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NURS 201-Chapter 11
Health Care Delivery Systems
| Question | Answer |
|---|---|
| A client is being prepared for discharge.The client needs assessment of cardiac status,instruction in medications,diet therapy,exercises,assistance with self-care,both in learning performing it. Who from interdisciplinary team would need to be involved? | -Nurse (cardiac, medications, diet) -Physical therapist (exercises and mobility) -Occupational therapist (self-care adaptations in activities of daily living) -Unlicensed assistive personnel (self-care now) -Social worker (supportive services) |
| Based on the Patient Protection and Affordable Care Act (ACA), nurses are to assume an important new role in health care. Which is an example of this new role? | Collaborating with all agencies to provide for the client's home health needs |
| What are the goals of the PPACA (Patient Protection and Affordable Care Act)? | -EXPAND coverage, control health care costs, improve the heath care delivery system -PROVIDE Medicaid or subsidized coverage to qualifying people with income up to 400% in poverty -PROVIDE new ways to get health insurance (Health Insurance Marketplace) |
| Medicaid | -Low income, disabled people, people released from prison -Coverage depends on STATE |
| Medicare | -Part A = FEDERALLY funded and benefits may change annually according to decisions related to the federal budget -Part B = Voluntary and is paid by a monthly premium and covers most outpatient costs |
| Which type of facility employs the greatest number of nurses? | Hospitals |
| The nurse is caring for several clients with chronic conditions that need to be evaluated for long-term care. After evaluating each client, the nurse determines which client is most appropriate to receive long-term care? | A client who suffered a stroke who has mobility issues and problems completing activities of daily living (ADLs). |
| The nurse is providing care to several clients on a medical-surgical unit. For which client's plan of care should the nurse include information regarding extended care? | An older adult client who fell at home and required a hip replacement |
| The nurse is a member of the multidisciplinary team in a large primary healthcare setting. The nurse understands that which healthcare team member is responsible for a client's swallow evaluation following a cerebral vascular accident? | Speech pathologist/therapist -Swallowing and clear speech |
| On a recent visit, the nurse notices patient's clothes are very loose,has difficulty letting the nurse leave when the visit is ending,has not been cooking for himself and he can’t get to the grocery store easily. What service could the nurse suggest? | Enroll the client in Meals on Wheels (a voluntary agency) |
| Which six trends in health care reflect the Institute of Medicine's (IOM) focus? | 1. Safe 2. Effective 3. Efficient 4. Patient centered 5. Timely 6. Equitable |
| The implementation of diagnosis-related groups (DRGs) by Medicare in 1983 affected hospitals in which way? | Medicare pays only the amount of money preassigned to a treatment for a diagnosis -If the cost for hospitalization is greater than that assigned, the hospital must absorb the additional cost -If the cost is less, the hospital makes a profit |
| Client admitted after fracturing a hip.Client undergoes surgery to repair fracture and receiving services to promote healing and regain mobility. Which discussion should nurse have with member of the interdiscip. team member to promote goal of mobility? | Speak with the physical therapist about exercises to strengthen muscles |
| Long-term care facilities | -Provide health care and help with daily living for people of any age who are physically or mentally unable to care for themselves independently -Care may extend for periods ranging from days to years |
| A client requiring medication monitoring needs what kind of care? | Primary health care -Treatment of common health problems |
| A client with a back injury and physical therapy needs treatment and what kind of care? | Outpatient care/therapy |
| A client diagnosed with pneumonia requiring mechanical ventilation requires what kind of care? | Acute care |
| Extended care | -Meets the health needs of clients who no longer require acute hospital care but require rehabilitation and skilled nursing care -May need additional assistance with mobility and more time for physical therapy before being ready to be discharged home |
| What is the triple aim for healthcare? | 1. Quality 2. Access 3. Cost |
| Diagnosis-related groups | A system where health care providers receive fixed payments for services provided that's predetermined by the medical diagnosis or specific procedure, rather than the actual cost of hospitalization and care |
| Respiratory therapists | Trained in techniques that improve pulmonary function and oxygenation |
| A new nurse is considering getting a job in either an acute care setting or a home care setting. Which statement about these care settings is most accurate? | Clients play a large role in helping themselves in the home care setting |
| The Nursing Agenda for Health Care Reform (American Nurses Association [ANA]) identifies the recipients of health care. This reform's main focus is on: | Health promotion |
| During a hospice visit, the client’s spouse suddenly begins to cry and says, “I am so tired. I just can’t do this anymore. I am not getting to sleep and I just eat sandwiches when I can.” What is the nurse’s best intervention? | Arrange for short-term inpatient care for the client -Spouse needs respite care |
| A nurse working for a home health agency is scheduled to evaluate a client with worsening heart failure to determine whether the client is a candidate for the new "Hospital at Home" program. Which statement accurately reflects an outcome for this program? | Clients in the "Hospital at Home" program have been found to require shorter lengths of stay than when admitted to the acute care setting -Clients who receive care in their own homes, surrounded by fam and friends, have been found to recover more quickly |
| A nurse demonstrates understanding of Healthy People 2030 by supporting which statement? | A client's health is affected by social, economic, and political factors |
| Which statement is most accurate in comparing nursing care provided in the acute care setting and that provided in the home care setting? | Both settings focus on the holistic care of an individual |
| The growth in home health care is largely attributed to which factor? | Early discharge of clients from the hospital setting |
| Respite care | Care provided for caregivers of homebound ill, disabled, or older clients -The main purpose is to give the primary caregiver some time away from the responsibilities of day-to-day care |
| Palliative care | Given in conjunction with medical treatment and in all types of health care settings, is client- and family-centered -Evolved from the hospice experience, but not restricted to the end of life and can be used from the point of initial diagnosis |
| Hospice care | Typically provided to clients with less than 6 months to live |
| A nurse is caring for a client with end-stage liver failure. Which healthcare agency should the nurse recommend for continuity of care? | Extended care |
| PPOs (Preferred Provider Organization) | Agents for health insurance companies that control healthcare costs on the basis of competition |
| HMOs (Health Maintenance Organization) | Corporations that provide health care for members in exchange for preset, fixed, or yearly fees |
| A hospital system has adopted the Institute for Healthcare Improvement’s “Triple Aim” dimensions and has surveyed nurses for planning ideas. Which strategies will help the hospital comply with this framework? | -Make results of quality studies available to nurses in a timelier manner -Create outreach education programs to improve the overall health of the community served. -Reduce redundancy in diagnostic tests |
| The nurse is providing care to several clients on a medical-surgical unit. For which client's plan of care should the nurse include information regarding extended care? | An older adult client who fell at home and required a hip replacement |
| The nurse understands that a diagnostic-related group is one of the reimbursement strategies in a prospective payment system. The diagnostic-related group is a part of which health care system? | Medicare |
| A nurse has very strong client education skills. In which health care setting would the nurse make best use of these skills? | Primary care center |
| One of the primary advantages of the managed care model is: | Economic, quality care |
| Which statement accurately reflects the findings of the 1999 Institute of Medicine report, "To Err Is Human"? | Anywhere from 44,000 to 98,000 people are estimated to die in U.S. hospitals each year as a result of preventable medical errors |
| Triple Aim Framework | 1) Improving the client experience of care (including satisfaction and quality) 2) Improving the health of populations 3) Reducing the per capita cost of health care |
| Reimbursement | Based on the diagnostic-related group, which is a classification system used to group clients with similar diagnoses |
Created by:
kmeans34
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