Chapter 01: The Health Care System
Linton: Introduction to Medical–Surgical Nursing, 6th Edition
MULTIPLE CHOICE
1. An 89-year-old man, who was recently discharged from a rehabilitation hospital because of an
inability to concentrate and frequent memory lapses, cannot be left alone while his family
works. What options should the discharge planning team suggest that will satisfy safety
concerns and give the greatest quality of life to the patient?
a.
Placement in a day care center from 8 AM to 5 PM daily
b.
Placement in a long-term psychiatric facility
c.
Placement in a high-security nursing home
d.
Admission to a general hospital for evaluation
2. A 66-year-old hospitalized patient is anxious about how the physician will be paid now that he
is on Medicare Parts A and B, instead of his previous privately funded insurance plan. Who
should the nurse explain is the payor to the physician on this plan?
a.
Previous privately funded insurance plan
b.
Medicare Part A
c.
Medicare Part B
d.
Patient or patient’s family
3. What health care plan is the best referral for an unemployed 42-year-old patient with renal
failure who has lost his job-related private insurance?
a.
Medicare
b.
Medicaid
c.
Public health facility
d.
Community-based outpatient clinic
4. A patient with terminal lung cancer with extensive metastasis is requesting a hospice transfer.
What criteria are included as requirements for this transfer?
a.
The patient requests and agrees to the guidelines of hospice care without requiring
a physician’s order.
b.
The physician confirms that the patient has 6 months or less of life remaining and
has provided a written order for hospice care.
c.
Proof confirms that the family can no longer care for the patient at home.
d.
The patient’s specific diagnosis is included on a list of accepted diseases that
qualifies the patient for hospice care.
5. A patient admitted yesterday with a diagnosis-related group (DRG) diagnosis of abdominal
pain of an unknown cause is being discharged this afternoon because all diagnostic test results
have been negative. What does this scenario exemplify?
a.
Effective laboratory response
b.
Medicare guidelines limiting hospital stay
c.
Cost containment related to a DRG diagnosis
d.
Patient who should not have been admitted in the first place
6. A nurse is discussing discharge to a transitional subacute facility with a 72-year-old patient
diagnosed with diabetes and bilateral leg amputation. What should the nurse inform the
patient regarding the stay in the new facility?
a.
It will be limited to 25 days.
b.
It will be limited to 50 days.
c.
It will be limited to 75 days.
d.
It is totally unlimited.
7. A patient is applying for Medicaid. What does the receipt of benefits require?
a.
Following a supervised health maintenance plan
b.
Enrolling in the Medicare-Preferred Drug Plan
c.
Qualifying for the food stamp program
d.
Having an annual income of less than $10,000
8. Which is true concerning proprietary agencies?
a.
They are organized to be nonprofit operations.
b.
They are organized to make a profit on their operation.
c.
Any profit they make is immediately used to purchase better equipment and
services.
d.
They must participate in Medicare.
9. Which patient should the nurse recognize as eligible for a referral to Medicaid?
a.
Military automobile mechanic with severe asthma
b.
Pregnant unmarried young woman employed at a discount retail store for 3 years
c.
College student on scholarship who works part-time at the college library and who
needs medication for arthritis
d.
Unemployed young mother on welfare who needs diabetic medication for one of
her children
10. Why was the Balanced Budget Act of 1997 the cause of closures of many proprietary home
health care agencies?
a.
It specified that all care be given by registered nurses (RNs).
b.
It listed specific diagnoses that could qualify a patient for home health care.
c.
It limited the amount of money that could be spent on a patient.
d.
It increased the criteria for patient eligibility for home care.
11. Who is considered the forerunner of modern public health nursing in the United States?
a.
Vincent DePaul
b.
William Rathbone
c.
Florence Nightingale
d.
Lillian Wald
12. What is true about voluntary health care agencies?
a.
They are supported by tax dollars.
b.
They are governed by boards made up of community members.
c.
They receive no fee for services.
d.
They use volunteers as health care providers.
13. A client who is hospitalized for treatment after a stroke asks the nurse how long Medicare can
be expected to cover his treatment. What is the nurse’s most informative response?
a.
“Your Part B will cover your hospital care as long as is necessary.”
b.
“Your health care provider will determine how long your Medicare coverage will
be in effect.”
c.
“You are allowed 50 days of inpatient care annually.”
d.
“You can receive skilled care for up to 100 days.”
14. What statement exemplifies that health care benefits are supported by both federal and state
funding?
a.
Cost-containment prospective funding
b.
Department of Health and Human Services (DHHS) Social Security benefits for
dentures
c.
Centers for Disease Control and Prevention (CDC) surveillance of persons at risk
for acquired immunodeficiency syndrome (AIDS)
d.
Medicaid provision for skilled care in the home
15. A nurse is assessing a 65-year-old patient scheduled for outpatient cataract removal surgery in
10 days. What should the nurse stress this patient will need?
a.
Adequate insurance
b.
Adequate postoperative care at home
c.
Specialized glasses
d.
Preservation and protection of vision
16. With what type of professionals are skilled nursing facilities mandated to staff facilities?
a.
Licensed health professionals around the clock
b.
RN in charge on each shift
c.
RNs to supervise the patient care given by aides
d.
Only RNs to provide complex care
17. What is the purpose of a long-term care facility?
a.
Rehabilitation of patients to their former level of functioning
b.
Restoration of patients to their optimal level of independence
c.
To offer care to patients who do not need hospitalization but cannot care for
themselves
d.
Exclusive care for patients with dementia
18. A resident in a long-term care facility has difficulty swallowing and frequently chokes on
food and liquids. The nurse identifies an increased risk of aspiration. To whom should the
nurse initiate a referral for a swallowing evaluation?
a.
Physician who specializes in throat disorders
b.
Dietitian
c.
Nutritionist
d.
Speech therapist
19. What did the 2003 report from the Institute of Medicine (IOM), “Health Professions
Education: A Bridge to Quality,” outline?
a.
Specific software technology to increase efficiency in health care
b.
Evaluation tool to evaluate the quality of health care
c.
Recommendations for curriculum changes in professional health care schools
d.
Five core competencies for health care professionals
MULTIPLE RESPONSE
20. What is the difference between a health maintenance organization (HMO) and a
fee-for-service plan? (Select all that apply.)
a.
An HMO requires a set fee from each client.
b.
An HMO allows clients to select their own health care providers.
c.
An HMO permits admission to any inpatient facility.
d.
An HMO offers limited referral options.
e.
An HMO provides both inpatient and outpatient care.
21. What should a nurse assure the parents of a newborn with a congenital heart defect that will
ease and support the home care for their child? (Select all that apply.)
a.
Availability of smaller and more compact equipment
b.
Specialized DRGs for home care of children
c.
Medicaid-funded home care services
d.
Home care services funded by private insurance
e.
Grants and stipends from various drug manufacturers
22. A nurse outlines the benefits of using a home health aide to a homebound patient. With what
should the home health aide assist this patient? (Select all that apply.)
a.
Bathing
b.
Doing laundry
c.
Shopping for groceries
d.
Administering medications
e.
Ambulating
23. A patient inquires about eligibility for home health care. What should the nurse explain is the
criteria for skilled home health care? (Select all that apply.)
a.
Annual income less than $20,000
b.
Need for physical or speech therapy
c.
Nonavailability of transportation
d.
Must be homebound
e.
Need for wound dressing changes
24. What is the mission of the Public Health Service (PHS)? (Select all that apply.)
a.
Ensure safety of foods and cosmetics.
b.
Provide access to health care services for low-income individuals.
c.
Conduct medical research.
d.
Support substance abuse prevention and treatment.
e.
Monitor and prevent disease outbreaks.
f.
Provide insurance coverage for low-income individuals.
25. What is true regarding the Medicare Prescription Drug Plan? (Select all that apply.)
a.
It is included in Medicare Part A.
b.
There is a $250 deductible.
c.
Approximately 25% of prescription drug expenses are covered.
d.
Only prescriptions written by a medical physician are covered.
e.
It reimburses 95% of out-of-pocket expenses over $3600.
26. Why do physicians prefer to use e-prescription systems? (Select all that apply.)
a.
Drug requests are processed more efficiently.
b.
Drug duplications are prevented.
c.
Less expensive drugs are used.
d.
Contraindications for a drug are identified.
e.
Both the generic and trade names are labeled.
27. What services are considered to be under the administration of the U.S. Department of Health
and Human Services (HHS)? (Select all that apply.)
a.
Public Health Service (PHS)
b.
Administration for Children and Families
c.
Administration on Aging
d.
American Medical Association
e.
Centers for Medicare and Medicaid
COMPLETION
28. The nurse clarifies that the insurance plan that pays the physician in advance each month for
each enrolled patient, whether or not the patient is treated by the physician, is a strategy
known as _____.