An older female client who was recently widowed has become increasingly confused and disoriented. Her family tells the healthcare provider's office nurse that it is imperative for their mother 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.
Healthcare costs are escalating because clients want to have diagnostic testing conducted in the hospital.
The client is grieving normally in response to her husband's death and hospitalization is not necessary.
Managed care providers have mandatory pre-certification requirements for hospitalization.
The Correct Answer is D
Choice A Reason: Managed healthcare plans do not pay for any in-hospital medical evaluations is not the best information for the nurse to provide this family. This statement is false and misleading. Managed healthcare plans may cover in-hospital medical evaluations if they are deemed medically necessary and authorized by the plan. The nurse should not discourage the family from seeking appropriate care for their mother based on inaccurate information.
Choice B Reason: Healthcare costs are escalating because clients want to have diagnostic testing conducted in the hospital is not the best information for the nurse to provide this family. This statement is irrelevant and insensitive. Healthcare costs are influenced by many factors, such as technology, inflation, regulation, and demand. The nurse should not blame the clients for wanting to have diagnostic testing done in the hospital, which may be essential for their health and well-being.
Choice C Reason: The client is grieving normally in response to her husband's death and hospitalization is not necessary is not the best information for the nurse to provide this family. This statement is presumptuous and dismissive. Grief is a complex and individual process that may affect people differently. The nurse should not assume that the client's confusion and disorientation are normal signs of grief, which may mask underlying medical conditions that require evaluation and treatment.
Choice D Reason: Managed care providers have mandatory pre-certification requirements for hospitalization is the best information for the nurse to provide this family. This statement is factual and helpful. Pre-certification is a process by which managed care providers review and approve proposed hospital admissions, procedures, or services before they are performed. The nurse should inform the family that they need to obtain pre-certification from their mother's plan before admitting her to the hospital, or they may face denial of coverage or higher out-of-pocket costs.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C"]
Explanation
Choice A Reason: Identifying locations of skin lesions on a newly admitted client is a nursing assessment that requires clinical judgment and cannot be delegated to the UAP.
Choice B Reason: Emptying the ostomy bag for a client with a temporary colostomy is a routine task that does not require clinical judgment and can be delegated to the UAP.
Choice C Reason: Providing a complete bed bath for a comatose client is a routine task that does not require clinical judgment and can be delegated to the UAP.
Choice D Reason: Performing foot care including toenail trimming and heel care is a nursing intervention that requires clinical judgment and cannot be delegated to the UAP. The UAP may cause injury or infection to the client's feet, especially if the client has diabetes or peripheral vascular disease.
Choice E Reason: Giving mouth care to an elderly client who has a tracheostomy is a nursing intervention that requires clinical judgment and cannot be delegated to the UAP. The UAP may cause trauma or aspiration to the client's trachea, especially if the client has poor oral hygiene or respiratory secretions.
Correct Answer is A
Explanation
Choice A Reason: This client has a potential airway obstruction and needs close monitoring by the nurse. Laryngeal nerve damage can cause vocal cord paralysis, which can lead to respiratory distress and aspiration.
Choice B Reason: This client needs education on the medication and its side effects, but this can be done by the PN under the supervision of the nurse. Levothyroxine is a synthetic thyroid hormone that replaces deficient hormones in hypothyroidism.
Choice C Reason: This client needs ongoing management of diabetes, but this can be done by the PN under the supervision of the nurse. Glycosylated Hgb (Hgb A1C) is a measure of the average blood glucose level over the past three months.
Choice D Reason: This client has a life-threatening condition that requires immediate treatment with corticosteroids, but this can be done by the PN under the supervision of the nurse. Addison's crisis is a severe form of adrenal insufficiency that causes hypotension, shock, and electrolyte imbalance.
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