Deck 6: Health Care Delivery Systems

Question 1

A client asks the nurse to explain the difference between an HMO and a PPO.What should the nurse include when responding to the client?

A)"You'll have good health care benefits,so don't worry."
B)"Both the HMO and PPO are covered by your employer,so it's really not your concern."
C)"Your PPO offered you a choice in your health care provider as well as services.Now,you will choose a primary care provider who will evaluate your health and will coordinate all of your care."
D)"You really should be happy about the HMO.You'll pay little,if any,out-of-pocket expense."

Answer 1

"Your PPO offered you a choice in your health care provider as well as services.Now,you will choose a primary care provider who will evaluate your health and will coordinate all of your care."

Question 2

The spouse of a client referred to hospice care asks why the client needs the change in services.How should the nurse respond to this ?

A)"So we can see if there's any way to improve your spouse's life."
B)"There is no need for acute care any longer."
C)"It's best for your spouse to be cared for at home."
D)"Hospice care is cheaper than acute care."

Answer 2

"So we can see if there's any way to improve your spouse's life."

Question 3

An older client has no family in the same community,lives alone in a small house,and is having greater difficulty with mobility due to advanced osteoarthritis.Cognitively,this client is alert,is able to manage her own business matters,and does her own cooking,but does not enjoy "cooking for one." The home health nurse who visits has noticed that the client is losing weight and does not have as much energy or interest in activities as on previous visits.What should the nurse recommend for this client?

A)See a psychiatrist because the client appears to be depressed.
B)Check out joint replacement options for the osteoarthritis.
C)Start thinking about long-term care.
D)Consider moving to an assisted living facility.

Answer 3

Consider moving to an assisted living facility.

Question 4

A clinic in a rural area depends primarily on the services of a nurse practitioner.Which legislation provided the opportunity for the nurse practitioner to have this position?

A)Medicare
B)Medicaid
C)Rural Health Clinics Act
D)National Health Planning and Resources Development Act

Question 5

The nurse is considering leaving a position in an organization that utilized differentiated practice.Which type of delivery system should the nurse consider as being the most similar to differentiated practice?

A)Case method
B)Shared governance
C)Functional method
D)Team nursing

Question 6

A client is in the end stages of cancer.Which type of service should the nurse consider as being the best for this client?

A)Rehabilitation
B)Health restoration
C)Acute care
D)Palliative care

Question 7

A seasoned RN is especially competent in knowledge of the computerized charting system in a facility and is able to assume the team leader role on a regular basis.In which type of care delivery system is this nurse most likely providing care?

A)Primary nursing
B)Team nursing
C)Differentiated practice
D)Case method

Question 8

The spouse of a client diagnosed with Stage I/II Alzheimer's disease must continue to work full-time.The spouse tells the occupational health nurse that the client has started to wander outside the house,forgets to turn off the stove after preparing food,and tries to drive the car if the keys are available.What should the nurse recommend for this family?

A)The client should be placed in long-term care.
B)The spouse should consider early retirement.
C)The client should be placed in an adult day-care environment.
D)An increase in the client's medications should be considered to slow the progress of the disease.

Question 9

A nurse is interviewing a client at a clinic near a shelter for the homeless.Understanding the increased risk a poor physical environment creates for this client,on what should the nurse focus during the intake phase of the interview?

A)Lack of social support
B)Recent history of chills and body aches
C)Improper nutrition
D)Few personal resources

Question 10

A client being discharged from an acute care hospital requires IV antibiotics,is not able to complete activities of daily living without assistance,and has no family available to assist in the recovery phase.Which type of recommendation should the nurse make for this client?

A)Stay in the hospital until the client is fully capable of self-care.
B)Remain in the hospital until the antibiotic course is completed.
C)Be discharged to an extended care facility.
D)Go to a nursing home.

Question 11

A nurse is working in a clinic that emphasizes cost control,customer satisfaction,health promotion,and preventive services.In which type of health system is this nurse providing care?

A)Managed care
B)Case management
C)Differentiated practice
D)Patient-focused care

Question 12

The manager of a small clinic has cross-trained the nurses to provide basic nursing care,and perform ECG testing,phlebotomy,and some respiratory therapy interventions.Which type of care delivery model has the manager implemented?

A)Managed care
B)Case management
C)Patient-focused care
D)Critical pathways

Question 13

A young adult client recovering from an injury that resulted in partial paralysis plans to live independently as before the injury.Which referral should the nurse identify as being the best for this client?

A)Paramedical technologist
B)Physical therapist
C)Occupational therapist
D)Case manager

Question 14

The nurse is reviewing the Healthy People 2020 primary goals.Which plan should the nurse realize is in alignment with one of the goals?

A)Providing free screening to schoolchildren
B)Opening a wellness clinic
C)Developing better insurance controls
D)Developing new pharmacological treatments

Question 15

Several nurses are looking for an agency to sponsor a program that would meet the needs of a community group lacking in health promotion education.Which agency should the nurse approach to fill this need?

A)State health department
B)Local health department
C)Local hospital
D)Federal government

Question 16

A new graduate nurse is looking for employment and is hoping to find a facility that utilizes nursing personnel based on their educational preparation and skill set.In which type of facility should the new graduate apply for a position?

A)Patient-focused care
B)Shared governance
C)Differentiated practice
D)Managed care

Question 17

The nurse is hired to provide care in a hospital that offers services in all specialty areas.How should the nurse categorize this type of health care facility?

A)General hospital
B)Specialty hospital
C)Long-term care hospital
D)Short-term hospital

Question 18

The nurse is reviewing the principles of the Affordable Care Act with a client.What information should the nurse include when discussing the act with the client?

A)Individuals will be fined if they do not have health insurance.
B)Employers must offer health insurance if they meet identified requirements.
C)Insurance can be purchased through exchanges.
D)Individuals with preexisting health conditions cannot be denied health insurance coverage.
E)Health insurance is free.

Question 19

A 68-year-old client is concerned about paying for extended hospitalization and expensive medications to treat his health problem.What should the nurse respond to this client?

A)"Don't worry.I'm sure everything will work out OK."
B)"You need to focus on recovering,not worrying about finances."
C)"Much of your care will be covered by Medicare."
D)"I'll have someone from the business office come and talk to you about your bill."

Question 20

Several nurses are working to open a clinic that focuses on health promotion.Which activity should the nurses expect to perform once this clinic opens?

A)Teaching biofeedback techniques for stress reduction
B)Providing immunization clinics
C)Evaluating regional industrial centers for environmental pollution
D)Teaching smoking cessation classes to adolescents

Question 21

The nurse is concerned that the hospital will not receive payment for care provided to a client.Which client health problems are causing the nurse this concern?
Standard Text: Select all that apply.

A)Intravenous fluids were prescribed for 4 days.
B)X-rays of the left leg and left arm were prescribed.
C)A stage II pressure ulcer developed on the client's heels.
D)A urinary tract infection occurred because of an indwelling urinary catheter.
E)Physical therapy treatments were prescribed for 7 days for crutch walking.

Question 22

The nurse is reviewing sources of federal funding for health care services provided to clients.For which clients should the nurse recognize as most likely having health care paid through a federal funding source?
Standard Text: Select all that apply.

A)35-year-old self-employed house painter
B)72-year-old retired schoolteacher
C)52-year-old nurse who runs the family farm
D)29-year-old mentally challenged sheltered workshop employee
E)40-year-old factory worker

Question 23

In order to comply with the U.S.Department of Health and Human Services' most current health care goals as stated in Healthy People 2020,what should the nurse do?
Standard Text: Select all that apply.

A)Plan a depression screening for senior citizens who regularly have lunch at the senior center.
B)Attend an educational in-service on the use of a new automated blood pressure monitor.
C)Advocate for psychiatric health care for those with no private insurance coverage.
D)Organize a park "cleanup day" to assure that the community's children have a safe place to play.
E)Counsel older clients regarding programs available to assist them to live in their homes independently.

Question 24

The nurse is considering a position with a home health agency.What type of care should the nurse realize will be provided when working for this type of agency?
Standard Text: Select all that apply.

A)Providing ventilatory support
B)Completing a health and wellness visit
C)Instructing about care of a surgical wound
D)Providing intravenous antibiotics once a day
E)Teaching about medications for self-management of diabetes