Because of the complexity of reimbursement systems and its implications for the services available to patients, the nurse has a key role in:

advocacy for patients by efficiently utilizing appropriate supplies for each patient visit.

limiting the amount of resources for each patient visit at the expense of patient outcomes.

seeing as many patients as possible to boost revenue.

decreasing the volume of services used to reduce cost.

Answer and Explanation

The Correct Answer is A

A. Advocating for patients involves utilizing resources effectively while ensuring that patient care is not compromised, aligning with ethical standards of nursing.
B. Limiting resources at the expense of patient outcomes contradicts the nurse's ethical responsibility to provide high-quality care.
C. Focusing solely on seeing more patients to boost revenue can lead to burnout and decreased quality of care, which is not sustainable or ethical.
D. Reducing the volume of services without considering patient needs can compromise care quality and negatively impact outcomes.

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Correct Answer is A

Explanation

A. Charges refer to the fees billed for services rendered, which in this case is the administration of each vaccination according to the insurance company's guidelines.
B. Contractual allowance refers to the difference between the billed amount and the amount agreed upon in the contract with the insurance company, which is not the primary focus here.
C. Prospective reimbursement is based on predetermined rates rather than charges billed after services are provided.
D. Cost-based reimbursement is determined by the actual costs incurred in providing services, which does not apply in this context as the billing is based on set charges for vaccinations.

A. The new graduate places all side rails up. B. The new graduate ensures the bed is in the lowest position (i.e., closest to the floor). C. The new graduate places patient's belongings at within reach. D. The new graduate ensures the wheels on the client's bed are locked.

Correct Answer is A

Explanation

A. Placing all side rails up may actually increase the risk of injury if the patient tries to climb over them, as it can create a false sense of security. This practice is considered a restraint and should be avoided unless indicated for patient safety.
B. Ensuring the bed is in the lowest position helps prevent falls and is a safe practice.
C. Placing the patient's belongings within reach promotes independence and reduces the risk of the patient trying to get up to retrieve items.
D. Ensuring the wheels on the client's bed are locked is crucial for patient safety to prevent unintended movement of the bed.

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Because of the complexity of reimbursement systems and its implications for the services available to patients, the nurse has a key role in:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

After a major flu vaccination campaign, an agency bills a private insurance company for the administration of each vaccination according to the insurance company's reimbursement guidelines. This is an example of which major payment method?

Correct Answer is A

Explanation

A nurse is supervising a new graduate who is caring for a patient who has fallen days ago. Which of the following interventions made by the new graduate REQUIRES CORRECTION by the supervising nurse?

Correct Answer is A

Explanation

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