Deck 5: The Health Care Delivery System

Question 1

A system of providing and monitoring care where access,cost,and quality are controlled before or during delivery of services describes what kind of care?

A)managed
B)primary
C)secondary
D)tertiary

Answer 1

managed

Question 2

When a client is ill,the health care provider whom a client sees first is considered to be:

A)a general practitioner
B)an exclusive provider
C)a preferred provider
D)a primary care provider

Answer 2

a primary care provider

Question 3

The client is participating in a health care structure where members must use providers within the system to obtain full reimbursement,but may use other providers for lesser reimbursement.The nurse is aware that this type of system is considered to be:

A)an exclusive provider organization
B)a health maintenance organization
C)a preferred provider organization
D)a primary health care plan

Answer 3

a preferred provider organization

Question 4

The term health care delivery system refers to a:

A)method for providing services to meet the health-related needs of individuals
B)collaboration of provider organizations
C)conglomerate of commercial health care suppliers
D)single-payer system

Question 5

Which of these components are part of the secondary care system?

A)diagnosis and treatment services
B)health promotion practices
C)protection against specific illnesses
D)restorative and rehabilitative activities

Question 6

What term describes the entry into the health care system that occurs through a point designated by the health maintenance organization plan?

A)exclusive provider
B)preferred provider
C)primary health care plan
D)single point of entry

Question 7

Which of these terms describes a health care system where the government is the only entity to reimburse health care costs?

A)exclusive provider organization
B)primary care system
C)prospective payment system
D)single-payer system

Question 8

What is the term describing the client's point of entry into the health care system that includes assessment,diagnosis,treatment,coordination of care,education,preventive services,and surveillance?

A)exclusive provider
B)preferred provider
C)primary health care
D)single point of entry

Question 9

When a client participates in a prepaid health plan that provides primary health care services for a preset fee and that focuses on cost-effective treatment measures,this is considered to be:

A)an exclusive provider organization
B)a health maintenance organization
C)an independent practice
D)a preferred provider organization

Question 10

The nurse is a health care team member who is involved in the delivery of acute care to clients.Which of these settings would the nurse primarily be employed in?

A)clinics
B)hospitals
C)nursing homes
D)health care providers' offices

Question 11

Through the use of a traditional medical model,the U.S.health care system could BEST be described as focusing on:

A)emergent problems
B)health
C)illness
D)prevention

Question 12

The activities of voluntary agencies are funded by membership dues,individual contributions,and:

A)the local government
B)the state government
C)the federal government
D)corporate philanthropy

Question 13

What is the purpose of tertiary care?

A)to diagnose and treat symptoms of an illness
B)to promote wellness and prevent future illness
C)to provide client education on health advancement
D)to restore the individual to the state of health that existed prior to the development of an illness

Question 14

Which of these organizations is an example of a public agency?

A)American Medical Association
B)American Nurses Association
C)National Federation of LPNs
D)Veterans Administration

Question 15

Preset flat fees based on membership in the health maintenance organization,and not on services provided,are called:

A)capitated rates
B)fee-for-service
C)prospective payment
D)single-payer funds

Question 16

The nurse provides care in which the focus is on the entire person,including physiologic,psychological,social,and spiritual aspects.The nurse is aware that this is an example of:

A)holistic care
B)managed care
C)primary care
D)secondary care

Question 17

Which of these statements about the role of the nurse in the multidisciplinary health care team is TRUE?

A)Nurses function in independent,interdependent,and dependent roles.
B)Nurses are responsible for leading the team in most situations.
C)Nurses are responsible for the follow-through of team decisions.
D)Nurses function only under the direction of other team members.

Question 18

Which of these terms describes the payment arrangement under which recipients of care directly pay the provider for services received?

A)fee-for-service
B)managed care
C)primary care
D)prospective payment

Question 19

Promotion of wellness and prevention of illness is the focus of which level of care?

A)managed
B)primary
C)subacute
D)tertiary

Question 20

The physician participates in a health care plan that requires care be delivered by the providers who are in the plan,in order for clients to receive any reimbursement.This type of system is considered to be:

A)an exclusive provider organization
B)a health maintenance organization
C)a preferred provider organization
D)a primary health care plan

Question 21

Which of the following populations in the United States is MOST likely to be underinsured or uninsured?

A)children
B)middle-aged adults
C)self-employed individuals
D)persons with preexisting diagnoses

Question 22

In the future,home health services will continue to expand to meet the growing needs of which of these populations?

A)clients who are HIV-positive
B)clients who are rapidly discharged from the hospital
C)children with special needs
D)older adults

Question 23

Among health care providers,which group is currently held in greatest esteem?

A)physicians
B)nurses
C)dentists
D)physical therapists

Question 24

The nurse is caring for a client who has diabetes and heart disease.The existence of both these illnesses in the client is considered to be a:

A)comorbidity
B)preemptive process
C)progressive mortality
D)tertiary illness

Question 25

Populations that can create significant financial burdens on hospital emergency departments include those living at or below poverty level and:

A)illegal aliens
B)the homeless
C)individuals who are HIV-positive
D)children

Question 26

American health care consumers are becoming disillusioned with health care providers because of what factors?

A)greed and waste within the health care system
B)rising malpractice suits
C)increased length of hospital stays
D)increasing provider specialization

Question 27

Factors contributing to decreased hospital population include such things as earlier discharge,growth in availability of outpatient services,and:

A)expectations or demands of consumers
B)advances in technology
C)greater complexity of needs and severity of illness of hospitalized clients
D)growth in number of hospitals

Question 28

One of the newer developments in health care requires that nurses strongly advocate for:

A)the just and ethical distribution of resources
B)doing everything possible to prolong life
C)ensuring that health care services wanted or needed are available for all citizens
D)stronger sanctions against unlicensed health care personnel

Question 29

Which of these programs are MOST cost-efficient in terms of administration?

A)Medicaid and Medicare
B)managed care plans
C)private small business plans
D)hospital-based exclusive provider organizations

Question 30

The major factors increasing the cost of health care include an oversupply of specialized providers,a surplus of hospital beds,and:

A)competition among major health care providers
B)the passive role assumed by most consumers
C)availability of health care services
D)growing number of uninsured children

Question 31

Public health includes services such as prenatal care,immunizations,and:

A)primary care
B)discharge planning
C)preadmission interviews
D)environmental concerns

Question 32

The Agency for Health Care Policy and Research was established for what purpose?

A)to assess the need for a National Socialized Medicine Program and a means to initiate it
B)to establish standards for the usual treatment of high-volume and expensive disease conditions
C)to conduct research about equitable access to health care services
D)to study the long-term effects of the lack of preventive and maintenance health care in the indigent population

Question 33

What is the biggest obstacle to advanced practice RNs (APRNs)practice?

A)lack of prescriptive authority in most states
B)lack of awareness of what APRNs can offer
C)lack of reimbursement from federal agencies
D)lack of health care provider support to order diagnostic tests and procedures

Question 34

The Children's Health Insurance Program was created in 1997 for what purpose?

A)to assist immigrant and indigent families in obtaining Medicaid coverage for their children
B)to educate the public on the need for affordable insurance for children
C)to establish minimum guidelines for children's coverage
D)to provide health care to uninsured children whose families earn too little to purchase health insurance but too much to qualify for Medicaid

Question 35

Among the factors that influence health care are such things as cost,access,and:

A)management
B)location of services
C)number of persons served
D)number of local and state governmental services

Question 36

Medicare coverage may be available to individuals who are at least 65 years old or who are:

A)permanently disabled
B)medically indigent
C)diagnosed with at least two chronic diseases
D)eligible for nursing home care

Question 37

In today's health care system,when attempts are being made to provide universal access to services in a cost-effective manner,what may be sacrificed?

A)preparation of health care professionals
B)client advocacy
C)quality of care
D)defensive medical practice

Question 38

Nurses do not have legal recognition of the ability to prescribe medications because they lack:

A)medical practice
B)medical licensure
C)pharmaceutical directive
D)prescriptive authority

Question 39

As the number of severely ill clients in hospitals increases,nurses working in these settings will need to possess interpersonal competence,technical expertise,and:

A)specialized nursing skills
B)ability to be cross-trained
C)critical thinking skills
D)prescriptive authority

Question 40

Nurses who are providing community-based care focus on:

A)acute care
B)analyses of prevailing disease patterns in a community
C)community advocacy
D)prevention and primary care

Question 41

An LP/VN's scope of practice allows for assuming several nursing roles,including which of the following? (Select all that apply. )

A)expert
B)manager
C)case manager
D)liaison
E)caregiver
F)teacher

Question 42

The nurse is a member of the health care team providing secondary care to a client.Which of the following would be included in this type of care? (Select all that apply. )

A)treatment of a heart attack
B)monitoring client immunizations to see that they are current
C)medications to control high blood pressure
D)having a breast lesion surgically removed
E)medications to control high cholesterol levels
F)assisting a client to learn to walk again after amputation of a leg