Question 1

In reviewing the current delivery model, the nurse manager is aware that a demographic change that will have a significant effect on healthcare delivery systems of the future is:

Accepted Answer

A demographic change that will significantly impact the healthcare system of the future is the increasing proportion of individuals 65 years and older.By 2025, more than 18% of the population is expected to be 65 years and older, which means that new healthcare organizations will evolve as the system attempts to maintain older adults in the community for as long as possible.

Question 2

A group of patients with early Alzheimer disease and their spouses approach you regarding help with the establishment of a local Alzheimer Society for the support and education of affected individuals and their families.As a manager in an ambulatory care clinic, what suggestion or advice would you offer this group?

Accepted Answer

Self-help groups often are made up of, and are directed by, peers who have healthcare needs.A growing trend is the development of community-based geriatric organizations in partnership with healthcare organizations.The request of the patients and their spouses indicates that this service is needed in the community and that they are looking for assistance in setting up the Alzheimer Society rather than having your agency take over the management of the group.

Question 3

A facility that provides care for patients whose average length of stay is less than 30 days and to patients whose average length of stay is longer than 30 days, and who require inpatient and ambulatory care for addictions, through a spectrum of wellness and illness services and providers, would be considered:

Accepted Answer

Healthcare networks embrace and provide wellness and illness services, including primary, secondary, and tertiary care, through a network of providers.

Question 4

A nursing informatics specialist hired by Blue Cross/Blue Shield Insurance System (a form of third-party payers benefit package for a prepaid fee that uses specific standards to approve a period of time for the use of inpatient and community health services) is participating in:

Accepted Answer

Managed care strives to contain costs (e.g., through limitation of time in care) while maintaining quality.Managed care combines care delivery with financing and provides comprehensive services for a fixed prepaid fee.Group practice plans take various forms.One form has a centralized administration that directs and pays salaries for physician practice (e.g., HMOs).

Question 5

The local health department nurse manager has developed and implemented a disaster readiness plan as part of a community service.Community services:

Accepted Answer

Community services, including public health departments, are focused on the treatment of the community rather than that of the individual.These funds provide personal health services, care for communicable diseases, services for children with birth defects, mental health care, investigation of epidemiology, and treatment of bioterrorism threats and attacks.Monies are allocated also for environmental services and for health resources.

Question 6

A nurse manager working for a not-for-profit organization should be familiar with the regulations that impact the organization.Not-for-profit organizations:

Accepted Answer

Not-for-profit organizations, often referred to as voluntary organizations, are controlled by voluntary boards and provide services to both paying and charity clients.Funds are redirected toward maintenance and growth as opposed to profit shares for stockholders.Historically, non-profit organizations have been exempt from paying taxes as they commit to providing an important community service.

Question 7

A nurse manager in a for-profit environment finds it difficult to recruit staff.This difficulty may be most related to aggressive profit goals and:

Accepted Answer

For-profit hospitals tend to have lower wage and salary costs that are most likely connected to aggressive goals for profit.

Question 8

With the help of a federal grant, the local school nurse has established a spreadsheet that contains relevant nursing data so that she can analyze children's health.School health programs are:

Accepted Answer

Traditionally, school health programs were organized to control infectious disease outbreaks, treat and control on-site injuries, and educate parents and children about basic health.Increasingly, schools are being seen as primary healthcare sites for children.

Question 9

What would be the most appropriate focus in developing a business plan for a nurse-owned home healthcare service?

Accepted Answer

Nurse-managed and nurse-owned healthcare services are part of a growing number of organizations that extend health care beyond that offered through traditional services.Growth in these organizations and services has been spurred by the implementation of the prospective payment system, which resulted in early discharge of many patients from acute care facilities.These nurse-managed and nurse-owned services focus on the care of individuals and families rather than on community-based outcomes for populations such as older adults, or on community-based issues such as injuries related to drunk driving.

Question 10

Tracy is an RN case manager who interfaces between the Centers for Medicare & Medicaid.Tracy's responsibilities most likely would include:

Accepted Answer

Nurse case managers serve as interfaces for the Centers for Medicare & Medicaid Services (CMS) and are key in monitoring compliance with Conditions of Participation (CoP) elements.The case managers routinely monitor for appropriate physician documentation of medical necessity and other required CoP elements.

Question 11

A local hospital has formed a corporate partnership with a reputable HMO (health maintenance organization).The nurse manager has had to educate staff and personnel about the financial implications of this partnership.An HMO:

Accepted Answer

The HMO is a configuration of healthcare agencies that provide basic and supplemental health maintenance and treatment services to voluntary enrollees who prepay a fixed periodic fee without regard to the amount of services used.HMOs have a centralized administration that directs and pays salaries for physician practice (e.g., HMOs).

Question 12

To prepare for the orientation of newly hired nurses, the nurse manager plans a presentation outlining the concept of healthcare networks.Healthcare networks are:

Accepted Answer

Healthcare networks are interconnected units.Their aim is serving large regional populations.

Question 13

As a nurse manager, you have been asked to assist in designing a subacute facility for open heart patients who require further complex care after hospitalization.In setting up the facility, what would require reassessment?

Accepted Answer

Because of the types of patients being accepted for care and the distance of the subacute facility from acute care, emergency response and seamless transfer issues in the event of an unanticipated crisis must be addressed.As a nurse manager, an important part of your position may be assisting to develop strategies to maximize the benefits and minimize the risks in this situation.

Question 14

What is an example of an HMO?

Accepted Answer

Fee-for-service systems provide compensation to healthcare providers in group practices based on fee-for-service, which in PPQs means that fees are paid promptly but at a discounted rate.HMOs are configurations of healthcare agencies that provide health maintenance and services for enrolled patients for a fee that is preestablished regardless of utilization of service.

Question 15

A merger has occurred between a hospital and a local home health agency, creating new roles for the nursing staff in both agencies.The nurse managers of both systems begin to evaluate and revise patient care processes and systems.With the merger, the healthcare organization's changes are:

Accepted Answer

Home care agencies staffed appropriately with adequate numbers of professional nurses have the potential to keep older adults, those with disabilities, and persons with chronic illnesses comfortable and safe at home.Home care is the fastest growing segment in health care and the volume of home health care may have a subsequent impact on the numbers of nurses required.

Question 16

You are a nurse manager in a facility that is part of a national system of specialized hospitals that provide services to children and that is funded and managed through a religious charity organization.This system emphasizes compassionate, faith-based care.What level of consolidated system is represented in this example?

Accepted Answer

Consolidated systems tend to be organized into five levels.The fifth level involves special interest groups that own and operate units along religious lines, teaching interests, or related special interests that drive their activities.In this example, the facilities are funded and managed by a religious organization that provides care that is congruent with its particular faith-based values.

Question 17

Healthcare organization XYZ provides women's health services on an inpatient basis (average stay of less than 30 days).This facility would likely be considered:

Accepted Answer

The AHA defines an acute care hospital as a facility in which the average length of stay is less than 30 days.Because of the focus on women's health services, it would also be considered specialized.

Question 18

You are the nurse manager for a not-for-profit health service for the homeless and for drug users in an impoverished neighborhood.As the manager, your concern about sustainability is related to:

Accepted Answer

Public and nonprofit hospitals are tax exempt and have a concomitant responsibility to provide mandated community service such as delivering care to the poor and indigent.To keep a nonprofit status, facilities must make a good-faith effort to provide community service and charity care.Nonprofit organizations located in impoverished urban and rural areas are often economically disadvantaged by the amount of uncompensated care that they provide.

Question 19

As a nurse manager, you have been offered a position at a Veterans Administration hospital.In accepting the position, it is important for you to understand that Veterans hospitals provide:

Accepted Answer

Veterans Administration hospitals provide a range of services to Veterans and are responsible to government and thus to taxpayers, who support the hospitals.

Question 20

A nurse manager at a home healthcare service has resigned to take a position at a local ambulatory care center.She has been hired because of her expertise in TJC accreditation.To initiate the changes, the nurse manager has to be knowledgeable about the differences between a home healthcare institution and an ambulatory care center, which is a primary care institution.Primary care institutions are facilities that provide:

Accepted Answer

The spectrum of care services provided are typically described as primary care (first-access care), secondary care (disease-restorative care), and tertiary care (rehabilitative or long-term care).Ambulatory care centers are an example of primary care.

Quiz 10: Health Care Organizations