.

Question 18

Health promotion programs focus on

A) Reducing the cost of health care.
B) Controlling risk factors for disease.
C) Immunizations.
D) Occupational health programs.

Question 19

The nurse is caring for a patient who has a diagnosis that she is not familiar with.The nurse uses reference materials and does a literature search to better understand the diagnosis.The nurse then utilizes this knowledge,along with the nurse's experience and patient preferences,to develop a plan of care.This is an example of the nurse using _____ to provide care for her patient.

A) Evidence-based practice
B) Research-based practice
C) Applied quality improvement
D) Nursing informatics

Question 20

Care designed to prevent further progression of a disease is termed

A) Primary prevention.
B) Secondary prevention.
C) Tertiary prevention.
D) Health promotion.