Nokea
A client with chronic obstructive pulmonary disease visits a local long-term care facility once a week to lead a bingo game for the residents. How does the nurse determine that this client is achieving a high level of wellness?
- A. The client enjoys the activity that the nurse provides to the clients.
- B. The client finds satisfaction in socialization with the residents.
- C. The client is achieving a high quality of life within the limits of the illness.
- D. The client needs to feel a part of a group setting.
Correct Answer: C
Rationale: Clients with chronic illness can achieve a high level of wellness if they can experience a high quality of life within the limits of that illness. By engaging in a personal and social activity weekly, this client would be considered healthy. Although the client may enjoy the activity, find satisfaction in socialization, or need to feel a part of a group, choosing to take part in an activity that promotes a high quality of life within the limits of the client's illness is what demonstrates wellness to the nurse.
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A 72-year-old client who is hospitalized will be going on anticoagulant therapy and will require home healthcare nurses to visit once weekly to draw blood for coagulation studies. What coverage does the client have that will cover this service?
- A. Medicaid
- B. Medicare Part A
- C. Medicare Part B
- D. Medicare Part C
Correct Answer: B
Rationale: Medicare covers individuals who are 65 years of age or older, permanently disabled workers of any age with specific disabilities, and persons with end-stage renal disease. 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. Medicaid coverage is coverage for indigent patients that are unable to afford healthcare and qualify financially.
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.
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.
A client with terminal cancer is being referred to hospice services to assist with care of the client and the family in the home environment. What type of care does the nurse determine this is?
- A. Primary care
- B. Secondary care
- C. Tertiary care
- D. Acute care
Correct Answer: C
Rationale: Tertiary care focuses more on complex medical and surgical interventions, cancer care, rehabilitative services, long-term care such as burn care, and palliative and hospice care. This client is terminally ill and being referred for hospice service. Secondary care includes referrals to facilities for additional testing such as cardiac catheterization, consultation, and diagnosis as well as emergency and acute care interventions. The client does not fall into the acute care category. Primary care would include being seen by the client's primary physician.
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.