ATI RN
Contemporary Ethical Issues in Nursing Questions
Question 1 of 5
A researcher is interested in learning if elderly persons perceive their health to be satisfactory even with comorbidities and chronic illness. A large multisite assistive living facility will be the site. The researcher lists residents in alphabetical order and chooses every third person on the list. To ensure improved generalizability, the researcher is using:
Correct Answer: B
Rationale: The correct answer is B: randomization. Randomization helps ensure improved generalizability by reducing bias and increasing the likelihood that the sample is representative of the population. In this scenario, choosing every third person from an alphabetical list introduces a systematic bias and may not represent the entire population accurately. Triangulation involves using multiple methods or data sources to validate findings, which is not applicable here. Informed consent is a necessary ethical consideration but does not directly impact generalizability. A meta-analysis approach involves combining and analyzing data from multiple studies, which is not relevant to the sampling method in this scenario. Thus, randomization is the best choice to improve generalizability in this study.
Question 2 of 5
When reviewing the literature on the effects of Medicaid on health care for the poor, the nurse researcher found that the poor:
Correct Answer: C
Rationale: The correct answer is C because lacking consistent providers is a common issue among the poor utilizing Medicaid. This impacts continuity of care, leading to fragmented health services and poor health outcomes. Choice A is incorrect as Medicaid does provide some level of access to healthcare. Choice B is incorrect as unnecessary treatments are not a common issue among the poor on Medicaid. Choice D is incorrect as preventive services are underutilized rather than abused by the poor on Medicaid.
Question 3 of 5
A client is admitted with chest pain. A series of diagnostic tests are ordered, and the client undergoes coronary artery bypass grafting. The cost of care for this client is increased because of a four-pack-per-day smoking history that resulted in extension of the client's intensive care unit (ICU) stay by 3 days because of respiratory problems. The case manager realizes that under the terms of the diagnosis-related group (DRG) payment system for this diagnosis:
Correct Answer: B
Rationale: The correct answer is B. The DRG payment system is a fixed reimbursement amount for a specific diagnosis or procedure. In this case, the cost of care exceeded the DRG reimbursement amount due to the extended ICU stay caused by the client's smoking history. The hospital will only be reimbursed at the set fee specified by the DRG, regardless of the actual cost incurred. Choice A is incorrect because the hospital cannot collect additional fees from the insurance company beyond the DRG reimbursement amount. Choice C is incorrect as the client is not typically held responsible for the additional costs incurred. Choice D is incorrect because physician payment is not directly impacted by the hospital's financial losses. The DRG system focuses on fixed reimbursements based on diagnoses, not individual physician payments.
Question 4 of 5
An elderly person, age 80, is finding it difficult to live alone and the family is considering long-term care. The elderly person is reasonably healthy, with only normal aging declines, and maintains a healthy appetite. All medications are administered orally and require only minimal assistance. She is financially secure with an income based on retirement from both the military and factory from her deceased husband and herself. The family contacts long- term care and is told that, based on this patient's information:
Correct Answer: C
Rationale: Rationale for Correct Answer (C): Medicare will pay for home health services should these additional services meet the needs of the individual. 1. Medicare covers home health services for individuals who meet specific criteria, which may include being homebound, needing skilled nursing care, and having a care plan established by a healthcare provider. 2. In this scenario, the elderly person is reasonably healthy and only requires minimal assistance with oral medications, indicating that she may benefit from home health services rather than long-term care. 3. Since the elderly person is financially secure, it is likely that she does not meet the eligibility criteria for Medicaid, which is a need-based program for individuals with limited income and resources. 4. Medicare does not cover long-term care in a nursing home unless specific criteria are met, such as requiring skilled services on a short-term basis. In this case, the elderly person's need for assistance with oral medications does not necessarily qualify as a skilled service for nursing home care. Summary of Incorrect Choices: A
Question 5 of 5
A patient is upset because her health insurance plan refused to pay for a mammogram and services by a women's health specialist because the primary care physician did not order the referral or the mammogram. Which type of insurance plan adheres to this type of payment system?
Correct Answer: B
Rationale: The correct answer is B: Health Maintenance Organization (HMO). In an HMO, services are typically provided by a primary care physician who acts as a gatekeeper for all medical services, including referrals to specialists and diagnostic tests like mammograms. The primary care physician must authorize and order these services for them to be covered by the insurance plan. This system helps control costs and ensures coordinated care. A: Fee for Service does not require a primary care physician to authorize referrals or services. C: PPO allows patients to see out-of-network providers without referrals. D: POS plans offer more flexibility in choosing healthcare providers without requiring a primary care physician's referral.