What is the main purpose of a utilization review?

Correct Answer: A

Rationale: The main purpose of a utilization review is to evaluate patient outcomes. This process involves assessing the appropriateness, necessity, and quality of healthcare services provided to patients. By evaluating patient outcomes, healthcare providers can ensure that patients receive effective and efficient care, leading to better health outcomes. Choice B (Ensure compliance with regulations) is incorrect because while utilization review may involve ensuring compliance with regulations, it is not the primary purpose of the process. Choice C (Reduce hospital readmissions) is incorrect as reducing hospital readmissions is a specific goal within healthcare quality improvement initiatives, but it is not the main purpose of utilization review. Choice D (Assess financial impact) is incorrect as while financial considerations may play a role in utilization review, the primary focus is on evaluating patient outcomes rather than financial implications.

Correct Answer: C

Rationale: The correct answer is C because evidence-based practice (EBP) involves integrating clinical expertise with the best available research evidence and considering patient preferences. This approach ensures that decisions are informed by both the clinician's experience and the most current and relevant research findings, leading to the most effective and individualized patient care. Choice A is incorrect as it solely relies on clinical expertise without considering research evidence. Choice B is incorrect as it suggests solely relying on research findings, neglecting the importance of clinical judgment. Choice D is incorrect as it focuses on following institutional guidelines rather than on the integration of clinical expertise and research evidence.

Correct Answer: B

Rationale: The correct answer is B: To ensure patient safety and quality care. Healthcare accreditation programs aim to establish and maintain standards for healthcare facilities to ensure that patients receive safe and high-quality care. This objective prioritizes patient well-being and satisfaction over financial gain (A), operational efficiency (C), or reducing readmissions (D). Patient safety and quality care are fundamental principles in healthcare accreditation to enhance overall healthcare outcomes and patient experience.

Correct Answer: C

Rationale: The correct answer is C: To prevent the onset of disease. Health promotion activities aim to prevent illnesses before they occur by promoting healthy behaviors and lifestyles. This is a proactive approach that focuses on preventing diseases rather than managing or treating them after they have developed. Choice A focuses on managing existing conditions, choice B emphasizes educating patients after the fact, and choice D focuses on early detection and treatment rather than prevention. Preventing disease through health promotion is the most effective and cost-efficient approach to improving overall health outcomes.

Correct Answer: D

Rationale: The correct answer is D because cultural humility in nursing emphasizes continuous learning from patients and adapting care based on their individual needs. This approach values patient input and focuses on building mutual respect and trust. Choice A is incorrect because cultural humility is not about a fixed set of competencies but rather an ongoing process. Choice B is incorrect as it only addresses one aspect of cultural humility related to power dynamics. Choice C is incorrect as it focuses on adapting care to fit different cultural contexts rather than individual patient needs. In summary, cultural humility in nursing involves actively listening, learning, and adapting to meet the unique needs of each patient.