A physician bills the insurance company for a computed tomography (CT) scan, laboratory tests, chest x-ray, and an extended visit and receives revenue for each procedure billed. This type of payment system is a payment system.

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Ethics and Issues in Contemporary Nursing Questions

Question 1 of 5

A physician bills the insurance company for a computed tomography (CT) scan, laboratory tests, chest x-ray, and an extended visit and receives revenue for each procedure billed. This type of payment system is a payment system.

Correct Answer: D

Rationale: The correct answer is D: capitated. In a capitated payment system, the physician receives a fixed amount per patient regardless of the services provided. This incentivizes cost-effective care and promotes preventive measures. In this scenario, the physician is receiving revenue for each procedure billed, which is not characteristic of capitated payment. A: Prospective payment is when a fixed amount is determined in advance for specific services rendered. This is not the case in the scenario provided. B: Retrospective payment involves reimbursement after the services are provided, which is not reflected in the scenario given. C: Diagnosis-related group (DRG) is a payment system used in hospitals based on the diagnosis and procedures performed, not applicable to individual physician billing as presented in the question.

Question 2 of 5

A patient is eligible to change health care providers and insurance and asks, "I am interested in health promotion activities; I walk, swim, and eat healthy. Which health insurance plan would support these activities rather than just pay for services when I am sick"? Which, if any, health insurance plan would best meet the needs of this patient?

Correct Answer: A

Rationale: The correct answer is A: Health Maintenance Organization (HMO). HMOs focus on preventive care and health promotion activities, such as regular check-ups, screenings, and wellness programs. They emphasize keeping patients healthy and offer incentives for healthy behaviors. This aligns with the patient's interest in health promotion activities like walking, swimming, and eating healthy. Choice B (Fee for Service) typically does not emphasize preventive care and may not provide the support for the patient's health promotion activities. Choice C (Preferred Provider Organization - PPO) may offer some preventive care services, but HMOs are more structured and proactive in promoting health and wellness. Choice D is incorrect because many health insurance plans, including HMOs, cover preventive care and health promotion activities to encourage overall well-being.

Question 3 of 5

A client arrives in active labor and exhibits toxemia with irregular fetal heart tones. The client is an immigrant and is uninsured. Which act would prevent the client from being transferred to another facility?

Correct Answer: A

Rationale: The correct answer is A: Emergency Medical Treatment and Active Labor Law (EMTALA). This act prohibits hospitals from transferring patients in active labor or with an emergency condition based on insurance status or ability to pay. It ensures that all individuals, regardless of insurance or immigration status, receive necessary emergency medical treatment. The other choices are incorrect because: B: Health Insurance Portability and Accountability Act (HIPAA) protects patient privacy and does not address transfer of patients in active labor. C: Patient Self-Determination Act focuses on patient autonomy in making healthcare decisions, not on preventing transfer based on insurance status. D: The Patient Safety and Quality Improvement Act promotes patient safety and quality improvement but does not specifically address transfer of patients in active labor.

Question 4 of 5

Which statement regarding informed consent is correct? Informed consent:

Correct Answer: D

Rationale: The correct answer is D because informed consent requires the registered nurse (RN) to communicate all necessary information to the patient so they can make an informed decision. This includes explaining the procedure, potential risks, benefits, alternatives, and any other pertinent information. The RN plays a crucial role in ensuring that the patient understands the information provided before giving consent. Choices A, B, and C are incorrect because informed consent is not solely mandated by federal law, must disclose risks as well as benefits, and should not involve concealing any known risks.

Question 5 of 5

A nurse who functions in the role of team leader can be held negligent for matters involving:

Correct Answer: D

Rationale: The correct answer is D: delegation of client care tasks. A team leader nurse can be held negligent for improper delegation as they are responsible for assigning tasks to appropriate staff ensuring safe and effective care. This is crucial for patient safety. Choices A, B, and C are incorrect because inadequate training, lack of policies, and failure to discipline unsafe workers are not directly related to the nurse's role in delegation and immediate patient care responsibilities.

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