Question 1

With regard to the effectiveness of the Medicare program,it can accurately be said that the program

Accepted Answer

Although the program is unable to prevent elderly recipients from suffering financial destitution,reduce health care costs,or ensure that the elderly receive appropriate care,it has vastly increased health care access for clients who are eligible and has helped reduce poverty among elderly people.

Question 2

A company's chief executive officer (CEO)discusses potential ways to control employee health care costs with the organization's occupational health nurse.Which of the following recommendations would the nurse be most likely to suggest?

Accepted Answer

Cost-containment strategies are becoming routine in employer-provided group health insurance plans as employers' costs continue to escalate.Employer cost-containment strategies include reimbursement for generic-only prescriptions;increasing reliance on second opinions for surgery;and increased reliance on outpatient surgery.

Question 3

A community/public health nurse is visiting a nuclear family.Both of the parents are employed full-time,have a moderate income,and have health insurance.Which of the following is the most likely source of their health insurance?

Accepted Answer

Currently,the most common form of health insurance is employer-provided insurance,although its availability is decreasing.

Question 4

A nurse educator teaches community/public health nursing students about how health care is financed in the United States.Why is it important that nursing students receive this information?

Accepted Answer

Nurses do have to charge for supplies used but can do so without understanding health care financing.In a position dealing with community/public health,advocating for a client may include making referrals to agencies that may be able to meet their needs on the basis of patient finances.All nurses have to focus on is giving care consistent with agency deadlines,which in turn must focus on reimbursement regulations in order to continue to be able to exist and provide care.

Question 5

A community/public health nurse is working with a low-income family that has children and is uninsured.What recommendation made by the nurse would assist the children in obtaining health care?

Accepted Answer

Low-income children who are not covered by other types of assistance programs may have health insurance coverage through CHIP,which took effect in 1997.Medicare is a federal program for elderly and disabled persons.A free clinic may meet short-term needs but will not help with long-term access to health care services.Visiting the local pediatrician's office will not assist this family in obtaining health insurance,which is what is necessary when they receive health care.

Question 6

How are the funds obtained to pay for the Medicare program?

Accepted Answer

A 1.45% tax of a worker's salary is paid by both employer and employee,regardless of whether the employee pays into Social Security.

Question 7

Which of the following is true about access to care?

Accepted Answer

Health care is rationed by the ability to pay.A person's financial status affects the quality and quantity of care that he or she receives.

Question 8

Which component of government is primarily responsible for health research spending?

Accepted Answer

The federal government bears the major responsibility for research,and most funds are distributed by the National Institutes of Health.

Question 9

Which of the following was true concerning the amounts paid by private funds and governmental funds in 2009?

Accepted Answer

In 2009,governments at all levels provided 49%,and private funding provided 51%.

Question 10

The primary criticism that may truthfully be made of the Medicare program is that it

Accepted Answer

Medicare has not changed substantially since it began,but benefits have been restricted as costs rise so that it does not meet the most serious medical needs of the population it serves.The greatest cost burdens are placed on poor persons because their out-of-pocket expenses reflect a larger proportion of their incomes than does the cost to persons with larger incomes.

Question 11

An elderly client reports that he has been told that he needs to "spend down" in order to be eligible for Medicaid.He is confused about what he needs to do in order to accomplish this task.Which of the following statements is the best response from the community/public health nurse?

Accepted Answer

"Spending down" is the process whereby elderly persons must exhaust most of their own assets,paying medical bills until they qualify for Medicaid,the program for the poor.

Question 12

A community/public health nurse is working with vulnerable populations in the community.Which population would be most likely to not have health insurance?

Accepted Answer

The working poor have low-paying jobs that lack benefits and therefore cannot afford to pay for services.

Question 13

Self-payment of health care costs are

Accepted Answer

Today,self-payment is usually accomplished through co-payment and deductibles required by insurance companies,as well as additional out-of-pocket costs for services not provided by insurance plans.

Question 14

A nurse has chosen to provide home care services to a needy client even though there is no source of reimbursement for this care.What problem may result?

Accepted Answer

The real danger that exists is that the nurse will not be covered in case of a malpractice claim because the service was not first sanctioned by the agency.The nurse should not be expected to provide free care to other clients because of the legal risks involved.Because it is stated there is no source of reimbursement for this client,the client is not at risk for being billed for the services provided.It is doubtful that other clients would start demanding free care as a result of this incident.

Question 15

A community/public health nurse is discussing insurance options with a healthy,young adult client who has recently lost her job.Why would the client most likely not be receptive to obtaining privately paid health insurance?

Accepted Answer

Individuals and families may not obtain privately paid insurance because they live in a state where insurance companies are not required to offer it or,especially if they are members of a high-risk group,because they cannot afford it.For low-income and marginal middle-income individuals,the premium costs are simply unaffordable.Private insurance is usually purchased only by persons who have regular employment and an adequate income to do so.Services provided at free clinics cannot meet all of the client's potential health care needs.It is highly recommended that all persons have health insurance because of the large expense associated with receiving care.

Question 16

A community/public health nurse is examining how health care dollars are distributed in the United States.Which of the following information would the nurse find in the literature?

Accepted Answer

Personal health care services account for 84% of the entire health budget.Hospital care is the most costly category.Public health,research,and construction together account for 9% of the entire budget.

Question 17

Why was the Health Insurance Portability and Accountability Act (HIPAA)not successful at making insurance more available?

Accepted Answer

The bill guarantees access for individuals who just left an insurance plan and requires renewal of coverage,but it does not limit the amount an insurer can charge for the insurance;therefore,the premiums may be too expensive for the majority of persons eligible to purchase insurance.

Question 18

Research has demonstrated that which of the following relationships is true with regard to paying for care?

Accepted Answer

There is an inverse relationship between services used and rate of payment;the higher the co-payment,the less people request service.

Question 19

What approach have nurses historically used when providing care and paying attention to costs?

Accepted Answer

Historically,cost was not considered relevant to the practice of nursing.The topic of cost was ignored by both clinicians and educators.

Question 20

A community/public health nurse is providing home care services to an elderly couple.They report that they believe they are spending more and more money on health care services and have limited funds available to meet their everyday living expenses.Which of the following offers the best explanation for their situation?

Accepted Answer

As a result of the increasing proportion of the gross domestic product (GDP)devoted to health care,individuals and families spend more on health care and have less to spend on food,clothing,housing,schooling,leisure,and other needs or interests.The number of elderly persons in the population has increased,but the health care costs are increasing for everyone,not just this population.Both the cost of living and the cost of health care are increasing because of inflation.Higher numbers of uninsured and underinsured clients have also increased the cost of health care.

Quiz 4: Financing of Health Care: Context for Communitypublic Health Nursing