A first response team is working at the location of a bombing incident. A nurse triaging a group of clients should give treatment priority to which of the following clients?

Choice A reason: Organizing an influenza immunization clinic with the American Red Cross is a service that the nurses should plan to provide to the congregation, as it is consistent with the role and scope of parish nursing. Parish nurses, or faith community nurses, are registered nurses who provide education, counseling, referral, advocacy, and volunteer coordination within the context of their faith community¹. They focus on holistic healing and prevention of illness, rather than hands-on care². Organizing an influenza immunization clinic is an example of a preventive and educational service that can benefit the health of the congregation and the community.

Choice B reason: Performing wound care in the home of members is not a service that the nurses should plan to provide to the congregation, as it is outside the role and scope of parish nursing. Parish nurses do not provide direct clinical care, such as wound care, medication administration, or blood pressure monitoring². They may refer members to other health care providers or agencies for these services, or teach members how to perform self-care³.

Choice C reason: Providing end of life care for members who are terminal is not a service that the nurses should plan to provide to the congregation, as it is outside the role and scope of parish nursing. Parish nurses do not provide direct clinical care, such as pain management, symptom control, or palliative care². They may provide spiritual and emotional support, counseling, and advocacy for members who are terminal, or refer them to hospice or other end of life care services³.

Choice D reason: Facilitating discharge from the facility to the home is not a service that the nurses should plan to provide to the congregation, as it is outside the role and scope of parish nursing. Parish nurses do not provide case management, discharge planning, or home health care². They may collaborate with other health care professionals or community agencies to ensure continuity of care and smooth transition for members who are discharged from the facility to the home³.

Choice A reason: A fee-for-service health care insurance program is not a payment structure of a health maintenance organization. In a fee-for-service program, the client pays a premium to the insurer, and the insurer pays the provider for each service rendered, regardless of the outcome or quality of care.

Choice B reason: A fixed sum payment for the client on a monthly or yearly basis is a payment structure of a health maintenance organization. In this structure, the provider receives a set amount of money per client per period of time, regardless of the number or type of services provided. This encourages the provider to deliver preventive and primary care, and to avoid unnecessary or costly procedures.

Choice C reason: A percentage of the total costs for each service rendered by the provider is not a payment structure of a health maintenance organization. This is a type of cost-sharing arrangement, where the client pays a portion of the expenses and the insurer pays the rest. This may result in higher out-of-pocket costs for the client and higher utilization of services by the provider.

Choice D reason: A predetermined percentage of the cost of services is not a payment structure of a health maintenance organization. This is a type of discounted fee-for-service arrangement, where the provider agrees to accept a lower fee than the usual charge for each service. This may reduce the costs for the insurer, but not necessarily for the client or the provider.