Fundamentals ch. 6 practice questions

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Which of the following is an example of a primary prevention activity?
1. Antibiotic treatment of a suspected urianry tract infection
2. Occupational therapy to assist a client in adapting his or her home environment following a stroke
3. Nutrition counseling for young adults with a strong family history of cholesterol
4. Removal of tonsils for a client with recurrent tonsillitis

3
page 1487 / pg 115

Which of the following statements is true regarding types of health care agencies?
1. Hospitals provide only acute, inpatient services
2. Public health agencies are funded by governments to investigate and provide health programs
3. Surgery can only be performed inside a hospital setting
4. Skilled nursing, extended care, and long term care facilities provide care for the elderly whose insurance no longer covers hospital stays

2
page 1487 / pg 115

In most cases, clients must have a primary care provider in order to receive health insurance benefits. If a client is in need of a primary care provider, it is most appropriate for the nurse to recommend which of the following?
1. Family practice physician
2. Physical therapist
3. Case manager/discharge planner
4. Pharmacist

1
pg 1487 / pg 115

The most significant method for reducing the ongoing increase in the cost of health care in the United States includes controlling which of the following?
1. Number of children according to the family's income
2. Numbers of uninsured and underinsured persons
3. Number of physicians and nurses nationwide
4. Competition among drug and medical equipment manufacturers

2
pg 1487 / pg 115

A client is seeking to control health care costs for both preventive and illness care. Although no system guarantees exact out-of-pocket expenditures, the most prepaid and predictable client contribution would be seen with:
1. Medicare
2. An individual fee for service insurance
3. A preferred provider organization (PPO)
4. A health maintenance organization (HMO)

4
pg 1488 / pg 115

A nurse is considering working in a hospice setting. The nurse should understand that the primary function of the nurse in a hospice setting is which of the following?


Performing ongoing assessments
Acting as a case manager
Assisting in finding client resources
Providing client care in a home setting

Correct Answer:
Acting as a case manager

Objective: Identify the roles of various health care professionals.

Rationale: Hospice nurses serve primarily as case managers, supervising direct care provided by other members of the team. The other choices are some of the functions of the hospice nurse, but are not the primary function.

Which fact should take priority when projecting future care for the frail elderly, people over age 85?


Ninety-five percent will live in their own homes.
They want to feel part of the community.
They are the fastest-growing population in the United States.
They want to feel productive.

Your Answer:
Ninety-five percent will live in their own homes.

Objective: Describe the factors that affect health care delivery.

Rationale: The frail elderly are projected to be the fastest-growing population in the United States. Only 5 percent are institutionalized, so the nurse must plan for home management of this population. The other choices are important, but home care needs must override any of the other facts.

Which statement regarding the women's movement is most accurate?


It has been instrumental in changing health care practices.
It has directed research examining women equally to men in health issues.
It has decreased the emphasis on psychosocial aspects of women's health.
It has increased the focus on reproductive aspects of health.

Your Answer:
It has been instrumental in changing health care practices.

Objective: Describe the factors that affect health care delivery.

Rationale: The women's movement has been instrumental in changing health care practices. It is only now beginning to increase research regarding equality to men in health issues. The movement has increased emphasis on psychosocial aspects of women's health. It has changed the focus away from just the reproductive aspects of health.

As demographic changes take place in North America, what are agencies doing to try to meet the challenges of these changes?


They are implementing managed care programs.
Increased access to health care is a priority for the homeless and poor.
They have a greater emphasis on the childcare needs of their employees.
Agencies are employing bilingual nurses.

Correct Answer:
Agencies are employing bilingual nurses.

Objective: Describe the functions and purposes of the heath care agencies outlined in this chapter.

Rationale: Agencies are employing bilingual nurses after recognizing the cultural and ethnic diversity in North America. Managed care is increasing, but is not a result of demographic changes in North America. There is limited access to health care for the homeless and poor. Although childcare needs are increasing, there is not increased emphasis on these needs due to demographic changes.

Which medical condition would best be suited to the use of a nursing critical pathway?


Foreign object in ear
Fever of unknown origin
Hip replacement surgery
Viral infection acquired in a foreign country

Correct Answer:
Hip replacement surgery

Objective: Differentiate health care services based on primary, secondary, and tertiary disease prevention categories.

Rationale: A critical pathway tracks the client's progress through assessment, interventions, treatments, and outcomes for conditions across a time line. Hip replacement surgery would have a specified time line, with specific interventions and treatments to get the client back to optimal functioning. The others do not have specific interventions and treatments to be able to track.

What type of unit would the nurse be working on if the unit were self-contained, with multiskilled workers?


Case-managed unit
Differentiated-practice unit
Functional-method unit
Patient-focused unit

Correct Answer:
Patient-focused unit

Objective: Identify the roles of various health care professionals.

Rationale: A patient-focused unit is self-contained, with its own admitting, pharmacy, lab, and radiology areas. Workers are crossed-trained, and perform multiple tasks. The other types of units are not self-contained.

Which statement best describes the federal Medicaid program?


It is public assistance paid for out of general taxes.
It is divided into two parts.
It now includes "catastrophic care" coverage.
The client pays a deductible for services rendered.

Your Answer:
It is public assistance paid for out of general taxes.

Objective: Compare various systems of payment for health care services.

Rationale: Medicaid is a public assistance program of the federal government that is paid for out of general taxes. The other answers are specific to Medicare.

Which would be an example of tertiary health care?


Promoting worker safety
Care of the dying
Immunization
Acute care

Correct Answer:
Care of the dying

Objective: Differentiate health services based on primary, secondary, and tertiary disease prevention categories.

Rationale: Tertiary health care involves rehabilitation and health restoration. The others are examples of primary and secondary health care.

What governs payment under the prospective payment system?


The record of admission
The record of treatment
A fixed payment without change for major occurrences
The length of the client's stay in the hospital

Your Answer:
The record of admission

Objective: Compare various systems of payment for health care categories.

Rationale: The prospective payment system, with diagnosis-related groups (DRGs), is determined prior to hospital admission and is based on specific diagnosis. Therefore, the record of admission is the guiding force behind payment. The other answers do not govern payment.

A client belongs to a health maintenance organization. Which statement by the client indicates a misunderstanding about this system?


"I will have more than one health care provider."
"I will pay for each individual part of my care."
"I will share in any surplus money in the HMO at the end of the year."
"I will pay a set fee for services."

Correct Answer:
"I will pay a set fee for services."

Objective: Compare various systems of payment for health care services.

Rationale: Members of an HMO choose one primary care provider that directs their care, and they pay a set fee for the services provided. The other answers represent other types of group plans.

A nurse working in an urban clinic has noticed an increase in tuberculosis among the clients. The nurse knows:


Low income is inversely related to a higher infectious disease rates.
There must be an epidemic
The problem will not resolve itself since the poor do not have access to treatment.
The poor wait until the last minute for treatment.

Your Answer:
Low income is inversely related to a higher infectious disease rates.

Objective: Differentiate health care services based on primary, secondary, and tertiary disease prevention categories.

Rationale: Low income is associated with higher incidences of infectious diseases such as tuberculosis and AIDS.

The nurse plans for the discharge of an elderly client with angina associate with coronary artery disease. The client discloses that they live on the fifth floor of an apartment complex that does not have an elevator. The nurse decides to contact which member of the health care team?


Physician's assistant
Rabbi
Social Worker
Occupational therapist

Correct Answer:
Social Worker

Objective: Describe the functions and purposes of the health care agencies outlined in this chapter.

Rationale: The health care team is composed of nurses, physicians, case managers, dentists, dietitians, occupational therapists, paramedical technologists, pharmacists, physical therapists, podiatrists, physician assistants, respiratory therapists, social workers, spiritual support persons, and unlicensed assistive personnel. Each specialty has an important role in assisting the client to become more independent.

A teenage client confides in the nurse that they are having suicidal thoughts. The nurse quickly refers the teenager to:


Hospice Service
Rehabilitation Centers
Family Counseling
Crisis Center

Correct Answer:
Crisis Center

Objective: Identify the roles of various health care professionals.

Rationale: There are several outpatient services available to assist in emergency situations. Crisis centers are designed to provide emergency counseling services to help individuals cope with an immediate crisis. Long term counseling can be recommended by the primary care provider.

A client has had a total hip replacement and is ready to leave the hospital. The next logical step for the client would be discharge to:


Rehabilitation setting
Home care
Nursing home
Assistive living center

Your Answer:
Rehabilitation setting

Objective: Describe the functions and purposes of the health care agencies outlined in this chapter.

Rationale: Primary prevention focuses on health promotion and illness prevention. Secondary prevention focuses on diagnosis and treatment, whereas, tertiary prevention correlates to rehabilitation services.

A client of Asian descent was admitted to the hospital with a fever and rash. When questioning the client about his medical history, the nurse knows to ask questions about:


Dental habits
Herbal or alternative therapies used
Type of health insurance
Vacation plans

Correct Answer:
Herbal or alternative therapies used

Objective: Differentiate health care services based on primary, secondary, and tertiary disease prevention categories.

Rationale: Non traditional health providers are playing increasing roles in health care. Therapies such as herbal, acupuncture, and holistic remedies can be used in conjunction with Western therapies.

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