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After hip surgery, a client is admitted to the rehabilitation hospital. What type of care is the client receiving?
- A. Secondary
- B. Tertiary
- C. Rehabilitation
- D. Primary
Correct Answer: B
Rationale: Hospitals where specialized technology is available provide tertiary care. Primary care is the initial contact that a client has, such as an appointment with a family practitioner. Secondary care includes referrals for additional testing. Rehabilitation is aimed at restoring a people to their fullest abilities.
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The nurse has been asked to assist in gathering data regarding the incidence of falls in the hospital as part of a project that is geared toward identifying avoidable contributing factors and their effects. What type of quality indicators (QI) is this considered?
- A. Prevention QI
- B. Inpatient QI
- C. Client safety QI
- D. Pediatric QI
Correct Answer: C
Rationale: Client safety QIs reflect quality of care within hospitals but focus on potentially avoidable complications and adverse effects. Prevention QIs identify hospital admissions that could be avoided through high-quality outpatient care. Inpatient QIs reflect quality of care inside hospitals, including inpatient mortality for medical conditions and surgical events. The question does not indicate that client age is considered when gathering data, so Pediatric QIs would not be relevant here.
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 nurse is providing care for a client who has had a hip replacement and is going to be discharged in 2 days. The nurse has provided the client instructions for care after discharge. Which instruction would be considered accessing tertiary care?
- A. Begin physical therapy in 1 week.'
- B. Follow up with your primary health care provider in 2 days to discuss laboratory results.'
- C. Go to the outpatient laboratory for blood studies in 3 days.'
- D. Report to the emergency department for signs of infection, shortness of breath, or chest pain.'
Correct Answer: A
Rationale: Starting physical therapy, a type of rehabilitation, is a form of tertiary care. Tertiary care focuses on complex medical and surgical interventions, and specialized services such as cancer care and rehabilitative services. Encouraging the client to see a family health care provider would be promoting primary care. Sending the client for lab studies or instructing them to go to the emergency department would be directing the client to seek secondary care, which includes additional testing and emergency care.
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 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.