ATI LPN
Fundamentals of Nursing: The Art and Science of Person-Centered Care Tenth, North American Edition
Chapter 11 : Health Care Delivery System Questions
Question 1 of 5
Nurses provide care to patients in secondary health care facilities. Which patients do the nurses anticipate will receive this type of care? Select all that apply.
Correct Answer: B,C,F
Rationale: Secondary health care treats problems that require specialized clinical expertise, such as an MI, a seizure, and a hernia repair. Treating strep throat is primary health care. Tertiary health care involves management of rare and complex disorders, such as osteogenesis imperfecta and congenital heart malformations.
Question 2 of 5
A nurse working in a primary care facility prepares insurance forms in which the provider is given a fixed monetary amount per enrollee in the health plan. What term do the nurses apply to this type of reimbursement?
Correct Answer: A
Rationale: Capitation plans give providers a fixed amount per enrollee in the health plan to build a payment plan that consists of the best standards of care at the lowest cost. The prospective payment system groups inpatient hospital services for Medicare patients into DRGs. With bundled payments, providers receive a fixed sum of money to provide a range of services. Rate setting means that the government could set targets or caps for spending on health care services.
Question 3 of 5
A nurse working in a pediatric clinic provides codes for a patient's services to a third-party payer who pays all or most of the care. How does the nurse refer to this method of payment?
Correct Answer: B
Rationale: The four basic modes of paying for health care are out-of-pocket payment, individual private insurance, employer-based group private insurance, and government financing. With individual private insurance, members pay monthly premiums either by themselves or in combination with employer payments. These plans are called third-party payers because the insurance company pays all or most of the cost of care. Out-of-pocket payment is paying for health care with cash payments. Employer-based private insurance is employer-sponsored coverage, and government financing is provided through Medicare and Medicaid, and other federally funded programs.
Question 4 of 5
A nurse researcher follows current trends in health care delivery. Which present-day trends does the nurse observe? Select all that apply.
Correct Answer: A,D,E,F
Rationale: Trends to watch in health care delivery include globalization of the economy and society, increasing complexity of patient care, changing demographics, shortages of key health care professionals and educators, technology explosion, and increasing diversity. A slowdown in technology development and decreasing diversity are not current trends.
Question 5 of 5
A nursing student is assisting with nursing care for patients in a primary care center. Based on the setting, what activities will the student expect to perform?
Correct Answer: B
Rationale: Performing health assessments is a common role of the nurse in a primary care center. Assisting with major surgery is a role of the nurse in the hospital setting. Maintaining patients' function and independence is a role of the nurse in a rehabilitation or extended-care facility, and keeping student immunization records up to date is a role of the school nurse.