Community-Based Nursing An Introduction 3rd Edition By Melanie McEwen - Test Bank

Community-Based Nursing An Introduction 3rd Edition By Melanie McEwen – Test Bank

 

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McEwen: Community-Based Nursing, 3^rd Edition

 

Test Bank

 

Chapter 5: Overview of the Health Care Delivery System

 

MULTIPLE CHOICE

 

1. Legislation for Medicare and Medicaid was originally enacted in:

1.	1865.
2.	1935.
3.	1965.
4.	1982.

 

 

ANS:  3                    DIF:    Knowledge    REF:   Page Reference: 73-74

OBJ:   4                    TOP:   Health Care Financing

 

2. An example of a governmental welfare assistance program under the Social Security Act that is financed jointly by the federal government and the states is:

1.	Blue Cross-Blue Shield.
2.	General Assistance Subsidy.
3.	Medicaid.
4.	Medicare.

 

 

ANS:  3                    DIF:    Knowledge    REF:   Page Reference: 74

OBJ:   4                    TOP:   Health Care Financing

 

3. Public health services exist at federal, state, and local levels. Federal level public health services include:

1.	Advisory and supportive roles.
2.	Direct protective service such as ensuring clean food and water and sanitation.
3.	Operating hospitals for indigent persons.
4.	Personal health services such as immunization, family planning, or care for persons with STDs.

 

 

ANS:  1                    DIF:    Application    REF:   Page Reference: 63

OBJ:   1                    TOP:   Structure of the Health Care System

 

4. Sarah Thompson is a client with a home health agency who has recently been diagnosed with diabetes. Sarah is eligible for Medicare Part A but believed she could not afford the premiums for Part B. In planning Sarah’s posthospitalization care, the home health nurse should help Sarah understand that her:

1.	Hospital bill and physician bill would be covered completely by Medicare.
2.	Hospital bill would be covered (except for a copayment), but her physician bill would not be covered by Medicare.
3.	Hospital bill and physician bill would not be covered by Medicare.
4.	Physician bill would be covered (except for a copayment), but her hospital bill would not be covered by Medicare.

 

 

ANS:  2                    DIF:    Application    REF:   Page Reference: 73

OBJ:   4                    TOP:   Health Care Financing

5. Andrew Jefferson is a new client with a home health agency being seen posthospitalization following a stroke. His care is being covered by Medicare Part A and Part B, but he did not join Part D. Home health nurses are scheduled to visit Andrew three times a week for 2 weeks to help him manage his health needs. In addition to taking medication for hypertension and a chronic heart condition, Andrew wears a hearing aid and needs cataract surgery. The nurse informs Andrew that Medicare will cover the costs of only the:

1.	Home health nurse, medications, and hearing aid.
2.	Home health nurse and cataract surgery (including the surgeon’s fees).
3.	Medications, cataract surgery (including the surgeon’s fees), and home health nurse.
4.	Cataract surgery (including the surgeon’s fees) and hearing aid.

 

 

ANS:  2                    DIF:    Application    REF:   Page Reference: 73-74

OBJ:   4                    TOP:   Health Care Financing

 

6. nspection of food services, control of waste and pollution, immunization surveillance, maternal/child programs, and personal health services are generally performed at what level of public health?

1.	Federal level
2.	Local level
3.	Regional level
4.	State level

 

 

ANS:  2                    DIF:    Comprehension

REF:   Page Reference: 64 (Box 5-1)          OBJ:   1

TOP:   Structure of the Health Care System

 

7. All of the following statements about Medigap insurance policies are true except:

1.	Medigap policies do not duplicate coverage provided by Medicare.
2.	Medigap policies require a premium to the insurance company and a premium to Medicare Part B.
3.	Medigap policies typically cover a portion of coinsurance for hospital and skilled nursing facility stays.
4.	Medigap policies typically cover long-term care, dental care, and private duty nursing care.

 

 

ANS:  4                    DIF:    Comprehension

REF:   Page Reference: 75 (Community Application box)             OBJ:   3

TOP:   Health Care Financing

 

 

 

 

 

 

 

 

 

8. The primary source of financing of health care in the United States, paying approximately 46% of all health care costs, is:

1.	Combined government payments (e.g., Medicare, Medicaid, military).
2.	Private health insurance (health maintenance organizations, preferred provider organizations, traditional indemnity).
3.	Private, philanthropic organizations (American Cancer Society, Robert Wood Johnson, Masonic Lodge).
4.	Out-of-pocket payment (premiums, deductibles, copayments, fees-for-service).

 

 

ANS:  1                    DIF:    Knowledge    REF:   Page Reference: 73

OBJ:   3                    TOP:   Health Care Financing

 

9. Rebecca Garcia recently graduated from nursing school and took a position as a school nurse. Because the school district is very large, they are able to offer employees several options in health care coverage. Because Rebecca has three physicians she sees regularly (gynecologist, allergist, and dermatologist) and does not want to change, she might decide to choose a health insurance plan that gives her the most freedom of choice of providers, which is a:

1.	Health maintenance organization—Individual Practice Association.
2.	Health maintenance organization—Staff model.
3.	Preferred provider organization.
4.	Traditional indemnity plan.

 

 

ANS:  4                    DIF:    Application    REF:   Page Reference: 79 (Table 5-5)

OBJ:   3                    TOP:   Health Care Financing

 

10. Alicia Myers recently graduated from nursing school and took a position as an occupational health nurse. The company she will be working for is very large, and they offer employees several options in health care coverage. Because Alicia’s income is not excessive and she has student loans to repay and time constraints, she might choose health insurance that offers services at a centralized facility where care is coordinated and the copayments are low, such as in a:

1.	Health maintenance organization—Individual Practice Association.
2.	Health maintenance organization—Staff model.
3.	Preferred provider organization.
4.	Traditional indemnity plan.

 

 

ANS:  2                    DIF:    Application    REF:   Page Reference: 79 (Table 5-5)

OBJ:   3                    TOP:   Health Care Financing

 

11. In the United States, the dominant paradigm of health care reimbursement during the 1990s and into the 21st century is:

1.	Fee for service.
2.	Individual pay.
3.	Managed care.
4.	Voluntary agency subsidy.

 

 

ANS:  3                    DIF:    Analysis         REF:   Page Reference: 75

OBJ:   3                    TOP:   Health Care Financing

12. All of the following statements comparing Medicare and Medicaid are true except:

1.	Both Medicare and Medicaid cover home health care and physician’s services.
2.	Medicaid may cover eyeglasses and eye examinations, but Medicare does not.
3.	Medicare requires monthly premiums and coinsurance payments, but Medicaid does not.
4.	Prescription drugs are covered under Medicare, but not under Medicaid.

 

 

ANS:  4                    DIF:    Analysis         REF:   Page Reference: 77 (Table 5-4)

OBJ:   4                    TOP:   Health Care Financing

 

13. All of the following statements about Medicaid are true except:

1.	Medicaid is jointly financed by federal and state governments.
2.	Medicaid pays for medical services to the poor, the blind, the disabled, and families with dependent children.
3.	Medicaid pays for radiologic services, physician services, and skilled nursing care at home for qualified recipients.
4.	Medicaid provides hospital and medical insurance to almost all of the nation’s elderly.
5.	Prescriptions, dental services, and eyeglasses are examples of allowable options covered by Medicaid.

 

 

ANS:  4                    DIF:    Comprehension                               REF:   Page Reference: 74

OBJ:   4                    TOP:   Health Care Financing

 

14. An organized health care system that provides services to enrolled individuals for a fixed, prepaid, or capitated fee is a(n):

1.	Actuarial indemnity organization.
2.	Health maintenance organization.
3.	Preferred provider organization.
4.	Traditional indemnity provider.

 

 

ANS:  2                    DIF:    Knowledge    REF:   Page Reference: 76

OBJ:   3                    TOP:   Health Care Financing

 

15. Alice Heart is a school nurse. One Wednesday, Alice saw Jackson Smith, a 3rd grader who failed his vision test. Jackson also has asthma and dental caries, and his immunizations were incomplete. Alice is aware that Jackson lives with his grandmother who receives government assistance. She called Mrs. Smith and learned that Jackson is eligible for Medicaid. Through Medicaid, including his state’s optional services, Jackson may be eligible for all of the following except:

1.	Dental care.
2.	Food stamps.
3.	New eye glasses.
4.	Prescription drugs.

 

 

ANS:  2                    DIF:    Application    REF:   Page Reference: 76 (Box 5-3)

OBJ:   4                    TOP:   Health Care Financing

 

 

16. Capitation is:

1.	A negotiated, prepaid fixed fee for each covered individual or family in a health care plan.
2.	A predetermined amount or percentage of the cost of covered services that the beneficiary will pay.
3.	A specified flat fee per unit of service or time that the individual pays.
4.	Fiscal payment by an intermediary such as an insurance company.

 

 

ANS:  1                    DIF:    Knowledge    REF:   Page Reference: 74

OBJ:   3                    TOP:   Health Care Financing

 

17. Jerry Bartlett had a severe stroke 2 months ago. Following recovery and rehabilitation, he was discharged to his home yesterday. He can use both legs and gets around well with the use of a walker, but he is still lacking sufficient coordination to feed or dress himself and has difficulty swallowing and speaking. His case manager at the rehabilitation center recommends that he be followed at home by a(n):

1.	Dietitian and physical therapist.
2.	Physical therapist and psychologist.
3.	Occupational therapist and psychologist.
4.	Social worker and speech therapist.
5.	Speech therapist and occupational therapist.

 

 

ANS:  5                    DIF:    Comprehension                               REF:   Page Reference: 70-71

OBJ:   2                    TOP:   Health Care Providers

 

18. Linda Patterson is a nurse at a state public health department participating in a study on perinatal transmission of hepatitis B. To obtain current state and national statistics on hepatitis B, she would contact the:

1.	Agency for Toxic Substance and Disease Registry.
2.	Bureau of Vital Statistics.
3.	Centers for Disease Control and Prevention.
4.	Health Resources and Service Administration.
5.	National Institutes of Health.

 

 

ANS:  3                    DIF:    Application    REF:   Page Reference: 63 (Table 5-1)

OBJ:   1                    TOP:   Health Care System

 

19. Diagnosis-related group refers to a:

1.	Classification system that groups patients into categories and is used to establish health care payments under Medicare.
2.	Fiscal payment system that uses an intermediary such as an insurance company.
3.	Negotiated, prepaid fixed fee for each covered individual or family in a health care plan.
4.	Prepaid and coordinated fee-for-service health care plan designed to encourage greater control over the use and cost of health care services.

 

 

ANS:  1                    DIF:    Knowledge    REF:   Page Reference: 74

OBJ:   3                    TOP:   Health Care Financing

 

20. Coinsurance is:

1.	A negotiated, prepaid fixed fee for each covered individual or family in a health care plan.
2.	A predetermined amount or percentage of the cost of covered services that the beneficiary will pay.
3.	A specified flat fee per unit of service or time that the individual pays.
4.	A sum that must be paid each calendar year before the insurance policy becomes active.

 

 

ANS:  2                    DIF:    Knowledge    REF:   Page Reference: 73

OBJ:   3                    TOP:   Health Care Financing

 

21. Third-party reimbursement refers to a:

1.	Negotiated, prepaid fixed fee for each covered individual or family in a health care plan.
2.	Prepaid and coordinated fee-for-service health care plan designed to encourage greater control over the use and cost of health care services.
3.	Specified flat fee per unit of service or time that the individual pays.
4.	System in which fiscal payment for health care services is provided by an intermediary such as an insurance company.

 

 

ANS:  4                    DIF:    Knowledge    REF:   Page Reference: 72

OBJ:   3                    TOP:   Health Care Financing

 

22. Factors that have worked together to increase health care costs include all of the following except:

1.	Apathy of federal and state legislators toward health care issues.
2.	Change in population demographics and an increase in chronic health conditions.
3.	General economic inflation and an increase in the income of health care providers.
4.	Growth in private insurance and third-party payment for services.
5.	Increasing dependence on technology.

 

 

ANS:  1                    DIF:    Analysis         REF:   Page Reference: 72

OBJ:   5                    TOP:   Health Care Financing

 

23. Medicare is federal health insurance for persons 65 and older and for:

1.	Native Americans and those with tuberculosis.
2.	Persons with end-stage renal disease and some who are totally disabled.
3.	Those living at 150% below the poverty index.
4.	Veterans and members of the armed forces.

 

 

ANS:  2                    DIF:    Comprehension                               REF:   Page Reference: 73

OBJ:   4                    TOP:   Health Care Financing

 

 

 

 

 

 

 

24. In the United States, which aggregates have the most physician contacts each year?

1.	Infants and small children and elders
2.	Elders and those with incomes greater than $50,000
3.	Young and middle-aged women and infants and small children
4.	Middle-aged and elderly men and those with incomes greater than $50,000

 

 

ANS:  1                    DIF:    Knowledge    REF:   Page Reference: 65

OBJ:   2                    TOP:   Health Care Providers

 

25. The most common reasons for primary care office visits include all of the following except:

1.	Acute upper respiratory infection.
2.	Chronic skin conditions.
3.	Hypertension.
4.	Normal pregnancy.
5.	Routine childhood health visits.

 

 

ANS:  2                    DIF:    Knowledge    REF:   Page Reference: 65

OBJ:   2                    TOP:   Health Care Providers

 

26. Some public hospitals are supported by the federal government. These include:

1.	Charity hospitals.
2.	Foundation or voluntary hospitals that provide specialized care (e.g., for children with cancer, for persons with AIDS).
3.	Mental hospitals and tuberculosis hospitals.
4.	Veterans Administration hospitals, military hospitals, and hospitals for designated groups such as Native Americans.

 

 

ANS:  4                    DIF:    Comprehension

REF:   Page Reference: 66 (Table 5-2)        OBJ:   1

TOP:   Structure of the Health Care System

 

27. Jerry Adams is a new client being served by a home health care agency. Jerry has been diagnosed with Alzheimer’s disease, and his family is exploring options for long-term care. Jerry’s daughter wants to try to manage his care at home as long as possible but needs assistance when she is at work or when she must be away to meet other obligations. The most appropriate options for the family to explore include:

1.	Adult day care and nursing homes.
2.	Long-term home health care and respite care.
3.	Nursing homes and skilled nursing facilities.
4.	Respite care and adult day care.
5.	Skilled nursing facilities and long-term home health care.

 

 

ANS:  4                    DIF:    Application    REF:   Page Reference: 68 (Box 5-2)

OBJ:   2                    TOP:   Health Care Providers

 

 

 

 

28. All of the following health care providers are licensed in most states to diagnose and treat patients except:

1.	Doctors of osteopathy.
2.	Nurse practitioners.
3.	Pharmacists.
4.	Physical therapists.
5.	Physician’s assistants.

 

 

ANS:  3                    DIF:    Comprehension                               REF:   Page Reference: 71

OBJ:   2                    TOP:   Health Care Providers