The nurse is working with a case manager for a client who participates in a health maintenance organization.
The nurse should identify which of the following payment structures?
The provider is paid a fixed sum for the client on a monthly or yearly basis.
The client is participating in a fee-for-service healthcare insurance program. The provider bills the client directly for a predetermined percentage of the cost of services.
The client pays the insurer a percentage of the total costs for each service rendered by the provider.
None of the above (This option is necessary because there are only three options provided in the original question).
The Correct Answer is A
The provider is paid a fixed sum for the client on a monthly or yearly basis. This payment structure is known as capitation. In a health maintenance organization (HMO), the provider is paid a fixed amount per enrolled member per month or year, regardless of the services provided.
Choice B is not the answer because it describes a fee-for-service healthcare insurance program, which is different from an HMO.
Choice C is not the answer because it describes a co-insurance payment structure, which is also different from an HMO.
Choice D is not the answer because it states that none of the above choices are correct.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
This statement indicates that the client is using rationalization as a coping mechanism by justifying their obesity with a seemingly logical reason 1.
Choice A, “I have difficulty resisting the items in vending machines,” does not indicate rationalization as it is a statement of fact.
Choice C, “I know you don’t like me because I am obese,” indicates the use of projection as a coping mechanism by attributing their own feelings to someone else.
Choice D, “I have lots of health problems from being obese,” does not indicate rationalization as it is a statement of fact.
Correct Answer is D
Explanation
The correct answer is choice D: “I should check the flow rate of my oxygen each day.”
Choice A rationale:
Keeping the oxygen delivery system at least 3 feet from a heating vent is a good safety practice, but it is not the best indicator that the client understands the teaching.The recommended distance is usually 5 to 10 feet to ensure safety.
Choice B rationale:
Using wool blankets is not recommended because wool can generate static electricity, which poses a fire hazard when using oxygen.
Choice C rationale:
Applying petroleum jelly to the nasal cannula prongs is not advised because petroleum-based products are flammable and can pose a fire risk when using oxygen.
Choice D rationale:
Checking the flow rate of the oxygen each day is crucial to ensure the client is receiving the correct amount of oxygen as prescribed.This practice demonstrates that the client understands the importance of monitoring their oxygen therapy.
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