A nurse is working with a case manager for a client who participates in a health maintenance organization. The nurse should identify that a health maintenance organization provides which of the following payment structures?

The provider is paid a fixed sum for the client on a monthly or yearly basis.

The provider bills the client directly for a predetermined percentage of the cost of services.

The client pays the insurer a percentage of the total costs for each service rendered by the provider.

The client is participating in a fee-for-service health care insurance program.

Answer and Explanation

The Correct Answer is A

A. In a health maintenance organization (HMO), providers typically receive a fixed sum (capitation) for each client enrolled, regardless of the services provided.
B. Billing the client directly for services rendered is more typical of fee-for-service or cost-sharing arrangements.
C. This option describes a cost-sharing model where the client pays a portion of the service costs, common in some insurance plans but not HMOs.
D. Fee-for-service insurance involves providers billing for each service provided, not typical in HMOs where payments are typically fixed.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is C

Explanation

A. Access to medical records by the billing department is not typically part of HIPAA without patient consent.
B. HIPAA allows patients to make decisions about who can access their health information, not solely their healthcare provider.
C. Sharing medical information with providers involved in the client's care is consistent with HIPAA privacy rules.
D. Assistive personnel would need specific authorization to access prior admission information under HIPAA.

A. Develop educational materials for employees. B. Have breast models available to employees during teaching sessions. C. Determine employee knowledge level of breast self-examination. D. Schedule a guest speaker to talk about breast cancer to employees.

Correct Answer is C

Explanation

A. Developing educational materials is important, but it is not the first step. Assessing the current knowledge level will guide the development of these materials.
B. Having breast models available is useful for teaching, but first, the nurse needs to assess the knowledge level to tailor the teaching appropriately.
C. Determining the employee's knowledge level of breast self-examination is the first step, as it helps the nurse understand what information needs to be provided and the areas that need more focus.
D. Scheduling a guest speaker can be beneficial, but only after understanding the baseline knowledge of the employees to ensure the speaker addresses their specific needs and questions.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

A nurse is working with a case manager for a client who participates in a health maintenance organization. The nurse should identify that a health maintenance organization provides which of the following payment structures?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A home health nurse is explaining a HIPAA acknowledgement form to a client in preparation for them to sign it. Which of the following information should the nurse provide?

Correct Answer is C

Explanation

An occupational health nurse is planning a program on early detection of breast cancer for employees at a local business. Which of the following is the first action the nurse should take?

Correct Answer is C

Explanation

A nurse is conducting discharge planning for several clients. When reviewing information to report to other members of the interprofessional team, which of the following actions is the nurse's priority?

A home health nurse is providing teaching to the guardian of a child who has leukemia about methods to prevent complications. Which of the following statements by the guardian indicates an understanding of the teaching?

A faith community nurse is planning care for a client who has been diagnosed with end-stage breast cancer. Which of the following interventions should the nurse include in the plan?

A faith community nurse is preparing to meet with the family of an adolescent who has leukemia. Which of the following actions should the nurse plan to take?

A community health nurse notes that six new cases of diabetes mellitus have been reported in the past 3 months. In the previous year, five cases were reported. The population of the community is 15,000 people. Which of the following is the prevalence proportion for the community?

A nurse in a health department is participating in an immunization clinic. The nurse should identify that which of the following children requires an alteration in the standard immunization schedule?

A nurse in a public health department is caring for a client. Exhibits Which of the following data in the client's medical record should cause the nurse to suspect the client is infected with the plague? Select all that apply.

A teacher suspects a child is being maltreated at home and takes them to the school nurse. Which of the following findings should the nurse report as an indication of possible maltreatment?