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A 65-year-old client is prescribed multiple medications for diabetes, hypertension, and angina and is going to the pharmacy to have the prescriptions filled. What coverage will the client use to assist with financial coverage of the medication?
- A. Medicare Part A
- B. Medicare Part B
- C. Medicare Part C
- D. Medicare Part D
Correct Answer: D
Rationale: Medicare Part D is Medicare Prescription Drug Coverage and helps to cover and possibly reduce prescription drug costs and protect against catastrophic drug expenses. Medicare Part A covers hospital care, skilled care, hospice, and home health services. Medicare Part B covers medically necessary services such as physician services that are not covered under Part A. Medicare Part C is the Medicare Advantage Plan and includes Parts A and B.
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A client complaining of bloody urine has scheduled an appointment with a family practitioner. What type of care is the client receiving?
- A. Tertiary
- B. Secondary
- C. Skilled nursing care
- D. Primary
Correct Answer: D
Rationale: The first provider that clients contact about a health need provides primary care; this person is typically a family practitioner or nurse practitioner. Secondary care includes referrals to facilities for additional testing. Tertiary care focuses on more complex medical and surgical intervention. Skilled nursing care occurs in facilities or units that offer prolonged health maintenance or rehabilitative services.
What method for financing healthcare is based on the ability to keep clients healthy and out of the hospital through periodic screening, health education, and preventive services?
- A. Managed care
- B. Preferred provider organization
- C. Health maintenance organization
- D. Point-of-service organization
Correct Answer: C
Rationale: Health maintenance organizations strive to keep their costs low and members out of the hospital through periodic screenings, health education, and preventive services. Managed care organizations are insurers who carefully plan and closely supervise the distribution of healthcare services. Preferred provider organizations are a community network of providers who are willing to discount their fees for service in exchange for a steady stream of referral customers. Point-of-service organizations involve a network of providers; clients select a primary care physician within the group who then serves as the gatekeeper for other healthcare services.
The nurse is aware of the various changes in the healthcare field. What important factor remains the same in this time of change?
- A. Nurses must provide safe, high-quality, cost-effective care to individuals, families, and communities.
- B. Nurses must inform clients that they will have to use facilities that are within their service area.
- C. Clients must become actively involved in the process of standardizing care.
- D. Nurses will have to work in unsafe conditions in order to provide care to clients.
Correct Answer: A
Rationale: In the midst of these dramatic changes and challenges, nurses must continue to provide safe, high-quality, cost-effective care to individuals, families, and communities. It is also imperative that nurses distinguish and communicate to clients the various choices that the clients may make about their healthcare. Clients have a choice as to location of care providers and are not limited to local facilities. Clients are not involved in standardizing care; this is a healthcare provider function. Nurses will not have to work in unsafe conditions in order to provide care to clients.
The nurse informs the administrative assistant that a client is expected to come in for lab work. The administrative assistant asks why the nurse refers to the individual as a client. What is the best response by the nurse?
- A. We should refer to everyone as a client. They pay for our service.'
- B. That's how the physician wants us to refer to them.'
- C. Using the term client implies that they are an active partner in nursing care.'
- D. Using the term client is more respectful that using the term patient.'
Correct Answer: C
Rationale: A client is an active partner in nursing care, and the person receiving healthcare services should no longer play a passive, ill role. The use of the term client reflects the attitude of personal responsibility for health. Though clients may be paying for these services, some physicians may request their staff members to use this terminology, and some people may consider it to be a more respectful term than 'patient', these are not the primary reasons to refer to the individual as a client.
The nurse is collecting data at the clinic from a new client who is being seen for an employee physical. The client informs the nurse that both parents have a history of high blood pressure, with one of them having a stroke at the age of 52 years. The nurse discusses diet and exercise programs that may benefit the client. What is the nurse displaying with this information?
- A. Early detection
- B. Health maintenance
- C. Health promotion
- D. Illness prevention
Correct Answer: D
Rationale: Illness prevention involves identifying risk factors such as family history of hypertension or diabetes and reducing the effects of risk factors on one's health. Early detection uses screening diagnostic tests and procedures to identify a disease process earlier, so that treatment may be initiated earlier and be more effective. Health maintenance refers to protecting one's current level of health by preventing illness or deterioration, such as by complying with medication regimens, being screened for diseases such as breast and colon cancers, or practicing safe sex. Health promotion refers to engaging in strategies to enhance health such as eating a diet high in grains and complex carbohydrates, exercising regularly, balancing work with leisure activities, and practicing stress-reduction techniques.