Review Practice Exercise 2

Healthcare Delivery Systems > Fundamentals

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Practice Exercise 2

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Total Questions : 7

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Question 1:

A nurse is developing a presentation for a local community group about the knowledgeable healthcare consumer. Which technology would the nurse include as having the greatest effect on this area?

A. Television B. Computers C. Cell phones D. Global positioning system (GPS) devices

Answer and Explanation

Choice A:

Television: While health education programs exist, television is passive and limited compared to interactive technology.

Choice B:

Computers, especially with internet access, allow consumers to research conditions, compare treatment options, and access online health portals, empowering informed healthcare decisions.Rationale for incorrect answers:

Choice C:

Cell phones: While mobile health apps are valuable, their content and function often depend on computer-based internet platforms for depth of information.

Choice D:

Global positioning system (GPS) devices: GPS technology is not directly related to healthcare consumer education, though it can aid in locating facilities.

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Question 2:

Private insurance most often is called a third-party payer, indicating which of the following?

A. You pay no monthly premium, paying for all healthcare costs yourself. B. You belong to a preferred provider organization. C. You are at risk if your healthcare provider is not a part of the plan. D. You pay a monthly premium, and the insurance company pays the bills.

Answer and Explanation

Choice A:

You pay no monthly premium, paying for all healthcare costs yourself: This describes self-pay, not third-party payer insurance.

Choice B:

You belong to a preferred provider organization: A PPO is a type of insurance network, but the term "third-party payer" refers to the financial role of the insurer, not the network type.

Choice C:

You are at risk if your healthcare provider is not a part of the plan: While true for some insurance plans like HMOs or PPOs, this is not the definition of “third-party payer.”

Choice D:

You pay a monthly premium, and the insurance company pays the bills: This is the essence of third-party payer systems - the insured pays premiums, and the insurance company pays the provider for covered services.Rationale for incorrect answers:

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Question 3:

Your newly employed friend is a part of the company’s HMO. You interpret that to mean the friend

A. Can have healthcare services from a provider of his choice B. Will be unable to have emergency care C. Receives all healthcare from providers within the organization D. Must pay an additional monthly premium

Answer and Explanation

Choice A:

Can have healthcare services from a provider of his choice: HMOs require members to use network providers except in emergencies.

Choice B:

Will be unable to have emergency care: Emergency care is covered, but usually requires follow-up within the HMO system.

Choice C:

Receives all healthcare from providers within the organization: HMOs contract with specific providers; members must receive most care within the network.Rationale for incorrect answers:

Choice D:

Must pay an additional monthly premium: Premiums are part of the plan but are not "additional" beyond the agreed amount; some HMOs may even have lower premiums.

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Question 4:

Which purpose best describes managed care as a framework for healthcare?

A. A design to control the cost of care while maintaining the quality of care B. Care coordination to maximize positive outcomes to contain costs C. The delivery of services from initial contact through ongoing care D. Based on a philosophy of ensuring death in comfort and dignity

Answer and Explanation

Choice A:

A design to control the cost of care while maintaining the quality of care: This is the primary goal of managed care systems.Rationale for incorrect answers:

Choice B:

Care coordination to maximize positive outcomes to contain costs: While related, this is more a description of case management, which is a component of managed care.

Choice C:

The delivery of services from initial contact through ongoing care: This describes continuity of care, which is a broader concept and not exclusive to managed care.

Choice D:

Based on a philosophy of ensuring death in comfort and dignity: This describes hospice care.

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Question 5:

A nurse is preparing to discharge a 72-year-old client who was admitted for heart failure management. Which of the following are common barriers to effective discharge planning? Select all that apply

A. Ineffective communication among providers B. Lack of role clarity among health care team members C. Number of hospital beds to manage patient volume D. Client’s long-term disabilities E. The client’s cultural background

Answer and Explanation

Choice A:

Ineffective communication among providers: Poor communication between nurses, physicians, therapists, case managers, and other providers can lead to conflicting instructions, missed referrals, or incomplete discharge plans.

Choice B:

Lack of role clarity among health care team members: When team members are unsure of their responsibilities, tasks like medication reconciliation, education, and follow-up scheduling may be duplicated or missed, leading to fragmented discharge planning.Rationale for incorrect answer:

Choice C:

Number of hospital beds to manage patient volume: While bed availability may affect admission and throughput, it is not a direct barrier to discharge planning. Discharge planning is more affected by the quality of coordination than by infrastructure like bed count.

Choice D:

Client’s long-term disabilities: Though long-term disabilities may require extensive planning, including home modifications, caregiver training, or access to outpatient services they are additional factors to consider, not barriers to discharge planning.

Choice E:

The client’s cultural background: Cultural factors can influence health beliefs, language comprehension, family involvement, and care preferences but are not traditional barriers to discharge planning.

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Question 6:

A nurse is educating student nurses about levels of prevention. Which activity does the nurse perform while providing tertiary care? Select all that apply

A. Conducting blood pressure screenings at a local food bank. B. Administering influenza vaccines for older adults at the local senior center. C. Inserting an indwelling catheter for a client in a medical-surgical unit. D. Performing endotracheal suctioning for a client on a ventilator in the medical ICU. E. Working with clients in a cardiac rehabilitation program.

Answer and Explanation

Choice A:

Conducting blood pressure screenings at a local food bank: This is an example of secondary prevention, which focuses on early detection and intervention to identify and manage diseases in the early stages.

Choice B:

Administering influenza vaccines for older adults at the local senior center: This is primary prevention, aimed at preventing disease before it occurs by promoting immunity and protecting against infectious illness.

Choice C:

Inserting an indwelling catheter for a client on a medical-surgical unit: This manages complications of an existing condition- such as urinary retention, neurogenic bladder, or immobility due to a stroke or surgery. This intervention supports recovery and prevents secondary complications.

Choice D:

Performing endotracheal suctioning for a patient on a ventilator in the medical ICU: This is a highly specialized, supportive procedure for clients with serious health conditions. It helps prevent complications in patients already experiencing critical illness.

Choice E:

Working with patients in a cardiac rehabilitation program: Cardiac rehab is a classic example of tertiary prevention, aimed at maximizing recovery, restoring function, and preventing further cardiovascular events in clients after a heart attack or cardiac surgery.Rationale for incorrect answers:

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Question 7:

A client is seeking to control health care costs for both preventive and illness care. Although no system guarantees exact out-of-pocket expenditures, the most prepaid and predictable client contribution would be seen with

A. Medicare B. An individual fee-for-service insurance C. A preferred provider organization (PPO) D. A health maintenance organization (HMO)

Answer and Explanation

Choice A:

Medicare: While Medicare offers comprehensive coverage for those over 65 and certain disabled individuals, it involves variable costs including premiums, deductibles, copays, and coinsurance.

Choice B:

An individual fee-for-service insurance: This model allows clients to see any provider and pay per service rendered, but it generally results in higher and less predictable out-of-pocket expenses, including deductibles and coinsurance.

Choice C:

A preferred provider organization (PPO): PPOs offer more flexibility than HMOs by allowing clients to see providers both in and out of the network without referrals, but this also means higher premiums and more variable cost-sharing.

Choice D:

A health maintenance organization (HMO): An HMO is a managed care plan that emphasizes prepaid, fixed payments (usually monthly premiums), which cover a broad range of services. HMOs provide the most predictable and limited out-of-pocket expenses compared to other models.Rationale for incorrect answers:

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