Foundations of Adult Health nursing 3rd edition by Lois White Duncan Baumle – Test Bank

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Sample Questions Posted Below

Chapter 5—The Health Care Delivery System

MULTIPLE CHOICE

1.The term health care delivery system refers to a:

ANS: A

The health care delivery system is a method for providing services to meet the health needs of individuals.

PTS:1DIF:KnowledgeREF:White (2010)

2.The nurse provides care in which the focus is on the entire person, including physiologic, psychological, social, and spiritual aspects. The nurse is aware that this is an example of:

ANS: A

Holistic care provides care with the focus on the entire person, including physiologic, psychological, social, and spiritual aspects.

PTS: 1 DIF: Comprehension REF: White (2010)

3.Promotion of wellness and prevention of illness is the focus of which level of care?

ANS: B

The purpose of primary care is to promote wellness and to prevent illness or disability. A primary care provider (a physician or a nurse practitioner) coordinates the care of each client. The primary care provider assists the client in adopting or maintaining health-promoting behavior with an emphasis on illness prevention. Some examples include teaching individual clients how to select and follow a well-balanced, nutritious diet or to adopt a regular exercise program such as walking daily; having clients who smoke begin a smoking cessation program; or monitoring client immunizations to see that they are current.

PTS: 1 DIF: Knowledge

4.Through the use of a traditional medical model, the U.S. health care system could BEST be described as focusing on:

ANS: C

Under the traditional medical model, the U.S. health care system was not a health care system but rather an illness care system, with services directed at care after disease and disability and not on prevention.

PTS: 1 DIF: Comprehension REF: White (2010)

5.Which of these components are part of the secondary care system?

ANS: A

The purpose of secondary care is to provide early diagnosis and treatment of disease. Secondary care services are usually provided by hospitals or ambulatory care centers. Some examples include hospitalizing a client for treatment of a heart attack, prescribing medications to control high blood pressure or high cholesterol levels, or having a suspicious breast lesion surgically removed.

PTS: 1 DIF: Comprehension REF: White (2010)

6.The nurse is a health care team member who is involved in the delivery of acute care to clients. Which of these settings would the nurse primarily be employed in?

ANS: B

The delivery of acute care to clients occurs primarily in hospitals.

PTS:1DIF:ApplicationREF:White (2010)

7.What is the purpose of tertiary care?

ANS: D

The purpose of tertiary care is to reduce the disability associated with some illnesses, with the aim of restoring a client’s health status to the highest level possible. Some examples include restoring function to extremities injured in an automobile or other type of accident or assisting a client to learn to walk again after amputation of a leg.

PTS: 1 DIF: Comprehension REF: White (2010)

8.Which of these organizations is an example of a public agency?

ANS: D

The Veterans Administration is a public agency administered and funded by the U.S. government.

PTS:1DIF:KnowledgeREF:White (2010)

9.The activities of voluntary agencies are funded by membership dues, individual contributions, and:

ANS: D

Activities of voluntary agencies are funded by membership dues, individual contributions, and corporate philanthropy or sponsorship. All government agencies are mandated and not of a voluntary nature.

PTS: 1 DIF: Comprehension REF: White (2010)

10.Which of these statements about the role of the nurse in the multidisciplinary health care team is TRUE?

ANS: A

The role of the nurse in the multidisciplinary health care team is to function in independent, interdependent, and dependent roles as a member of the health care team.

PTS: 1 DIF: Comprehension REF: White (2010)

11.Which of these terms describes the payment arrangement under which recipients of care directly pay the provider for services received?

ANS: A

Fee-for-service is the payment arrangement under which recipients of care directly pay the provider for services received. Fee-for-service clients may have private insurance or use their own funds to pay for the services.

PTS:1DIF:KnowledgeREF:White (2010)

12.Which of these terms describes a health care system where the government is the only entity to reimburse health care costs?

ANS: D

A single-payer system is a health care system where the government is the only entity to reimburse health care costs, such as in Canada.

PTS:1DIF:KnowledgeREF:White (2010)

13.A system of providing and monitoring care where access, cost, and quality are controlled before or during delivery of services describes what kind of care?

ANS: A

Managed care organizations focus on providing services as cost-efficiently as possible; these organizations combine financing and delivery of health care services. A primary care provider is responsible for managing all health care services a client receives and for coordinating referrals to other providers as necessary.

PTS:1DIF:KnowledgeREF:White (2010)

14.When a client is ill, the health care provider whom a client sees first is considered to be:

ANS: D

The primary care provider assists the client in adopting or maintaining health-promoting behavior with an emphasis on illness prevention. Some examples include teaching individual clients how to select and follow a well-balanced, nutritious diet or to adopt a regular exercise program such as walking daily; having clients who smoke begin a smoking cessation program; or monitoring client immunizations to see that they are current.

PTS: 1 DIF: Comprehension REF: White (2010)

15.When a client participates in a prepaid health plan that provides primary health care services for a preset fee and that focuses on cost-effective treatment measures, this is considered to be:

ANS: B

Health maintenance organizations (HMOs) involve prepaid plans that provide primary health care services for a preset fee, focusing on cost-effective treatment.

PTS: 1 DIF: Comprehension REF: White (2010)

16.The client is participating in a health care structure where members must use providers within the system to obtain full reimbursement, but may use other providers for lesser reimbursement. The nurse is aware that this type of system is considered to be:

ANS: C

Preferred provider organizations (PPOs) are organizations in which members must use providers within the system to obtain full reimbursement but have the option of using other providers for less reimbursement.

PTS: 1 DIF: Comprehension REF: White (2010)

17.The physician participates in a health care plan that requires care be delivered by the providers who are in the plan, in order for clients to receive any reimbursement. This type of system is considered to be:

ANS: A

Exclusive provider organizations (EPOs) are organizations in which members must use providers within the organization to receive any reimbursement.

PTS: 1 DIF: Comprehension REF: White (2010)

18.Preset flat fees based on membership in the health maintenance organization, and not on services provided, are called:

ANS: A

Capitated rates are preset flat fees based on membership in the health maintenance organization, and not on services provided. This provides risk for those who are heavy users and exert control over the use of services.

PTS:1DIF:KnowledgeREF:White (2010)

19.What term describes the entry into the health care system that occurs through a point designated by the health maintenance organization plan?

ANS: D

Single point of entry is entry into the health care system that occurs through a point designated by the health maintenance organization plan. This is another common feature of HMOs.

PTS:1DIF:KnowledgeREF:White (2010)

20.What is the term describing the client’s point of entry into the health care system that includes assessment, diagnosis, treatment, coordination of care, education, preventive services, and surveillance?

ANS: C

The term primary health care describes the client’s point of entry into the health care system that includes assessment, diagnosis, treatment, coordination of care, education, preventive services, and surveillance.

PTS: 1 DIF: Comprehension REF: White (2010)

21.The nurse is caring for a client who has diabetes and heart disease. The existence of both these illnesses in the client is considered to be a:

ANS: A

Comorbidity is the simultaneous existence of more than one disease process in an individual.

PTS: 1 DIF: Comprehension REF: White (2010)

22.Medicare coverage may be available to individuals who are at least 65 years old or who are:

ANS: A

Medicare is designed to cover people over age 65 and those who are permanently disabled or have end-stage renal disease.

PTS:1DIF:KnowledgeREF:White (2010)

23.The Children’s Health Insurance Program was created in 1997 for what purpose?

ANS: D

The Children’s Health Insurance Program provides health care to uninsured children whose families do not earn enough to afford private insurance but earn more than allowed for Medicaid eligibility.

PTS: 1 DIF: Comprehension REF: White (2010)

24.Among the factors that influence health care are such things as cost, access, and:

ANS: C

Three major factors influence the provision of health care services to individuals: cost, access, and quality. Issues related to quality of health care include such concepts as defensive medicine and lack of access to and continuity of services. Quality may be sacrificed by health care agencies and providers in their attempts to provide universal access to services in a cost-effective manner. These sacrifices may include reducing the number of nurses on staff or increasing the use of unlicensed personnel.

PTS: 1 DIF: Comprehension REF: White (2010)

25.Which of these programs are MOST cost-efficient in terms of administration?

ANS: A

Medicaid and Medicare are programs are most cost-efficient in terms of administration but costly in delivery of services.

PTS: 1 DIF: Comprehension REF: White (2010)

26.The major factors increasing the cost of health care include an oversupply of specialized providers, a surplus of hospital beds, and:

ANS: B

Health care costs have increased because of such factors as an oversupply of specialized providers, a surplus of hospital beds, the passive role assumed by most consumers, the increasing number of older adults and those who have chronic illnesses, the increase in health-related lawsuits, and the growth of advanced health care technology. Nurses need to be aware of the influence of cost factors for their clients: whether they are insured, how much out-of-pocket expense they are responsible for, how prescriptions will be paid for, how complex their health care problems are, and so on. Nurses also need to consider the costs of equipment and supplies used in client care.

PTS: 1 DIF: Comprehension REF: White (2010)

27.Which of the following populations in the United States is MOST likely to be underinsured or uninsured?

ANS: A

As more people are unable to gain access to health care services because of age, lack of insurance coverage, and poverty, an increasing number are medically unserved or underserved, including children and the homeless. The homeless population often uses inner-city hospitals for care, creating an economic burden on such facilities and a lack of follow-up care.

PTS: 1 DIF: Comprehension REF: White (2010)

28.Populations that can create significant financial burdens on hospital emergency departments include those living at or below poverty level and:

ANS: B

As more people are unable to gain access to health care services because of age, lack of insurance coverage, and poverty, an increasing number are medically unserved or underserved, including children and the homeless. The homeless population often uses inner-city hospitals for care, creating an economic burden on such facilities and a lack of follow-up care.

PTS: 1 DIF: Comprehension REF: White (2010)

29.In today’s health care system, when attempts are being made to provide universal access to services in a cost-effective manner, what may be sacrificed?

ANS: C

Issues related to quality of health care include such concepts as defensive medicine and lack of access to and continuity of services. Quality may be sacrificed by health care agencies and providers in their attempts to provide universal access to services in a cost-effective manner. These sacrifices may include reducing the number of nurses on staff or increasing the use of unlicensed personnel.

PTS:1DIF:ApplicationREF:White (2010)

30.American health care consumers are becoming disillusioned with health care providers because of what factors?

ANS: A

Consumers are concerned about the high costs of medical care and have begun to question medical practices. Issues related to provider greed and waste within the health care delivery system have been identified as major problems. Public perception of nurses, however, remains positive; clients believe that nurses enhance quality of care and contribute to reducing costs because of their focus on holistic care.

PTS: 1 DIF: Comprehension REF: White (2010)

31.Among health care providers, which group is currently held in greatest esteem?

ANS: B

Issues related to provider greed and waste within the health care delivery system have been identified as major problems. Public perception of nurses, however, remains positive; clients believe that nurses enhance quality of care and contribute to reducing costs because of their focus on holistic care.

PTS:1DIF:KnowledgeREF:White (2010)

32.Nurses do not have legal recognition of the ability to prescribe medications because they lack:

ANS: D

Prescriptive authority is the legal recognition of the ability to prescribe medications. This is granted to physicians holding a valid medical licensure and nurse practitioners with prescriptive authority granted by the board of nurses where they are practicing.

PTS: 1 DIF: Comprehension REF: White (2010)

33.Factors contributing to decreased hospital population include such things as earlier discharge, growth in availability of outpatient services, and:

ANS: B

Although hospitals remain at the heart of the health care delivery system in the United States, many factors have contributed to the current decrease in hospital clients, including the trend toward earlier discharge following surgery or complex inpatient treatment, the growth of outpatient services and facilities, technological advances, and changes in insurance reimbursement practices. One consequence is the restructuring of hospitals, including the expansion of the range of services provided, the merging of hospitals, and the use of nonlicensed personnel.

PTS: 1 DIF: Comprehension REF: White (2010)

34.As the number of severely ill clients in hospitals increases, nurses working in these settings will need to possess interpersonal competence, technical expertise, and:

ANS: C

Nurses must possess interpersonal competence, technical expertise, and critical-thinking skills to provide care to the increasing presence of severely ill clients.

PTS: 1 DIF: Comprehension REF: White (2010)

35.In the future, home health services will continue to expand to meet the growing needs of which of these populations?

ANS: D

As more people are unable to gain access to health care services because of age, lack of insurance coverage, and poverty, an increasing number are medically unserved or underserved, including children and the homeless. The homeless population often use inner-city hospitals for care, creating an economic burden on such facilities and a lack of follow-up care.

PTS: 1 DIF: Comprehension REF: White (2010)

36.One of the newer developments in health care requires that nurses strongly advocate for:

ANS: A

The conflict of containing costs versus providing compassionate care provides a major challenge to the U.S. health care delivery system. Many clients’ health care needs are greater than the available resources, resulting in such actions as establishing plans for allocation of health care resources for those who are terminally ill. The nurse’s role remains to strongly advocate for the just and ethical distribution of resources for clients.

PTS: 1 DIF: Comprehension REF: White (2010)

37.The Agency for Health Care Policy and Research was established for what purpose?

ANS: B

Nursing’s Agenda for Health Care Reform, a platform developed by the American Nurses Association (ANA) in 1991 to address issues of cost, access, and quality within the health care delivery system, has been endorsed by many organizations as a public policy agenda. The foundation of the platform is delivery of health care services in environments that are easily accessible and consumer friendly. Nurses will work to promote consumer self-care through education and legislative efforts. Another approach, proposed by the Agency for Health Care Policy and Research, is to establish standards of care, guidelines for the diagnosis, and treatment of particular health problems.

PTS: 1 DIF: Comprehension REF: White (2010)

38.What is the biggest obstacle to advanced practice RNs (APRNs) practice?

ANS: B

The development of advanced practice nursing is another approach to providing quality primary health care services, particularly to those with inadequate or limited access to health care services. Advanced practice nurses are registered nurses who have advanced education and clinical training in areas such as midwifery, adult health, and family health care. The biggest obstacle to APRN practice is the lack of awareness of what APRNs can offer.

PTS: 1 DIF: Comprehension REF: White (2010)

39.Public health includes services such as prenatal care, immunizations, and:

ANS: D

Nurses strongly support the integration of public and private sector health care services. These services should be available for those who have resources and those who do not. Services that emphasize consumer health promotion and disease prevention in primary care settings can be expanded to ensure public health. Many of these services, such as prenatal care, immunizations, and environmental concerns, are being provided by nurses and should be expanded to meet current health needs.

PTS: 1 DIF: Comprehension REF: White (2010)

40.Nurses who are providing community-based care focus on:

ANS: D

Nurses that are providing community-based care focus on prevention and primary care.

PTS: 1 DIF: Comprehension REF: White (2010)

MULTIPLE RESPONSE

1.An LP/VN’s scope of practice allows for assuming several nursing roles, including which of the following? (Select all that apply.)

ANS: B, E, F

An LP/VN’s scope of practice allows for assuming several nursing roles, including that of manager, teacher, and caregiver.

PTS: 1 DIF: Comprehension REF: White (2010)

2.The nurse is a member of the health care team providing secondary care to a client. Which of the following would be included in this type of care? (Select all that apply.)

ANS: A, C, D, E

The purpose of secondary care is to provide early diagnosis and treatment of disease. Secondary care services are usually provided by hospitals or ambulatory care centers. Some examples include hospitalizing a client for treatment of a heart attack, prescribing medications to control high blood pressure or high cholesterol levels, or having a suspicious breast lesion surgically removed.

PTS:1DIF:ApplicationREF:White (2010)