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A client comes to the clinic and reports being ill for several weeks but does not have insurance and has delayed care. What does the nurse understand about the overall healthcare reform goals that will address issues such as this client?
- A. The goal of healthcare reform is to provide care to women, infants, and children.
- B. The goal of healthcare reform is to provide more healthcare programs to address illness.
- C. The goal of healthcare reform is to provide quality healthcare for those that can afford it.
- D. The goal of healthcare reform is to provide affordable healthcare to more citizens.
Correct Answer: D
Rationale: The overall goal of healthcare reform is to provide affordable healthcare to more U.S. citizens. Other goals are to reduce the insurance companies' control of healthcare and to provide more assistance to senior citizens on fixed incomes. Providing care to women, infants and children and offering more healthcare programs to address illness may be results of healthcare reform but are not themselves the overall goal. Healthcare reform seeks to provide quality healthcare that is affordable to as many U.S. citizens as possible, not to only provide it to those who can already afford it.
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Since losing a leg years ago, the client and their spouse have formed a community walking group to raise money for the homeless in their area. Which of the following has contributed to the client being viewed as 'healthy'?
- A. The client is married and is moving on.
- B. The client is experiencing high quality of life within the limits of the physical condition.
- C. The client is facing various states of health and illness.
- D. The client is physiologically and psychologically stable.
Correct Answer: B
Rationale: Clients adapt physically, emotionally, and socially, enabling them to maintain comfort, stability, and self-expression. Clients with chronic illness can achieve a high level of wellness and experience high quality of life. Marriage is an aspect that contributes to quality of life but does not by itself define the quality of the client's life. All clients experience various states of health and illness.
A nurse is working for a health care provider who participates in a health maintenance organization (HMO) and will be assisting with the billing. What type of information regarding capitation does the nurse need to understand?
- A. Fees are not based on the number of services provided but rather are projected to the number of participants and expected services.
- B. Fees are based on the number of services billed for by the primary care provider.
- C. The HMO makes money based on the degree of illness and number of diagnostic tests that are performed.
- D. The fees that are charged are different even with the same diagnosis.
Correct Answer: A
Rationale: With an HMO, fees are not based on the number of services provided but rather are projected to the number of participants and expected services. This type of financial management is referred to as capitation, which refers to the actual head or person count. Fees are not based on the number of services a provider bills for rather are based on capitation. The HMO makes money by keeping people healthy and out of the hospital and does not base fees on the client's degree of illness or the number of diagnostic tests done. The fees are the same regardless of the actual service or frequency of care provided.
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.
A client undergoing a surgical procedure at the hospital died related to complications during the procedure. The nurse is required to collect data about the event so that a cause can be determined. What type of quality indicators would be used in this incident?
- A. Prevention QIs
- B. Inpatient QIs
- C. Client safety QIs
- D. Pediatric QIs
Correct Answer: B
Rationale: Inpatient QIs reflect quality of care inside hospitals, including inpatient mortality for medical conditions and surgical procedures. Prevention QIs identify hospital admissions that could be avoided through high-quality outpatient care. Client safety QIs also reflect quality of care within hospitals but focus on potentially avoidable complications and adverse events. Pediatric QIs reflect quality of care inside hospitals and identify potentially avoidable hospitalization among children.
A 17-year-old client is having protected sex one to two times a week in a monogamous relationship. What is the client participating in?
- A. Health promotion
- B. Health maintenance
- C. Illness prevention
- D. Wellness
Correct Answer: B
Rationale: Protecting one's current level of health by practicing safe sex to prevent illness is an example of a health maintenance activity. Health promotion strategies are used to enhance health, such as eating a diet high in fiber. Illness prevention includes identifying risk factors such as hypertension. Wellness is the balance of total well-being.