An older adult client who was recently widowed has become increasingly confused and disoriented. The family tells the healthcare provider's office nurse that it is imperative for their parent to be admitted to the hospital for medical evaluation. The client is a member of a managed healthcare plan. Which information is best for the nurse to provide this family?
Managed healthcare plans do not pay for any in-hospital medical evaluations.
The client is grieving normally in response to the loss of a spouse and hospitalization is not necessary.
Managed care providers have mandatory precertification requirements for hospitalization.
Healthcare costs are escalating because clients want to have diagnostic testing conducted in the hospital.
The Correct Answer is C
Choice A rationale: This statement is inaccurate. Managed healthcare plans typically cover in-hospital medical evaluations, but the decision may be subject to precertification requirements.
Choice B rationale: While grief is a natural response to the loss of a spouse, the client's confusion and disorientation warrant a medical evaluation, and this option dismisses the family's concerns.
Choice C rationale: Managed care providers often have mandatory precertification requirements for hospitalization. Informing the family about this requirement is important for them to navigate the process effectively.
Choice D rationale: This statement does not provide relevant information about the managed healthcare plan's policies or the client's current condition.
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Naxlex Comprehensive Predictor Exams
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Correct Answer is D
Explanation
Choice A rationale: Paging a chaplain on call can be a supportive measure, but it might not address the immediate need for communication and coordination with the family.
Choice B rationale: Allowing each family member to ask a question one at a time may not be the most effective approach when dealing with multiple and repetitive questions.
Choice C rationale: Requesting the healthcare provider to speak with the family might be appropriate, but it could take time, and the immediate need is to establish effective communication.
Choice D rationale: Asking the family to identify a specific spokesperson helps streamline communication and ensures that information is conveyed more efficiently. This approach can help manage the situation and address the family's concerns collectively.
Correct Answer is C
Explanation
Choice A rationale: Asking the healthcare provider to remain on "hold" may cause a delay in addressing the prescription and may not be the most efficient way to handle the situation.
Choice B rationale: Remaining with the client and monitoring vital signs is important, but it may not be necessary for the nurse to take the call personally.
Choice C rationale: Informing the healthcare provider that the nurse will return the phone call as soon as possible is a reasonable and appropriate response to address the prescription in a timely manner.
Choice D rationale: Writing down and repeating back the prescription is a good practice, but it may not address the urgency of the situation and the need for prompt communication with the healthcare provider.
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