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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale: The risk management nurse is not typically responsible for coordinating patient care through rehabilitation and discharge.
Choice B rationale: The neurology unit supervisor may have expertise in neurology care but may not be directly involved in coordinating care through rehabilitation and discharge.
Choice C rationale: The nurse case manager is specifically trained to coordinate and manage the care of patients through the entire healthcare continuum, including rehabilitation and discharge.
Choice D rationale: While the adult nurse practitioner may be involved in the patient's care, the nurse case manager is spec
Correct Answer is B
Explanation
Choice A rationale: A client with combined partial and full-thickness burns on the anterior chest with a decreased O2 saturation is likely in need of critical care and should not be transferred to a general unit.
Choice B rationale: A client with nephrotic syndrome and mild edema is the most stable and has the least risk of complications among the four options.
Choice C rationale: The client with thyroidectomy has a risk of bleeding and needs frequent assessment of vital signs and dressing.
Choice D rationale: The client with renal transplant has a risk of rejection and infection and needs strict isolation and immunosuppressive therapy.
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