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A nurse is working with a care manager for a client who participates in a health maintenance organization. The nurse should identify that a health maintenance organization provides which of the following payment structures?
- A. The client is participating in a fee-for-service health care insurance program
- B. The provider is paid a fixed sum for the client on a monthly or yearly basis
- C. The client pays the insurer a percentage of the total costs for each service rendered by the provider
- D. The provider bills the client directly for a predetermined percentage of the cost of services
Correct Answer: B
Rationale: The correct answer is B. In a health maintenance organization (HMO), the provider is paid a fixed sum for the client on a monthly or yearly basis. This payment structure incentivizes providers to focus on preventive care and cost-effective treatments. This model aims to keep clients healthy and reduce unnecessary services.
A: Fee-for-service is not characteristic of an HMO.
C: This describes a cost-sharing model, not typical of an HMO.
D: Providers do not bill clients directly in an HMO.
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A nurse is teaching a prenatal class about infection prevention at a community center. Which of the following statements by a client indicates an understanding of the teaching?
- A. I should take antibiotics when I have a virus.
- B. I can visit my nephew who has chickenpox 5 days after the sores have crusted.
- C. I can clean my cat's litter box during my pregnancy.
- D. I should wash my hands for 10 seconds with hot water after working in the garden.
Correct Answer: B
Rationale: The correct answer is B: I can visit my nephew who has chickenpox 5 days after the sores have crusted. This answer demonstrates understanding of infection prevention because chickenpox is contagious until the sores have crusted over completely. Visiting the nephew after this period reduces the risk of contracting the virus.
Incorrect answers:
A: Taking antibiotics for a virus is ineffective as antibiotics only work against bacterial infections.
C: Cleaning a cat's litter box can expose the client to toxoplasmosis, a harmful parasite during pregnancy.
D: Washing hands for only 10 seconds with hot water is insufficient for proper hand hygiene; CDC recommends washing for at least 20 seconds.
A hospice nurse is talking with the partner of a client who is near death. The partner states, 'How will I go on without them? I already feel alone.' Which of the following actions should the nurse take?
- A. Express sympathy to the client's partner.
- B. Ask the client's partner if they need anything.
- C. Hug the client's partner.
- D. Reassure the client's partner that it will get better.
Correct Answer: A
Rationale: Correct Answer: A: Express sympathy to the client's partner.
Rationale: Expressing sympathy acknowledges the partner's emotions, validates their feelings, and shows empathy. It helps the partner feel heard and supported during a difficult time. This action focuses on the partner's emotional needs, offering comfort and understanding.
Summary:
B: Asking if the partner needs anything is helpful but may not address the emotional distress directly.
C: Hugging without consent may not be appropriate and could make the partner uncomfortable.
D: Reassuring without acknowledging the partner's feelings may come across as dismissive and invalidating.
A faith-based organization asks a community health nurse to develop a mobile meal program for older adults. Which of the following actions should the nurse plan to take first?
- A. Determine potential funding sources for the program
- B. Inquire about the availability of volunteers
- C. Identify alternative solutions to address concerns
- D. Perform a needs assessment
Correct Answer: D
Rationale: The correct answer is D: Perform a needs assessment. This is because conducting a needs assessment is the first crucial step in program planning. It helps the nurse to gather data on the specific needs and preferences of older adults in the community. This data will guide the nurse in developing a mobile meal program that is tailored to meet the actual needs of the target population.
Option A: Determining potential funding sources should come after identifying the specific needs of the population, as funding sources will be based on the program's requirements.
Option B: Inquiring about the availability of volunteers is important but should be considered after understanding the needs of the older adults.
Option C: Identifying alternative solutions is premature without first understanding the actual needs of the population through a needs assessment.
In summary, performing a needs assessment is the first step as it provides essential information to guide the development of an effective and targeted mobile meal program for older adults.
A community health nurse is educating a parent about the importance of hepatitis B immunization. Which of the following explanations should the nurse give the parent about the disease?
- A. One dose of the immunization gives children lifelong protection from hepatitis B
- B. Hepatitis B spreads easily among children through casual contact
- C. Many people who acquire acute hepatitis B develop chronic hepatitis
- D. People who have had a hepatitis B infection still need the immunization
Correct Answer: C
Rationale: The correct answer is C: Many people who acquire acute hepatitis B develop chronic hepatitis. This explanation is important for the parent to understand the potential long-term consequences of hepatitis B infection. Acute hepatitis B can progress to chronic hepatitis in some cases, leading to liver damage and other complications. It highlights the seriousness of the disease and the importance of prevention through vaccination.
Choice A is incorrect because although hepatitis B vaccination provides long-lasting protection, it may not necessarily offer lifelong immunity. Choice B is incorrect as hepatitis B is primarily transmitted through exposure to infected blood or body fluids, not casual contact among children. Choice D is incorrect because prior infection does not confer complete immunity, so immunization is still recommended.
An occupational health nurse is discussing health promotion with a client who has a history of obesity. Which of the following comments indicates the client is using rationalization as a coping mechanism?
- A. I have lots of health problems from being obese
- B. I am obese, it's in my genes
- C. I have difficulty resisting the items in vending machines
- D. I know you don't like me because I am obese
Correct Answer: B
Rationale: The correct answer is B because the client is using rationalization by attributing their obesity to genetics rather than taking personal responsibility. This deflects accountability and provides a justification for their weight issue. Choice A acknowledges the health problems related to obesity. Choice C acknowledges a specific struggle with resisting temptations. Choice D reflects projection, attributing dislike to the nurse. Other choices are incomplete.