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

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

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

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

Answer and Explanation

The Correct Answer is B

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

A health maintenance organization (HMO) is a type of health insurance that contracts with a network of providers and facilities to offer care at a discounted rate. The HMO pays the provider a fixed sum for each client, regardless of the services they use. This is called capitation³. The HMO also requires the client to have a primary care provider who coordinates their care and makes referrals to specialists².

a. This statement is wrong because it describes a co-payment, which is a fixed amount that the client pays for each service. Co-payments are usually low in HMOs, but they are not the main payment structure².
c. This statement is wrong because it describes a fee-for-service health care insurance program, which is the opposite of an HMO. In a fee-for-service program, the client pays the insurer for each service they use, and the insurer reimburses the provider. This gives the client more freedom to choose their provider, but it also increases the cost of health care¹.
d. This statement is wrong because it describes a co-insurance, which is a percentage of the total cost that the client pays for each service. Co-insurance is more common in preferred provider organizations (PPOs), which are another type of health insurance that offer more flexibility than HMOs, but also higher premiums

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Correct Answer is A

Explanation

"Determine potential environmental health hazards." The first action a nurse should take when developing a disaster plan for an assisted care facility is to determine potential environmental health hazards. Natural disasters, such as hurricanes, floods, and wildfires, can disrupt the delivery of healthcare services and pose a risk to the safety and well-being of residents in assisted care facilities. Identifying potential environmental hazards, such as proximity to a river, a history of flooding, or a location in a high-wind zone, is essential in developing an effective disaster plan. The plan should also include strategies for evacuation, sheltering in place, communication with staff, and coordination with local emergency management agencies.

A. Request the facility chaplain to visit the client. B. Ask the client to sign an informed consent form. C. Explain the process for completing a living will. D. Complete an against medical advice form.

Correct Answer is C

Explanation

When caring for a client with terminal cancer who expresses a desire to discontinue enteral tube feedings, the nurse's priority is to ensure that the client's wishes are respected and appropriate steps are taken. The most suitable action is:

c) Explain the process for completing a living will.

A living will is a legal document that outlines a person's preferences regarding medical treatment in the event they are unable to communicate their wishes. In this situation, the client can express their desire to forgo enteral tube feedings through a living will, ensuring that their wishes are documented and legally recognized.

The other options may not be as appropriate:

a) Request the facility chaplain to visit the client:While spiritual and emotional support is important, the immediate concern is ensuring the client's autonomy in decision-making regarding medical interventions.

b) Ask the client to sign an informed consent form:Informed consent typically pertains to specific medical procedures, and discontinuing enteral tube feedings is more aligned with the broader context of advance care planning.

d) Complete an against medical advice form:This form is typically used when a patient refuses a recommended treatment against the medical team's advice. However, in this case, the client is expressing their own treatment preferences, and the focus should be on facilitating advance care planning and documentation.

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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 nurse working in an assisted care facility is developing a disaster plan. Which of the following is the first action the nurse should take?

Correct Answer is A

Explanation

A home health nurse is caring for a client who has terminal cancer and no longer wants to receive enteral tube feedings. Which of the following actions should the nurse take?

Correct Answer is C

Explanation

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?

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A nurse manager at a clinic is reviewing the preventative services offered to clients. Which of the following activities should the nurse identify as a secondary prevention activity?

When providing teaching to a 50-year-old female client, which of the following statements should a nurse include in the teaching?

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