ATI LPN
Fundamentals of Nursing: The Art and Science of Person-Centered Care Tenth, North American Edition
Chapter 11 Questions
Question 1 of 5
During a meeting with nurses at all levels in an acute care hospital, the Director of Nursing discusses lost revenue due to Medicare penalties. The nurses plan improvements in practice designed to prevent penalties from which events? Select all that apply.
Correct Answer: A,B,C,D
Rationale: Medicare penalties are given to hospitals when patients are readmitted soon after discharge; this is designed to ensure patients receive needed coordinated care after discharge. In addition, Medicare no longer reimburses hospitals for conditions that result from preventable errors and lead to increased costs, including pressure injuries, infections associated with indwelling urinary catheters, and vascular catheter-associated infections. High blood pressure is not a preventable hospital-acquired condition subject to penalties.
Question 2 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.
Question 3 of 5
Nursing students are reviewing information about health care delivery systems in post conference. Which statements describing current U.S. health care delivery practices should be included in the discussion? Select all that apply.
Correct Answer: C,E,F
Rationale: The Health Insurance Marketplace is designed to help people more easily find health insurance that fits their budget. All plans in the Marketplace offer comprehensive coverage, from doctors to medications to hospital visits. There are many fewer primary care providers in the United States than there were 50 years ago. Quality is the right care for the right person at the right time. Access to care depends on both the ability to pay and the availability of services. The Patient Protection and Affordable Care Act provides Medicaid or subsidized coverage to qualifying people with incomes up to 400% of poverty. The uninsured pay for more than one third of their care out of pocket and are often charged higher amounts for their care than the insured pay.
Question 4 of 5
A nurse caring for patients in a primary care setting submits paperwork for reimbursement from managed care plans for services provided. What best describes managed care?
Correct Answer: A
Rationale: Managed care is a way of providing care designed to control costs while maintaining the quality of care. The other options describe care coordination, continuum of care, and hospice care, respectively.
Question 5 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.