The precise classification of clients according to the highest diagnosis-related group (DRG) has created a new role for nurses, known as a nurse.

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Question 1 of 5

The precise classification of clients according to the highest diagnosis-related group (DRG) has created a new role for nurses, known as a nurse.

Correct Answer: A

Rationale: The correct answer is A: case management. Case management involves coordinating care for patients to ensure they receive appropriate services and resources. DRGs determine reimbursement based on patient diagnoses, making accurate classification crucial. Nurses in case management play a key role in ensuring patients are placed in the correct DRG category for optimal care and reimbursement. Other choices are incorrect because: B: Quality assurance focuses on monitoring and improving the quality of care, not specifically tied to DRG classification. C: Utilization review involves assessing the appropriateness and necessity of healthcare services, not directly related to DRG classification. D: Cost-control pertains to managing healthcare costs, but does not address the specific role of nurses in DRG classification and patient care coordination.

Question 2 of 5

A nurse is offered several health care plans as part of employee benefits. Which plan is based on a monthly fee per participant and offers a range of preventive, diagnostic, and treatment services?

Correct Answer: D

Rationale: The correct answer is D: Capitation. Capitation is a payment model where healthcare providers receive a fixed amount per patient per month to provide all necessary healthcare services. This aligns with the description of the plan in the question, offering services based on a monthly fee per participant. Capitation also emphasizes preventive care, diagnostic services, and treatment, making it the most suitable choice. A: Prospective payment system is a method where healthcare providers are paid a fixed amount per service in advance. This does not match the description of the plan in the question. B: Retrospective payment system involves reimbursing healthcare providers after services are delivered based on the actual costs incurred. This is not based on a monthly fee per participant. C: Single-payer system refers to a healthcare system where a single public or quasi-public agency organizes healthcare financing. This is not based on a monthly fee per participant.

Question 3 of 5

Health care is one of the major stories in newspaper and television and a group of nurses are interested in how the economy impacts their nursing practice. The group critiques the relationship between contemporary economic trends and professional nursing practice and finds:

Correct Answer: C

Rationale: The correct answer is C because pay for performance initiatives incentivize nurses to improve patient outcomes by reducing errors and following best practices. This directly links economic incentives to nursing practice. Choice A is incorrect because the DRG system primarily affects hospital reimbursement, not nursing shortages. Choice B is incorrect as it focuses on the type of care, not the economic impact on nursing practice. Choice D is incorrect as economic factors like funding, resources, and reimbursement significantly influence nursing practice.

Question 4 of 5

Medicare would be responsible for: (select all that apply)

Correct Answer: A

Rationale: The correct answer is A because Medicare covers hospital stays for individuals aged 65 and older, which would include a 70-year-old client. Choice B is incorrect because Medicare typically covers dialysis for individuals with end-stage renal disease, not nursing home costs. Choice C is incorrect because Medicare does not typically cover rehabilitation care for individuals under 65. Choice D is incorrect because AFDC is a separate program from Medicare that provides assistance for low-income families, and prescription costs for the young mother would likely be covered under a different program.

Question 5 of 5

When differentiating between slander and libel, the nurse knows that libel:

Correct Answer: A

Rationale: The correct answer is A because libel refers to written defamatory statements. In this scenario, subjective comments written in the nurse's notes can be considered libel as they are documented in writing. Choice B is incorrect because it describes negative comments made verbally, which would be considered slander, not libel. Choice C is incorrect as it involves verbal communication, which falls under slander, not libel. Choice D is incorrect as it describes repeating prejudiced comments verbally, which is also considered slander, not libel.

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