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During a meeting with nurses at all levels in an acute care hospital, the Director of Nursing discusses lost revenue due to Medicare penalties. The nurses plan improvements in practice designed to prevent penalties from which events? Select all that apply.
- A. Urinary catheter-related infections
- B. Blood infections from central venous catheters
- C. Excessive readmissions
- D. Pressure injuries
- E. High blood pressure
Correct Answer: A,B,C,D
Rationale: Medicare penalties are given to hospitals when patients are readmitted soon after discharge; this is designed to ensure patients receive needed coordinated care after discharge. In addition, Medicare no longer reimburses hospitals for conditions that result from preventable errors and lead to increased costs, including pressure injuries, infections associated with indwelling urinary catheters, and vascular catheter-associated infections. High blood pressure is not a preventable hospital-acquired condition subject to penalties.
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Nursing students are asked to provide interprofessional care during their clinical experience. Which member of the health care team will the student contact for an uninsured patient?
- A. Nurse practitioner
- B. Admissions coordinator
- C. Social worker
- D. Hospital chaplain
Correct Answer: C
Rationale: Social workers assist patients and families in dealing with the social, emotional, and environmental factors that affect their well-being, including making referrals to community resources and assisting with health care finances for uninsured patients. Nurse practitioners manage medical and nursing needs, admissions coordinators handle administrative tasks, and hospital chaplains address spiritual needs.
A nursing student is assisting with nursing care for patients in a primary care center. Based on the setting, what activities will the student expect to perform?
- A. Assisting with major surgery
- B. Performing health assessments
- C. Maintaining patients' function and independence
- D. Maintaining immunization records
Correct Answer: B
Rationale: Performing health assessments is a common role of the nurse in a primary care center. Assisting with major surgery is a role of the nurse in the hospital setting. Maintaining patients' function and independence is a role of the nurse in a rehabilitation or extended-care facility, and keeping student immunization records up to date is a role of the school nurse.
As part of a clinical paper, a nursing student interviews a hospice nurse about their role. How will the student describe the type of care the nurse provides?
- A. Physical, psychological, social, and spiritual care for dying patients, their families, and loved ones
- B. Preventive, primary care, focusing on diabetes education, immunizations, and prenatal care
- C. Care focusing on rare diseases and specialty care
- D. Care to meet the patient's health care needs while giving a break to the patient's caregiver
Correct Answer: A
Rationale: The hospice nurse combines the skills of the home care nurse with the ability to provide daily emotional support to dying patients and their families. The other options describe primary care, tertiary care, and respite care, respectively.
A nurse caring for patients in a primary care setting submits paperwork for reimbursement from managed care plans for services provided. What best describes managed care?
- A. System designed to control cost of care while maintaining quality
- B. Care coordination to maximize positive outcomes to contain costs
- C. Delivery of services from initial contact through ongoing care
- D. Based on a philosophy of ensuring death in comfort and dignity
Correct Answer: A
Rationale: Managed care is a way of providing care designed to control costs while maintaining the quality of care. The other options describe care coordination, continuum of care, and hospice care, respectively.
Nurses provide care to patients in secondary health care facilities. Which patients do the nurses anticipate will receive this type of care? Select all that apply.
- A. Patient seeking treatment at a community clinic for possible strep throat
- B. Patient treated in the hospital following a myocardial infarction
- C. Child brought to the emergency department following a seizure
- D. Individual with osteogenesis imperfecta being treated in a medical center
- E. Child visiting a specialist to correct a congenital heart defect
- F. Patient who has a hernia repair in an ambulatory care center
Correct Answer: B,C,F
Rationale: Secondary health care treats problems that require specialized clinical expertise, such as an MI, a seizure, and a hernia repair. Treating strep throat is primary health care. Tertiary health care involves management of rare and complex disorders, such as osteogenesis imperfecta and congenital heart malformations.