Question 1

A student nurse asked to identify the types of services currently provided in the U.S.health care delivery system should mention which of the following?

Accepted Answer

A)   Restructuring
B)   Health promotion
C)   Diagnosis and treatment
D)   Illness prevention
E)   Seamless systemsF)  Alliances and networks B,C,D

Question 2

A 70-year-old patient tells the nurse,"I can't go to the hospital for treatment,because I have no hospital insurance.My Social Security and my pension pay my living expenses,but I don't have any savings." The nurse's response should be focused on

Accepted Answer

A)   providing information about Medicare.
B)   explaining the provisions of Medicaid.
C)   exploring the patient's ability to purchase group health insurance.
D)   investigating which hospitals provide free care for indigent patients. A

Question 3

A patient tells the nurse,"I received a questionnaire that said my answers would be used for purposes of continuous quality improvement.I wonder if it's worth my time to fill it out?" The response that best explains continuous quality improvement is,"Continuous quality improvement activities are used to"

Accepted Answer

A)   restructure hospital departments and personnel assignments to ensure cost savings."
B)   provide an opportunity for staff members to participate in self-governance."
C)   obtain appropriate reimbursement for care given to ambulatory and inpatients."
D)   monitor and improve processes involved in providing safe, effective care for patients." D

Question 4

Which of the following is a quality improvement activity in which the LPN/LVN engages routinely?

Accepted Answer

A)   Collecting data for care plan development
B)   Identifying nursing diagnoses
C)   Initiating patient teaching about medications
D)   Evaluating patient goal attainment

Question 5

A patient asks the nurse,"What do health maintenance organizations (HMOs)do to reduce health care costs?" The response giving the best example of an HMO cost-containment method would be

Accepted Answer

A)   "HMOs pool individual contributions for use in catastrophic illness."
B)   "HMOs provide supplemental coverage for items not covered by Medicare."
C)   "HMOs use a retrospective payment system."
D)   "HMOs provide services aimed at keeping members healthy."

Question 6

Which of the following are problems associated with the present health care delivery system that could be identified by a nursing student who is writing an essay?

Accepted Answer

A)   High cost
B)   Insufficient number of doctors
C)   Widespread shortage of RNs
D)   Continuous quality improvement

Question 7

A set monthly fee charged by the provider of health care services for each member of the insurance group for a specific set of services is known as

Accepted Answer

A)   inflation.
B)   capitation.
C)   fee-for-service.
D)   gross domestic product.

Question 8

The amount an insured person must pay at the time of an office visit,when picking up a prescription,or before a hospital service is known as the

Accepted Answer

A)   premium.
B)   deductible.
C)   copayment.
D)   coinsurance.

Question 9

The monthly fee a person must pay for health care insurance coverage is known as the

Accepted Answer

A)   premium.
B)   deductible.
C)   copayment.
D)   coinsurance.

Question 10

Once a deductible has been met,the percentage of the total bill paid by the insured person is known as the

Accepted Answer

A)   premium.
B)   deductible.
C)   copayment.
D)   coinsurance.

Question 11

The LPN/LVN charge nurse has been designated to participate in the orientation of a new LPN/LVN by explaining cost-containment measures.Measures the charge nurse should mention include which of the following?

Accepted Answer

A)   Charge patients for all supplies used in their care.
B)   Document patient care according to the policy for reimbursement.
C)   Use time management principles to work efficiently.
D)   Use supplies carefully to avoid waste.
E)   Implement measures to prevent complications.F)  Advise insured patients to select higher tiers whenever possible.

Question 12

The yearly amount an insured person must spend out-of-pocket for health care services before a health insurance policy will begin to pay its share is known as the

Accepted Answer

A)   premium.
B)   deductible.
C)   copayment.
D)   coinsurance.

Question 13

Which program offers an incentive to hospitals to discharge patients as quickly as possible?

Accepted Answer

A)   Retrospective payment system
B)   Prospective payment system
C)   Seamless system
D)   Private insurance plans in effect for under 1 year

Question 14

A patient tells the nurse,"I didn't sign up for health care insurance at my job because I'm young and healthy and can use the money in other ways." The response that best explains the advantage of health insurance would be,"With insurance

Accepted Answer

A)   a fiscal middleman pays your health care bills."
B)   your individual contributions go directly to paying your personal expenses."
C)   you can borrow money for unexpected health care expenses at a very low interest rate."
D)   you are spreading the risk in case you have a serious health event, such as cancer or major trauma."

Question 15

A mother and her three children often seek medical services at the emergency room.The nurse realizes that they have no insurance and are unable to pay for services.The action the nurse should take that would provide the greatest assistance to the family would be to

Accepted Answer

A)   advise them to use urgent care centers where fees are lower.
B)   leave the newspaper classified ads in a visible place.
C)   advise the mother to seek work at the hospital personnel office.
D)   contact a social worker to discuss Medicaid with the mother.

Question 16

Diagnosis-related groups (DRGs)and prospective payment systems are most clearly the reason for

Accepted Answer

A)   Medicare and Medicaid.
B)   critical pathways and managed care.
C)   group health insurance and centralization.
D)   a shortage of nurses and unlicensed assistive personnel.

Question 17

The nurse is asked by a patient,"Why is it necessary to have deductibles and copayments when I already have health insurance?" The best response would be

Accepted Answer

A)   "They are a way to improve the margin of profit in the fee-for-service method of paying for health care."
B)   "They prevent health care agencies from having huge deficits associated with uncompensated care."
C)   "They were developed to save health care dollars at the time Medicare introduced DRGs."
D)   "They are part of the incremental changes designed to provide more universal care."

Question 18

The skill that will be most helpful to an LPN/LVN in navigating health care system changes successfully is

Accepted Answer

A)   the ability to work efficiently for long hours.
B)   problem-solving and critical thinking abilities.
C)   identifying the need for comprehensive system change.
D)   becoming knowledgeable about CQI processes.

Question 19

A method of financing health care costs in which physicians are paid a fee by the patient for each service they provide is known as

Accepted Answer

A)   inflation.
B)   capitation.
C)   fee-for-service.
D)   gross domestic product.

Question 20

Which of the following constitutes a problem that affects data collected by the nurse interviewing an elderly,chronically ill patient? Many elderly who are covered only by Medicare Parts A and B find it difficult to pay the cost of

Accepted Answer

A)   hospital care for an acute short-term illness.
B)   prescription drugs while living at home.
C)   post-hospitalization rehabilitation services in a skilled nursing facility.
D)   doctor's office visits, Pap smears, and mammography.

Exam 19: Health Care System: Financing, Issues, and Trends

A student nurse asked to identify the types of services currently provided in the U.S.health care delivery system should mention which of the following?

A 70-year-old patient tells the nurse,"I can't go to the hospital for treatment,because I have no hospital insurance.My Social Security and my pension pay my living expenses,but I don't have any savings." The nurse's response should be focused on

Which of the following is a quality improvement activity in which the LPN/LVN engages routinely?

A patient asks the nurse,"What do health maintenance organizations (HMOs) do to reduce health care costs?" The response giving the best example of an HMO cost-containment method would be

Which of the following are problems associated with the present health care delivery system that could be identified by a nursing student who is writing an essay?

A set monthly fee charged by the provider of health care services for each member of the insurance group for a specific set of services is known as

The amount an insured person must pay at the time of an office visit,when picking up a prescription,or before a hospital service is known as the

The monthly fee a person must pay for health care insurance coverage is known as the

Once a deductible has been met,the percentage of the total bill paid by the insured person is known as the

The LPN/LVN charge nurse has been designated to participate in the orientation of a new LPN/LVN by explaining cost-containment measures.Measures the charge nurse should mention include which of the following?

The yearly amount an insured person must spend out-of-pocket for health care services before a health insurance policy will begin to pay its share is known as the

Which program offers an incentive to hospitals to discharge patients as quickly as possible?

A patient tells the nurse,"I didn't sign up for health care insurance at my job because I'm young and healthy and can use the money in other ways." The response that best explains the advantage of health insurance would be,"With insurance

A mother and her three children often seek medical services at the emergency room.The nurse realizes that they have no insurance and are unable to pay for services.The action the nurse should take that would provide the greatest assistance to the family would be to

Diagnosis-related groups (DRGs) and prospective payment systems are most clearly the reason for

The nurse is asked by a patient,"Why is it necessary to have deductibles and copayments when I already have health insurance?" The best response would be

The skill that will be most helpful to an LPN/LVN in navigating health care system changes successfully is

A method of financing health care costs in which physicians are paid a fee by the patient for each service they provide is known as

Which of the following constitutes a problem that affects data collected by the nurse interviewing an elderly,chronically ill patient? Many elderly who are covered only by Medicare Parts A and B find it difficult to pay the cost of