Question 1

Which of the following is an example of the changes seen in health care delivery as a result of the introduction of managed care?

Accepted Answer

A)  Employee Christmas parties can no longer be held on the unit.
B)  Cyclical work schedules are used.
C)  More UAPs have been hired and they have been allowed a wider scope of responsibilities.
D)  RN salaries have gone up over the past 10 years. C

Question 2

The impact of spiraling health care costs on the nursing profession is demonstrated by the fact that:

Accepted Answer

A)  RN salaries are stagnant.
B)  Nurse practitioners are used as primary caregivers for patients with routine health problems.
C)  Hospitals are hiring fewer UAPs and more RNs.
D)  Nursing schools have had to close due to low enrollment. B

Question 3

The nurse understands that which of the following patients would be covered under the federal Medicare program? Select all that apply.

Accepted Answer

A)  A person aged 65 years or older
B)  A patient with long-term disabilities
C)  A patient with end-stage heart failure
D)  An uninsured patient
E)  A low-income patientF) A 27-year-old with a spinal cord injury A,B,F

Question 4

The nurse understands that the patient who would most likely not qualify for admission to the hospital in today's health care climate is the patient with a(n):

Accepted Answer

A)  Wrist fracture.
B)  DKA.
C)  Dehydration.
D)  Acute myocardial infarction.

Question 5

In some circumstances,nurses care for patients whose outcome is predictable but,due to family dynamics,for whom advance directives are not available and therefore the patient's lives are extended without realistic outcomes.This presents an ethical dilemma for many nurses.Which of the following actions by the nurse is most appropriate when the patient's outcome is unpredictable and no advance directive is available?

Accepted Answer

A)  Advise the family of their irrational perception of the patient's ultimate outcome.
B)  Advise the family of the need for prayer to help make the decision that is right for the patient.
C)  Advise the family that you have seen patients awaken from this type of insult and function normally.
D)  Advise the family that the patient is not going to recover and for the ultimate benefit to the patient,they should reconsider the use end of life measures.

Question 6

As a manager,the nurse must make decisions based on the guidelines of regulatory and certifying agencies.In addition to those regulatory bodies,what must also be considered when delivering care to patients?

Accepted Answer

A)  Moral decision making by patient and family
B)  Economics of the environment
C)  Infection rates for subset of patients
D)  Personality of unit secretary
E)  Decisions of payor regarding reimbursements

Question 7

The use of diagnosis-related groups (DRGs)was initiated by federal Medicare and private insurers to reduce health care costs.Which situations demonstrate the potential effect this initiative has had on clinical nursing practice?

Accepted Answer

A)  A patient is discharged with only one opportunity to change his dressing with supervision.
B)  A patient can delay her discharge if she is unsure about changing her dressing.
C)  A patient's ambulation is delayed if he experiences too much pain.
D)  A patient can be admitted to the hospital for a colonoscopy.

Question 8

The nurse would identify which action as a strategy that represents a fiscal responsibility in clinical nursing practice?

Accepted Answer

A)  Begin discharge planning as soon as there is an order.
B)  Patients should be admitted the evening before a major surgical procedure.
C)  Provide care delivered by LPNs whenever possible.
D)  Document the current status of the patient.

Question 9

In the clinical setting,the nurse understands that certain practice standards are implemented to ensure fiscal responsibility.What would be the best example of fiscal responsibility to the institution?

Accepted Answer

A)  Providing high-quality,safe nursing care
B)  Prioritizing the patient's needs
C)  Accurately documenting the patient's condition
D)  Maintaining accurate charges for supplies used

Question 10

As a case manager,the nurse is aware of the many types of organizations that fund health care,including PPOs and HMOs.The nurse understands that they all function under the philosophy of:

Accepted Answer

A)  Managing health care costs.
B)  Making the most current research trials available to patients.
C)  Saving money on research.
D)  Providing quality health care.

Question 11

Which of the following is the best example of the nurse's fiscal responsibility to the patient?

Accepted Answer

A)  To provide health care based on the ability of the patient to pay
B)  To provide health care that the insurance company will allow
C)  To use cost-efficient resources
D)  To use new-age practices for providing care

Question 12

Which factor has occurred as a result of the current health care delivery system?

Accepted Answer

A)  Restriction in numbers of emergency department visits
B)  Spiraling health care costs
C)  Restrictions on over-the-counter medications
D)  Restrictions to access for immunizations

Question 13

The World Health Organization (WHO)is an agency of the United Nations that coordinates international public health care.Which are examples of care delivered internationally as a result of the work of WHO? Select all that apply.

Accepted Answer

A)  Doctors Without Borders
B)  Red Cross
C)  HIV/AIDS medication distribution
D)  Response to cholera epidemics
E)  Immunizations of Third World country populations

Question 14

In caring for patients in nursing homes or extended care facilities,the nurse recognizes that some patients' care is being funded by Medicaid.Which of the following patients is most likely to be covered under Medicaid?

Accepted Answer

A)  A 70-year-old recovering from a hip replacement.
B)  A 6-year-old with spina bifida.
C)  An elderly patient who can no longer care for herself and has no appreciable assets.
D)  A patient with end-stage renal disease.

Question 15

As a result of the spiraling costs of health care delivery,patients admitted to the hospitals are much sicker than were patients even a decade ago.The nurse understands that patients with which conditions or disease would most likely be admitted to the hospital in today's health care climate?

Accepted Answer

A)  End-stage renal disease
B)  Anorexia
C)  Ankle fracture
D)  Acute myocardial infarction

Question 16

A new employee asks about reducing health care costs to the hospital.What would help to reduce health care costs in the clinical setting? Select all that apply.

Accepted Answer

A)  Frequent handwashing
B)  Delegating taking of vital signs of a new admission to the UAP
C)  Turning at-risk patients frequently
D)  Discharging patients before their lab results are back
E)  Instituting early ambulation of patients after surgery

Question 17

Medicare Part B covers services and products not covered by Medicare Part A.Which of the following patients would the nurse expect Medicare Part B to cover?

Accepted Answer

A)  A 67-year-old patient requiring a cane to walk who works as an attorney
B)  A 67-year-old patient who has rheumatoid arthritis and needs assistive devices to independently ambulate
C)  A 50-year-old women who requires a breast prosthesis
D)  A 60-year-old who requires a new pair of glasses after cataract surgery

Question 18

The impact on the U.S.economy from the disproportionate number of uninsured or underinsured people is predicted to continue for many years to come.Which of the following is a potential result of this situation? Select all that apply.

Accepted Answer

A)  People will exercise more.
B)  People will seek medical care only in an emergency.
C)  Hospitals will have to provide more charity care.
D)  People will eat healthier.
E)  People will become more religious.

Question 19

Which factors have influenced the U.S.health care delivery system? Select all that apply.

Accepted Answer

A)  Cultural diversity
B)  For-profit health insurance
C)  Co-pays
D)  Fee-for service
E)  Economic interests of the parties

Question 20

In caring for patients in nursing homes or extended care facilities,the nurse recognizes that some patients' care is being funded by Medicare.Which of the following patients is most likely to be covered under Medicare?

Accepted Answer

A)  A 55-year-old patient recovering from a knee replacement
B)  A 70-year-old patient recovering from a hip replacement
C)  A 16-year-old recovering from a compound fracture of the femur
D)  A 30-year-old recovering from an overdose

Exam 6: Health Care